Caries Management By Risk Assessment Flashcards
What does CAMBRA stand for?
Caries Management By Risk Assessment
What is CAMBRA?
an evidence-based disease management protocol aimed at the prevention of dental caries.
What is the first step in the CAMBRA protocol?
Risk assessment.
What are the 4 components of the CAMBRA risk assessment?
Risk factors
Caries disease indicators
Protective factors
An evidence-based care plan is created
Dental caries is:
- Multifactorial disease
- A transmissible bacterial infection
- Preventable
- Sometimes reversible
- Not self-limiting
- Not amenable to a course of antibiotics
What is the pH scale range?
The pH scale ranges from 0 (acidic) to 14 (alkaline).
what is a neutral pH?
pH of 7
What is demineralization?
the net loss of minerals from the tooth surface, which occurs when the pH drops below 5.5.
What groups of bacteria are primarily responsible for causing dental caries?
- Mutans streptococci
- Lactobacillus species
How does the pH level in plaque biofilm change when fermentable carbohydrates are ingested?
the pH of plaque biofilm rapidly drops, becoming acidic
What happens to the pH level in plaque biofilm after the ingestion of fermentable carbohydrates stops?
The pH level gradually returns to neutral within 30-60 minutes, if salivary flow is adequate
What is remineralization?
Remineralization is the deposition of minerals into areas of tooth structure that have been demineralized.
What role does fluoride play in remineralization?
by enhancing the deposition of minerals into demineralized areas and protecting carious lesions.
What is a white spot lesion?
A white spot lesion is a demineralized area of enamel that usually has an intact surface remaining over the body of an early carious lesion.
What happens to the enamel surface in a white spot lesion?
The enamel surface typically remains intact, but the demineralized area underneath appears white.
What causes a white spot lesion?
Net loss of minerals in the subsurface zone of enamel.
What role does saliva play in remineralization?
Saliva provides calcium and phosphate for remineralization and carries topical fluoride around the mouth to support this process.
How does saliva neutralize acids?
Saliva neutralizes organic acids produced in plaque biofilm, helping to maintain a balanced pH in the mouth.
How does saliva discourage bacterial growth?
Saliva discourages the growth of bacteria, inhibiting infections in the mouth.
What is the role of saliva in fluoride recycling?
Saliva recycles ingested fluoride, bringing it back into the mouth for further use in remineralization.
How does saliva protect tissues in the mouth?
Saliva protects both hard and soft tissues from drying, ensuring they stay hydrated.
What functions does saliva have in digestion?
Saliva facilitates chewing and swallowing, and speeds up the oral clearance of food.
What are the four clinical observations that indicate caries history and past activity?
- Teeth with frank cavitations or lesions that show penetration into dentin on radiographs
- Approximal radiographic lesions confined to enamel only
- Visual white spots on smooth surfaces
- Any restorations placed in the last 3 years for a new patient or in the last 12 months for a patient of record
what are some Caries RISK Factors?
- Medium or high S. mutans and lactobacilli counts
- Visible heavy plaque biofilm on teeth
- Frequent snacking between meals
- Deep pits and fissures
- Recreational drug use
- Inadequate salivary flow
- Saliva-reducing factors
- Exposed roots
- Oral appliances
what are some Caries PROTECTIVE Factors?
- Lives, works, attends school in fluoridated community
- Uses 5000 ppm fluoride toothpaste at least once daily
- Uses fluoride mouthrinse daily
- Had fluoride varnish applied in the last 6 months
- Used prescribed chlorhexidine daily for 1 week during each of the last 6 months
- Used xylitol gum or lozenges four to five times daily for the last 6 months
- Used calcium and phosphate supplement paste during last 6 months
- Has adequate salivary flow
What are the criteria for high caries risk in patients aged 6 years and older?
One or more of the following disease indicators:
- Cavities
- Radiographic lesions to dentin and beyond
- Radiographic lesions in enamel
- Recent restorations
- White spot lesions on smooth surfaces
- Multiple caries risk factors
What should be considered if you cannot determine whether a patient is at high or low risk for caries?
the patient should be considered to be at moderate risk for caries.
What is Silver Diamine Fluoride (SDF)?
SDF is a noninvasive dental caries treatment that has been shown to arrest and remineralize caries lesions.
How is Silver Diamine Fluoride applied?
SDF is applied directly to the affected (decayed) area of the tooth dropwise, following the manufacturer’s instructions.
What does the SDF panel recommend for cavitated caries lesions?
The SDF panel supports the use of 38% Silver Diamine Fluoride for arresting cavitated caries lesions in children, adolescents, or individuals with special healthcare needs.
