Caries Risk Assesment & Management -Ms. Bryan Flashcards
Caries Disease Indicators
White spots
Restoration (w/in 3 yrs)
Enamel lesions
Cavities/dentin
How an initial caries appears clinically
white spot lesion- shows some demineralization
Traditional Diagnostic Measures for caries detection
radiographs, visual, tactile
When a “watch is placed on a tooth”
Potential lesion-although Ms. Bryan just says drill the thing. Questionable
Surgical Repair Model
Little prevention-more drill and fill without much regard for prevention or lesion reversal
Do restorations stop caries? Do they last forever?
No, they repair the tooth but do not stop caries.
They have a finite life span.
MID-what is it?
Minimally Invasive Dentistry: it is part of the paradigm shift towards prevention
CAMBRA-What is it?
CAries Management By Risk Assessment
Wellness Model
-Focus is on primary prevention -Early intervention for high risk subjects -Let’s DO something! -Reductions in disease and tooth loss could be related to this conceptual shift
Risk is influence by
risk indicators
Does risk = disease?
No
Are risk factors supported by research?
Yes-longidtudinal
Risk Factors include
Local, genetic, environmental, behavioral, or biologic factors that when present, directly increase the probability of (a disease) occurrence, AND if absent or removed, reduces the probability of (a disease) occurrence.
– “Attack” mechanisms – “Defense” mechanisms
Those immediately
involved in the cause of
the caries process
Risk indicators
affect the course or progression of the disease
without actually being causal
expose the host to the causal chain
Those related to the
occurrence of cavities
– Educational factors Socioeconomic factors Past caries experience
Risk Indicators confirmed by longitudinal studies?
No
How to determine caries risk? (2 phases)
Determine and identify specific disease/risk
indicators; risk factors; AND identify
protective factors
Determine and characterize the level of risk
based on these factors
Is dose of Bacteria a good predictor of future caries development?
No
Low levels of Mutans Streptococci are a good
predictor of
future cavity avoidance
in 5 minutes a __% sucrose solution will cause plaque pH to change from 7 to 4.5
5%
-Remember…Additional sugar does not make the pH fall any
lower, but does increase the clearance time of
the sugar
If you can increase the amount of Ca2+ and
PO43- in the saliva, you can decrease the
solubility of the apatite mineral (common ion effect)
Amount of F in enamel when the tooth first erupts?
Very little
Parental Interview
– Caries Risk Indicators
Mother has recent dental decay
• Recent dental restorations
• Visible heavy plaque
CAMBRA assessment criteria Parental Interview and Caries Risk Indicators
Continued bottle use Sleeps w/ bottle Nursing on demand Frequent snacks Medical / genetic issues Developmental issues Low SES or health illiteracy Deep pits & fissures Recreational drug use Ortho/ appliances Exposed root surfaces Reduced saliva Saliva reducing issues No dental home or regular care
CAMBRA assessment criteria for the Clinical Examination
– Obvious white spots, decalcifications, decay – Restorations within 2 years – Plaque, BOP – Dental or orthodontic appliances – Inadequate saliva flow
