Caries Risk Assesment & Management -Ms. Bryan

Question 1

Caries Disease Indicators

Answer 1

White spots
Restoration (w/in 3 yrs)
Enamel lesions
Cavities/dentin

Question 2

How an initial caries appears clinically

Answer 2

white spot lesion- shows some demineralization

Question 3

Traditional Diagnostic Measures for caries detection

Answer 3

radiographs, visual, tactile

Question 4

When a “watch is placed on a tooth”

Answer 4

Potential lesion-although Ms. Bryan just says drill the thing. Questionable

Question 5

Surgical Repair Model

Answer 5

Little prevention-more drill and fill without much regard for prevention or lesion reversal

Question 6

Do restorations stop caries? Do they last forever?

Answer 6

No, they repair the tooth but do not stop caries.

They have a finite life span.

Question 7

MID-what is it?

Answer 7

Minimally Invasive Dentistry: it is part of the paradigm shift towards prevention

Question 8

CAMBRA-What is it?

Answer 8

CAries Management By Risk Assessment

Question 9

Wellness Model

Answer 9

-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

Question 10

Risk is influence by

Answer 10

risk indicators

Question 11

Does risk = disease?

Answer 11

No

Question 12

Are risk factors supported by research?

Answer 12

Yes-longidtudinal

Question 13

Risk Factors include

Answer 13

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

Question 14

Risk indicators

Answer 14

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

Question 15

Risk Indicators confirmed by longitudinal studies?

Answer 15

No

Question 16

How to determine caries risk? (2 phases)

Answer 16

Determine and identify specific disease/risk
indicators; risk factors; AND identify
protective factors

Determine and characterize the level of risk
based on these factors

Question 17

Is dose of Bacteria a good predictor of future caries development?

Answer 17

No

Question 18

Low levels of Mutans Streptococci are a good

predictor of

Answer 18

future cavity avoidance

Question 19

in 5 minutes a __% sucrose solution will cause plaque pH to change from 7 to 4.5

Answer 19

5%

-Remember…Additional sugar does not make the pH fall any
lower, but does increase the clearance time of
the sugar

Question 20

If you can increase the amount of Ca2+ and

PO43- in the saliva, you can decrease the

Answer 20

solubility of the apatite mineral (common ion effect)

Question 21

Amount of F in enamel when the tooth first erupts?

Answer 21

Very little

Question 22

Parental Interview

– Caries Risk Indicators

Answer 22

Mother has recent dental decay
• Recent dental restorations
• Visible heavy plaque

Question 23

CAMBRA assessment criteria Parental Interview and Caries Risk Indicators

Answer 23

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

Question 24

CAMBRA assessment criteria for the Clinical Examination

Answer 24

– Obvious white spots, decalcifications, decay 
– Restorations within 2 years
– Plaque, BOP
– Dental or orthodontic appliances 
– Inadequate saliva flow