Caries RIsk assessment

Question 1

what are factors necessary for caries?

Answer 1

• tooth
• substrate
• flora
• saliva
• buffering capacity
• time

Question 2

what are local caries risk factors?

Answer 2

• Oral Hygiene
• Diet
• Fluoride Experience
• Past Caries Experience
• Orthodontic Treatment

Question 3

what are 7 elements of caries risk?

Answer 3

• Clinical Evidence
• Dietary Habits
• Social History
• Fluoride use
• Plaque control
• Saliva
• Medical History

Question 4

what is role of diet in caries development?

Answer 4

• > 3 sugar intakes per day
• High frequency more of an issue than volume of sugar
• Highly processed/refined carbohydrate more cariogenic than natural sugars (e.g. sucrose more cardiogenic than glucose and fructose)
• Natural sugars still cause harm e.g lactose in Early Childhood Caries

Question 5

what is important for social history in caries?

Answer 5

• SIMD category
• Education
• Unemployment
• Work stressors
• Single parent families
• Violence
• Inequalities and access to healthcare
• Dependents

Question 6

what does fluoride do?

Answer 6

• promotes remineralisation
• forms fluroapatitie on tooth which is more resisitant to demineralisation
• inhibits bacteria growth

Question 7

what is role of plaque control in caries development?

Answer 7

• Poor technique
• Irregular brushing
• Unassisted (very young/very old, those with manual dexterity issues)
• Access to toothbrush/toothpaste
• Difficulty due to changes (mixed dentition/orthodontics/gaps/recession)

Question 8

what is role of saliva?

Answer 8

• Amount
• Flow
• Buffering Capacity
• pH
• Viscosity

Question 9

what is role of medication in caries?

Answer 9

• Xerostomia (desired effect/side effect e.g. scopolamine patches/asthma inhalers)
• Other drug side effects making OH difficult e.g.Mucositits
• Free sugars to make medicine more palatable
• Lactulose
• Frequency of sugar containing medicine
• Recreational drug use/rehabilitation from drug addiction
• Social convention of how we act towards people who are ill- bring them sweets!

Question 10

what is caries experience for a high risk child?

Answer 10

• dmft > 5, DMFT > 5 (decayed missing filled teeth lower case means primary upper permanent)
• > 10 initial lesions in primary dentition at first attendance
• caries in 6’s at 6 years
• 3 year caries increment > 3

Question 11

what are additional considerations for infants and toddlers with caries?

Answer 11

• mother’s caries rate
• prolonged nursing habits
• bottle/ pacifier at bedtime
• cariogenic snacking
• No tooth cleaning
• Little Fluoride exposure

Question 12

what is typical high risk caries risk adult?

Answer 12

• Level of education
• Attends only when they identify a problem
• Social difficulties
• “Sweet tooth” with poor OH
• Sugar containing meds or meds affecting saliva
• Root caries
• Secondary caries

Question 13

what are 8 elements of preventative programme for caries?

Answer 13

• Radiographs
• Toothbrushing instruction
• Strength of F in toothpaste
• F varnish
• F supplementation
• Diet advice
• Fissure sealants
• Sugar free medicine