Caries Risk Assessment

Question 1

what are the three factors required for caries to develop

Answer 1

tooth
flora
substrate

Question 2

which factors of a tooth can impact its likelihood to develop caries

Answer 2

age
fluoride
morphology
trace elements
nutrition
carbonate level

Question 3

which factors of substrate can impact the likelihood of caries development

Answer 3

oral clearance level
oral hygiene
salivary stimulants
frequency of eating
carbohydrate type and concentration

Question 4

what is meant by caries risk assessment

Answer 4

a process of evaluating individuals, likelihood of developing dental caries in the future.

prognostic indicator to help determine what care that individual patient needs to avoid the development of further caries

Question 5

how can caries risk factors be divided

Answer 5

into general and local factors

Question 6

what are the general factors impacting caries risk

Answer 6

socioeconomic status and general health

Question 7

what are the local factors affecting caries risk

Answer 7

oral hygiene
diet
fluoride experience
past caries experience
orthodontic treatment

Question 8

four elements of caries risk assessment

Answer 8

biological
environmental
behavioural
protective

Question 9

what are the four biological factors in caries risk assessment

Answer 9

previous caries history
diet
salivary function
bacterial load

Question 10

explain how previous caries history relates to CRA

Answer 10

a previous history of caries significantly increases future risk of developing further caries

Question 11

explain how diet relates to CRA

Answer 11

frequent consumption of sugary or acidic drinks increases the risk of developing caries

Question 12

explain how salivary function relates to CRA

Answer 12

reduces salivary flow seen in xerostomia impairs the natural defects against caries

Question 13

explain how bacterial load relates to CRA

Answer 13

high levels of cariogenic bacteria increases risk eg streptococcus mutans

Question 14

what are the environmental factors in CRA

Answer 14

fluoride exposure
socioeconomic status

Question 15

how does fluoride exposure affect CRA

Answer 15

reduces exposure increases caries risk eg brushing less than twice daily with no or low fluoride content, lack of professionally applied fluoride

Question 16

describe how socioeconomic status relates to CRA

Answer 16

more deprived individuals have a higher risk due to limited access to dental care and dental resources eg cost of brushes and paste

Question 17

what are the behavioural factors in CRA

Answer 17

oral hygiene
dental visits

Question 18

how does oral hygiene affect CRA

Answer 18

poor oral hygiene allows plaque and bacteria to accumulate which increases the risk

Question 19

how do dental visits affect CRA

Answer 19

regular check ups and professional cleanings help to prevent caries and provide early detection

Question 20

what are the protective factors in CRA

Answer 20

sealants
diet
salivary function
bacterial load

Question 21

how do sealants affect CRA

Answer 21

fissures in teeth can be difficult to clean and increase risk of caries so sealing the fissures can aid in protecting the teeth

Question 22

describe how diet affects CRA in a protective manner

Answer 22

frequent consumption of sugary or acidic foods increases risk of developing caries

Question 23

describe how salivary function has a protective role in CRA

Answer 23

reduced flow impairs the natural defences

Question 24

why is caries risk assessment an individual matter

Answer 24

it is a disease process that is individually tailored and should be treated in a basis of case management and treatment planning in the short and long term including ongoing reassessment

Question 25

what are the seven elements of caries risk

Answer 25

clinical evidence
dietary habits
social history
fluoride use
plaque control
saliva
medical history

Question 26

what are key pieces of clinical evidence in caries risk

Answer 26

caries experience - dmft greater than 5, caries in first molars at 6 years old or a 3 year caries increment

orthodontics - fixed appliance therapy

prosthetics - both fixed and removable

Question 27

what does dmft mean

Answer 27

decayed missing or filled teeth

Question 28

which elements of social history are important in regards to caries risk

Answer 28

simd category
education
unemployment
work stressors
single parent families
violence
inequalities and access to healthcare
dependents

Question 29

what does fluoride do to bacteria

Answer 29

inhibits bacterial growth by interrupting bacterial metabolism, reducing bacterial ability to produce acids
interferes with the adhesion force of bacteria, reducing their ability to stick to the surface of the teeth, hence disrupting the formation of the biofilm

Question 30

what does fluoride do to enamel

Answer 30

remineralisation of enamel is promoted in the presence of fluoride
fluoride ions are incorporated into enamel during remineralisation creating a stronger and more acid resistant enamel crystal
this is because fluorapatite has a stronger bond strength than hydroxyapatite

Question 31

which factors of saliva impact caries risk

Answer 31

amount
flow
buffering capacity
pH
viscosity

Question 32

describe the role of medication in CRA

Answer 32

some drug side effects make OH difficult such as mucositits as a side effect of chemotherapy

Question 33

what are some additional considerations to make in CRA for infants and toddlers

Answer 33

mothers caries rate
prolonged nursing habits
bottle/pacifier at bedtime
cariogenic snacking
no tooth cleaning
little fluoride exposure

Question 34

what are the behaviours often seen in typical adults with high caries risk

Answer 34

level of education is low
attends only when in pain
social difficulties
sweet tooth and low OH
sugar containing meds
root caries
secondary caries