Caries Risk Assessment Flashcards
what are the three factors required for caries to develop
tooth
flora
substrate
which factors of a tooth can impact its likelihood to develop caries
age
fluoride
morphology
trace elements
nutrition
carbonate level
which factors of substrate can impact the likelihood of caries development
oral clearance level
oral hygiene
salivary stimulants
frequency of eating
carbohydrate type and concentration
what is meant by caries risk assessment
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
how can caries risk factors be divided
into general and local factors
what are the general factors impacting caries risk
socioeconomic status and general health
what are the local factors affecting caries risk
oral hygiene
diet
fluoride experience
past caries experience
orthodontic treatment
four elements of caries risk assessment
biological
environmental
behavioural
protective
what are the four biological factors in caries risk assessment
previous caries history
diet
salivary function
bacterial load
explain how previous caries history relates to CRA
a previous history of caries significantly increases future risk of developing further caries
explain how diet relates to CRA
frequent consumption of sugary or acidic drinks increases the risk of developing caries
explain how salivary function relates to CRA
reduces salivary flow seen in xerostomia impairs the natural defects against caries
explain how bacterial load relates to CRA
high levels of cariogenic bacteria increases risk eg streptococcus mutans
what are the environmental factors in CRA
fluoride exposure
socioeconomic status
how does fluoride exposure affect CRA
reduces exposure increases caries risk eg brushing less than twice daily with no or low fluoride content, lack of professionally applied fluoride
describe how socioeconomic status relates to CRA
more deprived individuals have a higher risk due to limited access to dental care and dental resources eg cost of brushes and paste
what are the behavioural factors in CRA
oral hygiene
dental visits
how does oral hygiene affect CRA
poor oral hygiene allows plaque and bacteria to accumulate which increases the risk
how do dental visits affect CRA
regular check ups and professional cleanings help to prevent caries and provide early detection
what are the protective factors in CRA
sealants
diet
salivary function
bacterial load
how do sealants affect CRA
fissures in teeth can be difficult to clean and increase risk of caries so sealing the fissures can aid in protecting the teeth
describe how diet affects CRA in a protective manner
frequent consumption of sugary or acidic foods increases risk of developing caries
describe how salivary function has a protective role in CRA
reduced flow impairs the natural defences
why is caries risk assessment an individual matter
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
what are the seven elements of caries risk
clinical evidence
dietary habits
social history
fluoride use
plaque control
saliva
medical history
what are key pieces of clinical evidence in caries risk
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
what does dmft mean
decayed missing or filled teeth
which elements of social history are important in regards to caries risk
simd category
education
unemployment
work stressors
single parent families
violence
inequalities and access to healthcare
dependents
what does fluoride do to bacteria
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
what does fluoride do to enamel
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
which factors of saliva impact caries risk
amount
flow
buffering capacity
pH
viscosity
describe the role of medication in CRA
some drug side effects make OH difficult such as mucositits as a side effect of chemotherapy
what are some additional considerations to make in CRA for infants and toddlers
mothers caries rate
prolonged nursing habits
bottle/pacifier at bedtime
cariogenic snacking
no tooth cleaning
little fluoride exposure
what are the behaviours often seen in typical adults with high caries risk
level of education is low
attends only when in pain
social difficulties
sweet tooth and low OH
sugar containing meds
root caries
secondary caries
