Caries Risk Assessment

Question 1

What does caris-risk assessment do?

Answer 1

1) Allows tx of the disease process rather than just treating the outcome
2) Understanding of the risk factors causing oral disease in an individual and developing individualized preventative discussions
3) Individualize, select and determine the frequency of preventative, and restorative tx
4) Anticipate caries progression and stabilization

Question 2

Caries risk model involves:

Answer 2

1) diet
2) Fl
3) susceptible host
4) microflora

combined with social, cultural and behavioral factors

Question 3

What is caries risk assessment?

Answer 3

Determination of the likelihood of increased risk of caries incidence during a certain time

Question 4

Caries risk indicators

Answer 4

variables that cause the disease, variables that are useful in predicting it and variables that prevent it

1) presence of carious lesions
2) low salivary flow
3) visible plaque on teeth
4) high-frequency sugar consumption
5) mouth appliance
6) health challenge
7) Socioeconomic factor
8) Access to health care
9) Cariogenic microflora

Protective factors:

1) fl water
2) Topical fl ( professional)
3) Brushing teeth with Fl toothpaste daily
4) regular dental check-up

Question 5

Children 0-5

Answer 5

High risk:

1) Mother/primary caregiver has active dental caries
2) Parent/caregiver has life-time of poverty, low health literacy
3) Child has frequent exposure (>3 times/day) between-meal sugar-containing snacks or beverages per day
4) Child uses bottle or non-spill cup containing natural or added sugar frequently, between meals and/or at bedtime
5) Child has non-cavitated lesions
6) Child has active caries, fillings or missing teeth due to caries
7) Visible plaque

Moderate:

1) Immigrant
2) special healthcare needs

Low:
Child receives optimally-fluoridated drinking water or fluoride supplements
Child has teeth brushed daily with fluoridated toothpaste
Child receives topical fluoride from health professional
Child has dental home/regular dental care

Question 6

Child 6 years or older

Answer 6

1) Patient has life-time of poverty, low health literacy
2) Child has frequent exposure (>3 times/day) between-meal sugar-containing snacks or beverages per day
3) Child has non-cavitated lesions
4) Child has 1 or more interproximal caries
5) Low salivary flow

Moderate:

1) Immigrant
2) special healthcare needs
3) Defective restorations
4) Inta oral appliance

Low:
Child receives optimally-fluoridated drinking water or fluoride supplements
Child has teeth brushed daily with fluoridated toothpaste
Child receives topical fluoride from health professional
Child has dental home/regular dental care

Question 7

Recommendations

Answer 7

Dental caries-risk assessment, based on a child’s age, social/biological factors, protective factors, and clinical findings, should be a routine component of new and periodic examinations by oral health and medical providers.

2. While there is not enough information at present to have quantitative caries-risk assessment analyses, estimating children at low, moderate, and high caries risk by a preponderance of risk and protective factors will enable a more evidence-based approach to medical provider referrals, as well as establish periodicity and intensity of diagnostic, preventive, and restorative services.
   3) Care pathways, based on a child’s age and caries risk, provide health providers with criteria and protocols for determining the types and frequency of diagnostic, preventive, and restorative care for patient-specific management of dental caries.

Question 8

Toothpaste amount by age

Answer 8

Twice daily brushing: Parental supervision of a “smear” amount of fluoridated toothpaste twice daily for children under age 3, “pea-size”
the amount for children ages 3-6.

Question 9

SDF use in high risk patients

Answer 9

Use of 38 percent silver diamine fluoride to assist in arresting caries lesions. Parental consent highlighting in
particular expected staining of treated lesions.

Question 10

sealants

Answer 10

Although studies report unfavorable cost/benefit ratio for sealant placement in low caries risk children, expert opinion favors sealants in permanent teeth of low risk children based on possible changes in risk over time and differences in tooth anatomy. The
decision to seal primary and permanent molars should account for both the individual level and tooth level risk