Caries Risk Assessment Flashcards
What factors are necessary for caries
Tooth
Substrate
Flora - strep. Mutans
Time
Give examples of general caries risk factors
Social
General health
Give examples of local caries risk factors
Oral hygiene Diet Fluoride experience Past caries experience Orthodontic treatment
What are the 7 elements of caries risk
Clinical evidence Dietary habits Social history Fluoride use Plaque control Medical history
How can caries experience class a patient as high caries risk
dmft >=5
DMFT >=5
Caries in 6’s at 6 years old
3 years caries increment >=3
What other pieces of clinical evidence would make a patient high caries risk
Orthodontics - fixed appliance therapy
Prosthodontics - fixed or removable
In diet, what would make a patient high caries risk
> = 3 sugar intakes per day
What in the diet can increase caries risk
High frequency more of an issue than volume of sugar
Highly processed carbohydrates more carcinogenic than natural sugars
Natural sugars can still cause harm eg - lactose in early childhood caries (nursing bottle caries)
What is important about a diet diary
Patient fills in honestly
One of the days should be at the weekend
What in social history can affect a patients carries risk
SIMD category Education Unemployment Work stressors Single patient families Violence Inequalities and access to healthcare Dependents
What role does fluoride play in caries development
More likely to have caries development without fluoridated toothpaste or if no fluoride in water supple
1000ppm is ideal
What are the actions of fluoride
Incorporation into enamel crystal to form fluoroapatite which is more caries resistant (resistant to demineralisation) than hydroxyapatite
Interferes with the adhesion force of bacteria reducing their ability to stick to the surface of the teeth
What role does plaque control play in caries development
Oral hygiene:
Poor technique
Irregular brushing
Unassisted (very young/old, manual dexterity issues)
Access to toothbrush/toothpaste
Difficulty due to changes - mixed dentition, orthodontics, gaps, recession
What role does saliva play in caries development
Amount you have
How quickly it flows
Buffering capacity - capacity to neutralise acids is different for different people
pH notable in people who have had acid erosion from fizzy drinks etc
Viscosity - thick saliva isn’t as good for washing away
What role does medication play in caries development
Can cause xerostomia
Other drug side effects make OH difficult - mucositis
Free sugars make medicines more palatable
Frequency of sugars containing medicine
Recreational drug use/rehabilitation from drug addiction
Social convention - bringing sweets to ill people
