Caries Risk Assessment and Caries Reduction Protocol

Question 1

what is the definition of caries

Answer 1

• multifactorial disease
• biofilm mediated, sugar driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues

Question 2

what pushes toward remineralization and away from demineralization

Answer 2

• regular dental care
• fluoride: in office treatments, water, OTC mouth rinse, OTC toothpaste, prescriptions, diet
• xylitol products - large amounts to be effective
• adequate saliva flow

Question 3

what amount of sugared beverage is desirable? moderate risk? high risk?

Answer 3

• desirable: less than 12 ounces a day
• moderate risk: 12-20 oz/day
• high risk: more than 20 oz/day

Question 4

when should you drink sugared beverages

Answer 4

best with meals

Question 5

what is low risk frequencywith soda? moderate risk? high risk?

Answer 5

• low: one exposure per day
• moderate: 2-3 exposures per day
• high risk: 4 or more exposures per day

Question 6

what is high risk and moderate risk for length of exposurefor soda

Answer 6

• moderate risk: 15-30 minutes
• high risk: more than 30 minutes

Question 7

what is the best drinking style? moderate? high?

Answer 7

• best: straw
• moderate: open container
• high: swishing around in mouth

Question 8

caries occur in areas where plaque:

Answer 8

accumulates and is undisturbed

Question 9

where do caries form

Answer 9

interproximally (class II), oclusally (class I), and along gum line (Class V)
- pits and fissures

Question 10

what does CAMBRA stand for

Answer 10

Caries Management By Risk Assessment

Question 11

what are caries disease indicators

Answer 11

low socioeconomic status, development problems, current caries, and restorations placed in the previous 3 years

Question 12

what are caries risk factors

Answer 12

• mutans streptococci (MS)
• lactobacilli (LB)
• plaque
• exposed roots
• insufficient saliva flow
• frequent snacks
• deep pits and fissures
• orthodontic appliances

Question 13

what are protective factors

Answer 13

systemic and/or topical fluoride, CHX use
- xylitol
- calcium and phosphate paste

Question 14

what is low caries risk

Answer 14

• no dental lesions
• no visible plaque
• optimal fluoride
• regular dental care

Question 15

what is moderate caries risk

Answer 15

= dental lesions in the last 12 months
- visible plaque
- suboptimal fluoride
- irregular dental care

Question 16

what is high risk for caries

Answer 16

• one or more lesions
• visible plaque
• suboptimal fluoride
• irregular dental care
• high bacterial challenge
• impaired saliva
• medications
• frequent snacking

Question 17

which is extreme caries risk

Answer 17

patients with special needs or severe hyposalivaiton

Question 18

active caries automatically places patient at ____ risk

Answer 18

high

Question 19

what are disease indicators

Answer 19

active decay
- initial decay
- white spot lesions
- treatment within 3 years

Question 20

2 or more risk factors places patient at ____ risk

Answer 20

high

Question 21

what do you do after you determine caries risk

Answer 21

• bacteria and saliva testing
• discuss home care, make a plan
• provide follow up and reassess risk level
• have a dental tem approach

Question 22

what are modifying factors

Answer 22

• fluoride exposure: prescription or OTC
• biofilm
• saliva flow rate and composition
• oral hygiene
• diet

Question 23

what should you do with patients with low saliva flow rate and abnormal composition

Answer 23

• testing can be done- measures strep mutans and lactobacilli - most require 48 hours
• consider saliva substitutes like biotene
• sugar free gum

Question 24

what affect does dairy have on teeth

Answer 24

increases remineralization and decreases demineralization
- increases saliva and buffers

Question 25

what affect do nuts have on teeth

Answer 25

• almonds, brazil nuts, and cashews are especially beneficial because they help fight tooth decay causing bacteria

Question 26

what dietary factors should be considered

Answer 26

• fermentable carbs
• frequent snacking/sugared drinks
• pH of drinks
• avoid breads pastas sweets and alcohol