Caries Risk Assessment and Caries Reduction Protocol Flashcards
what is the definition of caries
- multifactorial disease
- biofilm mediated, sugar driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues
what pushes toward remineralization and away from demineralization
- 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
what amount of sugared beverage is desirable? moderate risk? high risk?
- desirable: less than 12 ounces a day
- moderate risk: 12-20 oz/day
- high risk: more than 20 oz/day
when should you drink sugared beverages
best with meals
what is low risk frequencywith soda? moderate risk? high risk?
- low: one exposure per day
- moderate: 2-3 exposures per day
- high risk: 4 or more exposures per day
what is high risk and moderate risk for length of exposurefor soda
- moderate risk: 15-30 minutes
- high risk: more than 30 minutes
what is the best drinking style? moderate? high?
- best: straw
- moderate: open container
- high: swishing around in mouth
caries occur in areas where plaque:
accumulates and is undisturbed
where do caries form
interproximally (class II), oclusally (class I), and along gum line (Class V)
- pits and fissures
what does CAMBRA stand for
Caries Management By Risk Assessment
what are caries disease indicators
low socioeconomic status, development problems, current caries, and restorations placed in the previous 3 years
what are caries risk factors
- mutans streptococci (MS)
- lactobacilli (LB)
- plaque
- exposed roots
- insufficient saliva flow
- frequent snacks
- deep pits and fissures
- orthodontic appliances
what are protective factors
systemic and/or topical fluoride, CHX use
- xylitol
- calcium and phosphate paste
what is low caries risk
- no dental lesions
- no visible plaque
- optimal fluoride
- regular dental care
what is moderate caries risk
= dental lesions in the last 12 months
- visible plaque
- suboptimal fluoride
- irregular dental care
what is high risk for caries
- one or more lesions
- visible plaque
- suboptimal fluoride
- irregular dental care
- high bacterial challenge
- impaired saliva
- medications
- frequent snacking
which is extreme caries risk
patients with special needs or severe hyposalivaiton
active caries automatically places patient at ____ risk
high
what are disease indicators
active decay
- initial decay
- white spot lesions
- treatment within 3 years
2 or more risk factors places patient at ____ risk
high
what do you do after you determine caries risk
- bacteria and saliva testing
- discuss home care, make a plan
- provide follow up and reassess risk level
- have a dental tem approach
what are modifying factors
- fluoride exposure: prescription or OTC
- biofilm
- saliva flow rate and composition
- oral hygiene
- diet
what should you do with patients with low saliva flow rate and abnormal composition
- testing can be done- measures strep mutans and lactobacilli - most require 48 hours
- consider saliva substitutes like biotene
- sugar free gum
what affect does dairy have on teeth
increases remineralization and decreases demineralization
- increases saliva and buffers
what affect do nuts have on teeth
- almonds, brazil nuts, and cashews are especially beneficial because they help fight tooth decay causing bacteria
what dietary factors should be considered
- fermentable carbs
- frequent snacking/sugared drinks
- pH of drinks
- avoid breads pastas sweets and alcohol
