CRA Flashcards
What factors place children ages 0-5yo in high risk CRA category?
- Risk factors:
- Mother/primary caregiver has active dental caries
- Parent/caregiver has life-time of poverty, low health literacy
- Child has frequent exposure (>3x/day) between-meal sugar-containing snacks or beverages/day
- Child uses a bottle or non-spill cup containing natural or added sugar frequently, between meals and/or at bedtime
- [No protective factors]
- Clinical findings
- Child has non-cavitated (incipient/white spot) caries or enamel defects
- Child has visible cavities or fillings or missing teeth due to caries
- Child has visible plaque on teeth
What factors place children ages 0-5yo in moderate risk CRA category?
- Risk factors:
- Child is a recent immigrant
- Child has special health care needs
- [No protective factors]
- [No clinical findings]
What factors place children ages 0-5yo in low risk CRA category?
- [No risk factors]
- Protective factors:
- Child receives optimally-fluoridated drinking water or fluoride supplements
- Child has teeth brushed daily w/ fluoridated toothpaste
- Child receives topical fluoride from health professional
- Child has dental home/regular dental care
- [No clinical findings]
What three factors are incorporated into CRA?
- Social + biological risk indicators
- Protective factors
- Clinical findings
Appropriate for age (0-5yo + 6yo+)
CRA assessment…
- Foster tx of disease process instead of treating the outcome of the disease
- Allows an understanding of the disease factors for a specific patient + aids in individualizing preventive discussions
- Individualizes, selects and determines frequency of preventive + restorative tx for a patient
- Anticipates caries progression or stabilization
Also, the determination of the likelihood for the increased incidence of caries (i.e. the number of new cavitated or incipient lesions) during a certain time period or the likelihood that there will be a change in the size or activity of lesions already present.
What factors place children ≥6yo in high risk CRA category?
- Risk factors, social/biological
- Patient has a lifetime of poverty, low health literacy
- Patient has frequent exposure (>3x/day) between-meal sugar-containing snacks or beverages/day
- [No protective factors]
- Clinical findings
- Patient has ≥1 interproximal caries lesions
- Patient has active non-cavitated (white spot) caries lesions or enamel defects
- Patient has low salivary flow
What factors place children ≥6yo in moderate risk CRA category?
- Risk factors, social/biological
- Child is a recent immigrant
- Patient has SHCN
- [No protective factors]
- Clinical findings
- Patient has defective restorations
- Patient wears an intraoral appliance
What factors place children ≥6yo in low risk CRA category?
- [No risk factors, social/biological]
- Protective factors
- Patient receives optimally-fluoridated drinking water
- Patient brushes teeth daily w/ fluoridated toothpaste
- Patient receives topical fluoride from health professional
- Patient has dental home/regular dental care
- [No clinical findings]
How often should a low risk child have recalls + radiographs?
RC every 6-12mo; radiographs every 12-24mo
How often should a moderate risk child have recalls + radiographs?
RC every 6mo; radiographs every 6-12mo
How often should a high risk child have recalls + radiographs?
RC every 3mo; radiographs every 6mo
Recommended fluoride interventions in high risk children?
- Drink optimally fluoridated water
- Professional topical tx every 3mo
- SDF on cavitated lesions
**In the ≥6yo children, brushing w/ 0.5% fluoride gel/paste
In what caries risk category are sealants + dietary counseling recommended?
All of them
How often is professional topical fluoride applied?
- Moderate risk: every 6mo
- High risk: every 3mo
“Smear” amount of fluoridated toothpaste is recommended for children how old?
under 3yo
