implementation of caries risk assessment

Question 1

Valuable for ________ and ________ of caries; permits _____-centered care

Used in conjunction with _____ and caries detection devices; not a _____

Steps for reducing risk factors for caries using CAMBRA (___ ____ ___ ___ ___ ____):
1. Caries risk assessment (assess caries disease ____, ____ factors, ____ factors)
2. Determine caries risk ____
3. Create ________-based care plan; Prevention/risk management strategies; “drill and fill’ without ________ and determination of risks factors is insufficient
4. Evaluate _____ of plan

Answer 1

Valuable for prevention and management of caries; permits patient-centered care
 Used in conjunction with radiographs and caries detection devices; not a replacement
 Steps for reducing risk factors for caries using CAMBRA (caries management by risk assessment)
methodology:
 1. Caries risk assessment (assess caries disease indicators, risk factors, protective factors)
 2. Determine caries risk level
 3. Create evidence-based care plan
Prevention/risk management strategies
“drill and fill’ without patient education and determination of risks factors is insufficient
 4. Evaluate success of plan

Question 2

Categorizes patient’s caries risk based on ____ and ________

Two ADA forms: Ages ____ years and over __ years old
Not intended to include all possible _______
Intended use is to help patients with _______ risk factors over time

Answer 2

Categorizes patient’s caries risk based on history and examination
 Two ADA forms: Ages 0 to 6 years and over 6 years old
Not intended to include all possible risk factors
Intended use is to help patient’s with lowering risk factors over time

Question 3

scoring instructions

circle or check the boxes of the conditions that _____.

low risk= only boxes in ___ risk checked
moderate risk= only conditions in ___ or ____ are checked
high risk= ____ or more conditions in the ___ risk checked

Answer 3

scoring instructions

circle or check the boxes of the conditions that apply.

low risk= only boxes in low risk checked
moderate risk= only conditions in low or moderate are checked
high risk= one or more conditions in the high risk checked

Question 4

what is an “extreme” caries risk (higher than high risk)

Answer 4

high risk pt + severe xerostomia

Question 5

ADA CDT codes

Not used in _______- do NOT need to _______ these
 For ___ keeping
 supporting evidence for _______
 Codes:
 _____- caries risk assessment and documentation, with a finding of low risk
 ______- caries risk assessment and documentation, with a finding of moderate risk
 ______- caries risk assessment and documentation, with a finding of high risk

Answer 5

Not used in ODU SODH- do NOT need to treatment plan these
 For record keeping
 For supporting evidenced for 3rd party payers
 Codes:
 D0601- caries risk assessment and documentation, with a finding of low risk
 D0602- caries risk assessment and documentation, with a finding of moderate risk
 D0603- caries risk assessment and documentation, with a finding of high risk

Question 6

CAMBRA clinical guidelines for ages 6 and up (low risk)

Rads:
Caries exam:
Fluoride:

When should OTC fluoride toothpaste be used?
What can fluoride varnish be used for?

Answer 6

Rads: BWX every 12-24 months
 Caries Exam: Every 6-12 months
 Fluoride: OTC fluoride toothpaste at breakfast and bedtime; OPTIONAL 5% NaF varnish for excessive root exposure or sensitivity

Question 7

CAMBRA clinical guidelines for ages 6+ (moderate risk)

Rads:
Caries Exam:
Diet counseling:
Fluoride: + (two options)
Sealants:

Answer 7

Rads: every 6-12 months
Caries Exam: Every 6 months
Diet counseling: YES
Fluoride: 5% NaF varnish every 6 months AND one of the following options:
 Option 1. OTC fluoride toothpaste bid and OTC NaF rinse qd (everyday)
 Option 2. Prescription fluoride toothpaste (5,000ppm) bid
Sealants: Children and adolescents

Question 8

CAMBRA clinical guidelines ages 6+ (high risk)

 Rads:
 Caries Exam:
 Antibacterial agents:
 Diet counseling:
 Fluoride:
 Sealants:

Answer 8

 Rads: every 6-12 months
 Caries Exam: every 4-6 months
 Antibacterial agents: 0.12% CHX 60 sec qd for 1 week/month (1 hour after brushing) - interferes w/ SLS
 Diet counseling: YES
 Fluoride: Prescription fluoride 1.1% NaF toothpaste (5,000 ppm) bid, 5% NaF varnish every 4-6 months
 Sealants: YES

Question 9

CAMBRA clinical guidelines for ages 6+ (extreme risk)

 Rads:
 Caries Exam:
 Antibacterial agents:
 Diet counseling:
 Fluoride:
 Rinse multiple times a day with a ______ solution (__ teaspoons per __ oz of water) to neutralize
acid
 Sealants:

Answer 9

 Rads: every 6-12 months
 Caries Exam: every 3-4 months
 Antibacterial agents: 0.12% CHX 60 sec qd for 1 week/month (1 hour after brushing)
 Diet counseling: YES
 Fluoride: Prescription fluoride toothpaste (5,000 ppm) bid, 5% NaF varnish every 4-6 months
 Rinse multiple times a day with baking soda solution (2 teaspoons per 8 oz of water) to neutralize
acid
 Sealants: YES

Question 10

CAMBRA clinical guidelines ages 0-6 (low risk)

 Rads:
 Caries Exam:
 Fluoride:
 Diet counseling:
 Sealants:

Answer 10

 Rads: every 12-24 months
 Caries Exam: every 6-12 months
 Fluoride: OTC fluoride toothpaste bid after teeth erupt, rice-sized up to age 3, pea-sized ages 3-6
 Diet counseling: No
 Sealants: Optional

Question 11

CAMBRA clinical guidelines ages 0-6 (moderate risk)

 Rads:
 Caries Exam:
Fluoride:
 Diet counseling:
 Sealants:

Answer 11

 Rads: every 6-12 months
 Caries Exam: Every 6 months
 Fluoride: OTC fluoride toothpaste bid; 5% NaF varnish every 6 months
 Diet counseling: YES
 Sealants: After age 2 for deep pits and fissures

Question 12

CAMBRA clinical guidelines for ages 0-6 (high risk)

 Rads:
 Caries Exam:
 Fluoride:
 Diet counseling:
 Sealants:

Answer 12

 Rads: Every 6 months
 Caries Exam: Every 3 months
 Fluoride: OTC fluoride toothpaste bid; 5% NaF varnish every 3 months
 Diet counseling: YES
 Sealants: After age 2 for deep pits and fissures

Question 13

CAMBRA guidelines for ages 0-6 (extreme risk)

 Rads:
 Caries Exam:
 Fluoride:
 Diet counseling:
 Sealants:

Answer 13

 Rads: Every 6 months
 Caries Exam: Every month
 Fluoride: OTC toothpaste 3x per day; 5% NaF varnish every 1-3 months
 Diet counseling: YES
 Sealants: After age 2 for all pits and fissures

Question 14

ODU CLINIC

 Caries risk assessment may be completed for ___ patient during ___
 Similar to the PHP, ____ provides a form to calculate the patient’s caries risk (low, moderate, high)
 Used in conjunction with ______ and caries detection devices; not a _______

Answer 14

 Caries risk assessment may be completed for any patient during OHI
 Similar to the PHP, axiUm provides a form to calculate the patient’s caries risk (low, moderate, high)
 Used in conjunction with radiographs and caries detection devices; not a replacement

Question 15

“caries experience of the mother, caregiver, and or siblings” is answered for:

Answer 15

patients ages 6-14, otherwise leave unanswered

Question 16

scoring in axium

Answer 16

0= low risk
1= moderate risk
10= high risk