Pediatric Caries Risk Assessment Flashcards
Why bother with a Caries Risk Assessment?
Required for OSU Clinical services
Third parties request it
May have a role in litigation
Will likely influence care in the future
Why are pediatric caries risk assessments different than that of adults?
Carbohydrate and exposure and oral hygiene do not have the same impact in adults as children
Rate of caries advancement is different
Exposure to fluoride and immunity factors may affect risk production
What help lower caries risk today?
Fluorides
Radiographs
Sealants
Management of occlusal surfaces
How many pre-school kids in Ohio have “caries experience”
38%
How many pre-school kids in Ohio have untreated caries?
28%
How many kids in Ohio have “baby bottle caries”?
12%
How many “Head Start” kids with “caries experience” have untreated caries?
73%
What are the results of children who have early preventive dental services?
More likely to use preventative services subsequently
Have fewer dental related costs than those starting later
Have fewer caries-related treatments
T/F - Intensifying prevention provides additional benefit
False
What are characteristics of the ideal caries risk assessment tool?
Quickly and easily applied Be non-invasive Be reproducible Have validity Be inexpensive Relate to treatment
According to the AAPD what are the factors for ‘low risk’?
No plaque Sugar only at meals No bottle use Optimal F intake No caries
According to the AAPD, what are the factors for ‘at risk’?
Plaque, but brushing Two sugar exposures outside meals Bottle with meals only Fluoride intake unsure White spots only
According to the AAPD, what are the factors for ‘high risk’?
Plaque and not brushing 3 or more sugar exposures outside meals Bottle at lib or at night Sub-optimal F intake Overt caries or restorations
Is there any evidence to support the claim to treat based on caries risk?
No - it’s used as a tool to help us teach patients
T/F - a caries risk test meets all requirements for individual patient use
False
T/F - caries assessment tools can be age and culture-specific
True
T/F - benefits of caries risk assessments are not individual, but population-based
True
T/F - simple tools do not have a role in practice
False
What historical markers are clinically relevant to determine caries risk?
Low socio-economic status
Sugar exposures
Fluoride status
Ethnicity
What clinical markers can be useful in determining caries risk?
Plaque on teeth
Existing caries
Dentist’s instinct
Strep mutans
Why is low socio-economic status associated with dental caries?
Poor children have more caries
Some risk at individual level, but not clinically useful
Probably a surrogate measure for other factors
What is the factor of Fluoride exposure based on?
On a population basis, fluoride exposure is a good risk factor, but is weak based on individual basis
T/F - Fluoride exposure plus oral hygiene is stronger risk factor than fluoride alone
True
Does race or ethnicity really matter in caries risk?
Numerous national and international studies attribute increased risk of caries to minority and immigrant populations
Individual application has not been shown to be useful in patient care
May be a surrogate for other measures (dietary, financial, accessibility to care, etc)
What population has the highest caries risk in the US?
Native American populations
Had lowest rate before westernized diet appeared
This demonstrates the complexity of CRA because risk is so great and no preventive techniques can drop caries rate to 0
What is plaque on teeth a signal of?
It’s a measure of tooth cleaning
Gingival health may be a surrogate measure
Probably reflects an overall attention to oral/general health
T/F - ECC predicts future caries in spite of prevention
True
White spot lesions
Will turn carious
Good reason for intensive prevention
In a caries-active child, it’s a good reason to treat the tooth
Good use for F varnish
