Peds Caries Risk Assessment Flashcards
why do caries risk assessment
required for clinical services, may be used in litigation and may determine standard of care in future
what are the three pillars of decision we use to combine and make a diagnosis
clinical evidence
clinical expertise
patients needs and preferences
how are children and adults different pertaining to caries
children and adults impacted differently by carb exposure and hygiene
advancement of caries different
exposure to F and immunity factors may affect risk prediction
what are the risk assessments used today
F, Radiographs, sealants, occlusal surface management
future applications for risk assessment
diet analysis, antimicrobial use, recall intervals, choice of restorative material
percentage of ohio pre school children with caries
38%
28% untreated
12% baby bottle decay
Head start= 73% untreated caries
what are the risk groups for caries in peds
CSHCN, maternal high caries, plaque, nocturnal breast or bottle, late order birth, low SES
when should EVERY child receive a oral health risk assessment by
BY 6 MONTHS!!
children identified as at risk should see a dentist by when
6 and 2 months
does intensifying prevention provide additional benefits?
NO!!
what happens with age
caries increase with age
what is the best indicator of risk
existing dental caries and or restorations and new caries
what should the ideal risk assessment tool include
easy and quick, non invasive, reproducible,
have validity, inexpensive, related to treatment
what are the primary risk factors of AAPD
low risk: no plaque sugar only at meals F intake, no bottle use, no caries
at risk: plaque but brushes, 2 sugar exposures, bottle at meals, F unsure, white spots only
HIGH risk: plaque no brushing, 3 or more sugar exposures outside meals, bottle at lib, sub optimal F, caries or restorations
what do studies tell us about caries risk assessments
no one test meets all needs, benefit may be population based, high risk = results may be disappointing
is there an evidence to support treatment of a patient based on carries risk assessment?
NO!
Historical tools used in clinic?
low SES, sugar exposures, F status, ethnicity
Clinical tools used in clinic?
plaque presence, existing caries, dentist’s instinct, S mutans
Socioeconomic status has an impact on caries rates?
most likely
poor children have more caries
is exposure to sugar a caries predictor?
Yes
how many sugar exposures put a child in the high risk category
3 sugar exposures= high risk
is F exposure a good or bad risk factor on a population basis?
F exposure = good factor on population basis
F exposure= weak for individual basis
complicated by halo effect
F as a predictor is good/ not good for primary teeth and caries
NOT good for primary teeth
primary teeth require F and what as a risk factor
F + oral hygeine
are minorities and immigrant population more at risk for caries?
YES at least studies show they are
who has highest caries rate in the US
native americans
used to be lowest until westernized diet appeared
included familial transmission and elements of microflora
does frequency of brushing teeth affect caries rate
yes the more a child brushes the less caries he/she has
what does plaque on teeth measure
plaque presence or absence measures tooth cleaning
Does ECC predict future dental caries?
YES often in spite of prevention
anterior ECC predicts what
posterior ECC
will white spot lesions turn carious?
YES!!
white spots in a caries free child says what?
START a intensive prevention program!
in a caries active child white spots mean what
treat the tooth!
white spot lesions are a good reason to use what
F varnish
what is the most beneficial use of carries risk assessment?
CRA most beneficial for caries free population
