Risk assessment Flashcards
What is a caries risk assessment
- A process of evaluating an individuals,
likelihood of developing dental caries in the
future
What are the types of risk factors
Biological
* Environmental
* Behavioural
* Protective
What are the biological risk factors
- Previous Caries History- a previous history of caries
significantly increases future risk of developing further caries.
* 2.Diet- frequent consumption of sugary or acidic foods/drinks
increases risk of developing caries.
* 3. Salivary Function- reduced saliva flow (xerostomia) impairs
natural defences against caries.
* 4. Bacterial Load- high levels of cariogenic bacteria increase
risk e.g. streptococcus mutans.
What are environmental caries risk factors
.1. Fluoride Exposure
- reduced exposure increases caries risk
e.g. brushing less than twice daily/toothpaste with no or low fluoride
content/lack of professionally applied fluoride
* 2. Socioeconomic Status
- more deprived individuals have a
higher risk due to limited access to dental care/information and
dental resources e.g. cost of brushes/paste.
What behavioural factors increase risk of caries
- Oral Hygiene- poor OH allows plaque and bacteria to
accumulate increasing risk.
2.Dental Visits- regular check-ups and professional
cleanings help to prevent caries and provide early
detection.
What protective factors can increase/decrease risk of caries
-Sealants- fissure sealants
-Diet- frequent consumption of sugary or acidic foods/drinks increases risk of developing caries.
-Salivary Function- reduced saliva flow (xerostomia)
impairs natural defences against caries.
-Bacterial Load- high levels of cariogenic bacteria increase risk e.g. streptococcus mutans
What are the 7 elements of caries risk
Clinical Evidence
Dietary Habits
Social History
Fluoride use
Plaque control
Saliva
Medical History
How can socail history indicate risk
- SIMD category
- Education
- Unemployment
- Work stressors
- Single parent families
- Violence
- Inequalities and access to healthcare
- Dependents
How does fluoride aid in preventing bacterial growth**
– Inhibits bacterial growth by interrupting bacterial metabolism,
reducing bacterial ability to produce acids.
– Interferes with the adhesion force of bacteria reducing their
ability to stick to the surface of the teeth, hence disrupting the
formation of the biofilm
What does fluoride do to enamel
– Remineralization of enamel is promoted in the presence of fluoride.
– Fluoride ions are incorporated into enamel during remineralization creating a stronger and more acid resistance enamel crystal. (Fluorapatite has stronger bond strength than
hydroxyapitite).
When might oral hygeine aid caries development
– Poor technique
– Irregular brushing
– Unassisted (very young/very old, those with manual dexterity issues)
– Access to toothbrush/toothpaste
– Difficulty due to changes (mixed
dentition/orthodontics/gaps/recession)
How does saliva impact caries progression
- Amount
- Flow
- Buffering Capacity
- pH
- Viscosity
How can illness and medication promote caries
- Xerostomia (desired effect/side effect e.g. scopolamine
patches/asthma inhalers) - Other drug side effects making OH difficult e.g.Mucositits
as a side effect of chemotherapy in oncology) - Free sugars to make medicine more palatable
- Lactulose
- Frequency/positioning of sugar containing medicine
- Recreational drug use/rehabilitation from drug addiction
- Social convention of how we act towards people who are
ill- bring them sweets!
What are the 8 elements of the preventive programme
- Radiographs
- Toothbrushing instruction
- Strength of F in toothpaste
- F varnish
- F supplementation
- Diet advice
- Fissure sealants
- Sugar free medicine
What factors are typical of a high caries risk child
- Social
– Mother’s education secondary only
– Poor dental attender
– Family Unit: single parent, social class, unemployment - Health
– Poor health/chronic sick
– Sugar-based medications - Caries Experience
– dmft > 5, DMFT > 5
– > 10 initial lesions in primary dentition at first attendance
– caries in 6’s at 6 years
– 3 year caries increment > 3 - Orthodontics
– Fixed appliance therapy
