Caries Risk Assessment Flashcards
(42 cards)
Dental Caries
(3)
Multifactorial disease
Bacterial infection, followed by acid attack
Trends
Multifactorial disease
Can be altered by secondary
factors: f luoride, saliva f low,
etc.
Bacterial infection, followed
by acid attack
(2)
Remin/demin
Controlled by multiple risk
factors
Trends
Decline:
Increase:
fluoride
fermentable
carbohydrate
Caries occurs in areas where
plaque accumulates, undisturbed
Each site has a unique
environment that influences
plaque composition, access by
(3)
dietary factors, saliva and anti-
caries factors
Site-specific Modifying Factors
(5)
Pre/post-eruption fluoride exposure
Patient’s oral hygiene practices
Biofilm (composition varies person to person, site to
site)
Saliva flow rate and composition
Dietary habits
Changes in our Understanding
(3)
Treatable vs controllable
Fluoride results in slower
progression
Caries process is dynamic. It can be
arrested or reversed.
Caries Prevention Strategies
(6)
Fluoride (highly effective in all forms)
Sealants (highly effective if applied correctly)
Salivary stimulation
Diet modification
Antimicrobial
Non- f luoride remineralizing strategies
Fluoride (highly effective in all forms)
(3)
Water fluoridation
Professionally applied
Home delivery
Salivary stimulation
(1)
Chewing gum
Diet modification
(2)
Behavioral
Protective food additives
Antimicrobial
(2)
Non-specific
Targeted
Casein phosphopeptide stabilized amorphous calcium
phosphate (Recaldent; CPP-ACP)
Claim:
(2)
CPP stabilize high concentrations of
calcium and phosphate ions, together
with f luoride ions, at the tooth
surface by binding to pellicle and
plaque
The ions are supposedly freely bio-
available and can diffuse into enamel
subsurface lesions, thus promoting
re-mineralization
Evidence suggests that, under highly favorable
conditions,
Recaldent re-mineralizes artificial lesions
to a modest extent.
There is need for
independent, randomized,
controlled studies, under clinically relevant
conditions
Bottom line
“The clinical benefits of CPP-ACP with and without
fluoride in paste form are not yet substantiated by
credible scientific evidence, and thus
it cannot be
recommended at this time. Topically applied fluoride
remains the standard for anti-caries effectiveness…”
ADA Center for Evidence Based
Dentistry:
*There is insufficient evidence from clinical trials
that use of agents containing
calcium and/or
phosphates with or without casein derivatives lowers
incidence of either coronal or root caries.
Allergies
(2)
These products are derived from milk products.
Patients with dairy allergies should avoid using them.
CAMBRA
CAries Management By Risk Assessment
determining caries risk
(3)
Caries disease indicators
Caries risk factors
Caries protective factors
Caries disease indicators
(3)
□Active caries
□Restorations within 3 years
□Areas of demineralization, including interproximal
skipped
Caries risk factors
(9)
□Multiple multi-surface restorations
□Frequent snacking/sugared drinks
□Reduced saliva
□Exposed roots
□Visible, heavy plaque
□Deep pits and fissures
□Ortho
□Recreational drug use
□Physical or mental limitations
skipped
Caries protective factors
(10)
□Regular dental care
□Regular professional fluoride treatments/varnish
□Sealants
□Fluoridated water
□Fluoridated toothpaste
□OTC fluoride mouthrinse (daily)
□Rx fluoride daily (5000 ppm)
□Xylitol gum
□Xylitol products
□Adequate saliva flow
