"Look Mom, no cavities!" These words are music to any parent's ears. However, cavities are still a major health issue for children and adults. But what if a caries risk assessment was performed on a patient before cavities form? This methodology offers a chance to identify risk factors and intervene with preventative measures. Here's all you need to know about this method and its benefits.
Risk Assessment Basics
About 10 years ago there was a concept shift in how dentists and dental hygienists approach cavity prevention. Caries management by risk assessment (CAMBRA) was developed by the California Dental Association in conjunction with the University of California - San Francisco. This caries risk assessment model shows promise for managing and preventing cavities.
According to the World Health Organization (WHO), dental decay is a major problem facing children and adults. It estimates that this oral disease affects 60 to 90 percent of schoolchildren in industrialized nations. WHO also notes that caries levels are high in the Americas due mostly to a high consumption of sugars and fermentable carbohydrates and less use of fluoride. By using CAMBRA, practicing clinicians – most often dental hygienists – detect their patients' risk and provides an individualized prevention protocol.
Principles of Caries Risk Assessment
The philosophy of CAMBRA is to assess every patient on an individual basis. This model has become the standard of care and an important part of dental hygiene education that should be included at a dental checkup. Dental hygienists are the ideal clinicians to perform this survey as their primary focus is prevention. After an assessment, a disease managing protocol is recommended to intervene and prevent early or incipient lesions from progressing. Using cavity detection methods – both old and new – they identify a patient's risk level. These methods include dental X-rays, a laser tool that measures fluorescence within the tooth, evaluating nutritional habits and saliva flow, and testing levels of acid-producing bacteria.
The key factor to stopping cavity formation is controlling the bacteria present in the mouth. By keeping a balance in the oral environment that suppresses or diminishes the power of these cavity-forming bacteria, caries risk can be reduced. Since dental decay is mostly bacteria-driven and a carious lesion or cavity is the end result, early interventions can prevent or arrest the process. The assessment form includes three major categories:
- Disease indicators like visible cavities, restorations placed within the last few years, white spots or demineralized enamel.
- Risk factors including systemic bacterial count, salivary flow, environmental (for example, exposed roots, braces, deep grooves in teeth), and behavioral habits (such as frequent snacking and poor oral hygiene).
- Protective factors, such as exposure to fluoride, xylitol and other anti-bacterial components that help remineralize the teeth. Colgate Total Advanced Pro-Shield mouthwash kills 99 percent of germs on contact, so products such as this one are key in the fight against dental decay.
Caries risk assessment focuses on multiple factors including bacteria, diet, and the condition of the mouth and teeth. Dental fillings do not solve this global health problem. Only early intervention can create a path to successful management. By using CAMBRA, clinicians are supported by research and are guided by their clinical experience to recommend prevention measures based on their patients' needs.