Caries Management

I spent the morning in Minneapolis recording a video for 3M to help dental offices implement a CaMBRA system. CaMBRA stands for caries management by risk assessment and is a process for evaluating a patient’s caries risk and recommending preventive strategies that has been instrumental over the last decade. The California Dental Association and the American Dental Association have adopted the principles of CaMBRA and have assessment forms that can be downloaded to use in your office. There are variations int he risk assessment for small children(0-6yrs) and adults (7-up) but the basic premise is to place patients into a low, moderate or high risk category of risk for developing a cavity. I strongly support the use of a patient centered prevention protocol as part of the services we provide our patients. Being focused on prevention differentiates our practice, is int he best interest of our patients and supports proactive empowered patients. Some of the major factors in assessing the patient’s caries risk are:

Low Risk

• No carious lesions in the last 36 months
• Exposure to fluoride toothpaste, water and in office application
• Routine dental visits and maintenance
• Not in active orthodontic therapy

Moderate Risk

• 1-2 cavities int he last 36 months
• Active Orthodontic Therapy
• Presence of plaque
• Dry Mouth
• Exposed root surfaces

High Risk

• More than 3 cavities int he last 3 months
• Missing Teeth Due To Decay
• Visible plaque
• Infrequent dental hygiene visits
• Dry Mouth
• Exposed Root Surfaces

There are additional factors that are considered in a full assessment and include things like chemotherapy or radiation and aberrant tooth morphology. Whether you use a standardized form or create your own, do the assessment or have the patient complete it, having some protocols around caries prevention has a place in every dental practice. In a post next week we will look at the management strategies once a patient’s risk has been determined.