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Caries Risk Assessment (CRA

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8 views15 pages

Caries Risk Assessment (CRA

Uploaded by

alaa.daoud
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Caries risk assessment

(CRA
Caries risk assessment (CRA(

One of the questions that remains unanswered is which


CRA tool (CRAT) to use and which CRATs are validated
with clinical studies.

They also stated a general observation relevant to several


CRATs that “some of the combined factor questions are
not evidence-based, developed by expert panels rather
than based on systematic reviews of the literature.

A Comparison of Four Caries Risk Assessment Methods, John D. B. Featherstone 1*, Yasmi O. Crystal 2,3, Pamela Alston 4,
Benjamin W. Chaffee 1, Sophie Doméjean 5,6,7,8, Peter Rechmann 1, Ling Zhan 4 and Francisco Ramos-Gomez 2021
CariFree Risk Assessment
Caries Management System - CMS
ADA Caries Risk Assessment
ADA Caries Risk Assessment
Prevention Recommendations
Based on Risk Levels:
• For Low-Risk Patients: • For Moderate-Risk Patients:
• Daily Oral Hygiene: • Enhanced Oral Hygiene:
• Brush twice daily with fluoride toothpaste (1450
• Brush twice daily with fluoride toothpaste (1000–1450
ppm).
ppm).
• Consider daily fluoride mouth rinses (0.05% NaF).
• Floss or use interdental brushes once a day.
• Professional Fluoride Treatments:
• Regular Dental Visits: • Apply fluoride varnish or gel at 6-month intervals.
• Routine check-ups and cleanings every 6–12 • Dietary Adjustments:
months. • Reduce sugar intake and replace snacks with low-
cariogenic foods.
• Dietary Guidance:
• Encourage chewing xylitol gum to promote saliva flow.
• Maintain a balanced diet low in sugar and avoid
• Oral Hygiene Support:
frequent snacking.
• Provide hands-on instructions for brushing and flossing.
• Fluoride Maintenance: • Recommend use of electric toothbrushes for better
• Continue regular use of fluoride toothpaste. plaque removal.
• Recall Schedule:
• Education and Motivation:
• Visits every 4–6 months for monitoring and
• Provide reinforcement about maintaining good habits. reinforcement.
• For High-Risk Patients:
• Intensive Fluoride Therapy:
• Professional fluoride application every 3–4 months.
• Prescription-strength fluoride toothpaste (5000 ppm) for daily use.
• Antimicrobial Therapy:
• Chlorhexidine 0.12% mouthwash daily for 1–2 weeks to reduce bacterial load.
• Follow up with xylitol gum or mints to maintain saliva stimulation.
• Restorative Intervention:
• Immediate treatment of existing caries to prevent progression.
• Use of sealants on pits and fissures in molars.
• Dry Mouth Management:
• Artificial saliva substitutes (Biotene or Oral Balance) for xerostomia.
• Hydration and avoidance of caffeine or alcohol, which can worsen dryness.
• Dietary Modifications:
• Eliminate frequent sugar consumption.
• Encourage healthy snacks such as fruits, nuts, and vegetables.
• Close Monitoring:
• Frequent recall visits every 3–4 months to monitor progress and adjust treatment.
The American Academy of Pediatric
Dentistry (AAPD)-carries risk
assessment
Cariogram
• The Cariogram generates a graphical picture illustrating in an interactive way the
patient's risk for developing new dental caries lesions in the future .
Cariogram Statistical Weights

Previous Caries Experience (DMFT)- 0.358


Streptococcus mutans (S. mutans)- 0.302
Lactobacillus (LB)- 0.321
Plaque Index (PI)- 0.291 = ‫החלק‬
Diet – Meal Frequency- 0.252 ‫הירוק‬
Diet – Sugar Content- 0.220
Saliva Flow Rate-0.200
Saliva Buffer Capacity (pH)- 0.180
Fluoride Exposure- 0.150
Clinical Judgment- 0.250
Cariogram evidence-based

• 1st International Conference on the Declining prevalence of dental caries, Boston 1982
• Cariology 1983, Zurich
• Joint Working Group FDI/WHO 1985
• CDA National Conference on Dental caries decline 1985
• ORCA Satellite Symposium in Ljubljana 1990
• 2nd international Conference on Changing caries prevalence, London 1994
CAMBRA

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