03_Part_2-_Our_Patients_Revisited_B_17-17.pdf

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Caries Management by Risk
Assessment
(CAMBRA)
:
Week 6 – Part 2
Our Patients Revisited - B
Moderate Caries Risk - Charles Gomez?
60
year old male
Root canal 6 years ago. No
new caries by exam
No symptoms of salivary
dysfunction
One medication has
potential dry mouth side
effects
Not a frequent snacker
Exposed root surfaces
Bacteria?
2X F toothpaste daily
The Caries Balance –
Moderate Risk
Disease Indicators and
Pathological Factors
•
Root canal 6 years ago
•
Acid-producing bacteria?
•One
hyposalivatory medication
•60
years old - Exposed roots
Protective Factors
•
Saliva flow and components
normal – no hyposalivation
•
2 X F toothpaste daily
•
Antibacterials: None
Caries
No Caries
Featherstone, Community Dent Oral Epidem, 1999
Caries Risk
Assessment Form
Featherstone
et
al, CDAJ, 2007
Circle
Yes’s
Visualize
the
Balance
Decide
on
caries risk level:
Low, Moderate,
High, Extreme
Moderate Risk
Bacteria
Risk Antimicrobials Test
Level
(CRT
test)
Saliva
Flow
May be
done as a
Moderate
Not indicated baseline
Risk
reference
for new
patients
or if
there is
suspicion
of high
bacterial
challenge
Frequency
Fluoride Frequency of
of
Periodic
Radiographs
Oral
Exams
(POE)
Bitewing
Every 12
OTC
radiographs months to
fluoride- every 12-18 reevaluate
containing months
caries
toothpaste
risk.
twice
daily +
Fluoride
rinse:
(0.05%
NaF)
daily. Or
5,000 ppm
F
Xylitol
and/or Sealants
Baking
Soda
Xylitol
gum
or
mints.
Two
sticks
of gum
or two
mints
four
times
daily.
Sealants
for deep
pits and
fissures

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