CAMBRA is an acronym for Caries Management by Risk Assessment. Caries is a dental term for disease risk that results in teeth cavities.
This form of preventive Dentistry allows us to categorise patients by their relative risk of developing dental caries and treating accordingly. This allows us to look at Patients as a whole and identify what factors are contributing to the patient’s caries risk. We can then devise a tailored and patient specific plan to prevent caries and reduce the need for fillings and encourage a lifelong positive experience for the patient.
Oral Hygiene: The effective removal of dental plaque is the first very important step in reducing the risk of caries. The effectiveness of the patient’s home care will be assessed using an in surgery disclosing solution which is a very effective visual tool to educate patients and carers of younger patients. Factors to consider for advising on home care would be dexterity and access, and for young children co-operation or compliance with twice daily floss and brushing.
Diet: Dental caries is caused by the action of acids on the enamel surface of teeth. This acid is produced when sugars (mainly sucrose) found in food and drinks react with the bacteria found in dental plaque.
A careful and through assessment of patient’s dietary habits should be recorded. This can be completed by the patient over a three day period to include one weekend day. All foods and drinks are recorded with the times of consumption. Discussion about alternative foods and identify risk foods and drinks follows. Patients learn that caries is driven by sugar frequency and not amount and make changes accordingly.
Identifying both the above risk factors will go a long way to giving the patient the information and tools they need to maintain a healthy caries free detention.
Anatomy: It’s is also important to identify the anatomical features in patient’s teeth that put them at greater risk of caries. These include deep occlusal pits and fissures and deep pits on palatal and buccal surfaces of posterior teeth (inside and outside surface of back teeth). Where fissures are deep and thorough removal of plaque by the patient is impossible, this will put the tooth at a much greater risk of decay. Under these circumstances fissure sealants will be placed to seal the deep fissure and help prevent caries and the need for an invasive filling down the track.