Cambra

1. Caries Management by Risk Assessment (CAMBRA) Jaclyn J. A29 1

2. Criteria-Low Risk no dental caries within last 3 years or today Minimal or no visible plaque Sealants or shallow pits & fissures Usually has regular dental care Often lives in a fluoridated environment or uses one or more fluoride containing products . 2 Low Risk

3. 3 Fluoridated toothpaste twice daily OPTIONAL professional fluoride applications BWX every 2-3 years Low Risk: Treatment

4. Criteria-Moderate Risk visible HEAVY plaque on teeth Frequent snacking > 3x daily between meals Deep pits & Fissures Exposed Roots Mild to moderate xerostomia From meds, radiation, systemic Orthodontic appliances Recreational drug use 4 Moderate Risk

5. Moderate Risk: Treatment 5 Dental Office Fluoride Varnish: Initial 1-2 applications Additional applications at maintenance appointments Fluoride toothpaste twice daily 0.05% NaF mouth rinses Xylitol (6-10g/day) of gum or candies Optional calcium phosphate paste If excessive root exposure dent inal sensitivity Salivary tests are OPTIONAL . BWX: 18-24 Months

6. Criteria-High Risk Visible cavities Radiographic caries Radiographic penetration of the dentin advanced or severe lesion from any position of the tooth (occlusal or interproximal) Radiographic interproximal enamel lesions (moderate) White spots lesions on smooth surfaces Restorations in the last 3 years 6 High Risk

7. High Risk: Treatment 7 Prescription 1.1% NaF toothpaste twice daily Also apply at night, expectorate after 1 min, don’t rinse, go to bed. Fluoride varnish applications at 3-month intervals Salivary tests recommended BWX: 6-18 Months

8. Criteria-EXTREME Risk Severe salivary gland hypofunction (salivary rate less than 0.5 ml per minute) Visible cavities Radiographic lesions Radiographic penetration of the dentin (advanced or severe lesion) from any position of the tooth (occlusal or interproximal) Radiographic interproximal enamel lesions (moderate) White spots on smooth surfaces Restorations in the last 3 years 8 Extreme Risk

9. Extreme Risk: Treatment 9 Prescription 1.1% NaF toothpaste twice daily Fluoride varnish applications at 3-month intervals Bacterial and salivary tests recommended Baking soda rinses, 0.5% NaF rinses , BWX Every 6 Months

10. CAMBRA – Therapeutic Product Guide 10