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Lesson 2: Caries Risk Assessment
Risk assessment is a technique used in health care to identify and to classify a patient according to his or her risk for developing a particular disease. It is used to customize treatment and prevention according to individual need. In addition, risk assessment is an integral part in determining the most efficient allocation of resources during this time of increasing health care costs. Caries risk assessment is used to identify and to classify dental patients according to risk for developing dental caries ("cavities"). Since patients have varying degrees of susceptibility to developing caries, it follows that not all patients should be treated alike. Caries risk assessment is recognized by national and international dental organizations as representing one aspect of the community standard of care practiced in dental clinics and private offices throughout the U.S. and in other industrialized countries.
The information in this lesson explores the following topics:
Background
Do you
think of caries as an infection, like other bacterial diseases that can be
passed from one person to another?
Ø
Epidemiology Is caries a problem for everyone?
“During the past two decades,
caries prevalence
has decreased significantly among children
and young adults in most industrialized
countries, while the prevalence
has increased in most developing
countries”
The WHO has declared the decrease in caries prevalence as one of the greatest public health successes in industrialized countries.
What is responsible for the success?
ü*Increased oral hygiene ü*Fluoride toothpaste ü*Fluoridated water ü*Nutritional counseling *üSchool-based preventive programs
Even though the overall prevalence of dental caries in the U.S. has decreased, certain segments of the population still suffer from the disease. Who's still getting cavities? Children Geriatric patients Patients with systemic disease
Exploration Phase Dental caries: Etiology and Contributing Factors
What causes caries?
1) The formation of dental caries is influenced by many factors. List as many factors as you can, and group them into 2 – 3 categories.
2) What name would you give to each category?
Models for the Treatment of Dental Caries
A surgical model for the treatment of any disease implies that surgery, or "cutting it out" is the primary method for treating the disease. A surgical model in dentistry implies that restoring the carious lesion (“cutting it out”), and the placement of a dental restoration ("filling") is the treatment of choice. A medical model, instead, addresses the cause and the contributing factors that might lead to disease.
3) Based on the categories of factors that you idenitified above, try writing a sentence that could be a definition for a medical model for the treatment of dental caries.
Based on the above exploration, consider the following questions:
Application Phase Caries Risk Assessment
4) All people don’t experience caries at the same rate. Based on the medical model that you defined above, try writing some parameters for how a patient might be identified and then categorized according to risk.
Philosophy of Treatment
5) Based on the medical model, what are some treatment strategies, in addition to restorations, that might be employed to prevent future caries in a high-risk patient?
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