Caries Process and Prevention Strategies: Risk Assessment
Overview

What is the point of undertaking risk assessment for a patient? Isn’t everyone who has natural teeth at risk of dental caries?

Dental Caries is a preventable disease. For years it has been treated, after cavitation had occurred by restorative means. Typically, the patient returned later with new lesions and required more restorations. Rather than dealing with all patients in the same way, the process of risk assessment can help identify those patients who are at high risk of developing caries, and those who are at low risk. In making this differentiation, preventive efforts can be focused on the high-risk group, so that their risk is reduced and caries reduced or avoided altogether. Having identified the risk factor in the high-risk group, a treatment plan can be designed to reduce the risk factors, such as dietary modification, use of additional fluoride agents, etc. The high-risk group should be recalled more frequently.

The low-risk group still has some risks, and they should be recalled and examined at appropriate intervals to make sure their risk is not increasing.

Which are the strongest indicators of risk?

• Active disease, new lesions in the patient.
• Active disease, new lesions in other family members.
• Frequent sugar intake.
• Irregular oral hygiene and infrequent use of fluoride toothpaste.
• Poor quantity or quality of saliva.
• Age (very young, or very old).
• Presence of restored teeth, or teeth having been extracted due to caries.