Caries risk assessment Prof MUDr. Martina Kukletová Caries risk assessment Prof. MUDr.Kukletová Martina Stomatological clinic Caries risk assessment factors Clinical Social and behavioural Developmental decalcification considerable plaque Irregular attendance Multiple sugar intakes Irregular attendance Mother has high caries rate Appropriate for age?? Symmetrical lesions Teeth recently erupted. Teeth are at increased caries risk in the first year post eruption hypomineralized or hypoplastic teeth primary dentition crowding No fluoride/irregular brushing prolonged breast feeding after tooth eruption salivary factors bottle-feeding during the night ECC Frequent appearance Very small children Reason of visit: dental caries complications Examination Dental plaque Destruction of teeth by the dental caries More in the upper jaws , less in the lower jaws Medical History Prolonged brest-feeding Sweet drink during the day and nights in suckling age Baby bottle in hand of the child Sweet drinks on nights in the suckling age. Medical History Baby bottle after one year or drinking with a straw from cartoons Information of mothers – 80% is informed about relation between sugar and dental caries Finding Microbial dental plaque of affected teeth Finding After plaque removal –large erosions ,penetration into the enamel Finding Dental plaque in transsmission E.M Finding Transfer of infection to the permanent dentition Conclusion Early childhood caries (ECC), is a serious situation Course is different Fast and large affection of tooth Consequence of poor oral hygiene,and inproper diet Function of saliva ECC(threatens child pain Problem with food intake Heathy development Inflammatory complications Perimandibular-permaxillary inflammation Treatment under general anaesthesia –health risks Focal infection Permenant tooth buds Premature loss of primary tooth Loss of space for permenant teeth Loss selfconfidence (esthetics) Negative attitude to dental treatment Transfer of cariogenic microflora to the permenant teeth Caries risk assessment for 0 – 5 year olds Factors High risk Moderate risk Low risk Biological Mother has active caries Parents/low socioec. status Child has more than 3 inbetween sugar containing snack/beverages In bed in a bottle/sugar child has special health care needs Child is recent imigrant Yes Yes Yes Yes Yes yes Protecting Optimally fluoridated water or F supplement Brushing daily with fluoride cont. tooth paste topical fluoride from health professional home/regular dental care Yes Yes Yes Yes Caries risk assessment for 0 – 5 year olds Factors High risk Moderate risk Low risk Clinical findings child has more then1dmft surfaces with active white spot lesions elevated mutans streptococci levels plaque on teeth Yes Yes Yes Caries risk assessment for 6 and more years olds Factors High risk Moderate risk Low risk Biological Patients/low socioec. status Patient has more than 3 inbetween sugar containing snack/beverages Patient has special health care needs Patient is recent imigrant Yes Yes Yes yes Protecting Optimally fluoridated water or F supplement Brushing daily with fluoride cont. tooth paste topical fluoride from health professional Additional home measures (Xylitol) Yes Yes Yes Yes Caries risk assessment for 6 and more years olds Factors High risk Moderate risk Low risk Clinical findings Patient has more than 1 interproximal lesions active white spot lesions Low salivary flow Defective restorations Intraoral appliance Yes Yes Yes Yes Yes