1. Caries risk assessment
By: Dr. Amany Moussa

2. Definition of Dental Caries
Is a chronic ,transmissible mal-nutrition disease.
Caries clinically manifested by three microbial events:
1-primary infection by S.Mutans.
2-formation of complex biofilm (dental plaque).
3-demeralization of enamel &cavitation.

3. Risk factors of Dental caries
1- diet &nutrition:
-cariogenic diet as freely fermentable carbohydrates
-malnutrition during period of teeth development.
2- age:
-the highest peak is at age 4-8 years.
years (pit &fissures).
years (proximal caries).
yeaars (root caries).

4. 4-emotional disturbances:
3- gender:
Females have a higher incidence than males
4-emotional disturbances:
Stress was found to be associated with high caries incidence.
5- role of microorganisms:
Streptococcus Mutans is the main microorganisms that is responsible for caries initiation.

5. Definition of Caries Risk Assessment
It is a qualitative and quantitative procedure to predict future caries development and introduce appropriate measures before the clinical onset of irreversible lesions of the disease.

6. Aim
Is to predict whether the disease is likely to develop in caries-free individual.
To determine the rate of progression in a patient who already has some caries experience .
To create a specific model for treatment of cases which are suitable for each case.
To direct effort and money to those that are in need for prevention.

7. Important Terms
Risk: defined as the probability that an unwanted or even a harmful event will occur.
Caries susceptibility: it is the possibility to develop caries in a caries producing environment.
Caries activity: is a measure of the speed of progression of a carious lesion.
Caries activity test: it is our tool to estimate the actual state of disease activity (progression or regression).

8. Levels of prevention
Primary
Secondary
Tertiary

9. caries prevention Primary prevention:
It means stop occurrence of the dental caries
By:
1- plaque control which essentially is the instruction of proper home care for the mechanical removal of the plaque.
2- use of fluorides either systemic or local to increase the resistance of the tooth towards decay.
Prevention of initiation of the disease-implement program –procedures &measures to prevent the disease as fluoridation the community drinking water –application of topical fluorides, tooth brushing , flossing, diet control, sealent application

10. 3-Dietary control through limitation of frequent intake of sucrose & other food stuffs which enable micro-organism to grow
4- use of sealants which act as a plastic like mechanical barrier on occlusal surfaces of teeth to prevent caries

11. Secondary prevention:
is the prevention of progression &recurrence of the caries process
through
Remineralization , the use of certain dental compounds which will help the dentin to remineralize
Operative dentistry techniques to remove the caries
Pulp capping procedures
Removal of initial stages of the disease

12. Tertiary prevention: That is to prevent total loss of function
Extensive prevention & intervention to replace some or all of the teeth in indentation

13. Services provided by the dental professional
Primary
Provision of oral hygiene aids; patient education
Plaque control
Program recall reinforcement
Topical fluoride application
Correction of tooth mal-alignment prophylaxis
Preventive orthodontics

14. Secondary Periodic examination Attention to developmental defects
Prompt treatment of incipient lesions
Scaling and curettage
Corrective restorative and orthodontic treatment
Treatment of well developed lesions
Pulp capping
Root canal therapy
Deep curettage
Root planning
Extractions

15. Services provided by the dental professional
Tertiary
Replacement of tooth structure by appliances (removable or fixed prosthodontics)
Services provided by the dental professional

16. Preventive level Primary Secondary Tertiary Health promotion
Specific protection
Secondary
Early diagnosis
Prompt treatment
Tertiary
Disability limitation
Rehabilitation

17. Services provided by the individual
Primary
Periodic visits to dental office
Demand for preventive services
Oral hygiene measures
Avoidance of sticky food, particularly between meals.
Secondary
Self-examination and referral ;use of dental services
Periodic screening and referral
Tertiary
Disability limitation
Provision of dental services
Use of dental services

18. Services provided by community
Primary
Dental health education programs.
Promotion of research efforts.
Dental prophylaxis.
Supervised school brushing programs
Fluoridation of public water
Secondary
Provision of dental services