SAN FRANCISCO, Preventive dental care often comes down to brushing and flossing, with dentists generally employed to find and treat cavities, but a recent study suggests more predictive treatment plans may help reduce cavities and other dental issues.
Researchers at the University of California San Francisco found the 17-item Caries Management by Risk Assessment, or CAMBRA, protocol helps dentists identify patients at higher risk to treat the causes of cavities before they become a health issue.
Dental caries, or cavities, are a form of oral disease caused by the action of bacteria breaking down the enamel of teeth and layers below it.
Many times, cavities do not cause pain unless bacteria has begun to affect the inside of the tooth or the tiny holes — the caries themselves — have caused a tooth to fracture. In children, the lack of pain means cavities can go unseen and untreated, leading to worse dental problems later in life.
Monitoring and controlling the cause of caries and tooth decay can help prevent their occurrence, with UCSF researchers finding the CAMBRA system helps dentists predict the patients at higher risk based on diet, frequency of snacking, access to fluoridated water and socioeconomic status, among other environmental and behavioral life factors linked to cavities.
“The traditional approach to dental caries for the last 100 years has been when a dentist sees a cavity to fill it and restore the tooth’s function, and that’s a critical aspect of what dentists should be doing,” Dr. Benjamin Chaffee, an assistant professor at the UCSF School of Dentistry, said in a press release. “But in and of itself, this approach doesn’t do anything to prevent the disease from occurring again. It treats the symptom — the consequences of disease — but it doesn’t get after the causes of the disease.”
For the study, published in the journal JDR Clinical and Translational Research, researchers analyzed dental records for 3,810 patients, creating predictive assessments based on the results of the 17-item CAMBRA form.
The assessments were then applied to a follow-up group of 1,315 patients ranging in age from 6 months to six years. Baseline risk was strongly associated with follow-up tooth decay — 20.4 percent of patients assessed to be at low risk, 30.6 percent of those at moderate risk and 68.7 percent of those at high or extreme risk later developed cavities.
“Risk assessment is predictive — it tells you what kinds of outcomes are going to occur in a patient population,” Chaffee said. “Together with other studies, our work has shown that providers are willing and able to use CAMBRA accurately, that it doesn’t take a lot of time to do it and that it is effective.”