DENTAL CARIES (Tooth Decay)

CURRENT UNDERSTANDING: Tooth decay is an infectious process. This process is caused by a bio-film composed of various bacteria and bacterial bio products that break down teeth. Once the teeth are significantly affected by this process, cavitation occurs, and may or may not be accompanied with pain. Once cavitation occurs the treatment to replace the infected tooth structure is restoration (filling, on-lay or crown), replacement of an existing restoration or extraction if the tooth cannot be restored.

TRADITIONAL OR SURGICAL APPROACH: Patient care focuses on restoring the teeth when they present with tooth decay. It addresses the effect of the problem, not the cause. When tooth decay has occurred this is a vital part of treatment care. However, the traditional method of treatment care does not address the risk factors that cause or contribute to the disease process of tooth decay. The preventive or medical approach addresses the underlying infection.

PREVENTIVE OR MEDICAL APPROACH: Patient care focuses on treating the infection prior to or concurrent with the restoration phase of treatment. This approach focuses on understanding patient risk factors that cause or contribute to the disease process. Risk assessment allows measurable steps to be taken to eradicate or greatly reduce the risk or recurrence of tooth decay.

THE PREVENTIVE APPROACH REQUIRES Patient COMMITMENT to:

• ACTIVE PARTICIPATION
• COMPLIANCE

DENTAL JOURNAL ARTICLES AND SUPPORTING STUDIES

CARIES MANAGEMENT BY RISK
ASSESSMENT – CONSENSUS STATEMENT
CDA JOURNAL, MARCH 2003, VOL. 33, NO. 3

SUMMARY: Dental caries (dental decay) is a continual balance, or imbalance, between pathological factors and protective factors. We must treat the disease rather than just the results of the disease, dealing with dental decay (caries) as a bacterially based transmissible infection, rather than simply drilling and filling cavities. This is the basis for the CAMBRA Assessment & Protocol treatment program.

The most current studies and articles related to CAMBRA protocol are available upon request