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Tooth Decay — How To Assess Your Risk

Don’t Wait For Cavities — Stop Them Before They Start!

By Dr. V. Kim Kutsch and Dr. Douglas A. Young

This article is endorsed by the
American Academy of Cosmetic Dentistry.


New Tools Of The Trade

This process is precisely what we are doing in dentistry today with the Caries Management by Risk Assessment (CAMBRA) approach. Modern dentistry can now evaluate risk factors for dental caries and use them to make preventive recommendations. Not everyone has the same risk level for developing dental caries, which is further complicated by the fact that risk is dynamic and changes daily, as well as over longer periods of time.

Prevention includes determining both pathogenic and protective factors — both sides of the balance, and the factors that tip the balance. Some of these include Disease Indicators and Risk Factors that lead to imbalance and Protective Factors that shift the balance toward health. These entities are measurable and quantifiable but more importantly, they can be modified leading to predictable disease prevention.

Accurate determination of risk is greatly aided when your dental professional uses a caries risk assessment form to ask you specific, scientifically validated questions to help pinpoint imbalances. Your dentist may use two types of forms, one for children between the ages of 0-5 and the other for everyone (including adults) over the age of 6.

Tooth decay risk assessment evaluation form.
Risk assessment forms allow dentists a simple way to determine your potential for future tooth decay. Evaluating disease indicators of past behavior is often the most accurate and best indicator of future disease.

Disease Indicators

Disease Indicators work by showing you what could happen based on what has happened. Identifying them includes the use of modern dentistry’s most sophisticated tools for early diagnosis of decay. They include:

  • Visible cavities (decay) that is visible in teeth ranging from very early (microscopic) detection using, for example, laser technology, to cavities that are visible to the naked eye.
  • X-ray pictures show early decay that is visible by using today’s highly sensitive yet low dosage x-rays.
  • White spot lesions are the first sign of decay in the contacting areas of adjacent teeth that are often reversible with fluorides.
  • Cavities within the last 3 years — any previous cavities add to your risk.