CAMBRA

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CAMBRA is an acronym for Caries Management by Risk Assessment. It describes a preventative form of dentistry in which patients are categorized by their relative risk for developing dental caries, based on risk factors including diet, oral hygiene, fluoride regiment, and past oral health history.

The CAMBRA system was developed as an evidence-based approach to the prevention, reversal, and treatment of patients with dental caries. The emphasis is on the whole disease process and employs the caries balance method, taking account of all factors that contribute to the development of dental caries (attacking factors) and all factors that research has shown to be protective from dental caries (defense factors). The assessment of this balance not only helps establish risk but suggests the correct strategies to prevent or reverse the process. The CAMBRA system provides a more in-depth assessment tool as a key element of the overall approach and takes account of: Caries disease indicators: Socio-economic status, developmental problems, and presence of lesions or restorations placed within the previous 3 years. Caries risk factors: Visible accumulations of plaque and quantitative assessment of Streptococcus mutans and Lactobacilli, frequent snacking, saliva flow and salivary modifying factors, fissure anatomy, root surface exposure, and the presence of appliances. Caries protective factors: Systemic and topical fluoride sources, adequate saliva flow, xylitol in the diet, use of calcium and phosphate paste or chlorhexidine. Clinical examination: Presence of white spots, decalcifications, restorations, plaque deposits. The tool assigns patients to low, moderate, high, or extreme risk and offers two formats, one for patients aged 0-5 years, and one for 6 years onward. A key benefit of CAMBRA is that it forces both the dental professional and the patient (or their caregiver) to consider all the factors relevant to the patient’s risk and disease state, shifting the focus away from the traditional restorative approach of cavitation and restoration toward the cause of the disease and the need to modify the causes wherever possible. It also allows for greater communication and understanding between all members of the dental team.

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Dental sealants are a dental treatment intended to prevent tooth decay. Teeth have recesses on their biting surfaces; the back teeth have fissures (grooves) and some front teeth have cingulum pits. It is these pits and fissures which are most vulnerable to tooth decay because food and bacteria stick in them and because they are hard-to-clean areas. Dental sealants are materials placed in these pits and fissures to fill them in, creating a smooth surface which is easy to clean. Dental sealants are mainly used in children who are at higher risk of tooth decay, and are usually placed as soon as the adult molar teeth come through.

Abrasion (dental) loss of tooth substance by mechanical contact with objects other than tooth-tooth contact

Abrasion is the non-carious, mechanical wears of tooth from interaction with objects other than tooth-tooth contact. It most commonly affects the premolars and canines, usually along the cervical margins. Based on clinical surveys, studies have shown that abrasion is the most common but not the sole aetiological factor for development of non-carious cervical lesions (NCCL) and is most frequently caused by incorrect toothbrushing technique.

<i>Streptococcus mutans</i> species of bacterium

Streptococcus mutans is a facultatively anaerobic, gram-positive coccus commonly found in the human oral cavity and is a significant contributor to tooth decay. It is part of the "streptococci", an informal general name for all species in the genus Streptococcus.The microbe was first described by J Kilian Clarke in 1924.

Fluoride therapy therapy

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Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

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Early childhood caries

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Tooth polishing Tooth polishing is the smoothing of all exposed tooth surface with a rubber cap, a brush or air polish by slow speed handpiece or water unit.

Tooth polishing is done to smooth the surfaces of teeth and restorations. The purpose of polishing is to remove extrinsic stains, remove dental plaque accumulation, increase aesthetics and to reduce corrosion of metallic restorations. Tooth polishing has little therapeutic value and is usually done as a cosmetic procedure after debridement and before fluoride application. Common practice is to use a prophy cup—a small motorized rubber cup—along with an abrasive polishing compound.

Oral hygiene Cleaning the mouth by brushing the teeth and cleaning in between the teeth.

Oral hygiene is the practice of keeping one's mouth clean and free of disease and other problems by regular brushing of the teeth and cleaning between the teeth. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.

Fluoride varnish

Fluoride varnish is a highly concentrated form of fluoride which is applied to the tooth's surface, by a dentist, dental hygienist or other health care professional, as a type of topical fluoride therapy. It is not a permanent varnish but due to its adherent nature it is able to stay in contact with the tooth surface for several hours. It may be applied to the enamel, dentine or cementum of the tooth and can be used to help prevent decay, remineralise the tooth surface and to treat dentine hypersensitivity. There are more than 30 fluoride-containing varnish products on the market today, and they have varying compositions and delivery systems. These compositional differences lead to widely variable pharmacokinetics, the effects of which remain largely untested clinically.

Remineralisation of teeth overview about the remineralisation of teeth

Tooth remineralisation is the natural repair process for non-cavitated tooth lesions, in which calcium, phosphate and sometimes fluoride ions are deposited into crystal voids in demineralised enamel. Remineralisation can contribute towards restoring strength and function within tooth structure.

Gingivitis Human disease

Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that is attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

Cariogram is a way to illustrate interactions between caries related factors. It demonstrates the caries risk graphically and shows the risk for developing new caries in the future and also chances to avoid new caries in the near future. It helps to understand the multifactorial aspects of dental caries. It can be used as a guide in attempts to estimate caries risk.

Dentistry for babies

Dentistry for babies is a branch of Pediatric dentistry related to the dental treatment provided to children from birth to around 36 months of age, aiming to maintain or re-establish a good oral health status, at the same time as it creates a positive attitude of parents and children about Dentistry. Although concerns about dental treatment directed to babies have been reported at the beginning of the twentieth century, only recently the dental community started to focus on this area of Dentistry, due to the high dental caries (decay) prevalence observed in young children. The first setting for providing dental care exclusively to babies started in 1986, at Londrina's State University (Brazil), changing the concept from early treatment of carious lesions and their consequences to early educative-preventive attention. These concepts were disseminated through the entire country introducing new clinics with a similar philosophy such as the Baby Clinic of Araçatuba Dental School, São Paulo State University (UNESP), and also abroad.

Plaque hypotheses are theories to explain the role of plaque bacteria in dental caries and in periodontitis. They rely heavily on the postulates of Koch and on the work of Louis Pasteur (1822-1895). Changing perceptions have altered treatment models.

Challacombe scale Medical scale measuring mouth dryness

The Challacombe scale is a widely used diagnostic medical tool designed to produce a clinical oral dryness score (CODS) which quantifies the extent of dryness of the mouth, with the aim of making a decision of whether to treat or not, and to monitor its progression or regression.

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