Preventive dentistry Seminar: CAMBRA
Ms.Paula Parise, USA
Preventive dentistry has historically focused its efforts on prevention of dental caries through interventions such as fluoride agents, pit and fissure sealants, dietary factors and biofilm control. While these efforts have been broadly supported by professional associations, the incidence and prevalence of dental caries continues to rise. Children continue to miss days from school because of dental infections. They continue to perform poorly in school because they cannot pay attention because of dental pain. Parents continue to leave work to tend to their child's appointment for dental extractions. Furthermore, dental patients continue to endure loss of tooth structure through cavity preparations for initial caries that can be treated less invasively. And, all too often, patients lose additional tooth structure when a previously restored tooth has to be treated for recurrent or secondary caries.
A model for caries management by risk assessment (CAMBRA) was created and validated by a host of stakeholders including dental and medical professionals, insurance companies, parents, teachers, and other health care professionals. The model shows promise in, not only preventing dental caries, but also in treating early carious lesions with techniques and preparations that can revolutionize preventive dentistry. CAMBRA focuses on the relationship of protective versus pathological factors involving protocols such as salivary measurement, bacterial challenge testing, the use of Xylitol and other agents, and the application of Diagnodent laser equipment.
Salivary testing is done to determine adequate flow of saliva. Saliva is an important factor in the caries process because of its buffering effect on oral microbes in addition to its ability to serve as a vehicle to circulate fluoride, calcium, phosphate and antimicrobial agents intraorally, thereby bathing the teeth with substances that can decrease microbial counts and/or remineralize weakened enamel. In conjunction with salivary testing, CAMBRA also employs caries bacterial challenge testing. From expressed saliva, cultured materials can determine the presence and counts of lactobacillus and streptococci mutans. Subsequently, protocols aimed directly at bacterial challenge findings can be applied to accurately address this risk factor. Xylitol chewing gum is another protocol recommended for patients with high cariogenic bacterial counts. Xylitol serves two purposes; one, to alter the way in which oral bacteria adheres to dental surfaces, and two, to increase saliva production and circulation in the mouth. Diagnodent takes the guesswork out of clinical detection of less than frank caries. It determines the progression of carious lesions beyond enamel. Protocols for treating caries within the bounds of enamel can be treated without loss of tooth structure that results from typical drilling and filling philosophies.
- Explain dental caries balance and role of pathologic and protective factors.
- Describe disease indicators and risk factors that determine levels of risk for dental caries.
- Discuss indication for remineralizing agents, antimicrobial therapy, buffering products, and calcium and phosphate products based on risk level.
- Discuss the team approach in applying CAMBRA in oral health care practice.
- Apply CAMBRA in a case study format.
- Integrate CAMBRA into your clinical practice setting.
- Knowing indications of using laser in dentistry
- Understand the tissue interaction
- Difference of laser types, wave lengths and application of each one
- Dental Hygienist
- Students, Nurse & Lab technician
20th April 2017 (17:00-20:00)
- Free for conference attendees