Patient caries risk assessment

Dental caries is an infectious process caused by bacteria that develop in the oral cavity.

The consequences of tooth decay are multiple and do not affect patients in the same way.

The most important manifestations of dental caries are the following:

  • Pain: a deep infectious process will reach the nerve endings of the pulp cells, generating pain quantified by a slight discomfort or even marked sensitivity, which interacts with the performance of daily activities.

  • Aesthetic damage: through lack of substance or dark stains, the patient is disturbed by the physiognomic appearance generated by the caries.

  • Food retention: during meals, food consumed may be retained in the cavities, causing discomfort and halitosis (unpleasant mouth odor).

  • Occlusal pathologies: dental caries alters normal occlusal relationships and these changes will be transmitted to the temporomandibular joint, the structure responsible for inter-arch balance and reception of masticatory shocks. Temporomandibular joint pain is quantified by pain, limitation of mouth opening or joint locks.

  • Impaired mastication and swallowing processes: embarrassment or pain will lead to insufficient chewing of food, which will end up in the stomach with increased size, affecting the digestion process.

Determining patients’ caries susceptibility means determining the individual’s risk of developing caries.

It is established in the first sessions by the dentist and is used to calculate how often the patient should be called for check-ups. The interval can vary from 3 to 12 months, depending on the patient’s predisposition to develop caries.

Caries risk can be largely influenced by the individual patient.

If they cooperate, by changing some habits, the caries risk can be significantly reduced.

Factors that can influence individual caries susceptibility

  • Diet: a high-sugar diet increases the incidence of caries by giving bacteria food to grow and colonize new tooth surfaces. The number of snacks between meals also plays an important role. It is good to know that saliva can neutralize the acidic effect of food 40 minutes after ingestion. Frequent snacking, before saliva has managed to counteract the acidity in the oral cavity, leads to an increased incidence of tooth decay.

  • The amount of dental plaque: represented by soft deposits that settle shortly after brushing, dental plaque is the scaffold on which bacteria will develop their pathogenic potential. Rigorous hygiene leads to less plaque.

  • Saliva: found in physiological consistency and quantity, saliva is an effective means of acid neutralization and self-cleaning of tooth surfaces. In certain general diseases that give xerostomia (dryness of the mucous membranes due to decreased saliva quantity), the incidence of cavities is increased.

  • Patient monitoring: the appearance of new carious processes at short intervals of time guides the dentist, who will classify the patient in a caries risk group, with a check-up every 3 months.

  • Stress, unbalanced lifestyle, chronic diseases or medication can have a destructive effect on the local cavity by altering the local immune response.

The co-operation between the patient and the dentist should be close, and the dentist should adopt treatments and prophylactic measures according to the caries risk of each patient.

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