Coursera - Caries Management by Risk Assessment (CAMBRA)

Dental Caries (tooth decay) is a bacterially based disease that progresses when acid produced by bacterial action on dietary fermentable carbohydrates travels into the tooth and dissolves the carbonated hydroxyapatite mineral. This process is called demineralization.

Pathological factors, including acidogenic bacteria, salivary dysfunction, and dietary carbohydrates are related to caries progression. Protective factors, which include antibacterials, salivary calcium, phosphate and proteins, salivary flow, and fluoride in saliva can balance, prevent or reverse dental caries through a process of remineralization. Remineralization is a natural and reliable repair mechanism for non-cavitated carious lesions.

This course will provide the scientific basis behind the “caries balance” concept, which is the key to caries management by risk assessment in clinical practice. If pathological factors prevail caries progresses. If protective factors prevail the caries process is halted or reversed.

The course will present tools to implement CAMBRA, “caries management by risk assessment,” in your clinical setting. It can be in implemented medical and dental settings, and can benefit children and adults of all ages. Implementation in dental practice provides patients with genuine hope and success for the management of their oral health. It is a practice builder for dentistry.

Syllabus

Week 1:
Understand what dental caries is
Understand the concept of the caries balance
Know the three principal pathological factors of caries formation
Understand that multiple bacterial species are responsible for dental caries
Understand the role of frequent ingestion of fermentable carbohydrates in dental caries
Recognize hyposalivation, how this occurs, and its importance in caries progression

Week 2:
Refine the concept of the caries balance
Know and understand the multiple caries protective components in saliva
Understand demineralization and the role of fluoride
Understand remineralization and the role of fluoride

Week 3:
Understand remineralization and the role of fluoride
Understand how fluoride interacts with cariogenic bacteria
Know the three main mechanisms of action of fluoride
Know about fluoride toothpastes and fluoride mouthrinses

Week 4:
Know about fluoride products for the dental office and for home use by prescription
Know why high concentration fluoride products are used for high caries risk individuals
Know the antibacterial products currently available for caries control
Understand the root caries process including similarities and differences with coronal caries

Week 5:
Understand the distinction among disease indicators, pathological (biological risk) factors, and protective factors
Know that the CAMBRA risk assessment method is validated in clinical use in thousands of patients for 6 years through adult
Know the bacterial assessment methods
Understand the sequence for the entire CAMBRA method

Week 6:
Know how to assess caries risk for an individual as low, moderate, high, or extreme
Know the currently recommended chemical therapy for patients at low, moderate, high, or extreme risk
To study numerous examples of risk assessment and therapy and how to build this into the treatment plan
Understand the differences between risk assessment for young children, older children, and adults

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