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3M ESPE Preventive Measures Oral Health Risk Assessment and Management

Preventive Measures

Oral Health Risk Assessment and Management

Taking preventive measures to protect tomorrow's smiles

Overview

The Preventive Measures Program has been developed to combine several dental professional risk analysis programs into one easy-to-follow system that can easily be introduced into daily practice. This site highlights key aspects of Preventive Measures program in regards to caries and periodontal disease risk assessment and treatment.

The information included in the Preventive Measures program is intended to provide an overview of the currently accepted guidelines and is not intended to replace clinical judgment regarding individual patient circumstances.

Comprehensive Care for Better Oral Health

Achieving or maintaining a healthy smile requires a comprehensive program of professional treatment and patient compliance with home care therapy.

Increasingly, dental offices have been instituting more formal risk assessment programs to:

  • assign patients into recognized risk categories
  • identify treatment options and therapies to achieve and maintain proper oral health

Patients appreciate a comprehensive approach

Dental professionals frequently tell us that the lack of patient understanding, acceptance of treatment options and compliance with maintenance therapies are the biggest obstacles they face in helping patients achieve or maintain good oral health.

Practices that have been most successful often tell us that they began to see better results when the adjusted their approach to include:

  • telling patients that caries, gingivitis and periodontitis are diseases that can be prevented and treated
  • discussing the causes that contribute to these diseases to improve patient understanding
  • advising patients that treatment success is greatly dependent on their involvement and compliance with treatment recommendations
  • providing home care medications in the office to reinforce the importance of these therapies
3M ESPE Preventive Measures Oral Health Risk Assessment and Management

Assessing risk and identifying clinical protocols

Determining whether a patient is at low, medium or high risk for caries or periodontal disease is the first step in implementing a formal risk assessment program. It begins by identifying the various environmental and clinical factors that can affect their oral health including oral hygiene habits, dietary habits, medical conditions, and drug and tobacco use.

A valuable tool for determining patient risk factors is to have the patient complete a questionnaire about their oral health and habits. (PDF, 518KB) This information, in combination with the clinical examination, will help assign a risk level to the patient.

Once the patient risk level is determined, protocols can be implemented to achieve or maintain optimal oral health.

Caries Risk & Management

The American Dental Association (ADA) has published guidelines for assessing caries and managing patients at various risk levels. A panel of national experts also published a set of guidelines in the Journal of the California Dental Association referred to as Caries Management by Risk Assessment (CAMBRA). The following has been summarized from these guidelines to provide you with a brief overview for assessing caries risk.

Visit www.ada.org and www.cdafoundation.org/journal to review the full reports and various tools available from these organizations.

Caries Risk Factors

Low risk:

  • no carious lesions in 36 months
  • adequate home care and fluoride exposure
  • infrequent meals
  • no orthodontic appliances
  • no dry mouth

Moderate risk:

  • one or two lesions in 36 months
  • ineffective plaque removal
  • interproximal restorations present
  • exposed roots may or may not be present
  • orthodontic appliances
  • dry mouth

High risk:

  • 3 or more lesions in 36 months
  • missing teeth due to decay
  • visible plaque
  • exposed root surfaces
  • overhangs or open margins on restorations
  • dry mouth
  • poor oral hygiene

Caries Management

The following has been summarized from American Dental Association (ADA) and CaMBRA published guidelines to provide you with an overview for managing caries risk.

Low risk patients:

  • prophylaxis treatment followed by fluoride application
  • sealants as needed

Moderate and high risk patients:

  • prophylaxis treatment followed by fluoride application
  • oral hygiene instruction
  • restore as needed
  • sealants as needed
  • provide home treatment or other adjunctive therapy
  • moderate risk recall 4-6 months
  • High risk recall 3-4 months

Reference

3M ESPE Preventive Measures oral Health Risk Assessment and Management Guide Book (PDF, 1.8MB)

Caries Management by Risk Assessment (CaMBRA)

American Dental Association

International Caries and Assessment System (ICDAS)

Periodontal Disease Risk & Management

The goal of a periodontal therapy and maintenance program is to preserve the dentition, while maintaining health, comfort, esthetics and function for the patient. No one treatment can provide the single best outcome, so several different options may be chosen for different cases or time periods in treatment plans (J Periodontal 2001; 72:1624,1628)

Periodontal Disease Risk Factors

Low risk:

  • pocket depths of 3-4mm or less and no calculus
  • few risk factors such as dry mouth, tobacco use, plaque index, uncontrolled diabetes, oral hygiene habits and irregular anatomy (crowding)

Moderate risk:

  • gingivitis to pocket depths of 4-6mm & limited calculus
  • tobacco use, poor oral hygiene habits, specific periodontal pathogens, diabetes mellitus, faulty dental restorations, irregular anatomy

High risk:

  • pocket depths of 6+mm & limited calculus
  • tobacco use, poor oral hygiene habits, specific periodontal pathogens, diabetes mellitus, faulty dental restorations, irregular anatomy
A more complex risk assessment calculator, for use by dental professionals, can be accessed at www.geocities.com/viswa_chandra/Risk_assessment_model.xls

Periodontal Disease Management

The first step in treating periodontal disease is to tell the patient that they have an infection in their mouth. Determining actual treatment plans, including whether a patient should be referred to a specialist, is dependent on your clinical judgment.

The guidelines below can assist you in developing appropriate protocols to achieve optimal results for at-risk patients. To review complete guidelines developed by the American Academy of Periodontology, please visit www.perio.org.

Treatment:

  • removal of subgingival and supragingival plaque and calculus
  • oral hygiene instruction and counseling on control of risk factors such as smoking and stress
  • selective scaling or root planing, if indicated
  • occusal adjustment, if indicated
  • use of systemic antibiotics and local antimicrobial agents
  • root desensitization, if indicated
  • surgical therapy, if indicated

Scheduling:

  • recall visits at 4-6 month intervals for moderate risk
  • recall visits at 3-4 month intervals for high risk

Reference

3M ESPE Preventive Measures oral Health Risk Assessment and Management Guide Book (PDF, 1.8MB)

American Academy of Periodontology

Treatment Product Guide

Preventive Measures Treatment Guide

3M ESPE offers numerous products to help implement your caries and periodontal disease treatment plans, many of which are highlighted below.

In-Office

Remove Plaque/Calculus

Protect

Treat

Clinpro™ Prophy Paste with Fluoride

Clinpro™ Prophy Paste with Fluoride

Clinpro™ Prophy Angles

Clinpro™ Prophy Angles

Clinpro™ Sealant
Pit & Fissure Sealant

Clinpro™ Sealant

Vanish™ XT Extended Contact Varnish

Vanish™ XT Extended Contact Varnish

Vanish™ 5% Sodium FluorideWhite Varnish

Vanish™ 5% Sodium FluorideWhite Varnish

CavityShield™
5% Sodium Fluoride Varnish

CavityShield™

Home Maintenance

Fluoride Toothpaste

Fluoride Rinse

Fluoride Brush-On Gel

Chlorhexidine
Gluconate

Clinpro™ 5000 1.1% Sodium Anti-Cavity Fluoride Toothpaste

Clinpro™ 5000 1.1% Sodium Anti-Cavity Fluoride Toothpaste

PerioMed™ 0.63% Stannous Fluoride Oral Rinse

PerioMed™ 0.63% Stannous Fluoride Oral Rinse

Just for Kids™ 0.4% Stannous Fluoride Brush-On Gel

Just for Kids™ 0.4% Stannous Fluoride Brush-On Gel

Peridex™ Chlorhexidine Gluconate 0.12% Oral Rinse

Peridex™ Chlorhexidine Gluconate 0.12% Oral Rinse

Adjunctive

TheraMints™ 100% Xylitol Sweetened Mints

TheraMints™ 100% Xylitol Sweetened Mints

White & Brite™ Tooth Whitening System

White & Brite™ Tooth Whitening System

For additional information, call 3M ESPE Customer Care at 1-800-634-2249.

To order
Contact your authorized 3M ESPE dental distributor.

Materials & Resources

Preventive Care


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