How to Assess Your Tooth Decay Risk

Tooth decay is quite a common affliction in modern society, for which many persons have lost teeth or have had to have them filled. Other forms of salvage techniques have had to be used to try to save teeth, like implants and crowns.

Over the years it has become clearer that rather than treating the symptoms of the underlying problem it is more beneficial for the patient, as well as more effective, to address the causes. This has resulted in the development of risk assessment for individual patients since each patient is affected by a different set of factors.

This tailor made approach helps to improve the lives of each patient and promotes healthier oral hygiene and an overall healthier lifestyle. This is a preventive and proactive approach, which seeks to stem the problem.

What Is Involved In Individual Tooth Decay Risk Assessment?


It is interesting to note that two individuals who may have similar lifestyles and habits are present with different risk levels for tooth decay. This is because each person’s personal physiology is different, and there are factors which may keep changing.

As a result, some people are more prone to tooth decay than others. On an individual level, it becomes necessary to try to identify these changing variables to be able to achieve a balance which will result in greater oral protection. The approach named CAMBRA, which stands for Caries Management by Risk Assessment can be explained in this way.

“The degree of risk is based on the balance between the bad factors, which create higher risk for tooth decay and the safe factors, which are protective. This balance is known as the Caries Balance. To know what the factors are which increase the risk of tooth decay, the acronym BAD is used, which stands for,

Bad acid producing bacteria,

Absence of healthy saliva to neutralize acids and

Dietary habits filled with snacking, sugars and acids

The factors which protect from risk are denoted by the acronym SAFE, which stands for saliva and Sealants for tooth surface protection

Antimicrobials to reduce bad bacteria in the mouth

Fluoride for strong teeth, and

Effective dieting

The dentist will then use a series of specific questions to assess your risk. This will provide details about your lifestyle, your general hygiene habits and also your dental history. Some of the questions include: ‘Do you brush twice and floss once daily? Do you live in a fluoridated area or use fluoride mouth rinse? Do you smoke? Have you had frequent cavities in the past?’ There is one assessment form for children aged 5 and younger and another for children over the age of 6 to adults.

This information will be combined with the results of your full dental examination as well as your acid level test results, to see how the balance can be shifted toward tooth decay prevention for you.

Indicators of Disease


Other factors which aid in determining individual risk also has to do with indicators of disease. These indicators provide information on your existing dental situation and show what may possibly happen in the future based on that.

The current situation can be identified through the use of dental diagnostic methods such as looking at visible cavities either with the naked eye or via laser methods, looking at white spot lesions which occur on teeth which are next to each other (indicator of early decay), using x-ray imagery to detect early decay, and also looking at your cavity profile over the last 3 years.

There are other factors which may increase a person’s risk for disease but do not necessarily result in the disease. Some of these include dry mouth, snacking often on sugary and acidic foods, taking a lot of medication (this is something you may not be able to control based on your health condition), having a lot of plaque on the teeth, wearing mouth accessories like braces, guards etc, having grooved teeth which serve as breeding surfaces and crevices for acidogenic or acid producing bacteria.

GERD and eating disorders like anorexia and bulimia which result in acid coming into contact with teeth drastically increase the risk for erosion and tooth decay.

What You Can Do To Lower Your Risk


Your dentist may make certain recommendations for you to carry out to support the preventive and protective efforts. This includes using mouth rinses. Based on your situation the mouth rinse may be one which neutralizes acid, kills bacteria by means of antimicrobial substances like chlorhexidine or reduces the acidity in the mouth, by raising the pH.

If you have dry mouth the dentist may recommend that you use products which contain calcium and phosphates to help re-add minerals to the teeth, which have been lost due to the low levels of saliva in the mouth.

Fluoride containing products may be recommended to strengthen the enamel, while products which contain xylitol, a natural sugar, the form of a rinse, spray or gum, maybe recommended to discourage acid producing bacteria, in replacement of sucrose.

Author Bio – This guest article is written by Paul Smith in support of Thantakit Dental Center, Thailand’s longest established dental center for quality dental implants and cosmetic dental work.