Assessment of Implementation of a CAMBRA‐Based Program in a Dental School Environment

Abstract

Caries development is determined by a balance of protective and pathological factors, so the clinician should be able to identify and document those factors, understand their relative weight in disease development or reversal, and make recommendations to patients that will lead to risk reduction. The caries management by risk assessment (CAMBRA) protocol frames these factors into an easy-to-follow template that also guides the clinician in making recommendations. The purposes of this study were to examine implementation of the CAMBRA-based risk assessment program in a predoctoral clinic at one dental school, assess the accuracy of caries risk evaluation by the students, and evaluate the utilization of professionally applied luoride varnish in a moderate-and high-risk patient cohort. After dental clinic patients were screened for previous caries risk status, sixty-eight moderate-or high-risk patients were invited to participate in the study. At the study visit that included four bite-wing radiographs, a new caries risk assessment (CRA) form was completed. Our results showed that students underestimated the risk in 25 percent of the cases; the underestimation occurred especially when visible cavitation or caries into dentin by radiograph was the only risk factor or when caries were not identiied at the initial visit when the CRA form was completed for the irst time despite the presence of other high-risk factors. Students also underestimated both risk and protective factors at the initial evaluation visit compared with the study visit. The results show that students were not rigorous enough in documenting these factors and determining the patient's risk. In order to increase the sensitivity of risk assessment, training and recalibration for students and faculty members should be an ongoing process.

Evaluation of Final-Year Turkish Dental Students’ Knowledge, Attitude, and Self-Perceived Competency towards Preventive Dentistry

“…Innovations in dental curricula are critically important in order to prepare students, who have the required skills and knowledge to incorporate evidence-based approaches into their dental practice [7, 10, 11]. Using the CAMBRA, the implementation of Caries Management by Risk Assessment is a critical component in both the pediatric and general dentistry practice [2, 43, 44], as well as in the dental education [20–24, 45]. Thus, we chose to use the CAMBRA approach and its general principles in the development of measures used in this study.…”

“…To date, many dental schools have integrated caries risk assessment and risk-based management into their clinical teaching using the Caries Management by Risk Assessment (CAMBRA), which is an evidence-based and patient-centered approach focuses on determining pathological and protective factors affecting the expression and management of the dental caries [20–24].…”

Patient‐Specific, Risk‐Based Prevention, Maintenance, and Supportive Care: A Need for Action and Innovation in Education

“…Based on the school's philosophies and values, varying weights can be assigned for preventive and supportive care procedures that do not mimic patient reimbursement plans. Students over time begin to place more emphasis on these therapies as opposed to surgically driven procedures as part of their daily practice, which in turn helps increase patient interest and awareness of less‐invasive procedures. Students also drive faculty to change from the traditional restorative approach to a more conservative, preventive approach.…”

Determinación del riesgo de caries en niños menores de 5 años en escuelas del sector norte de Quito, Ecuador

“…Estos, en general, demuestran resultados similares al da presente investigación (7,13,17) . Sin embargo, es fundamental contar con un personal evaluador capacitado en presentar esas preguntas a los padres y con conocimiento para la identificación de ciertos aspectos básicos cuando se trata de considerar preguntas sobre la morfología de las superficies dentales (18,19) , presentando algunos problemas en la subestimación del riesgo, sobre todo en la evaluación clínica (20) .…”