New Visions in Pediatric Dentistry - Keeping Healthy Teeth Caries Free: Pediatric Cambra Protocols

Ramos‐Gomez, Francisco; Kim, Young Jae; Ng, Man-Wai; Yang, S.Q.

doi:10.5933/jkapd.2013.40.1.72

Cited by 24 publications

(39 citation statements)

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“…Demineralization extending into the dentin may benefit from a sealant placement to arrest the incipient decay [12] or a minimally invasive preventive resin placement [34]. These options could be over utilized in scenarios with minor enamel demineralization [34] where CAMBRA based recommendations would indicate addressing the overlying risk factors, such a diet and hygiene, and attempting to remineralize the early ‘near surface’ lesion with topical therapeutics [11,35]. …”

Section: Discussionmentioning

confidence: 99%

“…For this study, a score 0 indicated that the tooth appeared sound with no evidence of demineralization. This corresponds to a CAMBRA recommendation to address risk factors [11,27,28]. A score ‘1’ indicated that the examiner assess the presence of an enamel-only occlusal caries lesion.…”

Section: Methodsmentioning

confidence: 99%

“…The likely treatment option applied clinically would be to determine key biological and behavior risk factors and consider topical therapies (e.g. fluoride based) to promote lesion remineralization [11,27,28]. A score ‘2’ indicated examiner evaluation of occlusal demineralization that progressed into the dentin.…”

Section: Methodsmentioning

confidence: 99%

“…The presence of non-cavitated lesions have been shown to have a predictive value [10] for future caries elsewhere. Detecting near-surface incipient lesions allow arresting or reversing the disease progression through topical therapies and improved oral hygiene and diet, as highlighted in CAMBRA caries management strategies [11]. For patients with incipient non-cavitated lesions that have progressed just into the outer surface of dentin, sealant placement or minimal invasive restorations are advantageous to arrest the lesion [12].…”

Section: Introductionmentioning

confidence: 99%

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Comparing potential early caries assessment methods for teledentistry

Hilsen

Jones

2013

BMC Oral Health

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BackgroundOptical caries detection has the potential to be incorporated in telehealth medicine for preventive dental screening. The objective of this study was to evaluate and compare visible and near infrared detection methods for identifying early non-cavitated ex vivo occlusal demineralization.MethodsSix blinded examiners were used to compare the accuracy of the following three examinations in detecting occlusal demineralization: Midwest Caries ID™ (MID), visual photographic examination (CAM) and Cross Polarization Optical Coherence Tomography (CP-OCT). For each diagnostic method, two examiners assessed the extracted tooth samples 1–2 weeks apart. Teeth were then sectioned and lesion depth was confirmed (n = 42) by a blinded histological examination using a glycol based caries indicator dye. The sensitivity (Sen), specificity (Sp), Intraclass Correlation Coefficient (ICC), and Area under the Receiver Operator Curve (AUC) were calculated.ResultsFor detecting any demineralization versus sound pit and fissure enamel, the mean Sen/Sp found was 46.9/85.0 for MID, 80.5/52.5 for CAM, and 83.4/45.0 for CP-OCT. For detecting non-cavitated demineralization that progressed into the dentin, the mean Sen/Sp found was 17.3/88.0 for MID, 48.0/57.8 for CAM, and 44.2/72.7 for CP-OCT. AUC values were statistically significant (P < 0.05) in three out of four examiner assessments when MID and CP-OCT were used to detect any demineralization. AUC values were significant for a single CAM examination. When assessing deeper non-cavitated lesions, none of the assessment methods were able to yield AUC values that were significantly different than a random ‘coin flip’ test. When examining reliability, MID demonstrated the highest ICC score (0.83) and CP-OCT had the lowest (0.49).ConclusionAlthough MID and CP-OCT were useful in detecting the presence of demineralization, examiners were not able to utilize these devices to adequately assess the depth of the demineralization. This study found that MID and CP-OCT did not have markedly superior diagnostic values from simple CAM assessment for use in teledentistry.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparing potential early caries assessment methods for teledentistry

Hilsen

Jones

2013

BMC Oral Health

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“…14,15 To overcome the growing problem of dental caries, a successful protocol "Caries Management By Risk Assessment" (CAMBRA) was developed by a group of experts in caries prevention, risk assessment, and management, for immediate implementation to improve oral health in California, and it has since been validated for implementation in several populations and settings. 14,[16][17][18][19][20] The CAMBRA is an educational and motivational technique that encourages patients to adopt a healthier, prevention-orientated lifestyle. The method is based on the pattern of caries risk factors, such as lack of saliva and a high-carbohydrate diet, that lead to a lower intraoral pH and, therefore, tooth demineralization and caries.…”

mentioning

confidence: 99%

Caries Management By Risk Assessment in a Cleft and Craniofacial Center

Gaudilliere¹,

Thakur

et al. 2014

Journal of Craniofacial Surgery

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Patients with craniofacial anomalies have an increased incidence of dental caries. The prevention program "Caries Management By Risk Assessment" (CAMBRA) has been previously validated but has not yet been introduced at a widespread level in a medical setting, particularly for this high-risk population.In this cross-sectional study, we aimed to evaluate the feasibility of implementing CAMBRA during the medical visit at an institutional tertiary care center, which treats children with craniofacial anomalies. The study included 161 participants aged 1 to 18 years. Patients and parents received a personalized educational session, toothbrushing tutorial, and fluoride varnish application. We assessed the prevalence of dental caries, caries risk factors, and knowledge of oral hygiene in this patient population.The overall caries prevalence in this group was higher than average (57% compared with 42%, according to the Centers for Disease Control and Prevention). The most prevalent risk factors were developmental delay, deep pits/fissures, low socioeconomic status, orthodontic appliances, and carbohydrate snacks. The greatest predictors of dental caries were having 1 or more risk factors and having low socioeconomic status. In summary, children with craniofacial anomalies were at high risk for dental caries, with high rates of risk factors and low rates of preventive factors.Our findings revealed that basic oral hygiene standards are not being met in this high-risk population, highlighting the need for implementation of protocols such as CAMBRA. The results of this study can aid healthcare workers in craniofacial centers and children's hospitals to improve the understanding of oral hygiene and dental care of their patients.

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Creating a New Generation of Pediatric Dentists: A Paradigm Shift in Training

Ramos‐Gomez

Silva

Law

et al. 2014

Journal of Dental Education

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The University of California, Los Angeles (UCLA) School of Dentistry has implemented a Health Resources and Services Administration‐funded program to prepare dentists for the complex and comprehensive needs of pediatric patients within rapidly changing demographics and a paradigm shift in dentistry. Traditional dental education has focused on how to respond to oral disease, whereas UCLA's program shifts the paradigm to emphasize early assessment, risk‐based prevention, and disease management. A holistic approach to dental care that considers social and environmental determinants is used with minimally invasive techniques for restorative care. To support this change, pediatric dental residents receive traditional training combined with new didactics, advocacy opportunities, and applied learning experiences at community‐based organizations. These new elements teach residents to recognize the causal factors of disease and to identify interventions that promote oral health at the individual, family, community, and policy level. Consequently, they are better prepared to treat a diverse group of patients who historically have faced the greatest burden of disease as well as an increased number of barriers to accessing oral health care; these consist of low‐income, minority, and/or pediatric populations including children with special health needs. The program's ultimate goal is for residents to deploy these skills in treating vulnerable populations and to demonstrate greater interest in collaborating with non‐dental health providers and community organizations to increase access to dental services in private or public health practice settings.

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New Visions in Pediatric Dentistry - Keeping Healthy Teeth Caries Free: Pediatric Cambra Protocols

Cited by 24 publications

References 5 publications

Comparing potential early caries assessment methods for teledentistry

Comparing potential early caries assessment methods for teledentistry

Caries Management By Risk Assessment in a Cleft and Craniofacial Center

Creating a New Generation of Pediatric Dentists: A Paradigm Shift in Training

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