Caries Management by Risk

Assessment (CAMBRA):
Implementation in Your Practice
Week 4
John D.B. Featherstone
Distinguished Professor and Dean

School of Dentistry
University of California San Francisco
Disclaimer
This course is designed for educational purposes only.
It is not intended as medical advice or medical
services. The information provided in this course
should not be used for diagnosing or treating a health
problem or a disease, nor does it qualify you as a
health care provider. It is not a substitute for
professional care. If you have or suspect you may
have a health problem, you should consult your health
care provider.

Product information is illustrative, not an endorsement

University of California San Francisco
Learning Objectives 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
Questions from Week 3
What do we say when our patients ask about
fluoride toothpaste?
There are so many mouthrinses out there.
How does one choose what to use?
How can we be sure that a fluoride product
will work effectively?
What about fluoride varnish?

Learning Objectives 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
The Caries Balance

Protective Factors
Saliva flow and components
Fluoride, Calcium, Phosphate:
remineralization
Antibacterials:-
chlorhexidine, xylitol, new?

No Caries
Caries

Pathological Factors
Acid-producing bacteria
Frequent eating/drinking of
fermentable carbohydrates
Sub-normal saliva flow and
function

Featherstone, Community Dent Oral Epidem, 1999