Table 2 Caries Management by Risk Assessment according to CAMBRA66
Risk Level | Antibacterials | Saliva Test (Saliva flow & bacterial Culture) | Fluoride | Frequency of radiographs | Frequency of caries recall Exams | Xylitol & soda water | Sealants |
|---|---|---|---|---|---|---|---|
Low risk | Not required | May be done as a base line reference for new patients | OTC fluoride-containing toothpaste twice daily | Bitewing radiographs every 18–24 months | Every 6–12 months to reevaluate caries risk | Not required | Not required |
Moderate risk | Not required | May be done as a base line reference for new patients or if there is suspicion of high bacterial challenge | OTC fluoride-containing toothpaste twice daily plus: 0.05% NaF rinse daily | Bitewing radiographs every 12–18 months | Every 4–6 months to reevaluate caries risk | Two tabs of gum or two candies four times daily | Required |
High risk | Chlorhexidine gluconate 0.12% 10 ml rinse for one minute daily for one week each month | Saliva flow test and bacterial culture initially and at every caries recall appointment | 1.1% NaF toothpaste twice daily instead of regular fluoride toothpaste. NaF varnish clinically | Bitewing radiographs every 6–12 months or until no cavitated lesions are evident | Every 3–4 months to reevaluate caries risk and apply fluoride varnish | Two tabs of gum or two candies four times daily | Required |
Extreme risk | Chlorhexidine 0.12% (preferably CHX in water base rinse) 10 ml rinse for one minute daily for one week each month | Saliva flow test and bacterial culture initially and at every caries recall appointment | 1.1% NaF toothpaste twice daily instead of regular fluoride toothpaste. NaF varnish clinically; household fluoride gel tray 5 min daily | Bitewing radiographs every 6 months or until no cavitated lesions are evident | Every 3 months to reevaluate caries risk and apply fluoride varnish | Two tabs of gum or two candies four times daily. Soda rinses four to six times daily | Required |
