Caries Management by Risk Assessment in Children

Paul Aaron Johnson

Abstract

Purpose: To investigate the efficacy of a modified caries management by risk assessment (CAMBRA) protocol on reducing the cariogenic bacterial load, improving oral hygiene care and dietary habits on children aged 5-9 years old.

Methods: Sixty-six children aged 5-9 years old participated in a single blind randomized controlled clinical trial and were assigned to either the modified CAMBRA or regular treatment group. Parents of intervention group were asked to give child 6-8g of xylitol mints per day (8-12 mints/day) for a total of six months. These individuals were seen every 3 months for fluoride varnish application, oral hygiene and diet evaluation with counseling. Additional diet and oral hygiene information was sent home to parents. dmfs/DMFS scores, caries risk assessment, saliva samples were taken at baseline and at 6 months and MS, LB and TVC of bacterial levels tabulated.

Results: MS, LB and TVC at baseline and 6 month showed slight decrease but there was no statistical significance between the modified CAMBRA and regular treatment groups p<0.05. There was consistent trend of decreasing caries risk factors (tooth brush and snacking frequency, plaque scores) from baseline to 6 months however these changes between the two groups were not statistically significant as well.

Conclusion: 6-8g of daily xylitol mints show a minimal, but not statistically significant decrease in cariogenic bacterial load in the oral cavity. Increased frequency of professional oral hygiene and diet counseling shows a positive trend in decreasing caries risk behavior at six months in this population.