A questionnaire vs. a needle and drill?
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The acronym CAMBRA stands for “CAries Management by Risk Assessment”. CAMBRA is a method of assessing caries (cavity) risk and making dental treatment and restoration recommendations based on a patient’s caries risk.
A simple comparison used to understand CAMBRA methodology is to compare it to a risk assessment for heart disease your physician may perform during a physical examination.
When assessing risk for heart disease a physician will perform tests for blood pressure and cholesterol count. Then they will examine other risk factors such as heredity, age, sex, tobacco usage, alcohol consumption, weight, dietary habits, physical activity level, stress level, and other present disease conditions.
The physician will then make recommendations based on the above risk factors. For example, patients with a low level of risk for heart disease may be good candidates for running a marathon or having cosmetic surgery. Whereas patients with a high level of risk for heart disease may not be good candidates for running a marathon or having elective cosmetic surgery and may require medical intervention such as a prescription medication or diet and exercise counseling.
Dentists who perform CAMBRA are performing a similar function. Based on risk factors for caries disease dentists will perform tests for oral bacteria levels as well as take x-rays. They will then examine disease indicators and risk factors such as current decay condition, current bacterial challenge, decay history, dietary habits, current prescription medications, saliva flow, medical conditions, and oral hygiene habits.
The dentist can then make recommendations based on the above risk factors. Patients at high risk may require medical intervention in the form of oral rinses, gels, gums, and sprays. They may also require restoration of any existing tooth decay. High risk patients may also receive recommendations to put off elective cosmetic dental procedures, or orthodontics until risk levels can be decreased. Patients at low risk may receive recommendations for oral home care preventive products to keep risk levels low and will be better candidates for elective cosmetic procedures.
Patients who are assessed as high risk are more likely to have failures of expensive dental work due to recurrent decay. The dentist performing CAMBRA will include treating the cavity-causing bacterial infection in addition to the restoration treatment plan based on the patient's specific risk factors to reduce the risk of restoration or cosmetic failure due to recurrent decay.
Many dental journals have been dedicated to the subject of CAMBRA and CAMBRA methodologies and like heart disease risk analysis, have proven to reduce decay rates.
- November 2007 CDA Journal:
- October 2007 CDA Journal:
- March 2003 CDA Journal:
- February 2003 CDA Journal: