by Dr. V Kim Kutsch
When I first started practicing Caries Management by Risk Assessment (CAMBRA) in 2001, I did so because I was frustrated that I was doing everything I had been taught in dental school and my patients were continuing to get decay. I was okay seeing new patients come into my practice with recurrent decay around their previous dentist’s restorations, but 5 years later I was not okay seeing that same patient with decay around my restorative work. My patients were frustrated with dental caries and so was I. I was an expert at drilling and filling teeth, but I really didn’t understand the disease process that well. With the help and direction of mentors like John Featherstone and Doug Young, I went about educating myself on dental caries, and I implemented CAMBRA immediately into my practice.
I can remember when I first discussed this concept with my patients. They all embraced it, but I continually heard them ask if CAMBRA really worked, was I putting myself out of business? I remember laughing and telling them if it improved my work load at all, I would enjoy taking more time off. I have to tell you, I thought I might be putting myself out of business, but I didn’t care, I wanted to solve their decay issues.
It took a while to figure it out, even took developing some products to accomplish what I was after in terms of clinical outcomes. But I did. And it worked, and it made a huge difference for my patients and surprisingly in my practice. A couple of years into the process an unanticipated thing happened. The patients who I had helped become decay free, and had been decay free for a couple of years, developed a new sense of confidence in their health. For the first time they felt like they understood what had been happening to them and now they were in control. The more experience and successes I had, the more confident I became in their health as well.
I didn’t understand why at the time, but suddenly all of these patients wanted complete restorative dentistry. They wanted new beautiful smiles. It took me a few conversations to connect the dots. It was because they had the confidence that whatever money and time they invested would not be a waste. So because of CAMBRA, I’m busier than I’ve ever been, and ironically doing more complete restorative cases than I ever have in my career. And I’m doing it on patients with the confidence of a long term successful outcome.
It never fails. I’ll be speaking at some dental meeting and I know the skeptics in the room view CAMBRA as a threat to their livelihood. It’s the elephant in the room. And after I’m done speaking, invariably a few CariFree dentists will come up to me and thank me. They proceed to share their success stories and tell me the impact CAMBRA has had on their practice. They’ve experienced the same thing I have.