04_Part_3-_The_Importance_of_Bacterial_Assessment_13-44.pdf

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Caries Management by Risk
Assessment
(CAMBRA)
:
Week 6 – Part 3
The importance of Bacterial
Assessment
The Caries Imbalance
Risk Factors
Disease Indicators
•
Cavities/dentin
•
Enamel lesions
•Restorations
< 3 yr
•
White spots
•
Acidogenic
bacteria
•
Frequent
carbohydrates
•Sub-normal
saliva
Protective
Factors
•
Saliva
•
Fluoride, Ca, P
•
Antibacterials
Caries Progression
No Caries
Featherstone, Young, Wolff, 2007
Cariogenic Bacteria Assessment
Why Do We Need to Do It?
A
patient with cavities has high levels of
cariogenic bacteria so why bother with a
bacterial test?
We need to know the starting levels of MS and
LB (and others) so that when we do
antibacterial treatments we can monitor
progress, compliance and success
We need to continue to monitor after
antibacterial treatment is stopped to know
whether recolonization occurs
Mixed saliva is added to
the two sided selective
media slide (mutans
streptococci and
lactobacilli)
Incubate for 72
hours and read
versus density
scale
Mutans
streptococci
Low
Lactobacilli
High
Vivadent Test Strips. Used to measure mutans
streptococci and lactobacilli bacterial challenge level.

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