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Caries Diagnosis and Risk 

Management

Dr Susan Hinckfuss 

Lecture Objectives

Selecting, obtaining and interpreting patient data, 

information and radiographs and to be able to use these findings to accurately  assess and treat patients

The prevention, identification, and management of  odontogenic and non‐odontogenic oral diseases and 

disorders in pediatric patients

Implementing strategies for the clinical management of  caries

Analyze health conditions and medications that .

Develop and maintain a recall/continuing care system/health maintenance program appropriate to 

the practice setting and individual patient/client needs. 

Data Collection Medical history 

Medications

Health

Immunizations

Diet

Habits

Oral Hygiene

Dental History  Concerns

First dental

Behavior

Reason for  visit

Water Intake

Siblings

Pets and hobbies

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Updates? Every  appointment?

Every  treatment planning session?

Every  

3 

months? Every  6 months?

Every   year?

Who can sign? Transporting person?

Mother?

Father?

s er ro er

Mom’s boyfriend

Grandmother?

Teacher?

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HistoryHistory

1. Child has special health care needs, 

especially  any  that impact motor coordination or cooperation.

History

2. Child has condition that impairs saliva (dry  mouth)

 www.drymouth.

History

 3. Child’s use of  dental  home (frequency of  dental  visits)

History

4. Child  has decayHistory

5. Time lapsed since child’s last cavity 

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History

6. Child  wears braces 

or orthodontic/oral appliances

History

7. Child’s parent and/or sibling(s) have decay 

History

8. Socioeconomic status of  child’s parents

History

9. Daily  between‐meal exposures to 

sugars/cavity ‐producing foods (including 

bottle/sippy  cup  with 

liquids other than 

 water 

and 

use 

of  

sweetened 

History

10. Child’s exposure to fluoride 

(toothpaste, drinking  water, supplements)

History

11. Times per day  that 

child’s teeth/ ums are brushed

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Clinical Evaluation

Clinical Evaluation

1. Visible plaque

2. Gingivitis

Clinical Evaluation

3. Areas of  demineralization

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Clinical Evaluation

4. Enamel defects, deep pits/fissures

Supplemental professional 

assessment

Supplemental professional assessment

1. Radiographic caries

Supplemental professional assessment

2. Levels of  mutans streptococci or lactobacilli

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Caries Risk?

High

Moderate

Low

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Considerations

Dental 

homeOH

Diet

Prevention tools

Question 1

What factors determine caries risk in 

children and adolescents? Special needs Caries status of  

Saliva quantity  and 

quality 

Dental  visits

Decay  present / time 

since last decay 

Orthodontic 

appliances

s ngs/parent

Socioeconomic status

Diet

Fluoride

OH

Question2

What are some preventive tools used for caries 

control in children and adolescents?

Fluoride

Chlorhexidine

Recall frequency 

Sibling/parent dental checks

Diet 

OH

Question 3

What are the possible reasons for dry mouth with 

children and adolescents?

Medical condition

Medications

Mouth‐breathing

Caffeine

Question 4

A patient that has been determined as high risk 

should be seen how often?

3 month recalls 

6 months radiographs

Question5 

What percentage of  children age 2‐5 have 

caries?

2