Dental caries: an updated medical model of risk assessment

Dental caries is a transmissible, complex biofilm disease that creates prolonged periods of low pH in the mouth, resulting in a net mineral loss from the teeth. Historically, the disease model for dental caries consisted of mutans streptococci and Lactobacillus species, and the dental profession focused on restoring the lesions/damage from the disease by using a surgical model. The current recommendation is to implement a risk-assessment-based medical model called CAMBRA (caries management by risk assessment) to diagnose and treat dental caries. Unfortunately, many of the suggestions of CAMBRA have been overly complicated and confusing for clinicians. The risk of caries, however, is usually related to just a few common factors, and these factors result in common patterns of disease. This article examines the biofilm model of dental caries, identifies the common disease patterns, and discusses their targeted therapeutic strategies to make CAMBRA more easily adaptable for the privately practicing professional.