March 2009, Volume 30, Issue 2
Published by AEGIS Communications
From the Guest Editor
V. Kim Kutsch, DMD
Dentistry is entering a new era of excellence. Gone forever are the days of mechanically repairing cavities and ignoring the bacterial disease that caused them. Dental caries is much more complex than the simple disease model that has persisted in the profession. Our understanding of dental caries as a biofilm disease is changing diagnosis, treatment, outcomes, and prognosis. New scientific evidence is emerging daily, and the evidence is clear: Caries is a complex multi-factorial disease that is best addressed with a risk assessment model. The bottom line is better and more predictable treatment outcomes for your patients. While “risk assessment” is a buzz word in many industries today, CAMBRA, or caries management by risk assessment, is a timely topic in dentistry for both you and your patients.
Eight years ago, Dr. John Featherstone and Dr. Douglas Young gathered an ad hoc group to address the emerging biofilm science of dental caries and create a plan to implement this new information into our educational curricula, state and national board testing criteria, third-party payment systems, and reduction of this knowledge to standard care in private practice. This group—the CAMBRA Coalition—has met annually to promote this standard of care. As a result, caries risk assessment is now standard in almost all dental schools in the US. It is recognized by state boards and appears in the Western Regional Examining Board examinations. In addition, insurance companies are examining how to create insurance products for this care. CAMBRA regularly appears in lectures at dental meetings and in dental journals. In January 2009, the American Dental Association Council on Scientific Affairs endorsed caries risk assessment and released a caries risk assessment form for private practitioners: http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3375 .
This issue of Compendium is dedicated to the topic of caries risk assessment. Our goal is to provide you with the information you need about CAMBRA in one source to help you understand the principles, evaluate the scientific evidence, and successfully reduce this knowledge to practice. We are fortunate to have as authors internationally recognized experts in CAMBRA. Dr. Philip Marsh (Leeds University, UK) explains the current scientific evidence of dental caries as a biofilm disease. Dr. Douglas Young (University of the Pacific, US) and colleagues contribute an article on selected treatment regimens and products typically used to treat the biofilm component. Dr. Graeme Milicich (private practice, New Zealand) provides insight into the routine implementation of CAMBRA in a private practice. Dr. Steven Duffin (private practice, US) describes the use of CAMBRA in treating early childhood caries.
It is my distinct privilege to serve as guest editor for this issue. I hope you find the information helpful and it provides you with the blueprint to implement CAMBRA successfully into your practice.
V. Kim Kutsch, DMD