Assessing patients' caries risk

Background. Caries management historically has focused on the renewal of cavitated carious tissue and restoration of the tooth. Overiew. Assessing a patient's risk of developing caries is a vital component of caries management. A comprehensive caries assement should consider factors such as past and current caries experience, diet, fluoride exposure, presence of cariogenic bacteria, salivary status, general medical history, behavioral and physical factors, and medical and demographic characteristics that may affect caries development. A caries risk assessment also should consider factors that may challenge the patient's ability to maintain good oral hygiene (for example, crowded dentition, deep fissures, wide open restorative margins or placement of oral appliances). Conclusions and Practical Implications. The authors review the importance of caries risk assessment as a prerequisite for appropriate preventive and treatment intervention decisions and provide some practical information on how general practitioners can incorporate caries risk asseement into the management of caries.