Implementation of a Dental School Caries Risk Assessment Program

Objectives: Students are taught that caries is a bacterial disease, that carious lesions are symptoms of that disease, and that treating the symptoms alone does not stop the disease. To treat caries disease, clinical protocols to assess every patient's risk factors, their current disease state, treatment and preventive management, and the prognosis for achieving a disease-free status are needed. Our objective is to fully implement the clinical management of caries disease for our patient pool, thus joining the evidence-based didactic cariology course work with clinical practice.

Methods: 1. Derive a Caries Risk Assessment (CRA) form to be used by students and faculty during patient treatment, and also used for patient education. 2. Establish clinical protocols for managing caries disease, including assessment, treatment, and preventive strategies. 3. Implement the form and clinical protocols through: a. Didactic Cariology course b. Didactic and clinical Orientation to the Clinical Practice of General Dentistry course c. Faculty orientation and cross-training sessions d. Patient education

Results: 1. A form was derived in the Spring of 2003, and implemented into the clinic that July. 2. Student understanding and use of caries risk assessment protocols has increased since 2003 as measured by completed CRA forms and by course performance. 3. Faculty acceptance and reinforcement of clinical protocols has slowly increased since 2003 due to continued presentation of evidence-based caries science through faculty orientation and cross-training sessions and presentation to extramural community clinic directors. 4. Patient understanding and acceptance has depended heavily upon the conviction of the presenting student and supervising faculty, and has slowly improved as measured by implemented disease interventions.

Conclusion: Caries Risk Assessment has been implemented into routine patient care, however, it is not uniformly and consistently practiced by all students and faculty. Continued training of all stakeholders is essential to achieve complete implementation.