One of the most overlooked areas in a dental practice today is Caries Assessment by Risk Management. (CAMBRA) It happens a lot that offices do not have a protocol in place to assess and prevent caries. CAMBRA is not new. The California Dental Journal produced two journals dedicated to this topic in October and November 2007 and again in October 2011.

It is very rewarding to be a part of the shift in other countries who have millions upon millions of their population without preventive care services! There are dentists in these countries looking to make a change in their country. Congratulations to these dentists for leading CHANGE!

Caries Risk is one of the areas we can see a huge shift in the underserved populations. With the guidance of a Consultant you will have a turn-key value added system in place to prevent disease and create one more profit center.

(Read below and add your own numbers to see what this means for your practice and profitability.)

What is CAMBRA?

CAMBRA assists providers to systematically evaluate caries risk in an individualized manner; children as well as adults.

Tailors a specific preventive therapeutic management plan or “care path”;

Customizes a restorative plan in conjunction with preventive care; and

Supports the dental professional to plan a timely, specific, and appropriate periodicity schedule based on the patients’ caries risk.

To effectively prevent and management the disease of caries, care should begin early, ideally during at age 1 a comprehensive oral exam visit is completed.

Yes, assessment begins very early. Do you tell parents that a child’s first visit is at age 3? NO? Think again.

Here are steps to prevent caries risk:

A caries risk assessment is the first of these critical steps; Give the provider more information to help them consider the risk and health status of each patient before beginning the exam.

Caries risk assessment provides information pertaining to three specific overarching domains: white spot lesions, decalcification enamel, defects or other obvious decay in the child.

The information obtained from a caries risk assessment allows the care provider to formulate a caries risk profile for the child, and also an adult. This is an essential first step to determining the prevention and treatment plan, as well as the periodicity of patient follow-up/continuing care visit. (one month, three months, six months, or one year).

The CAMBRA-based dental practice will increase the usage of current preventive products. (Another profit center for your dental hygiene department)  The dental practice needs to have these products available to the patient so they can easily improve self-efficacy and begin using these preventive care products immediately.

CAMBRA-based prevention and nonsurgical caries management should lead to a shift away from restorative procedures to procedures focused on prevention and early intervention; cost analysis and development of financial models should show the economic value change the psychology of the dental professional’s messaging style.

Include attractive literature for patients to read in your reception areas and take home with them to learn more about Caries Prevention.

The new CDT codes for CAMBRA will assist in reimbursement for the patient.

In January 2013 the CDT codes were revised and D 1204 and D1203 are no longer used. For the patient who receives a fluoride varnish the insurance billing code will be: D1206.

For adults and children who receive a fluoride other than a varnish the code for billing used will be: D1208.

What does this mean for the profits to your practice?

For patients who are assessed moderate to extremely high risk they will return every 1-3 months for a short appointment to assess biofilm, review home care and diet, provide a fluoride varnish and if the patient will always use a 1.1% Sodium Fluoride each night.

Most offices will enroll at least 100 patients annually into CAMBRA. This above chart can be used to assess your profit potential. (Average practice is approximately 1500 patients)

CAMBRA strategies are implemented with a focus toward prevention and early intervention. Studies should also determine if there is significant practice growth and case acceptance once the patient oral health is improved.

CAMBRA represents best practices and should become the standard of care in caries disease prevention and treatment.

If you want to dive deeper into CAMBRA, Prevention and Increase Profits you may want to try 30 Days Dental Hygiene Profits Program

READ MORE

CDA JOURNAL October 2007 Assess here: http://www.cda.org/Portals/0/journal/journal_102007.pdf

CDA JOURNAL November 2007 Assess here: http://www.cda.org/Portals/0/journal/journal_112007.pdf

CDA JOURNAL October2011 Assess here: http://www.cdafoundation.org/learn/resources/library/publications

The CDA Journal October 2011 has an assessment you can use for your patients.

Each of these journals explains how to categorize and what products should be used to prevent caries.