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Dental Tribune Middle East & Africa No. 4, 2016

Dental Tribune Middle East & Africa Edition | 4/2016 36 NEWS Researchers examinehow providersimplement cariesrisk assessmentprotocol ByDTI SAN FRANCISCO, USA: New research has shown that assessment of indi- vidual risk of developing dental car- iescanhelpdentistseffectivelytailor prevention and treatment efforts. The study focused on how providers implemented a protocol that com- bines risk assessment with person- alized preventive care and regular monitoring. The researchers also in- vestigated how risk assessments af- fected patients’ course of treatment andoralhealth. The Caries Management by Risk As- sessment (CAMBRA) protocol was developed at the University of Cali- fornia, San Francisco School of Den- tistry.Inthecurrentstudy,abaseline sample of 3,810 pediatric patients at UCSF were assessed using a 17-item form that records multiple envi- ronmental and behavioral factors known to contribute to caries, such as the patient’s access to fluoridated water,frequencyofsnacking,andso- cio-economic status. The predictive value of these risk assessments was then evaluated in a follow-up group of 1,315 patients from 6 months old to 6 years old from a largely low-in- comeurbanpopulation. The researchers found that dental care providers’ risk assignments were correlated with the risk of fu- ture decay, said study author Dr. Benjamin Chaffee, assistant profes- sor and Director of the Global Oral Health Program at the dental school. Atthefollow-upvisits,onlyabout20 percent of the low-risk patients pre- sented with tooth decay; however, nearly 70 percent of those in the high-riskgrouphaddecay. “Risk assessment is predictive—it tells you what kinds of outcomes are going to occur in a patient popula- tion,” Chaffee said. “Together with other studies, our work has shown that providers are willing and able to use CAMBRA accurately, that it doesn’t take a lot of time to do it, and thatitiseffective.” Caries risk assessments like CAM- BRA help providers account for fac- tors known to influence oral health and to then tailor their approaches to care according to the designated risk level. For example, a patient considered as being at a high risk of developing dental caries may re- quire more frequent radiographs and dental checkups than a patient designatedlowrisk. “Dental caries, like so many chronic diseases, follow a social gradient,” Chaffee further explained. “We want providers to recognize that our pa- tients who come to us from a lower socioeconomic position are more likely to face a heavier burden of dis- ease. It’s important to consider that what is going on beyond the dental chair is contributing to the health statusofourpatients.” CAMBRA has the potential to funda- mentally change dentistry, but this will be gradual, Chaffee said. “The traditional approach to dental caries for the last 100 years has been when a dentist sees a cavity to fill it and re- store the tooth’s function, and that’s a critical aspect of what dentists should be doing. But in and of itself, this approach doesn’t do anything to prevent the disease from occur- ring again. It treats the symptom— the consequences of disease —but it doesn’t get after the causes of the disease,”heconcluded. “More than half of the schools and colleges of dentistry in the US have adopted CAMBRA in one form or anotheraspartoftheirstandardcur- riculum,” said Dean of the School of Dentistry Prof. John Featherstone, who led the research teams that de- vised the protocol. “There are also increasing numbers of face-to-face and online courses that teach the CAMBRA methods. I am encouraged by the accelerated adoption of CAM- BRAinthefield.” According to the Centers for Disease Control and Prevention, approxi- mately 23 percent of children aged 2–5 had dental caries in their pri- mary dentition in 2015. Untreated tooth decay in primary teeth among children aged 2–8 was twice as high for Hispanic and non-Hispanic black children compared with non- Hispanic white children. In addition, about three in five adolescents aged 12–19 had experienced dental caries in their permanent dentition and 15 percenthaduntreatedtoothdecay. The study, titled “Caries risk assess- ment item importance: Risk desig- nation and caries status in children under age 6,” was published online and in the July print issue of the JDR ClinicalandTranslationalResearch,a newoffshootoftheJournalofDental Research. Anindividualizedriskassessment ofaninfant fordevelopingcariesservesas thefoundationforhealthcareproviders to identifyandunderstandachild’sriskofearlychildhoodcaries.(Photograph:jarmluk/pixabay) Dentist first Thai woman to climb Mount Everest ByDTI BANGKOK, Thailand: As the first woman from Thailand to do so, a dentist from Prachuap Khiri Khan has successfully summited Mount Everest. Napassaporn Chumnarnsit, who works at the provincial hospital in the southern town, reached the peak of the world’s highest moun- tain already on the morning of 23 May as part of the Thai Everest 2016 expedition. The 32-year-old’s achievement fol- lows that in May 2008 of her fellow- countryman Vithitnan Rojanapan- ich, who was the first person from the South East Asian country ever to reachthesummit.Chumnarnsitsuc- cessfully climbed Everest through the popular southern route starting in Nepal. The mountain can also be accessed from a northern route in China,aswellassixteenotherroutes. Chumnarnsit is one of the latest of almost 7,000 climbers to have ascended Everest since the first suc- cessful attempt by New Zealand mountaineer Edmund Hillary and the Nepalese Sherpa Tenzing Nor- gay in 1953. In 2016, over 400 people successfully reached the summit, ac- cording to figures from the Nepalese Ministry of Culture, Tourism and Civil Aviation. This year’s climbing season was overshadowed by the death of six people, most notably Australian climber Maria Strydom, who began suffering severe symp- toms of altitude sickness 15 minutes away from the peak and died soon thereafter. In total, the mountain has claimed 265 lives over the last 70 years. Only two years ago, 16 Nepalese climbers died in an avalanche in the Khumbu Icefall, which resulted in the moun- tainbeingclosedformostofthe2015 climbingseason. Alsonotoriouswasthe1996disaster, which took eight lives and was docu- mentedinabookandfeaturefilm. Part of the Mahālangūr Himāl sec- tion of the Himalayas stretching from Nepal to Tibet, Mount Everest istheworld’shighestmountainwith a height of 8,848 m. It overtops K2, which is approximately 250 m low- er,andthenearbyKangchenjungaat the India–Nepal border. Every year, hundreds of climbers from all over the world attempt to scale the giant peak. Moutnt Everest (Photograph:crazy777/pixabay) PhotoofNapassapornChumnarnsit. (Photograph:HuaHinTodaywebsite)

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