CARIOGRAM

BY:RUNIT JAIN
FLOWCHART
 INTRODUCTION
 CONCEPT

 PRINCIPLES OF CARIES RISK ESTIMATION

 CARIOGRAM FOR EVALUATION OF CARIES RISK

 CONTROLING DENTAL CARIES

 MEASURES TO REDUCE CARIES ACTIVITY AND

CARIES RISK
 CONCLUSION

 REFERENCES.
INTRODUCTION
Cariogram is a model proposed by Bratthall D in
1996,WHO collaborating Centre, Malmo University,
Sweden, to illustrate the interactions between bacteria,
diet and host response. The process of making the
evaluation is called Cariography.
 It is a graphical picture illustrating in an interactive way
the individual's/patient's risk for developing new caries
in the future, simultaneously expressing to what extent
different etiological factors of caries affect the caries risk
for that particular patient.
 It does never specify a particular number of cavities that
will or will not occur in the future but rather illustrates a
possible over-all risk scenario.
 The PC version was created in collaboration with Dr L.
Allander and K-O. Lybegård.
 AIMS OF CARIOGRAM
1. Illustrates the interaction of caries related factors.
2. Illustrates the chance to avoid caries.
3. Expresses caries risk graphically.
4. Recommends targeted preventive actions.
 CONCEPT
The concept of caries risk assessment is, from one
point of view, simple and straightforward. The
idea is to:
(a) identify those persons who will most likely
develop caries and
(b) provide these individuals proper preventive and
treatment measures to stop the disease.
PRINCIPLES OF CARIES RISK
ESTIMATION.
 Based on the “cariogram concept”
“Caries risk” is the term used to indicate what will
happen in future.
The cariogram model can be used to illustrate the
caries risk.
The risk is expressed as “Per Cent Chance to Avoid
Cavities”.
A low percentage, for example 5%, indicates a high
caries risk.
In contrast, 90% chance to avoid cavities indicates
a very low caries risk.
 Points to consider when using the “Cariogram” for
evaluation:

 “Chance to avoid cavities” must be between 0 to100%,

it cannot be “negative” or more than 100%.

 In addition to Diet, Bacteria and Susceptibility, a fourth factor

“Circumstances” is also included.
SECTORS OF CARIOGRAM

susceptibity Circumstances

Chance

Bacteria

Diet
CARIES RELATED FACTORS NEEDED TO
CREATE A CARIOGRAM.
1. Caries experience
2. Related diseases
3. Diet , content
4. Diet , frequency
5. Plaque amount
6. Mutans Streptococci
7. Flouride programme
8. Saliva secretion
 Factor Information to be Cariogram score
collected
Caries experience DMFT, DMFS, new 0: No caries, no fillings
caries experience 1: Better than normal for the age group
2: Normal for the age group
3:Worse than normal for the age group

Related general Medical history, 0: Healthy

diseases medications 1: Presence of a general disease that can indirectly
influence the caries process
2: Continuous medication or bedridden

Diet content Diet history (or 0: Very low fermentable carbohydrate

Lactobacillus test): 1: Low fermentable carbohydrate
quality of diet 2: High fermentable carbohydrate
3: Very high fermentable carbohydrate intake
Diet frequency Questionnaire results: 0: Maximum 3 meals/day
quantity of 1: Maximum 5 meals/day
dietary intake 2: Maximum 7 meals/day
3: More than 7 meals/day

Amount of plaque Silness-Löe plaque PI 0: <5% plaque adhering surfaces

index11 PI 1: 5%–20% plaque adhering surfaces
PI 2: 21%–50% plaque adhering surfaces
PI 3: >50% plaque adhering surfaces
 Factor Information to be collected Cariogram score

Streptococcus mutans Dentocult SM Strip mutans test 0: S. mutans < 104/mL saliva
(or similar test)a 1: S. mutans < 106/mL saliva
2: S. mutans < 107/mL saliva
3: S. mutans > 107/mL saliva
Fluoride program Fluoride exposure 0: Maximum fluoride exposure
1: Additional fluoride measures (other than
toothpaste), but infrequent application
2: Fluoride toothpaste only
3: Avoidance of fluorides (i.e., no fluoride
exposure)
Saliva secretion rate Secretion rate on stimulated saliva 0: Normal saliva secretion
test; 1: Low, 0.9–1.1 mL/min
the examiner’s own clinical and 2: Low, 0.5–0.9 mL/min
personal 3: Very low, <0.5 mL/min
score for the individual patient.
For scoring 0–3, please read the
manual.
Saliva buffering Dentobuff (or similar) test 0: Adequate, saliva pH > 6.0
capacity 1: Reduced, saliva pH 4.5–5.5
2: Low, saliva pH < 4.0
Clinical judgement Opinion of dental examiner; the
examiner’s own clinical and personal
score for the individual patient.
For scoring 0–3, please read the
manual.
THANK YOU