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Module 3: Caries Risk Assessment

3.2 Caries Risk Assessment

Oral Health Screening

Once the child is in position to be screened, lift the lip and look for the following:

Eruption of Primary Teeth

Teeth typically follow a pattern when they erupt. The central and lateral incisors usually erupt first, followed by the first primary molars, then the cuspids (canines), and ending with the second primary molars. On average, all of the primary teeth erupt by age 28 months, but timing of tooth eruption varies widely.

Healthy Primary Teeth and Gums

Healthy primary teeth are white and have smooth surfaces, except for the occlusal surfaces (chewing surfaces) of the posterior teeth. Occlusal surfaces are grooved, and there may be wide spaces between the anterior teeth.

Healthy gum tissue is pink or pigmented, depending on the child’s race and ethnicity, and tight to the tooth, with knife-like edges. Stippling, characterized by very small elevations and depressions in the gum tissue (similar to the surface of an unpeeled orange), may also be present.

Healthy teeth and gums
Healthy teeth and gums with melanin deposits
Healthy Teeth and Gums   Healthy Teeth and Gums
with Melanin Deposits
Photo: Used with permission from American Academy of Pediatrics. 2008.
Oral Health Risk Assessment: Training for Pediatricians and
Other Child Health Professionals.
Elk Grove Village, IL: American Academy of Pediatrics.
  Used with permission from Norman Tinanoff, D.D.S., M.S.,
University of Maryland Dental School.

Dental Plaque

Dental plaque is a biofilm that attaches itself to tooth surfaces. It is composed primarily of Mutans streptococci and other bacteria. Failure to remove plaque through regular toothbrushing allows it to build up in a thick layer. Nourished by foods and beverages containing sugar, Mutans streptococci produces acid that initiates the tooth demineralization process.

Dental plaque Dental plaque
Dental Plaque   Dental Plaque
Used with permission from Norman Tinanoff, D.D.S., M.S., University of Maryland Dental School.