Dental Tribune U.S. Edition

HYGIENE TRIBUNE The World’s Dental Hygiene Newspaper · U.S. Edition g HT page 3D By Shirley Gutkowski, RDH, BSDH, FACE What’s new in CAMBRA? As you may know, CAMBRA stands for Caries Management By Risk Assessment. It doesn’t sound new or innovative for most clinicians because we believe we practice this way. Clinicians believe that they practice this protocol by looking into the mouth, seeing debris (the risk) and telling patients that they need to brush or floss to remove the soft deposits that have accumulated on the teeth (caries management). This strategy worked for a long time. We can see it work by the declining edentulous rate. Some- how, over time, the focus of treating caries has shifted to repairing caries lesions — the ones caused by the bacterial infection. This is akin to treating diabetes complications by amputating gangrenous appendages and calling it treatment. Prevention is not really hitting all the high points, and this is partly because of confusing dental lan- guage. Bacteria cause holes in the teeth, and CAMBRA impresses this idea on students by reducing quotas for drilling and filling and increasing the requirements for managing the disease. The requirement for saliva testing, bacterial testing and treatments that center on cariology receive more emphasis. Even today, some schools do not teach cariology as a separate class, but introduce bits and parts of cariology into other classes. The CAMBRA dental students of today elevate the patients’ risk pro- file into a diagnostic tool to help launch a treatment plan that doesn’t center on surgically altering teeth and placing prosthetics in an effort to reestablish the biological dimen- sions of the tooth. It’s a difficult undertaking. The dentists employed to manage the student clinic are of the surgical mindset, filling the holes in the teeth. When the new CAMBRA graduates are released into the public, they are often at odds with their employers. The traditional dentist removes the infected part of the tooth, never really dealing with the cause of the damage. The current thought is that there’s no money in risk manage- ment. The national board exams also do not reflect the CAMBRA focus on caries control protocols. The Western CAMBRA meeting this past year focused on continually refining the language of dentistry and finding ways to reflect this edu- cational model in the board exams. Dr. M. Fontana led a committee in the Cariology Special Interest Group (now a Section) on terminol- ogy at the American Dental Educa- tors Association (ADEA). Together with other interested parties, the group created a “standardization of dental terms” to be used in dental programs. The glossary is published in Dental Clinics of North America, August 2010 (Dent Clin N Am 54 (2010) 423–440). Over the past five years or so, these issues — of clinical instruc- tor’s focus and standardizing dental language — are being ironed out at the schools. The liaison between CAMBRA and the dental examin- ing boards has been working too. Requirements for drilling still far outweigh the requirements for including caries management rec- ommendations, or even considering caries risk when establishing recall intervals. While the idea of CAMBRA is working its way into the stream of traditional dentistry, the CAMBRA team is working on getting on top of the cause to educate dental and dental hygiene students about the management of caries and going beyond damage control. Language drives clarity and change. What’s interesting about the lan- guage change is the list of words to be retired. Words such as “watch.” Watch has never been a techni- cal term. The word “watch” in the context of caries management has traditionally been used to monitor an area. Without further treatment, “watch” really described passivity on the part of the practitioner to wait until the area had progressed to the point of cavitating and needing a restoration of some kind. In the recent past (Dec. 2010), the FDA again addressed the safety of amalgam as a restorative for dis- eased enamel. The salient point that was never addressed, the elephant January/February 2011 www.dental-tribune.com Vol. 4, no. 1 Crest® Oral-B® announces Ann Benson, RDH, as the first recipient of the new Pros in the Profession award program for registered den- tal hygienists who go above and beyond the call of duty. Benson was selected from an overwhelm- ing pool of qualified candidates for her initiative in starting Mobile Dentistry of Arizona, a practice that brings comprehensive dental care to those with limited trans- portation. Providing excellent oral care for all is a passion for Benson, who works tirelessly to combat tooth decay and gum disease in her surrounding community, in and around the Phoenix metro area. “I am so honored to be recog- nized by Crest Oral-B as the first of five Pros in the Profession,” said Benson, who graduated from Uni- versity of Iowa and now resides in Mesa, Ariz. “I truly love what I do and could not imagine doing any- thing else; I so appreciate Crest Oral-B supporting me through and through.” High-quality dental care with a personal touch is not just an aspi- ration for Benson, it is her way of life. Together with a staff of three dentists, three assistants and one other hygienist, she visits skilled nursing, long-term care and other age qualified communities and assisted living homes to provide dental care to residents. Since starting Mobile Dentistry of Arizona in June 2009, Benson has noticed a growing demand for its services, especially for patients with Alzheimer’s and dementia. These patients ask specifically for Benson, whose caring nature and keen skills, acquired through more than 15 years as an RDH, enable her to rise above challeng- ing situations. For Benson, suc- cessful treatment of these patients is the ultimate reward. “I have been working with Ann Benson for years to ensure her patients have the proper tools to improve their oral care, and couldn’t be more proud of her for winning this award,” said Terri Pipes, Crest Oral-B account man- ager. “As evident through her intense dedication and everlasting passion for providing proper oral care for her patients, many of which would not have the care without her, she is truly deserving of being recog- nized by Crest Oral-B as a Pro in the Profession.” To learn more about Pros in the Profession, including how to nom- inate a pro for consideration and for rules and regulations, please visit www.dentalcare.com/prosin theprofession. HT Crest Oral-B announces Ann Benson, RDH, as first of five recipients Ann Benson, RDH of Phoenix is the first awardee of Pros in the Profes- sion. (Photo/P&G) First ‘Pros in the Profession’ winner is announced