Whilst at the dentist, they will be doing a risk assessment for you. This will help them to develop a plan and tailor any advice they give to you. These risk assessments include:
- Tooth decay (dental caries) risk.
- Gum disease (periodontal disease) risk.
- Oral cancer risk.
- Tooth wear risk.
Some other risk assessments may be done, depending on your dentist, your job and many other factors.
You will be put into a high, medium, or low risk category. The risk category helps to plan how often you need checkups, helps plan treatments required (if any), and helps your dental professional to give you oral health advice specific to you.
To decide which category you fall into, your dental professional will ask you questions about your dietary and cleaning habits. They will also look at your dental history and whether there is any active disease present. Other factors which are taken into account include family history of disease, and smoking and alcohol intake.
If you are at low risk for tooth decay and gum disease, you could consider using a manual toothbrush and dental floss. With correct use, these are sufficient for cleaning, and have less impact on the environment. They are also cheaper.
If you are at higher risk for tooth decay and gum disease, you should focus on optimum cleaning. This includes using an electric toothbrush and interdental brushes. These are more effective at plaque removal, which is key to preventing dental diseases. The investment you make in buying these tools will pay off when it comes to avoiding dental treatment.
You can discuss this with your dental professional and ask them where you fall in terms of risk for dental diseases.
The table below gives a brief summary of the low risk vs high risk category. This IS NOT a complete risk assessment, but simply gives an idea of the main risk factors you may be aware of)
| Higher risk | Low risk | |
|---|---|---|
| Tooth decay (dental caries) risk. | Has needed fillings in last 12 months Added sugar in diet (in hot drinks, snacks between meal times, more than one sweet snack per day) Poor cleaning – not brushing twice daily, no interdental cleaning Using a fluoride free toothpaste or using a fluoride containing toothpaste only once daily | No fillings Low sugar diet Good plaque control Brushes twice daily Daily interdental cleaning Use of fluoride toothpaste twice daily |
| Gum disease (periodontal disease) risk. | Signs and symptoms of active mild gum disease (gingivitis) or bone loss seen on xrays Poor plaque control – not brushing twice daily, no interdental cleaning Family history of tooth loss due to gum disease Smoking or chewing tobacco, or recreational drug use Certain medical conditions and medications e.g. diabetes, blood pressure medications | Healthy gums and no bone loss on x-rays Good plaque control Brushes twice daily Daily interdental cleaning |
| Oral cancer risk. | Relevant family history Tobacco use – smoking, chewing and vaping Increased alcohol intake (above government recommended limits) HPV infection | |
| Tooth wear risk. | High acid intake from food and drink Over-brushing (e.g. scrub brushing with a manual toothbrush) Medical conditions e.g. gastric reflux or regular vomiting | Low acid intake Good brushing technique |
You could look at these factors to help you decide whether you are low risk or not. Ultimately the only way to know if you are at high risk or dental diseases or clinically vulnerable, is to discuss this with a dental professional.
Useful resources to find out more:
- Scottish Dental Clinical Effectiveness Programme Oral Health Assessment and Review
- Delivering better oral health: an evidence-based toolkit for prevention is endorsed by a collection of over 100 UK organisations and has an explanation of risk factors for all categories above
- The American Dental Association guide to Caries Risk Assessment and Management
- American Academy of Periodontology explanation of Periodontitis Risk Factors
- Oral Cavity, Oropharyngeal, Hypopharyngeal, and Laryngeal Cancers Prevention by the National Cancer Institue (US) contains information about cancer risk factors
- GSK Information about Tooth Wear Identification
