Table 2.

Caries Management by Risk Assessment according to CAMBRA⁶⁶

Risk Level	Antibacterials	Saliva Test (Saliva flow & bacterial Culture)	Fluoride	Frequency of radiographs	Frequency of caries recall Exams	Xylitol & soda water	Sealants
Low risk	Not required	May be done as a base line reference for new patients	OTC fluoride-containing toothpaste twice daily	Bitewing radiographs every 18–24 months	Every 6–12 months to reevaluate caries risk	Not required	Not required
Moderate risk	Not required	May be done as a base line reference for new patients or if there is suspicion of high bacterial challenge	OTC fluoride-containing toothpaste twice daily plus: 0.05% NaF rinse daily	Bitewing radiographs every 12–18 months	Every 4–6 months to reevaluate caries risk	Two tabs of gum or two candies four times daily	Required
High risk	Chlorhexidine gluconate 0.12% 10 ml rinse for one minute daily for one week each month	Saliva flow test and bacterial culture initially and at every caries recall appointment	1.1% NaF toothpaste twice daily instead of regular fluoride toothpaste. NaF varnish clinically	Bitewing radiographs every 6–12 months or until no cavitated lesions are evident	Every 3–4 months to reevaluate caries risk and apply fluoride varnish	Two tabs of gum or two candies four times daily	Required
Extreme risk	Chlorhexidine 0.12% (preferably CHX in water base rinse) 10 ml rinse for one minute daily for one week each month	Saliva flow test and bacterial culture initially and at every caries recall appointment	1.1% NaF toothpaste twice daily instead of regular fluoride toothpaste. NaF varnish clinically; household fluoride gel tray 5 min daily	Bitewing radiographs every 6 months or until no cavitated lesions are evident	Every 3 months to reevaluate caries risk and apply fluoride varnish	Two tabs of gum or two candies four times daily. Soda rinses four to six times daily	Required