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If I could design, I would include few more elements other than parameters that are already there. First, I would check if patient has normal hypothalamic function. Hypothalamus plays roles as a controlling center of the dentinal fluid preventing caries formation. Outflow of the dentinal fluid is interfering attachment of bacteria, ultimately disrupting colonization of the bacteria on the tooth surface. [2]
Secondly, I would ask if they are eating enough probiotics. Although, caries formation is multifactorial process, it is well known that colonization of the certain bacteria are the one of main cariogenic factor. Colonization of the cariogenic bacteria such as S. mutans, and lactobacillus can be interfered by using probiotics. For example, consumption of cheese containing L. rhamnosus GG and L. rhamnosus LC 705 showed beneficial affect to the oral microbial flora reducing counts for cariogenic bacteria. As a result consuming enough probiotic will decrease caries susceptibility. [1]
Malocclusion also could be a sign of future caries formation. According to Borzabadi, “prevalence of severe caries experience and the severity of malocclusion is related each other. Although the current findings suggest that the relationship between caries experience and malocclusion should be assessed in a wider context and background factors…severity of malocclusion and severity of dental caries showed positive relationship.” [3]
참고 자료
Teughels, W., Van Essche, M., Sliepen, I., & Quirynen, M. (2008). Probiotics and oral healthcare. Periodontology 2000, 48111-147.
Leonora, J. J., Tjäderhane, L. L., & Tieche, J. M. (2002). Effect of dietary carbamyl phosphate on dentine apposition in rat molars. Archives Of Oral Biology, 47(2), 147-153. doi:10.1016/S0003-9969(01)00104-2
Borzabadi-Farahani, A., Eslamipour, F., & Asgari, I. (2011). Association between orthodontic treatment need and caries experience. Acta Odontologica Scandinavica, 69(1), 2-11. doi:10.3109/00016357.2010.516732
Moss, M. E., Lanphear, B. P., & Auinger, P. P. (1999). Association of dental caries and blood lead levels. JAMA, Journal Of The American Medical Association, 281(24), 2294-2298.
Köhler, ,., & Andréen, ,. (2010). Mutans streptococci and caries prevalence in children after early maternal caries prevention: a follow-up at eleven and fifteen years of age. Caries Research, 44(5), 453-458. doi:10.1159/000320168