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Caries Management by Risk Assessment (CAMBRA)

University of California, San Francisco via Coursera

This course may be unavailable.


Dental Caries (tooth decay) is a bacterially based disease that progresses when acid produced by bacterial action on dietary fermentable carbohydrates travels into the tooth and dissolves the carbonated hydroxyapatite mineral.  This process is called demineralization.

Pathological factors, including acidogenic bacteria, salivary dysfunction, and dietary carbohydrates are related to caries progression.  Protective factors, which include antibacterials, salivary calcium, phosphate and proteins, salivary flow, and fluoride in saliva can balance, prevent or reverse dental caries through a process of remineralization.  Remineralization is a natural and reliable repair mechanism for non-cavitated carious lesions.

This course will provide the scientific basis behind the “caries balance” concept, which is the key to caries management by risk assessment in clinical practice.  If pathological factors prevail caries progresses.  If protective factors prevail the caries process is halted or reversed.

The course will present tools to implement  CAMBRA, “caries management by risk assessment,” in your clinical setting.  It can be in implemented medical and dental settings, and can benefit children and adults of all ages. Implementation in dental practice provides patients with genuine hope and success for the management of their oral health.  It is a practice builder for dentistry.


Week 1:
  • Understand what dental caries is
  • Understand the concept of the caries balance
  • Know the three principal pathological factors of caries formation
  • Understand that multiple bacterial species are responsible for dental caries
  • Understand the role of frequent ingestion of fermentable carbohydrates in dental caries
  • Recognize hyposalivation, how this occurs, and its importance in caries progression
Week 2:
  • Refine the concept of the caries balance 
  • Know and understand the multiple caries protective components in saliva
  • Understand demineralization and the role of fluoride
  • Understand remineralization and the role of fluoride 
Week 3:
  • Understand remineralization and the role of fluoride 
  • Understand how fluoride interacts with cariogenic bacteria 
  • Know the three main mechanisms of action of fluoride 
  • Know about fluoride toothpastes and fluoride mouthrinses
Week 4:
  • Know about fluoride products for the dental office and for home use by prescription 
  • Know why high concentration fluoride products are used for high caries risk individuals 
  • Know the antibacterial products currently available for caries control 
  • Understand the root caries process including similarities and differences with coronal caries
Week 5: 
  • Understand the distinction among disease indicators, pathological (biological risk) factors, and protective factors
  • Know that the CAMBRA risk assessment method is validated in clinical use in thousands of patients for 6 years through adult
  • Know the bacterial assessment methods
  • Understand the sequence for the entire CAMBRA method 
Week 6:
  • Know how to assess caries risk for an individual as low, moderate, high, or extreme 
  • Know the currently recommended chemical therapy for patients at low, moderate, high, or extreme risk 
  • To study numerous examples of risk assessment and therapy and how to build this into the treatment plan 
  • Understand the differences between risk assessment for young children, older children, and adults 

Taught by

John Featherstone


5.0 rating, based on 2 Class Central reviews

Start your review of Caries Management by Risk Assessment (CAMBRA)

  • Jayne McCormack
    The course is aimed at somewhere between educated layman and dental professionals. It requires some dedication to complete and isn't really appropriate for the complete beginner. I haven't placed it as an Intermediate course as a general science background should cover you rather then specific dental knowledge. It's not the easiest course out there, but if it's something you're interested in, it's a really useful and interesting one to take. Lots of information to digest but with an excellent lecturer.
  • Anonymous
    Went to log in yesterday to listen to more of the lectures, course closed though suddenly. (22 days after end of course) So disappointed that I didn't get them downloaded in time! It was a very interesting course & I hope it's offered again soon!

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