1.4 Modifying Factors

Medical Conditions

Medical conditions can affect a patient’s risk for caries. For example, patients with physical disabilities that affect coordination have difficulty cleaning their teeth. Patients with arthritis often find tasks such as toothbrushing almost impossible to perform. Patients with cognitive disabilities may not be able to properly brush their teeth, may forget to brush, may forget their dental appointments, and/or may be unable to modify a diet high in fermentable carbohydrates.

Lower-than-normal estrogen levels in women contribute to decreased salivary flow, increasing caries risk. Patients who are addicted to alcohol or drugs or who are recovering from such addiction may lack the ability or motivation to care for their teeth and are at higher risk for caries.

Medications

Medications also impact a patient’s risk for caries. Children with recurrent ear infections or other conditions that require frequent antibiotic therapy are often prescribed antibiotics high in sugar. Patients with asthma, hay fever, or other seasonal allergies often take prescription or over-the-counter medications, which cause dry mouth. In addition, these patients may breathe through their mouths, which increases dryness and thus raises caries risk.

Radiation

Patients who have undergone head and neck radiation usually have permanent damage to their salivary glands, resulting in dry mouth and increased caries risk.

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