1.4 Modifying Factors
Orthodontics
Patients with orthodontic appliances have difficulty with plaque control because the appliances create plaque traps. If the patient’s plaque is infected with cariogenic bacteria, white spot lesions will develop in the areas where plaque control is poor. This puts the patient at a higher risk for caries. Removal of orthodontic bands and brackets allows remineralization of white spot lesions and can reduce the likelihood that caries will progress.
Removable Prosthetic Appliances
Patients with prosthetic appliances (especially poorly designed ones) have a higher risk for caries if they are not maintaining good plaque control.
Special Assistance Requirements
Many patients require special assistance to meet their oral health needs. Young children and cognitively impaired children, adolescents, and adults, all of whom are in the high-risk category, need brushing supervision as well as appropriate education and reinforcement. Older adults require different types of assistance and education depending upon their skills and abilities. The need for this type of assistance and its availability may impact risk classification and recall interval.
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