Manual en ingl és:

1. CariogramaBajar de internet:cariogram (a)Programa:http://www.mah.se/fakulteter-och-omraden/Odontologiska-fakulteten/Avdelning-och-kansli/Cariologi/Cariogram/ Manual en inglés: http://www.mah.se/upload/OD/cariogram%20program%20caries/cariogmanual201net.pdf

2. Criterios • Caries experience • General diseases • Dietcontent • Dietfrequency • Plaque amount • S mutans • Fluorideprogramme • Saliva secretionamount • Saliva, buffer capacity • Clinicaljudgement

3. Thegreensector shows anestimation of the ‘Actual chance toavoid new cavities’. Thegreen sector is ‘whatisleft’ whentheotherfactorshavetakentheir share! • Thedarkbluesector ‘Diet’ isbasedon a combination of dietcontentsand dietfrequency. • Thered sector ‘Bacteria’ isbasedon a combination of amount of plaque and mutansstreptococci. • Thelight bluesector ‘Susceptibility’ isbasedon a combination of fluorideprogram, saliva secretionand saliva buffer capacity. • Theyellowsector ‘Circumstances’ isbasedon a combination of pastcaries experienceand relateddiseases.

4. Caries experience (prevalence) 0 = Cariesfree and no fillings Completely caries-free, no previousfillings, no cavitiesor M-missingteethdueto caries. 1 = Betterthan normal Betterthan normal - better status than normal, forthatagegroup in thatarea. 2 = Normal foragegroup Normal status forthatagegroup. 3 = Worsethan normal Worse status than normal foragegroup, orseveral new caries-lesionsthelastyear.

5. General disease • 0 = No disease • There are no signs of general diseases of importancerelatedto dental caries. Thepatientis ‘healthy’. • 1 = Disease/conditions, milddegree • A general disease, which can indirectlyinfluencethe caries process, orotherconditionswhich can contributetohigher caries risk, e.g. pooreye-sight, inabilitytomove. • 2 = Severedegree, long-lasting • Patientcould be bed-riddenormayneedcontinousmedicationforexampleaffectingthe saliva secretion.

6. Diet, content 0 = Verylow fermentable carbohydrate, Verylow fermentable carbohydrate, extremely ‘good’ dietfromthe caries point of view. Sugarsorother caries- inducingcarbohydrateson a verylowlevel. Lowestlactobacillusclassneededtosupport a zero. 1 = Low fermentable carbohydrate, ‘non- cariogenic’ diet Low fermentable carbohydrate, ‘non- cariogenic’ diet, appropriatedietfrom a caries perspective. Sugarsorother caries inducingcarbohydrateson a lowlevel. Diet, as foran ‘informed’ group. 2 = Moderate fermentable carbohydratecontent Moderate fermentable carbohydratecontent. Dietwithrelativelyhighcontent of sugarsorother caries inducingcarbohydrates. 3 = High fermentable carbohydrateintakeinappropriatediet Inappropriatedietfrom a caries perspective. High intake of sugarorother caries inducingcarbohydrates

7. Diet, frequency 0 = Maximumthreemeals per day (includingsnacks) Verylowdietintakefrequency, a maximum of three times per 24 hour as a mean under a longer time period. 1 = Maximumfivemeals per day Lowdietintakefrequency, a maximum of five times per 24 hour, as a mean. 2 = Maximumsevenmeals per day High dietintakefrequency, a maximum of seven times per 24 hour, as a mean. 3 = More thansevenmeals per day Veryhighdietintakefrequency, a mean of more thanseven times per 24 hour.

8. Plaque, amount • 0 = Extremelygood oral hygiene, Plaque Index, PI < 0.4 • No plaque, allteethsurfaces are veryclean. Very ‘oral hygieneconscious’ patient, uses bothtoothbrush and inter- dental cleaning. • 1 = Good oral hygiene, PI = 0.4-1.0 • A film of plaque adheringtothe free gingival margin and adjacentarea of thetooth. The plaque may be seenin situ onlyafterapplication of disclosingsolutionorbyusingtheprobeonthetoothsurface. • 2 = Lessthangood oral hygiene, PI = 1.1- 2.0 • Moderateaccumulation of softdeposits, which can be seenwiththenakedeye. • 3 = Poor oral hygiene, PI > 2.0 • Abundance of softmatterwithinthe gingival pocket and/oronthetooth and gingival margin. Thepatientisnotinterested in cleaningtheteethor has difficulties in cleaning. Youfeellikecleaninghis/herteeththoroughly, professionally and immediately!

9. S mutans 0 = Stripmutansclass 0 Veryloworzeroamount of mutansstreptococci in saliva. Onlyabout 5% of thetoothsurfacecolonisedbythe bacteria. 1 = Stripmutansclass 1 Lowlevels of mutansstreptococci in saliva. About 20% of thetoothsurfacescolonisedbythe bacteria. 2 = Stripmutansclass 2 High amount of mutansstreptococci in saliva. About 60% of thetoothsurfacescolonisedbythe bacteria. 3= Stripmutansclass 3 Veryhighamounts of mutansstreptococci in the saliva. More than 80% of thetoothsurfacescolonisedbythe bacteria.

10. Fluorideprogramme 0 = Receives ‘maximum’ fluorideprogramme Fluoridetoothpaste plus constant use of additionalmeasures - tabletsorrinsings and varnishes. A ‘maximum’ fluorideprogram. 1 = Additional F measures, infrequently Fluoridetoothpaste plus someadditionalmeasures - tabletsorrinsings and varnishesinfrequently. 2 = Fluoridetoothpasteonly Fluoridetoothpasteonly, no supplements. 3 = Avoidingfluorides, no fluoride Avoidingfluorides, notusingfluoridetoothpastes

11. Saliva secretion, amount 0 = Normal saliva secretion Normal saliva secretion, more than 1.1 ml stimulated saliva per minute. 1 = Low, 0.9 - 1.1 ml stimulated saliva/min Low, from 0.9 tolessthan 1.1 ml stimulated saliva per minute. 2 = Low, 0.5- 0.9 ml saliva/min Low, from 0.5 to less than 0.9 ml stimulatedsaliva per minute. 3= Verylow, Xerostomia, <0.5 ml saliva/min Verylowsalivasecretion, drymouth, less than 0.5 ml saliva per minute; problem judged to be long-standing.

12. Saliva buffer, capacity 0 = Adequate, Dentobuffblue Normal orgood buffer capacity, Saliva end - pH > 6.0 1 = Reduced, Dentobuffgreen Lessthangood buffer capacity, Saliva end- pH 4.5-5.5 2= Low, Dentobuffyellow Low buffer capacity, Saliva end - pH <4.0

13. Clinicaljudgement 0 = More positive thanwhattheCariogram shows basedonthe scores entered The total impression of the caries situation, including social factors, gives a positive view, more positive thanwhattheCariogramseemstoindicate. Theexaminerwouldliketomakethegreen sector bigger, i.e. improvethe ‘Chance toavoid caries’ forthepatient. 1= Normal setting! Riskaccordingtotheothervaluesentered The total impression of the caries situation, including social factors, gives a view, in line withwhatthetests and theotherfactorsseemtoindicate and pointstothesame caries risk as in theCariogram. Theexaminerdoesnothaveanyreasontochangetheprogram'sinbuiltevaluation. 2= WorsethanwhattheCariogram shows basedonthe scores entered The total impression of the caries situation, including social factors, points in thedirection of increased caries risk. Lessthangoodcomparedtowhatthetests and theotherfactorsseemtoindicate. Theexaminerwouldliketomakethegreen sector smaller, whichisto reduce the ‘Chance toavoid caries’. 3 = Veryhigh caries risk, examinerisconvincedthat caries willdevelop, irrespective of whattheCariogram shows basedonthe scores entered The total impression of the caries situation, including social factors, isverybad. Theexaminerisverysurethat caries willoccurthecomingyear and wouldwantthegreen sector to be minimal, irrespective of theCariogramresults. Theexamineroverrulestheprogram'sinbuiltestimation.