One characteristic we love about our PDA Tribe is the passion our teams have for great patient care. One of the many effective ways to show patients you truly care is being adamant about the implementation of preventive protocols. As we know, dental caries is the number one chronic disease in the US. It is routine for most practices to treat cavities with the drill and fill model. However, many PDA offices want more for themselves and their patients and choose to implement Caries Management by Risk Assessment (CaMBRA). A partner of PDA, CariFree offers a turn-key solution to the caries epidemic with their risk assessment protocols and professional treatment products. If you have heard about CaMBRA and are still on the fence or have CariFree in your practice and need a bit of a refresh we have collected some answers from the CariFree training team just for you!
There are two options for CRA presentation. Either in the waiting room, or in the operatory before the hygiene exam begins. Most offices have patients fill the form out in the waiting room before their cleaning appointment. Some offices choose to go over it when they have the patient back in the chair to help open up communication, it depends on what works best for the team, and what they have time for.
The Caries Risk Assessment places the patient in a risk category based on their caries risk factors. It also provides statistics for the likelihood that patient (given their set of risk factors) will experience new decay in the next 12 months. The specific risk factors identified also provides the team with a clear picture of how the patient may begin to lower their risk. Are their modifiable factors like diet and home care that can be discussed?
The ATP test gives us a better understanding as to what is occurring in a patient’s biofilm. A patients risk is driven by one (or more) of The Usual Suspects: saliva, diet, bacteria, genetics or pH. The meter helps us understand the cause.
Someone that has a lot of ATP and a high meter reading has an issue with bacteria (we would recommend the antimicrobial CTx4 treatment rinse). Whereas a patient that has normal ATP production and a low meter reading might have an issue with saliva or diet (we would recommend the CTx3 rinse and gel to elevate pH)
Knowing this we can better recommend behavioral changes to reduce risk and have a more targeted therapy in terms of the CariFree products we recommend.
Most offices are offer the ATP bacterial testing free test to encourage participation. Some offices charge $10 or more to cover the cost of the swab and time. Several offices choose to charge $10 for the test up-front but then give it back as a credit toward products if the patient ends up purchasing. There are a few billing codes that can be tried for the different caries risk levels – some delta plans pay $6 which covers the price of the swab.
Most of the time the hygienist is the one performing the swabbing test because it’s done before the cleaning, but anyone in the office can perform it. When recommending products to the patients, either the hygienist is doing that after the swabbing test or the doctor will address it when he or she comes in to check the patient after the prophy.
The products are specially formulated to treat patients as individuals. A low risk patient who wants to stay low risk needs a different protocol than an extreme risk patient. The products are formulated and packaged to treat each type of patient you see.
CariFree offers suggested retail pricing that most offices follow. However, pricing can be determined by practice based on the demographic they serve. Contact the CariFree office to get a list of suggested retail pricing and use that as a starting point when determining pricing in your office.
Dr. Baird emphasizes that productivity has more to do with patient relationships than anything else. CaMBRA is a way for you to dig deep into the WHY of your patient’s issues. Also, the difference between being able to treat a patient’s problem and treating a patient for life drastically changes your production. Dr. V. Kim Kutsch, founder of Carifree and practicing dentist for over 35 years explains that healthy patients buy more dentistry. Patient’s that stop getting cavities trust their dentist and start exploring options for elective procedures; and that is the key to CaMBRA and productivity.
There are several options for information. Your PDA coach is a great resource. You can also order a FREE copy of Balance: A guide for managing dental caries for patients and practitioners that provides fantastic information on WHY CaMBRA is important. You can also set up a free introduction to CariFree and CaMBRA by calling 866.928.4445. It is a great way for the whole team to see how the protocol works in office.