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Quizzes > Health & Medicine

CAMBRA Risk Assessment Quiz: Practice Caries Risk Decisions

Quick, free caries risk assessment test. Instant results.

Editorial: Review CompletedCreated By: Micah HoffmannUpdated Aug 25, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art style dental quiz on dark blue background with stylized tooth and quiz text about caries risk assessment

This CAMBRA quiz helps you practice caries risk assessment and set risk levels for sample cases. You will get instant answers with brief tips, so you can spot gaps before clinic or exams. To build broader knowledge, try a dental anatomy quiz, a restorative dentistry terminology quiz, or a dental nursing quiz.

What does CAMBRA stand for?
Caries and Microbial Based Risk Application
Caries Assessment by Risk Management
Caries and Management Based Risk Analysis
Caries Management by Risk Assessment
CAMBRA is an acronym for Caries Management by Risk Assessment, an approach that focuses on identifying and modifying patient-specific caries risk factors. This evidence-based model integrates disease indicators, risk factors, and protective factors to guide individualized care. It shifts the emphasis from restorative treatment to prevention and risk management. For more information see .
What is the primary goal of CAMBRA?
Standardize dental billing codes
Restore all existing cavitated lesions
Identify and modify risk factors to prevent caries
Educate patients only on flossing technique
CAMBRA's primary goal is to identify and modify individual risk factors to prevent new caries lesions. It emphasizes prevention and management rather than simply restoring cavities. By focusing on risk assessment, clinicians can create tailored preventive strategies. Learn more at .
Which of the following is considered a disease indicator in CAMBRA?
Low salivary flow rate
Use of fluoride toothpaste
White spot lesions on enamel
High frequency sugar intake
Disease indicators in CAMBRA are clinical signs of current or past caries activity, including white spot lesions on enamel. Low salivary flow and high sugar intake are risk factors rather than direct indicators of disease. The use of fluoride is considered a protective factor. For more details see .
Which factor is a protective factor in CAMBRA?
High sugar soft drink consumption
Reduced salivary flow
Frequent snacking on sugary foods
Use of fluoride toothpaste
Protective factors in CAMBRA help reduce the risk of caries and include fluoride use through toothpaste, varnish, or rinses. Fluoride enhances remineralization and inhibits bacterial metabolism. Frequent snacking, sugary drinks, and low saliva are risk factors, not protective. See .
In CAMBRA, low salivary flow is classified as what?
Treatment modality
Protective factor
Risk factor
Disease indicator
Low salivary flow reduces the mouth's natural buffering and antimicrobial properties, making it a risk factor in the CAMBRA model. Risk factors increase the likelihood of disease progression. Disease indicators are signs of existing or past disease. For more information visit .
For a patient at high caries risk, how often is fluoride varnish recommended?
Every 2 weeks
Not recommended
Every 3 - 6 months
Every 2 years
High-risk patients benefit from professional fluoride varnish applications every 3 - 6 months to enhance remineralization and inhibit bacterial activity. Longer intervals reduce protective benefits, while very frequent applications are unnecessary. The timing should be based on individual risk profiles. See .
Which patient would be categorized as high caries risk under CAMBRA?
Patient using fluoride toothpaste daily with no lesions
Patient with no history of decay and good diet
Patient with only restored teeth but no new lesions
Patient with active white spot lesions and low salivary flow
Active white spot lesions and low salivary flow are strong indicators of ongoing demineralization and insufficient natural protection, categorizing a patient as high risk. A history of decay without active lesions may be moderate risk. Consistent fluoride use without lesions suggests low risk. Learn more at .
What is the recommended frequency for bitewing radiographs for a high-risk adult patient?
Only when symptoms occur
Every 6 - 18 months
Every 3 years
Annually regardless of risk
High-risk adults benefit from bitewing radiographs every 6 - 18 months to detect interproximal lesions early. Longer intervals may miss rapid lesion progression. Radiographs should be tailored to individual risk and clinical findings. Refer to .
Which antimicrobial rinse is commonly prescribed in CAMBRA to reduce mutans streptococci?
0.12% chlorhexidine gluconate
5% povidone-iodine
Hydrogen peroxide 3%
0.2% cetylpyridinium chloride
Chlorhexidine gluconate 0.12% is the most researched antimicrobial rinse for reducing mutans streptococci levels and caries risk. Povidone-iodine and other rinses have less evidence in caries management. Chlorhexidine is often prescribed for 1 week per month in high-risk patients. Learn more at .
Which dietary advice aligns with CAMBRA recommendations?
Limit sugar exposures to fewer than three times per day
Snack on candies between meals
Increase fruit juice to two cups daily
Rinse mouth with soda to neutralize acids
CAMBRA promotes limiting fermentable carbohydrate exposures, ideally to fewer than three per day, to reduce acid challenges. Fruit juice and candy between meals increase caries risk. Rinsing with soda worsens demineralization. For guidance see .
How does frequent snacking contribute to caries risk in CAMBRA?
It protects enamel by constant lubrication
It increases the number of acid attacks lowering pH
It enhances saliva's buffering capacity
It kills cariogenic bacteria
Frequent consumption of fermentable carbohydrates increases acid challenges on tooth surfaces, leading to demineralization. Saliva needs time between acid attacks to buffer and repair enamel. Excessive snacking reduces this recovery time. More details at .
A patient uses xylitol gum five times a day. What CAMBRA category does this reflect?
Protective factor
Diagnostic test
Risk factor
Disease indicator
Xylitol chewing gum stimulates saliva and reduces mutans streptococci, making it a protective factor in CAMBRA. Protective factors help rebalance the caries equilibrium. Risk factors increase disease potential, which xylitol does not. See .
Which salivary test is commonly used in CAMBRA to assess buffering capacity?
No test available
Gram stain analysis
Ericsson method
Paper strip pH without titration
The Ericsson method evaluates saliva's buffering capacity by titrating stimulated saliva with acid. It categorizes patients into high, medium, or low buffering, informing risk management. Gram stains and pH strips alone do not provide buffering information. More at .
In CAMBRA, a patient's socio-economic status is considered what type of factor?
Risk factor
Protective factor
Disease indicator
Treatment recommendation
Socio-economic status can influence dietary choices, access to care, and oral hygiene practices, making it a risk factor in CAMBRA. Risk factors increase the likelihood of disease development. Socio-economic status is not a direct disease sign or protective element. For context see .
What is the optimal fluoride concentration in prescription toothpaste for a high-risk adult?
1000 ppm
1500 ppm
2500 ppm
5000 ppm
High-risk adults often benefit from prescription-strength fluoride toothpaste containing 5000 ppm fluoride, which provides greater remineralization potential. Over-the-counter toothpastes typically contain 1000 - 1500 ppm. Higher concentrations should be used under professional guidance. See .
Which is an example of a caries disease indicator that is detected radiographically?
Fissure stain
Orthodontic bracket shadow
Radiolucency into dentin
Enamel hypoplasia
Radiolucency into dentin visible on bitewing radiographs indicates active or past demineralization, a true disease indicator. Enamel hypoplasia is a developmental defect, not an active lesion. Stains and bracket shadows are not caries indicators. More at .
Which component of the caries balance is influenced by casein phosphopeptide - amorphous calcium phosphate (CPP-ACP)?
Risk factors
Disease indicators
Salivary flow
Protective factors
CPP-ACP is a remineralization agent that increases calcium and phosphate availability, enhancing the protective side of the caries balance. It does not directly alter disease indicators or risk factors. Studies show CPP-ACP can reduce demineralization in high-risk patients. Learn more at .
Under CAMBRA guidelines, when should a dental sealant be considered for a first permanent molar in a moderate-risk child?
Five years after eruption
Upon eruption into the oral cavity
Sealants are not recommended for moderate risk
Only after a cavity is detected
Sealants are most effective when placed on newly erupted permanent molars before pits and fissures become carious. CAMBRA supports sealant use in moderate-risk children at eruption. Delayed placement reduces preventive benefits. For clinical guidelines see .
What pH level is considered the critical threshold for enamel demineralization?
5.5
6.8
7.0
4.0
The critical pH for enamel demineralization is approximately 5.5, below which hydroxyapatite dissolves and lesion formation begins. Above this threshold, saliva can remineralize early lesions. This concept underpins many CAMBRA recommendations. See .
Which bacteria species does CAMBRA primarily target for reduction?
Candida albicans
Lactobacillus acidophilus
Mutans streptococci
Escherichia coli
Mutans streptococci are the primary cariogenic bacteria implicated in the initiation of enamel demineralization. Reducing their levels is central to CAMBRA's antimicrobial strategies. Lactobacilli contribute to lesion progression but are secondary targets. For details see .
The Caries Risk Assessment Form evaluates all except:
Fluoride exposure history
Body mass index
Salivary flow rate
Dietary carbohydrate intake
The CAMBRA form assesses salivary flow, fluoride exposure, diet, disease indicators, and other oral factors, but not a patient's body mass index. BMI is unrelated to caries activity. CAMBRA focuses on oral-specific risk and protective factors. More at .
Which radiographic technique is preferred for detecting proximal caries in high-risk patients?
Vertical bitewing radiographs
Periapical films
Panoramic radiographs
Occlusal films
Vertical bitewing radiographs maximize coverage of posterior proximal surfaces and crestal bone, improving detection of early lesions in high-risk patients. Panoramic and periapical films are less sensitive for proximal caries. Occlusal films are used for other diagnostics. See .
According to CAMBRA, what salivary mutans streptococci colony count indicates high caries risk?
>10^8 CFU/ml
>10^3 CFU/ml
>10^2 CFU/ml
>10^6 CFU/ml
A salivary mutans streptococci count greater than 1×10^6 CFU/ml is generally accepted as indicating high caries risk in CAMBRA protocols. Counts below this threshold correlate with moderate or low risk. Laboratory culture methods help guide antimicrobial interventions. For evidence see .
In the CAMBRA Keyes triad, which three components interact to cause caries?
Diet, pH, and genetics
Host, saliva, and fluoride
Fluoride, sealants, and hygiene
Host, diet, and microflora
The Keyes triad describes caries as an interaction among the host (teeth and saliva), diet (fermentable carbohydrates), and microflora (acidogenic bacteria). CAMBRA builds on this model by adding risk and protective factors for each component. This classic framework underpins modern risk assessments. Learn more at .
Which study design provides the strongest evidence for chlorhexidine varnish efficacy in caries prevention?
Case report on enamel bleaching
Randomized controlled trial with double-blind design
Cohort study on periodontal outcomes
Animal study in rodents
A randomized controlled trial (RCT) with double-blind design minimizes bias and provides the highest level of clinical evidence for chlorhexidine varnish efficacy in caries prevention. Cohort studies and case reports offer lower levels of evidence. Animal studies can be informative but not definitive for human applications. See .
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Study Outcomes

  1. Understand CAMBRA risk assessment criteria -

    Gain a clear grasp of the principles and criteria used in the CAMBRA Quiz to assess dental caries risk effectively.

  2. Apply CAMBRA protocols in clinical scenarios -

    Learn to implement evidence-based CAMBRA protocols during patient evaluations to support preventive care planning.

  3. Analyze patient case studies with the Delta Dental CAMBRA framework -

    Interpret real-world scenarios presented in the Delta Dental CAMBRA quiz questions to refine your diagnostic skills.

  4. Identify key factors influencing dental caries risk -

    Recognize behavioral, biological, and environmental factors that contribute to increased caries risk in patients.

  5. Evaluate preventive and treatment strategies -

    Assess the effectiveness of various preventive measures and treatment options to reduce caries risk and improve oral health outcomes.

  6. Differentiate personalized care plans based on CAMBRA findings -

    Distinguish between tailored interventions to create individualized patient care plans guided by CAMBRA assessment results.

Cheat Sheet

  1. Balance of Risk and Protective Factors -

    The core CAMBRA framework assesses the dynamic between pathologic factors (like acidogenic bacteria and frequent sugar intake) and protective factors (such as fluoride exposure and saliva buffer capacity). You can remember the equation "Caries Balance = Risk Factors ÷ Protective Factors" to quickly gauge a patient's net risk (Penn Dental Medicine 2021). Ensuring a higher denominator (protective factors) through interventions is key to shifting the balance toward oral health.

  2. Salivary Flow & Buffer Capacity -

    Saliva serves as a primary defense by neutralizing acids and supplying calcium and phosphate for remineralization; a stimulated flow rate below 0.7 mL/min often indicates high caries risk (American Academy of Pediatric Dentistry 2022). To test flow, have patients chew Parafilm for five minutes and collect expectorate - this real-world step is featured in many dental school protocols (NYU College of Dentistry). Use the mnemonic "SWIFT" (Saliva, Water, Immunity, Flow Testing) to recall key salivary diagnostics during your CAMBRA quiz practice.

  3. Bacterial Culture & Thresholds -

    Quantifying mutans streptococci and lactobacilli levels via chairside kits or lab culture guides risk categorization - counts above 10❶ CFU/mL often flag high risk (Journal of Dental Research 2020). Remember the "Six-Log Rule" (10❶), where one log unit increase corresponds to tenfold bacterial growth. Accurate microbial assessment is a cornerstone of the Delta Dental CAMBRA approach and will likely appear in your CAMBRA quiz questions.

  4. Fluoride & Remineralization Strategies -

    Fluoride varnish (5% NaF) and high-fluoride toothpaste (1.1% NaF) are proven to enhance enamel remineralization and should be tailored based on risk level per ADA guidelines (ADA Council on Scientific Affairs 2023). Incorporate at-home adjuncts like chlorhexidine rinses or xylitol gum for synergistic effects. A quick mnemonic is "FVR" (Fluoride, Varnish, Remineralization) to recall your key preventive protocols.

  5. Recall Intervals & Follow-up Protocols -

    CAMBRA assigns patients to low, moderate, high, or extreme risk categories and recommends recall visits from 3 to 12 months accordingly (University of California, San Francisco School of Dentistry). High-risk individuals need 3- to 4-month intervals along with re-evaluation of salivary function and bacterial counts at each visit. Be sure the pattern of periodic reassessment is clear when answering any dental caries risk assessment quiz question to reflect real-world clinical practice.

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