Moving People Toward Health with Risk Management

At Keystone Dental, we embrace the Risk Management model of care.  Historically the approach taken in dentistry was to wait for disease damage to occur and then try to fix the damage.  Risk management looks at the disease process so we can intervene before someone has a problem.  If we find significant risk in any of the four areas of dental health (Periodontal, Structural, Functional, Aesthetic), we work to lower the risk that the problem will develop before it becomes an issue.  By being prevention-focused, we can help to create more predictable and more cost-effective outcomes for dental and overall health. 


The word ‘periodontal’ refers to the bone and soft tissue that surrounds the tooth.  Several things that can increase risk for periodontal problems are genetics, bleeding gums, bone loss and deep pocketing of the gums around the teeth, smoking and diabetes.  When we look at how these risk factors apply to an individual we can determine whether they are at low, moderate, or high risk periodontal problems.  This allows us to customize dental treatment to give our patients the best chance at minimizing future irreversible damage to periodontal tissues.  Having periodontal issues can greatly increase a person’s risk of cardiovascular problems and diabetes- it matters beyond your mouth!


This category of dental health deals with tooth decay, acid damage, and broken or fragile teeth and fillings.  Historically your dentist would say to brush and floss more if you were getting tooth decay. We now know that even the best brushers and flossers can still get decay because of a biofilm imbalance or having too many acids in the mouth.  By going through a risk assessment we can figure out why someone might be getting decay instead of just repairing tooth decay over and over again.  We can then create an individualized plan to prevent future tooth decay. If acid damage is a concern, we can figure out what what the sources might be- dietary or stomach acids for example- and how to reduce them.  We also assess teeth or fillings that may be at risk for fracture and discuss ways to stabilize them. 


This area of dental health includes jaw muscle soreness, jaw joint inflammation, abnormal tooth wear or loose teeth.  We can determine risk in these categories by looking at someone’s bite. We have technology in the office that allows us to see how much force occurs on individual teeth. If someone has a bite that doesn’t function well, damage to the teeth and jaw joints can occur.  We can determine if certain oral appliances, orthodontics or a bite adjustment can lower risk for these types of problems.


This risk category doesn’t apply to everyone, but if someone is concerned about the appearance of their smile we assess tooth position and color, gum tissue, and lip movement when smiling.  We can recommend a personalized plan to improve smile aesthetics if a patient is interested in learning more. 

Dental health is a crucial part of overall health.  Dr. Doug Thompson sums it up nicely with the saying, “You can be sick with a healthy mouth but you can’t have a sick mouth and be healthy.”  Risk assessment allows us to personalize care to each of our patients based on their individual needs in order to achieve great dental and overall health.