Hughes’ Views Dr. Michael Hughes’ Dental Blog

What You Should Know About Tooth Decay. Really!


Old school treatment is to “drill and fill” and admonish the patient to “brush and floss better”.

Over the past decade dental researchers have made huge strides in understanding why people get cavities. Dental offices at the forefront of this science use CAMBRA and ATP Bioluminescence to help you to reduce your risk of getting cavities. CAMBRA is an acronym for Caries Management By Risk Assessment ( caries is the formal name for decay in teeth ).

Old school believed the concept that decay was a result of sugar on the teeth and two specific bacteria; Strep. Mutans and Lactobacillus. Now we know that we all have a biofilm in our mouths that has anywhere from 120 to 500 different bacteria with some being good and some not so much. There are at the current count over 50 different acid producing bacteria possible in a person’s biofilm that can cause decay. More importantly we understand that it is more about the overall balance of bacteria in our biofilm than it is about specific bacteria so tooth decay is actually due to a Biofilm Imbalance. What this means is that our biofilm has more acid producing bacteria in proportion to non-acid producing bacteria with an end result of higher risk of tooth decay.


A new tool in determining a person’s risk of decay is ATP Bioluminescence. This is a simple procedure using a quick swab of some of your teeth and inserting the swab into the CariScreen device.The bioluminescence is determined and there is a number given in 15 seconds that corresponds to your Biofilm. The range of readings is from 1 – 9999 with healthy readings coming in below 1500. This test is very quick and simple and also very significant. We have seen readings from 169 all the way to 9999 and the fact of the matter is there is no way tell who is high and who is low using traditional examination. The first person to get a reading of 9999 was actually a dental staff member who takes good care of their teeth! Once a person’s risk is determined using CAMBRA and ATP Bioluminescence a plan can be developed to help patient’s lower their risk and maintain a decay free mouth.

CAMBRA and ATP Bioluminescence readings are just a small part of my patient exam process and are included at no extra charge. If you don’t know your ATP score or haven’t been assessed using CAMBRA you should call my office and schedule an appointment for a new patient exam. Prevention is the most affordable way to stay healthy!

Michael F. Hughes, DDS



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