The Wellness Model
Patients of all ages can benefit from the emerging technology of computer-aided risk assessment. Highly accurate risk assessment enables targeted treatments and health strategies to help any patent improve their health or maintain their health with the most efficient and least costly measures available. A true wellness model can now be employed by identifying those at greatest risk of breakdown before it occurs. Interceptive treatments and strategies can beat gum disease and tooth decay before the damage requires repair. In this context, all treatment is designed to reduce the need for future treatment.

The first step is to identify the individual patient's risks. Those risks are then modified with interceptive treatment before the damage occurs, requiring repair. Every patient has a unique risk profile. Research has identified the risk factors for the two main diseases of dentistry, gum disease and tooth decay. The difficulty has been (until now) assessing the complex interplay of these risk factors to assign a patient an individual risk profile. The computer assisted risk calculator for periodontal disease and soon to be released dental decay risk calculator have made it possible for a dentist to assess the complex risk profile of each patient.

Your risk profile
What you discover can change your life and the way you see dentistry forever. Even if you have allowed your health to deteriorate, knowing your risk profile puts you in control of your dental destiny.

The majority of dental treatment is consumed treating the two most prevalent dental diseases, dental caries (tooth decay) and periodontal disease (gum disease). Both of these diseases are slow progressing bacterial infections. There is much confusion among patients as to why they might have more severe levels of disease than another seemingly similar person. "Soft teeth" or "genetic disease" are often used to explain the difference. The real explanation is more about the severity of the causative infection. In the repair model the damage is diagnosed and restored but little is done to modify the underlying cause of the disease. With the risk factors and underlying causes of disease left unchecked the cycle of breakdown and repair continues. The wellness model focuses on the underlying causes and risk factors, intervening before the damage requires repair. Simply put, the risk factors are treated before the damage can occur.

Dental caries(tooth decay) and periodontal disease are both multi-factorial, meaning there are many factors interacting to give each patient a unique risk profile. Because of this complex interplay of factors, until a recent technologic breakthrough, it has been impossible for the average dentist or periodontist to precisely calculate the individual risk profile for a patient. The periodontal risk calculator has become available to a select group of periodontists and general dentists in the U.S. This software program can be accessed by participating dentists trained in the technology and the information input techniques. Required patient data is information that is routinely gathered during a periodontal examination and health history. The data is submitted online through an encrypted connection to a secure database and processed to an individual risk profile within seconds.

The periodontal risk calculator proved to be accurate to an odds ratio of 4000 to 1 at predicting gum disease progression and tooth loss in 5 separate risk profiles with accuracy to15 years. The research was conducted at the University of Washington and published in the May 2002 Journal of the American Dental Association. The periodontal risk calculator was the original concept of Dr. Randy Nolf, developed with Dr. John Martin and a group of 8 periodontist colleagues. The developers founded a new company, PreViser, to help these discoveries reach the dental profession and you, the patient.

How can this accurate risk profile change your treatment?
In a move to the wellness model the first piece of the puzzle is the calculation of an individual risk profile. With an understanding of the risks, a plan to modify, control or eliminate the risks can be formulated. Without the RiskCalculator the estimation of a patient's risk by a dentist has been shown to be highly variable and unreliable. With the risk calculator a consistent baseline of risk is established and a treatment to modify those risks is automatically produced, leading to more uniform and predictable treatments.

With the increasingly complex body of knowledge, those doctors who embrace technology can make more effective use of their treatment talents by providing better, more patient-specific care. It is not unlike the change from seat-of-the-pants navigation in early aviation to the new standards of sophisticated electronic instruments. While the new instruments provided a detailed view of the environment unavailable to pilots of the past, the pilot of the present is still a very necessary component of the airplane, his senses have simply been enhance making him a safer, more versatile pilot.

Now with the risk profile for periodontal disease and the soon to be release risk calculator for dental decay a patient's treatment can be customized to more specifically meet their needs.

What type of changes can we anticipate?
· Frequency of maintenance:
o For instance you may be a very conscientious, healthy patient, who visits your dentist regularly for 6 month cleanings and checkups. Based upon your risk profile a 6 month interval may be unnecessary and a less frequent maintenance schedule suggested.
o Alternately you may have a risk profile that suggests a more frequent cleaning and check up schedule to prevent breakdown and the need for future repair.
· Restorative decisions.
o When the risk profile is a prediction of likely long-term success it can assist with a patient's decision to move forward with complex dentistry.
o Conversely a patient presenting with a high-risk profile, the initiation of a complex restorative plan could be a mistake until the risk profile is modified to a more favorable for long-term prediction of success.

Later on the continuum of dental health, after some degradation of health has occurred, the initiation of the wellness model is still possible and very beneficial. Some of the risks to be modified may require operative treatment. An example of such a risk is active periodontal disease. Active disease is a risk for future tooth-supporting bone loss and tooth loss. With risk factors controlled and behavior modification accepted, the risk of breakdown can be reduced to delay or eliminate the need for future operative treatment. Whatever treatment is required within the wellness model the outcome should be more enduring and cost effective than simply following the repair model treatment pathways.

Participating Providers
Currently the providers in the U.S. are limited to the developers of the technology and a select few dentists who have been trained in the data collection and entry protocol.

List of Providers