Caries risk assessment in young adults: A 3-year validation of clinical guidelines used in Public Dental Service

Petersson, Gunnel Hänsel; Ericson, E; Isberg, Per‐Erik; Twetman, Svante

doi:10.3109/00016357.2013.788734

Cited by 15 publications

(21 citation statements)

References 12 publications

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“…The rational to select a cumulative preventive score 0–3 as ‘basic prevention’ was based on the assumption that this preventive care basically was delivered in association with the regular check‐ups while a score 4–9 (‘additional prevention’) indicated that the patient was recalled and treated at least once between the regular intervals during the study period. It should also be stressed that the baseline risk grouping was based on the patient's caries situation in 93.2% of all cases which explained the present focus on the anticaries activities implemented by the clinicians.…”

Section: Discussionsupporting

confidence: 71%

“…The selection of the material and the socio-economic characteristics has been further detailed in a previous publication (8). The attrition rate was 24.2% over 3 years, mostly due to relocation, leaving 982 patients for the final analyses (for a flow chart, see (9). All the participants were residents in areas with low natural fluoride content in the drinking water supply but they reported use of fluoridated dentifrice on regular basis.…”

Section: Study Groupmentioning

confidence: 99%

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Preventive care delivered within Public Dental Service after caries risk assessment of young adults

Petersson

Ericson

Twetman

2015

Int J Dental Hygiene

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Section: Discussionsupporting

confidence: 71%

Section: Study Groupmentioning

confidence: 99%

Preventive care delivered within Public Dental Service after caries risk assessment of young adults

Petersson

Ericson

Twetman

2015

Int J Dental Hygiene

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“…The selection and enrolment of the study cohort has been described before [6]. In brief, 1699 19-year-olds were invited from eight different Public Dental Clinics (PDC’s) across the region to form a representative sample of this age group.…”

Section: Methodsmentioning

confidence: 99%

“…At baseline, the risk category of each patient was assessed by the patient’s regular dental team (dentist and/or dental hygienist) according to the “adult guidelines for risk assessment of oral diseases” issued by the regional Public Dental Service. Based on clinical and radiographic findings, the risk grouping relied on past and present caries, periodontal conditions, general risk and technical risk as previously described [6]. Four risk categories were used and each patient was classified into one of the following risk groups; “low risk” (42.7%), “some risk” (45.4%), “high risk” (10.4%) and “very high risk” (1.5%).…”

Section: Methodsmentioning

confidence: 99%

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Relationship between risk assessment and payment models in Swedish Public Dental Service: a prospective study

Petersson

Twetman

2017

BMC Oral Health

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BackgroundTo a) compare risk categories in patients selecting a capitation payment (CP) model with those in fee-for-service (FFS), b) determine the 3-year caries increment in the two groups, and c) compare the amount of delivered preventive care in the two groups.MethodsA comprehensive risk assessment was carried out in 1295 young adults attending eight Public Dental Clinics in the Scania region and 75% could be re-examined after 3 years; 615 had selected the CP model and 310 the traditional FFS. Caries was scored according to WHO and data concerning preventive care was extracted from the dental records.ResultsMore patients in the low risk category preferred the CP model (74% vs. 26%) while >80% with high risk selected FFS. The baseline caries level was significantly higher in the FFS group as well as the 3-year caries increment (1.6 vs. 0.8 DFS: p < 0.05). The amount of additional preventive care delivered to each patient was generally lower in the FFS model; it was most frequent among patients with “some” risk in the CP model (83.8%) while the lowest delivery rates were found among low risk patients in the FFS system (32.4%).ConclusionsYoung adults in public dental care with low risk preferred the prepaid model while those in the higher risk categories selected fee-for-service. As more additional preventive care was delivered to patients in the subscribed care, oral health planners and decision makers should be aware of the fact that capitation payment models may enhance inequalities in dental health over time.

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Quality Assurance Study of Caries Risk Assessment Performance by Clinical Faculty Members in a School of Dentistry

Rechmann

Featherstone

2014

Journal of Dental Education

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The goal of this quality assurance study was to explore the decision making of clinical faculty members at the University of California, San Francisco School of Dentistry predoctoral dental clinic in terms of caries risk level assignment using the caries risk assessment (CRA) as part of the Caries Management by Risk Assessment (CAMBRA) concept. This research was done in part to determine if additional training and calibration were needed for these faculty members. The study tested the reliability and reproducibility of the caries risk levels assigned by different clinical teachers who completed CRA forms for simulated patients. In the irst step, ive clinical teachers assigned caries risk levels for thirteen simulated patients. Six months later, the same ive plus an additional nine faculty members assigned caries risk levels to the same thirteen simulated and nine additional cases. While the intra-examiner reliability with weighted kappa strength of agreement was very high, the inter-examiner agreements with a gold standard were on average only moderate. In total, 20 percent of the presented high caries risk cases were underestimated at caries levels too low, even when obvious caries disease indicators were present. This study suggests that more consistent training and calibration of clinical faculty members as well as students are needed.

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Caries risk assessment in young adults: A 3-year validation of clinical guidelines used in Public Dental Service

Abstract: The risk assessment scheme used by the Public Dental Service for young adults relied basically on past and current caries activity and 65-70% of the patients were correctly classified. The model was most effective to screen out patients with low caries risk.

Cited by 15 publications

References 12 publications

Preventive care delivered within Public Dental Service after caries risk assessment of young adults

Preventive care delivered within Public Dental Service after caries risk assessment of young adults

Relationship between risk assessment and payment models in Swedish Public Dental Service: a prospective study

Quality Assurance Study of Caries Risk Assessment Performance by Clinical Faculty Members in a School of Dentistry

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