Long‐Term Adoption of Caries Management by Risk Assessment Among Dental Students in a University Clinic

Abstract

The aim of this study was to evaluate the long-term adoption of a risk-based caries management program at a university dental clinic. The authors extracted data from electronic records of adult non-edentulous patients who underwent a comprehensive oral evaluation in the university predoctoral clinic from July 2007 through June 2014 (N=21,984). Consistency with caries management guidelines was measured as the percentage of patients with caries risk designation (low, moderate, high, or extreme) and the percentage of patients provided non-operative anti-caries agents within each designated caries risk category. Additionally, patient and provider characteristics associated with risk assessment completion and with provision of anti-caries therapy were identiied. Results showed that the percentage of patients with documented caries risk grew steadily from 62.3% in 2007-08 to 92.8% in 2013-14. Overall, receipt of non-operative anti-caries agents increased with rising caries risk, from low (6.9%), moderate (14.1%), high (36.4%), to extreme (51.4%), but percentages were stable over the study period. Younger patients were more likely to have a completed risk assessment, and among high-and extreme-risk patients, delivery of anti-caries therapy was more common among patients who were younger, identiied as Asian or Caucasian, received public dental beneits, or were seen by a student in the four-year DDS program or in the inal year of training. These results demonstrate that extensive compliance in documenting caries risk was achieved within a decade of implementing risk-based clinical guidelines at this dental school clinic. Caries risk was the most strongly associated of several factors related to delivery of non-operative therapy. The eventual success of this program suggests that, in dental education, transition to a risk-based, prevention-focused curriculum may require a longterm commitment.

Patient‐Specific, Risk‐Based Prevention, Maintenance, and Supportive Care: A Need for Action and Innovation in Education

“…Although the majority of predoctoral programs require their students to complete a caries risk assessment on all their patients and have a formal protocol for risk‐based preventative plans, not all students and faculty support implementation or adequate patient monitoring. These results are consistent with studies from other institutions . The results are even more disheartening within advanced prosthodontic programs, as only a third of programs required caries risk assessment.…”

“…Scientific advancement has expanded the scope of preventive strategies, and several schools have modified their didactic and clinical curriculum relative to caries prevention and management education . Yet discontinuity exists between what is taught didactically, what is expected clinically, and what occurs operationally within dental schools.…”

The Canadian Core Cariology Curriculum: Outcomes of a national symposium

“…Bringing this prevention‐based approach into dental clinical practice is not new; it has a long history in the dental education community 21,22 . However, “while efforts by dental educators may be essential, they may by themselves be insufficient to achieve the desired results”; 21 changes on the level of oral health care polices and organization, reimbursement systems, dental associations fees guide policies, dental national board exams, accreditation and licensure processes, insurance coverage, and public awareness levels are also essential.…”

Evaluation of Final-Year Turkish Dental Students’ Knowledge, Attitude, and Self-Perceived Competency towards Preventive Dentistry

“…Previous evidences showed that the successful implementation of risk-based caries management in clinical training should be improved through the calibration with a specific set of guidelines and assessing the accuracy of caries risk evaluation for both faculty members and students [22–24, 51]. Future studies are needed to provide the training and calibration of other faculty members.…”