Risk Assessment Criteria Applied to a Screening Exam: Implications for Improving the Efficiency of a Sealant Program

Abstract

There is a relationship between carious lesion experience in 1st grade and carious lesion incidence in the first permanent molars by 4th grade. Using the dmfs + DMFS > 0 criterion may help public health providers determine which children should receive sealants when resources do not allow the delivery of sealants to all children.

Prospective study of 5‐year caries increment among children receiving comprehensive dental care in the New England children’s amalgam trial

“…Statistically significant differences in the extent of decay were observed by race/ethnicity, urban versus rural dwelling, and immigrant versus US‐born caregiver at baseline (34, 35), but not during follow‐up. In addition, the strength of the association between baseline caries and increment was slightly lower in our study than in previous studies (5–9, 21, 25), which could partly be due to the dental care provided by NECAT. For example, although the extent of decay at baseline among our participants was greater than that among the high‐risk children in the previously cited Swedish study (5.3 versus 2.6 DMFT), the 2‐year caries increment was similar and even slightly lower among NECAT participants (21).…”

“…Furthermore, NECAT's controlled environment of dental care, in both the extent of care given as well as the delivery system, provided a sound basis in which to measure caries increment. Previous studies of high-risk children have been conducted without consideration for professional dental care or in other countries, but their results serve to substantiate our measured caries increment (5,21,22). For example, in a representative sample of rural and urban Swedish children aged 10-11 years at baseline, children who were deemed high-risk had a similar mean caries increment during the 2-year study (1.7 teeth, 2.6 surfaces) as NECAT children did during their first 2 years of follow-up (1.4 teeth, 2.2 surfaces) (21).…”

“…Dental caries continues to be a highly endemic chronic disease among certain groups of children, particularly those of lower socioeconomic status or minority race/ethnicity (1–4). One of the most well‐established predictors of new caries is prior caries experience (5–9). The predictive value of caries experience may be attributed to predisposing genetic factors (e.g.…”

Use of occlusal sealant in a community program and caries incidence in high- and low-risk children

“…The DMFT/dmft were calculated and the status of the permanent first molars was recorded. Considering that past caries experience has been an excellent predictor, as shown in several studies 16,18,29,30,33 , and has also proved to be a practical and effective predictor for use in community health 6 , the children were classified according to caries risk [HR=high caries risk when DMFT+dmft>0; LR=low caries risk when DMFT+dmft=0)] and sealant placement on the permanent first molars, as follows:…”

Evidence on existing caries risk assessment systems: are they predictive of future caries?

“…Findings from prediction models in longitudinal studies not using a specific CRA system/guideline Table 5 summarizes the findings from selected predictive models from longitudinal studies conducted after 2001 (13,(24)(25)(26)(27)(28)(29)(30). The choice of using the year 2001 as a cut-off point was because two comprehensive reviews in this area were published in 1998 (31) and 2001 (32).…”