Success of Two Caries Risk Assessment Tools in Children: A Pilot Study With a 3-Year Follow-Up

Abstract

Caries risk is defined as the dental caries probability under the individual bacteriological environment, dietary habits, and environmental factors. Assessment of caries risk plays a major role in the prevention of dental caries. The aim of this study was to compare the effectiveness of two different caries risk assessment methods on caries-free preschool children. A sample of 90 caries-free 4- to 6-year-old children were selected from 400 preschool children. The selection was limited to children who had no dental caries, visible plaque, and systemic disease. American Academy of Pediatric Dentistry’s Caries Risk Assessment Tool (CAT) and Clinpro Cario L-Pop (CCLP; 3M ESPE, Germany) were used to categorize children into caries risk groups. Children were classified as being in high-, medium-, or low-risk groups by two methods. Determining risk factors according to CAT were examined. The compliance among the two methods was evaluated. Sixty-eight children were reevaluated intraorally after 3 years. The compliance between CAT and CCLP was sought using Kappa test. Statistical evaluation revealed moderate compliance among methods at baseline. The three most determinant factors in the high-risk group according to CAT were no topical fluoride exposure, no use of dental services, and active caries in mother. CAT is found statistically more successful than CCLP in predicting caries risk 3 years later. Caries risk assessment is effective to predict future caries and can be helpful for the clinician to choose the right tailor-made caries prevention plans.

A systematic review of caries risk in children <6 years of age

“…10 Five studies reported the sensitivity and specificity of specific CRA tools with different populations or made comparisons between existing CRA tools (Table 2). [14][15][16][17][18] Key findings from multivariate analyses of the combined 47 publications appear in Table 3. This new search allowed the evaluation of the association between caries and 36 sociodemographic and family risk factors, 13 behavioral factors, seven clinical factors, and five salivary and bacterial factors (Table 3).…”

“…23 No topical application of fluoride in a high-risk group (93.9%) population was reported by another study, supporting the above result. 17 Three studies reported that water fluoridation can influence caries development (IRR: 0.42; ORs: 0.7, 2.4). 20,39,44 One study suggested that children who received fluoride treatment in the dental office were more likely to develop caries (ORs: 3.50, 2.30) and that by age one, increased fluoride in the dental office from a healthcare provider was linked with known risk factors for tooth decay.…”

A mixed methods approach to obtaining health care provider feedback for the development of a Canadian pediatric dental caries risk assessment tool for children <6 years

“…However, the apps have to be informed by health professionals, with good design detail, grounded and validated for use, as the Canadian CRA tool has been (33,34). Although there have been numerous studies that have investigated caries risk factors and the predictive validity of CRA tools, this paper appears to be the first to report on the qualitative analysis of feedback acquired through pilot testing of a CRA tool indicated for use by non-dental primary health care providers (9,25,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49). A similar British study has reported on feedback from the pilot testing of an online integrated oral health and risk assessment tool (DEPPA).…”

“…It should be user friendly, easy to understand with clear and sufficient instructions ( 23 , 24 ). Information that is evaluative and engages patients have higher chances of adoption and encouraging behaviour change ( 25 ). Thus, many would-be users of the CRA tool want it to be in colour versus black and white, in a format that would be user friendly for parents and caregivers, would include information that is pictorial, visually appealing, easy to understand and use.…”

Dental Care for a Child with Congenital Hydrocephalus: A Case Report with 12-Month Follow-Up

“…Disorders in growth and puberty in children with CHC have been reported to include a craniofacial asymmetry in those patients who always had a shunt on the same side, premature fusion of the cranial sutures (craniosynostosis), and disruptions of dental (teeth) maturation [15,[17][18][19]. The facial asymmetry is caused by a moderate growth restriction caused by scar tissue and fibrosis around the shunt on the side where it was inserted.…”