The application of caries risk assessment in minimum intervention dentistry

Abstract

Caries risk assessment forms the cornerstone for the successful application of a minimum intervention dentistry philosophy in the management of dental caries. Patients, particularly those with evidence of active dental caries at baseline, require a caries risk assessment to identify those risk factors that will most likely contribute to the progression of the carious disease process. Once identified, these factors should be eliminated or at least moderated to ensure the disease progression is stabilized before conservative and rehabilitative dental procedures are undertaken. Each individual will present with a slightly different caries risk profile and the principles of a patient centred approach to manage each case should be applied to the individual diagnostic and treatment planning phases of dental care. Current chairside technologies such as caries susceptibility and activity tests can be utilized to provide baseline and follow-up data to assist the dental practitioner in this task. However, clinician intuition or 'gut feeling' has been found to be a better prognostic indicator for future dental caries experience than present caries prediction instruments in most cases. As caries risk data are accumulated and refined at a population, community and individual level, the sensitivity and specificity of the caries risk assessment modelling will improve as will the positive predictive power of the final statistical model algorithm. It is likely that online caries predictive tools will be available for general dental practitioners in the not too distant future to help clinicians formulate accurate caries risk profiles for their patients.

A Study on Assessing the Chance of Dental Caries Level using Early Childhood Oral Health Impact Scale in 5-yearold Children in Kandy District, Sri Lanka

“…[13][14][15] However, most of these caries prediction attempts are not noninvasive but minimally invasive and individual level studies. 13,20 The caries prediction model that was generated from our preliminary study is a totally noninvasive population level study as reported by others.…”

“…[13][14][15] However, most of these caries prediction attempts are not noninvasive but minimally invasive and individual level studies. 13,20 The caries prediction model that was generated from our preliminary study is a totally noninvasive population level study as reported by others. 14,15 Further, several recent reviews 13,21 have highlighted the importance of having minimally invasive dentistry caries management strategies that should be incorporated to estimate caries activity at each visit.…”

“…13,20 The caries prediction model that was generated from our preliminary study is a totally noninvasive population level study as reported by others. 14,15 Further, several recent reviews 13,21 have highlighted the importance of having minimally invasive dentistry caries management strategies that should be incorporated to estimate caries activity at each visit. These reviews 13,21,22 have also highlighted the current lack of such methods validated for reliable and precise estimation of caries activity.…”

“…14,15 Further, several recent reviews 13,21 have highlighted the importance of having minimally invasive dentistry caries management strategies that should be incorporated to estimate caries activity at each visit. These reviews 13,21,22 have also highlighted the current lack of such methods validated for reliable and precise estimation of caries activity. In fact, the model we used to assess the chance of level of caries can be used at the individual level as well as population level to assist dental professionals in implementing effective treatment and preventive strategies, in order to reduce the prevalence of dental caries in Sri Lanka.…”

“…As a result, there are a number of research papers published on the use of caries risk assessment tools as prediction instruments to identify the relative occurrence or absence of caries in the setup of minimally invasive clinical management. [11][12][13] Further, Abernathy et al 14 used the discriminate function and logistic regression analysis to predict the caries risk and showed that both statistical methods are equal in specificity and sensitivity. However, it further says that the logistic regression is a relatively new technique in this area of application, i.e., not limited by requiring predictor variable to be normally distributed.…”