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Tassery H, Miletic I, Turkun LS, Sauro S, Gurgan S, Banerjee A, Basso M, Khelafia S, Terrer E, Pilliol V, Slimani A. Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions. Br Dent J 2024; 236:603-610. [PMID: 38671111 DOI: 10.1038/s41415-024-7292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 04/28/2024]
Abstract
Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.
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Affiliation(s)
- Hervé Tassery
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France; LBN, Université de Montpellier, UR-UM104, Montpellier, France.
| | - Ivana Miletic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva ul. 5, 10000 Zagreb, Croatia
| | - Lezize Sebnem Turkun
- Department of Restorative Dentistry, Ege University School of Dentistry, Izmir 35040, Turkey
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, CEU Cardenal Herrera University, CEU Universities, 46115 Valencia, Spain; Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Avijit Banerjee
- Conservative and Minimally Invasive Dentistry, Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, SE1 9RT, UK
| | - Matteo Basso
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Saber Khelafia
- Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Elodie Terrer
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Virginie Pilliol
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Amel Slimani
- LBN, Université de Montpellier, UR-UM104, Montpellier, France; Faculté d'Odontologie, Université de Montpellier, 34193 Montpellier, France
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Cheng L, Zhang L, Yue L, Ling J, Fan M, Yang D, Huang Z, Niu Y, Liu J, Zhao J, Li Y, Guo B, Chen Z, Zhou X. Expert consensus on dental caries management. Int J Oral Sci 2022; 14:17. [PMID: 35361749 PMCID: PMC8971510 DOI: 10.1038/s41368-022-00167-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 02/05/2023] Open
Abstract
Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
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Affiliation(s)
- Lei Cheng
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China
| | - Lu Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong, China
| | - Mingwen Fan
- School of Medicine, Jianghan University, Wuhan, China
| | - Deqin Yang
- College of Stomathology, Chongqing Medical University, Chongqing, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Yumei Niu
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, China
| | - Jianguo Liu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Yanhong Li
- Affiliated Stomatological Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Bin Guo
- Department of Stomatology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China.
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Gowdar I, BinKhames Y, Althani R, Almuthaybiri S, Alabdulmuhsin S, Alatiyyah F. Knowledge of caries risk assessment among dental students in Riyadh Region Saudi Arabia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S327-S330. [PMID: 36110735 PMCID: PMC9469363 DOI: 10.4103/jpbs.jpbs_804_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Caries is a preventable dental disease; further, it is associated with many risk factors. If risk factors are identified and evaluated in time, prevention can be achieved. Aim: Present study attempts to assess the knowledge of caries risk evaluation among dental students in Riyadh using a cross-sectional observational study design. Materials and Methods: The study comprised 390 dental students, interns, from the Riyadh region, Saudi Arabia. Questionnaire was developed to assess knowledge about Caries Risk Assessment (CRA). Questionnaire included ten straight statements with options for acceptance or refusal by marking true or false. Results: About 10.3% of the participants accepted dental caries as transmissible disease. About 69.5% of the participants think White spot lesions as carious lesions. 66.9% predict radiographic approximal lesions are disease indicators. Conclusion: Majority of the participants possessed knowledge about caries risk assessment, although prevention-oriented knowledge needs to be improved because knowledge of caries inducing aspects and risk of occurrence among clinicians help to deliver tailored preventive measures and appropriate execution of treatment.
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Yeo AN, Lee SY. Effect of dental caries management using 'CAMBRA-kids' mobile application for children under 5 years old. Int J Dent Hyg 2021; 20:443-452. [PMID: 34897968 DOI: 10.1111/idh.12565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/08/2021] [Accepted: 12/09/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine effects of dental caries management using 'CAMBRA-kids' mobile application for children under 5 years old for a period of a year. METHODS This study was conducted on 119 preschoolers and parents. Parents downloaded 'CAMBRA-kids' mobile application and entered risk factors and protective factors for children. Clinician entered disease indicators after clinical examination of children. Based on the input, the caries risk group was automatically determined by the 'CAMBRA-kids' application. According to the caries risk level, caries management was conducted for 12 months according to guidelines. RESULTS Children's caries risk level changed after conducting caries management for 1 year. In the change of CRA (Caries risk assessment) by factor, risk factors decreased in all risk groups, whereas protective factors increased in all risk groups. Disease indicators increased after 12 months in the extreme high-risk group and the high-risk group, but decreased in the low-risk group. CONCLUSION This study evaluated the effect of systematic dental caries management using 'CAMBRA-kids' mobile application for preschool children. As a result, dental caries management had effects on children, especially for the extreme high-risk group and the high-risk group. Thus, it is expected to be used in a variety of areas for caries management of preschoolers.
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Affiliation(s)
- An-Na Yeo
- Department of Dental Hygiene, Daejeon Institute of Science and Technology, Daejeon, Korea
| | - Su-Young Lee
- Department of Dental Hygiene, Namseoul University, Cheonan, Korea
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Evaluation of Final-Year Turkish Dental Students' Knowledge, Attitude, and Self-Perceived Competency towards Preventive Dentistry. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2346061. [PMID: 31828094 PMCID: PMC6885817 DOI: 10.1155/2019/2346061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/28/2019] [Accepted: 09/09/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Dental education plays an important role in providing students with the opportunity to develop their evidence-based knowledge and clinical skills regarding patient-specific preventive care and caries management strategies. The aims of this study were to examine the knowledge, attitude, and self-perceived competency towards preventive dentistry among final-year dental students and to investigate their preventive practice for high-caries-risk children. Methods. Data were collected from a convenience sample of 126 dental students using a questionnaire. The IBM SPSS Statistics version 21 was used for data analysis. RESULTS A total of 126 students completed the questionnaire, and 63% of the respondents were female. Significant gender differences were found in the total Professional Preventive Knowledge Scale (PPKS) (p=0.016) and its subscales of the noncariogenic nutrition (p=0.015), dental hygiene/clinical examination (p < 0.001), caries-preventive practice (p=0.02), and the Hiroshima University-Dental Behavioral Inventory (HU-DBI) (p=0.028). Significant differences were observed in the total PPKS (p=0.003) and its subscales of the noncariogenic nutrition (p=0.043) and caries risk management (p=0.006) in terms of self-perceived need to receive education and training. Caries-preventive practice was correlated with the self-perceived competency (r = 0.279; p=0.002), the attitudes (r = 0.394; p < 0.001), the total PPKS (r = 0.457; p < 0.001) and its all subscales of dental hygiene and clinical examination (r = 0.425; p < 0.001), noncariogenic nutrition (r = 0.410; p < 0.001), and caries risk management (r = 0.184; p=0.039). The self-perceived competency was positively correlated with the total PPKS (r = 0.192; p=0.031) and its subscale of noncariogenic nutrition (r = 0.259; p=0.003). Greater self-perceived competence, more positive attitudes, and good knowledge regarding preventive dentistry were found to be important predictors of the caries-preventive practice of dental students, explaining 31% of the variance (adjusted R 2 = 0.312, p < 0.001). CONCLUSION 40% of dental students reported educational and training needs regarding the diagnosis, caries-preventive agents, and risk-based treatment plan. These results should be taken into account by the stakeholders in developing the national core curriculum for undergraduate Turkish dental education.
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Rechmann P, Chaffee BW, Rechmann BMT, Featherstone JDB. Changes in Caries Risk in a Practice-Based Randomized Controlled Trial. Adv Dent Res 2018; 29:15-23. [PMID: 29355409 DOI: 10.1177/0022034517737022] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To demonstrate that Caries Management by Risk Assessment (CAMBRA) can be successfully implemented in dental practice, 30 dentists were recruited to perform a 2-y CAMBRA trial. Twenty-one dentists (18 private practices, 3 community clinics) participated in a randomized, controlled, parallel-arm, double-blind clinical trial with individual-level assignment of 460 participants to standard of care (control) versus active CAMBRA treatment (intervention). Control or active antimicrobial and remineralizing agents were dispensed at baseline and 6-, 12-, 18-, and 24-mo recall visits according to risk level and assigned treatment arm. Primary outcome measure was dentist-determined caries risk level at recall. Among initially high-risk participants, secondary outcomes were recorded disease indicators. Generalized estimating equations were used to fit log-linear models for each outcome while accounting for repeated measurements. At 24 mo, follow-up rates were 34.3% for high-risk participants (32.1% intervention, 37.1% control) and 44.2% for low-risk participants (38.7% intervention, 49.5% control). Among 242 participants classified as high caries risk at baseline (137 intervention, 105 control), a lower percentage of participants remained at high risk in the intervention group (statistically significant at all time points). At 24 mo, 25% in the intervention group and 54% in the control group remained at high risk ( P = 0.003). Among 192 participants initially classified as low risk (93 intervention, 99 control), most participants remained at low risk. At 24 mo, 89% in the intervention group and 71% in the control group were low caries risk ( P = 0.18). The percentage of initially high-risk participants with recorded disease indicators decreased over time in both intervention and control groups, being always lower for the intervention group (statistically significant at the 12- and 18-mo time point). In this practice-based clinical trial, a significantly greater percentage of high-caries-risk participants were classified at a lower risk level after CAMBRA preventive therapies were provided. Most participants initially assessed at low caries risk stayed at low risk (ClinicalTrials.gov NCT01176396).
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Affiliation(s)
- P Rechmann
- 1 Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
| | - B W Chaffee
- 1 Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
| | - B M T Rechmann
- 1 Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
| | - J D B Featherstone
- 1 Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
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Abstract
A system for Caries Management by Risk Assessment (CAMBRA®) has been developed in California. The purpose of this article is to summarize the science behind the methodology, the history of the development of CAMBRA, and the outcomes of clinical application. The CAMBRA caries risk assessment (CRA) tool for ages 6 y through adult has been used at the University of California, San Francisco (UCSF), for 14 y, and outcome studies involving thousands of patients have been conducted. Three outcomes assessments, each on different patient cohorts, demonstrated a clear relationship between CAMBRA-CRA risk levels of low, moderate, high, and extreme with cavitation or lesions into dentin (by radiograph) at follow-up. This validated risk prediction tool has been updated with time and is now routinely used at UCSF and in other settings worldwide as part of normal clinical practice. The CAMBRA-CRA tool for 0- to 5-y-olds has demonstrated similar predictive validity and is in routine use. The addition of chemical therapy (antibacterial plus fluoride) to the traditional restorative treatment plan, based on caries risk status, has been shown to reduce the caries increment by about 20% to 38% in high-caries-risk adult patients. The chemical therapy used for high-risk patients is a combination of daily antibacterial therapy (0.12% w/v chlorhexidine gluconate mouth rinse) and twice-daily high-concentration fluoride toothpaste (5,000 ppm F), both for home use. These outcomes assessments provide the evidence to use these CRA tools with confidence. Caries can be managed by adding chemical therapy, based on the assessed caries risk level, coupled with necessary restorative procedures. For high- and extreme-risk patients, a combination of antibacterial and fluoride therapy is necessary. The fluoride therapy must be supplemented by antibacterial therapy to reduce the bacterial challenge, modify the biofilm, and provide prevention rather than continued caries progression.
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Affiliation(s)
- J D B Featherstone
- 1 Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, USA
| | - B W Chaffee
- 1 Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, USA
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Alhabdan YA, Albeshr AG, Yenugadhati N, Jradi H. Prevalence of dental caries and associated factors among primary school children: a population-based cross-sectional study in Riyadh, Saudi Arabia. Environ Health Prev Med 2018; 23:60. [PMID: 30497366 PMCID: PMC6267843 DOI: 10.1186/s12199-018-0750-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/30/2018] [Indexed: 01/27/2023] Open
Abstract
Background Dental caries is a preventable childhood disease, but public health efforts are hampered due to limited information on associated factors in vulnerable populations. Our study was aimed at estimating the prevalence of dental caries and identifying key associated factors in four major risk domains, including socioeconomic factors, child oral health behavior and practices, child feeding practices, and dietary habits among primary school children in Saudi Arabia. Methods A cross-sectional study design was used to recruit 578 male Saudi primary school children, aged 6–8 years, from 12 primary schools in five different regions of Riyadh. Children were clinically screened to detect carious lesions in primary teeth according to World Health Organization’s criteria. Structured self-administered questionnaire was used to collect information on social and individual factors from the parents. The odds ratios and 95% confidence intervals of associated factors for dental caries were computed using logistic regression models; key factors were identified by systematic selection process that accounted for multicollinearity and bias correction. Results Dental caries was prevalent among children (83%, 95% confidence interval 79.7–86.0%). Individual factors, including irregular brushing, late adoption of brushing habit, consulting dentist for symptomatic treatment, lack of breast feeding, sleeping with a bottle in mouth, habit of snacking between meals, low consumption of fruits, and frequent consumption of soft drinks and flavored milk, were predominantly associated with dental caries in children, instead of socioeconomic factors (p < 0.05, adjusted R-square 80%). Conclusion Dental caries were prevalent in school children, and individual factors were predominantly associated with the disease. Electronic supplementary material The online version of this article (10.1186/s12199-018-0750-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yazeed Abdullah Alhabdan
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.,Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Mail Code 2350, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.,King Abdulaziz Medical City for National Guard, Ministry of National Guard, Riyadh, Saudi Arabia
| | - Abdulhameed Ghassan Albeshr
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.,Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Mail Code 2350, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.,King Abdulaziz Medical City for National Guard, Ministry of National Guard, Riyadh, Saudi Arabia
| | - Nagarajkumar Yenugadhati
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia. .,Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Mail Code 2350, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
| | - Hoda Jradi
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.,Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Mail Code 2350, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
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Goodwin TL, Devlin H, Glenny AM, O'Malley L, Horner K. Guidelines on the timing and frequency of bitewing radiography: a systematic review. Br Dent J 2018; 222:519-526. [PMID: 28387272 DOI: 10.1038/sj.bdj.2017.314] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 01/24/2023]
Abstract
Objectives To identify guidelines on when and how frequently bitewing radiographs should be used in dentistry for the diagnosis of caries, and to provide an objective appraisal of their quality.Data sources MEDLINE (OVID), US National Guideline Clearinghouse (www.guideline.gov) and the Royal College of Surgeons of England (https://www.rcseng.ac.uk/fds/publications-clinical-guidelines/clinical_guidelines) websites were searched using a variety of relevant search terms (2 August 2016).Data selection Publications were included if they made recommendations on the issue of when and how frequently radiographs should be used in any dentally-related specialty pertaining to the diagnosis of caries; and/or if they were aimed at the individual practitioner (any health professional working within dentistry) and/or patients.Data analysis Thirteen published guidelines were included and assessed using the AGREE II instrument.Conclusions There was a significant variation amongst the guidelines in the recommendations at what age radiography should be undertaken. There was also disagreement on the frequency of repeat radiographs and how this is influenced by the age of the patient and their caries risk.
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Affiliation(s)
- T L Goodwin
- The University of Manchester &Central Manchester University Hospitals Foundation Trust
| | - H Devlin
- The University of Manchester &Central Manchester University Hospitals Foundation Trust
| | - A M Glenny
- The University of Manchester &Central Manchester University Hospitals Foundation Trust
| | | | - K Horner
- The University of Manchester &Central Manchester University Hospitals Foundation Trust
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Rechmann P, Jue B, Santo W, Rechmann BMT, Featherstone JDB. Calibration of dentists for Caries Management by Risk Assessment Research in a Practice Based Research Network - CAMBRA PBRN. BMC Oral Health 2018; 18:2. [PMID: 29301527 PMCID: PMC5755129 DOI: 10.1186/s12903-017-0457-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 12/13/2017] [Indexed: 11/19/2022] Open
Abstract
Background To prove that Caries Management by Risk Assessment (CAMBRA) can be successfully implemented in dental practices outside of the university setting, dentists in the San Francisco Bay Area (CA) were approached to participate in a Practice Based Research Network (PBRN) study. The overall goal of the CAMBRA-PBRN study was to recruit 30 dentists to perform a two-year study involving approximately 900 patients. Goal of the calibration study was to standardize and calibrate dentists potentially participating in the CAMBRA-PBRN study. Methods To minimize inter-examiner variability in data collection, including classification of carious lesions and recording of existing restorations, participating dentists were trained and calibrated in accurate DMFS (decayed, missing, filled surfaces) charting. Dentists were also trained and calibrated to diagnose and differentiate between sound surfaces and non-cavitated caries lesions (International Caries Detection and Assessment - ICDAS scores 1 and 2) for posterior occlusal surfaces. Thirty dentists were calibrated to a single gold standard examiner (BJ) during 6 calibration sessions, between 2011 and 2014. Kappa statistics were used to determine inter-examiner reliability on 13 or more patients, aged 12–63 (average age 38 ± 15 years), per examiner during each session, resulting in 94 patient encounters over the course of all 6 sessions. To participate in the main study, examiners needed to achieve a minimum required kappa of 0.75. During the calibration process, examiners scored between 1036 and 2220 tooth surfaces. Results The kappa values (unweighted kappa) of the participating dentists compared to the gold standard examiner ranged from 0.75 to 0.90, with an average kappa of 0.84 ± 0.03. 90% of the examiners achieved overall kappa values above 0.8. However, separate reliability for assessment of non-cavitated lesions, as in other studies, was lower (0.55 ± 0.15). Multiple subcategories were evaluated. All dentists reached sufficient reliability values to proceed into the study; nevertheless, one dentist discontinued with the study due to scheduling conflicts. Conclusions The high inter-examiner reliability results have shown that dentists who work in primarily non-research based practices can be effectively standardized and calibrated in data collection, based on specific guidelines created to anticipate potential research study scenarios.
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Affiliation(s)
- Peter Rechmann
- School of Dentistry, Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Avenue, San Francisco, CA, 94019, USA.
| | - Bonnie Jue
- School of Dentistry, Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Avenue, San Francisco, CA, 94019, USA
| | - William Santo
- School of Dentistry, Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Avenue, San Francisco, CA, 94019, USA
| | - Beate M T Rechmann
- School of Dentistry, Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Avenue, San Francisco, CA, 94019, USA
| | - John D B Featherstone
- School of Dentistry, Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Avenue, San Francisco, CA, 94019, USA
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Young DA, Alvear Fa B, Rogers N, Rechmann P. The Effect of Calibration on Caries Risk Assessment Performance by Students and Clinical Faculty. J Dent Educ 2017; 81:667-674. [PMID: 28572412 DOI: 10.21815/jde.017.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/09/2017] [Indexed: 11/20/2022]
Abstract
Caries management requires a complete oral examination and an accurate caries risk assessment (CRA). Performing Caries Management by Risk Assessment (CAMBRA) is inefficient when the caries risk level assignment is incorrect. The aim of this study was to evaluate the ability of faculty members and students at one U.S. dental school to correctly assign caries risk levels for 22 CRA cases, followed by calibration with guidelines on how to use the CRA form and a post-calibration test two months after calibration. Inter-examiner reliability to a gold standard (consensus of three experts) was assessed as poor, fair, moderate, good, and very good. Of the 162 students and 125 faculty members invited to participate, 13 students and 20 faculty members returned pre-calibration tests, for response rates of 8% and 16%, respectively. On the post-calibration test, eight students and 13 faculty members participated for response rates of 5% and 10%, respectively. Without guidelines and calibration, both faculty members and students when evaluated as one group performed only poor to fair in assigning correct caries risk levels. After calibration, levels improved to good and very good agreements with the gold standard. When faculty and students were evaluated separately, in the pre-calibration test they correctly assigned the caries risk level on average in only one-quarter of the cases (students 24.1%±13.3%; faculty 23.6%±17.5%). After calibration, both groups significantly improved their correct assignment rate. Faculty members (73.8% correct assignments) showed even significantly higher correct assignment rates than students (47.7% correct assignments). These findings suggest that calibration with a specific set of guidelines improved CRA outcomes for both the faculty members and students. Improved guidelines on how to use a CRA form should lead to improved caries risk assessment and proper treatment strategy for patients.
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Affiliation(s)
- Douglas A Young
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco.
| | - Bernadette Alvear Fa
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco
| | - Nicholas Rogers
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco
| | - Peter Rechmann
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco
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Goolsby SP, Young DA, Chiang HK, Carrico CK, Jackson LV, Rechmann P. The Effects of Faculty Calibration on Caries Risk Assessment and Quality Assurance. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.11.tb06214.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Susie P. Goolsby
- Department of General Practice and Department of Admissions; School of Dentistry; Virginia Commonwealth University
| | - Douglas A. Young
- Department of Dental Practice; Arthur A. Dugoni School of Dentistry; University of the Pacific
| | - Harmeet K. Chiang
- Department of General Practice; School of Dentistry; Virginia Commonwealth University
| | - Caroline K. Carrico
- Department of Periodontics; School of Dentistry; Virginia Commonwealth University
| | - Leonard V. Jackson
- Department of General Practice and Department of Admissions; School of Dentistry; Virginia Commonwealth University
| | - Peter Rechmann
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
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van de Sande FH, Collares K, Correa MB, Cenci MS, Demarco FF, Opdam N. Restoration Survival: Revisiting Patients' Risk Factors Through a Systematic Literature Review. Oper Dent 2016; 41:S7-S26. [PMID: 27689931 DOI: 10.2341/15-120-lit] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A literature review was conducted to investigate the influence of patient-related factors on restoration survival in posterior permanent teeth as well as to report the methods used to collect these factors. The selection of articles on longitudinal clinical studies investigating the survival of posterior restorations (except full crowns and temporary fillings) and including patient-related factors was performed by applying predefined criteria. The review was organized into two parts, the first describing how patient factors were assessed in the studies (n=45) and the second presenting the statistical significance (n=27) and size of the effect (n=11) of these factors on restoration survival. Patient-related factors mentioned in the studies included age; gender; caries risk; caries activity/severity; decayed, missing, filled teeth; number of restorations; oral hygiene; and bruxism, among others. Sixteen studies included the patient age or age range in the analysis, which was found to be significant in 47% of the studies. Regarding gender, four of 17 reports found a significant effect on survival, showing more failures for men in three studies. The caries risk profile or related variables were included in the analysis of 15 studies, and a significant effect on survival was reported for high-caries-risk individuals (or related variables) in 67% of these studies. Bruxism was also found to influence restoration survival in three of six studies where this variable was investigated. Some issues were found regarding the reporting of methods used to classify patients according to risk and were thoroughly discussed. In view of the information gathered in this review, the assessment of patient factors along with other variables should become part of clinical studies investigating restoration survival, since several of these factors were shown to influence the failure of restorations, regardless of the material type.
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Chaffee BW, Featherstone JD. Long-Term Adoption of Caries Management by Risk Assessment Among Dental Students in a University Clinic. J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.5.tb05913.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Benjamin W. Chaffee
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
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Doméjean S, Léger S, Rechmann P, White JM, Featherstone JD. How Do Dental Students Determine Patients’ Caries Risk Level Using the Caries Management By Risk Assessment (CAMBRA) System? J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.3.tb05882.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie Doméjean
- Department of Operative Dentistry and Endodontics; Faculté d’Odontologie; Clermont-Ferrand France
| | - Stéphanie Léger
- Department of Mathematics; Université Blaise Pascal; Clermont-Ferrand France
| | - Peter Rechmann
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| | - Joel M. White
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| | - John D.B. Featherstone
- Department of Preventive and Restorative Dental Sciences and Dean; School of Dentistry; University of California; San Francisco
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Rechmann P, Featherstone JD. Quality Assurance Study of Caries Risk Assessment Performance by Clinical Faculty Members in a School of Dentistry. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.9.tb05805.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Rechmann
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| | - John D.B. Featherstone
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
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Maupome G, Isyutina O. Dental Students’ and Faculty Members’ Concepts and Emotions Associated with a Caries Risk Assessment Program. J Dent Educ 2013. [DOI: 10.1002/j.0022-0337.2013.77.11.tb05624.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Gerardo Maupome
- Department of Preventive and Community Dentistry; Indiana University School of Dentistry
| | - Olga Isyutina
- Department of Preventive and Community Dentistry; Indiana University School of Dentistry
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18
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Validity of caries risk assessment programmes in preschool children. J Dent 2013; 41:787-95. [DOI: 10.1016/j.jdent.2013.06.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 06/13/2013] [Accepted: 06/13/2013] [Indexed: 11/18/2022] Open
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Hallett KB. The application of caries risk assessment in minimum intervention dentistry. Aust Dent J 2013; 58 Suppl 1:26-34. [DOI: 10.1111/adj.12047] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- KB Hallett
- Department of Dentistry; The Royal Children's Hospital; Melbourne; Victoria
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20
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Young DA, Featherstone JDB. Caries management by risk assessment. Community Dent Oral Epidemiol 2013; 41:e53-63. [DOI: 10.1111/cdoe.12031] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Douglas A. Young
- Department of Dental Practice; University of the Pacific; San Francisco; CA; USA
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Markowitz K, Fairlie K, Ferrandiz J, Nasri-Heir C, Fine DH. A longitudinal study of occlusal caries in Newark New Jersey school children: relationship between initial dental finding and the development of new lesions. Arch Oral Biol 2012; 57:1482-90. [PMID: 22841633 DOI: 10.1016/j.archoralbio.2012.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 06/28/2012] [Accepted: 07/08/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Dental caries is a significant public health problem especially amongst children from low-income backgrounds. This longitudinal study examined the development of new occlusal caries in 227 Newark, NJ children ages 10-18. The role of previous caries experience and the presence of occlusal white and dark lesions in predicting the development of new lesions were examined. DESIGN At each visit, the patient's teeth were given a visual-tactile examination and the subject's decayed, missing and filled (DMFS) score was determined. Next, molars lacking probeable caries or restorations were examined using transillumination for occlusal white and dark spots. This examination was repeated periodically. A Cox proportional hazard was used to analyse data concerning the development of new occusal caries in molars. RESULTS The longitudinal data indicates that patients who were caries free at visit-1 developed significantly fewer occlusal caries during the longitudinal study. The hazard ratio for subjects who had first-visit caries was 2.27 compared to caries free subjects. Intact molars with occlusal white or dark lesions had caries hazard ratios of 0.78 and 1.49 respectively, compared to molars lacking initial colour changes. CONCLUSION Having a prior caries history places the subject at increased risk of developing future caries. Teeth with dark lesions but not white lesions are at significantly increased risk for developing decay. White lesions may represent remineralizing or slowly progressing lesions. The results of this study can help identify patients and tooth surfaces at risk for future occlusal decay.
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Affiliation(s)
- Kenneth Markowitz
- Department of Oral Biology, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, 185 South Orange Ave, Newark, NJ 07103, USA
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Teich ST, Demko C, Al-Rawi W, Gutberg T. Assessment of Implementation of a CAMBRA-Based Program in a Dental School Environment. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2013.77.4.tb05489.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Rechmann P, Charland D, Rechmann BMT, Featherstone JDB. Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:036006. [PMID: 22502564 DOI: 10.1117/1.jbo.17.3.036006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The aim of this study was to evaluate the diagnostic capabilities of a laser fluorescence tool DIAGNOdent (KaVo, Biberach, Germany) and two light-emitting diode fluorescence tools-Spectra Caries Detection Aid (AIR TECHNIQUES, Melville, NY), and SOPROLIFE light-induced fluorescence evaluator in daylight and blue florescence mode (SOPRO, ACTEON Group, La Ciotat, France)-in comparison to the caries detection and assessment system (ICDAS-II) in detection of caries lesions. In 100 subjects (age 23.4±10.6 years), 433 posterior permanent unrestored teeth were examined. On the occlusal surfaces, up to 1066 data points for each assessment method were available for statistical evaluation, including 1034 ICDAS scores (intra-examiner kappa=0.884). For the SOPROLIFE tool, a new caries-scoring system was developed. Per assessment tool each average score for one given ICDAS code was significantly different from the one for another ICDAS code. Normalized data linear regression revealed that both SOPROLIFE assessment tools allowed for best caries score discrimination followed by DIAGNOdent and Spectra Caries Detection Aid. The area under the receiver operating characteristics curve calculations showed the same grading sequence when cutoff point ICDAS codes 0-1-2 were grouped together. Sensitivity and specificity values at the same cutoff were calculated (DIAGNOdent 87/66, Spectra Caries Detection Aid 93/37, SOPROLIFE 93/63, SOPROLIFE blue fluorescence 95/55.).
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Affiliation(s)
- Peter Rechmann
- University of California at San Francisco, School of Dentistry, Department of Preventive and Restorative Dental Sciences, San Francisco, California 94143, USA.
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Markowitz K, Stenvall RM, Graye M. The effect of distance and tooth structure on laser fluorescence caries detection. Oper Dent 2011; 37:150-60. [PMID: 22166110 DOI: 10.2341/10-179-l] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The DIAGNOdent, a device used in caries detection, uses a laser to excite fluorescence from pigments in carious tooth structure. In clinical use assessing occlusal surfaces, distance and tooth structure may separate the instrument's tip from the fluorescent source.The aim of this in vitro study was to examine the effect of distance and tooth structure on laser fluorescence (LF) readings.In one set of experiments, a porphyrin pigmentin oil suspension was used as a LF signal source. Thin slices of enamel and dentin were obtained from extracted molars. Pigment-induced LF readings were obtained when these slices were placed between the porphyrin pigment and the LF instrument's tip. The effect of either demineralized or intact tooth tissue on pigment-induced LF readings was assessed.In other experiments on extracted molars with small occlusal caries, LF readings were taken from pit/fissure sites before and after removal of the occlusal surface.LF readings are proportional to pigment con-centration and inversely proportional to the distance between the suspension and the instrument's tip. Enamel, demineralized enamel,dentin, and demineralized dentin all caused significant reductions in LF signal, all readings being taken with the same tip-pigment distance. Demineralized enamel (white with intact surface) caused the most reduction.After sectioning of carious teeth, there was a significant increase in LF readings.The results of this study indicate that distance and the presence of tooth structure between the carious lesion and the instrument's tip reduce LF readings. These results indicate that anatomic factors interfere with the LF device's ability to assess occlusal caries. DIAGNOdent readings should not be relied on when making diagnostic decisions.
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Affiliation(s)
- K Markowitz
- Department of Oral Biology, New Jersey Dental School, Newark, NJ, USA.
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25
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Riley JL, Gordan VV, Ajmo CT, Bockman H, Jackson MB, Gilbert GH. Dentists' use of caries risk assessment and individualized caries prevention for their adult patients: findings from The Dental Practice-Based Research Network. Community Dent Oral Epidemiol 2011; 39:564-73. [PMID: 21726268 DOI: 10.1111/j.1600-0528.2011.00626.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Few studies have examined dentists' subjective ratings of importance of caries risk factors or tested whether dentists use this information in treatment planning. This study tested several hypotheses related to caries risk assessment (CRA) and individualized caries prevention (ICP). METHODS Data were collected as part of a questionnaire entitled 'Assessment of Caries Diagnosis and Caries Treatment', completed by 547 practitioners who belong to The Dental Practice-Based Research Network (DPBRN), a consortium of participating practices and dental organizations. RESULTS Sixty-nine percent of DPBRN dentists perform CRA on their patients. Recently graduated dentists, dentists with busier practices, and those who believe a dentist can predict future caries were the most likely to use CRA. The association between CRA and individualized prevention was weaker than expected (r = 0.21). Dentists who perform CRA provide ICP to 57% of their patients, compared with 42% for dentists who do not perform CRA. Based on their responses to radiographic and clinical scenarios in the questionnaire, dentists who use CRA appear to use this information in restorative decisions. CONCLUSION A substantial percentage of DPBRN dentists do not perform CRA, and there is not a strong linkage between its use and use of individualized preventive regimens for adult patients. More progress in the implementation of current scientific evidence in this area is warranted.
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Affiliation(s)
- Joseph L Riley
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL 32610-04415, USA
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Beikler T, Flemmig TF. Oral biofilm-associated diseases: trends and implications for quality of life, systemic health and expenditures. Periodontol 2000 2011; 55:87-103. [PMID: 21134230 DOI: 10.1111/j.1600-0757.2010.00360.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Yorty JS, Walls AT, Wearden S. Caries Risk Assessment/Treatment Programs in U.S. Dental Schools: An Eleven-Year Follow-Up. J Dent Educ 2011. [DOI: 10.1002/j.0022-0337.2011.75.1.tb05023.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Eckert GJ, Jackson R, Fontana M. Sociodemographic variation of caries risk factors in toddlers and caregivers. Int J Dent 2010; 2010:593487. [PMID: 20953367 PMCID: PMC2952902 DOI: 10.1155/2010/593487] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 05/05/2010] [Accepted: 07/29/2010] [Indexed: 11/18/2022] Open
Abstract
Objectives. Dental caries is the most common chronic childhood disease, with numerous identified risk factors. Risk factor differences could indicate the need to target caregiver/patient education/preventive care intervention strategies based on population and/or individual characteristics. The purpose of this study was to evaluate caries risk factors differences by race/ethnicity, income, and education. Methods. We enrolled 396 caregiver-toddler pairs and administered a 105-item questionnaire addressing demographics, access to care, oral bacteria transmission, caregiver's/toddler's dental and medical health practices, caregiver's dental beliefs, and caregiver's/toddler's snacking/drinking habits. Logistic regressions and ANOVAs were used to evaluate the associations of questionnaire responses with caregiver's race/ethnicity, income, and education. Results. Caregivers self-identified as Non-Hispanic African-American (44%), Non-Hispanic White (36%), Hispanic (19%), and "other" (1%). Differences related to race/ethnicity, income, and education were found in all risk factor categories. Conclusions. Planning of caregiver/patient education/preventive care intervention strategies should be undertaken with these caries risk factor differences kept in mind.
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Affiliation(s)
- G. J. Eckert
- Division of Biostatistics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - R. Jackson
- Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis, IN 46202, USA
| | - M. Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109-1078, USA
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Gonzalez CD, Okunseri C. Senior Dental Students’ Experience with Cariogram in a Pediatric Dentistry Clinic. J Dent Educ 2010. [DOI: 10.1002/j.0022-0337.2010.74.2.tb04861.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Cesar D. Gonzalez
- Division of Pediatric Dentistry; Department of Developmental Sciences
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Abstract
Dentists and the dental health care industry have a renewed interest in clinical risk assessment, because they offer the potential to identify a patient's clinical needs for oral health care more specifically, to maximize prevention by early intervention, and to educate patients to become more informed consumers of oral health care and direct resources where they are most needed and can produce the greatest value. To realize this potential, risk assessment must be applied appropriately, and its indirect ramifications for access to care should be considered. Several ideas for the appropriate application of risk assessment are discussed and the ramifications for access to care are explored.
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Affiliation(s)
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- Council on Dental Practice, American Dental Association, 211 E. Chicago Avenue, Chicago, IL 60611, USA.
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Abstract
Clinical RelevanceChlorhexidine rinses should not be recommended for use in caries prevention due to the current lack of evidence for their effectiveness.
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Calderón SH, Gilbert P, Zeff RN, Gansky SA, Featherstone JD, Weintraub JA, Gerbert B. Dental Students’ Knowledge, Attitudes, and Intended Behaviors Regarding Caries Risk Assessment: Impact of Years of Education and Patient Age. J Dent Educ 2007. [DOI: 10.1002/j.0022-0337.2007.71.11.tb04412.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sophia H. Calderón
- Department of Preventive and Restorative Dental Sciences; School of Dentistry, University of California; San Francisco
| | - Paul Gilbert
- Department of Preventive and Restorative Dental Sciences; School of Dentistry, University of California; San Francisco
| | - Rasika N. Zeff
- Department of Preventive and Restorative Dental Sciences; School of Dentistry, University of California; San Francisco
| | - Stuart A. Gansky
- Department of Preventive and Restorative Dental Sciences; School of Dentistry, University of California; San Francisco
| | - John D.B. Featherstone
- Department of Preventive and Restorative Dental Sciences; School of Dentistry, University of California; San Francisco
| | - Jane A. Weintraub
- Department of Preventive and Restorative Dental Sciences; School of Dentistry, University of California; San Francisco
| | - Barbara Gerbert
- Department of Preventive and Restorative Dental Sciences; School of Dentistry, University of California; San Francisco
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