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Devraj IM, Shankaraguru GM, Jairam LS, Dhull KS, Bhojraj N. Comparison of two different caries risk assessment tools for infants and toddlers - A cross-sectional study. J Indian Soc Pedod Prev Dent 2024; 42:9-14. [PMID: 38616421 DOI: 10.4103/jisppd.jisppd_546_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/21/2024] [Indexed: 04/16/2024] Open
Abstract
CONTEXT One of the essential components for successful caries management is caries risk assessment (CRA). Among CRA tools (CRATs) published in the literature: Caries management by risk assessment (CAMBRA) 123 and American Academy of Pediatric Dentistry (AAPD) CRATs are specifically designed for infants and toddlers. AIMS The aim of this study is to compare readily available internationally accepted CRAT for infants and toddlers and check the usability of these tools in assigning caries risk among the Indian population. SETTINGS AND DESIGN The study was conducted at Baby Oral Health Promotion Clinic, Department of Pediatrics, Tertiary Care Hospital using a cross-sectional study design. SUBJECTS AND METHODS Data were collected using CAMBRA 123 and AAPD CRATs from 379 children aged 0-6 years. The caries risk of the children was recorded with each CRAT and a comparison was made between the two tools used. STATISTICAL ANALYSIS USED The percentage of agreement and Cohen's kappa coefficient were used to know the agreement between the CAMBRA 123 and AAPD CRATs using the SPSS statistical tool. The significance level was set at 5% (α = 0.05). RESULTS For children aged <2 years, the study showed slight agreement between the CAMBRA 123 and AAPD, whereas, for children more than 2 years, there was a fair agreement between the two methods which was statistically significant. This indicates that the agreement between the two methods is still not perfectly established, and AAPD CRA assigns a higher risk category than CAMBRA 123. CONCLUSIONS CAMBRA 123 is a promising user-friendly quantitative method for CRA in clinical practice. Since there is ambiguity in assessing the caries risk in children <2 years, there is a need to establish a CRAT that can be used exclusively for children below 2 years.
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Affiliation(s)
- Indira Mysore Devraj
- Department of Pediatric and Preventive Dentistry, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Girish M Shankaraguru
- Department of Pediatric and Preventive Dentistry, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Lalitha S Jairam
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Gnanagangothri Campus, Bengaluru, Karnataka, India
| | - Kanika Singh Dhull
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Nandlal Bhojraj
- Department of Pediatric and Preventive Dentistry, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Havsed K, Hänsel Petersson G, Isberg PE, Pigg M, Svensäter G, Rohlin M. Multivariable prediction models of caries increment: a systematic review and critical appraisal. Syst Rev 2023; 12:202. [PMID: 37904228 PMCID: PMC10614348 DOI: 10.1186/s13643-023-02298-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/28/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Multivariable prediction models are used in oral health care to identify individuals with an increased likelihood of caries increment. The outcomes of the models should help to manage individualized interventions and to determine the periodicity of service. The objective was to review and critically appraise studies of multivariable prediction models of caries increment. METHODS Longitudinal studies that developed or validated prediction models of caries and expressed caries increment as a function of at least three predictors were included. PubMed, Cochrane Library, and Web of Science supplemented with reference lists of included studies were searched. Two reviewers independently extracted data using CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) and assessed risk of bias and concern regarding applicability using PROBAST (Prediction model Risk Of Bias ASessment Tool). Predictors were analysed and model performance was recalculated as estimated positive (LR +) and negative likelihood ratios (LR -) based on sensitivity and specificity presented in the studies included. RESULTS Among the 765 reports identified, 21 studies providing 66 prediction models fulfilled the inclusion criteria. Over 150 candidate predictors were considered, and 31 predictors remained in studies of final developmental models: caries experience, mutans streptococci in saliva, fluoride supplements, and visible dental plaque being the most common predictors. Predictive performances varied, providing LR + and LR - ranges of 0.78-10.3 and 0.0-1.1, respectively. Only four models of coronal caries and one root caries model scored LR + values of at least 5. All studies were assessed as having high risk of bias, generally due to insufficient number of outcomes in relation to candidate predictors and considerable uncertainty regarding predictor thresholds and measurements. Concern regarding applicability was low overall. CONCLUSIONS The review calls attention to several methodological deficiencies and the significant heterogeneity observed across the studies ruled out meta-analyses. Flawed or distorted study estimates lead to uncertainty about the prediction, which limits the models' usefulness in clinical decision-making. The modest performance of most models implies that alternative predictors should be considered, such as bacteria with acid tolerant properties. TRIAL REGISTRATION PROSPERO CRD#152,467 April 28, 2020.
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Affiliation(s)
- Kristian Havsed
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden.
- Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
- Faculty of Odontology, Malmö University, Malmö, Sweden.
| | | | | | - Maria Pigg
- Faculty of Odontology, Malmö University, Malmö, Sweden
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Taqi M, Zaidi SJA. Predictive validity of the reduced Cariogram model for caries increment in non-cavitated and cavitated lesions: cohort study. BMC Oral Health 2023; 23:790. [PMID: 37875839 PMCID: PMC10598975 DOI: 10.1186/s12903-023-03479-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND The aim of this study is to assess the caries prediction of the reduced Cariogram by comparing baseline caries risk profiles with non-cavitated and cavitated lesions over periods of six, twelve, and 18 months. METHODS From May 2016 to October 2017, seven schools in Bhakkar, Pakistan, participated in a cohort study. First base line examination was conducted followed by examinations at 6, 12 and 18 months. Children intraoral examinations were performed on portable dental chair with in school premises by a trained examiner. A modified ICDAS index was used to measure caries at baseline and at follow-up examinations after 6, 12, and 18-months. A receiver operating curve (ROC) analysis was performed to evaluate its effectiveness for predicting dental caries increment. RESULTS About 40% of children had a low-risk status, 30.5% medium risk, and 29.7% high risk, at baseline risk assessment. At 18 months, 73% of high-risk children, 59% of medium-risk children, and 41% of low-risk children showed a caries increment. For the reduced Cariogram model, the area under the curve on the 6, 12 and 18 months follow-up was 0.63, 0.65 and 0.70 respectively. CONCLUSIONS Our findings indicates that a reduced Cariogram can predict the progression of caries in both cavitated and non-cavitated lesions and model exhibits a level of discriminatory ability. While it might not achieve a very high accuracy, it suggests that the model is able to predict caries increment effectively than random guessing.
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Affiliation(s)
- Muhammad Taqi
- Department of Community Dentistry Dow Dental College, Dow University of Health Sciences, Karachi, 74200, Pakistan.
| | - Syed Jaffar Abbas Zaidi
- Department of Oral Biology, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
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Pammi T, Jois KN. Monitoring patient compliance to dental home care instructions with the mobile-based ecosystem. J Indian Soc Pedod Prev Dent 2023; 41:51-56. [PMID: 37282412 DOI: 10.4103/jisppd.jisppd_63_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Background Caries risk assessment and management from the cornerstone for successfully applying a minimum intervention dentistry philosophy in managing dental caries. Most applied work on caries prevention acknowledges the role of oral hygiene and dietary control strategies in reducing the prevalence and incidence of caries. What we need to address, however, is the necessity of initiating and sustaining behaviors that will ensure the implementation of strategies, that is "patient compliance." Aims and Objectives To present a novel method to monitor oral health-care behavior on a day-to-day basis and guide the parent-child team to set self-help goals. In addition, sustain them over time until the oral environment has positively changed and improved in caries risk status. Methodology A mobile-based application and digital ecosystem have been developed to record daily data, motivate the user and present it as monthly and periodic graphic output. This supplements other caries risk assessment methods employed in recall follow-up to understand the changing oral environment. Results and Conclusion Pilot trial results are promising and our mobile-based application seems to be definite adjuvant in improving and monitoring patient compliance.
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Affiliation(s)
- Thejokrishna Pammi
- Dr. Thejokrishna's Dental Health Clinic, Navi Mumbai, Maharashtra, India
| | - Krishaay N Jois
- Dr. Thejokrishna's Dental Health Clinic, Navi Mumbai, Maharashtra, India
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Taqi M, Razak IA, Ab-Murat N, Zaidi SJA. Establishing risk-based recall interval for caries management among 11-12-year-old Pakistani children. BMC Oral Health 2022; 22:349. [PMID: 35964068 PMCID: PMC9375350 DOI: 10.1186/s12903-022-02383-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/05/2022] [Indexed: 11/12/2022] Open
Abstract
Background This study aims to investigate the rate of caries increment among 11-12-year-old Pakistani children over 18 months using modified International Caries Detection and Assessment Systems II (ICDAS) and subsequently establish an appropriate dental recall interval for our targeted population according to their caries risk intensity.
Methods A prospective longitudinal study was conducted in Bhakkar, Punjab, Pakistan. The 226 children from seven schools of Bhakkar with the highest student enrolment were conveniently selected. Caries risk assessment was performed using a computer-based reduced Cariogram program. Caries increment among cavitated lesions was measured by modified Beck's method or adjusted caries increment. Two ICDAS II cutoffs were created for the analysis of cavitated lesion (ICDAS code 3–6) and cavitated plus non-cavitated lesion (ICDAS code A-6).
Results At the risk assessment stage, 39.8% of the children were classified as low risk, 30.5% as medium risk, and 29.7% as high risk. Caries increment at both cutoff points increased with caries risk at all follow-ups. The highest caries increment was recorded at the third follow-up among high-risk children at cutoff 3–6 (1.95 ± 3.18) and A-6 (4.01 ± 4.31). However, the lowest caries increment was recorded at the third follow-up among low-risk children at cutoff 3–6 (0.18 ± 1.42) and A-6 (1.11 ± 3.33). Conclusion Based on the study findings for Pakistani children with cavitated lesions, the recommended risk-based recall interval for caries management is 18 months for those with low and medium caries risk and six months for those with high caries risk. On the other hand, recommendations for risk-based recall intervals for caries management in non-cavitated and cavitated lesions are six months for low-risk, moderate risk and high-risk for Pakistani 11-12-year-old children.
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Affiliation(s)
- Muhammad Taqi
- Department of Community Dentistry, Dow Dental College, Dow University of Health Sciences, Karachi, 74200, Sindh, Pakistan.
| | - Ishak Abdul Razak
- Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Jenjarom, Selangor, Malaysia
| | - Norintan Ab-Murat
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Syed Jaffar Abbas Zaidi
- Department of Oral Biology, Dow Dental College, Dow University of Health Sciences, Karachi, 74200, Pakistan
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Featherstone JDB, Crystal YO, Alston P, Chaffee BW, Doméjean S, Rechmann P, Zhan L, Ramos-Gomez F. A Comparison of Four Caries Risk Assessment Methods. FRONTIERS IN ORAL HEALTH 2021; 2:656558. [PMID: 35048004 PMCID: PMC8757708 DOI: 10.3389/froh.2021.656558] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions. Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0-6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups. Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.
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Affiliation(s)
- John D. B. Featherstone
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Yasmi O. Crystal
- Pediatric Dentistry Department, College of Dentistry, New York University, New York, NY, United States
- Comprehensive Pediatric Dentistry, Bound Brook, NJ, United States
| | - Pamela Alston
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin W. Chaffee
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Sophie Doméjean
- Department of Operative Dentistry and Endodontics, UFR d'Odontologie de Clermont-Ferrand, Clermont-Ferrand, France
- EA 4847, Clermont-Ferrand, France
- Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Peter Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Ling Zhan
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Francisco Ramos-Gomez
- Section of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
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Hultquist AI, Brudin L, Bågesund M. Early childhood caries risk assessment in 1-year-olds evaluated at 6-years of age. Acta Odontol Scand 2021; 79:103-111. [PMID: 32697607 DOI: 10.1080/00016357.2020.1795247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim was to identify caries risk factors in 1-year-olds predicting dentine caries in 6-year-olds. MATERIALS AND METHODS Caries risk assessment was performed in 804 one-year-olds. Their parents answered a questionnaire, regarding family factors, general health, food habits and oral hygiene. Clinical examinations and caries risk assessments at 1, 3 and 6 years of age were performed. Simple and multiple regression analyses were used for identification of caries-associated factors. RESULTS Caries risk was found in 5% of the 1-year-olds, and 12% of the 3-year-olds. Dentine caries was found in 3% of the 3-year-olds and in 16% of the 6-year-olds. Caries risk assessment was associated with caries at 6 years of age (OR = 5.1, p < .001). Multiple logistic regression analysis found the following variables associated with caries at 6 years of age: Caries in sibling (OR = 2.1, p = .012), Beverage other than water (OR = 2.1, p < .001), Night meal (OR = 1.9, p = .002), Presence of mutans streptococci (MS) (OR = 1.6, p = .033) and Male gender (OR = 1.5, p = .053). An overall caries risk assessment was more reliable than any single caries risk factor. CONCLUSIONS Caries risk assessment for 1-year-olds in a region with low caries prevalence has limited accuracy to predict dental caries at 6 years of age. Caries risk often changes over time and should be reassessed on a regularly basis. The presence of MS in 1-year-olds did not increase the prognostic accuracy at 6 years of age.
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Affiliation(s)
- Ann Ingemansson Hultquist
- Västervik Public Dental Service, Kalmar County Council, Kalmar, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lars Brudin
- Department of Clinical Physiology, Region Kalmar Council, Kalmar, Sweden
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Mats Bågesund
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Orthodontics and Pediatric Dentistry, Norrköping, Sweden
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Trottini M, Campus G, Corridore D, Cocco F, Cagetti MG, Vigo MI, Polimeni A, Bossù M. Assessing the Predictive Performance of Probabilistic Caries Risk Assessment Models: The Importance of Calibration. Caries Res 2020; 54:258-265. [PMID: 32516777 DOI: 10.1159/000507276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 03/10/2020] [Indexed: 11/19/2022] Open
Abstract
Probabilistic caries risk assessment models (P-CRA), such as the Cariogram, are promising tools to planning treatments in order to control and prevent caries. The usefulness of these models for informing patients and medical decision-making depends on 2 properties known as discrimination and calibration. Current common assessment of P-CRA models, however, ignores calibration, and this can be misleading. The aim of this paper was to provide tools for a proper assessment of calibration of the P-CRA models and improve calibration when lacking. A combination of standard calibration tools (calibration plot, calibration in-the-large, and calibration slope) and 3 novel measures of calibration (the Calibration Index and 2 related metrics, E50 and E90) are proposed to evaluate if a P-CRA model is well calibrated. Moreover, an approach was proposed and validated using data from a previous follow-up study performed on children evaluated by means of a reduced Cariogram model; Platt scaling and isotonic regression were applied showing a lack of calibration. The use of the Cariogram overestimates the actual risk of new caries for forecast probabilities <0.5 and underestimates the risk for forecast probabilities >0.6. Both Platt scaling and isotonic regression were able to significantly improve the calibration of the reduced Cariogram model, preserving its discrimination properties. The average specificity and sensitivity for both Platt scaling and isotonic regression using the cut-off point p= 0.5 were >83 and their sum well exceeded 160. The benefits of the proposed calibration methods are promising, but further research in this field is required.
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Affiliation(s)
- Mario Trottini
- Department of Mathematics, University of Alicante, Alicante, Spain
| | - Guglielmo Campus
- Clinic for Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland, .,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy,
| | - Denise Corridore
- Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Fabio Cocco
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy
| | - M Isabel Vigo
- Department of Applied Mathematics, University of Alicante, Alicante, Spain
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Maurizio Bossù
- Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
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Dolic O, Obradovic M, Kojic Z, Trtic N, Sukara S, Knezevic N, Veselinovic V. Validation of Cariogram in Caries Prediction in Women and Their Children 4 Years After Pregnancy - Longitudinal Study. Risk Manag Healthc Policy 2020; 13:549-557. [PMID: 32607023 PMCID: PMC7295109 DOI: 10.2147/rmhp.s243907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/12/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cariogram®, an algorithm-based software model, for predicting caries risk has been used to assess the caries risk profile of many different groups. The aims of the study were to evaluate Cariogram caries risk assessment during pregnancy with DMFT/dmft incidence in mothers and their children 4 years after pregnancy and to check if there is an association between children's caries risk profiles using Cariogram and caries risk profiles (by Cariogram) of their mothers during pregnancy. METHODS The study population consisted of 96 pregnant women (average age 27.4±7.2 years at baseline) who completed clinical baseline examination and salivary tests. The follow-up study was initiated 4 years later and the 80 pairs of mother and children (from that pregnancy) were re-examined using the same procedure at baseline. An individual caries risk profile and DMFT/dmft incidence were made for each woman and child. The prediction of the Cariogram was compared to the actual dental experience in 4 years. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for two cut-offs were calculated to express the outcome. RESULTS The results showed a strong association between the risk categories of pregnant women and their offspring as well as between caries development in offspring and the Cariogram risk categories of pregnant women. Sensitivity and PPV for new DMFT (ΔDMFT>0) 4 years after for women were high (>80%) for those participants assessed with 0-60% "chance to avoid caries", as well as diagnostic accuracy (74.00%). High specificity (91.00%), very high PPV (95.00%) and clinically useful values according to Youden's index (0.53) were obtained for moderate-risk and two lowest-risk groups for dmft in children. CONCLUSION Cariogram was valid in the authors' sample only and highly predictive in caries risk assessment in investigated children based on caries risk assessment of their mothers in pregnancy.
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Affiliation(s)
- Olivera Dolic
- Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Marija Obradovic
- Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Zeljka Kojic
- Department of Periodontics and Oral Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Natasa Trtic
- Department of Periodontics and Oral Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Slava Sukara
- Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Natasa Knezevic
- Department of Endodontics and Restorative Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Valentina Veselinovic
- Department of Prosthodontics, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
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Rechmann P, Chaffee BW, Rechmann BMT, Featherstone JDB. Efficacy of an adenosine triphosphate meter for evaluating caries risk in clinical dental practice. J Am Dent Assoc 2019; 150:873-882. [PMID: 31472759 DOI: 10.1016/j.adaj.2019.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adenosine triphosphate bioluminescence (ATP-B) readings have been proposed as markers of caries risk. ATP readings may indicate bacteria or oral streptococci activity in microbial plaque. The authors of this study aimed to evaluate whether readings using a commercial ATP meter (CariScreen Testing Meter, Oral BioTech) are significantly different for patients with low, moderate, and high caries risk in the Caries Management by Risk Assessment Practice-Based Research Network study. METHODS Twenty practice-based research network dentists enrolled 460 patients; 271 returned for 2 or more semiannual follow-up visits over 2 years. Dentists were trained and calibrated to perform ATP-B testing and caries risk assessment (CRA) using established protocols. ATP-B readings were compared via CRA category (low, moderate, high). Generalized estimating equations were used to compare the risk of experiencing incident clinical outcomes (newly recorded decayed, missing, or restored tooth surfaces and CRA disease indicators) according to ATP-B reading at prior patient visits (≥ 1,500 versus < 1,500 relative light units). RESULTS Median ATP-B readings did not differ statistically significantly by clinician-assessed caries risk level (low, 2,323; moderate, 2,940; high, 3,217; P = .65). Adjusted for patient demographics and trial intervention assignment, higher readings were not associated with newly developed decayed, missing, or restored tooth surface (relative risk, 1.57; 95% confidence interval, 0.55 to 4.45) or disease indicators (relative risk, 1.08; 95% confidence interval, 0.85 to 1.37) at the following visit, whereas clinician-assessed caries risk level was strongly associated. CONCLUSIONS ATP-B readings poorly predicted caries risk and future clinical outcomes. CRA incorporating multiple risk, protective, and disease indicators has superior predictive performance. PRACTICAL IMPLICATIONS The findings of this study do not provide evidence supporting the use of ATP-B to predict caries risk.
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Cagetti MG, Bontà G, Cocco F, Lingstrom P, Strohmenger L, Campus G. Are standardized caries risk assessment models effective in assessing actual caries status and future caries increment? A systematic review. BMC Oral Health 2018; 18:123. [PMID: 30012136 PMCID: PMC6048716 DOI: 10.1186/s12903-018-0585-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Assessing caries risk is an essential element in the planning of preventive and therapeutic strategies. Different caries risk assessment (CRA) models have been proposed for the identification of individuals running a risk of future caries. This systematic review was designed to evaluate whether standardized caries risk assessment (CRA) models are able to evaluate the risk according to the actual caries status and/or the future caries increment. METHODS Randomized clinical trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, reporting caries risk assessment using standardized models (Cariogram, CAMBRA, PreViser, NUS-CRA and CAT) in patients of any age related to caries data recorded by DMFT/S or ICDAS indices, were included. PubMed, Scopus and Embase were searched from 2000 to 2016. A search string was developed. All the papers meeting the inclusion criteria were subjected to a quality assessment. RESULTS One thousand three-undred ninety-two papers were identified and 32 were included. In all but one, the Cariogram was used both as sole model or in conjunction with other models. All the papers on children (n = 16) and adults (n = 12) found a statistically significant association between the risk levels and the actual caries status and/or the future caries increment. Nineteen papers, all using the Cariogram except one, were classified as being of good quality. Three of four papers comprising children and adults found a positive association. For seven of the included papers, Cariogram sensibility and specificity were calculated; sensibility ranged from low (41.0) to fairly low (75.0), while specificity was higher, ranging from 65.8 to 88.0. Wide 95% confidence intervals for both parameters were found, indicating that the reliability of the model differed in different caries risk levels. CONCLUSIONS The scientific evidence relating to standardized CRA models is still limited; even if Cariogram was tested in children and adults in few studies of good quality, no sufficient evidence is available to affirm the method is effective in caries assessment and prediction. New options of diagnosis, prognosis and therapy are now available to dentists but the validity of standardized CRA models still remains limited.
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Affiliation(s)
- Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Italy. .,WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy.
| | - Giuliana Bontà
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Italy
| | - Fabio Cocco
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy.,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry University of Sassari, Viale San Pietro, 43, Sassari, Italy
| | - Peter Lingstrom
- Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 12 A-G, P.O. Box 450, 405 30, Gothenburg, Sweden
| | - Laura Strohmenger
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Italy.,WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy
| | - Guglielmo Campus
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy.,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry University of Sassari, Viale San Pietro, 43, Sassari, Italy
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Garg A, Madan M, Dua P, Saini S, Mangla R, Singhal P, Dupper A. Validating the Usage of Cariogram in 5- and 12-year-old School-going Children in Paonta Sahib, Himachal Pradesh, India: A 12-month Prospective Study. Int J Clin Pediatr Dent 2018; 11:110-115. [PMID: 29991863 PMCID: PMC6034047 DOI: 10.5005/jp-journals-10005-1495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 11/28/2022] Open
Abstract
Aim To validate the caries risk profiles in 5- and 12-year-old school-going children and to single out main contributing factor, if any, using cariogram over a period of 1 year. Materials and methods A cariogram model was used to create caries risk profiles on 499 children aged 5 and 12 years ±6 months. They were divided into 2 groups. The group I and group II consisted of 250 and 249 children respectively. Re-examination was done after 1 year and caries increment was recorded. The caries risk profiles generated by the cariogram software were compared with caries increment. Results Percentage of subject having caries increment in groups I and II in high-, medium-, and low-risk group after 1 year was 66.2, 39.5, and 13%, and 48.5, 27.3, and 13.9% respectively. The mean caries increment after 1 year in groups I and II in high-, medium-, and low-risk patients was 0.96, 0.49, and 0.13, and 0.7, 0.36, and 0.11 respectively. Linear regression analysis showed dental caries, diet content, diet frequency, plaque index, Streptococcus mutans count, fluoride, salivary flow rate, and buffer capacity are significantly associated with actual chance to avoid caries. Conclusion The risk of developing new carious lesions consistently reduced from high-risk category to low-risk category, reflecting the cariogram ability in accurately estimating future caries. Hence, cariogram can be said to be a useful tool for caries prediction. Initial dental caries came out to be the strongest predictor of future caries. How to cite this article: Garg A, Madan M, Dua P, Saini S, Mangla R, Singhal P, Dupper A. Validating the Usage of Car-iogram in 5- and 12-year-old School-going Children in Paonta Sahib, Himachal Pradesh, India: A 12-month Prospective Study. Int J Clin Pediatr Dent 2018;11(2):110-115.
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Affiliation(s)
- Anu Garg
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
| | - Manish Madan
- Professor and Head, Department of Pedodontics and Preventive Dentistry Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
| | - Parminder Dua
- Professor, Department of Pedodontics and Preventive Dentistry Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
| | - Sheeba Saini
- Redear, Department of Pedodontics and Preventive Dentistry Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
| | - Ritu Mangla
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
| | - Pallav Singhal
- Senior Lecturer, Department of Oral Pathology, Sarjug Dental College & Hospital, Darbhanga, Bihar, India
| | - Akash Dupper
- Reader, Department of Conservative Dentistry and Endodontics Yamuna Institute of Dental Sciences & Research, Yamunanagar Haryana, India
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Afuakwah C, Welbury R. WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME? Prim Dent J 2015; 4:56-66. [PMID: 26966775 DOI: 10.1308/205016815816682155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. AIMS Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. DESIGN Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. RESULTS In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. CONCLUSIONS The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.
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14
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Caries risk assessment in children: how accurate are we? Eur Arch Paediatr Dent 2015; 17:27-32. [DOI: 10.1007/s40368-015-0195-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 06/24/2015] [Indexed: 10/23/2022]
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15
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Twetman S, Fontana M, Featherstone JDB. Risk assessment - can we achieve consensus? Community Dent Oral Epidemiol 2015; 41:e64-70. [PMID: 24916679 DOI: 10.1111/cdoe.12026] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The object of this conference paper was to review and discuss caries risk assessment in general practice from the questions i) 'Why', ii) 'When', and iii) 'How'. METHOD Narrative review. RESULTS i) Patient caries risk assessment is the basic component in the decision-making process for adequate prevention and management of dental caries and for determination of individual recall intervals. ii) Caries risk assessment should always be performed at a child's first dental visit and then regularly throughout life, and especially when social or medical life events are occurring. iii) There are several risk assessment methods and models available for but the evidence for their validity is limited. Although there is no clearly superior method for predicting future caries, the use of structured protocols combining socioeconomy, behavior, general health, diet, oral hygiene routines, clinical data, and salivary tests or computer-based systems are considered best clinical practice. The accuracy ranges between 60% and 90%, depending on age. Caries risk assessment is more effective in the selection of patients at low risk than those with high caries risk. CONCLUSION As evidence suggests that past caries experience is far from ideal but the most important single risk component for more caries at all ages, any clinical sign of likely active demineralization on smooth, occlusal, and proximal tooth surfaces should be taken as a signal for the implementation of individually designed preventive and disease management measures.
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Affiliation(s)
- Svante Twetman
- Institute of Dentistry, Department of Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Ismail AI, Tellez M, Pitts NB, Ekstrand KR, Ricketts D, Longbottom C, Eggertsson H, Deery C, Fisher J, Young DA, Featherstone JDB, Evans W, Zeller GG, Zero D, Martignon S, Fontana M, Zandona A. Caries management pathways preserve dental tissues and promote oral health. Community Dent Oral Epidemiol 2015; 41:e12-40. [PMID: 24916676 DOI: 10.1111/cdoe.12024] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In May 2012, cariologists, dentists, representatives of dental organizations, manufacturers, and third party payers from several countries, met in Philadelphia, Pennsylvania, to define a common mission; goals and strategic approaches for caries management in the 21th century. The workshop started with an address by Mr. Stanley Bergman, CEO of Henry Schein Inc. which focused on the imperative for change in academia, clinical practice, and public health. For decades, new scientific evidence on caries and how it should be managed have been discussed among experts in the field. However, there has been some limited change, except in some Scandinavian countries, in the models of caries management and reimbursement which have been heavily skewed toward 'drilling and filling'. There is no overall agreement on a caries' case definition or on when to surgically intervene. The participants in the workshop defined a new mission for all caries management approaches, both conventional and new. The mission of each system should be to preserve the tooth structure, and restore only when necessary. This mission marks a pivotal line for judging when to surgically intervene and when to arrest or remineralize early noncavitated lesions. Even when restorative care is necessary, the removal of hard tissues should be lesion-focused and aim to preserve, as much as possible, sound tooth structure. Continuing management of the etiological factors of caries and the use of science-based preventive regimens also will be required to prevent recurrence and re-restoration. These changes have been debated for over a decade. The Caries Management Pathways includes all systems and philosophies, conventional and new, of caries management that can be used or modified to achieve the new mission. The choice of which system to use to achieve the mission of caries management is left to the users and should be based on the science supporting each approach or philosophy, experience, utility, and ease of use. This document also presents a new 'Caries Management Cycle' that should be followed regardless of which approach is adopted for caries prevention, detection, diagnosis, and treatment. To aid success in the adoption of the new mission, a new reimbursement system that third party payers may utilize is proposed (for use by countries other than Scandinavian countries or other countries where such systems already exist). The new reimbursement/incentive model focuses on the mission of preservation of tooth structure and outcomes of caries management. Also described, is a research agenda to revitalize research on the most important and prevalent world-wide human disease. The alliance of major dental organizations and experts that started in Philadelphia will hopefully propel over the next months and years, a change in how caries is managed by dentists all over the world. A new mission has been defined and it is time for all oral health professionals to focus on the promotion of oral health and preservation of sound teeth rather than counting the number of surgical restorative procedures provided.
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Affiliation(s)
- Amid I Ismail
- Korenberg School of Dentistry, Temple University, Philadelphia, PA, USA
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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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Chang J, Kim HY. Does caries risk assessment predict the incidence of caries for special needs patients requiring general anesthesia? Acta Odontol Scand 2014; 72:721-8. [PMID: 24666244 DOI: 10.3109/00016357.2014.898788] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to correlate the caries-related variables of special needs patients to the incidence of new caries. MATERIALS AND METHODS Data for socio-demographic information and dental and general health status were obtained from 110 patients treated under general anesthesia because of their insufficient co-operation. The Cariogram program was used for risk assessment and other caries-related variables were also analyzed. Within a defined follow-up period (16.3 ± 9.5 months), 64 patients received dental examinations to assess newly developed caries. RESULTS At baseline, the mean (SD) values of the DMFT (decayed, missing and filled teeth) and DT (decayed teeth) for the total patients were 9.2 (6.5) and 5.8 (5.3), respectively. During the follow-up period, new caries occurred in 48.4% of the patients and the mean value (SD) of the increased DMFT (iDMFT) was 2.1 (4.2). The patients with a higher increment of caries (iDMFT ≥3) showed significantly different caries risk profiles compared to the other patients (iDMFT <2) (p < 0.05). Close correlations existed between the caries increment and several caries-related variables; baseline DMFT, insufficient self-tooth-brushing and malocclusion were greatly associated with new caries development. CONCLUSIONS Caries risk assessment could predict the incidence of future caries in hospital-based dentistry. Past caries experience and inadequate oral hygiene maintenance were largely related to caries development in special needs patients.
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Affiliation(s)
- Juhea Chang
- Clinic for Persons with Disabilities, Seoul National University Dental Hospital, Dental Research Institute, School of Dentistry, Seoul National University , Seoul , Korea
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19
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Tellez M. Caries risk profiles using cariogram are predictive of caries incidence in permanent dentition. J Evid Based Dent Pract 2014; 13:58-9. [PMID: 23773468 DOI: 10.1016/j.jebdp.2013.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Marisol Tellez
- Pediatric Dentistry and Community Oral Health Sciences, Maurice H. Kornberg School of Dentistry, Temple University, USA.
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20
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Hänsel Petersson G, Ericson E, Isberg PE, Twetman S. Caries risk assessment in young adults: A 3-year validation of clinical guidelines used in Public Dental Service. Acta Odontol Scand 2013; 71:1645-50. [PMID: 23834530 DOI: 10.3109/00016357.2013.788734] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To validate a risk classification model according to the Public Dental Service (PDS) guidelines with the actual 3-year caries outcome in terms of predictive values. MATERIALS AND METHODS All 19-year-old patients registered at eight public dental clinics in Skåne, Sweden were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects, representing 10% of the age group attending the public dental care in the region. A risk classification of each patient in four categories was made by the patient's regular team according to the guidelines. At the follow-up 3 years later, 75.8% were accessible. The final examinations included bitewing radiographs and the actual caries increment for 982 patients was calculated. RESULTS At baseline, 11.9% were assessed as being at 'high' or 'very high' risk. The dropouts had significantly more caries than the remaining patients (p < 0.05). The general disease activity was low, but those grouped into the two highest risk groups displayed significantly more new caries than those at lower risk (p < 0.05). With a cut-off value ΔDFS > 0 vs DFS = 0, the sensitivity was 81% and the specificity 56% for 'low' risk vs any risk. By combining the 'low' and 'some' risk categories, the PDS model generated an improved specificity (94%). CONCLUSIONS The risk assessment scheme used by the Public Dental Service for young adults relied basically on past and current caries activity and 65-70% of the patients were correctly classified. The model was most effective to screen out patients with low caries risk.
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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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Giacaman RA, Miranda Reyes P, Bravo León V. Caries risk assessment in chilean adolescents and adults and its association with caries experience. Braz Oral Res 2013; 27:7-13. [DOI: 10.1590/s1806-83242013000100002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 11/21/2012] [Indexed: 11/21/2022] Open
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Tellez M, Gomez J, Pretty I, Ellwood R, Ismail AI. Evidence on existing caries risk assessment systems: are they predictive of future caries? Community Dent Oral Epidemiol 2012; 41:67-78. [DOI: 10.1111/cdoe.12003] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M Tellez
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
| | | | - I Pretty
- Colgate Palmolive Dental Health Unit; School of Dentistry, University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - R Ellwood
- Colgate Palmolive Dental Health Unit; School of Dentistry, University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - AI Ismail
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
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Peker I, Mangal T, Erten H, Alp G, Avci E, Akca G. Evaluation of caries risk in a young adult population using a computer-based risk assessment model (Cariogram). J Dent Sci 2012. [DOI: 10.1016/j.jds.2012.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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