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European Archives of Paediatric Dentistry

, Volume 17, Issue 1, pp 27–32 | Cite as

Caries risk assessment in children: how accurate are we?

  • S. TwetmanEmail author
Original Scientific Article

Abstract

Purpose

To summarise the findings of recent systematic reviews (SR) covering caries risk assessment in children, updated with recent primary studies.

Methods

A search for relevant papers published 2012–2014 was conducted in electronic databases. The systematic reviews were quality assessed with the AMSTAR tool and the primary publications according to the Cochrane handbook. The quality was rated as low, moderate, or high risk of bias. The findings were descriptively synthesised and the quality of evidence was graded according to GRADE. For the recommendations of practice, the SIGN scores were used (recommendation levels A–D).

Results

Three SR, three guidelines, and five papers, not considered in previous SR, were identified and formed the base for the present summary and recommendations. One of the systematic reviews and three of the primary publications were of moderate risk of bias, while the rest displayed a high risk of bias.

Conclusions

Based on the present summary of literature, it may be concluded: (1) a caries risk assessment should be carried out at the child’s first dental visit and reassessments should be done during childhood (D); (2) multivariate models display a better accuracy than the use of single predictors and this is especially true for preschool children (C); (3) there is no clearly superior method to predict future caries and no evidence to support the use of one model, program, or technology before the other (C); and (4) the risk category should be linked to appropriate preventive care with recall intervals based on the individual need (C).

Keywords

Caries Children Dental Prediction Risk tools 

Notes

Acknowledgments

The input and discussions with Professor Margherita Fontana, University of Michigan School of Dentistry, is gratefully acknowledged.

Conflicts of interest

The author has no conflict of interest to declare.

References

  1. American Academy of Pediatric Dentistry, Council on Clinical Affairs. Guidelines on caries risk assessment and management for infants, children and adolescents. AAPD 2014;Reference manual V36;No36 14/15.Google Scholar
  2. Abanto J, Celiberti P, Braga MM, et al. Effectiveness of a preventive program based on caries risk assessment and recall intervals on the incidence and regression of initial caries lesions in children. Int J Paediatr Dent. 2015;25:291–9.CrossRefPubMedGoogle Scholar
  3. Arola L, Bonet ML, Delzenne N, Duggal MS, Gómez-Candela C, Huyghebaert A, Laville M, Lingström P, Livingstone B, Palou A, Picó C, Sanders T, Schaafsma G, van Baak M, van Loveren C, van Schothorst EM. Summary and general conclusions/outcomes on the role and fate of sugars in human nutrition and health. Obes Rev. 2009;10(Suppl 1):55–8.CrossRefPubMedGoogle Scholar
  4. Campus G, Cagetti MG, Sale S, Carta G, Lingström P. Cariogram validity in schoolchildren: a two-year follow-up study. Caries Res. 2012;46:16–22.CrossRefPubMedGoogle Scholar
  5. Chaffee BW, Gansky SA, Weintraub JA, Featherstone JDB, Ramos-Gomez FJ. Maternal oral bacterial levels predict early childhood development. J Dent Res. 2014;93:238–44.PubMedCentralCrossRefPubMedGoogle Scholar
  6. Chou R, Cantor A, Zakher B, Mitchell JP, Pappas M. Preventing dental caries in children <5years; systematic review updating USPSTF recommendation. Pediatrics. 2013;132:332–50.CrossRefPubMedGoogle Scholar
  7. Evans RW, Dennison PJ. The Caries Management System: an evidence-based preventive strategy for dental practitioners. Application for children and adolescents. Aust Dent J. 2009;54:381–9.CrossRefPubMedGoogle Scholar
  8. Gao X, Di Wu I, Lo EC, et al. Validity of caries risk assessment programmes in preschool children. J Dent. 2013;41:787–95.CrossRefPubMedGoogle Scholar
  9. Gao X, Hsu CY, Loh T, Hwarng B, Koh D. Role of microbiological factors in predicting early childhood caries. Pediatr Dent. 2014;36:348–54.PubMedGoogle Scholar
  10. Guyatt GH, Oxman AD, Sultan S, GRADE Working Group, et al. GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol. 2011;64:1311–6.CrossRefPubMedGoogle Scholar
  11. Hart JT. The inverse care law. Lancet. 1971;1(7696):405–12.CrossRefPubMedGoogle Scholar
  12. Hayden C, Bowler JO, Chambers S, et al. Obesity and dental caries in children: a systematic review and meta-analysis. Community Dent Oral Epidemiol. 2013;41:289–308.CrossRefPubMedGoogle Scholar
  13. Holgerson PL, Twetman S, Stecksèn-Blicks C. Validation of an age-modified caries risk assessment program (Cariogram) in preschool children. Acta Odontol Scand. 2009;67:106–12.CrossRefPubMedGoogle Scholar
  14. Julihn A, Molund U, Drevsäter E, Modéer T. High birth weight is a risk factor for dental caries increment during adolescence in Sweden. Dent J. 2014;2:118–33.CrossRefGoogle Scholar
  15. Leong PM, Gussy MG, Barrow SY, de Silva-Sanigorski A, Waters E. A systematic review of risk factors during first year of life for early childhood caries. Int J Paediatr Dent. 2013;23:235–50.CrossRefPubMedGoogle Scholar
  16. Mejàre I, Axelsson S, Dahlén G, et al. Caries risk assessment. A systematic review. Acta Odontol Scand. 2014;72:81–91.CrossRefPubMedGoogle Scholar
  17. Mejàre I, Klingberg G, Mowafi F, et al. A systematic map of systematic reviews in pediatric dentistry—what do we really know? PLoS One. 2015;10(2):e0117537.PubMedCentralCrossRefPubMedGoogle Scholar
  18. Moynihan PJ, Kelly SA. Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. J Dent Res. 2014;93:8–18.PubMedCentralCrossRefPubMedGoogle Scholar
  19. Petersson GH, Isberg PE, Twetman S. Caries risk profiles in schoolchildren over 2 years assessed by Cariogram. Int J Paediatr Dent. 2010;20:341–6.CrossRefPubMedGoogle Scholar
  20. Pitts NB, Ekstrand KR, ICDAS Foundation. International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS)—methods for staging of the caries process and enabling dentists to manage caries. Community Dent Oral Epidemiol. 2013;41:e41–52.CrossRefPubMedGoogle Scholar
  21. Riley JL 3rd, Qvist V, Fellows JL, DPBRN Collaborative Group, et al. Dentists’ use of caries risk assessment in children: findings from the Dental Practice-Based Research Network. Gen Dent. 2010a;58:230–4.PubMedCentralPubMedGoogle Scholar
  22. Riley JL, Richman JS, Rindal DB, PBRN Dental Collaborative Group, et al. Use of caries-preventive agents in children: findings from the dental practice-based research network. Oral Health Prev Dent. 2010b;8:351–9.PubMedCentralPubMedGoogle Scholar
  23. Schwendicke F, Dörfer CE, Schlattmann P, et al. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res. 2015;94:10–8.CrossRefPubMedGoogle Scholar
  24. Scottish Intercollegiate Guidelines Network. Dental interventions to prevent caries in children. SIGN 2014; publication no. 138. Available at: http://www.sign.ac.uk. Accessed Feb 2015.
  25. Shea BJ, Hamel C, Wells GA, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol. 2009;62:1013–20.CrossRefPubMedGoogle Scholar
  26. 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. 2013;41:67–78.CrossRefPubMedGoogle Scholar
  27. Trueblood R, Kerins CA, Seale NS. Caries risk assessment practices among Texas pediatric dentists. Pediatr Dent. 2008;30:49–53.PubMedGoogle Scholar
  28. Twetman S, Fontana M, Featherstone JD. Risk assessment—can we achieve consensus? Community Dent Oral Epidemiol. 2013;41:e64–70.CrossRefPubMedGoogle Scholar
  29. Vadiakas G. Case definition, etiology and risk assessment of early childhood caries (ECC). A revisited review. Eur Arch Paediatr Dent. 2008;9:114–25.CrossRefPubMedGoogle Scholar
  30. Varsio S, Vehkalahti M. Dentists’ decisions on caries risk and preventive treatment by dental state among 15-year-old adolescents. Community Dent Health. 1997;14:166–70.PubMedGoogle Scholar
  31. Vermaire JH, van Loveren C, Brouwer WB, Krol M. Value for money: economic evaluation of two different caries prevention programmes compared with standard care in a randomized controlled trial. Caries Res. 2014;48:244–53.CrossRefPubMedGoogle Scholar
  32. Zukanović A. Caries risk assessment models in caries prediction. Acta Med Acad. 2013;42:198–208.CrossRefPubMedGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2015

Authors and Affiliations

  1. 1.Department of Odontology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagen NDenmark

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