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Preventive Dentistry Restorative Dentistry

Are current caries risk-assessment systems predictive of future caries?

This Systematic Review Summary is adapted from the British Evidence-Based Dentistry Journal

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Caries risk assessmentClinical Question

Are current caries risk assessment systems predictive of future caries?

Context

The identification of high risk individuals to allow both prevention and intervention based on susceptibility to disease is commonplace in contemporary treatment planning. A systematic review of the literature by Harris et al in 2004 found ‘106 risk factors significantly related to the prevalence or incidence of caries’2. In general caries risk assessment systems standardise the risk factor information collected in order to predict potential caries outcome for the patient.

Results

  • One hundred and thirty-seven study reports remained for review following systematic strategic search and title review.
  • Of these, six studies of existing caries risk assessment models were selected for inclusion. Of the six studies reviewed four were deemed ‘fair’ by the ADA criteria and two ‘poor’.
  • The authors found variation in the parameters used for caries risk assessment and the population groups studied. No study found the risk assessment systems to have reliable prediction utility in children.
  • One prospective study found Cariogram to give good to moderate caries prediction in elderly adults and one retrospective study found the CAMBRA assessment to provide prediction for cavitated lesions, but only between low risk and extreme risk individuals over the age of six.

Conclusion

This systematic review suggests that evidence available on the validity of a number of existing systems for caries risk assessment is limited and weak.

 

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