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).
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References
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.
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.
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.
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.
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.
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.
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.
Gao X, Di Wu I, Lo EC, et al. Validity of caries risk assessment programmes in preschool children. J Dent. 2013;41:787–95.
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.
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.
Hart JT. The inverse care law. Lancet. 1971;1(7696):405–12.
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.
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.
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.
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.
Mejàre I, Axelsson S, Dahlén G, et al. Caries risk assessment. A systematic review. Acta Odontol Scand. 2014;72:81–91.
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.
Moynihan PJ, Kelly SA. Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. J Dent Res. 2014;93:8–18.
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.
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.
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.
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.
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.
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.
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.
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.
Trueblood R, Kerins CA, Seale NS. Caries risk assessment practices among Texas pediatric dentists. Pediatr Dent. 2008;30:49–53.
Twetman S, Fontana M, Featherstone JD. Risk assessment—can we achieve consensus? Community Dent Oral Epidemiol. 2013;41:e64–70.
Vadiakas G. Case definition, etiology and risk assessment of early childhood caries (ECC). A revisited review. Eur Arch Paediatr Dent. 2008;9:114–25.
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.
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.
Zukanović A. Caries risk assessment models in caries prediction. Acta Med Acad. 2013;42:198–208.
Acknowledgments
The input and discussions with Professor Margherita Fontana, University of Michigan School of Dentistry, is gratefully acknowledged.
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Twetman, S. Caries risk assessment in children: how accurate are we?. Eur Arch Paediatr Dent 17, 27–32 (2016). https://doi.org/10.1007/s40368-015-0195-7
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DOI: https://doi.org/10.1007/s40368-015-0195-7