Gunnel Hänsel Petersson

Caries risk profiles in schoolchildren over 2 years assessed by Cariogram

BACKGROUND Caries risk assessment is an important tool in clinical decision making. AIM To evaluate longitudinal changes in caries risk profiles in a group of schoolchildren in relation to caries development. DESIGN The Cariogram model was used to create caries risk profiles and to identify risk factors in 438 children being 10-11 years at baseline. The assessment was repeated after 2 years and the caries increment was recorded. The frequency of unfavourable risk factors were compared between those considered at the lowest and the highest risk. RESULTS Fifty percent of the children remained in the same risk category after 2 years. One third of the children were assessed in a higher-risk category while 18.4% showed a lower risk. Those with increased risk compared with baseline developed significantly more caries than those with an unchanged risk category. The most frequent unfavourable risk factors among those with high risk at baseline were high-salivary mutans streptococci and lactobacilli counts as well as frequent meals. CONCLUSION Half of the children showed a changed risk category after 2 years, for better or for worse, which suggests that regular risk assessments are needed in order to make appropriate decisions on targeted preventive care and recall intervals.

Caries risk assessment as a predictor of metabolic control in young Type 1 diabetics

Aims  To investigate the relationship between caries risk and glucosylated haemoglobin and to evaluate the use of a computerized caries risk assessment program as a predictor of metabolic control in schoolchildren with Type 1 diabetes mellitus.

Caries risk assessment in young adults: a 3 year validation of the Cariogram model

BackgroundTo validate baseline caries risk classifications according to the Cariogram model with the actual caries development over a 3-year period in a group of young adults living in Sweden.MethodsThe study group consisted of 1,295 19-year-old patients that completed a comprehensive clinical baseline examination, including radiographs and salivary tests. An individual caries risk profile was computed and the patient was placed in one of five risk categories. After 3 years, 982 patients (75.8%) were re-examined and caries increment for each patient was calculated. The outcome was expressed as sensitivity, specificity and predictive values and compared with a risk assessment scheme used in Public Dental Service.ResultsThe drop-outs displayed more risk factors and a significantly higher caries burden at baseline compared with those that remained in the project (p < 0.05). There was a strong association between the Cariogram risk categories and the 3-year caries increment on cavity level but the predictive values were modest. The high or very high caries risk categories yielded high specificities (>90%) but poor sensitivities. The low risk groups displayed higher sensitivities on expense of impaired specificities. No combinations proved clinically useful values according to Yuoden’s index.ConclusionsWithin the limitations of the present study, the computer-based Cariogram did not perform better than a caries risk assessment scheme based on past caries experience and caries progression, over a 3-year period in young adults.