Study Examines Accuracy of Risk Assessment in Caries Management
Assessing patients’ caries risk is key to developing effective, personalized prevention and treatment plans, according to University of California San Francisco (UCSF) School of Dentistry researchers. They recently published a study, “Caries Risk Assessment Item Importance: Risk Designation and Caries Status in Children Under Age 6,” on the caries management by risk assessment (CAMBRA) protocol in the July issue of Journal of Dental Research Clinical & Translational Research. An evidence-based approach, CAMBRA focuses on assessing risk and remineralizing or minimally restoring early caries lesions; it also addresses the entire disease process, not just the cavitated lesion.
Based on a study sampling of 3810 pediatric patients at UCSF, researchers found that risk assessments performed by oral health professionals were accurate in determining the risk of future decay. Each of the subjects’ parents/caregivers completed a 17-question form regarding environmental factors and behavioral factors known to affect caries status (e.g., drinking fluoridated water, frequency of snacking and socioeconomic status). Based on the responses, patients were categorized as low risk or high risk. The predictive value of these assessments was evaluated in follow-ups with 1315 subjects between the ages of 6 months and 6 years. Among low-risk patients, 20% presented with tooth decay at the follow-up visit. Conversely, 70% of those categorized as high risk presented with decay at the follow-up visit.
The CAMBRA protocol, the researchers state, helps oral health professionals’ account for factors known to influence oral health status. This insight helps tailor their approach to care and allows for modifications of behavior (i.e., prevention) versus treatment. Personalized therapy based on risk assessment fully embraces the idea of prevention as the best medicine.