Validation of 3 Caries Risk Assessment Methods in Preschool Children from High Caries Risk Areas

Background. Caries risk assessment is paramount for preventive and therapeutic caries management and different methods can be used to evaluate caries risk. The purpose of this study was the assessment of the validity of Cariogram, CAT and CAMBRA in caries risk prediction for a group of preschool children from high caries risk areas, over a 2-year period.

Methods Children 2-5 yo (N=175) from areas with high caries prevalence were examined at baseline and after 2 years. Mutans streptococci counts (MS) and saliva buffer capacity (SBC) were measured with chair side tests. Parents completed a questionnaire on diet and oral health attitudes. Caries increment was assessed at 2 years as the sum of cavitated and non cavitated lesions. Cariogram, CAT and CAMBRA caries risk profiles were calculated at baseline with modifications appropriate for this age group. Associations using Kendall’s tau, Poisson regression models and ROC analysis were used to assess the predictive ability of the 3 systems. Statistical significance: 5%

Results. The distribution of the risk profiles for Cariogram, CAT and CAMBRA was respectively: low 20%,3%,3%, medium 26%,4%,61% and high 54%,93%,36%. A statistically significant association with 2 years caries increment was found for Cariogram (Kendall’s tau= 0.260, p=0.003) and CAMBRA (Kendall’s tau=0.342, p<0.001) but not for CAT (Kendall’s tau= -0.004, p=0.930). The AUC (95%) for the three systems were Cariogram: 0.694 (0.587, 0.801), CAT: 0.498 (0.457, 0.539), CAMBRA: 0.729 (0.630, 0.828). Poison regression models indicated a higher incidence ratio for caries development according to CAMBRA risk categories compared to the other systems

Conclusions. The overall performance of the three methods was poor. However, compared with CAT and Cariogram, CAMBRA displayed somewhat better results in predicting caries increment in this population over a 2-year period.