Identification of high caries risk adults: attitudes, social factors and diseases

Since agent, host and environmental factors have been associated with caries, the development of multivariate risk assessment models is warranted. This process comprises the identification of risk factors, the development and testing of risk models, assessment and targeting. Work-in-progress by the authors in delineating oral, social/behavioural and medical risk factors for root caries in older adults shows that regression models explain 48 per cent of the variance in root caries scores for males and 47 per cent for females. Discriminant analyses using the risk factors identified in the regressions differentiated between people who did and did not get root caries during an 18-month period. The sensitivity of the predictions for men was 0.75 and the specificity was 0.79. For women, the sensitivity was 0.79 and the specificity was 0.83. These results suggest that it will be possible to develop a clinically useful risk assessment model. Future studies should include data on oral risk factors, such as micro-organisms present, salivary flow and buffering capacity, that can be added to the multivariate model.