Validation of Three Caries Risk Assessment Tools for Preschool Children From Areas with High Caries Prevalence

The purpose of this study was to compare the validity of Cariogram (an algorithm-based software), the American Academy of Pediatric Dentistry's caries risk assessment form (CRAF), and Caries Management by Risk Assessment (CAMBRA) in predicting caries increment in a group of two- to four-year-olds with high caries prevalence over two years. Children (N equals 175) were examined at baseline, and caries was scored according to World Health Organization criteria. Diet and oral health habits were captured from questionnaires, and saliva variables were captured from chairside tests. Cariogram, CRAF, and CAMBRA risk categories were calculated with age-appropriate modifications. Caries increment was assessed after two years by counting the number of surfaces that changed from "sound" to "decayed." The predictive ability was assessed using Kendall's Tau, Poisson regression, and receiver operating characteristic analysis. Risk categories differed at baseline, with 93 percent (CRAF), 54 percent (Cariogram), and 36 percent (CAMBRA) placed in the high-risk group. A statistically significant association with the two-year caries increment was found for Cariogram (P=0.003) and CAMBRA (P=0.001) but not for CRAF (P=0.9). CAMBRA displayed better performance in distinguishing subjects between risk categories compared with the other tools. Cariogram and CAMBRA displayed a higher validity than the CRAF in predicting caries increment in this population over a two-year period, but the over all accuracy was limited. (Pediatr Dent 2019;41(5):391-6. E53-E55).