Bacteriologic and nonbacteriologic criteria for identifying individuals at high risk of developing dental caries: a...

A review of the literature on bacteriologic and nonbacteriologic criteria for identifying individuals at high risk to dental caries is presented. The studies have been evaluated on the basis of 1) their ability to predict future caries activity of individuals and 2) their practical use. Single measurements of past caries experience in the primary and permanent dentitions, filled tooth surfaces, and S. mutans in dental plaque and saliva were found to have limited value in identifying individuals that later would develop carious lesions, as judged from the low values of sensitivity and specificity. Lactobacilli counts in saliva indicated some evidence of high reliability as a basis for selecting patients susceptible to dental decay. The results of these studies, however, were not comparable because of variations in methods, critical value of the screening criteria, and age and size of the samples. A combination of two or more predictors showed promising results, as the predictive value was increased. More research is needed on appropriate screening methods to provide higher reliability and validity of the predictors.