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Pilot validation of the new Canadian Caries Risk Assessment Tool for preschoolers
Robert J Schroth1,2, Adam Siray1, Victor Hk Lee1,2
1Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Background:
Caries risk assessment (CRA) is an important step in preventive and therapeutic management of caries in children. This study assessed the sensitivity and specificity of a new Canadian Caries Risk Assessment Tool (<6 years) for preschoolers to predict caries development.
Methods:
In this prospective cohort study, CRA was performed at baseline and 12 months among 190 children aged <6 years from 3 clinics in Manitoba, Canada. CRA included information on child's fluoride exposure, teeth cleaning, diet, socio-economic status, and oral examinations. Sensitivity and specificity were calculated, and logistic regression for new caries at follow-up was performed.
Results:
The sensitivity and specificity for baseline CRA rating and development of new caries at follow-up were 87.2% and 42.7%, respectively. Presence of visible caries and/or past evidence of dental treatment for caries at baseline was the strongest independent indicator of new caries by follow-up (OR = 6.49; CI = 3.28, 12.85; p < 0.001). Children with high caries risk (score ≥3) were more likely to develop new caries by follow-up (OR = 4.58; 95% CI = 2.07, 10.11).
Discussion:
The combined sensitivity and specificity score is comparable to findings from other studies examining CRA. Results support the increased weighting of the score for the presence of visible caries and/or evidence of dental treatment for caries at baseline. Results from this study provide evidence for the CRA tool's predictability.
Conclusion:
The Canadian Caries Risk Assessment Tool for preschoolers has high sensitivity to identify children with high caries risk, and modest specificity to identify children with low caries risk. However, future population-based studies with primary care providers are recommended.
