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Comparative Evaluation of Caries Risk Assessment using Three Different Tools among Toddlers and Preschoolers
K C Vignesh1, Gnanasekaran Felsypremila2, P Hariharan1
1Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India.
Contemporary Clinical Dentistry
|July 10, 2026
Summary
Early childhood caries risk assessment tools vary in effectiveness. The American Academy of Pediatric Dentistry tool identified more high-risk toddlers, while American Dental Association and Caries Management by Risk Assessment tools showed better agreement.
Area of Science:
- Pediatric Dentistry
- Public Health
- Dental Caries Research
Background:
- Early childhood caries (ECC) is a global public health issue.
- Caries risk assessment (CRA) tools aid in early ECC detection and prevention.
- Limited comparative data exists for CRA tools in young children.
Purpose of the Study:
- To compare the performance of three CRA tools: American Academy of Pediatric Dentistry (AAPD), American Dental Association (ADA), and Caries Management by Risk Assessment (CAMBRA).
- To evaluate these tools in children aged 1-6 years.
Main Methods:
- A cross-sectional study was conducted at a tertiary care dental hospital in South India.
- One hundred nineteen children (aged 1-6 years) were assessed using AAPD, ADA, and CAMBRA tools by a single calibrated examiner.
- Inter-tool agreement was assessed using Cohen's kappa coefficient; risk category distribution was compared across age groups and gender.
Main Results:
- The AAPD tool identified significantly more high-risk children (4.2%) compared to ADA and CAMBRA (0.8% each), particularly in children under 3 years.
- ADA and CAMBRA demonstrated high agreement (κ = 0.885), while AAPD showed moderate agreement with ADA (κ = 0.596) and CAMBRA (κ = 0.520).
- No significant differences in risk categorization were found based on age groups or gender.
Conclusions:
- All three CRA tools are effective for pediatric caries risk assessment, exhibiting varying sensitivities.
- The AAPD tool may offer enhanced sensitivity for early risk detection in toddlers.
- ADA and CAMBRA tools exhibit higher concordance, suggesting they may be more consistent in risk classification.
