A systematic review to inform the development of a Canadian caries risk assessment tool for use by primary healthcare providers

Abstract

Despite all the advancements in dental prevention over the past decades, the problem of early childhood caries (ECC) still exists. Evidence suggests that whereas the prevalence of caries among older children, youth, and adults has declined, the prevalence of ECC in the preschool population has increased. [1][2][3] For many children with ECC, dental surgery under general anaesthesia is the only treatment option. 4 In-hospital day surgery to treat ECC is the most common day surgical procedure in Canada. 5 A 2013 report from the Canadian Institute of Health Information revealed that the

A Comparison of Four Caries Risk Assessment Methods

“…The successful management of dental caries relies upon assessment of the caries risk of the individual and a treatment plan with personalized therapy that is derived from the details recorded in the risk assessment [13][14][15][16][17][18]. There are numerous published CRA methods and guidelines for caries management several of which are listed in Table 1 .…”

“…They also suggested that the evidence to inform the selection of current CRATs for children is mostly yet to be established. The most recent systematic review by Schroth et al [18] reported extensive assessment of each of the possible caries risk assessment components that contributed to numerous published CRATs. However, the review was done 4 years prior to the paper being published so their extensive tables did not include some of the most recent studies in the field.…”

“…One of the questions that remains unanswered is which CRA tool (CRAT) to use and which CRATs are validated with clinical studies. There are several systematic reviews of CRATs and methods that have reported the “state of the art” over the past decade [ 13 , 18 , 49 – 53 ]. The earlier reviews came to similar conclusions that more studies are needed, especially to clinically validate the CRATs.…”

“…Christian et al [ 53 ] summarized their review by stating “Studies on tools that were assessed as having strong evidence for content validity identified the relevant risk factors for caries in the population being studied, before developing and testing their respective CRATs.” They also suggested that the evidence to inform the selection of current CRATs for children is mostly yet to be established. The most recent systematic review by Schroth et al [ 18 ] reported extensive assessment of each of the possible caries risk assessment components that contributed to numerous published CRATs. However, the review was done 4 years prior to the paper being published so their extensive tables did not include some of the most recent studies in the field.…”

Genetic variants in taste genes play a role in oral microbial composition and severe early childhood caries

“…These include diet, oral hygiene, enamel defects, oral microbiota, and saliva buffering capacity and flow rate. 1 , 2 It has been estimated, based on twin studies, that the heritability of dental caries, or the proportion of variation that is due to genes, can reach over 50%. 3 , 4 …”