Cariogram – a multifactorial risk assessment model for a multifactorial disease

Abstract

This paper reviews some common methods for the assessment of caries risk. It also describes a new way of illustrating the caries risk profile of an individual, the Cariogram. Past caries experience and socioeconomic factors are often used for prediction of caries. As prediction models, the methods are simple, inexpensive and fast. However, they are not risk models, as they do not specify which particular risk factors are operating. Various biological factors can be used for risk assessment. Common ones are bacteria, diet and host factors. Taken separately, these biological factors often have limited predictive values. Socioeconomic factors often have a heavy impact on the biological factors as they can explain why an individual, for example, has a cariogenic diet or neglects oral hygiene. The biological factors are the immediate cause of the cavities. Caries experience is an illustration of how the host copes up with the biological activity. To facilitate the interpretation of biological data, the Cariogram was developed. It is a computer program showing a graphical picture that illustrates a possible overall caries risk scenario. The program contains an algorithm that presents a 'weighted' analysis of the input data, mainly biological factors. It expresses as to what extent different etiological factors of caries affect caries risk. The Cariogram identifies the caries risk factors for the individual and provides examples of preventive and treatment strategies to the clinician.

Caries Risk Profiles in Orthodontic Patients at Follow-Up Using Cariogram

“…[20][21][22][23] Moreover, only cavities are included in the ''caries experience'' according to the Cariogram. 24 …”

Re-Visiting the Decay, Missing, Filled Teeth (DMFT) Index with a Mathematical Modeling Concept

“…This does not appear in other models of diseases where the environment is unique for all individuals under screening; such as with tuberculosis, diabetes, hypertension, and HIV [12]. Certainly dental caries within a mouth is determined by a great number of variables such as biological, genetic, social and behavioral factors [13] [14]. Hence, calculation of the prevalence and average using DMFT index might not be representative to the individuals considered in the estimation of these parameters and hence the population from where these samples will be selected because of heterogeneous environments [15].…”

Estimación Del Riesgo De Caries Dental Mediante El Uso Del Cariogram® en Estudiantes De Odontología: Análisis Preliminar

“…Entre éstos se encuentra el Riesgograma diseñado por la Universidad El Bosque, el Caries Risk Assessment Tool (CAT) propuesto por la Academia Americana de Odontología Pediátrica, el Caries Management by Risk Assessment (CAMBRA) sugerido por la Asociación Dental de California y el Cariogram ® diseñado por Bratthal y colaboradores. [7][8][9][10][11] Han y colaboradores compararon el CAT, el CAMBRA y el Cariogram ® , encontraron que este último es más útil para predecir el riesgo de caries ya que sus factores pueden brindar más información que los otros. 12 Este estudio fue de corte transversal lo que limita sus hallazgos y sus resultados no son claros ya que no usaron pruebas salivales que se requieren para diligenciar el Cariogram ® .…”

“…La razón es que si un factor de riesgo se reduce debe reflejarse en el resultado del programa. 8 De esta manera, diferentes aspectos tienen diferentes "pesos" en situaciones distintas y el número de posibles combinaciones es enorme. 22 En un estudio realizado por Leous y Tikhonova (2006) se encontró que el mayor peso sobre el riesgo de caries dental lo dio el sector "susceptibilidad" que incluye el uso de elementos fluorados, el flujo salival y el pH.…”

“…La razón es que si un factor de riesgo se reduce debe reflejarse en el resultado del programa. 8 De esta manera, diferentes aspectos tienen diferentes "pesos" en situaciones distintas y el número de posibles combinaciones es enorme. …”