Caries Risk Assessment
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Caries risk/susceptibility assessment (CRA) is regarded as a cornerstone for clinical decision-making and disease management. Although CRA is implicit in routine patient care, its formal, objective and recorded implementation in everyday practice seems less common. The aim of this chapter is to review the science and evidence behind the CRA process for use in general oral healthcare practice. It is concluded that the beneficial effects of CRA clearly outweigh harm and can therefore be strongly recommended. There is however no specific method with perfect accuracy and no conclusive research evidence to support the use of one CRA tool, model or technology over another. Multivariate models tend to display an improved accuracy over those using single predictors. The ability to predict future caries is greater among pre-school and school children than later in life, with an accuracy that can exceed 80%. Validated tools for root caries prediction are lacking. There is emerging evidence that interventions based on CRA can increase patient behavioural adherence and reduce the onset of new carious lesions. Thus, the adoption of a formal method may offer more appropriate treatments, more effective utilization of resource and possibly strengthen a case from a medico-legal perspective. Further research is needed, in particular on the health-economic impact of CRA and its value for patients, oral health care providers and other stakeholders.
The authors have no conflicts of interests to declare.
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