Review of methods of identification of high caries risk groups and individuals. Fédération Dentaire Internationale Technical Report No. 31

Abstract

The search for methods of predicting dental caries activity began during the last century. The purpose of this review was to update the report on methods of caries prediction which resulted from the 1977 workshop, sponsored by the National Institutes of Health, Washington, DC, and also to identify the methods most likely to provide effective prediction of caries risk which should be given high priority in future research. The factors that need to be considered in assessing the value of a method of predicting caries risk are the correlation coefficient between the predictions and the final caries scores and in particular an assessment of the ability of the method to recognize subjects who will develop caries (sensitivity) and to exclude those who will not (specificity). The predictive power of the method should also be known. There is, however, the risk that when predictive tests are applied to a population with decreasing caries prevalence the number classified as false positive could be increased. This may limit the cost-effectiveness of preventive technique. The requirements of a good method of predicting dental caries are that the method should be simple, inexpensive and rapid and should identify subjects who will become diseased and exclude subjects who will remain healthy. To date, a wide variety of factors have been considered in the search for an effective method of predicting caries risk, but only a few have had some success. Certain epidemiological methods have shown reasonable sensitivity but less specificity. Measures in this category include specific indicator surfaces and DMFT increment in the previous year. Among the more useful specific tests have been mutans streptococci and lactobacillus counts and measurement of saliva buffering capacity. Other methods that show some promise include the physical measurement of incipient carious lesions of enamel. The measurement of possible determinants of a multifactorial disease is extremely difficult and regardless of which single method has been tried the authors have usually concluded that it is difficult to develop a reliable method of identifying caries susceptible individuals from the method. To a lesser extent the same conclusions have been applied to methods for identifying risk groups. There does, however, appear to have been little research in which a combination of tests or methods have been used, particularly combinations of tests that involve different scientific disciplines.(ABSTRACT TRUNCATED AT 400 WORDS)