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Validity of caries risk assessment programmes in preschool children

机译：学龄前儿童龋齿风险评估计划的有效性

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Objectives Various programmes have been developed for caries risk assessment (CRA). Nevertheless, scientific evidence on their validity is lacking. This study aimed to compare the validity of 4 CRA programmes (CAT, CAMBRA, Cariogram, and NUS-CRA) in predicting early childhood caries. Methods A total of 544 children aged 3 years underwent oral examination and biological tests (saliva flow rate, salivary buffering capacity and abundance of cariogenic bacteria mutans Streptococci and Lactobacilli). Their parents completed a questionnaire. Children's caries risk was predicted using the 4 study programmes without biological tests (screening mode) and with biological tests (comprehensive mode). After 12 months, caries increment in 485 (89%) children was recorded and compared with the baseline risk predictions. Results Reasoning-based programmes (CAT and CAMBRA screening) had high sensitivity (≥93.8%) but low specificity (≤43.6%) in predicting caries in children. CAMBRA comprehensive assessment reached a better balance (sensitivity/ specificity of 83.7%/62.9%). Algorithm-based programmes (Cariogram and NUS-CRA) generated better predictions. The sensitivity/specificity of NUS-CRA screening and comprehensive models were 73.6%/84.7% and 78.1%/85.3%, respectively, higher than those of the Cariogram screening (62.9%/77.9%) and comprehensive assessment (64.6%/78.5%). NUS-CRA comprehensive model met the criteria for a useful CRA tool (sensitivity + specificity ≥ 160%), while its screening model approached that target. Conclusions Our results supported algorithm-based approach of caries risk modelling and the usefulness of NUS-CRA in identifying children susceptible to caries. Clinical significance This prospective study provided evidence for practitioners to select tools for assessing children's caries risk, so that prevention measures can be tailored and treatment plan can be optimised.
机译：目标已经制定了各种计划来进行龋齿风险评估（CRA）。然而，缺乏关于其有效性的科学证据。这项研究旨在比较4种CRA程序（CAT，CAMBRA，Cariogram和NUS-CRA）在预测儿童早期龋病中的有效性。方法对544名3岁以下儿童进行口腔检查和生物学检查（唾液流速，唾液缓冲能力和变形致变菌链球菌和乳杆菌的丰富性）。他们的父母填写了调查表。儿童的龋齿风险是通过没有生物学测试（筛查模式）和生物学测试（综合模式）的4个研究计划进行预测的。 12个月后，记录了485名（89％）儿童的龋齿增加，并将其与基线风险预测进行了比较。结果基于推理的程序（CAT和CAMBRA筛查）在预测儿童龋齿中具有较高的敏感性（≥93.8％），但特异性较低（≤43.6％）。 CAMBRA综合评估达到了更好的平衡（敏感性/特异性为83.7％/ 62.9％）。基于算法的程序（Cariogram和NUS-CRA）产生了更好的预测。 NUS-CRA筛查和综合模型的敏感性/特异性分别为73.6％/ 84.7％和78.1％/ 85.3％，高于心电图筛查（62.9％/ 77.9％）和综合评估的敏感性/特异性（64.6％/ 78.5％） ）。 NUS-CRA综合模型符合有用的CRA工具的标准（敏感性+特异性≥160％），而其筛选模型可达到该目标。结论我们的研究结果支持了基于算法的龋齿风险建模方法以及NUS-CRA在识别易患龋齿儿童中的有用性。临床意义这项前瞻性研究为从业人员提供证据，以帮助他们选择评估儿童龋齿风险的工具，从而可以制定预防措施并优化治疗计划。

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