IADR Abstract Archives
An Evaluation of Caries Risk Assessments in Older Adults
Objectives: The aim of this study was to evaluate and compare the Cariogram and CAMBRA risk assessment tools in predicting caries risk in independently-living older adults.
Methods: A two-year prospective study recording root caries incidence was conducted with participation from 334 dentate adults aged >65 years. Data were collected on medications, fluoride exposure, dental attendance patterns, recent dental history and diet. Saliva samples were collected to measure salivary flow rate, buffer capacity and to estimate bacterial counts. Clinical examination was completed to record decayed, missing and filled teeth (DMFT) and also exposed, filled and decayed root surfaces (RDFS). This was repeated after 12 and 24 months. Scores were entered into the Cariogram and CAMBRA tools and baseline risk category was recorded. The performances of the Cariogram and CAMBRA in predicting root and coronal caries incidence was evaluated by receiver operating characteristic (ROC) analysis
Results: Two hundred and eighty participants were examined at two year follow up. 25% (n=70) developed new root caries at 2 years and 27.5% (n=77) developed new coronal caries at 2 years. Among the participants assessed as high risk by the Cariogram (n=63), 55.6% developed new root caries and 42.9% developed new coronal caries. Of those categorized as high risk using CAMBRA (n=70), 68.6% developed new root caries and 58.6% developed new coronal caries. The area under the ROC curve (AUROC) for root and coronal caries prediction using the Cariogram was 0.76 (95% CI 0.69-0.82) and 0.61 (95% CI 0.53-0.68) respectively. The AUROC for root and coronal caries prediction using CAMBRA was 0.79 (95% CI 0.72-0.86) and 0.69 (95% CI 0.62-0.77) respectively.
Conclusions: Within the limitations of this study, the performances of the Cariogram and CAMBRA tools were good when identifying individuals at a high risk of developing root caries within an older population, and fair for the prediction of coronal caries.
Methods: A two-year prospective study recording root caries incidence was conducted with participation from 334 dentate adults aged >65 years. Data were collected on medications, fluoride exposure, dental attendance patterns, recent dental history and diet. Saliva samples were collected to measure salivary flow rate, buffer capacity and to estimate bacterial counts. Clinical examination was completed to record decayed, missing and filled teeth (DMFT) and also exposed, filled and decayed root surfaces (RDFS). This was repeated after 12 and 24 months. Scores were entered into the Cariogram and CAMBRA tools and baseline risk category was recorded. The performances of the Cariogram and CAMBRA in predicting root and coronal caries incidence was evaluated by receiver operating characteristic (ROC) analysis
Results: Two hundred and eighty participants were examined at two year follow up. 25% (n=70) developed new root caries at 2 years and 27.5% (n=77) developed new coronal caries at 2 years. Among the participants assessed as high risk by the Cariogram (n=63), 55.6% developed new root caries and 42.9% developed new coronal caries. Of those categorized as high risk using CAMBRA (n=70), 68.6% developed new root caries and 58.6% developed new coronal caries. The area under the ROC curve (AUROC) for root and coronal caries prediction using the Cariogram was 0.76 (95% CI 0.69-0.82) and 0.61 (95% CI 0.53-0.68) respectively. The AUROC for root and coronal caries prediction using CAMBRA was 0.79 (95% CI 0.72-0.86) and 0.69 (95% CI 0.62-0.77) respectively.
Conclusions: Within the limitations of this study, the performances of the Cariogram and CAMBRA tools were good when identifying individuals at a high risk of developing root caries within an older population, and fair for the prediction of coronal caries.