The State of Risk Assessment in North American Dental Schools

Objectives: The purpose of this study was to gather data regarding the medical, caries, and periodontal risk assessment tools and protocols implemented throughout dental schools in North America, in addition to which electronic health record(EHR) systems and competencies are used.
Methods: After IRB approval, a 25-question Qualtrics survey about medical, caries, and periodontal risk assessment tools, protocols, and competencies was sent to 76 dental institutions in North America(66 United States, 10 Canada). The survey link was sent to two clinical faculty from each institution. The data was analyzed using Stata 13.1.
Results: Roughly 40%(30/76) of institutions responded to the survey. 96% of programs utilized Axium as their EHR system. Over 90% of institutions required competencies for proper completion of medical history and oral cancer screening, but less than 50% of programs had competencies for discussion of risk factors for oral cancer and counseling related to tobacco cessation. 90% of institutions used a caries risk assessment(CRA) tool, of which 80% integrated the tool into their EHR system. 57% of these schools used Caries Management By Risk Assessment, while others used a modified version of an existing tool. 70% of programs required a CRA competency. Less than 30% of institutions reported using a periodontal risk assessment tool, but 80% of programs required students to discuss the risk factors of periodontal health and the link between periodontal disease and systemic health.
Conclusions: Most programs use EHR systems with medical and caries risk assessment tools built in, but without an integrated periodontal risk assessment tool. Most schools lacked referral for conditions noted in the dental clinic, especially with smokers. This research will document what risk assessment protocols and competencies are currently in place and provide insight on what areas of holistic and preventative care our institutions must work on improving.