Modeling Caries Risk Assessment in Chinese Children

Although the importance of Caries Risk Assessment (CRA) in effective caries prevention has been widely recognized, the reliable CRA models are yet to be established. Objective: to identify the appropriate model for caries risk assessment/prediction in Chinese children. Methods: 235 children aged 4-7 (mean 6.5) years were surveyed through a questionnaire (demographic background, diet frequency/content, fluoride applications and systemic diseases), plaque amount and caries status examination, stimulated saliva flow rate and buffering capacity tests. After 12 months, caries status of 128 subjects was followed up. Data from 64 randomly selected subjects were used to identify risk factors and construct 2 predictive models, while data from the remaining 64 subjects were used for model validation. The predictive performance of these 2 models was also compared with Cariogram CRA model. Results: Within 12 months, new caries lesions occurred in 38.1% subjects. Girls were more prone to have new lesions than boys (52% vs. 28%, P=0.007), with an odds ratio of 2.72 (95% CI 1.30-5.71). The mean new affected teeth and surfaces over one year were 4.38±0.35 & 2.15±0.17 among children developing new lesions and 1.75±0.28 & 0.87±0.14 in the entire cohort. "Plaque amount", "saliva flow rate" and "diet content" were identified as risk factors. Two multiple regression models were constructed to predict "chance of developing new lesions" and "number of new affected teeth". Odds Ratio (predicted chance >50% / predicted chance ≤50%) of "developing new lesion" was 4.3 (95% CI: 1.4-13.2). The Receiver Operating Characteristic (ROC) Curves showed strong predictive values of these 2 models (P<0.001 & P=0.027, respectively), which performed significantly better than Cariogram. The sensitivity and specificity may reach 82.6% and 73.0% when 35.74% "chance of developing new lesions" was used as a cut-off point. Conclusion: Predictive models constructed in this study may be promising for further development.