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Caries Risk Assessment and Detection

Individual Caries Risk Assessment

Caries is a multi-factorial disease with a number of risk factors that can be evaluated to predict caries risk. Practitioners use the demographic, background and social information they collect when taking detailed case histories together with their clinical and radiographic findings and any supplementary tests to come up with a caries risk profile for an individual patient. Determining the caries risk of individual patients will also aid the dentist in planning review appointments and the intervals for subsequent bitewing radiographs. High caries-risk patients are seen at 3-monthly intervals whilst low-risk patients are seen at 6-monthly intervals.

Caries Risk Assessment Factors

Socio-demographic:

• Socio-economic status: low economic levels are associated with high caries risk.
• Educational level: low education levels are associated with high caries risk.
• Ethnicity: first-generation immigrants are at increased caries risk.

Behavioural:

• Diet: high-frequency intakes of cariogenic foods and drinks are associated with high caries risk.
• Fizzy drinks and juices: increased frequency of intake and sipping are associated with high caries risk.
• Habits: swishing and/or holding habits for fizzy drinks and juices are associated with high caries risk.
• Baby bottle: night-time and on demand drinking of cariogenic drinks in a baby bottle are associated with high caries risk.
• Fluoride exposue: irregular or no exposure to daily fluoride is associated with high caries risk.
• Toothbrushing: irregular non-supervised brushing is associated with high caries risk.

Clinical:

• Caries prevalence: past caries is strongly associated with high caries risk.
• Oral hygiene level: plaque index scores >50% are associated with high caries risk.
• Gingival inspection: bleeding on probing is associated with high caries risk.

Radiographic:

• Bitewing radiographs: interproximal as well as new or progression of lesions are associated with high caries risk.

Supplementary tests:

• Salivary flow: low (<0.5 ml/min) salivary flow is associated with high caries risk.
• Salivary buffering capacity: low salivary pH and poor bufferin/>
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