Oral Health and Dental Management

Abstract

Validation of Cariogram as a Tool for Caries Risk Prediction Among 12-Year- Old Institutionalized Children - A Longitudinal Follow-up Study

Sudhir KM, Karthik Kumar Kanupuru, Fareed Nusrath, Srikanth Embeti, Nelagondanahalli T Chaitra

Aim: To evaluate cariogram as a tool for caries risk prediction among 12- year-old institutionalized children and to validate it against the new increment of caries lesions. Materials and Methods: A longitudinal follow-up study was conducted among 36 institutionalized children. Baseline data were collected in the month of January 2012. Children were individually interviewed to record the nonclinical information necessary to complete the cariogram. Clinical information for the assessment of visible plaque was recorded using the Silness and Löe plaque index and evidence of decalcification and caries was recorded using ICDAS criteria. The children underwent the follow-up examination in July 2013 to determine the new increment of dental caries. Results: 52.77% of the participants were classified as low risk and very low risk for future development of dental caries, remainder of the subjects were fairly equally distributed in the medium (19.44%) and high (19.44%) risk groups. Very few (8.33%) participants were classified under very high risk group. Highest odds ratio for disease indicators was 4.20 for past caries experience. Highest odds ratio for pathological factors was 7.15 and 5.54 for the association of M streptococci and visible heavy plaque respectively. Mean caries increment noted from the time of the initial examination to the follow-up was 0.55 ± 0.80 for the total sample. A trend could be noted in which caries increment increased with elevated risk classification, mean caries increment was 1.66 ± 0.57for very high risk, 0.85 ± 0.89 for high risk, 0.71 ± 0.75 for medium risk and 0.27 ± 0.64 for low risk. Sensitivity for CAMBRA was found to be 47.62% with a specificity of 80%, and the area under the ROC curve was found to be 0.638. Conclusion: Cariogram was valid and highly predictive in determining the caries risk among institutionalised children.