Pilot validation of a new Canadian pediatric caries risk assessment tool for preschool children

Abstract

Purpose: The purpose of this pilot study was to determine the sensitivity and specificity of a newly developed Canadian Caries Risk Assessment Tool for children < 6 years to predict caries development in a cohort of individuals followed in community-based dental clinics.

Methods: A prospective observational cohort study was conducted to test the Canadian Caries Risk Assessment Tool. Children were recruited over a 12-month period. The child’s parent/caregiver completed a baseline CRA via interview, and dmft/dmfs were recorded. Participants returned for a follow-up examination at which time a second interview and changes in oral health, including new dental caries activity and dmft/dmfs were recorded. Data was analyzed using standard, bivariate statistics (chi square, t test, McNemar). Odds ratios (OR), sensitivity, specificity and positive/negative predictive values were calculated.

Data: Overall, 173 preschool children were initially enrolled. The average age was 39.9 ± 17 months. Baseline CRA enrollment and follow up occurred between January 2019 and October 2021 with an average time between assessments of 13 ± 4 months. 122 (70.5%) children were assigned a high CRA rating at their baseline appointment and 106 (61.3%) were found to have active caries or past evidence of dental treatment for caries. Baseline presence of visible caries and/or past evidence of dental treatment was found to be statistically significant (p <0.0001) with new caries noted at their follow up assessment (OR=7.39). Individuals assigned to a high risk CRA rating were found to be significantly associated (p 0.0001) with formation of new caries noted at their follow up assessment (OR= 4.9). Sensitivity and specificity for baseline CRA rating (high and low risk) and new caries noted at clinical follow-up was determined to be 86.1% and 44.2% with a positive predictive value of 59.1% and a negative predictive value of 77.3%.

Conclusion: The current assessment of the Canadian Caries Risk Assessment Tool revealed a sensitivity of 86.1% and specificity of 44.2% when predicting new caries formation in preschool children, with a combined total of 130.3%, and a positive predictive value of 59.1% and negative predictive value of 77.3%. However, before it is to be utilized within different populations throughout Canada, further investigation is required into the development and refinement of the Canadian Caries Risk Assessment Tool.