ABSTRACT: 0720

Evaluating 3 Caries Risk Assessment Tools: CaMBRA, Cariogram, & CAT

P. HAN, University of California - Berkeley, San Francisco, USA, K. AAMODT, University of California, San Diego - Scripps, San Francisco, USA, T. BUI, University of California - San Francisco, USA, B. SAGIER, San Francisco State University, CA, USA, and S.A. GANSKY, University of California, San Francisco School of Dentistry, USA

Early childhood caries (ECC) prevalence is higher in certain subpopulations (Vargas&Ronzio 2006; Peterson 2003; Dye et al. 2004) Thus, accurate ECC risk prediction tools are needed. American Association of Pediatric Dentistry (AAPD) guidelines designate CAT for children's caries risk assessment.

Objective: (1) to retrospectively compare utility of CAT, CaMBRA, and Cariogram in preschoolers in the 1993-4 California Oral Health Needs Assessment (COHNA). (2) to compare utility of Cariogram in retrospective COHNA to two prospective reports.

Methods: (1) fluoride, diet, and socioeconomic status questions from COHNA (N=2249) were categorized to classify low, moderate or high risk for CAT and CaMBRA and low, intermediate, high, and very high risk for Cariogram. Risk for CAT and CaMBRA and probability of future caries for Cariogram were compared to actual ECC incidence (# of decayed, extracted or filled tooth-surfaces (defs)>0) (Drury, et al., 1999) for validation. (2) Two prospective studies compared five risk groupings of chance of avoiding caries to caries. Receiver operating characteristic (ROC) curves of sensitivity versus 100-specificity illustrated tools' predictions.

Results: (1) Cariogram identified 18% of children as very high risk, 48% as high risk, and 34% as intermediate risk, but none as low risk. CAT identified 95% and CaMBRA identified 29% as moderate or high risk. Although ROC curves of CAT and CaMBRA showed poor combined sensitivities and specificities, Cariogram demonstrated improved sensitivities and specificities. (2) Cariogram probability can be converted to ROC curves showing sensitivity and specificity; those properties show Cariogram yields reasonably good prediction.

Conclusions: Cariogram may be more useful in predicting caries risk than the AAPD endorsed CAT. Cariogram's ordinal categories and weighting of factors may be potentially more informative than binary systems of CAT and CaMBRA. This evaluation was limited by cross-sectional data and lack of bacterial and salivary flow measures.

Support: US DHHS/NIH/NIDCR U54DE14251.

Seq #113 - Student Posters
1:30 PM-2:30 PM, Friday, April 4, 2008
Hilton Anatole Hotel Trinity I - Exhibit Hall

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