Strategies for caries risk assessment in children and adolescents at public dental clinics in a Swedish county

BACKGROUND: Since caries prevalence has decreased and become polarized, high-risk preventive strategies have been widely adopted. The underlying factors leading to assessment and management of caries risk are poorly understood. AIM: The aim of this study was to identify the factors forming the basis for dentist's caries risk assessment in dental care for children and adolescents. DESIGN: From all 3372 children in a Swedish county identified as at high risk for developing caries, a sample of dental records from 432 children, aged 3-19 years, were randomly selected to be analysed in the study. Information about medical and social history, dental status, dietary habits, oral hygiene, and salivary data was obtained from the records. RESULTS: The results show that the only data registered in the majority of the dental records were dental status from the clinical examination and bitewing radiographs. In approximately half of the dental records, medical history and data concerning oral hygiene were registered. Dental history and dietary habits were noted in approximately 25% of the dental records, whereas other risk factors/indicators were occasionally registered. CONCLUSIONS: Dentists mainly base their caries risk assessments on past caries experience, a reliable risk indicator for assessing the risk of being affected by caries again. In children with no experience of caries, knowledge of other risk factors/indicators needs to be available to perform a caries risk assessment. In this study, documentation of such knowledge was strongly limited.