Twetman Svante, Fontana Margherita, Featherstone John D B
Institute of Dentistry, Department of Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Community Dent Oral Epidemiol. 2013 Feb;41(1):e64-70. doi: 10.1111/cdoe.12026.
The object of this conference paper was to review and discuss caries risk assessment in general practice from the questions i) 'Why', ii) 'When', and iii) 'How'.
Narrative review.
i) Patient caries risk assessment is the basic component in the decision-making process for adequate prevention and management of dental caries and for determination of individual recall intervals. ii) Caries risk assessment should always be performed at a child's first dental visit and then regularly throughout life, and especially when social or medical life events are occurring. iii) There are several risk assessment methods and models available for but the evidence for their validity is limited. Although there is no clearly superior method for predicting future caries, the use of structured protocols combining socioeconomy, behavior, general health, diet, oral hygiene routines, clinical data, and salivary tests or computer-based systems are considered best clinical practice. The accuracy ranges between 60% and 90%, depending on age. Caries risk assessment is more effective in the selection of patients at low risk than those with high caries risk.
As evidence suggests that past caries experience is far from ideal but the most important single risk component for more caries at all ages, any clinical sign of likely active demineralization on smooth, occlusal, and proximal tooth surfaces should be taken as a signal for the implementation of individually designed preventive and disease management measures.
本会议论文的目的是从以下三个问题：i）“为何”，ii）“何时”，以及iii）“如何”，对全科医疗中的龋齿风险评估进行回顾和讨论。
叙述性综述。
i）患者龋齿风险评估是龋齿充分预防和管理决策过程以及确定个体复诊间隔的基本组成部分。ii）龋齿风险评估应在儿童首次看牙时进行，然后在一生中定期进行，尤其是在发生社会或医疗生活事件时。iii）有几种可用的风险评估方法和模型，但其有效性的证据有限。虽然没有明显优于其他方法来预测未来龋齿，但结合社会经济、行为、总体健康、饮食、口腔卫生习惯、临床数据以及唾液检测或基于计算机的系统的结构化方案被认为是最佳临床实践。准确率在60%至90%之间，取决于年龄。龋齿风险评估在选择低风险患者方面比高龋齿风险患者更有效。
由于有证据表明过去的龋齿经历远非理想，但却是所有年龄段发生更多龋齿的最重要单一风险因素，光滑面、咬合面和邻面牙齿表面任何可能存在的活跃脱矿临床迹象都应被视为实施个体化预防和疾病管理措施的信号。
