Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Gothenburg, Sweden.
Public Dental Service, Region Östergötland, Linköping, Sweden.
Eur Arch Paediatr Dent. 2024 Oct;25(5):695-705. doi: 10.1007/s40368-024-00928-0. Epub 2024 Aug 5.
To investigate the predictive ability of individual Caries Risk Assessments (CRA) regarding oral factors supplemented with social factors in relation to caries outcome in preschool children. Furthermore, to assess various models of CRA with oral and social factors included, aiming to identify the most suitable models for different age groups.
The design is a retrospective registry-based cohort study. Children visiting the dentists at ages 3 and 6 years were included. Data on oral and social factors were obtained from dental records, the Swedish Quality register for caries and periodontitis (SKaPa), and Statistics Sweden (SCB). Various models of CRA were designed, combining oral and social factors. Models were analyzed with univariable associations using simple logistic regression, and the results were presented as odds ratios (ORs). In addition, models were analyzed with area under the receiver operating characteristic (ROC) curve (AUC). Pairwise comparisons were conducted by DeLong's test, with p < 0.05 considered significant.
Oral factors were the most significant for caries outcome (OR 9.6), followed by social factors: foreign background (OR 4.6), low income (OR 2.83), low education of the mother (OR 2.77), single-parent family (OR 2.11), and having ≥ 3 siblings (OR 1.71), (p < 0.01). The predictive ability of CRA improved when models combining oral and social factors were used, compaired to CRA based solely on oral factors (p < 0.05). An increase of up to 15% was seen when CRA was conducted closer to the outcome.
Models for Caries Risk Assessment including oral and social factors increase the predictive ability. Caries Risk Assessment has limited durability.
研究个体龋病风险评估（CRA）在补充社会因素的情况下对口腔因素与学龄前儿童龋齿结果的预测能力。此外，评估包含口腔和社会因素的各种 CRA 模型，旨在确定最适合不同年龄组的模型。
该设计是一项回顾性基于登记的队列研究。纳入 3 岁和 6 岁时看牙医的儿童。从牙科记录、瑞典龋齿和牙周炎质量登记处（SKaPa）和瑞典统计局（SCB）获取口腔和社会因素的数据。设计了各种结合口腔和社会因素的 CRA 模型。使用简单逻辑回归对模型进行单变量关联分析，并以优势比（OR）表示结果。此外，还使用接收者操作特征曲线（ROC）下面积（AUC）分析模型。通过 DeLong 检验进行两两比较，p<0.05 认为有统计学意义。
口腔因素对龋齿结果的影响最大（OR9.6），其次是社会因素：外国背景（OR4.6）、低收入（OR2.83）、母亲受教育程度低（OR2.77）、单亲家庭（OR2.11）和有≥3个兄弟姐妹（OR1.71）（p<0.01）。与仅基于口腔因素的 CRA 相比，使用结合口腔和社会因素的模型可提高 CRA 的预测能力（p<0.05）。当 CRA 更接近结果时，可提高多达 15%的预测能力。
包含口腔和社会因素的龋病风险评估模型可提高预测能力。龋病风险评估的耐久性有限。
