Can the development of new dental caries in Danish schoolchildren be predicted from surveillance data in the School Dental Service?

Abstract

Dental screening programmes for Danish children generally target all children, irrespective of their individual caries risk. The standard screening interval is approximately 12 months. A valid systematic screening tool based on routine information sources is however indispensable, if more selective screening strategies should be developed to target the children at highest risk. To estimate the precision with which Danish schoolchildren at high risk for developing dental caries within 1 year can be identified based on information from routine registers. Based on data from the Danish National Board of Health's Recording System for the Danish Child Dental Services and from the Central Office of Civil Registration, 3705 schoolchildren aged 7-12 years were followed through 1994-1996. Dental health information as of 1994 and changes 1994-1995 were applied in multiple logistic regressions together with social data as of 1995 to estimate the individual 1-year (1995-1996) risk of developing caries. In 1995, 37.4% of the children had a DMFS index above 0, and during the following year 21.8% of all children developed new caries. The individual child's 1-year caries risk could be estimated relatively accurately at baseline as indicated by the area (76%) under the receiver operating characteristic curve. About 40% of children with an estimated risk of 20% and above developed new caries, whereas 90% of the rest of the children did not do so. Based on information from Danish routine registers children at low caries risk may be identified relatively precisely. This may form the basis for the continuous development and targeting of high-risk strategies, in which the screening for caries among children of estimated low risk may be postponed at least 1 year.