Integrating oral and social factors in individual caries risk assessments in preschool children-a registry-based study.

Abstract

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 6years 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.