Abstract
BackgroundThe 'high-risk approach' is a commonly adopted strategy recommended for the prevention of dental caries in populations. The scientific basis for the strategy has been questioned. The objective of this study is to assess the contribution that children identified at 'high-risk' made towards the total of new caries lesions over a 4-year period, by analysing the distribution of new lesions per 100 children.MethodsData are from the National Preventive Dentistry Demonstration Programme (NPDDP) in the United States. The analyses identified the distribution of new carious lesions over a 4-year period in four groups of 7 year-old children who received differing preventive regimes.ResultsThe majority of new lesions occurred in those children classified at lowest caries risk at baseline. Irrespective of the preventive regime adopted and the initial caries levels, children classified as 'highest risk' contributed less than 6% of the total number of new lesions developing over 4 years.ConclusionThese findings challenge the basis for the adoption of a high-risk strategy.
Highlights
The 'high-risk approach' is a commonly adopted strategy recommended for the prevention of dental caries in populations
The approach is based on three assumptions: first, those individuals with high future caries increments can be identified; second, measures taken to prevent the caries lesions are effective, and third, that those individuals belonging to sub-groups within a population who have previously experienced the highest levels of caries in the past will continue to do so in future
The data used were derived from the National Preventive Dentistry Demonstration Programme (NPDDP)
Summary
The 'high-risk approach' is a commonly adopted strategy recommended for the prevention of dental caries in populations. A commonly adopted approach for the prevention of caries is the 'high-risk' strategy. The approach is based on three assumptions: first, those individuals with high future caries increments can be identified; second, measures taken to prevent the caries lesions are effective, and third, that those individuals belonging to sub-groups within a population who have previously experienced the highest levels of caries in the past will continue to do so in future. From a public health perspective, what is important when deciding upon a preventive approach is what impact the measure adopted would have on the total dental health and disease burdens of the population as a whole. Even if a high-risk group had a far higher annual increment than the remaining sub-groups of the (page number not for citation purposes)
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