International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 18 , ISSUE 1 ( January, 2025 ) > List of Articles

ORIGINAL RESEARCH

Development and Refinement of the Indian Caries Risk Assessment Tool for Children

Saima Y Khan, Robert J Schroth, Faraha Javed

Keywords : Child, Dental caries, Pediatric dentistry, Preschool, Risk assessment

Citation Information : Khan SY, Schroth RJ, Javed F. Development and Refinement of the Indian Caries Risk Assessment Tool for Children. Int J Clin Pediatr Dent 2025; 18 (1):58-63.

DOI: 10.5005/jp-journals-10005-3025

License: CC BY-NC 4.0

Published Online: 14-02-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Aim and background: Early childhood caries (ECC) is a significant oral health problem in India. Personalized care based on individual or group risk has become a key aspect of dental caries prevention and management. However, an appropriate tool for caries risk assessment (CRA), taking into consideration the protective and risk factors for ECC specific to the Indian population, does not exist. This study aimed to report on the development and refinement of an evidence-based CRA tool for Indian children <6 years of age through consultation and feedback by dental professionals. Materials and methods: Stakeholder consultation sessions were conducted with 65 participants, which included dental professionals and postgraduate residents. A survey questionnaire was also used to collect feedback on the initial draft of the newly developed Indian CRA tool. Predominant preferences and recommendations for improvement were taken into consideration, and the data were descriptively analyzed. Results: The consultation sessions were conducted separately with three groups. A total of 80% of participants also completed the survey questionnaire. Survey questionnaire results reveal that 82.7% considered the current proposed questions in the Indian CRA tool to be sufficient, while 86.5% indicated that the tool would be understandable by parents. Overall, the majority of respondents (96.2%) agreed on the importance of the drafted Indian CRA tool for tailoring anticipatory guidance and treatment for individual children. Conclusion: The newly developed CRA tool for Indian preschool children will be a useful resource for dental practitioners to assess young children's individual caries risk levels and assist with providing a personalized preventive service to children. The developed tool was refined based on dental professional feedback and was found to be a user-friendly, simple, practical, and evidence-based approach. Clinical significance: This study developed the first evidence-based CRA tool for preschoolers in India. Researchers drafted and then refined the tool through consultation with stakeholders. The final CRA tool is evidence- and algorithm-based, easy to use, and considers the risk factors specific to ECC of the Indian preschool population.


PDF Share
  1. American Academy of Pediatric Dentistry. Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry 2020:79–81.
  2. O'Sullivan DM, Tinanoff N. The association of early childhood caries patterns with caries incidence in preschool children. J Public Health Dent 1996;56(2):81–83. DOI: 10.1111/j.1752-7325.1996.tb02401.x
  3. Al-Shalan TA, Erickson PR, Hardie NA. Primary incisor decay before age 4 as a risk factor for future dental caries. Pediatr Dent 1997;19(1):37–41.
  4. Ladrillo TE, Hobdell MH, Caviness AC. Increasing prevalence of emergency department visits for pediatric dental care 1997–2001. J Am Dent Assoc 2006;137(3):379–385. DOI: 10.14219/jada.archive.2006.0188
  5. Griffin SO, Gooch BF, Beltran E, et al. Dental services, costs, and factors associated with hospitalization for Medicaid-eligible children, Louisiana 1996-97. J Public Health Dent 2000;60(3):21–27. DOI: 10.1111/j.1752-7325.2000.tb03287.x
  6. Agency for Healthcare Research and Quality. Total Dental Care Expenditure, Medical Expenditure Panel Survey; 2010.
  7. Edelstein BL, Reisine S. Fifty-one million: a mythical number that matters. J Am Dent Assoc 2015;146(8):565–566. DOI: 10.1016/j.adaj.2015.06.003
  8. Blumenshine SL, Vann WF Jr, Gizlice Z, et al. Children's school performance: impact of general and oral health. J Public Health Dent 2008;68(2):82–87. DOI: 10.1111/j.1752-7325.2007.00062.x
  9. Filstrup SL, Briskie D, da Fonseca M, et al. The effects on early childhood caries (ECC) and restorative treatment on children's oral health-related quality of life (OHRQOL). Pediatr Dent 2003;25(5):431–440.
  10. American Dental Association. Caries Risk Assessment and Management; 2021.
  11. Thakkar R, Jawdekar AM. CRAFT-A proposed framework for caries risk assessment in Indian children. EC Paediatrics 2022:33–45.
  12. Khan SY, Javed F, Ebadi MH, et al. Prevalence and risk factors for ECC among preschool children from India along with the need of its own CRA tool—a systematic review. J Int Soc Prev Community Dent 2022;12(3):295–308.
  13. Bratthall D, Petersson GH. Cariogram—a multifactorial risk assessment model for a multifactorial disease. Community Dent Oral Epidemiol 2005;33(4):256–264. DOI: 10.1111/j.1600-0528.2005.00233.x
  14. Featherstone J, Gomez FR, Crystal YO. CAMBRA® caries management by risk assessment: a comprehensive caries management guide for dental professionals. J Calif Dent Assoc 2019.
  15. Featherstone JDB, Crystal YO, Alston P, et al. A comparison of four caries risk assessment methods. Front Oral Health 2021;2:656558. DOI: 10.3389/froh.2021.656558
  16. Ismail AI, Pitts NB, Tellez M, et al. The International Caries Classification and Management System (ICCMS™) an example of a caries management pathway. BMC Oral Health 2015;15:S9. DOI: 10.1186/1472-6831-15-S1-S9
  17. Khan SY, Schroth RJ, de Jesus VC, et al. A systematic review of caries risk in children <6 years of age. Int J Paediatr Dent 2024;34:410–431. DOI: 10.1111/ipd.13140
  18. O'Brien BC, Harris IB, Beckman TJ, et al. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med 2014;89(9):1245–1251. DOI: 10.1097/ACM.0000000000000388
  19. Schroth RJ, Kyoon-Achan G, Levesque J, et al. A mixed methods approach to obtaining health care provider feedback for the development of a Canadian pediatric dental caries risk assessment tool for children <6 years. Front Oral Health 2023;4:1074621. DOI: 10.3389/froh.2023.1074621
  20. Schroth RJ, Rothney J, Sturym M, et al. A systematic review to inform the development of a Canadian caries risk assessment tool for use by primary healthcare providers. Int J Pediatr Dent 2021;31(6):767–791. DOI: 10.1111/ipd.12776
  21. Usha C. Caries risk assessment: a critical look. J Oper Dent Endod 2018;3(1):22–27.
  22. Gao X, Wu ID, Man Lo EC, et al. Validity of caries risk assessment programmes in preschool children. J Dent 2013;41(9):787–795. DOI: 10.1016/j.jdent.2013.06.005
  23. Busby M, Chapple E, Matthews R, et al. Practitioner evaluation of a novel online integrated oral health and risk assessment tool: a practice pilot. Br Dent J 2013;215(3):115–120. DOI: 10.1038/sj.bdj.2013.738
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.