title: Building caries risk assessment models for children.
abstract: Despite the well-recognized importance of caries risk assessment, practical models remain to be established. This study was designed to develop biopsychosocial models for caries risk assessment in various settings. With a questionnaire, an oral examination, and biological (salivary, microbiological, and plaque pH) tests, a prospective study was conducted among 1782 children aged 3-6 years, with 1576 (88.4%) participants followed in 12 months. Multiple risk factors, indicators, and protective factors were identified. Various risk assessment models were constructed by the random selection of 50% of the cases and further validated in the remaining cases. For the prediction of a "one-year caries increment", screening models without biological tests achieved a sensitivity/specificity of 82%/73%; with biological tests, full-blown models achieved the sensitivity/specificity of 90%/90%. For identification of a quarter of the children with high caries burden (baseline dmft > 2), a community-screening model requiring only a questionnaire reached a sensitivity/specificity of 82%/81%. These models are promising tools for cost-effective caries control and evidence-based treatment planning.
  
  
  BACKGROUND
  decayed, missing, filled teeth in primary dentition (dmft); receiver operation characteristics (ROC); relative risk (RR); confidence interval (CI); National Institutes of Health (NIH); World Health Organization (WHO); US Department of Health and Human Services (US/DHHS); American Academy of Pediatric Dentistry (AAPD).
authors.affiliation: Dental Public Health, Faculty of Dentistry, University of Hong Kong.
authors.forename: X-L
authors.initials: XL
authors.lastname: Gao
authors.forename: C-Y S
authors.initials: CY
authors.lastname: Hsu
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.forename: H B
authors.initials: HB
authors.lastname: Hwarng
authors.forename: T
authors.initials: T
authors.lastname: Loh
authors.forename: D
authors.initials: D
authors.lastname: Koh
mesh_terms: D002648:Child; D002675:Child, Preschool; D004245:DMF Index; D003729:Dental Care; D003731:Dental Caries / Q000209:etiology* / Q000517:prevention & control; D003733:Dental Caries Susceptibility; D003773:Dental Plaque / Q000382:microbiology / Q000503:physiopathology; D003774:Dental Plaque Index; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007778:Lactobacillus / Q000302:isolation & purification; D008297:Male; D015233:Models, Statistical; D009909:Oral Health; D009910:Oral Hygiene; D009911:Oral Hygiene Index; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology / Q000502:physiology; D012680:Sensitivity and Specificity; D012923:Social Class; D013295:Streptococcus mutans / Q000302:isolation & purification