title: Accuracy of a chair-side test for predicting caries risk compared with established methods. A pilot study.
abstract: OBJECTIVE
  The aim of this study was to determine the prognostic accuracy of a new chair-side test, determination of lactic-acid production on the tongue, for caries-risk assessment according to caries increment within two years.
  
  
  METHODS
  35 children (6-8 years old) participated in the study. The past caries experience (df-t1, DF-T1), caries at second deciduous molars (df-2.mol), approximal plaque index (API) were the clinical, and salivary counts of mutans streptococci (MS)/lactobacilli (LB) and lactic-acid production on the tongue (LAP) the subclinical predictors recorded at baseline. Two years later, the dental examination was repeated (df-t2/DF-T2). According to the increase in DF-T (delta DF-T), caries-risk groups (delta DF-T = 0 versus delta DF-T > or = 0) were built. To assess the prognostic accuracy sensitivity and specificity were calculated. Statistical analysis was performed using Spearman's test for nonparametric correlations.
  
  
  RESULTS
  The DF-T increased from 0.3 +/- 0.8 to 1.2 +/- 1.6. 20 children were in the no-caries-risk and 15 in the caries-risk group. The p-value for the correlation of delta DF-T to API was 0.007 and to LB counts 0.069. The highest sensitivity and specificity levels were found for LB (65%/70%), LAP reached a maximum sensitivity of 33% with a specificity of 55%.
  
  
  CONCLUSIONS
  According to the results, because of its insufficient prognostic accuracy the LAP test is not suitable as a sole screening-tool for an accurate caries-risk assessment.
authors.affiliation: Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz. azrak@uni-mainz.de
authors.forename: Birgül
authors.initials: B
authors.lastname: Azrak
authors.forename: Christiane
authors.initials: C
authors.lastname: Gleissner
authors.forename: Brita
authors.initials: B
authors.lastname: Willershausen
authors.forename: Johanna
authors.initials: J
authors.lastname: Jadamus-Stöcker
authors.forename: Angelika
authors.initials: A
authors.lastname: Callaway
mesh_terms: D016009:Chi-Square Distribution; D002648:Child; D015169:Colony Count, Microbial; D004245:DMF Index; D003731:Dental Caries / Q000175:diagnosis* / Q000453:epidemiology; D003732:Dental Caries Activity Tests; D003774:Dental Plaque Index; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D019344:Lactic Acid / Q000032:analysis* / Q000378:metabolism; D007778:Lactobacillus / Q000302:isolation & purification; D010865:Pilot Projects; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012463:Saliva / Q000382:microbiology; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000302:isolation & purification; D014059:Tongue / Q000382:microbiology
chemical_list: D019344:Lactic Acid