title: Caries risk assessment in young adults: A 3-year validation of clinical guidelines used in Public Dental Service.
abstract: OBJECTIVE
  To validate a risk classification model according to the Public Dental Service (PDS) guidelines with the actual 3-year caries outcome in terms of predictive values.
  
  
  METHODS
  All 19-year-old patients registered at eight public dental clinics in Skåne, Sweden were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects, representing 10% of the age group attending the public dental care in the region. A risk classification of each patient in four categories was made by the patient's regular team according to the guidelines. At the follow-up 3 years later, 75.8% were accessible. The final examinations included bitewing radiographs and the actual caries increment for 982 patients was calculated.
  
  
  RESULTS
  At baseline, 11.9% were assessed as being at 'high' or 'very high' risk. The dropouts had significantly more caries than the remaining patients (p < 0.05). The general disease activity was low, but those grouped into the two highest risk groups displayed significantly more new caries than those at lower risk (p < 0.05). With a cut-off value ΔDFS > 0 vs DFS = 0, the sensitivity was 81% and the specificity 56% for 'low' risk vs any risk. By combining the 'low' and 'some' risk categories, the PDS model generated an improved specificity (94%).
  
  
  CONCLUSIONS
  The risk assessment scheme used by the Public Dental Service for young adults relied basically on past and current caries activity and 65-70% of the patients were correctly classified. The model was most effective to screen out patients with low caries risk.
authors.affiliation: Department of Cariology, Faculty of Odontology, Malmö University , Malmö , Sweden.
authors.forename: Gunnel
authors.initials: G
authors.lastname: Hänsel Petersson
authors.forename: Ewa
authors.initials: E
authors.lastname: Ericson
authors.forename: Per-Erik
authors.initials: PE
authors.lastname: Isberg
authors.forename: Svante
authors.initials: S
authors.lastname: Twetman
mesh_terms: D000328:Adult; D003731:Dental Caries / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018570:Risk Assessment; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult