How do dental students determine patients' caries risk level using the Caries Management By Risk Assessment (CAMBRA) system?
Research has demonstrated the validation of specific caries risk assessment (CRA) systems, but little is known about how dental practitioners assign a caries risk level to their patients. The aim of this study was to explore dental students' decision making in caries risk assignment when using the Caries Management By Risk Assessment (CAMBRA) system. Multiple correspondence analysis and chi-squared automated interaction detector analysis were performed on data collected retrospectively for a period of six years (2003-09) at the University of California, San Francisco predoctoral dental clinic. The study population consisted of 12,952 patients from six years of age through adult who received a baseline CRA during the period, were new to CAMBRA, and had not received any prior CAMBRA recommendations. The results showed variation in decision making and risk level assignment, illustrated by the range of percentages for the three scores (low, moderate, and high/extreme caries risk) when CRA was assigned for the first time. For those first-time CRAs, decision making was mainly based on four factors: cavities or caries lesions into dentin on radiograph, restorations during the last three years due to caries, visible heavy plaque, and interproximal lesions into enamel (by radiographs). This study's findings provide important data regarding one group of CAMBRA users and thus contribute to the development of knowledge about the implementation of caries risk assessment in contemporary dental practice.
Dr. Doméjean is Professor, Department of Operative Dentistry and Endodontics, Faculté d'Odontologie, Clermont-Ferrand, France; Dr. Léger is Associate Professor, Department of Mathematics, Université Blaise Pascal, Clermont-Ferrand, France; Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; and Dr. Featherstone is Professor, Department of Preventive and Restorative Dental Sciences and Dean, School of Dentistry, University of California, San Francisco. sophie.domejean@udamail.fr.
Sophie
S
Doméjean
Dr. Doméjean is Professor, Department of Operative Dentistry and Endodontics, Faculté d'Odontologie, Clermont-Ferrand, France; Dr. Léger is Associate Professor, Department of Mathematics, Université Blaise Pascal, Clermont-Ferrand, France; Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; and Dr. Featherstone is Professor, Department of Preventive and Restorative Dental Sciences and Dean, School of Dentistry, University of California, San Francisco.
Stéphanie
S
Léger
Dr. Doméjean is Professor, Department of Operative Dentistry and Endodontics, Faculté d'Odontologie, Clermont-Ferrand, France; Dr. Léger is Associate Professor, Department of Mathematics, Université Blaise Pascal, Clermont-Ferrand, France; Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; and Dr. Featherstone is Professor, Department of Preventive and Restorative Dental Sciences and Dean, School of Dentistry, University of California, San Francisco.
Peter
P
Rechmann
Dr. Doméjean is Professor, Department of Operative Dentistry and Endodontics, Faculté d'Odontologie, Clermont-Ferrand, France; Dr. Léger is Associate Professor, Department of Mathematics, Université Blaise Pascal, Clermont-Ferrand, France; Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; and Dr. Featherstone is Professor, Department of Preventive and Restorative Dental Sciences and Dean, School of Dentistry, University of California, San Francisco.
Joel M
JM
White
Dr. Doméjean is Professor, Department of Operative Dentistry and Endodontics, Faculté d'Odontologie, Clermont-Ferrand, France; Dr. Léger is Associate Professor, Department of Mathematics, Université Blaise Pascal, Clermont-Ferrand, France; Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; Dr. White is Professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco; and Dr. Featherstone is Professor, Department of Preventive and Restorative Dental Sciences and Dean, School of Dentistry, University of California, San Francisco.
John D B
JD
Featherstone
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003657:Decision Making; D003731:Dental Caries / Q000145:classification* / Q000000981:diagnostic imaging; D003733:Dental Caries Susceptibility; D003743:Dental Enamel / Q000000981:diagnostic imaging; D003750:Dental Fissures / Q000145:classification; D003773:Dental Plaque / Q000145:classification; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D003804:Dentin / Q000000981:diagnostic imaging; D004497:Education, Dental; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009967:Orthodontic Appliances; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062410:Snacks; D013335:Students, Dental; D013997:Time Factors; D014092:Tooth Root / Q000473:pathology; D055815:Young Adult
biological risk factors; caries; caries risk assessment; clinical decision making; clinical education; dental education; disease indicators; protective factors