title: Comparison of risk assessment based on clinical judgement and Cariogram in addition to patient perceived treatment need.
abstract: BACKGROUND
  Predicting future risk for oral diseases, treatment need and prognosis are tasks performed daily in clinical practice. A large variety of methods have been reported, ranging from clinical judgement or "gut feeling" or even patient interviewing, to complex assessments of combinations of known risk factors. In clinical practice, there is an ongoing continuous search for less complicated and more valid tools for risk assessment. There is also a lack of knowledge how different common methods relates to one another. The aim of this study was to investigate if caries risk assessment (CRA) based on clinical judgement and the Cariogram model give similar results. In addition, to assess which factors from clinical status and history agree best with the CRA based on clinical judgement and how the patient's own perception of future oral treatment need correspond with the sum of examiners risk score.
  
  
  METHODS
  Clinical examinations were performed on randomly selected individuals 20-89 years old living in Skåne, Sweden. In total, 451 individuals were examined, 51 % women. The clinical examination included caries detection, saliva samples and radiographic examination together with history and a questionnaire. The examiners made a risk classification and the authors made a second risk calculation according to the Cariogram.
  
  
  RESULTS
  For those assessed as low risk using the Cariogram 69 % also were assessed as low risk based on clinical judgement. For the other risk groups the agreement was lower. Clinical variables that significantly related to CRA based on clinical judgement were DS (decayed surfaces) and combining DS and incipient lesions, DMFT (decayed, missed, filled teeth), plaque amount, history and soft drink intake. Patients' perception of future oral treatment need correlated to some extent with the sum of examiners risk score.
  
  
  CONCLUSIONS
  The main finding was that CRA based on clinical judgement and the Cariogram model gave similar results for the groups that were predicted at low level of future disease, but not so well for the other groups. CRA based on clinical judgement agreed best with the number of DS plus incipient lesions.
authors.affiliation: Department of Cariology, Faculty of Odontology, Malmö University, SE-205 06, Malmö, Sweden. gunnel.hansel-petersson@mah.se.
authors.forename: Gunnel
authors.initials: G
authors.lastname: Hänsel Petersson
authors.affiliation: Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: Sigvard
authors.initials: S
authors.lastname: Åkerman
authors.affiliation: Department of Statistics, Lund University School of Economics and Management, Lund University, Lund, Sweden.
authors.forename: Per-Erik
authors.initials: PE
authors.lastname: Isberg
authors.affiliation: Department of Cariology, Faculty of Odontology, Malmö University, SE-205 06, Malmö, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Ericson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004245:DMF Index; D003731:Dental Caries; D003733:Dental Caries Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden; D055815:Young Adult
keywords: Caries risk assessment; Dental caries; Guidelines; Prediction; Risk model