Cariesrisikovurdering af børn og unge
Cariesrisikovurdering på individniveau er et vigtigt grundlag for adækvate beslutninger om forebyggende og bevarende behandling samt for fastsættelsen af et passende indkaldeinterval. Der savnes i vid udstrækning information om, hvordan cariesrisikovurdering af børn og unge finder sted i den kliniske hverdag, og relativt få tandlæger anvender en objektiv, struktureret model eller et computerprogram. Systematiske litteraturoversigter har vist, at multivariate modeller generelt er mere pålidelige end enkelte prædiktorer, og at nøjagtigheden er højere for førskolebørn end for skolebørn og teenagere. Tidligere carieserfaring er den mest pålidelige individuelle variabel som indikator for nye cariesangreb, særligt hos førskolebørn. Cariesrisikoen er størst i de blivende tænder i de første år efter eruption, og risikovurderingen bør derfor kobles til disse såkaldte risikoaldre.
Klinisk relevans:
Caries risk assessment of children an d adolescents: Risk assessment is an essential component in the decision-making process for adequate prevention and management of dental caries, and for the determination of recall intervals. Yet, there is little information on how this process is performed in everyday paediatric dentistry. A comprehensive risk assessment is a synthesis of data from the case history, clinical examination and biochemical tests and the use of structured forms or computer-based programs is considered “best clinical practice”. Recent systematic reviews have concluded that concerning accuracy, there is no perfect and clearly superior method for caries risk assessment in children. The accuracy of multivariate models is however generally higher for pre-school children than for schoolchildren and adolescents. Baseline caries prevalence is the most accurate single predictor in all age groups with moderate/good accuracy in pre-school children but limited accuracy in schoolchildren/adolescents. Other single variables are of little or no value. The period of highest risk for caries is the first few years after tooth eruption. In general, the quality of evidence is limited.
