Caries risk assessment in children: experimental study on the effectiveness of the C.A.M.B.R.A. system

Background The caries risk assessment (CRA) is the set of procedures that aim to determine a personalised treatment of the caries pathology in the patient. CRA establishes the probability to develop carious lesions over a certain time period or the likelihood that there will be a change in size or activity of lesions already present [Kriegler et al., 2021]. This "assessment" occurs in two phases: the first phase is to determine specific disease indicators, risk factors, and protective factors each patient has such as the presence of bacterial biofilm, the quantity and quality of saliva, the quality and quantity of the patient's diet, the presence or absence of a correct lifestyle from a hygienic point of view; the use of fluorine and calcium phosphate substances; In the second phase a risk level is assigned to the patient (low, moderate, high, or extreme) in order to allow an individualised treatment plan, which combines restorative treatments with a preventive chemical therapy [Featherstone and Chaffee, 2018; Khallaf et al., 2021]. The aim of this preliminary study is to analyse the correlation of caries with the risk factors related in young patients from 6 to 12 years old, associated to moderate and severe risk levels of caries. Methods This was a cross-sectional and descriptive study that included 64 children and adolescents aged from 6 to 12 years, considering the possible and possible samples not acceptable to the study, due to the exclusion criteria. Inclusion criteria were as follows: all children visiting the pediatric dental clinic who co-operated during the oral examination who have from "moderate" to" high" risk of caries according with CAMBRA [Featherstone et al., 2007]. Results The sample consisted of 64 subjects, of which only one with a C.R.A. score less than 11 (score 1 for the compliance factor, workable soil index, and score 3 for the fluorine factor to indicate no fluoroprophylactic measure) and was considered "low risk".This patient was excluded from the subsequent analysis, which compared subjects with a C.R.A. score of 11-15 ("high risk", n = 29) with those with a score of 16-27 ("extreme risk", n = 34). Conclusions The results showed that patients at extreme risk of tooth decay compared to high-risk patients, not only had all the highest rating rates, but also had more difficulty changing their habits. We can therefore conclude that both the risk of caries is directly proportional to a worsening of the clinical conditions and the delay of the intervention by the clinician is itself a risk factor.