Caries risk assessment in adolescents

Detailed caries records and salivary microbiological tests were utilized to predict caries development in a group of 15-16-year-old Swedish adolescents. Both, caries experience and salivary microorganisms, correlated significantly with a subsequent 3-year increment of DFS. The strongest associations were recorded between the prevalence of baseline incipient lesions and the development of manifest caries (r = 0.51). Incipient lesions accounted for 27% of the 31% variability in the DFS increment explained by joined caries and salivary data. All predictors analysed showed insufficient sensitivity for identifying true caries active individuals. However, the combined sensitivity and specificity for incipient lesions and comprehensive caries record (incipient + manifest lesions) attained values allowing to predict caries development in the majority of individuals. Using precavity lesions as a sole predictor, 79-81% of the individuals were correctly classified with regard to their future caries levels. The addition of manifest caries increased the accuracy of classification to 86-89% depending on the stringency of screening and validation criteria.