Caries Risk Assessment Practices Among Texas Pediatric Dentists

Author(s): Trueblood R. Kerins CA., and Seale NS
Journal: Pediatric Dentistry
Volume (number): Volume 30, Number 1
Month, Year: January, February 2008
Major topic: Caries Risk Assessment in private practice
Minor topic(s): none
Type of Article: Survey
Purpose: This paper evaluates how caries risk assessment is practiced by Texas pediatric dentists. It further determines if the practice is doing a CRA, if they are documenting the CRA, who is performing the CRA, and if the practitioner believes continuing education in CRA is needed.
Overview of method of research: A 20 question survey was sent to all 204 members of the TX Academy of pediatric dentistry which asked demographic information about the practitioner and the practice as well as specific questions regarding the use of CRA in practice.
Findings: Key points/Summary: Sixty two percent of the surveys were returned. The most common risk factors for decay were diet, caries history, and SES. Most dentists provided oral hygiene instruction, and education to patients about dietary risk factors during a typical recall appointment. Only 2/3rds placed sealants for prevention, with 17% providing fluoride testing and less than 2% used salivary flow testing or bacterial testing during recall appointments. The types of preventive treatments used in the dental practices included sealants (92%), fluoride treatments (92%), detailed oral hygiene instruction (87%), increased recall frequency (76%),, and diet counseling (65%). Chemotherapy i.e. chlorhexidine rinses and xylitol are used less commonly in practice. It was interesting to note that the most common risk factor was diet, yet 67% felt it was important to discuss at a recall visit, and 16% never provided diet counseling at a recall visit. Caries risk assessment was mainly performed by verbal questions (69%), while 39% reported using both verbal and written CRA’s. However most reported documenting preventive treatment recommendations in the chart. It was noted that in 76% of the practices that multiple people whether hygienists, assistants, or dentists completed the CRA on the patients.
Conclusions: The author found that there was a need for a more detailed CRA, a more customized treatment plan based on the findings of the CRA, and lastly, better documentation of the caries risk status of the pediatric patient.
Assessment of article: Nonscientific article illustrating the need for a more standardized method of implementing a CRA in pediatric dental practice. Good article pointing out our deficiencies in private practice.