(PO-129) Impact of a Caries Risk Assessment on a Management Plan

Author: Maria DiLuigi, RDH, M.S.Ed. – Dental Hygiene Educator, Department of Comprehensive Care, Tufts University School of Dental Medicine
Author: Natalie Hagel, RDH, M.S. – Assistant Professor, Department of Comprehensive Care, Tufts University School of Dental Medicine
Author: Andrea F. Zandona, D.D.S, MSD, PhD – Professor and Chair, Department of Comprehensive Care, Tufts University School of Dental Medicine
Author: Matthew D. Finkelman, Ph.D. – Associate Professor, Director of Biostatistics and Experimental Design, Tufts University School of Dental Medicine
Submitter: Maria DiLuigi, RDH – Tufts University School of Dental Medicine

Impact of a Caries Risk Assessment on a Management Plan

Objective: Tufts University School of Dental Medicine (TUSDM) implemented the use of the Caries Management by Risk Assessment (CAMBRA) form in 2010 to support an evidence-based preventive approach to patient care in their pre-doctoral clinic. The aims of this retrospective IRB-approved study were (1) to determine if completion of caries risk assessment (CRA) is associated with the inclusion of a caries management treatment (CRM) plan and (2), to determine the association between baseline CRA and CRM plan.

Methods: A convenience sample of 10,000 new patients’ electronic health records of adult dentate patients without a full denture treatment plan seen in the predoctoral clinic with a comprehensive oral examination completed between 1/1/2013-1/31/2020 were selected. Data extracted included completion of a CRA, caries risk classification, and CRM plan as evidenced by presence of selected procedures (RX fluoride toothpaste, fluoride varnish, silver diamine, nutritional counseling, sealant). Statistical significance of associations was assessed using the chi-square test.

Results: 70.5% of 10,000 patients had a completed CRA. 24.9% of the 7,045 patients with a completed CRA received a CRM plan, whereas 22.9% of the 2,955 patients without a CRA received a CRM plan. The difference between these percentages was statistically significant (P=.030). Patients with higher baseline CRA levels (i.e., greater risk) were more likely to have a CRM treatment plan (16.9% of the 785 patients at low risk, 21.1% of the 1282 patients at moderate risk, 26.3% of the 4,347 patients at high risk, 32.6% of the 631 patients at extreme risk); the association between these two variables was significant (P < .001).

Conclusion: Patients with a completed baseline caries risk assessment are more likely to have a caries risk management plan, as are patients with higher baseline CRA levels.