Caries-risk Assessment and Management for Infants, Children, and Adolescents

Abstract

This best practice reviews caries-risk assessment and patient care pathways for pediatric patients. Caries-related topics presented include caries-risk assessment, active surveillance, caries prevention, sealants, fluoride, diet, radiology, and non-restorative treatment. Caries-risk assessment forms are organized by age: 0-5 years and ≥ 6 years old, incorporating three factor categories (social/behavioral/ medical, clinical, and protective factors) and disease indicators appropriate for the patient age. Each factor category lists specific conditions to be graded yes if applicable, with the answers tallied to render a caries-risk assessment score of high, moderate, or low. The care management pathway presents clinical care options beyond surgical or restorative choices and promotes individualized treatment regimens dependent on patient age, compliance with preventive strategies, and other appropriate strategies. Caries management forms also are organized by age: 0-5 years and ≥ 6 years old, addressing risk categories of high, moderate, and low, based on treatment categories of diagnostics, interventions (fluoride, diet counseling, sealants), and restorative care. Caries-risk assessment and clinical management pathways allow for customized periodicity, diagnostic, preventive, and restorative care for infants, children, adolescents, and individuals with special needs.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and recommendations regarding assessment of caries risk and risk-based management protocols.

KEYWORDS:   CARIES-RISK ASSESSMENT, CARIES PREVENTION, CLINICAL MANAGEMENT PATHWAYS, DENTAL SEALANTS, FLUORIDE