The Role of Caries Risk Assessment Methods in the Development of Preventive Programmes in High Risk Region. Summary of the Doctoral Thesis

Abstract

Caries is still a problem of all society in the world, also in Latvia. Although the causes of caries are well known for almost a century, the specialists of denstistry have not succeeded to exterminate this problem in none of the countries. The objective of the current study was to evaluate the role of caries risk assessment methods in the development of preventive programmes in high risk regions. School has been acknowleged an ideal environment for implementing prevention methods, therefore in the region with the lowest rates of access to dentistry services in Latvia, teenagers with the highest caries risk (the age of 12-13 years, when permanent dentition are being formed and new dental surfaces are appearing) were selected for the research. A group of research participants was randomly selected, which added up to 30% of 12-13 years old students of Gulbene county. The study included three sections – 1) an epidemiological study to evaluate caries prevalence, severity, incidence, and risk factors in 12-13 year-old schoolchildren in the Gulbene region, 2) a cohort study to evaluate the accuracy and cost effectiveness of caries risk assessment (CRA) methods using Cariogram, CAMBRA and experimental 4-factor models on Gulbene region schoolchildren and 3) a randomized controlled clinical trial to evaluate the effectiveness of the school prevention programme (toothbrushing in a school environment) for Gulbene region schoolchildren. After application of proper methodology, taking into account strength and limitations of the study, it can be concluded that when planning to introduce a caries risk assessment in the state programme, it is important to work out the corresponding method for a definite population by previously analyzing the caries risk factors and proportion of their effect in a long-term longitudinal study, but, since the low caries risk group in Gulbene county is so insignificant, there is no need to apply a high risk strategy by introducing caries prevention programmes, instead population-targeted programmes such as toothbrushing in schools should be used.