Clinical decision support for caries risk management by assessment for patients aged 6 through adult

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Description: A decision support tool to assist dental clinicians in managing dental caries in patients from ages 6 to adult, by identifying the caries risk of the individual patient.

Publet Introduction:

According to the WHO 60–90% of school children and nearly 100% of adults worldwide have dental cavities1. Dental caries can be prevented from occurring or stopped from progressing further if the risk factors associated with dental caries can be identified and adequate steps are taken. Caries risk assessment can help the clinician assess the overall caries risk for the individual dental patient and also help identify the risk factors that increase the risk of the patient from dental caries, or identify protective factors that can protect the patient from dental caries.

Caries risk assessment is also crucial for prescribing the proper clinical interventions to prevent dental caries and also assists in long term caries management of the patient. It also helps the patient understand his/her dental health status better and lets the patient set their own targets for dental hygiene improvement. 

Caries management by risk assessment (CAMBRA) is a validated and reliable caries risk assessment developed by Featherstone, JD et al.2 CAMBRA caries risk assessment is the underlying methodology used in this decision support tool and is based on the principle of identifying and achieving the right balance between risk factors and protective factors of dental caries.

Guideline objectives


  • Determine the specific disease indicators, risk factors, and protective factors that each patient has.
  • Determine the level of caries risk based on the sum of these factors
  • Prescribe a treatment plan based on the caries risk of the patient
Target setting Primary care dentistry
Target users Primary care dental clinicians

Disease indicators such as cavities, approximal lesions, smooth surface lesions and recent restorations indicate the presence of dental decay.

Pathological factors such as acidogenic(acid producing) bacteria, salivary dysfunction, and frequent consumption of dietary carbohydrates can increase the risk of a patient getting dental caries.

Protective factors such as adequate salivary function, fluoride use, antibacterial agents and proper diet can protect the patient against dental decay.

The aim of proper caries management is to achieve the right balance between the risk factors and the protective factors by reducing the pathological factors and increasing the protective factors3. Patients at low risk of caries will have more protective factors than caries risk factors.

Once the caries risk for the patient has been estimated the clinician can prescribe the appropriate therapeutic interventions and undertake treatment planning.

The current tool does not allow recording of data  

Provenance 7.No provenance has been assigned (default value)
  • Author: Gopikrishnan Chandrasekharan
  • Release date:
  • Status: Draft - Under Review
  • History: Edited on 23/10/2015
Safety case

Caries risk assessment in practice for age 6 through adult. J Calif Dent Assoc. 2007 Oct;35(10):703-7, 710-3. Featherstone JD, Domejean-Orliaguet S, Jenson L, Wolff M, Young DA.


1 "WHO | Oral health." 2007. 21 Nov. 2015 <>

2 Featherstone, JD. "Caries risk assessment in practice for age 6 through adult." 2007. <>

3 Featherstone, JD. "Prevention and reversal of dental caries: role of low level ..." 1999. <>