Caries risk assessment as a predictor of metabolic control in young Type 1 diabetics.

AIMS: To investigate the relationship between caries risk and glucosylated haemoglobin and to evaluate the use of a computerized caries risk assessment program as a predictor of metabolic control in schoolchildren with Type 1 diabetes mellitus. METHODS: The material consisted of 64 young Type 1 diabetes mellitus patients (8-16 years) attending an outpatient paediatric clinic. Within 2 weeks after the onset of diabetes, a caries risk assessment was carried out with the aid of a computer-based program (Cariogram) and data on the level of metabolic control were collected from the medical records at the 3-year check-up. Caries increment was registered at recall clinical examinations. RESULTS: A statistically significant positive relationship between caries risk and metabolic control was found (r = 0.51; P < 0.01), with a sevenfold increased risk of impaired metabolic control after 3 years in those assessed with high caries risk at onset (OR 7.3; P < 0.01). When the Cariogram was used as a predictor for the metabolic state of the disease, the sensitivity and specificity was 75% and 71%, respectively. The negative predictive value was 91%. CONCLUSIONS: Our data suggested that a caries risk assessment at the diagnosis of diabetes mellitus in children may be a good indicator of overall health care that can provide useful prognostic information on the level of metabolic control after 3 years.

Caries risk assessment: a comparison between the computer program 'Cariogram', dental hygienists and dentists.

UNLABELLED: The 'Cariogram', which is an interactive PC-program for caries risk evaluation, illustrates the interaction between caries related factors and expresses the caries risk graphically. It also demonstrates a weighted impact of the different etiological factors on the risk. The aim of this paper was to use the Cariogram program on a set of patients, and to compare the outcome of its risk evaluation with those made by dental hygienists and dentists. A questionnaire, containing the descriptions of five patients with detailed information on nine factors generally associated with caries, was given to the participants. They were asked to rank the patients according to their 'chance to avoid dental caries' during the coming year. The results were compared with the assessments obtained from the Cariogram. RESULTS: 73.5% of the dental hygienists and 78.5% of the dentists ranked the patients for caries risk either identically or with only one deviation when compared to the Cariogram. It was concluded that the 'opinion' of the Cariogram on caries risk was in agreement with that of the majority of the participants. In addition, the Cariogram program induced discussions about the relative impact of etiological factors of caries. It is envisaged that the Cariogram can serve as one further tool in the teaching of caries risk.