Caries risk assessment in adults with highlights to nutrigenomics and nutrigenetics

Abstract

Caries risk assessment and caries management by risk assessment cannot be related only to children and their parents’ answers. Camra and Cariogram have been working for decades in few countries. Prediction and preventive measures are especially important for young adults (16-25 years old), young professionals (25-35 years old), before pregnancy and during menopause. Aim. To develop a card for an easy caries risk assessment with chair-aside questions, clinical examination and salivary tests. To draw up a protocol for patient treatment and follow-up related to the caries risk. Methodology. It is based on the data of 1,167 participants in 6 different clinical studies conducted within various research trials, granted programmes and projects during the 30-year period from 1988 to 2018. Prediction of risk can be useful if 4 groups, i.e. low risk, moderate risk, high risk and very high risk groups are evaluated. Results. Packages of measures were targeted for each group. Among the important factors were the type, habits and frequency of nutrition, detected with 6 targeted questions, lifestyle hygiene with 5 questions, dental status with 6 parameters (DMFT scores, gingival status, 
size of teeth, etc.) and oral hygiene. Biochemical patterns of saliva, i.e. salivary flow rate and pH, with and without stimulation were included. Low risk and Moderate risk groups of different ages do not need further tests. High risk and Very high risk groups can be additionally tested with chair-aside tests for Streptococcus mutans and Lactobacilli counts and oral sucrose clearance for preventive evaluation of dental caries management. The card validation and tests last no longer than 40 minutes, 1 page for a single patient. Conclusions. Caries risk in adults can be measured, assessed and predicted in relation to nutrigenomics. Treatment behaviour can be managed and targeted for each patient, according to the group for long, lifetime saving of natural teeth in the mouth. In the last 100 years, concentrated and refined foods have decreased all sizes of the upper first and second incisors as a natural physiological response and a change has been observed in the anatomy of canines, making them stronger via enlargement of their MD sizes. From this current academic year, “Caries risk” is included into our new lecture programme.