Policy on use of a caries-risk assessment

Policy on Use of a Caries-risk Assessment
Tool (CAT) for Infants, Children, and Adolescents
Originating Council
Council on Clinical Affairs
Adopted
2002
Purpose
The American Academy ofPediatric Dentistry (AAPD) recognizes
that caries-risk assessment is an essential element of
contemporary clinical care for infants, children, and adolescents.
Background
Over the past 15 years,strategies for managing dental caries
increasingly have emphasized the concept of risk
assessment.1-5 However, a practical tool for assessing caries
risk in infants, children, and adolescents has beenlacking.
While assessment of caries risk undoubtedly will benefit
from emerging science and technologies, the AAPD believes
that sufficient evidence exists to support the creation of a
framework forclassifying caries risk in infants, children, and
adolescents based on a set of physical, environmental, and
general health factors.6-8
The table on page 28 represents a first step towardincorporating
available evidence into a concise, practical tool
to assist both dental and nondental health care providers in
assessing levels of risk for caries development in infants,
children, andadolescents. The AAPD intends this to be a
dynamic instrument that will be evaluated and revised periodically
as new evidence warrants.
Clinicians using this tool should:
1. be able to visualizeadequately a child’s teeth and
mouth and have access to a reliable historian for nonclinical
data elements;
2. assess all 3 components of caries risk—clinical conditions,
environmental characteristics,and general health
conditions;
3. be familiar with footnotes that clarify use of individual
factors in this instrument;
4. understand that each child’s ultimate risk classification
is determined bythe highest risk category where a risk
indicator exists (ie, the presence of a single risk indicator
in any area of the “high-risk” category is sufficient
to classify a child as being at “high...