Risk Management and Healthcare Policy (Jun 2020)
Validation of Cariogram in Caries Prediction in Women and Their Children 4 Years After Pregnancy – Longitudinal Study
Abstract
Olivera Dolic,1 Marija Obradovic,1 Zeljka Kojic,2 Natasa Trtic,2 Slava Sukara,1 Natasa Knezevic,3 Valentina Veselinovic4 1Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina; 2Department of Periodontics and Oral Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina; 3Department of Endodontics and Restorative Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina; 4Department of Prosthodontics, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and HerzegovinaCorrespondence: Olivera DolicFaculty of Medicine, University of Banja Luka, Bulevar Vojvode Petra Bojovića 1A, Banja Luka 78000, Bosnia and HerzegovinaTel +387 51 348 131Email [email protected]: Cariogram®, an algorithm-based software model, for predicting caries risk has been used to assess the caries risk profile of many different groups. The aims of the study were to evaluate Cariogram caries risk assessment during pregnancy with DMFT/dmft incidence in mothers and their children 4 years after pregnancy and to check if there is an association between children’s caries risk profiles using Cariogram and caries risk profiles (by Cariogram) of their mothers during pregnancy.Methods: The study population consisted of 96 pregnant women (average age 27.4± 7.2 years at baseline) who completed clinical baseline examination and salivary tests. The follow-up study was initiated 4 years later and the 80 pairs of mother and children (from that pregnancy) were re-examined using the same procedure at baseline. An individual caries risk profile and DMFT/dmft incidence were made for each woman and child. The prediction of the Cariogram was compared to the actual dental experience in 4 years. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for two cut-offs were calculated to express the outcome.Results: The results showed a strong association between the risk categories of pregnant women and their offspring as well as between caries development in offspring and the Cariogram risk categories of pregnant women. Sensitivity and PPV for new DMFT (ΔDMFT> 0) 4 years after for women were high (> 80%) for those participants assessed with 0– 60% “chance to avoid caries”, as well as diagnostic accuracy (74.00%). High specificity (91.00%), very high PPV (95.00%) and clinically useful values according to Youden’s index (0.53) were obtained for moderate-risk and two lowest-risk groups for dmft in children.Conclusion: Cariogram was valid in the authors’ sample only and highly predictive in caries risk assessment in investigated children based on caries risk assessment of their mothers in pregnancy.Keywords: specificity, early childhood caries, Cariogram, pregnant women, sensitivity, longitudinal study
