Bright Futures in Practice: Oral Health Pocket Guide National Maternal and Child Oral Health Resource Center


Health professionals using the Caries-Risk Assessment Tool (CAT) should

  1. Be able to visualize adequately an infant’s, child’s, or adolescent’s teeth and mouth and have access to a reliable historian for nonclinical data elements.
  2. Assess all three components of caries risk: clinical conditions, environmental characteristics, and general health conditions.
  3. Be familiar with footnotes that clarify use of individual factors in the CAT.
  4. Understand that each infant’s, child’s, or adolescent’s ultimate risk classification is determined by the highest risk category in which a risk indicator exists. That is, the presence of a single risk indicator in the “high-risk”category results in a “high-risk” classification; the presence of a single risk indicator in the “moderate-risk” category, with no indicator in the “high-risk” category, results in a “moderate-risk” classification; and no indicators in the “moderate-risk” or “high-risk” categories results in a “low-risk” classification.

Users of the CAT must understand the following caveats:

  1. The CAT provides a means of classifying caries risk at a point in time and, therefore, should be applied periodically to assess changes in an infant’s, child’s, or adolescent’s risk status.
  2. The CAT is intended for use when clinical guidelines call for caries risk assessment. Decisions about clinical management of caries, however, are left to qualified dentists (ideally, the dentist at the infant’s, child’s, or adolescent’s dental home).
  3. The CAT can be used by both oral health and non-oral health professionals. It does not render a diagnosis. However, health professionals using the CAT must be familiar with the clinical presentation of caries and with factors related to caries initiation and progression.
  4. Since health professionals with differing skill levels working in a variety of settings will use the CAT, advanced technologies, such as radiographic assessment and microbiologic testing (shaded areas), have been included. However, such technologies are not essential for using the CAT.