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Module 3: Caries Risk Assessment

3.1 Children at High Risk for Dental Caries

Photo of childCaries risk assessment is based on the premise that all children are not equally likely to develop dental caries. Children at high risk for dental caries are likely to need more preventive oral health care than their counterparts at lower risk. Caries risk assessment involves the identification of contributing or protective factors that may impact a child’s oral health.

Children at high risk for developing dental caries include:

Children with limited exposure to fluoride.
Children who receive suboptimal amounts of fluoride are at increased risk for dental caries.1,2 (For more information about fluoride, see Fluoride Exposure.) It is therefore important for medical providers to determine the level of fluoride exposure in the children they care for.

Children with special health care needs (CSHCN).
Oral health care is the most common unmet health need for CSHCN.3 The impact of oral health problems is larger in CSHCN because of underlying health conditions.4 Asthma and allergy medications can decrease salivary flow,1,2 and the rates of enamel defects are higher among children who are born preterm or at low birthweight.5 In addition, demanding and resistant behavior by some CSHCN can interfere with the delivery of oral health care,6 placing them at greater risk for the onset and progression of dental caries. Coupled with these issues, many families with CSHCN report difficulty in finding and accessing needed oral health care services.3

Children from families with low incomes.
Prevalence and severity of dental caries is linked to socioeconomic status. Children from families with low incomes experience more dental caries compared to their more affluent counterparts. Lack of dental insurance and access to care results in disease that is more likely to go untreated.1,2