Development of the Dundee Caries Risk Assessment Model: (DCRAM) - Risk model development using a novel application of a statistical approach

Objectives:  To use a novel statistical analysis in the development of caries risk assessment models for preschool children for use in a particular community setting. Methods:  Data were collected longitudinally on a cohort of approximately 1500 children born in one calendar year in the city of Dundee, Scotland. A dental examination and oral microbiological saliva sample, together with parental and health visitor questionnaires, were completed for each child at ages 1, 2, 3 and 4 years. The 1-year data were analysed using chi-squared automated interaction detector analysis (CHAID) to produce a set of caries risk assessment models for predicting caries in 4-year-olds. Results:  Four risk models were developed using CHAID analysis for caries at 4 years of age using risk assessment data collected at age 1. These models included two ‘any’ caries–risk models (n = 697, dmft >0) and two ‘high’ caries–risk models (n = 784, dmft ≥3) depending on the use of the d1 (enamel and dentine) or d3 (dentine only) level of caries detection. The most appropriate model developed for use was shown to be the CHAID high caries–risk model at the d3 level of detection (d3mft ≥3). This had a sensitivity of 65% and specificity of 69%. Conclusions:  An appropriate risk assessment model for use in a particular community setting predicting caries at age 4 years from data collected at age 1 year was developed. This has been termed the Dundee Caries Risk Assessment Model.