CAT: Caries-risk Assessment Tool

No, we are not talking about the feline; we are talking about what puts a child at greater risk for developing dental caries. Did you know that preschool children with family incomes below the federal poverty level have nearly five times as many decayed teeth as children with family incomes three times the poverty level according to the Surgeon General’s Report on Oral Health. The disparity in decay prevalence is most pronounced among preschool children and diminishes with age. Nearly one out of five children (18 percent) ages 2 to 4 already has caries that is evident on a simple visual exam and 16 percent have untreated caries.

The caries-risk assessment tool (CAT) as described the by American Academy of Pediatric Dentistry, is used to assess the level of risk for caries (cavity) development in infants, children and adolescents based on a set of clinical, environmental and general health factors. It can be used by both dental and non-dental personnel. As a lay person who works daily with children, you can play a vital role in identifying some of these risk factors and making the appropriate referrals for further care. Once there, the dental team can customize a preventive care program for the child and avoid the progression of costly and devastating dental disease.

Caries risk indicator

Low Risk
Optimal fluoride exposures both systemic and topical
Consumption of simple sugars or limiting to mealtime
High caregiver socioeconomic status (financially stable)
Regular dental visits

Moderate Risk
Suboptimal systemic fluoride exposure with optimal topical exposure
Between meal snacking (1-2)
Midlevel caregiver socioeconomic status (eligible school lunch/SCHIP)
Irregular use of dental services

High Risk
Suboptimal topical fluoride exposure
Frequent between meal snacking (3 or more)
Low level caregiver socioeconomic status (eligible for Medicaid)
No usual source of dental care
Active caries present in the mother
Children with special health care needs
Conditions decreasing saliva flow (medications)

What you can do:
If a child has one or more risk factors refer to a dentist immediately.