{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:19:18Z","timestamp":1783113558106,"version":"3.54.6"},"reference-count":34,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Young adulthood is a transitional period associated with changes in lifestyle and preventive dental attendance, which may influence caries risk. In routine practice, the use of comprehensive caries risk assessment systems is often limited by time and diagnostic requirements, highlighting the need for simplified diagnostic screening tools. This study aimed to develop and clinically validate a simplified, questionnaire-based caries risk assessment tool derived from the CAMBRA framework for use in young adults. Methods: An observational cross-sectional study was conducted among 246 Romanian young adults aged 18\u201325 years. The instrument was designed to enable rapid caries risk stratification based exclusively on questionnaire data, without radiographic or laboratory investigations. Internal consistency, test\u2013retest reliability, and construct validity were evaluated by comparison with clinically recorded indicators, including DMFT values, early enamel changes, visible dental plaque, and active carious lesions. Results: The questionnaire showed acceptable internal consistency (Cronbach\u2019s alpha = 0.71) and good temporal stability (ICC = 0.82). Higher caries risk categories were consistently associated with unfavorable clinical findings, including increased DMFT values, a higher prevalence of early enamel changes, greater plaque accumulation, and more frequent active caries (p &lt; 0.01). Conclusions: The simplified CAMBRA-based questionnaire demonstrated satisfactory reliability and clinical relevance in young adults. It may serve as a practical diagnostic screening and decision-support tool for risk-based caries prevention in routine and community dental settings.<\/jats:p>","DOI":"10.3390\/diagnostics16060859","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:12:25Z","timestamp":1773400345000},"page":"859","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Simplified CAMBRA-Based Diagnostic Caries Risk Assessment Tool for Young Adults: Development and Clinical Validation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0176-1894","authenticated-orcid":false,"given":"Liana","family":"Beresescu","sequence":"first","affiliation":[{"name":"Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1665-3239","authenticated-orcid":false,"given":"Alexandra Mihaela","family":"Stoica","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7147-5623","authenticated-orcid":false,"given":"Andrea","family":"Bors","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Ormenisan","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Felicia","family":"Beresescu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Lucaciu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8167-1997","authenticated-orcid":false,"given":"Elena","family":"Stepco","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, The State University of Medicine and Pharmacy \u201cNicolae Testemitanu\u201d, 2004 Chisinau, Moldova"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csilla","family":"Benedek","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 T\u00e2rgu-Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025). Oral Health. Fact Sheet, Geneva. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/oral-health."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (CDC) (2026, February 07). 2024 Oral Health Surveillance Report: Selected Findings. Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/oral-health\/php\/2024-oral-health-surveillance-report\/selected-findings.html."},{"key":"ref_3","unstructured":"National Institute of Dental and Craniofacial Research (NIDCR) (2026, February 07). Dental Caries (Tooth Decay) in Adults (Ages 20 to 64 Years), Available online: https:\/\/www.nidcr.nih.gov\/research\/data-statistics\/dental-caries\/adults."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Li, Z., Yu, C., and Chen, H. (2025). Global, regional, and national caries of permanent teeth incidence, prevalence, and disability-adjusted life years, 1990-2021: Analysis for the global burden of disease study. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-06086-z"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Bud, E.S., Bica, C.I., Stoica, O.E., Vlasa, A., E\u0219ian, D., Bucur, S.-M., Bud, A., Chibelean, M., and P\u0103curar, M. (2021). Observational Study Regarding the Relationship between Nutritional Status, Dental Caries, Mutans Streptococci, and Lactobacillus Bacterial Colonies. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18073551"},{"key":"ref_6","first-page":"317","article-title":"Contemporary Trends in Dental Caries Management: A Systematic Review","volume":"28","author":"Almthami","year":"2025","journal-title":"Int. J. Med. Toxicol. Leg. Med."},{"key":"ref_7","first-page":"317","article-title":"CAMBRA\u00ae caries management by risk assessment a comprehensive caries management guide for dental professionals","volume":"47","author":"Featherstone","year":"2019","journal-title":"J. Calif. Dent. Assoc."},{"key":"ref_8","first-page":"709","article-title":"Validation of the CDA CAMBRA caries risk assessment\u2014A six-year retrospective study","volume":"39","author":"White","year":"2011","journal-title":"J. Calif. Dent. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/jphd.12586","article-title":"Dental caries incidence and associated factors in young adults","volume":"83","author":"Ogwo","year":"2023","journal-title":"J. Public Health Dent."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Hadler-Olsen, E., Bond\u00f8, T., Bergli, L.M., Schmalfuss, A., and Nermo, H. (2025). Oral health and use of dental services in early adulthood and changes from adolescence\u2014Fit Futures, a longitudinal cohort study. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-06241-6"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Featherstone, J.D.B., Crystal, Y.O., Alston, P., Chaffee, B.W., Dom\u00e9jean, S., Rechmann, P., Zhan, L., and Ramos-Gomez, F. (2021). A Comparison of Four Caries Risk Assessment Methods. Front. Oral Health, 2.","DOI":"10.3389\/froh.2021.656558"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E15","DOI":"10.1038\/sj.bdj.2013.224","article-title":"The use of a self-report questionnaire for dental health status assessment: A preliminary study","volume":"214","author":"Levin","year":"2013","journal-title":"Br. Dent. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/cdoe.12003","article-title":"Evidence on existing caries risk assessment systems: Are they predictive of future caries?","volume":"41","author":"Tellez","year":"2013","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_14","first-page":"391","article-title":"Validation of Three Caries Risk Assessment Tools for Preschool Children From Areas with High Caries Prevalence","volume":"41","author":"Agouropoulos","year":"2019","journal-title":"Pediatr. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ajodo.2019.07.017","article-title":"Validation of caries risk assessment methods in orthodontic patients","volume":"158","author":"Bresin","year":"2020","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"831","DOI":"10.3897\/folmed.62.e51874","article-title":"Caries Risk Assessment in Adults Using the Cariogram","volume":"62","author":"Doitchinova","year":"2020","journal-title":"Folia Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ng, T.C., Luo, B.W., Lam, W.Y., Baysan, A., Chu, C.H., and Yu, O.Y. (2024). Updates on Caries Risk Assessment-A Literature Review. Dent. J., 12.","DOI":"10.3390\/dj12100312"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e20540","DOI":"10.7717\/peerj.20540","article-title":"Dental caries risk assessment using caries management by risk assessment (CAMBRA) tool in Yanbu city, Saudi Arabia-a cross-sectional study","volume":"14","author":"Albishi","year":"2026","journal-title":"PeerJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/0022034517737022","article-title":"Changes in Caries Risk in a Practice-Based Randomized Controlled Trial","volume":"29","author":"Rechmann","year":"2018","journal-title":"Adv. Dent. Res."},{"key":"ref_20","first-page":"226","article-title":"Integrating Caries Management by Risk Assessment (CAMBRA) and Prevention Strategies Into Contemporary Dental Practice","volume":"39","author":"Rechmann","year":"2018","journal-title":"Compend. Contin. Educ. Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.jdent.2013.06.005","article-title":"Validity of caries risk assessment programmes in preschool children","volume":"41","author":"Gao","year":"2013","journal-title":"J. Dent."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/j.0022-0337.2015.79.5.tb05913.x","article-title":"Long-term adoption of caries management by risk assessment among dental students in a university clinic","volume":"79","author":"Chaffee","year":"2015","journal-title":"J. Dent. Educ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.jdent.2015.02.013","article-title":"Baseline caries risk assessment as a predictor of caries incidence","volume":"43","author":"Chaffee","year":"2015","journal-title":"J. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1600-0528.2005.00233.x","article-title":"Cariogram\u2014A multifactorial risk assessment model for a multifactorial disease","volume":"33","author":"Bratthall","year":"2005","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Park, M., Patel, F., Santos, M.J., Tikhonova, S., Athanasakos, A., and Jessani, A. (2025). Utilization of caries risk assessment tools within the underserved population: A scoping review. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-05637-8"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Lucchi, P., Nasuti, A.D., Franciosi, G., Gaeta, C., Grandini, S., Ludovichetti, F.S., Mazzoleni, S., and Malvicini, G. (2024). Introducing the Index of Caries Risk (ICR): A Comparative Study on a Novel Tool for Caries Risk Assessment in Pediatric Patients. Children, 11.","DOI":"10.3390\/children11101166"},{"key":"ref_27","unstructured":"Bratthall, D., Petersson, G.H., and Stjernsw\u00e4rd, J.R. (2026, February 08). Cariogram Manual, A New and Interactive Way of Illustrating the Interaction of Factors Contributing to the Development of Dental Caries. Internet Version 2.01. Available online: https:\/\/laalamedilla.esla.com\/Utilidades\/cariogmanual201net.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"144","DOI":"10.21815\/JDE.019.017","article-title":"Predictive Validity of a Caries Risk Assessment Model at a Dental School","volume":"83","author":"Eckert","year":"2019","journal-title":"J. Dent. Educ."},{"key":"ref_29","first-page":"1","article-title":"Dental caries revisited","volume":"36","author":"Chen","year":"2020","journal-title":"J. Oral Sci. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41368-022-00167-3","article-title":"Expert consensus on dental caries management","volume":"14","author":"Cheng","year":"2022","journal-title":"Int. J. Oral Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/j.1752-7325.2002.tb03432.x","article-title":"Validation of self-reported oral health measures","volume":"62","author":"Pitiphat","year":"2026","journal-title":"J. Public Health Dent."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1902\/jop.2007.060199","article-title":"Validity of Self-Reported Periodontal Status in the Florida Dental Care Study","volume":"78","author":"Gilbert","year":"2007","journal-title":"J. Periodontol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"103664","DOI":"10.1016\/j.jdent.2021.103664","article-title":"Assessment of predictive performance of caries risk assessment models based on a systematic review and meta-analysis","volume":"110","author":"Su","year":"2021","journal-title":"J. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S320","DOI":"10.4103\/0975-7406.163436","article-title":"Caries management by risk assessment: A review on current strategies for caries prevention and management","volume":"7","author":"Maheswari","year":"2015","journal-title":"J. Pharm. Bioallied Sci."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/6\/859\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:24:41Z","timestamp":1773401081000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/6\/859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":34,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["diagnostics16060859"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16060859","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]}}}