{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:21:32Z","timestamp":1787764892044,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Early childhood caries remains a significant public health concern globally. Caries risk assessment (CRA) tools are essential for early identification and prevention, yet comparative evidence in young children is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To compare three CRA tools \u2013 American Academy of Pediatric Dentistry (AAPD), American Dental Association (ADA) and Caries Management by Risk Assessment (CAMBRA) \u2013 in children aged 1\u20136 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>Cross-sectional study at a tertiary care dental hospital in South India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>One hundred and nineteen children (61 males, 58 females; mean age 2.8 \u00b1 0.9 years) were examined. All three CRA tools were applied simultaneously by a single calibrated examiner. Risk categories were compared across age groups (&lt;3 years vs. \u22653 years) and gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis Used:<\/jats:title>\n                    <jats:p>\n                      Cohen\u2019s kappa coefficient assessed inter-tool agreement. Chi-square and Fisher\u2019s exact tests compared distribution (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      AAPD identified significantly more high-risk children (4.2%) than ADA and CAMBRA (0.8% each), most pronounced in children under 3 years (5.1% vs. 0%). ADA and CAMBRA showed almost perfect agreement (\u03ba = 0.885, 98.3%), while AAPD showed moderate agreement with ADA (\u03ba = 0.596) and CAMBRA (\u03ba = 0.520). No significant differences were observed across age groups or gender (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>All three tools are effective for pediatric CRA with varying sensitivity. AAPD may be more sensitive for early risk detection in toddlers, while ADA and CAMBRA demonstrate higher concordance. Tool selection should be guided by clinical context and whether sensitivity or specificity is prioritized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ccd.ccd_642_25","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T15:00:20Z","timestamp":1781535620000},"page":"92-96","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Evaluation of Caries Risk Assessment using Three Different Tools among Toddlers and Preschoolers"],"prefix":"10.4103","volume":"17","author":[{"given":"K. C.","family":"Vignesh","sequence":"first","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gnanasekaran","family":"Felsypremila","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Sri Ramachandra Faculty of Clinical Research, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Hariharan","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Mokshaa","family":"Tejashwini","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinothkumar","family":"Kalidoss","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selvakumar","family":"Haridoss","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"R1-20260803","first-page":"166","article-title":"Reclassification of caries disease patterns into age cohorts in the primary dentition","volume":"43","author":"Keels","year":"2021","journal-title":"Pediatr Dent"},{"key":"R2-20260803","doi-asserted-by":"crossref","first-page":"17030","DOI":"10.1038\/nrdp.2017.30","article-title":"Dental caries","volume":"3","author":"Pitts","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"R3-20260803","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.cden.2010.03.007","article-title":"Defining dental caries for 2010 and beyond","volume":"54","author":"Fontana","year":"2010","journal-title":"Dent Clin North Am"},{"key":"R4-20260803","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1177\/0022034515573272","article-title":"Global burden of untreated caries: A systematic review and metaregression","volume":"94","author":"Kassebaum","year":"2015","journal-title":"J Dent Res"},{"key":"R5-20260803","doi-asserted-by":"crossref","first-page":"C39","DOI":"10.1177\/154405910408301s08","article-title":"The continuum of dental caries \u2013 Evidence for a dynamic disease process","volume":"83","author":"Featherstone","year":"2004","journal-title":"J Dent Res"},{"key":"R6-20260803","doi-asserted-by":"crossref","first-page":"650","DOI":"10.14219\/jada.archive.2009.0250","article-title":"Beyond the dmft: The human and economic cost of early childhood caries","volume":"140","author":"Casamassimo","year":"2009","journal-title":"J Am Dent Assoc"},{"key":"R7-20260803","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.2105\/AJPH.2010.200915","article-title":"Impact of poor oral health on children's school attendance and performance","volume":"101","author":"Jackson","year":"2011","journal-title":"Am J Public Health"},{"issue":"Suppl 1","key":"R8-20260803","first-page":"259","article-title":"The caries balance: The basis for caries management by risk assessment","volume":"2","author":"Featherstone","year":"2004","journal-title":"Oral Health Prev Dent"},{"key":"R9-20260803","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1002\/j.0022-0337.2001.65.10.tb03461.x","article-title":"Clinical applications and outcomes of using indicators of risk in caries management","volume":"65","author":"Zero","year":"2001","journal-title":"J Dent Educ"},{"key":"R12-20260803","first-page":"703","article-title":"Caries risk assessment in practice for age 6 through adult","volume":"35","author":"Featherstone","year":"2007","journal-title":"J Calif Dent Assoc"},{"key":"R13-20260803","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.14219\/jada.archive.2006.0380","article-title":"Assessing patients'caries risk","volume":"137","author":"Fontana","year":"2006","journal-title":"J Am Dent Assoc"},{"key":"R14-20260803","first-page":"746","article-title":"Pediatric dental care: Prevention and management protocols based on caries risk assessment","volume":"38","author":"Ramos-Gomez","year":"2010","journal-title":"J Calif Dent Assoc"},{"key":"R15-20260803","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1600-0528.2005.00233.x","article-title":"Cariogram \u2013 A multifactorial risk assessment model for a multifactorial disease","volume":"33","author":"Bratthall","year":"2005","journal-title":"Community Dent Oral Epidemiol"},{"key":"R16-20260803","first-page":"709","article-title":"Validation of the CDA CAMBRA caries risk assessment \u2013 A six-year retrospective study","volume":"39","author":"Dom\u00e9jean","year":"2011","journal-title":"J Calif Dent Assoc"},{"key":"R17-20260803","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":"R18-20260803","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1080\/00016350802714734","article-title":"Validation of an age-modified caries risk assessment program (Cariogram) in preschool children","volume":"67","author":"Holgerson","year":"2009","journal-title":"Acta Odontol Scand"},{"key":"R19-20260803","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"key":"R23-20260803","first-page":"687","article-title":"Caries risk assessment appropriate for the age 1 visit (infants and toddlers)","volume":"35","author":"Ramos-Gomez","year":"2007","journal-title":"J Calif Dent Assoc"},{"key":"R24-20260803","doi-asserted-by":"crossref","first-page":"656558","DOI":"10.3389\/froh.2021.656558","article-title":"A comparison of four caries risk assessment methods","volume":"2","author":"Featherstone","year":"2021","journal-title":"Front Oral Health"},{"key":"R25-20260803","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4103\/jisppd.jisppd_546_23","article-title":"Comparison of two different caries risk assessment tools for infants and toddlers \u2013 A cross-sectional study","volume":"42","author":"Devraj","year":"2024","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"R26-20260803","doi-asserted-by":"crossref","first-page":"5378","DOI":"10.3390\/jcm14155378","article-title":"Comparative study of methods for caries risk evaluation: CAMBRA, the cariogram, and caries risk semaphore","volume":"14","author":"Catal\u00e0-Benavent","year":"2025","journal-title":"J Clin Med"}],"container-title":["Contemporary Clinical Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ccd.ccd_642_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:50:13Z","timestamp":1787763013000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ccd.ccd_642_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ccd.ccd_642_25","relation":{},"ISSN":["0976-237X","0976-2361"],"issn-type":[{"value":"0976-237X","type":"print"},{"value":"0976-2361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-11-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}