Aug 2026· Journal of Dental Education· 0 citations· 11 references
Medicine
TL;DR
It is found that although CRA tools are incorporated into dental curricula, their clinical integration is still limited and challenges remain in their consistent clinical application, particularly with faculty and student calibration and the implementation of preventive caries management.
Abstract
INTRODUCTION
Caries Risk Assessment (CRA) facilitates individualized, prevention-focused management of dental caries. Despite its recognized value, CRA remains inconsistently implemented and underutilized. This systematic review aimed to evaluate the implementation of CRA tools within North American dental programs and their integration into curricula.
Methods
This systematic review was conducted in accordance with the PRISMA 2020 guidelines (PROSPERO # C CRD420251173049). A comprehensive search was conducted across five electronic databases to identify studies in English from September 2014 to September 2024. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool.
Results
From 1178 potentially relevant articles, 12 were included for analysis. The included papers comprised cross-sectional studies, retrospective analyses, quality assurance, and workshop papers from Canada and the United States. This review found that although CRA tools are incorporated into dental curricula, their clinical integration is still limited. Few studies showed that faculty and student calibration improved CRA accuracy from 8%-56% to 50%-86%, respectively; however, outcome measures varied, and inconsistencies in risk categorization persist.
Discussion
A gap exists between didactic teaching and clinical application of CRA tools. This inconsistency stems partly from CRA variability and insufficient preventive care. Regular calibration may help improve consistency.
Conclusion
Although caries risk assessment tools have been incorporated into North American dental curricula, challenges remain in their consistent clinical application, particularly with faculty and student calibration and the implementation of preventive caries management. Strengthening training, calibration, and curriculum design may enhance the integration of CRA throughout dental education and support more effective patient-centered care.
AIM
The meta-analysis systematically summarized evidence on how socioeconomic status (SES), access to dental care, and oral health programs (OHP) affect caries prevalence and severity among children and adults in Europe.
METHODS
Four electronic databases (PubMed, Scopus, Cochrane Library and Embase) were systematically screened from 1947-2026, supplemented by cross-referencing and manual searches, without language restrictions. Study selection, data extraction and quality assessment were done in duplicate. Methodological quality was assessed using the NHLBI Study Quality Assessment Tools according to study design. Certainty of evidence was graded using GRADE Profiler 3.6. Mean differences (MD) were calculated for changes in DMFT, and odds ratios (OR) for the presence of dental caries in individuals using fixed-or random-effects models.
RESULTS
Electronic searching identified 1800 articles; 23 studies were included in the review (>169000 participants) and 14 in the meta-analyses (>88,000). Nine studies evaluated the effectiveness of OHP stratified by SES, and ten examined OHP in low-SES populations. Among low-SES individuals, participation in OHP was associated with a significantly lower increase in DMFT (MD[95% CI]=-0.63[-0.94;-0.31];very low certainty) and significantly lower odds of having dental caries (OR[95% CI]=0.61[0.52;0.73];very low) compared with non-participation. Among program participants, individuals with low SES showed a significantly greater increase in DMFT than those with high SES (MD[95% CI]=0.79[0.30;1.21];very low) and had significantly higher odds of having dental caries (OR[95% CI]= 2.88[1.97;4.22];very low).
CONCLUSION
Participation in OHP may be associated with reducing dental caries in European populations, but benefits are unequally distributed and increase with higher SES. However, this conclusion is based on a limited number of well-conducted trials.
Sophia Magdalena Weiberlenn, Lea Maria Menesklou, M. Maas et al.· E -journal of dentistry· 0 citations
BACKGROUND
Adopting core cariology curricula into dental schools remains a dental education and clinical practice international challenge. For the first time implementation science is supporting this adoption process. Therefore, as part of the Exploration phase of the Latin-American-Cariology-Curriculum-Framework implementation, this baseline COM-B study assessed how best-practice caries risk/lesions diagnosis and management behaviours are being performed across regional dental schools.
METHODS
We administered an adapted, previously validated COM-B model (Capability, Opportunity, Motivation-Behaviour) caries-care best-practice questionnaire to 1,317 participants (806 final-year students and 511 clinical educators) across eight Latin American dental schools. The 56-item instrument evaluated self-reported behaviours regarding caries diagnosis and management (5-point Likert-response scale). Descriptive statistics, Welch's ANOVA, and multiple linear regression models applied to ordinal Likert-frequency ratings treated as approximately continuous, with heteroskedasticity-consistent robust standard errors (HC3) were performed.
RESULTS
The overall response rate was 71.1% (students: 74.8%, educators: 65.4%). Respondents reported performing these behaviours 'most of the time', with averages (mean±SD) ranging from 4.0±1.0 to 4.3±0.9. The most frequently reported behaviours were related to caries management, particularly 'Advising on reducing free-sugar intake' and 'Implementing oral hygiene behaviour change strategies' (both 4.5±0.7). The least frequent behaviour was 'Monitoring/watching initial inactive caries lesions' (3.7±1.2). Only one dental school showed overall behaviour-frequency values below 'most of the time'. Within the COM-B model, capability showed the strongest association with diagnostic behaviours, whereas opportunity-resources showed the strongest association with management behaviours.
CONCLUSION
Clinical educators and final-year students from Latin American dental schools reported high baseline engagement in evidence-based caries diagnosis and management. Capability and opportunity were COM-B components most strongly associated with these behaviours. As part of a regional implementation-science study, these findings serve as a case study of a global implementation challenge: translating evidence-based cariology principles into dental education and clinical practice.
S. Martignon, Angie Sanabria, V. Avila et al.· Caries Research· 0 citations
The objective is to present evidence through umbrella review format about motivational intervention (MI) effectiveness in early childhood caries (ECC). A comprehensive search was done utilizing three databases till March 2026 for a systematic review (SR) of randomized controlled trials. The following PICO was used for search strategy and eligibility criteria: population was mother–child dyads; intervention included MI principles; comparators were any other comparator; the outcome was ECC. AMSTAR-2 was used to judge the quality of included SRs. Five SRs were included. The total sample size was 4577 subjects after correcting for overlapping studies. Four SRs showed a significant reduction in dental caries in children when MI was used and compared to a control and one showed a reduction, but not statistically significant. The overall confidence in the included SRs was mostly moderate. In conclusion MI interventions showed promising effects; however, effectiveness may vary by patient, setting, and intervention characteristics.
A. Marghalani· Journal of Contemporary Dent...· 0 citations
INTRODUCTION
Caries care protocols (CCPs), commonly known as caries management systems, adopt a patient-centred, hygiene-focused approach to caries prevention. Although individual preventative strategies are well-studied, evidence on their combined efficacy is limited. The aim of this scoping review was to map and evaluate current evidence from clinical studies on the efficacy of CCPs in children and adults.
METHODS
Primary outcomes were caries incidence (increment), progression and regression, and secondary outcomes were changes in caries risk from baseline to follow-up. Inclusion criteria were randomised controlled trials (RCTs) comparing CCP interventions with control groups receiving only standard preventive care within routine dental services. Titles and abstracts were screened from MEDLINE, Embase, CINAHL and Web of Science databases, and data were extracted from full texts on study setting, methodology and outcomes. Quality was assessed using the Joanna Briggs Institute checklist.
RESULTS
The three included studies (n = 1186 patients) from Australia, Greece and Colombia showed positive outcomes for CCPs. Risk of bias was moderate in two studies and high in one. Intervention groups in the higher-quality studies showed significantly lower caries increment and progression from baseline, along with a greater reduction in caries risk, compared to control groups.
CONCLUSION
Limited evidence from two heterogeneous RCTs shows moderate efficacy of CCPs, highlighting the need for more standardised outcomes and reporting to strengthen the evidence base.
Vickie Cai, S. Ranjitkar, B. Christian et al.· International Journal of Den...· 0 citations
Background: Geriatric dentistry prepares dentists to care for an aging population. Yet, its integration into undergraduate curricula remains inconsistent. Objectives: To map evidence on the barriers to and facilitators of the implementation and development of undergraduate geriatric dental education. Methods: A scoping review was conducted using systematic searches of PubMed, Scopus, and Embase for English-language original research articles published from 1 January 2016 onward. Two reviewers screened titles, abstracts, and full texts independently against eligibility criteria. Studies were included if they examined barriers and/or facilitators related to undergraduate geriatric dental education. Data were extracted independently and synthesized descriptively to identify themes and evidence gaps. No critical appraisal was performed. Results: This review identified 1376 studies and included 11 studies, including seven cross-sectional and four cohort studies. Barriers clustered into three themes: structural and workforce-related barriers (resource constraints and a lack of equipped/trained staff), curricular and regulatory barriers (overcrowded curricula and a lack of curriculum guidelines), and interprofessional and attitudinal barriers (limited interprofessional collaboration and negative attitudes among students and teaching staff towards older adults). Facilitators were grouped into three themes: pedagogical and experiential learning strategies (didactic teaching, clinical training, extramural exposure, simulation-based training, and communication training), curricular and policy enablers (integrated curricula and national guidelines), and institutional and faculty support (staff support). Conclusions: This review identifies the multifaceted, modifiable educational, institutional, and policy factors that influence the implementation and development of geriatric dental education. By consolidating the existing evidence, this review provides a foundation for curriculum development and policy planning to prepare graduates to deliver age-responsive oral healthcare.
A. K. Chan, Li Hu, Joanna Cheuk Yan Hui et al.· Dental journal· 0 citations
Dental caries remains a major oral health problem, particularly in Indonesia, and requires effective preventive and therapeutic strategies. This meta-analysis compared natural remedies with chemical interventions for managing dental caries and reducing Streptococcus mutans populations. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included randomized controlled trials published from 2018 to August 2023. Searches were conducted in PubMed, Cochrane, Scopus, and Epistemonikos using predefined PICO criteria. Eligible studies evaluated chemical interventions, including fluoride, chlorhexidine, and probiotics, or natural ingredients, including gum arabic, green tea, and miswak. Risk of bias was assessed using the Cochrane RoB 2 tool, while pooled effects were analyzed with Review Manager using fixed- or random-effects models according to heterogeneity. The findings showed that chemical interventions produced an overall significant reduction in dental caries incidence, with fluoride demonstrating the strongest and most consistent evidence. Probiotics significantly reduced Streptococcus mutans populations, whereas chlorhexidine showed favorable but less conclusive effects. Natural remedies also demonstrated preventive potential: gum arabic and green tea reduced caries incidence, while gum arabic and miswak significantly reduced Streptococcus mutans populations. Nevertheless, substantial heterogeneity and differences in intervention protocols limited direct comparison. A combined approach integrating evidence-based chemical therapy with promising natural remedies may provide comprehensive caries management. Larger, well-designed clinical trials are required to establish optimal dosages, application frequencies, long-term effectiveness, and safety.
Mohamad Daffa Yuansyah, Ghani Phalosa, F. J. P. Pradana· Indonesian Journal of Multid...· 0 citations
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