Development and Testing of a Caries Risk Assessment Tool ‘CRAFT’ for Indian Children

Ashwin Jawdekar
YMT Dental College and Hospital, Professor and Head, Pediatric and Preventive Dentistry, Navi Mumbai, Maharashtra, India

Background: Caries Risk Assessment (CRA) is ‘prediction of future caries based on the diagnosis of current disease by evaluation of risk and protective factors for making evidence-based clinical decisions’. Various CRA tools have been used in the Western countries. However, for the Indian scenario, none is available. “Caries Risk Assessment For Treatment (CRAFT)” is an indigenous, chairside, four-point scale proposed for the risk-based management of caries in children. In both adults and children, WHO (2015) recommends reducing the intake of free sugars to less than 10% of total energy intake. “Sugar-Meter”, a ready-reckoner for counting free sugars consumed from commonly marketed foods, is integrated with CRAFT in an android app APT4CARIES.

Methods: Two preliminary studies were carried out to evaluate CRAFT in 3-6 year-old otherwise healthy children with caries. In the first, CRAFT scores were correlated with the MS colony counts of their Mothers. In the second, CRAFT scores of children were correlated with their Alban test scores.

Results: Positive correlation was evident between CRAFT score of the child and mother’s MS Colony count (r=0.380, p<0.05) and between CRAFT score of the child and mother’s DMFT (r=0.220, p<0.05). CRAFT scores were positively related with cumulative Alban’s test scores (r=0.82, p<0.05).

Conclusion: CRAFT has a potential as a caries risk assessment tool. CRAFT is quick, economical and non-invasive. It allows a dentist to customize a risk-based caries management plan, and presents a framework for enhanced patient-participation.

Ashwin Jawdekar