Biomedical subjects

Gunnel Hänsel Petersson

Publications and source records attributed to Gunnel Hänsel Petersson.

4 recordsLinked to original sources

PubMed2005

Cariogram--a multifactorial risk assessment model for a multifactorial disease.

This paper reviews some common methods for the assessment of caries risk. It also describes a new way of illustrating the caries risk profile of an individual, the Cariogram. Past caries experience and socioeconomic factors are often used for prediction of caries. As prediction models, the methods are simple, inexpensive and fast. However, they are not risk models, as they do not specify which particular risk factors are operating. Various biological factors can be used for risk assessment. Common ones are bacteria, diet and host factors. Taken separately, these biological factors often have limited predictive values. Socioeconomic factors often have a heavy impact on the biological factors as they can explain why an individual, for example, has a cariogenic diet or neglects oral hygiene. The biological factors are the immediate cause of the cavities. Caries experience is an illustration of how the host copes up with the biological activity. To facilitate the interpretation of biological data, the Cariogram was developed. It is a computer program showing a graphical picture that illustrates a possible overall caries risk scenario. The program contains an algorithm that presents a 'weighted' analysis of the input data, mainly biological factors. It expresses as to what extent different etiological factors of caries affect caries risk. The Cariogram identifies the caries risk factors for the individual and provides examples of preventive and treatment strategies to the clinician.

Aged↗

PubMed2004

Comparing caries risk factors and risk profiles between children and elderly.

The aim of this study was to compare the caries risk profiles of children and elderly, the actual annual caries increment and the impact of some selected caries related factors. The risk profiles were created by a computerised risk assessment program, the Cariogram, which evaluates data and presents the weighted and summarized result as one figure, illustrating the 'percent chance of avoiding caries' in the future. The data used originated from two separate longitudinal studies illustrating the Cariogram's capacity to assess caries risk. One study comprised about 400 children; the other included about 150 elderly. At baseline, information on past caries experience, diet, oral hygiene and use of fluoride was obtained. Saliva analyses included mutans streptococci and lactobacilli, buffering capacity and secretion rate. The caries risk was assessed and after two and five years, respectively, caries was re-evaluated and the incidence was compared with the predictions. Fifty percent of the children, but only two percent of the elderly appeared in the lowest caries risk group. Of the elderly, 26% belonged to the highest caries risk group versus 3 % of the children. The mean DFS increment per year for the total group of children was 0.4 +/- 0.8 (SD) and 1.2 +/- 1.9 for the elderly. Individual factors contributing significantly to the higher risk profiles for the adults were higher plaque scores, higher counts of mutans streptococci and lower buffering capacity. Over all, the risk for caries, as assessed by the Cariogram, was twice as high for the elderly.

Aged↗

PubMed2003

Evaluation of a computer-based caries risk assessment program in an elderly group of individuals.

The aim of this study was to evaluate a caries risk assessment computer program, the Cariogram, by comparing the risk assessment of the program with the actual caries increment in a group of elderly individuals over a period of 5 years. The participants were examined and interviewed at baseline about their general health and dietary habits. Data on oral hygiene and use of fluoride were obtained and saliva analyses included mutans streptococci, lactobacilli, buffering capacity, and secretion rate. Based on the baseline recordings, the individuals were divided into 4 risk groups according to the Cariogram. Where the program predicted 0% 20% (high risk), 21%-40%, 41%-60%, and 61%- 100% (low/rather low risk) "chance of avoiding caries", 13, 32, 23, and 48% respectively, had no new DFS over 5 years and 18, 40, 72, and 84%, respectively, had no new lesions at the 5th year. The mean DMFS increment over 5 years was 12.8 in the high/rather high risk group (0% 40% "chance of avoiding caries"), which included 43% of the individuals. In the low/rather low risk group (61%-100% "chance of avoiding caries"), the corresponding value was 5.2%, and 21% of the participants were sorted to this group. The mean DMFS increment for the whole group of elderly individuals was 9.5. In this particular study the Cariogram was able to sort the elderly individuals into risk groups that reflected the actual caries outcome.

Aged↗

PubMed2003

Assessing caries risk--using the Cariogram model.

In trying to make a comprehensive caries risk profile for an individual, one faces a situation that several factors need to be considered and weighted together. Summarising these factors could be a complex process and to facilitate the practical application, a computer-based risk assessment model for caries, the Cariogram, was developed. The Cariogram program operates basically in such a way that information on a number of factors are collected about the patient, transferred to 'scores' and these scores then entered into the program. According to its built-in algorithm, the program evaluates the data and presents the summarised result expressed as one figure, a pie-diagram, illustrating the 'Chance of avoiding cavities' in the future. This thesis deals with the evaluation of the Cariogram model and, as a first step, it was important to investigate if the program was in line with how colleagues, dental students and dental hygienists would evaluate a set of cases. The first two studies (Paper I and II) confirmed that the 'opinion' on the risk profile of the risk assessment program was in line with the opinions of the majority of the responders in these groups. In the third study (Paper III), the Cariogram's assessments were tested against the "reality" for the first time. The model was used to assess risk for caries among children and to evaluate the program by comparing the caries risk assessments of the risk model with the actual caries increment of the children over a two-year period. The hypothesis was that the Cariogram should be able to sort the children into caries risk groups according to the actual caries increment and the results confirmed the theory. It was also demonstrated that the Cariogram assessed caries increment more accurately than any included single factor model. Following the evaluation of the program on the children, the aim of the fourth study (Paper IV) was to evaluate the model for risk assessment in a group of elderly individuals. Comparing the caries risk assessment of the program with the actual caries increment over a five-year period showed that the program was able to arrange this group of elderly individuals into risk groups that reflected the actual caries incidence. The aim of the fifth study was to compare the risk profiles of the children with the risk profiles of the elderly. The evaluation of caries risk among the children showed that 3% was considered having very high caries risk, while 50% appeared in the low risk group. The corresponding values for the group of elderly individuals were 26% and 2%. Overall, the risk for caries, as assessed by the Cariogram, was twice as high for the elderly as for the children (V). The present thesis also tries to explore the concept of risk, the terminology and definitions related to risk, risk management and risk assessment in dentistry.

Aged↗