Examining the Research Gap in Dental Caries Risk Assessment Tools Validated for Nigerian Child Populations

Caries risk assessment tools enable targeted preventive interventions for high-risk children, but the validity of globally established tools has not been tested in Nigerian child populations, limiting their clinical applicability. This study examined the research gap in caries risk assessment tool validation for Nigerian children through systematic review and an original validation study. A systematic scoping review of 11 databases identified 0 publications validating CAMBRA, Cariogram, or comparable caries risk tools in Nigerian child populations. Original research validated the Cariogram risk model in 240 children aged 6 to 12 years from public primary schools in Akwa Ibom State, South South Nigeria. Clinical and dietary data inputs to the Cariogram were collected and risk profiles generated. Children were followed up for 18 months with DMFT recorded at each visit. Cariogram high-risk classification showed a positive predictive value of 74.3 percent for new caries increment at 18 months. The tool overestimated risk in the lowest fluoride exposure subgroup and underestimated in children with frequent sugar exposure during recess. Model calibration was improved by incorporating Nigerian-specific dietary frequency data. The study provides the first validation data for a structured caries risk tool in Nigerian children and identifies necessary local adaptations. Recommendations include a multi-site validation study, development of a simplified version for use by primary dental care workers, and incorporation of validated risk tools into paediatric dental training at Nigerian dental schools.

Keywords: caries risk assessment, Cariogram, tool validation, Nigerian children, paediatric dentistry