Caries Risk Assessment Tools in North American Dental Curricula and Educational Implications: A Systematic Review.

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.