Diagnóstico de caries dental como base para estrategias de prevención en niños: una revisión integrativa

Abstract

Dental caries is a preventable disease whose progression can be reduced if diagnosis includes the identification of early lesions, assessment of lesion activity, and categorization of individual risk. The aim was to examine the scientific evidence on dental caries diagnosis to guide prevention strategies in children and adolescents aged 2 to 16 years. Searches were conducted in PubMed/MEDLINE, SciELO, DOAJ, ScienceDirect, and Redalyc following the SALSA approach; the question was formulated using PICO and study selection was reported according to PRISMA 2020. A total of 154 records were identified, 8 duplicates were removed, and 146 records remained for screening. After screening, 120 were excluded, 26 reports were sought for retrieval, and 9 could not be retrieved. Seventeen reports were assessed for eligibility and 1 was excluded because it did not address prevention strategies derived from diagnosis; consequently, 16 studies were included. The studies comprised systematic reviews and meta-analyses, Cochrane reviews, umbrella reviews, one prospective cohort, cross-sectional studies, an evidence-based guideline, and narrative reviews. Systematic visual examination and ICDAS played a central role in lesion detection, whereas radiographs and intraoral photographs were complementary. Risk assessment incorporated previous caries experience, lesion activity, fluoride exposure, diet, oral hygiene, and social conditions. Preventive measures identified included health education, risk-based follow-up, reduction of frequent sugar exposure, sealants, fluoride, and silver diamine fluoride. The evidence was heterogeneous in design, populations, diagnostic methods, and interventions; therefore, conclusions were interpreted without establishing a general hierarchy of effectiveness.