Risk Scores

The PreViser RiskCalculator™ measures several types of conditions for which a Patient might be at risk.

On Treatment Option Plans, the results of Risk Assessments are expressed in numeric terms, defined below. On Patient Reports, some explanatory text accompanies each numeric score; this text is also included here below in italics.

These scores also appear on the Patient Details page in abbreviated form for any Risk Assessments in that Patient's history.

A Perio Risk Assessment produces two separate scores; a Caries, Root, and Fracture Risk Assessment produces three separate scores.; and an Oral Cancer Risk Assessment produces one score. The Legend for these scores (explained below) is as follows:

Perio Score Legend:
PR: Perio Risk
D: Disease State

Caries Score Legend:
CR: Caries Risk
FR: Fracture Risk
RR: Root Surface Risk

Oral Cancer Score Legend:
OR: Oral Cancer Risk

Risk in general:

Risk is expressed as the chance that the adverse effects will occur. Probability is, of course, not an absolute certainty. This means that a person at low risk might experience the same effects as a person at high risk, although this occurrence is rare. Similarly, there is no guarantee that a patient at high risk will definitely experience severe disease.

Periodontal Risk Assessment:
Periodontal Disease Risk (PR):

The periodontal disease risk score is based on a 1 to 5 scale, with 1 indicating the lowest risk, 5 the highest risk, and 2, 3, and 4 intermediate levels of risk. Risk for periodontal disease is the likelihood that in the future the disease will occur (if not yet present) or progress (if already present).

Advancing periodontal disease means that supporting bone is destroyed, which causes teeth to be come loose and eventually lost. Studies have shown that increasing levels of risk are associated with more bone and tooth loss.

Explanatory text on Patient Reports for Perio Risk says: Risk predicts your future disease state. Your risk is determined by risk factors, which are distinct from the signs and symptoms of disease. Preventing disease requires treatment that reduces your risk factors. With routine dental care, tooth loss is 10 times more likely for an individual who has very high (5) risk compared to an individual who has low (2) risk. However, by considering risk when selecting the appropriate treatment plan, tooth loss can be reduced 50% to 100%.

Periodontal Risk Assessment:
Periodontal Disease State (D):

The “Disease State” score measures the current health or disease of the periodontal tissues, the gums and bone. It is a measure of the number of teeth affected and the severity or amount of bone loss. The numeric score is more useful than the traditional diagnostic terminology. The score is based on a 1 to 100 scale where 1 represents health and 100 the most extensive and severe disease state. The table below lists the relationship between the numeric score and traditional terminology.

Numeric Score
Traditional terminology
0
No teeth
1
Health
2-3
Gingivitis
4-10
Beginning periodontitis
11-36
Moderate periodontitis
37-100
Severe periodontitis
Explanatory text on Patient Reports for Perio Disease State says: Your disease state reflects the amount of damage caused by gum disease. As the disease state worsens, treatment increases in amount, complexity and cost. Tooth loss and the failure rate of repairs are greater for individuals with higher disease state scores. Treatment can repair the damage caused by disease, but tends not to help much in preventing new disease, and may even increase the risk of new disease. Disease prevention requires treatment that reduces your risk factors. The best treatment incorporates both repair (where needed) and prevention.

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Caries, Root, and Fracture Risk Assessment:
Caries Risk (CR):

The caries risk score is based on a 1 to 3 scale, with 1 indicating the lowest risk and 3 the highest level of risk. Risk for Caries is the likelihood that in the future the disease will occur (if not yet present) or progress (if already present). Advancing Caries means that tooth structure is destroyed, weakening the tooth and eventually killing the nerve.

Note that the PreViser RiskCalculator™ does not differentiate between coronal caries and root caries in calculating Caries risk. This means that by indicating active root caries, you will see a high risk score for caries in general. The "Root" risk score R is different, as described below.

It is possible to have a risk score of "zero" if this is not applicable to the patient due to absence of contributing risk factors. In that case, the summary score on the Patient Details page would be CR0, and on reports you will see CR:0 on the history chart and the bar graph for Caries Risk will not display.

Explanatory text on Patient Reports for Caries Risk says: Risk predicts your future disease state. Risk is determined by risk factors, which are distinct from the signs and symptoms of disease. Preventing disease requires treatment that reduces your risk factors. Low risk (1) means that you are unlikely to have a cavity whereas high risk (3) means that you are very likely to have a cavity within the next 3 years.

Caries, Root, and Fracture Risk Assessment:
Fracture Risk (FR):

The fracture risk score is based on a 1 to 3 scale, with 1 indicating the lowest risk and 3 the highest level of risk. Risk for fracture is the likelihood that in the future the tooth or restoration will fracture.

It is possible to have a risk score of "zero" if this is not applicable to the patient due to absence of contributing risk factors. In that case, the summary score on the Patient Details page would be FR0, and on reports you will see FR:0 on the history chart and the bar graph for Fracture Risk will not display.

Explanatory text on Patient Reports for Fracture Risk says: This is the risk that a tooth or filling will fracture. The risk scale is 1, 2, and 3, with 3 representing high risk.

Caries, Root, and Fracture Risk Assessment:
Root Surface Risk (RR):

The root surface risk score is based on a 1 to 3 scale, with 1 indicating the lowest risk and 3 the highest level of risk. The risk that the root surface will be adversely affected is the likelihood that grooves or notches in it will occur in the future. This is a separate measure than risk of Caries, and relates to defects in the root which may lead to the tooth breaking.

It is possible to have a risk score of "zero" if this is not applicable to the patient due to absence of contributing risk factors. In that case, the summary score on the Patient Details page would be RR0, and on reports you will see RR:0 on the history chart and the bar graph for Root Surface Risk will not display.

Explanatory text on Patient Reports for Root Surface Risk says: This is the risk that grooves or notches will occur in the roots of your teeth. These defects can increase sensitivity to hot and cold, cause tooth nerve damage leading to an abscess, or weaken the tooth causing it to fracture. The risk scale is 1, 2, and 3, with 3 representing high risk.

Oral Cancer Risk Assessment:
Oral Cancer Risk (OR):

The Oral Cancer risk score is based on a 1 to 5 scale, where 1 is very low, 2 low, 3 moderate, 4 high, and 5 very high risk. Risk for oral cancer is the likelihood that in the future the cancer will occur (if not yet present) or progress (if already present).

Explanatory text on Patient Reports for Oral Cancer Risk says: Oral cancer includes mouth cancer, tongue cancer, and throat cancer. Oral cancer can result in disfigurement and other negative effects on quality of life. 56% of all patients treated for oral cancer survive 5 years. However the percentage of patients that survive 5 years is 82% when cancer is localized, 46% when regional, and only 21% when it has spread to a distant site. Hence preventing disease is most desirable followed by diagnosis and treatment at the earliest possible stage. Risk of oral cancer predicts the likelihood of developing the disease and indicates the need to lower risk by selecting interventions targeted to the risk factors. Your risk score is reflected against the chart to the left and interventions appropriate for your risk level and factors are listed below.

Early diagnosis is very important. Common symptoms that require an evaluation include a red or white patch or ulcer, especially when present for more than 14 days. Other symptoms include numbness, a lump in your mouth or neck, or difficulty swallowing, speaking, or chewing.

Oral cancer, like many other diseases, can progress without pain or readily apparent symptoms. A diagnosis of oral cancer can only be determined by a biopsy. The conventional examination is visual and palpation, which can be assisted with diagnostic tools designed specifically to make identifying lesions easier. A positive finding warrants a biopsy, especially if the lesion has been present for more than 14 days.


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