const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Can We Predict Tooth Decay Before It Happens?";
pres.author = "Dr Avani Doiphode";

// ─── COLOUR PALETTE ────────────────────────────────────────────────────────
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// ─── HELPERS ───────────────────────────────────────────────────────────────
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// ══════════════════════════════════════════════════════════════════════════
// SLIDE 1 – TITLE
// ══════════════════════════════════════════════════════════════════════════
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  s.addText("MDS SEMINAR  |  DEPARTMENT OF PEDODONTICS & PREVENTIVE DENTISTRY", {
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  s.addText("Presented by: Dr Avani Doiphode  |  PG Student", {
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// ══════════════════════════════════════════════════════════════════════════
// SLIDE 2 – CLINICAL HOOK
// ══════════════════════════════════════════════════════════════════════════
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    "\"A 6-year-old child visits your clinic with no visible cavities.\n\nShould you give the same preventive advice as every other child — or can you identify TODAY that this child will develop caries within the next 2 years?\"",
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}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 3 – OVERVIEW
// ══════════════════════════════════════════════════════════════════════════
{
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  accentBar(s);
  slideHeading(s, "Overview");
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    ["2", "Cariogram", "Visual, computer-based CRA model"],
    ["3", "CAMBRA", "Evidence-based risk management protocol"],
    ["4", "ICDAS", "Standardized caries detection system"],
    ["5", "Other CRA Tools", "AAPD, ADA, TLM, CRAFT, CRA-RT, CARE"],
    ["6", "Comparative Evidence", "Which tool performs best?"],
    ["7", "Recent Advances & AI", "Digital tools and machine learning"],
    ["8", "Conclusion", "Answering the central question"],
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// ══════════════════════════════════════════════════════════════════════════
// SLIDE 4 – SECTION DIVIDER: Background
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 1\nBackground & Rationale");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 5 – INTRODUCTION / DEFINITIONS
// ══════════════════════════════════════════════════════════════════════════
{
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    ["Caries Risk Assessment", "A procedure to predict future caries development BEFORE the clinical onset of disease, to identify high-risk individuals and direct preventive resources appropriately."],
    ["Risk Factor", "A biological, behavioural or social factor that directly contributes to caries aetiology — e.g., high S. mutans count, frequent sugar intake, poor oral hygiene."],
    ["Risk Indicator", "A cross-sectional variable associated with caries but not proven to be causative — e.g., low socioeconomic status."],
    ["Risk Marker", "A background variable not modifiable by treatment — e.g., past caries experience (DMFT/dmft)."],
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}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 6 – WHY ASSESS CARIES RISK?
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Why Assess Caries Risk?");

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    "Reactive, drill-and-fill approach",
    "No distinction between low and high-risk patients",
    "Preventive resources wasted on low-risk patients",
    "High-risk individuals missed until disease advances",
    "Increased treatment burden and patient cost",
  ];
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    "Proactive, prevention-first approach",
    "Targeted interventions for high-risk patients",
    "Efficient allocation of preventive resources",
    "Early lesion identification and management",
    "Reduced long-term treatment burden",
  ];
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}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 7 – SECTION DIVIDER: Cariogram
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 2\nCariogram");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 8 – CARIOGRAM: What is it?
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Cariogram — Overview");

  s.addText([
    { text: "Origin: ", options: { bold: true, color: C.teal, fontFace: "Calibri", fontSize: 14 } },
    { text: "Pioneered by Bo Krasse (Gothenburg). Bratthall (1997, Malmö) developed the computer-based model.", options: { color: C.text, fontFace: "Calibri", fontSize: 14 } },
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    { text: "Definition: ", options: { bold: true, color: C.teal, fontFace: "Calibri", fontSize: 14 } },
    { text: "A computer program displaying a pie chart that illustrates the overall caries risk scenario by weighing multiple aetiological factors.", options: { color: C.text, fontFace: "Calibri", fontSize: 14 } },
  ], { x: 0.35, y: 1.6, w: 9.3, h: 0.65 });

  // Sector boxes
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    [C.red,    "Bacteria",      "Diet + bacteria score"],
    [C.gold,   "Diet",          "Diet contents + frequency"],
    ["1A5276", "Susceptibility","Fluoride + saliva + clinical"],
    ["7D3C98", "Circumstances", "General diseases, medications"],
    [C.green,  "Green Sector",  "Chance to AVOID caries (%)"],
  ];
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    s.addText(label, { x, y: y + 0.05, w: 3.0, h: 0.28, fontSize: 12, bold: true, color: C.white, align: "center", fontFace: "Calibri" });
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}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 9 – CARIOGRAM: Scoring Criteria
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Cariogram — Scoring Criteria");

  const rows = [
    ["Parameter",         "Score 0",        "Score 1",         "Score 2"],
    ["Caries Experience", "None",           "Low",             "High"],
    ["Related Diseases",  "None",           "Some relevance",  "High relevance"],
    ["Diet: Content",     "Low sugar",      "Moderate sugar",  "High sugar"],
    ["Diet: Frequency",   "≤3 times/day",   "4 times/day",     "≥5 times/day"],
    ["Plaque",            "Score 0–1",      "Score 2",         "Score 3–5"],
    ["S. mutans",         "≤10,000 CFU/mL","10,000–100,000",  ">100,000 CFU/mL"],
    ["Fluoride",          "Optimal",        "Some exposure",   "No fluoride"],
    ["Saliva Secretion",  "Normal",         "Reduced",         "Very low"],
    ["Saliva Buffer",     "High",           "Moderate",        "Low"],
    ["Clinical Judgement","Low risk",       "Moderate risk",   "High risk"],
  ];
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  const colX = [0.35, 3.2, 5.35, 7.5];
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        x: colX[ci], y, w: colW[ci], h: 0.4,
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        line: { color: C.teal, pt: 0.5 },
      });
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        fontSize: isHeader ? 11.5 : 10.5,
        bold: isHeader, color: isHeader ? C.white : C.text,
        fontFace: "Calibri", valign: "middle",
      });
    });
  });
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 10 – CARIOGRAM: Interpreting the Green Sector
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Cariogram — Interpreting the Green Sector");

  s.addText("The GREEN sector = \"Chance to Avoid Caries\" (NOT the probability of getting caries)", {
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    [C.green, "≥ 75%", "Very Good", "Very good chance of avoiding new caries"],
    ["5DADE2", "50–74%", "Good",     "Positive prognosis with preventive measures"],
    [C.gold,  "25–49%", "Moderate", "Some measures needed to reduce risk"],
    [C.red,   "< 25%",  "High Risk","Very high caries risk — intensive intervention required"],
  ];
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    const y = 1.75 + i * 0.9;
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    s.addShape(pres.ShapeType.roundRect, { x: 0.35, y, w: 1.6, h: 0.8, fill: { color: col }, line: { color: col }, rectRadius: 0.08 });
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    s.addText(label, { x: 2.1, y: y + 0.05, w: 2.5, h: 0.35, fontSize: 13, bold: true, color: col, fontFace: "Calibri" });
    s.addText(desc, { x: 2.1, y: y + 0.4, w: 7.3, h: 0.32, fontSize: 11.5, color: C.text, fontFace: "Calibri" });
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  s.addText("Country & Group settings allow calibration for local fluoridation status and population risk.", {
    x: 0.35, y: 5.25, w: 9.3, h: 0.3, fontSize: 11, color: C.subtext, italic: true, fontFace: "Calibri",
  });
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 11 – CARIOGRAM: Advantages & Limitations
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Cariogram — Advantages & Limitations");

  s.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 1.0, w: 4.4, h: 4.3, fill: { color: "EAFAF1" }, line: { color: C.green, pt: 1.5 }, rectRadius: 0.1 });
  s.addShape(pres.ShapeType.roundRect, { x: 5.2, y: 1.0, w: 4.4, h: 4.3, fill: { color: "FDEDEC" }, line: { color: C.red, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("ADVANTAGES", { x: 0.35, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.green, align: "center", fontFace: "Calibri" });
  s.addText("LIMITATIONS", { x: 5.2, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.red, align: "center", fontFace: "Calibri" });
  bulletBody(s, ["Affordable and user-friendly", "Visual output motivates patients", "Integrates multiple risk factors", "Supports clinical decision making", "Validated in multiple studies"], 0.55, 1.55, 3.9, 3.5, C.green, 12.5);
  bulletBody(s, ["May oversimplify complex cases", "Subjectivity in factor weighting", "Variable predictive accuracy across age groups", "Dependent on accurate patient data entry", "Requires computer/software access"], 5.4, 1.55, 3.9, 3.5, C.red, 12.5);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 12 – SECTION DIVIDER: CAMBRA
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 3\nCAMBRA");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 13 – CAMBRA: Overview
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "CAMBRA — Caries Management By Risk Assessment");

  s.addText([
    { text: "CAMBRA", options: { bold: true, color: C.teal, fontFace: "Calibri", fontSize: 15 } },
    { text: " is an evidence-based approach to preventing and managing dental caries at the earliest stages.", options: { color: C.text, fontFace: "Calibri", fontSize: 14 } },
  ], { x: 0.35, y: 1.0, w: 9.3, h: 0.55 });
  s.addText("California Dental Association (2002)  |  Revised with updated evidence (2019)", {
    x: 0.35, y: 1.55, w: 9.3, h: 0.38, fontSize: 12, color: C.subtext, italic: true, fontFace: "Calibri",
  });

  const boxes = [
    ["Risk Assessment", "Past caries, clinical & radiographic findings, S. mutans, Lactobacilli, salivary flow, pH, dietary habits, fluoride exposure"],
    ["Risk Stratification", "Low Risk: minimal risk factors\nModerate Risk: some risk factors or history\nHigh Risk: multiple risk factors or significant caries history\nExtreme Risk: xerostomia, rampant caries"],
    ["Individualized Plan", "Tailored preventive strategies: fluoride varnish, chlorhexidine, dietary counselling, recall interval, restorative care as needed"],
  ];
  boxes.forEach(([title, desc], i) => {
    const y = 2.1 + i * 1.08;
    s.addShape(pres.ShapeType.roundRect, { x: 0.35, y, w: 9.3, h: 0.95, fill: { color: i % 2 === 0 ? C.mint : C.white }, line: { color: C.teal, pt: 1 }, rectRadius: 0.08 });
    s.addShape(pres.ShapeType.ellipse, { x: 0.42, y: y + 0.2, w: 0.55, h: 0.55, fill: { color: C.teal }, line: { color: C.teal } });
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    s.addText(title, { x: 1.1, y: y + 0.06, w: 3.5, h: 0.35, fontSize: 13, bold: true, color: C.navy, fontFace: "Calibri" });
    s.addText(desc, { x: 1.1, y: y + 0.43, w: 8.4, h: 0.46, fontSize: 11, color: C.text, fontFace: "Calibri", wrap: true });
  });
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 14 – CAMBRA: Risk Factors vs Protective Factors
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "CAMBRA — Risk Factors vs Protective Factors");

  s.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 0.98, w: 4.4, h: 4.35, fill: { color: "FDEDEC" }, line: { color: C.red, pt: 1.5 }, rectRadius: 0.1 });
  s.addShape(pres.ShapeType.roundRect, { x: 5.2, y: 0.98, w: 4.4, h: 4.35, fill: { color: "EAFAF1" }, line: { color: C.green, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("RISK FACTORS", { x: 0.35, y: 1.0, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.red, align: "center", fontFace: "Calibri" });
  s.addText("PROTECTIVE FACTORS", { x: 5.2, y: 1.0, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.green, align: "center", fontFace: "Calibri" });
  bulletBody(s, [
    "Visible cavities or white spot lesions",
    "Elevated S. mutans and Lactobacilli",
    "Frequent sugar intake (>3x/day)",
    "Low salivary flow or buffering capacity",
    "Orthodontic appliances",
    "Low socioeconomic status",
    "Special healthcare needs",
  ], 0.55, 1.53, 3.9, 3.6, C.red, 12);
  bulletBody(s, [
    "Fluoride exposure (water, toothpaste, varnish)",
    "Good oral hygiene habits",
    "Regular dental visits",
    "Adequate salivary flow",
    "Chlorhexidine use",
    "Xylitol use",
    "Sealants on susceptible pits/fissures",
  ], 5.4, 1.53, 3.9, 3.6, C.green, 12);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 15 – SECTION DIVIDER: ICDAS
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 4\nICDAS");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 16 – ICDAS
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "ICDAS — International Caries Detection & Assessment System");

  s.addText("A standardized, internationally recognized visual-tactile system to detect and stage caries lesions. Captures early lesions missed by DMFT alone. ICDAS-II is the current revised version.", {
    x: 0.35, y: 1.0, w: 9.3, h: 0.65, fontSize: 13, color: C.text, fontFace: "Calibri", wrap: true,
  });

  const scores = [
    ["0", "Sound Tooth", "No visual evidence of caries", C.green],
    ["1", "First Change in Enamel", "White/brown spot visible only after drying", "5DADE2"],
    ["2", "Distinct Change in Enamel", "White/brown spot visible when wet", "2E86C1"],
    ["3", "Localised Breakdown", "Enamel breakdown, no visible dentin", C.gold],
    ["4", "Underlying Dark Shadow", "Dark shadow from dentin (may be wet)", "E67E22"],
    ["5", "Distinct Cavity with Dentin", "Visible dentin, <50% surface", "E74C3C"],
    ["6", "Extensive Cavity", "Visible dentin, ≥50% surface involved", C.red],
  ];
  scores.forEach(([sc, label, desc, col], i) => {
    const y = 1.78 + i * 0.53;
    s.addShape(pres.ShapeType.roundRect, { x: 0.35, y, w: 9.3, h: 0.48, fill: { color: i % 2 === 0 ? C.mint : C.white }, line: { color: col, pt: 1 }, rectRadius: 0.06 });
    s.addShape(pres.ShapeType.ellipse, { x: 0.42, y: y + 0.04, w: 0.4, h: 0.4, fill: { color: col }, line: { color: col } });
    s.addText(sc, { x: 0.42, y: y + 0.04, w: 0.4, h: 0.4, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri" });
    s.addText(label, { x: 0.95, y: y + 0.04, w: 2.8, h: 0.4, fontSize: 11.5, bold: true, color: col, fontFace: "Calibri" });
    s.addText(desc, { x: 3.85, y: y + 0.04, w: 5.6, h: 0.4, fontSize: 11, color: C.text, fontFace: "Calibri" });
  });
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 17 – SECTION DIVIDER: Other Tools
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 5\nOther CRA Tools");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 18 – AAPD & ADA Forms
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "AAPD & ADA Caries Risk Assessment Forms");

  // AAPD
  s.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 1.0, w: 4.4, h: 4.3, fill: { color: C.mint }, line: { color: C.teal, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("AAPD Form", { x: 0.35, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.navy, align: "center", fontFace: "Calibri" });
  s.addText("American Academy of Pediatric Dentistry", { x: 0.35, y: 1.42, w: 4.4, h: 0.35, fontSize: 10.5, color: C.subtext, align: "center", italic: true, fontFace: "Calibri" });
  bulletBody(s, [
    "Adopted 2002, revised 2019",
    "Two separate forms: 0–5 yrs & ≥6 yrs",
    "Considers biological, protective & clinical factors",
    "Classifies risk as Low / Moderate / High",
    "Guides recall intervals and preventive protocols",
    "Specifically designed for paediatric patients",
  ], 0.55, 1.83, 3.9, 3.35, C.navy, 12);

  // ADA
  s.addShape(pres.ShapeType.roundRect, { x: 5.2, y: 1.0, w: 4.4, h: 4.3, fill: { color: "EBF5FB" }, line: { color: "2980B9", pt: 1.5 }, rectRadius: 0.1 });
  s.addText("ADA Form", { x: 5.2, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.navy, align: "center", fontFace: "Calibri" });
  s.addText("American Dental Association", { x: 5.2, y: 1.42, w: 4.4, h: 0.35, fontSize: 10.5, color: C.subtext, align: "center", italic: true, fontFace: "Calibri" });
  bulletBody(s, [
    "For adult patients",
    "Assesses contributing conditions: fluoride exposure, saliva, diet",
    "General health factors: medications, special conditions",
    "Classifies risk as Low / Moderate / High",
    "Guides preventive therapy selection",
    "Primarily focused on individual clinical practice",
  ], 5.4, 1.83, 3.9, 3.35, C.navy, 12);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 19 – Traffic Light Matrix & CRAFT
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Traffic Light Matrix (TLM) & CRAFT");

  // TLM
  s.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 1.0, w: 4.4, h: 4.3, fill: { color: C.mint }, line: { color: C.teal, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("Traffic Light Matrix", { x: 0.35, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.navy, align: "center", fontFace: "Calibri" });
  s.addText("Commonly used in Australia", { x: 0.35, y: 1.42, w: 4.4, h: 0.32, fontSize: 10.5, italic: true, color: C.subtext, align: "center", fontFace: "Calibri" });
  bulletBody(s, [
    "Based on 19 criteria in 5 categories",
    "Saliva (6): hydration, viscosity, pH, flow rate, buffer capacity",
    "Plaque (3): pH, maturity, S. mutans count",
    "Diet (2): sugar/acid exposures between meals",
    "Fluoride (3): water, toothpaste, topical",
    "Modifying factors (5): general health, medications",
    "Output: RED (high), YELLOW (moderate), GREEN (low)",
    "Simple visual communication with patients",
  ], 0.55, 1.82, 3.9, 3.35, C.navy, 11.5);

  // CRAFT
  s.addShape(pres.ShapeType.roundRect, { x: 5.2, y: 1.0, w: 4.4, h: 4.3, fill: { color: "EBF5FB" }, line: { color: "2980B9", pt: 1.5 }, rectRadius: 0.1 });
  s.addText("CRAFT Approach", { x: 5.2, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.navy, align: "center", fontFace: "Calibri" });
  s.addText("Jawdekar et al.", { x: 5.2, y: 1.42, w: 4.4, h: 0.32, fontSize: 10.5, italic: true, color: C.subtext, align: "center", fontFace: "Calibri" });
  bulletBody(s, [
    "Simple, chairside, non-invasive tool for children",
    "Four parameters: Diet, Decay status, Fluoride exposure, Other factors",
    "Parents interviewed using the CRAFT chart",
    "Risk score: 0–4 (Very low / Low / Moderate / High)",
    "Green star = satisfactory; Red star = needs intervention",
    "Suitable for community and paediatric clinical settings",
  ], 5.4, 1.82, 3.9, 3.35, C.navy, 11.5);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 20 – CARE Test & CRA-RT
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "CARE Test & CRA-RT");

  // CARE
  s.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 1.0, w: 4.4, h: 4.3, fill: { color: C.mint }, line: { color: C.teal, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("CARE Test", { x: 0.35, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.navy, align: "center", fontFace: "Calibri" });
  s.addText("Caries Assessment & Risk Evaluation\nUniv. of Southern California", { x: 0.35, y: 1.42, w: 4.4, h: 0.5, fontSize: 10.5, italic: true, color: C.subtext, align: "center", fontFace: "Calibri" });
  bulletBody(s, [
    "Novel salivary test for genetic caries risk",
    "Based on correlation between caries history and salivary oligosaccharides",
    "Some oligosaccharides facilitate bacterial attachment",
    "Others promote bacterial agglutination and removal",
    "Measures specific oligosaccharide profiles in whole saliva",
    "Offers a biochemical/genetic risk dimension not captured by other tools",
  ], 0.55, 2.0, 3.9, 3.15, C.navy, 11.5);

  // CRA-RT
  s.addShape(pres.ShapeType.roundRect, { x: 5.2, y: 1.0, w: 4.4, h: 4.3, fill: { color: "EBF5FB" }, line: { color: "2980B9", pt: 1.5 }, rectRadius: 0.1 });
  s.addText("CRA-RT", { x: 5.2, y: 1.02, w: 4.4, h: 0.42, fontSize: 13, bold: true, color: C.navy, align: "center", fontFace: "Calibri" });
  s.addText("Caries Risk Assessment & Referral Tool\nSeetha et al., 2020 (ages 2–6 y)", { x: 5.2, y: 1.42, w: 4.4, h: 0.5, fontSize: 10.5, italic: true, color: C.subtext, align: "center", fontFace: "Calibri" });
  bulletBody(s, [
    "Designed for non-dental / non-medical community settings",
    "11-item tool — assessed by interviewing the mother",
    "Simple, valid and reliable scoring system for ECC",
    "Quick risk score with a defined cut-off for dental referral",
    "Enables child care providers to identify at-risk preschool children",
    "Community Dent Oral Epidemiol. 2020",
  ], 5.4, 2.0, 3.9, 3.15, C.navy, 11.5);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 21 – Dundee Model
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Dundee Caries Risk Assessment Model");

  s.addText("MacRitchie et al. (2012) — Dundee, Scotland", {
    x: 0.35, y: 1.0, w: 9.3, h: 0.42, fontSize: 13, bold: true, color: C.teal, fontFace: "Calibri",
  });
  bulletBody(s, [
    "Novel statistical model for preschool children, developed for a specific community setting.",
    "Longitudinal cohort of ~1,500 children born in one year in Dundee, Scotland.",
    "Data collected at 1, 2, 3, and 4 years: dental exam, salivary microbiological sample, parental and health visitor questionnaires.",
    "1-year data analysed using CHAID (Chi-squared Automated Interaction Detector) analysis to produce risk models.",
    "Key strength: developed from real-world community data, locally validated.",
    "Significance: shows that CRA models may need local adaptation for different populations — highly relevant for diverse countries like India.",
  ], 0.35, 1.55, 9.3, 3.8, C.text, 13);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 22 – SECTION DIVIDER: Comparative Evidence
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 6\nComparative Evidence");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 23 – Research Summary Table
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Which Tool Performs Best? — Evidence Summary");

  const rows = [
    ["Tool",       "Population",        "Validity",       "Best Setting"],
    ["CAMBRA",     "Adults / Children", "High",           "General & specialist practice"],
    ["Cariogram",  "Adults / Children", "High",           "Research + individual clinical"],
    ["AAPD CRAF",  "0–5 & ≥6 yrs",     "Moderate",       "Paediatric practice"],
    ["ADA Form",   "Adults",            "Moderate",       "General dental practice"],
    ["TLM",        "All ages",          "Moderate–High",  "Community & specialist"],
    ["CRAFT",      "Children",          "Moderate",       "Chairside, community"],
    ["CRA-RT",     "2–6 yrs (ECC)",     "High (validated)","Non-dental community setting"],
  ];
  const colW = [1.9, 2.3, 1.8, 3.0];
  const colX = [0.35, 2.3, 4.65, 6.5];
  rows.forEach((row, ri) => {
    const y = 1.0 + ri * 0.58;
    const isHeader = ri === 0;
    row.forEach((cell, ci) => {
      s.addShape(pres.ShapeType.rect, {
        x: colX[ci], y, w: colW[ci], h: 0.52,
        fill: { color: isHeader ? C.navy : ri % 2 === 0 ? C.mint : C.white },
        line: { color: C.teal, pt: 0.5 },
      });
      s.addText(cell, {
        x: colX[ci] + 0.06, y: y + 0.05, w: colW[ci] - 0.12, h: 0.42,
        fontSize: isHeader ? 12 : 11.5,
        bold: isHeader, color: isHeader ? C.white : C.text,
        fontFace: "Calibri", valign: "middle",
      });
    });
  });

  s.addText("Featherstone et al. 2021: Cariogram and CAMBRA categorized patients into identical risk categories. CAMBRA showed highest agreement with Cariogram. AAPD and ADA tools gave divergent results in several comparison examples.", {
    x: 0.35, y: 5.2, w: 9.3, h: 0.35, fontSize: 10.5, color: C.subtext, italic: true, fontFace: "Calibri",
  });
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 24 – Research Study 1
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Key Evidence — Study 1");

  s.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 1.0, w: 9.3, h: 2.05, fill: { color: C.mint }, line: { color: C.teal, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("Featherstone et al. (2021) — Comparison of Four CRA Methods", {
    x: 0.55, y: 1.05, w: 8.9, h: 0.42, fontSize: 14, bold: true, color: C.navy, fontFace: "Calibri",
  });
  bulletBody(s, [
    "Compared CAMBRA, Cariogram, ADA, and AAPD CRA tools",
    "Cariogram and CAMBRA categorized patients into identical risk categories",
    "ADA and AAPD gave divergent results compared to CAMBRA/Cariogram in several cases",
    "Conclusion: CAMBRA and Cariogram are most concordant and evidence-validated",
  ], 0.55, 1.55, 8.9, 1.38, C.text, 12.5);

  s.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 3.2, w: 9.3, h: 2.1, fill: { color: "EBF5FB" }, line: { color: "2980B9", pt: 1.5 }, rectRadius: 0.1 });
  s.addText("Agouropoulos et al. (2019) — Validation in High-Caries Preschool Children", {
    x: 0.55, y: 3.25, w: 8.9, h: 0.42, fontSize: 14, bold: true, color: C.navy, fontFace: "Calibri",
  });
  bulletBody(s, [
    "Assessed Cariogram, AAPD CRAF, and CAMBRA in 2–4 year-olds with high caries prevalence",
    "2-year follow-up to compare tools' ability to predict caries increment",
    "Cariogram and CAMBRA showed higher validity than AAPD CRAF in this high-risk population",
    "Conclusion: CAMBRA and Cariogram are more sensitive for high-risk paediatric populations",
  ], 0.55, 3.73, 8.9, 1.44, C.text, 12.5);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 25 – SECTION DIVIDER: Recent Advances
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 7\nRecent Advances & AI");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 26 – Recent Advances
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Recent Advances in Caries Risk Assessment");

  const items = [
    ["Cariometer App", "Estimates cariogenic risk based on daily diet and oral hygiene inputs. Patients register details and receive a daily risk status that can be shared with their dentist. Aims at early prevention, especially in children."],
    ["Lactic Acid Impression", "Uses Clinpro 3M ESPE to detect lactic acid — a key product of cariogenic bacterial fermentation. Provides a chairside biochemical indicator of caries risk."],
    ["Salivary Biomarkers", "Advances in point-of-care salivary diagnostics allow rapid detection of S. mutans, Lactobacilli, IgA, and buffering capacity at chairside without laboratory processing."],
    ["Genetic Testing", "Polymorphisms in genes encoding for enamel proteins, salivary proteins, and immune factors are being explored as future genetic risk markers for caries susceptibility."],
  ];
  items.forEach(([title, desc], i) => {
    const y = 1.08 + i * 1.1;
    s.addShape(pres.ShapeType.roundRect, { x: 0.35, y, w: 9.3, h: 0.98, fill: { color: i % 2 === 0 ? C.mint : C.white }, line: { color: C.teal, pt: 1 }, rectRadius: 0.08 });
    s.addText(title, { x: 0.55, y: y + 0.06, w: 3.0, h: 0.36, fontSize: 12.5, bold: true, color: C.teal, fontFace: "Calibri" });
    s.addText(desc, { x: 0.55, y: y + 0.48, w: 8.9, h: 0.44, fontSize: 11.5, color: C.text, fontFace: "Calibri", wrap: true });
  });
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 27 – Artificial Intelligence
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "Artificial Intelligence in Caries Risk Prediction");

  s.addText("AI — particularly machine learning — is showing promise in enhancing the accuracy and personalization of caries risk prediction beyond traditional tools.", {
    x: 0.35, y: 1.0, w: 9.3, h: 0.65, fontSize: 13.5, color: C.text, fontFace: "Calibri", wrap: true,
  });

  const aiBoxes = [
    ["Data Integration", "Analyses patient history, clinical records, radiographic imaging, and microbiome data simultaneously to identify patterns not apparent by traditional methods."],
    ["Machine Learning Models", "Random Forest, Neural Networks, and CNNs have been applied to radiographic data for automated early caries detection and risk classification."],
    ["Clinical Decision Support", "AI tools provide real-time risk assessments and treatment recommendations, assisting dentists in evidence-based decision making."],
    ["Limitations of AI", "Data bias, lack of large validated datasets, 'black box' problem, limited generalizability across populations, and regulatory approval challenges."],
  ];
  aiBoxes.forEach(([title, desc], i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = 0.35 + col * 4.85;
    const y = 1.8 + row * 1.75;
    s.addShape(pres.ShapeType.roundRect, { x, y, w: 4.55, h: 1.6, fill: { color: i % 2 === 0 ? C.mint : "EBF5FB" }, line: { color: C.teal, pt: 1 }, rectRadius: 0.1 });
    s.addText(title, { x: x + 0.12, y: y + 0.08, w: 4.3, h: 0.38, fontSize: 13, bold: true, color: C.navy, fontFace: "Calibri" });
    s.addText(desc, { x: x + 0.12, y: y + 0.5, w: 4.3, h: 1.0, fontSize: 11, color: C.text, fontFace: "Calibri", wrap: true });
  });
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 28 – SECTION DIVIDER: Conclusion
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  sectionDivider(s, "SECTION 8\nConclusion");
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 29 – CONCLUSION
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.95, fill: { color: C.teal }, line: { color: C.teal } });
  s.addText("CONCLUSION", { x: 0.3, y: 0.18, w: 9.4, h: 0.6, fontSize: 16, bold: true, color: C.white, align: "center", charSpacing: 4, fontFace: "Calibri" });

  s.addShape(pres.ShapeType.roundRect, {
    x: 0.4, y: 1.05, w: 9.2, h: 1.25, fill: { color: "1A3A55" }, line: { color: C.gold, pt: 2 }, rectRadius: 0.12,
  });
  s.addText("So — can we predict tooth decay before it happens?  YES.", {
    x: 0.6, y: 1.12, w: 8.8, h: 0.52, fontSize: 17, bold: true, color: C.gold, align: "center", fontFace: "Calibri",
  });
  s.addText("CRA tools give us structured, evidence-based frameworks to do exactly that.", {
    x: 0.6, y: 1.65, w: 8.8, h: 0.52, fontSize: 13, color: C.white, align: "center", italic: true, fontFace: "Calibri",
  });

  bulletBody(s, [
    "CRA is a standard of care — it should be integrated into every dental examination.",
    "No single tool is universally superior; choice should be based on patient age, clinical setting, and available resources.",
    "CAMBRA and Cariogram have the strongest evidence base and highest concordance.",
    "For India's diverse population, locally validated and adapted CRA tools are essential.",
    "Emerging technologies (AI, salivary biomarkers, genetic markers) will enhance predictive precision.",
    "The goal is not just to detect disease — it is to prevent it.",
  ], 0.4, 2.45, 9.2, 2.9, C.white, 13);
}

// ══════════════════════════════════════════════════════════════════════════
// SLIDE 30 – REFERENCES
// ══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s);
  accentBar(s);
  slideHeading(s, "References");

  const refs = [
    "1. Gannam CV, Chin KL, Gandhi RP. Caries risk assessment. Gen Dent. 2018;66(6):12-17.",
    "2. Anup N, Vishnani P. Cariogram: A multi-factorial risk assessment software for risk prediction of dental caries. Intl J Sci Study. 2014;1(4):58-62.",
    "3. Suneja ES, et al. An overview of caries risk assessment. Indian J Dent Sci. 2017;9:210-218.",
    "4. American Academy of Pediatric Dentistry. Caries-risk Assessment and Management for Infants, Children, and Adolescents. Pediatr Dent. 2019;41(6):220-224.",
    "5. Featherstone JDB, et al. Caries risk assessment in practice for age 6 through adult. J Calif Dent Assoc. 2007;35(10):703-713.",
    "6. Featherstone JDB, et al. A comparison of four caries risk assessment methods. Front Oral Health. 2021;2:656681.",
    "7. Agouropoulos A, et al. Validation of three caries risk assessment tools for preschool children. Pediatr Dent. 2014;36(3):221-228.",
    "8. MacRitchie HMB, et al. Development and testing of the Dundee Caries Risk Assessment Model (DCRAM). Community Dent Oral Epidemiol. 2012;40(1):37-43.",
    "9. Seetha Lakshmi B, et al. CRA-RT: A simple novel risk scoring system for ECC. Community Dent Oral Epidemiol. 2020.",
    "10. Hung M, et al. Using machine learning to predict 30-day hospital readmissions in patients with atrial fibrillation undergoing catheter ablation. J Clin Med. 2020.",
  ];
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// ══════════════════════════════════════════════════════════════════════════
// SLIDE 31 – THANK YOU
// ══════════════════════════════════════════════════════════════════════════
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  s.addText("Dr Avani Doiphode  |  PG Student\nGuided by: Dr Ritesh Kalaskar  |  Prof & HOD", {
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// ── WRITE FILE ──────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/caries-seminar/Caries_Risk_Assessment_Revised.pptx" })
  .then(() => console.log("DONE"))
  .catch(e => { console.error(e); process.exit(1); });

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const path = require("path");

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pres.layout = "LAYOUT_16x9";
pres.title = "Can We Predict Tooth Decay Before It Happens?";
pres.author = "Dr Avani Doiphode";

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// ═══════════════════════════════════════════════════════════════
// SLIDE 1 – TITLE
// ═══════════════════════════════════════════════════════════════
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  s.addText("A Critical Appraisal of Caries Risk Assessment Tools",{x:0.5,y:3.2,w:9,h:0.6,fontSize:18,color:C.gold,align:"center",fontFace:"Calibri"});
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  s.addText("June 2026",{x:0.5,y:4.9,w:9,h:0.3,fontSize:11,color:C.mint,align:"center",fontFace:"Calibri"});
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// ═══════════════════════════════════════════════════════════════
// SLIDE 2 – CLINICAL HOOK
// ═══════════════════════════════════════════════════════════════
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  darkSlide(s);
  s.addShape(pres.ShapeType.rect,{x:0,y:0,w:10,h:1.0,fill:{color:C.teal},line:{color:C.teal}});
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  s.addText("This is the core question that Caries Risk Assessment (CRA) tools are designed to answer.",{x:0.5,y:4.28,w:9,h:0.7,fontSize:14,color:C.gold,align:"center",fontFace:"Calibri"});
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// ═══════════════════════════════════════════════════════════════
// SLIDE 3 – OVERVIEW
// ═══════════════════════════════════════════════════════════════
{
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  lightSlide(s);
  accentBar(s);
  heading(s,"Overview");
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    ["2","Cariogram","How it works — step by step"],
    ["3","CAMBRA","Evidence-based risk management"],
    ["4","ICDAS","Standardized detection system"],
    ["5","Other CRA Tools","AAPD, ADA, TLM, CRAFT, CRA-RT, CARE"],
    ["6","Comparative Evidence","Which tool performs best?"],
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// ═══════════════════════════════════════════════════════════════
// SLIDE 4 – SECTION: Background
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 1\nBackground & Rationale"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 5 – INTRODUCTION
// ═══════════════════════════════════════════════════════════════
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    ["Risk Factor","A factor that plays an essential role in the etiology and occurrence of disease — lifestyle and biochemical determinants to which the tooth is directly exposed (e.g., S. mutans, dietary sugars, poor hygiene)."],
    ["Risk Indicator","A cross-sectional variable associated with higher caries levels but not proven to be causative (e.g., low socioeconomic status)."],
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}

// ═══════════════════════════════════════════════════════════════
// SLIDE 6 – WHY ASSESS?
// ═══════════════════════════════════════════════════════════════
{
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}

// ═══════════════════════════════════════════════════════════════
// SLIDE 7 – SECTION: Cariogram
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 2\nCariogram"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 8 – CARIOGRAM: What is it?
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — What Is It?");
  s.addText([
    {text:"Origin: ",options:{bold:true,color:C.teal,fontSize:14,fontFace:"Calibri"}},
    {text:"Pioneered by Bo Krasse & team (Gothenburg). Bratthall (1997, Malmö) developed the computer-based model.",options:{color:C.text,fontSize:14,fontFace:"Calibri"}},
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    {text:"A computer program showing a graphical picture (pie chart) that illustrates a possible overall caries risk scenario. It expresses to what extent different aetiological factors of caries affect caries risk.",options:{color:C.text,fontSize:14,fontFace:"Calibri"}},
  ],{x:0.35,y:1.5,w:9.3,h:0.75,wrap:true});

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  const i0=img("slide05_img00.png");
  if(i0) s.addImage({data:i0, x:0.35, y:2.35, w:4.2, h:2.9});

  // sectors explanation
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    [C.red,    "Bacteria",      "Caries experience + related diseases\n+ plaque + S. mutans"],
    [C.gold,   "Diet",          "Diet contents + diet frequency"],
    ["2471A3", "Susceptibility","Fluoride + saliva secretion + saliva buffer"],
    ["7D3C98", "Circumstances", "General diseases / medications"],
    [C.green,  "Green Sector",  "Chance to AVOID caries (0–100%)"],
  ];
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    s.addShape(pres.ShapeType.rect,{x:4.75,y,w:1.5,h:0.56,fill:{color:col},line:{color:col}});
    s.addText(label,{x:4.75,y,w:1.5,h:0.56,fontSize:11,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
    s.addText(desc,{x:6.32,y:y+0.04,w:3.35,h:0.48,fontSize:10.5,color:C.text,fontFace:"Calibri",wrap:true,valign:"middle"});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 9 – CARIOGRAM: Start the Program (Step 1 + 2)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Step 1: Starting the Program");
  s.addText("Download: http://www.db.od.mah.se/car/cariogram/cariograminfo.html",{x:0.35,y:0.88,w:9.3,h:0.38,fontSize:12.5,color:C.teal,fontFace:"Calibri"});
  bullets(s,["Start the program on PC (Windows)","Use the 'Hints' option for guidance on scoring each parameter","Enter patient data across the input fields"],0.35,1.3,4.5,1.2,C.navy,13);

  const i3=img("slide07_img03.png"); // screenshot step 1
  const i4=img("slide07_img04.png"); // screenshot step 2
  if(i3) s.addImage({data:i3, x:0.35, y:2.58, w:4.3, h:2.75});
  if(i4) s.addImage({data:i4, x:4.9,  y:2.58, w:4.7, h:2.75});

  s.addText("Step 1: Opening Screen",{x:0.35,y:5.35,w:4.3,h:0.22,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  s.addText("Step 2: Functions Panel",{x:4.9,y:5.35,w:4.7,h:0.22,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 10 – CARIOGRAM: Step 3 + 4 (Registration + Colours)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Step 3 & 4: Registration & Colour Sectors");

  const i5=img("slide08_img05.png");
  const i6=img("slide08_img06.png");
  const i7=img("slide08_img07.png");
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  if(i5) s.addImage({data:i5, x:0.35, y:2.42, w:4.4, h:2.9});

  // Step 4 colour sectors
  s.addText("Step 4: Colour-Coded Sectors",{x:5.1,y:0.9,w:4.55,h:0.38,fontSize:14,bold:true,color:C.teal,fontFace:"Calibri"});
  const colDesc=[
    [C.red,   "Red",    "Bacteria"],
    [C.gold,  "Yellow", "Diet"],
    ["2471A3","Blue",   "Susceptibility"],
    ["7D3C98","Purple", "Circumstances"],
    [C.green, "Green",  "Chance to avoid caries"],
  ];
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    const y=1.32+i*0.48;
    s.addShape(pres.ShapeType.ellipse,{x:5.1,y:y+0.06,w:0.35,h:0.35,fill:{color:col},line:{color:col}});
    s.addText(cname+" — "+meaning,{x:5.55,y:y+0.04,w:3.9,h:0.38,fontSize:12,color:C.text,fontFace:"Calibri"});
  });
  if(i6) s.addImage({data:i6, x:5.1,  y:2.42, w:2.1, h:2.9});
  if(i7) s.addImage({data:i7, x:7.35, y:2.42, w:2.3, h:2.9});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 11 – CARIOGRAM: Step 5 + 6 (Country & Group settings)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Step 5 & 6: Settings");

  const i8=img("slide09_img08.png");
  const i9=img("slide09_img09.png");

  s.addText("Step 5: Country Setting",{x:0.35,y:0.9,w:4.4,h:0.38,fontSize:14,bold:true,color:C.teal,fontFace:"Calibri"});
  bullets(s,["Impact of caries risk factors may differ by country","Standard set = industrialized country WITHOUT water fluoridation","'Low risk' and 'High risk' options available","Adjusts for local fluoridation and dietary patterns"],0.35,1.32,4.4,1.5,C.navy,12.5);
  if(i8) s.addImage({data:i8, x:0.35, y:2.9, w:4.4, h:2.5});

  s.addText("Step 6: Group Setting",{x:5.1,y:0.9,w:4.55,h:0.38,fontSize:14,bold:true,color:C.teal,fontFace:"Calibri"});
  bullets(s,["Patient may belong to a higher or lower risk group compared to the general population","Selecting the appropriate group calibrates the risk output","Important for special populations (medically compromised, special needs)"],5.1,1.32,4.55,1.5,C.navy,12.5);
  if(i9) s.addImage({data:i9, x:5.1,  y:2.9, w:4.55, h:2.5});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 12 – CARIOGRAM: Step 7 (Scoring)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Step 7: Scoring Each Factor");

  const i10=img("slide10_img10.png");
  const i11=img("slide10_img11.png");
  const i12=img("slide10_img12.png");

  s.addText("Each parameter is given a score of 0, 1, or 2 based on the patient's clinical and anamnestic data.",{x:0.35,y:0.9,w:9.3,h:0.5,fontSize:13,color:C.text,fontFace:"Calibri"});

  if(i10) s.addImage({data:i10, x:0.35, y:1.5,  w:3.0, h:2.0});
  if(i11) s.addImage({data:i11, x:3.55, y:1.5,  w:3.0, h:2.0});
  if(i12) s.addImage({data:i12, x:6.75, y:1.5,  w:2.85,h:2.0});

  s.addText("Input screen: Caries exp.",{x:0.35,y:3.52,w:3.0,h:0.25,fontSize:9.5,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  s.addText("Input screen: Diet",{x:3.55,y:3.52,w:3.0,h:0.25,fontSize:9.5,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  s.addText("Input screen: Susceptibility",{x:6.75,y:3.52,w:2.85,h:0.25,fontSize:9.5,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 13 – CARIOGRAM: Scoring Criteria Table
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Scoring Criteria");
  const rows=[
    ["Parameter","Score 0","Score 1","Score 2"],
    ["Caries Experience","None","Low","High"],
    ["Related Diseases","None","Some relevance","High relevance"],
    ["Diet: Content","Low sugar","Moderate sugar","High sugar"],
    ["Diet: Frequency","≤3 times/day","4 times/day","≥5 times/day"],
    ["Plaque","Score 0–1","Score 2","Score 3–5"],
    ["S. mutans","≤10,000 CFU/mL","10,000–100,000","≥100,000 CFU/mL"],
    ["Fluoride","Optimal","Some exposure","No fluoride"],
    ["Saliva Secretion","Normal","Reduced","Very low"],
    ["Saliva Buffer","High","Moderate","Low"],
    ["Clinical Judgement","Low risk","Moderate risk","High risk"],
  ];
  const colW=[2.8,2.1,2.1,2.1], colX=[0.35,3.2,5.35,7.5];
  rows.forEach((row,ri)=>{
    const y=0.9+ri*0.43;
    const isH=ri===0;
    row.forEach((cell,ci)=>{
      s.addShape(pres.ShapeType.rect,{x:colX[ci],y,w:colW[ci],h:0.41,fill:{color:isH?C.navy:ri%2===0?C.mint:C.white},line:{color:C.teal,pt:0.5}});
      s.addText(cell,{x:colX[ci]+0.05,y:y+0.05,w:colW[ci]-0.1,h:0.31,fontSize:isH?11.5:10.5,bold:isH,color:isH?C.white:C.text,fontFace:"Calibri",valign:"middle"});
    });
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 14 – CARIOGRAM: Step 8 — Estimation + Interpretation
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Step 8: Estimation & Output");

  const i13=img("slide11_img13.png");
  const i14=img("slide12_img14.png");
  if(i13) s.addImage({data:i13, x:0.35, y:0.9,  w:4.5, h:3.5});
  if(i14) s.addImage({data:i14, x:5.05, y:0.9,  w:4.6, h:3.5});
  s.addText("Cariogram Output — Pie Chart",{x:0.35,y:4.42,w:4.5,h:0.25,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  s.addText("Interpreted Result Screen",{x:5.05,y:4.42,w:4.6,h:0.25,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});

  const levels=[
    [C.green,"≥75%","Very Good — Very good chance to avoid new caries"],
    ["5DADE2","50–74%","Good — Positive prognosis with preventive measures"],
    [C.gold,"25–49%","Moderate — Risk reduction measures are needed"],
    [C.red,"<25%","High Risk — Intensive intervention required"],
  ];
  levels.forEach(([col,pct,desc],i)=>{
    const y=4.75+i*0.0; // these won't fit; show below images
  });
  s.addText([
    {text:"Green sector interpretation: ",options:{bold:true,color:C.teal,fontSize:12,fontFace:"Calibri"}},
    {text:"≥75% = Very Good  |  50–74% = Good  |  25–49% = Moderate  |  <25% = High Risk",options:{color:C.text,fontSize:12,fontFace:"Calibri"}},
  ],{x:0.35,y:4.7,w:9.3,h:0.6});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 15 – CARIOGRAM: Step 9+10 — Proposed Measures + Print
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Step 9 & 10: Proposed Measures & Printout");

  const i15=img("slide13_img15.png");
  const i16=img("slide13_img16.png");
  const i17=img("slide13_img17.png");
  const i18=img("slide13_img18.png");

  s.addText("Step 9: Preliminary Interpretation & Proposed Measures",{x:0.35,y:0.88,w:9.3,h:0.38,fontSize:14,bold:true,color:C.teal,fontFace:"Calibri"});
  s.addText("The program generates individualized preventive recommendations based on the scored factors.",{x:0.35,y:1.28,w:9.3,h:0.42,fontSize:13,color:C.text,fontFace:"Calibri"});

  if(i15) s.addImage({data:i15, x:0.35,y:1.8,w:2.25,h:1.8});
  if(i16) s.addImage({data:i16, x:2.75,y:1.8,w:2.25,h:1.8});
  if(i17) s.addImage({data:i17, x:5.15,y:1.8,w:2.25,h:1.8});
  if(i18) s.addImage({data:i18, x:7.55,y:1.8,w:2.1, h:1.8});

  s.addText("Step 10: Printout",{x:0.35,y:3.72,w:9.3,h:0.38,fontSize:14,bold:true,color:C.teal,fontFace:"Calibri"});
  const i19=img("slide14_img19.png");
  const i20=img("slide14_img20.png");
  const i21=img("slide14_img21.png");
  const i22=img("slide14_img22.png");
  if(i19) s.addImage({data:i19, x:0.35,y:4.15,w:2.2,h:1.35});
  if(i20) s.addImage({data:i20, x:2.7, y:4.15,w:2.2,h:1.35});
  if(i21) s.addImage({data:i21, x:5.05,y:4.15,w:2.2,h:1.35});
  if(i22) s.addImage({data:i22, x:7.4, y:4.15,w:2.25,h:1.35});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 16 – CARIOGRAM: Full output images
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Full Output Examples");

  const i23=img("slide15_img23.png");
  const i24=img("slide15_img24.png");
  if(i23) s.addImage({data:i23, x:0.35, y:0.9, w:5.8, h:4.4});
  if(i24) s.addImage({data:i24, x:6.3,  y:0.9, w:3.35,h:4.4});
  s.addText("Full Cariogram Output — Pie + risk factor breakdown",{x:0.35,y:5.35,w:9.3,h:0.22,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 17 – CARIOGRAM: Advantages & Limitations
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Cariogram — Advantages & Limitations");
  s.addShape(pres.ShapeType.roundRect,{x:0.3,y:0.92,w:4.5,h:4.45,fill:{color:"EAFAF1"},line:{color:C.green,pt:1.5},rectRadius:0.1});
  s.addShape(pres.ShapeType.roundRect,{x:5.2,y:0.92,w:4.5,h:4.45,fill:{color:"FDEDEC"},line:{color:C.red,pt:1.5},rectRadius:0.1});
  s.addText("ADVANTAGES",{x:0.3,y:0.94,w:4.5,h:0.42,fontSize:13,bold:true,color:C.green,align:"center",fontFace:"Calibri"});
  s.addText("LIMITATIONS",{x:5.2,y:0.94,w:4.5,h:0.42,fontSize:13,bold:true,color:C.red,align:"center",fontFace:"Calibri"});
  bullets(s,["Affordable and user-friendly","Visual output motivates patients","Integrates 9 aetiological factors simultaneously","Supports clinical decision making","Validated in multiple populations","Country and group settings allow local calibration","Useful as research and teaching tool"],0.5,1.44,4.1,3.75,C.green,12);
  bullets(s,["May not capture full complexity of individual risk","Subjectivity in factor weighting across practitioners","Predictive accuracy varies across age groups","Dependent on accurate patient data input","Requires computer/software access","'Dependency' factor not well-defined for all populations","Does not incorporate genetic or epigenetic risk markers"],5.4,1.44,4.1,3.75,C.red,12);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 18 – SECTION: CAMBRA
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 3\nCAMBRA"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 19 – CAMBRA: Overview
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CAMBRA — Caries Management By Risk Assessment");
  s.addText([
    {text:"CAMBRA ",options:{bold:true,color:C.teal,fontSize:14,fontFace:"Calibri"}},
    {text:"is an evidence-based approach to preventing and managing dental caries at the earliest stages.",options:{color:C.text,fontSize:14,fontFace:"Calibri"}},
  ],{x:0.35,y:0.9,w:9.3,h:0.52});
  s.addText("California Dental Association (2002)  |  Updated with evidence (2019)",{x:0.35,y:1.44,w:9.3,h:0.35,fontSize:12,color:C.subtext,italic:true,fontFace:"Calibri"});
  const steps=[
    ["Risk Assessment","Past caries, clinical & radiographic findings, S. mutans, Lactobacilli, salivary flow & pH, dietary habits, fluoride exposure"],
    ["Risk Stratification","Low / Moderate / High / Extreme Risk categories based on balance of risk and protective factors"],
    ["Individualized Preventive Plan","Tailored protocol: fluoride varnish, chlorhexidine, dietary counselling, recall interval, restorative care as needed"],
  ];
  steps.forEach(([title,desc],i)=>{
    const y=1.9+i*1.1;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:9.3,h:0.98,fill:{color:i%2===0?C.mint:C.white},line:{color:C.teal,pt:1},rectRadius:0.08});
    s.addShape(pres.ShapeType.ellipse,{x:0.42,y:y+0.22,w:0.54,h:0.54,fill:{color:C.teal},line:{color:C.teal}});
    s.addText(String(i+1),{x:0.42,y:y+0.22,w:0.54,h:0.54,fontSize:14,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
    s.addText(title,{x:1.1,y:y+0.06,w:3.2,h:0.35,fontSize:13,bold:true,color:C.navy,fontFace:"Calibri"});
    s.addText(desc,{x:1.1,y:y+0.45,w:8.4,h:0.46,fontSize:11.5,color:C.text,fontFace:"Calibri",wrap:true});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 20 – CAMBRA: Risk Assessment detail
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CAMBRA — Risk Assessment Parameters");
  const params=[
    ["Past Caries Experience","History of caries development — strongest single predictor of future caries risk."],
    ["Clinical & Radiographic Findings","Signs of demineralization, white spot lesions, and cavitation on clinical exam and bitewing radiographs."],
    ["Bacterial Levels","Microbial load assessment: Streptococcus mutans and Lactobacilli counts from salivary cultures."],
    ["Salivary Flow & pH","Quality and quantity of saliva: flow rate and buffering capacity (essential protective factors)."],
    ["Dietary Habits","Frequency and type of fermentable carbohydrate intake; sugar exposure between meals."],
    ["Fluoride Exposure","Fluoridated water, toothpaste, professional topical fluoride, fluoride supplements."],
  ];
  params.forEach(([term,desc],i)=>{
    const y=0.9+i*0.77;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:9.3,h:0.7,fill:{color:i%2===0?C.mint:C.white},line:{color:C.teal,pt:0.8},rectRadius:0.07});
    s.addShape(pres.ShapeType.ellipse,{x:0.42,y:y+0.17,w:0.35,h:0.35,fill:{color:C.teal},line:{color:C.teal}});
    s.addText(String(i+1),{x:0.42,y:y+0.17,w:0.35,h:0.35,fontSize:11,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
    s.addText(term+":",{x:0.88,y:y+0.06,w:2.5,h:0.3,fontSize:12,bold:true,color:C.teal,fontFace:"Calibri"});
    s.addText(desc,{x:0.88,y:y+0.36,w:8.55,h:0.28,fontSize:11.5,color:C.text,fontFace:"Calibri",wrap:true});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 21 – CAMBRA: Risk Categories + Form image
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CAMBRA — Risk Categories & Form");

  const cats=[
    [C.green, "Low Risk",     "Minimal risk factors, no recent caries, optimal salivary flow, good fluoride exposure."],
    [C.gold,  "Moderate Risk","Some risk factors or history of caries, but not at highest level."],
    [C.red,   "High Risk",    "Multiple risk factors or significant caries history, indicating greater likelihood of future development."],
    ["7D3C98","Extreme Risk", "Xerostomia, rampant caries, medically compromised — requires intensive intervention."],
  ];
  cats.forEach(([col,label,desc],i)=>{
    const y=0.95+i*0.88;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:5.4,h:0.78,fill:{color:C.white},line:{color:col,pt:2},rectRadius:0.08});
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:1.7,h:0.78,fill:{color:col},line:{color:col},rectRadius:0.08});
    s.addText(label,{x:0.35,y,w:1.7,h:0.78,fontSize:13,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
    s.addText(desc,{x:2.12,y:y+0.1,w:3.5,h:0.58,fontSize:11.5,color:C.text,fontFace:"Calibri",wrap:true,valign:"middle"});
  });

  const i26=img("slide21_img26.jpg");
  if(i26) s.addImage({data:i26, x:6.0, y:0.85, w:3.65, h:4.6});
  s.addText("CAMBRA Risk Assessment Form",{x:6.0,y:5.47,w:3.65,h:0.2,fontSize:9.5,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 22 – CAMBRA: CAMBRA form (full slide image)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CAMBRA — Risk/Protective Factors Form");
  const i25=img("slide20_img25.png");
  if(i25) s.addImage({data:i25, x:0.35, y:0.92, w:9.3, h:4.55});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 23 – CAMBRA: Individualized Preventive Strategies
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CAMBRA — Individualized Preventive Strategies");
  twoCol(s,
    "RISK FACTORS (Address These)",
    ["High S. mutans / Lactobacilli — prescribe chlorhexidine rinse","Frequent sugar intake — dietary counselling","Poor oral hygiene — OHI, professional prophylaxis","No fluoride exposure — prescribe fluoride varnish/supplements","Deep pits and fissures — fissure sealants","Orthodontic appliances — chlorhexidine + fluoride"],
    "PROTECTIVE FACTORS (Reinforce These)",
    ["Fluoridated water and toothpaste — maintain and reinforce","Regular dental visits — positive recall","Good oral hygiene — positive reinforcement","Adequate saliva — salivary substitutes if needed","Xylitol use — encourage gum/lozenges","Sealants on susceptible surfaces — place proactively"],
    C.mint, C.ltblue, C.navy, C.navy
  );
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 24 – SECTION: ICDAS
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 4\nICDAS"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 25 – ICDAS: Overview + Scores
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"ICDAS — International Caries Detection & Assessment System");
  s.addText("A standardized, internationally recognized visual-tactile system for caries detection. Captures early lesions missed by DMFT. ICDAS-II is the current revised version.",{x:0.35,y:0.9,w:9.3,h:0.6,fontSize:13,color:C.text,fontFace:"Calibri",wrap:true});
  const scores=[
    ["0","Sound Tooth","No visual evidence of caries.",C.green],
    ["1","First Change in Enamel","White/brown spot visible ONLY after drying.","5DADE2"],
    ["2","Distinct Change in Enamel","White/brown spot visible when WET.","2E86C1"],
    ["3","Localised Enamel Breakdown","Enamel breakdown, no visible dentin.",C.gold],
    ["4","Underlying Dark Shadow","Dark shadow from dentin visible (may be wet).","E67E22"],
    ["5","Distinct Cavity with Dentin","Visible dentin, less than half the surface.","E74C3C"],
    ["6","Extensive Cavity","Visible dentin, half or more of the surface.",C.red],
  ];
  scores.forEach(([sc,label,desc,col],i)=>{
    const y=1.6+i*0.55;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:9.3,h:0.49,fill:{color:i%2===0?C.mint:C.white},line:{color:col,pt:1},rectRadius:0.06});
    s.addShape(pres.ShapeType.ellipse,{x:0.42,y:y+0.05,w:0.38,h:0.38,fill:{color:col},line:{color:col}});
    s.addText(sc,{x:0.42,y:y+0.05,w:0.38,h:0.38,fontSize:12,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
    s.addText(label,{x:0.92,y:y+0.04,w:2.8,h:0.4,fontSize:11.5,bold:true,color:col,fontFace:"Calibri"});
    s.addText(desc,{x:3.85,y:y+0.04,w:5.6,h:0.4,fontSize:11,color:C.text,fontFace:"Calibri"});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 26 – ICDAS: Images from original (AAPD form images)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"ICDAS — Clinical Examples");
  const i27=img("slide24_img27.png");
  if(i27) s.addImage({data:i27, x:0.35, y:0.9, w:9.3, h:4.5});
  s.addText("ICDAS Score 0–6: Visual clinical representation",{x:0.35,y:5.42,w:9.3,h:0.2,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 27 – SECTION: Other Tools
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 5\nOther CRA Tools"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 28 – AAPD Form
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"AAPD — Caries Risk Assessment Form");
  s.addText("AAPD recognizes that CRA and management protocols are essential elements of contemporary clinical care for infants, children and adolescents. Developed by Council on Clinical Affairs, adopted 2002, last revised 2019.",{x:0.35,y:0.9,w:9.3,h:0.72,fontSize:13,color:C.text,fontFace:"Calibri",wrap:true});
  const i28=img("slide26_img28.png");
  const i29=img("slide26_img29.png");
  if(i28) s.addImage({data:i28, x:0.35, y:1.7, w:4.55, h:3.65});
  if(i29) s.addImage({data:i29, x:5.05, y:1.7, w:4.6,  h:3.65});
  s.addText("AAPD Form: Age 0–5 years",{x:0.35,y:5.37,w:4.55,h:0.22,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  s.addText("AAPD Form: Age ≥6 years",{x:5.05,y:5.37,w:4.6,h:0.22,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 29 – ADA Form
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"ADA — Caries Risk Assessment Form");
  const i30=img("slide27_img30.png");
  const i31=img("slide27_img31.png");
  if(i30) s.addImage({data:i30, x:0.35, y:0.9, w:4.55, h:4.45});
  if(i31) s.addImage({data:i31, x:5.05, y:0.9, w:4.6,  h:4.45});
  s.addText("ADA CRA Form — Contributing Conditions",{x:0.35,y:5.37,w:4.55,h:0.22,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  s.addText("ADA CRA Form — Clinical Findings",{x:5.05,y:5.37,w:4.6,h:0.22,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 30 – Traffic Light Matrix
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Traffic Light Matrix (TLM)");
  s.addText("Commonly used CRA tool in Australia. Based on 19 criteria across 5 categories.",{x:0.35,y:0.88,w:9.3,h:0.42,fontSize:13,color:C.text,fontFace:"Calibri"});

  const i32=img("slide28_img32.png");

  const cats=[
    ["Saliva (6 criteria)","Resting: hydration, viscosity, pH\nStimulated: quantity/rate, pH, buffering capacity"],
    ["Plaque (3 criteria)","pH, maturity, bacteria — S. mutans count"],
    ["Diet (2 criteria)","Number of sugar and acid exposures between meals per day"],
    ["Fluoride (3 criteria)","Exposure through fluoridated water, toothpaste, professional topical application"],
    ["Modifying Factors (5 criteria)","General health conditions, medications, socioeconomic factors"],
  ];
  cats.forEach(([label,desc],i)=>{
    const y=1.35+i*0.74;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:5.85,h:0.68,fill:{color:i%2===0?C.mint:C.white},line:{color:C.teal,pt:0.8},rectRadius:0.07});
    s.addText(label,{x:0.5,y:y+0.05,w:2.3,h:0.3,fontSize:12,bold:true,color:C.teal,fontFace:"Calibri"});
    s.addText(desc,{x:0.5,y:y+0.35,w:5.55,h:0.28,fontSize:10.5,color:C.text,fontFace:"Calibri",wrap:true});
  });

  if(i32) s.addImage({data:i32, x:6.4, y:1.3, w:3.25, h:4.0});

  // colour coding explanation
  const colCodes=[[C.red,"Red","High risk"],[C.gold,"Yellow","Moderate risk"],[C.green,"Green","Low risk"]];
  colCodes.forEach(([col,label,meaning],i)=>{
    const x=0.35+i*2.0;
    s.addShape(pres.ShapeType.roundRect,{x,y:5.2,w:1.85,h:0.35,fill:{color:col},line:{color:col},rectRadius:0.06});
    s.addText(label+" = "+meaning,{x,y:5.2,w:1.85,h:0.35,fontSize:11,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 31 – TLM continued (image)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Traffic Light Matrix — Visual Output");
  const i33=img("slide29_img33.png");
  const i34=img("slide30_img34.png");
  if(i33) s.addImage({data:i33, x:0.35, y:0.9, w:4.55, h:4.5});
  if(i34) s.addImage({data:i34, x:5.05, y:0.9, w:4.6,  h:4.5});
  s.addText("TLM colour-coded output — patient communication tool",{x:0.35,y:5.42,w:9.3,h:0.2,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 32 – CRAFT Approach
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CRAFT Approach — Caries Risk in Children");
  s.addText("Ashwin M Jawdekar et al. — Simple, chairside, non-invasive, four-point approach for caries management in children based on risk assessment.",{x:0.35,y:0.9,w:9.3,h:0.6,fontSize:13,color:C.text,fontFace:"Calibri",wrap:true});

  const i35=img("slide32_img35.png");
  const i36=img("slide33_img36.jpg");
  const i37=img("slide33_img37.jpg");

  const params=[
    ["D","Diet","Frequency of fermentable carbohydrates"],
    ["E","Decay Status","Presence of active caries/restorations"],
    ["C","Fluoride Exposure","Fluoride toothpaste, water, professional"],
    ["T","Other Factors","Oral hygiene habits, salivary factors, medical history"],
  ];
  params.forEach(([letter,label,desc],i)=>{
    const y=1.6+i*0.7;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:5.4,h:0.62,fill:{color:i%2===0?C.mint:C.white},line:{color:C.teal,pt:0.8},rectRadius:0.07});
    s.addShape(pres.ShapeType.ellipse,{x:0.42,y:y+0.13,w:0.36,h:0.36,fill:{color:C.teal},line:{color:C.teal}});
    s.addText(letter,{x:0.42,y:y+0.13,w:0.36,h:0.36,fontSize:13,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
    s.addText(label,{x:0.88,y:y+0.04,w:1.8,h:0.3,fontSize:12,bold:true,color:C.teal,fontFace:"Calibri"});
    s.addText(desc,{x:0.88,y:y+0.34,w:4.7,h:0.25,fontSize:11,color:C.text,fontFace:"Calibri"});
  });
  s.addText("Risk score: 0–4  (0=Very Low/None  1=Low  2=Moderate  3–4=High)\nGreen star = satisfactory  |  Red star = intervention required",{x:0.35,y:4.45,w:5.4,h:0.6,fontSize:11.5,color:C.navy,fontFace:"Calibri",wrap:true});

  if(i35) s.addImage({data:i35, x:6.0, y:1.5, w:3.65, h:2.5});
  if(i36) s.addImage({data:i36, x:6.0, y:4.1, w:1.75, h:1.3});
  if(i37) s.addImage({data:i37, x:7.9, y:4.1, w:1.75, h:1.3});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 33 – CRA-RT
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CRA-RT — Caries Risk Assessment & Referral Tool");
  s.addText("Seetha et al. Community Dent Oral Epidemiol. 2020",{x:0.35,y:0.88,w:9.3,h:0.36,fontSize:13,bold:true,color:C.teal,fontFace:"Calibri"});

  const i38=img("slide34_img38.png");
  if(i38) s.addImage({data:i38, x:5.0, y:0.9, w:4.65, h:4.5});

  bullets(s,[
    "Designed for non-dental, non-medical community settings",
    "11-item tool — assessed by interviewing the mother",
    "Valid and reliable novel risk scoring system for Early Childhood Caries (ECC)",
    "Quick scoring with a defined cut-off score",
    "Guides dental referral of preschool children (2–6 years) by child care providers",
    "Can be administered by non-dental health workers in community settings",
    "Developed and validated in an Indian population — highly relevant for Indian practice",
  ],0.35,0.9,4.5,4.5,C.navy,13);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 34 – CARE Test & Dundee Model
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"CARE Test & Dundee Caries Risk Assessment Model");
  s.addShape(pres.ShapeType.roundRect,{x:0.3,y:0.9,w:4.5,h:4.5,fill:{color:C.mint},line:{color:C.teal,pt:1.5},rectRadius:0.1});
  s.addShape(pres.ShapeType.roundRect,{x:5.2,y:0.9,w:4.5,h:4.5,fill:{color:C.ltblue},line:{color:C.blue,pt:1.5},rectRadius:0.1});
  s.addText("CARE Test",{x:0.3,y:0.92,w:4.5,h:0.42,fontSize:13,bold:true,color:C.navy,align:"center",fontFace:"Calibri"});
  s.addText("Dundee Model",{x:5.2,y:0.92,w:4.5,h:0.42,fontSize:13,bold:true,color:C.navy,align:"center",fontFace:"Calibri"});
  s.addText("Univ. of Southern California",{x:0.3,y:1.32,w:4.5,h:0.3,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  s.addText("MacRitchie et al. (2012)",{x:5.2,y:1.32,w:4.5,h:0.3,fontSize:10,italic:true,color:C.subtext,align:"center",fontFace:"Calibri"});
  bullets(s,["Novel salivary test for genetic caries risk","Based on salivary oligosaccharide profiles","Some oligosaccharides facilitate bacterial attachment — risk","Others promote agglutination and bacterial removal — protective","Offers a biochemical/genetic risk dimension beyond traditional tools","Measures specific oligosaccharide ratios in whole saliva"],0.5,1.7,4.0,3.55,C.navy,12);
  bullets(s,["Statistical model for preschool children (Dundee, Scotland)","Longitudinal cohort: ~1,500 children","Data collected at 1, 2, 3, 4 years","CHAID analysis used to develop risk models from 1-year data","Locally validated — shows need for population-specific CRA models","Highly relevant: India's diverse population needs local CRA adaptation"],5.4,1.7,4.0,3.55,C.navy,12);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 35 – SECTION: Comparative Evidence
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 6\nComparative Evidence"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 36 – Comparison Table
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Which Tool Performs Best? — Summary Comparison");
  const rows=[
    ["Tool","Population","Validity","Best Used For"],
    ["CAMBRA","Adults & Children","High","General & specialist practice"],
    ["Cariogram","Adults & Children","High","Research + individual clinical"],
    ["AAPD CRAF","0–5 & ≥6 yrs","Moderate","Paediatric practice"],
    ["ADA Form","Adults","Moderate","General dental practice"],
    ["TLM","All ages","Moderate–High","Community & specialist"],
    ["CRAFT","Children","Moderate","Chairside & community"],
    ["CRA-RT","2–6 yrs (ECC)","High (validated)","Non-dental community setting"],
    ["CARE Test","Adults & Children","Experimental","Genetic risk research"],
  ];
  const colW=[1.9,2.2,1.7,3.1], colX=[0.35,2.3,4.55,6.3];
  rows.forEach((row,ri)=>{
    const y=0.88+ri*0.53;
    const isH=ri===0;
    row.forEach((cell,ci)=>{
      s.addShape(pres.ShapeType.rect,{x:colX[ci],y,w:colW[ci],h:0.48,fill:{color:isH?C.navy:ri%2===0?C.mint:C.white},line:{color:C.teal,pt:0.5}});
      s.addText(cell,{x:colX[ci]+0.06,y:y+0.06,w:colW[ci]-0.12,h:0.36,fontSize:isH?11.5:11,bold:isH,color:isH?C.white:C.text,fontFace:"Calibri",valign:"middle"});
    });
  });
  s.addText("Featherstone et al. 2021: CAMBRA and Cariogram showed highest concordance. AAPD and ADA tools diverged in several risk categorizations.",{x:0.35,y:5.38,w:9.3,h:0.22,fontSize:10,italic:true,color:C.subtext,fontFace:"Calibri"});
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 37 – Research Study 1
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Research — Literature on Best CRA Tool");
  s.addShape(pres.ShapeType.roundRect,{x:0.35,y:0.9,w:9.3,h:2.2,fill:{color:C.mint},line:{color:C.teal,pt:1.5},rectRadius:0.1});
  s.addText("1. Featherstone et al. (2021) — Comparison of Four CRA Methods",{x:0.55,y:0.95,w:8.9,h:0.42,fontSize:14,bold:true,color:C.navy,fontFace:"Calibri"});
  bullets(s,["Compared CAMBRA, Cariogram, ADA, and AAPD CRA tools across multiple patient scenarios","Cariogram and CAMBRA categorized patients into identical risk categories","ADA and AAPD gave divergent results compared to CAMBRA/Cariogram in several comparison examples","Conclusion: CAMBRA gave the same caries risk level results as the Cariogram — highest concordance"],0.55,1.4,8.9,1.55,C.text,12.5);
  s.addShape(pres.ShapeType.roundRect,{x:0.35,y:3.2,w:9.3,h:2.2,fill:{color:C.ltblue},line:{color:C.blue,pt:1.5},rectRadius:0.1});
  s.addText("2. Agouropoulos et al. (2019) — Validation in High-Caries Preschool Children",{x:0.55,y:3.25,w:8.9,h:0.42,fontSize:14,bold:true,color:C.navy,fontFace:"Calibri"});
  bullets(s,["Assessed Cariogram, AAPD CRAF, and CAMBRA in 2–4 year-olds with high caries prevalence over 2 years","Cariogram and CAMBRA displayed higher validity than AAPD CRAF in predicting caries increment","Conclusion: CAMBRA and Cariogram more sensitive for high-risk paediatric populations"],0.55,3.72,8.9,1.6,C.text,12.5);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 38 – SECTION: Recent Advances
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 7\nRecent Advances & AI"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 39 – Recent Advances
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Recent Advances in Caries Risk Assessment");
  const items=[
    ["Cariometer App","Estimates cariogenic risk based on daily diet and oral hygiene inputs. Patients register details and receive a daily risk status shareable with their dentist. Aims at early prevention in children."],
    ["Lactic Acid Impression","Uses Clinpro 3M ESPE to detect lactic acid — a key fermentation product of cariogenic bacteria. Chairside biochemical indicator of caries activity and risk."],
    ["Salivary Biomarkers","Point-of-care diagnostics for rapid chairside detection of S. mutans, Lactobacilli, salivary IgA, and buffer capacity without laboratory processing."],
    ["Genetic & Epigenetic Testing","Polymorphisms in genes encoding enamel proteins, salivary proteins, and immune factors being explored as future caries susceptibility markers."],
  ];
  items.forEach(([title,desc],i)=>{
    const y=1.05+i*1.12;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:9.3,h:1.0,fill:{color:i%2===0?C.mint:C.white},line:{color:C.teal,pt:1},rectRadius:0.08});
    s.addText(title,{x:0.55,y:y+0.07,w:3.2,h:0.36,fontSize:12.5,bold:true,color:C.teal,fontFace:"Calibri"});
    s.addText(desc,{x:0.55,y:y+0.5,w:8.9,h:0.44,fontSize:11.5,color:C.text,fontFace:"Calibri",wrap:true});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 40 – Artificial Intelligence
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Artificial Intelligence in Caries Risk Prediction");
  s.addText("AI — particularly machine learning — is showing promise in enhancing accuracy and personalization of caries risk prediction beyond traditional tools.",{x:0.35,y:0.9,w:9.3,h:0.55,fontSize:13.5,color:C.text,fontFace:"Calibri",wrap:true});
  const aiBoxes=[
    ["Data Integration","Analyses patient history, clinical records, radiographic imaging, and microbiome data simultaneously to identify risk patterns not apparent by traditional methods."],
    ["Machine Learning Models","Random Forest, Neural Networks, and CNNs applied to radiographic data for automated early caries detection and risk classification."],
    ["Clinical Decision Support","Real-time risk assessments and treatment recommendations, assisting dentists in evidence-based decision making during consultations."],
    ["Limitations of AI","Data bias, lack of large validated datasets, 'black box' problem, limited generalizability across populations, regulatory approval challenges."],
  ];
  aiBoxes.forEach(([title,desc],i)=>{
    const col=i%2, row=Math.floor(i/2);
    const x=0.35+col*4.85, y=1.6+row*1.85;
    s.addShape(pres.ShapeType.roundRect,{x,y,w:4.55,h:1.7,fill:{color:i%2===0?C.mint:C.ltblue},line:{color:C.teal,pt:1},rectRadius:0.1});
    s.addText(title,{x:x+0.12,y:y+0.09,w:4.3,h:0.38,fontSize:13,bold:true,color:C.navy,fontFace:"Calibri"});
    s.addText(desc,{x:x+0.12,y:y+0.54,w:4.3,h:1.08,fontSize:11,color:C.text,fontFace:"Calibri",wrap:true});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 41 – Advantages of CRA Tools (general)
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Advantages of Caries Risk Assessment Tools");
  const advs=[
    ["Targeted Prevention","Directs preventive resources to patients who need them most, avoiding a one-size-fits-all approach."],
    ["Early Intervention","Identifies high-risk individuals before clinical disease manifests, enabling early remineralisation strategies."],
    ["Patient Motivation","Visual outputs (e.g., Cariogram pie chart, TLM colour codes) help patients understand their own risk and motivate behaviour change."],
    ["Clinical Decision Support","Guides recall interval selection, fluoride prescription, and restorative decisions based on individualized risk level."],
    ["Public Health Utility","Community-level CRA tools (CRA-RT, CRAFT) enable non-dental health workers to screen and refer at-risk children."],
    ["Research Value","Standardized CRA tools enable longitudinal research on caries incidence, preventive efficacy, and population risk trends."],
  ];
  advs.forEach(([title,desc],i)=>{
    const y=0.9+i*0.75;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:9.3,h:0.68,fill:{color:i%2===0?C.mint:C.white},line:{color:C.teal,pt:0.8},rectRadius:0.07});
    s.addShape(pres.ShapeType.ellipse,{x:0.42,y:y+0.16,w:0.36,h:0.36,fill:{color:C.teal},line:{color:C.teal}});
    s.addText(String(i+1),{x:0.42,y:y+0.16,w:0.36,h:0.36,fontSize:11,bold:true,color:C.white,align:"center",valign:"middle",fontFace:"Calibri"});
    s.addText(title+":",{x:0.88,y:y+0.05,w:2.5,h:0.3,fontSize:12,bold:true,color:C.teal,fontFace:"Calibri"});
    s.addText(desc,{x:0.88,y:y+0.36,w:8.55,h:0.28,fontSize:11.5,color:C.text,fontFace:"Calibri",wrap:true});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 42 – Public Awareness
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"Public Awareness & CRA");
  s.addText("Effective caries prevention begins with public awareness. CRA tools serve as a bridge between clinical assessment and patient education.",{x:0.35,y:0.9,w:9.3,h:0.6,fontSize:13.5,color:C.text,fontFace:"Calibri",wrap:true});
  const pts=[
    ["Community Outreach","CRA tools like CRA-RT and CRAFT can be administered by ASHA workers, anganwadi teachers, and community health workers in India to identify at-risk children early."],
    ["School-Based Programs","Simple CRA screening in school dental health programmes helps identify high-risk children who need prompt dental referral."],
    ["Parental Counselling","CRA questionnaires involve parents in understanding their child's risk — diet, hygiene habits, and fluoride use — converting assessment into actionable change."],
    ["Indian Context","With wide socioeconomic, dietary, and cultural diversity, India requires locally validated CRA tools. The Dundee and CRA-RT models highlight the need for population-specific adaptation."],
  ];
  pts.forEach(([title,desc],i)=>{
    const y=1.6+i*0.95;
    s.addShape(pres.ShapeType.roundRect,{x:0.35,y,w:9.3,h:0.85,fill:{color:i%2===0?C.mint:C.white},line:{color:C.teal,pt:0.8},rectRadius:0.07});
    s.addText(title+":",{x:0.52,y:y+0.07,w:2.8,h:0.3,fontSize:12,bold:true,color:C.teal,fontFace:"Calibri"});
    s.addText(desc,{x:0.52,y:y+0.42,w:8.8,h:0.38,fontSize:11.5,color:C.text,fontFace:"Calibri",wrap:true});
  });
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 43 – SECTION: Conclusion
// ═══════════════════════════════════════════════════════════════
{ const s=pres.addSlide(); sectionDiv(s,"SECTION 8\nConclusion"); }

// ═══════════════════════════════════════════════════════════════
// SLIDE 44 – CONCLUSION
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);
  s.addShape(pres.ShapeType.rect,{x:0,y:0,w:10,h:0.95,fill:{color:C.teal},line:{color:C.teal}});
  s.addText("CONCLUSION",{x:0.3,y:0.18,w:9.4,h:0.6,fontSize:16,bold:true,color:C.white,align:"center",charSpacing:4,fontFace:"Calibri"});
  s.addShape(pres.ShapeType.roundRect,{x:0.4,y:1.05,w:9.2,h:1.05,fill:{color:"1A3A55"},line:{color:C.gold,pt:2},rectRadius:0.12});
  s.addText("So — can we predict tooth decay before it happens?  YES.",{x:0.6,y:1.12,w:8.8,h:0.45,fontSize:17,bold:true,color:C.gold,align:"center",fontFace:"Calibri"});
  s.addText("CRA tools give us structured, evidence-based frameworks to do exactly that.",{x:0.6,y:1.6,w:8.8,h:0.42,fontSize:13,color:C.white,align:"center",italic:true,fontFace:"Calibri"});
  bullets(s,[
    "Caries risk assessment is a standard of care and should be part of every dental examination.",
    "No single tool is universally superior — choose based on patient age, setting, and available resources.",
    "CAMBRA and Cariogram have the strongest evidence base and highest concordance with each other.",
    "For India's diverse population, locally validated and culturally adapted CRA tools are essential.",
    "Emerging technologies — AI, salivary biomarkers, genetic markers — will further enhance precision.",
    "The ultimate goal is not just to detect disease, but to prevent it from ever occurring.",
  ],0.4,2.25,9.2,3.0,C.white,13);
}

// ═══════════════════════════════════════════════════════════════
// SLIDE 45 – REFERENCES
// ═══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  lightSlide(s); accentBar(s); heading(s,"References");
  const refs=[
    "1. Gannam CV, Chin KL, Gandhi RP. Caries risk assessment. Gen Dent. 2018;66(6):12-17.",
    "2. Anup N, Vishnani P. Cariogram: A multi-factorial risk assessment software for risk prediction of dental caries. Intl J Sci Study. 2014;1(4):58-62.",
    "3. Suneja ES, Suneja B, Tandon B, Philip NI. An overview of caries risk assessment. Indian J Dent Sci. 2017;9:210-218.",
    "4. American Academy of Pediatric Dentistry. Caries-risk Assessment and Management for Infants, Children, and Adolescents. Pediatr Dent. 2019;41(6):220-224.",
    "5. Featherstone JDB, et al. A comparison of four caries risk assessment methods. Front Oral Health. 2021;2:656681.",
    "6. Agouropoulos A, et al. Validation of three caries risk assessment tools for preschool children from areas with high caries prevalence. Pediatr Dent. 2014;36(3):221-228.",
    "7. MacRitchie HMB, et al. Development and testing of the Dundee Caries Risk Assessment Model (DCRAM). Community Dent Oral Epidemiol. 2012;40(1):37-43.",
    "8. Seetha Lakshmi B, et al. CRA-RT: A simple, valid and reliable novel risk scoring system for ECC. Community Dent Oral Epidemiol. 2020.",
    "9. Jawdekar AM. CRAFT approach: Chairside caries risk assessment tool for children. J Indian Soc Pedod Prev Dent. 2020.",
    "10. Zero DT, Zandona AF, Vail MM, Spolnik KJ. Dental caries and pulpal disease. Dent Clin North Am. 2011;55(1):29-46.",
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// ═══════════════════════════════════════════════════════════════
// SLIDE 46 – THANK YOU (bonus, makes a clean end)
// ═══════════════════════════════════════════════════════════════
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