Caries Risk Assessment in a Longitudinal Discrimination Study

Leverett, Dennis H.; Proskin, Howard M.; Featherstone, J.D.B.; Adair, Steven M.; Eisenberg, A.D.; Mundorff-Shrestha, S.A.; Shields, C.P.; Shaffer, Carrie L.; Billings, Ronald J.

doi:10.1177/00220345930720021101

Cited by 87 publications

(71 citation statements)

References 10 publications

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“…Unfortunately, there is no simple, valid, and reliable caries risk assessment model currently available. Previous caries experience and/or untreated (active) lesions are the best predictors for future caries development [Bibby and Shern, 1978;Disney et al, 1992;Leverett et al, 1993;Hausen et al, 1994;Vanobbergen et al, 2001;Featherstone et al, 2003]. However, these predictors are post-disease and do not serve well for early detection and primary prevention of the disease.…”

Section: Discussionmentioning

confidence: 99%

Association between Enamel Hypoplasia and Dental Caries in Primary Second Molars: A Cohort Study

Hong

Levy²,

Warren³

et al. 2009

Caries Res

116

126

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poplasia had a significantly higher risk for caries at age 5 and 9 after controlling for other risk factors. Enamel hypoplasia appears to be a significant risk factor for caries and should be considered in caries risk assessment. Copyright © 2009 S. Karger AG, Basel Developmental enamel defects are disturbances during enamel formation and may be manifested as enamel hypoplasia or opacities. Enamel hypoplasia is a quantitative defect associated with reduced thickness of enamel formed during the secretory stage of amelogenesis [Suckling, 1989;Seow, 1991]. Developmental enamel defects, such as hypoplasia, have been speculated to increase the risk of dental caries in the affected teeth [Pascoe and Seow, 1994;Li et al., 1996;Lai et al., 1997]. Defective enamel sites (hypoplasia or hypocalcification) may provide suitable local environment for adhesion and colonization of cariogenic bacteria, and bacteria may retain at the base of the defect in contact with exposed dentin, thus dental caries on these defective sites may develop more rapidly [Li et al., 1996]. Defective enamel has higher acid solubility than normal enamel and is more susceptible to caries attack [Zheng et al., 1998]. The association between enamel hypoplasia and dental caries has been reported in several cross-sectional studies [Matee et al., 1994;Pascoe and Seow, 1994;Li et al., 1996;Ellwood and O'Mullane, 1996; Key Words Dental caries ؒ Enamel hypoplasia ؒ Primary teeth AbstractThe purpose of this study was to assess the longitudinal relationships between enamel hypoplasia and caries experience of primary second molars. The study sample was 491 subjects who received dental examinations at both age 5 and 9 by the calibrated examiners. Four primary second molars (n = 1,892) were scored for the presence of enamel hypoplasia for each participant. Caries presence and number of decayed and filled surfaces (dfs) were determined at age 5 and 9. The relationships between enamel hypoplasia and caries experience were assessed. Among primary second molars, 3.9% of children and 1.7% of primary second molars had enamel hypoplasia. At age 5, 36.8% of children with hypoplasia had caries, while 16.9% of children without enamel hypoplasia had caries. At age 9, the corresponding numbers were 52.6% for children with hypoplasia and 34.5% for children without hypoplasia, respectively. At the tooth level, for age 5, 28.1% of teeth with hypoplasia had caries (mean dfs = 0.40), and 7.6% of teeth without hypoplasia had caries (mean dfs = 0.11). At age 9, the corresponding numbers were 41.9% (mean dfs = 0.76) for teeth with hypoplasia and 18.3% (mean dfs = 0.34) for teeth without hypoplasia. In multivariable logistic regression analyses, teeth of subjects with enamel hy-

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Section: Discussionmentioning

confidence: 99%

Association between Enamel Hypoplasia and Dental Caries in Primary Second Molars: A Cohort Study

Hong

Levy²,

Warren³

et al. 2009

Caries Res

116

126

View full text Add to dashboard Cite

show abstract

“…Also, Kawasaki et al [2000] showed an effect of fluoride on remineralization of shallow (!165 Ìm) dentinal lesions with various mineral distributions. With an in situ model Nyvad et al [1997] showed -in comparison with non-treatment -that daily plaque removal and application of 2% NaF could inhibit progression and even result in partial remineralization of dentinal lesions Intra-oral fluoride levels between 0.04 and 0.1 ppm may be found in saliva and plaque fluid when a fluoride toothpaste or rinse is being used [Duckworth and Morgan, 1991;Leverett et al, 1993]. Fluoride levels in the subparts per million range have been shown to shift the deremineralization balance significantly in vitro [Jacobson et al, 1991], although it was observed that higher levels of fluoride were needed to attain a similar degree of caries prevention when compared with enamel [ten Cate, 1999].…”

Section: Discussionmentioning

confidence: 99%

Remineralization of Advanced Root Dentin Lesions in vitro

Mukai

Cate

2002

Caries Res

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The possibility for remineralization of advanced root dentin lesions was investigated in vitro. Lesions were produced in acidic buffer solution with 0.1 and 0.5 ppm fluoride, for 3 and 5 weeks, respectively, using a single-section model. Next, the sections were immersed in a remineralization solution containing 0.1 ppm F (as NaF) for 20 weeks. Microradiographs were made after each 4-week-period. The lesions were around 500 µm deep, with mineral loss values between 11,000 and 18,000 vol%·µm. After 20 weeks of remineralization, the absolute amounts of deposited mineral ranged from 7,500 to 10,000 vol%·µm, corresponding to a repair between 50 and 85%. Lesion depth was, on average, reduced by 199 µm. This was not significantly different (at p < 0.05) between the four experimental groups. This study showed that remineralization of advanced dentinal lesions is possible in spite of the virtual absence of mineral in the lesion body after demineralization. The surface layer of the lesion was the preferred site for mineral deposition until mineral content values reached those of sound dentine. The mineral content in the lesion body increased with time, at a rate reflecting the initial severity of the lesion. We conclude that a remineralized surface layer does not inhibit transport of mineral ions to the body and that the remineralization in the lesion body reflected the number of sites for crystal growth.

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“…Potentially positive risk factors and potential protective factors were combined as proposed in the scientific literature [Leverett et al, 1993]. 'Daily use of sugar containing drinks' was confirmed to be a behavioural risk factor.…”

Section: Validation Of Risk Indicatorsmentioning

confidence: 99%

“…In previously published studies a number of workers have attempted to identify high-risk individuals and groups with varying degrees of success, depending on the age group, the baseline caries experience and the caries incidence rate of the study group. Several studies use a combination of tests for caries prediction, stressing past caries experience or salivary counts [ter Pelk- , 1990;Helfenstein et al, 1991;Leverett et al, 1993]. Several other studies have examined the use of a wider range of factors in caries prediction, involving behavioural and socio-demographic factors.…”

Section: Risk Predictorsmentioning

confidence: 99%

The Value of a Baseline Caries Risk Assessment Model in the Primary Dentition for the Prediction of Caries Incidence in the Permanent Dentition

et al. 2001

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To establish a reliable screening method for caries prediction and to identify predominant risk factors, this study tested whether a cross–sectional caries risk model assessed at age 7 could be used to predict future caries onset in the permanent first molars at age 10 in 3,303 children born in 1989. As prediction variables, assessing the believed risk, baseline data at age 7 on oral health status, oral hygiene level, oral health behaviour and sociodemographic factors were used. The real risk, based on data collected for the first permanent molars during the follow–up, was assessed by different approaches. Cumulative incidence during the 3–year observation period was 31.6%, ranging from 22.4% in the believed low–risk group to 43.2% in the believed high–risk group. A stepwise logistic regression analysis was performed with net caries increment as outcome measure, adjusted for the real time at risk, using eruption times. Baseline dmfs and occlusal and buccal plaque indices were highly significant for having a high caries increment in permanent first molars with respective odds ratios of 1.07, 1.43 and 1.35. Brushing less than once a day and the daily use of sugar–containing drinks between meals were confirmed as risk factors (OR 2.43 and 1.25, respectively). The logistic regression analysis provided a sensitivity of 59–66% and a specificity of 65.7–72.8%, which indicates that the risk marker did not have an important predictive power. None of the socio–demographic and behavioural variables had enough predictive power at community level to be useful for identifying caries susceptible children. Even the power of dmfs at baseline must be considered modest.

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Caries Risk Assessment in a Longitudinal Discrimination Study

Cited by 87 publications

References 10 publications

Association between Enamel Hypoplasia and Dental Caries in Primary Second Molars: A Cohort Study

Association between Enamel Hypoplasia and Dental Caries in Primary Second Molars: A Cohort Study

Remineralization of Advanced Root Dentin Lesions in vitro

The Value of a Baseline Caries Risk Assessment Model in the Primary Dentition for the Prediction of Caries Incidence in the Permanent Dentition

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