Correlates of root caries experience in middle-aged and older adults in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network

Abstract

STRUCTURED ABSTRACT Background We examined the correlates of root caries experience for middle-aged (ages 45–64 years) and older adults (ages 65+ years) to test the hypothesis that the factors related to root caries are different for middle-aged versus older adults. Methods This observational cross-sectional study focused on adult patients ages 45–97 years recruited from the Northwest PRECEDENT (N=775 adults). The outcome variable was any root caries experience (no/yes). Sociodemographic, intraoral, and behavioral factors were hypothesized as potential root caries correlates. We used Poisson regression models to generate overall and age-stratified prevalence ratios (PR) of root caries and Generalized Estimating Equations to account for practice-level clustering of participants. Results About 20% of adults had any root caries. Dentists’ assessment that the patient was at high risk for any caries was associated with greater prevalence of root caries experience in both middle-aged adults (PR=2.70, 95% CI: 1.63,4.46) and older adults (PR=1.87, 95% CI: 1.19,2.95). The following factors were significantly associated with increased root caries prevalence, but only for middle-aged adults: male sex (P=.02), self-reported dry mouth (P<.0001), exposed roots (P=.03), and increased frequency of eating or drinking between meals (P=.03). No other covariates were related to root caries experience for older adults. Conclusions Within a practice-based research network, the factors associated with root caries experience were different for middle-aged and older adults. Future work should identify relevant root caries correlates for adults ages 65+ years. Clinical Implications Interventions aimed at preventing root caries are likely to be different for middle-aged and older adults. Root caries prevention programs should address the appropriate aged-based risk factors.

Risk indicators associated with root caries in independently living older adults

“…Therefore, while published studies include calibration of examiners and report good inter and intra-examiner reliability, examiners working on different studies are working to different criteria for root caries diagnosis and working under different examination conditions. This (combined with differences in geographic location, population characteristics and sampling procedures) may explain the variability in reported root caries experience between studies with some studies reporting a root caries prevalence of 100% [29] and others reporting 25% [8].…”

“…An increase in exposed root surfaces in the over 65 age group predisposes this group to a higher prevalence of root caries than younger populations [5]. Estimating the prevalence of root caries can be challenging as loss of teeth confounds the data and diagnostic criteria and methods of reporting the data differ between studies [6][7][8].…”

The Dietary Approaches to Stop Hypertension Diet and New and Recurrent Root Caries Events in Men

“…Another limitation is the lack of information about whether sugary foods were consumed at mealtime or between meals, which may affect cariogenicity . Lastly, dietary quality may be a marker of a generally healthier lifestyle and regular medical and dental care.…”

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“…Looking specifically at dental factors that are associated with root caries, self‐reported dry mouth, number of teeth at baseline and gingival recession have been associated with root caries. Among elders, surfaces with visible plaque, denture contact and more prominent gingival recession are areas that are likelier to get affected by root caries .…”