Dental caries thresholds among adolescents in England, Wales, and Northern Ireland, 2013 at 12, and 15 years: implications for epidemiology and clinical care

Abstract

Background Dental caries is the most prevalent condition globally. Despite improvements over the past few decades, there remains a significant disease burden in childhood. Epidemiological surveys provide insight to disease patterns and trends, and have traditionally focused on obvious decay which are inconsistent with contemporary clinical criteria. This study examined the distribution of dental caries in 12- and 15-year-olds in England, Wales and Northern Ireland, by severity threshold, at surface, tooth and child level and explored its association with socioeconomic, psychological and behavioural factors. Methods Data from 12- and 15-year-olds in the 2013 Children’s Dental Health Survey (CDHS 2013) were analysed at three levels, taking account of dental caries thresholds which involved recording both clinical decay [visual enamel caries (AV) and above] and obvious decay [non-cavitated dentine lesions (2V) and above]. Negative binomial regression was used to identify factors associated with dental caries experience at both thresholds. Results The prevalence and severity of dental caries experience was higher among 15-year-olds at all levels. Visual change in enamel (AV) was by far the most common stage of caries recorded in both ages. The average number of surfaces with obvious decay experience, which has been the traditional epidemiological threshold, in 12- and 15-year-olds was 2.3 and 3.9 respectively. The corresponding values under the clinical decay threshold were higher, at 3.9 and 5.9 respectively. Visualisation of the distribution of dental caries at surface/tooth-level exhibited horizontal symmetry and to a lesser extent vertical symetry. In the adjusted models for both ages, country/region, school type, area deprivation, high frequency sugar consumption and irregular dental attendance were associated with greater caries experience in both groups. Dental anxiety was inversely associated with caries experience among 15-year-olds. Conclusion This research highlights the importance of recognising dental caries patterns by surface, tooth and child-level amongst adolescents and the value of reporting dental caries distribution by threshold in epidemiological surveys, including its relevance for clinical care. Inclusion of enamel caries reveals the extent of caries management required at a point when non-invasive care is possible, emphasising the importance of prevention through contemporary primary care, which includes supporting self-care.

New Method of Avoiding Underestimation of Caries Incidence and Its Association with Possible Risk Factors in Japanese University Students: A Prospective Cohort Study

“…The highest prevalence of dental caries of occlusal surfaces was in the lower first molar at baseline and at follow-up. First and second molars overall have a high risk for dental caries, and the prevalence of dental caries in occlusal surfaces is higher than that in proximal surfaces [36][37][38][39][40]. The trend in the present study was supported by these previous reports.…”

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model

“…A significant association was found between high DFA and poor oral health-related quality of life (OHRQoL), a multidimensional measure evaluating oral health status and its related functional and psychosocial impacts [ 87 ], in children [ 88 , 89 , 90 , 91 , 92 ] as well as adults [ 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. Significant relationships were also reported between high levels of DFA and measures of poor oral health (e.g., caries experience, gingival health, and toothbrushing frequency) in children [ 3 , 5 , 6 , 7 , 17 , 50 , 51 , 53 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 ] and adults [ 4 , 61 , 65 , 66 , 93 ,…”

“…Eighteen articles examined the relationship between oral health and dental attendance ( n = 4 pediatric, n = 14 adult). In children, irregular dental attendance was associated with DMFT [ 7 , 122 , 206 ] and poor OHRQoL [ 207 ]. In 13 studies of adults, irregular dental attendance was associated with poor oral health (e.g., DMFT and self-report of poor oral health) [ 8 , 56 , 66 , 96 , 100 , 125 , 135 , 160 , 167 , 169 , 171 , 208 , 209 ].…”

Prevalence of dental caries in the first permanent molar and associated risk factors among sixth-grade students in São Tomé Island

“…According to Petersen et al [ 3 ], the reason could be due to parents’ unawareness of oral health, lower education level, and relatively low-income family income; it is also possible that children are afraid of dental treatment, thus concealing the symptoms or not cooperating with the dentist. Researches have demonstrated that pit and fissure sealant can effectively prevent caries [ 26 ] and is closely related to the prevalence of caries among children aged 6–17 years old [ 27 ]. This survey showed that the caries filling rate and pit and fissure sealant rate in São Tomé Island were both at a low level, indicating that strengthening oral health education, implementing oral health promotion to schools, improving oral health care knowledge, and popularizing caries preventing measures are necessary.…”