Root caries risk indicators: a systematic review of risk models

Abstract

Objective-To identify risk indicators that are associated with root caries incidence in published predictive risk models.Methods-Abstracts (n=472) identified from a MEDLINE, EMBASE, and Cochrane registry search were screened independently by two investigators to exclude articles not in English (n=39), published prior to 1970 (none), or containing no information on either root caries incidence, risk indicators, or risk models (n=209). A full-article duplicate review of the remaining articles (n=224) selected those reporting predictive risk models based on original/primary longitudinal root caries incidence studies. The quality of the included articles was assessed based both on selected criteria of methodological standards for observational studies and on the statistical quality of the modeling strategy. Data from these included studies were extracted and compiled into evidence tables, which included information about the cohort location, incidence period, sample size, age of the study participants, risk indicators included in the model, root caries incidence, modeling strategy, significant risk indicators/predictors, and parameter estimates and statistical findings.Results-Thirteen articles were selected for data extraction. The overall quality of the included articles was poor to moderate. Root caries incidence ranged fro m 12%-77% (mean±SD=45% ±17%); follow-up time of the published studies was ≤10 years (range=9; median=3); sample size ranged from 23-723 (mean±SD=264±203; median=261); person-years ranged from 23-1540 (mean±SD=760±556; median=746). Variables most frequently tested and significantly associated with root caries incidence were (times tested; % significant; directionality): baseline root caries (12; 58%; positive); number of teeth (7; 71%; 3 times positive, twice negative), and plaque index (4; 100%; positive). Ninety-two other clinical and non-clinical variables were tested: 27 were tested 3 times or more and were significant between 9% and 100% of the times tested; and 65 were tested but never significant. Conclusions-The root caries incidence indicators/predictors most frequently reported were root caries prevalence at baseline, number of teeth, and plaque index. This finding can guide targeted root caries prevention. There was substantial variation among published models of root caries risk in terms of variable selection, sample size, cohort location, assessment methods, incidence periods, association directionality, and analytical techniques. Future studies should emphasize variables frequently tested and often significant, and validate existing models in independent databases.

Tooth-surface-specific Effects of Xylitol

“…Although coronal caries is more prevalent than root caries, root caries is an increasingly important clinical problem in dentistry, with an annual incidence of 27% among older adults (Griffin et al, 2004;Ritter et al, 2010). Nonetheless, little research emphasis is given to preventing caries in adults and, specifically, to preventing root caries.…”

Cohort Study on Incidence of Coronal and Root Caries in Japanese Adults

“…The results revealed that the mean number of coronal decayed, missing, or filled tooth surfaces (DMFS) was 2.43, and that the mean number of root DFS was 0.43 in the placebo group. A systematic review 7) by Ritter et al reported that the incidence of root caries could be predicted by risk models, and that the most frequently described predictors of the incidence of root caries in published studies on risk models were the prevalence of root caries, the number of teeth, and the plaque index. Another report 1) , on the other hand, noted that the factors related to root caries differed more for middle-aged adults (aged 45-64 years) than for older adults (>65 years).…”

Patient-reported outcomes for immediate identification of dental care needs

“…: mucosa, saliva) and the risk of infection from an oral source are not identified. Periodontal attachment loss may be a good predictor of root caries incidence (29), but it is not assessed with the DMFT index.…”