Abstract
BackgroundThe main purpose of this study was to compare the 30% of Nevada Youth who presented with the highest Decayed Missing and Filled Teeth (DMFT) index to a cohort who were caries free and to national NHANES data. Secondly, to explore the factors associated with higher caries prevalence in those with the highest DMFT scores compared to the caries-free group.MethodsOver 4000 adolescents between ages 12 and 19 (Case Group: N = 2124; Control Group: N = 2045) received oral health screenings conducted in public/private middle and high schools in Nevada in 2008/2009 academic year. Caries prevalence was computed (Untreated decay scores [D-Score] and DMFT scores) for the 30% of Nevada Youth who presented with the highest DMFT score (case group) and compared to the control group (caries-free) and to national averages. Bivariate and multivariate logistic regression was used to analyze the relationship between selected variables and caries prevalence.ResultsA majority of the sample was non-Hispanic (62%), non-smokers (80%), and had dental insurance (70%). With the exception of gender, significant differences in mean D-scores were found in seven of the eight variables. All variables produced significant differences between the case and control groups in mean DMFT Scores. With the exception of smoking status, there were significant differences in seven of the eight variables in the bivariate logistic regression. All of the independent variables remained in the multivariate logistic regression model contributing significantly to over 40% of the variation in the increased DMFT status. The strongest predictors for the high DMFT status were racial background, age, fluoridated community, and applied sealants respectively. Gender, second hand smoke, insurance status, and tobacco use were significant, but to a lesser extent.ConclusionsFindings from this study will aid in creating educational programs and other primary and secondary interventions to help promote oral health for Nevada youth, especially focusing on the subgroup that presents with the highest mean DMFT scores.
Highlights
The main purpose of this study was to compare the 30% of Nevada Youth who presented with the highest Decayed Missing and Filled Teeth (DMFT) index to a cohort who were caries free and to national National Health and Nutrition Examination Survey (NHANES) data
Some suggest that mean DMFT does not accurately reflect this skewed distribution leading to incorrect conclusions that the caries situation for the whole population is under control, while in reality population subgroups still suffer from high caries rates
This study included an equal proportion of males and females (49% male; 51% female), with an approximately equal proportion split between areas with community water fluoridation (46%) and those without community water fluoridation (54%)
Summary
The main purpose of this study was to compare the 30% of Nevada Youth who presented with the highest Decayed Missing and Filled Teeth (DMFT) index to a cohort who were caries free and to national NHANES data. There has been a significant decline in dental caries prevalence since the early 1970s, oral disease, including caries, remains a major public health challenge [2,3,4]. The decayed, missing, and filled teeth (DMFT) index is commonly accepted by the dental community for measuring caries prevalence in the population and has been used repeatedly in the National Health and Nutrition Examination Survey (NHANES) [4]. WHO reported that oral disease, including dental caries, remains a major public health challenge [2]. In the USA, dental caries is the single most common childhood disease, occurring 5 times more frequently than asthma and 7 times more than hay fever [3]
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