Association between root/coronal caries and individual factors in institutionalised elderly using ICDAS severity and activity

Margarita Usuga-Vacca,Dairo Javier Marin-Zuluaga,Stefania Martignon,Jaime Eduardo Castellanos

doi:10.1186/s12903-021-01520-4

Margarita Usuga-Vacca, Dairo Javier Marin-Zuluaga + Show 2 more

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https://doi.org/10.1186/s12903-021-01520-4

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Abstract

BackgroundCaries in the elderly has been associated with dependence, oral-health status and -care practices. This cross-sectional study aimed to investigate the association between root/coronal caries and individual factors among institutionalised elderly people in Bogotá, Colombia, using the International Caries Detection and Assessment System severity and activity criteria (ICDAS).MethodsA total of 226 institutionalised elderly were clinically examined for root and coronal caries in 40 institutions. Caries risk was assessed with Cariogram, and demographics, oral health knowledge and practices, oral health-related quality of life and denture-use habits using a questionnaire.ResultsParticipants (mean age: 80.1 ± 9.3 years; 63.7% female) presented a mean number of 10.8 ± 7.3 teeth and 19.4 ± 18.8 exposed root surfaces. Prevalence of Coronal-ICDAS caries experience (C-ICDAS DF) was of 100% and of 54.4% for C-ICDAS D; mean number of C-ICDAS DFS was 16.76 ± 27.36, with 50.9% of subjects having ≥ one active C-ICDAS DS. Prevalence of Root Caries Index was of 49.1% and of R-ICDAS DF of 46%; mean number of R-ICDAS DFS was 2.03 ± 2.78, with 40.3% of subjects having ≥ one active R-ICDAS DS. Most individuals had a systemic condition (94.2%) and required oral-hygiene assistance (58%). Logistic regression analyses showed significant associations (p < 0.05): for coronal active caries when having over six teeth (OR: 2.7), and for root caries, when having coronal caries (OR: 2.41), being a man (OR: 1.95), and having over 14 teeth (OR: 0.30). Those presenting with > eight exposed root surfaces were 4.04 more likely to have root caries and 2.4 times more likely to have active root caries.ConclusionIn the institutionalised elderly population in Bogotá significant associations were found, both for the presence as for the activity status of root and coronal caries, with individual clinical factors including coronal caries, exposed root surfaces and number of teeth.

Highlights

Caries in the elderly has been associated with dependence, oral-health status and -care practices
Frailty and dependence are common among institutionalised elderly people [5, 6] and are associated with a higher likelihood of having oral health problems, such as dental caries [5, 7]
The sample size was calculated with the sample calculation software 1.1®, based on the epidemiological data of prevalence of caries experience (DMF coronal caries lesions) of of 96.3% among the elderly obtained from the 2015 National Oral Health Survey [2], anticipating a similar corresponding prevalence and considering a proportion of oversample of 10% for possible drop-out of subjects during acquisition of clinical exam and surveys

Summary

Introduction

Caries in the elderly has been associated with dependence, oral-health status and -care practices. An increase in the number of retained teeth [7,8,9] and those with pre-existing root caries lesions, plaque [9,10,11], coronal caries [12, 13], exposed root surfaces [10,11,12,13,14] and hyposalivation [15] and intake of free sugar [16, 17] have been described as risk factors for root caries [16, 17]. Root Caries Index (RCI) is one of the most frequently used epidemiological indices to measure the root caries experience at the tooth/surface level [18, 19] This conventional index quantifies in teeth with exposed roots, the cavitated caries lesions (D) and fillings (F)

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