Association of Enamel Caries Lesions with Oral Hygiene and DMFT among Adults

Abstract

The aim of this study was to evaluate the prevalence of enamel caries lesions and their association with tooth brushing frequency, tooth brushing quality, and past caries experience among Finnish adults. The study population comprised 46-year-old members of the Northern Finland Birth Cohort 1966 (n = 1,961). Caries lesions were examined and recorded at surface level using the International Caries Detection and Assessment System (ICDAS). The cut-off point for enamel caries was set to ICDAS score 3. The cut-off point for brushing frequency was twice daily. Visible plaque on buccal tooth surfaces represented brushing quality. Using enamel caries lesions (ICDAS_1–3) as a dependent variable, an adjusted logistic regression model was conducted to investigate the association with gender, brushing frequency, visible plaque, dentin caries lesions (ICDAS_4–6), teeth with restorations, extractions and fractures. Almost all participants (99%) had enamel and 40% had dentin caries lesions; the mean number of teeth with enamel caries lesions was 13.8 (SD 4.6). According to the adjusted logistic regression model, the high prevalence of ICDAS_1–3 lesions was associated with having visible plaque on more than 20% of teeth and having more than 13 restored teeth. In conclusion, the prevalence of enamel caries lesions is high among the Finnish adult population. The results of this study suggest that in addition to tooth brushing frequency, the presence of visible plaque seems to be critical when evaluating the association between tooth brushing and enamel caries.