Abstract
The aim of this study was to examine the correlation among socio-behavioral factors, caries status and caries risk, calculated through Cariogram, in an adult population. Four hundred eighty subjects (mean age 40.73, SE ± 0.33) randomly selected from the municipal electoral registry consented to participate in the survey. Subjects were examined, and the International Caries Detection Assessment System (ICDAS) index was registered. A highly structured questionnaire was submitted to investigate (1) personal data (i.e., age, gender, educational level, job categorization), (2) life-style behavior (i.e., smoking and dietary habits), and (3) oral health behavior (i.e., tooth brushing, use of fluoride and dental check-up frequency). An evaluation of the mutans streptococci concentration in saliva was also performed. Information on caries-related factors was entered into the Cariogram in order to generate an individual caries risk profile for each subject. Multinomial logistic regression was performed using Cariogram levels as the dependent variable. The possible correlated variables were analyzed using the principal component analysis (PCA). Considering ICDAS scores, 5.62% of the sample had at least an initial decay (ICDAS = 1-2), whereas 40.83% of the sample presented at least one moderate decay (ICDAS = 3-4) and 17.08% a severe decay (ICDAS = 5-6). Decay at ICDAS levels 5-6 and more than 5 missing teeth were statistically associated with Cariogram scores (OR = 2.36, 95%CI = 1.83-3.03 and OR = 1.43, 95%CI = 1.13-1.82, respectively). The results suggest that the Cariogram model was able to identify caries-related factors in an adult population. A direct association among the risk categories from Cariogram, the caries status and some socio-behavioral variables was verified.
Highlights
Children are the primary recipients of caries prevention programs in the Western world, dental caries is still one of the primary causes of tooth loss among adults.[1,2,3,4] Among the clinical risk factors, mutans streptococci play an important role in the development of dental caries
Despite some studies reporting a high predictive value for Cariogram risk levels,[13,18] other studies have not found a correlation between caries experience and any single risk factor proposed by Cariogram.[17,19]
Little information exists on the performance of Cariogram in adult individuals,[10,13,14,15,16,17,18,19] so the aim of this study was to describe the relation among caries status, background variables and caries risk as calculated with Cariogram
Summary
Children are the primary recipients of caries prevention programs in the Western world, dental caries is still one of the primary causes of tooth loss among adults.[1,2,3,4] Among the clinical risk factors, mutans streptococci play an important role in the development of dental caries. The focus on the non-biological determinants of the disease (socio-behavioral and environmental factors) is essential.[5] A lower educational level has been statistically associated with greater severity of dental caries in adults.[6,7] Among the prediction models available,[8] Cariogram. Software has been developed and validated to illustrate graphically the chance of an individual avoiding caries in the near future.[9,10,11,12] Cariogram has been used to predict caries in children,[12] adults[13,14,15,16,17,18,19] and the elderly,[20] and the scientific evidence regarding its prediction efficiency is still questionable. Despite some studies reporting a high predictive value for Cariogram risk levels,[13,18] other studies have not found a correlation between caries experience and any single risk factor proposed by Cariogram.[17,19] The use of Cariogram in an adult population might be useful to try to modify caries-related behaviors and increase patients’ motivation
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