Risk indicators for root caries in institutionalized elders.

Abstract

To investigate the risk indicators for root caries in institutionalized elders. Nonfrail elders living in 21 residential elderly homes who had at least 5 teeth with exposed roots were examined in this cross-sectional study. The dental examinations were conducted by one trained dentist in the elderly homes using a portable clinic light, mouth mirror, and dental explorer. Two-level logistic regression analyses, one using the presence of decay and the other using decay/filling in the root surface as the dependent variable, were conducted to study the relationship between root caries and a number of selected subject-level and site-level factors. A total of 306 elders with a mean age of 78.8 years were examined. Their mean DS-root and DFS-root scores were 1.3 and 2.1, respectively. Their mean root caries index score was 3.92. Results from the regression analyses revealed a positive correlation between the caries status of the root surfaces in the same subject (ICC1 =0.37, ICC2 =0.29, P < 0.001). Root surfaces with visual plaque, with denture contact, with more gingival recession, and in the upper anterior region were found to have a higher chance of being affected by root caries. Presence of plaque, proximity to denture, and gingival recession are important site-level risk indicators for root caries in institutionalized elders. More attention should be paid to plaque control on exposed root surfaces and avoiding placement of denture components close to roots so as to lower the risk of root caries in elders.