Untreated Coronal Caries Research Articles

Depression and dental caries in US adults, NHANES 2015–2018

PurposeThis study aimed to investigate the link between depression and untreated dental caries among adults in the United States.MethodsData were collected from the National Health and Nutrition Survey (2015–2018); respondents aged 20 years or older who completed a patient health questionnaire and underwent a comprehensive oral examination were included. Participants were categorized into three groups according to depressive symptoms as follows: those with no, mild, or moderate to severe depression. Data were weighted, and multiple potential covariates were included in the analysis to provide national estimates and account for the complex sample design. A multivariable weighted logistic regression model was performed to test the hypothesis that varying degrees of depression in American adults are associated with untreated dental caries. Subgroup analyses were performed based on age and gender after adjusting for potential covariates. A P value of <.05 was considered significant.ResultsAmong 8740 participants, the prevalence of untreated coronal and root caries was 20.50% and 12.92%, respectively. Moderate to severe depression was a significant risk factor (odds ratio, 1.25; 95% confidence interval, 1.09–1.66) for untreated root caries. The risk of untreated root caries increased by 87% in young adults (aged 20–44 years) and by 46% in women with moderate to severe depression. The suest analysis revealed that the impact of moderate to severe depressive disorder on untreated root caries was non-significantly different between the age subgroup (p=0.09) and sex subgroup (p=0.51). However, depression was non-significantly associated with untreated coronal caries (mild depression: OR, 1.07; 95% CI, 0.85–1.34; moderate to severe depression 1.06; 95% CI, 0.83–1.36; respectively).ConclusionThe results of this study suggested a significant association between moderate and severe depression and untreated root caries; however, the association with untreated coronal caries was non-significant. In the United States, moderate and severe depression in adults is associated with root caries.

Association of Interdental Cleaning and Untreated Root Caries in Adults in the United States of America

PurposeThis study aimed to evaluate the association between interdental cleaning and untreated root caries amongst middle-aged and older adults in the US. Materials and methodsData were obtained from the National Health and Nutrition Examination Survey (NHANES) (2015–2016 and 2017–2018). Adults aged ≥40 years who underwent full mouth examination and root caries assessment were included. Participants were classified based on their interdental cleaning frequency as none, 1–3 d/wk, and 4–7 d/wk. Associations between interdental cleaning and untreated root caries were assessed using a weighted multivariable logistic regression model adjusted for sociodemographics, general behaviour, general health condition, oral conditions, oral health behavior, and dietary factors. Subgroup analyses stratified by age and sex were performed after adjusting for covariates in the logistic regression models. ResultsThe prevalence of untreated root caries was 15.3% amongst 6217 participants. Interdental cleaning for 4–7 d/wk was a significant risk factor (odds ratio, 0.67; 95% confidence interval, 0.52–0.85). It was associated with a 40% reduction in the risk of untreated root caries in participants aged 40 to 64 years and a 37% reduction in women. Untreated root caries was also significantly associated with age, family income, smoking status, root restoration, number of teeth, untreated coronal caries, and recent dental visit. ConclusionsInterdental cleaning for 4–7 d/wk was associated with fewer untreated root caries amongst middle-aged adults and women in the US. The risk of root caries increases with age. Low family income was a risk indicator for root caries amongst middle-aged adults. Additionally, smoking, root restoration, number of teeth, untreated coronal caries, and recent dental visits were common risk factors for root caries in middle-aged and older people in the US.

Dentition and nutritional status of aged New Zealanders living in aged residential care.

Previous studies of the nutritional status of older individuals have used measures such as plasma vitamin and mineral levels, which can be difficult to interpret. The relationship between nutrition and dentition has been limited to studying exposures such as the number of posterior occluding pairs of teeth, edentulousness, and the number of natural teeth. To investigate the association between dentition status and nutritional status in a national survey of older New Zealanders living in aged residential care facilities. Secondary analysis of clinical oral status and nutrition data collected in 2012 in New Zealand's Older People's Oral Health Survey. The validated Mini Nutritional Assessment short format was used to categorize participants as "normal nutritional status," "at risk of malnutrition" or "malnourished." Just under half of older New Zealanders living in aged residential care facilities were classified as either at risk of malnutrition or malnourished (with about one in sixteen in the latter category). The prevalence of malnutrition was higher among those in hospital-level and psychogeriatric-level care, as well as in those of high socioeconomic status. Individuals who were at risk of malnutrition had the most untreated dental caries and untreated coronal caries. Relative to their counterparts in nursing-home-level care, dentate individuals in hospital-level care were 2.4 times-and those in psychogeriatric-level care were 2.8 times-as likely to be malnourished or at risk of it. Just under half of the New Zealanders living in aged residential care were at risk of malnutrition or were malnourished. Greater experience of untreated dental caries was associated with a higher rate of being malnourished or at risk of it. Poorer cognitive function and greater dependency were important risk indicators for malnutrition.

The Healthy Eating Index and coronal dental caries in US adults: National Health and Nutrition Examination Survey 2011-2014

BackgroundThe purpose of this cross-sectional study was to determine if Healthy Eating Index (HEI-2015) scores are associated with coronal caries and the odds of untreated coronal caries in adults 20 years and older. MethodsData on decayed, missing, and filled teeth (DMFT), untreated coronal caries, and HEI-2015 scores were obtained from 7,751 adults who completed a dental examination and two 24-hour dietary recalls in National Health and Nutrition Examination Survey cycles 2011-2012 and 2013-2014. HEI-2015 scores were categorized into quintiles, with HEI-2015 quintile 1 scores indicating the least compliance with 2015-2020 Dietary Guidelines for Americans. The authors used multivariable linear regression to assess associations of HEI-2015 with DMFT and logistic regression for associations with untreated coronal caries. All regression models were controlled for age, sex, race or ethnicity, current cigarette use, family income to poverty threshold ratio, last dental visit, education, and whether participants were ever told they had a heart attack. ResultsRelative to HEI-2015 quintile 1, the adjusted odds of any untreated coronal caries were quintile 5 (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.46 to 0.80), quintile 4 (OR, 0.66; 95% CI, 0.53 to 0.84), quintile 3 (OR, 0.76; 95% CI, 0.56 to 1.04), and quintile 2 (OR, 0.93; 95% CI, 0.66 to 1.31). Participants who met the recommendations for the total fruits, whole fruits, greens and beans, and added sugars components of the HEI-2015 score were less likely to have untreated coronal caries than those who did not meet the recommendations. Overall, mean coronal DMFT also decreased as HEI-2015 scores increased, but trends were not consistent in all racial or ethnic groups. Conclusions and Practical ImplicationsGreater compliance with the Dietary Guidelines for Americans is associated with lower prevalence and the odds of untreated caries in adults. Dietary counseling for caries prevention by dental professionals should incorporate comprehensive dietary guidelines that are consistent with those intended for enhancing overall health and reducing the risk of developing common systemic diseases.

Depressive symptoms and untreated coronal dental caries among adults ages 21-64 years, NHANES 2013-2014.

Depression has been linked to poor oral health among patients seeking dental care. However, systematic research on the relationship between depressive symptoms and oral health is limited. To examine the association of depressive symptoms with untreated dental caries among adults aged 21-64 years. Cross-sectional secondary analysis. The data were extracted national data collected in the United States (2013-2014 National Health Nutrition and Examination Survey). The sample consisted of 3,127 non-institutionalized civilians. Untreated coronal dental caries (yes, no) was the key outcome variable. Depressive symptom categories (none, moderate, and severe) were derived from the Patient Health Questionnaire-9 Depression Scale. In the study sample, 33.4% of adults had untreated coronal dental caries. Most participants (77.9%) did not report depressive symptoms; 13.9% had mild and 8.2% had moderate or severe depressive symptoms. In unadjusted analyses, individuals with mild (Odds Ratio = 1.62 [95% CI: 1.26, 2.08] and moderate/severe depressive symptoms (Odds Ratio = 2.70 [95% CI: 1.81, 4.02]) were more likely to have untreated coronal caries as compared with individuals without depressive symptoms. When sex, race, age, education, family income-to-poverty ratio, dental visits, history of previous dental restorations, health insurance, and smoking were included into the model, the associations were no longer statistically significant (1.27 [95% CI: 0.96, 1.69] and 1.61 [95% CI: 0.95, 2.73], respectively). The relationship between depressive symptoms and untreated coronal dental caries failed to remain significant after the addition of tobacco usage in the analysis.

Disparities in untreated caries among children and adults in the U.S., 2011\u20132014

BackgroundThe Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults. Few studies in current scholarship make use of up-to-date, nationally representative data to examine oral health disparities in the U.S. population. The purpose of this study is to use nationally representative data to determine the prevalence of untreated caries among children and adults of different socioeconomic and racial/ethnic groups and to examine the factors associated with untreated caries among children and adults.MethodsThis study used the 2011–2014 National Health and Nutrition Examination Survey (NHANES) demographic, oral health questionnaire, and oral health dentition examination data (n = 7008 for children; n = 9673 for adults). Participants that had a standardized oral health examination and at least one natural primary or permanent tooth considering 28 tooth spaces were included in this study. Our main outcome measure was untreated coronal caries defined as decay on the crown or enamel surface of a tooth that had not been treated or filled. Population estimates were calculated to determine the prevalence of untreated caries among children and adults in the United States. Frequencies and Pearson’s chi-square tests were used to compare those with and without untreated caries. Multivariate logistic regression models were used to evaluate the factors associated with untreated caries. We conducted analyses among children and adults separately.ResultsFrom 2011 to 2014, 12.4 million children and 57.6 million adults in the United States had untreated caries. Age, family income level, recent dental visit, and financial and non-financial barriers were significantly associated with untreated caries in both children and adults. Race/ethnicity, gender and education level were also significantly associated with untreated caries among adults. The odds of untreated caries associated with financial barriers were 2.06 for children and 2.84 for adults while the odds of untreated caries associated with non-financial barriers were 2.86 for children and 1.67 for adults.ConclusionsDemographic and socio-economic disparities in untreated caries exist among children and adults.

Dental caries in Victorian nursing homes.

The poor oral health of nursing home residents is the cause of substantial morbidity and has major implications relating to health care policy. The aim of this study was to measure dental caries experience in Australians living in nursing homes, and investigate associations with resident characteristics. Clinical dental examinations were conducted on 243 residents from 19 nursing homes in Melbourne. Resident characteristics were obtained from nursing home records and interviews with residents, family and nursing home staff. Two dental examiners assessed coronal and root dental caries using standard ICDAS-II criteria. Residents were elderly, medically compromised and functionally impaired. Most required assistance with oral hygiene and professional dental care was rarely utilized. Residents had high rates of coronal and root caries, with a mean 2.8 teeth with untreated coronal caries and 5.0 root surfaces with untreated root caries. Functional impairment and irregular professional dental care were associated with higher rates of untreated tooth decay. There were no significant associations with medical conditions or the number of medications taken. Nursing home residents have high levels of untreated coronal and root caries, particularly those with high needs due to functional impairment but poor access to professional services.

Co‐Relationships between glandular salivary flow rates and dental caries

This study was designed to evaluate the relationship of age, gender, ethnicity and salivary flow rates on dental caries in an adult population using data collected from the Oral Health San Antonio Longitudinal Study of Aging (OH: SALSA). Saliva is essential to maintain a healthy oral environment and diminished output can result in dental caries. Although gender and age play a role in the quantity of saliva, little is known about the interaction of age, gender and ethnicity on dental caries and salivary flow rates. Data from the 1147 participants in the OH: SALSA were analysed. The dependent variables were the number of teeth with untreated coronal caries, number of teeth with root caries and the number of coronal and root surfaces with untreated caries. The independent variables were stimulated and unstimulated glandular salivary flow rates along with the age, sex and ethnicity (e.g. European or Mexican ancestry) of the participants. Coronal caries experience was greater in younger participants while root surface caries experience was greater in the older participants. Coronal caries was lower in the older age groups while the root caries experience increased. Men had a statistically significant (p < 0.02) higher experience of root caries than women. Values for unstimulated and stimulated parotid salivary flow rates showed no age difference and remained constant with age, whereas the age differences in the unstimulated and stimulated submandibular/sublingual salivary flow rates were significant. The mean number of teeth with coronal and root caries was higher in Mexican-Americans than in European-Americans. Over one-fourth of the adults between the ages of 60 and 79 have untreated root caries over one-third having untreated coronal caries. Lower salivary flow rates play a significant role in both the number of teeth and the number of surfaces developing caries in these adults. Women and individuals of European-American ancestry experience less caries.

The oral health of ageing baby boomers: a comparison of adults aged 45–64 and those 65 years and older

To compare the oral health status of adults aged 45-64 (baby boomers) and those aged 65 and older. An observational, cross-sectional survey of adults living independently in rural and urban settings in Nova Scotia, Canada was conducted. Using random digit dialing, calibrated interviewers completed a telephone survey, and clinicians calibrated to WHO standards conducted clinical examinations. Weighting was used to correct for sampling bias. 747 community dwelling adults completed both the clinical exam and the questionnaire (n=411, age 45-64; n=336, age 65 or older). Rates of edentulism were low (2.6% aged 45-64; 15.7% aged 65+; p<0.001). Untreated root caries was greater in the older dentate group (19.7 vs. 10.1%; p<0.001). Being 65 years of age or older was identified as a predictor of increased decayed, missing, filled teeth, presence of decayed and/or filled roots and presence of attachment loss≥4 mm, but was not a significant predictor of presence of untreated coronal caries. A falling rate of edentulism and a higher risk for root caries with increasing age may predict the need for more complex dental care as our population ages.

Novel technologies for the prevention and treatment of dental caries: a patent survey

Importance of the field: Dental caries is one of the most common preventable childhood diseases; people are susceptible to this ailment throughout their lifetime. In the US, 90% of late adolescents and young adults have dental caries, while 94% of all dentate adults had evidence of treated or untreated coronal caries. Dental caries is often not self-limiting and without proper care can progress until the tooth is destroyed.Areas covered in this review: In this paper, the etiology of dental caries is briefly introduced. It is followed by a thorough review of patents and literatures on the recent development of various novel technologies for the prevention and treatment of dental caries.What the reader will gain: Recent advances in anti-plaque agents, including chemoprophylactic agents, antimicrobial peptides, vaccines, probiotics/replacement therapy and sugar substitutes, and remineralization agents including fluorides and casein phosphopeptides are analyzed.Take home massage: Both the discovery of new anti-caries agents and the development of dentotropic delivery systems will be the future focus of this research field.

Home or away? Differences between home‐ and clinic‐based dental examinations for older people

To determine whether home-based and clinic-based dental examinations of older people are comparable. Despite a number of studies which have examined the concordance between different examiners or examination circumstances, none has directly compared an oral examination conducted at home with one conducted in an appropriate clinical setting. Dentate participants (n = 61) aged between 65 and 74 years underwent two clinical examinations, one in a conventional dental clinic and the other in the person's home. Kappa statistics, intra-class correlation coefficients and 'Difference against mean' plots were used to determine the nature and extent of any bias. The summary estimates for missing teeth and dental caries were close, although the home-based examinations resulted in a lower estimate of the mean number of decayed teeth and of untreated coronal decay. The lowest reliability statistics were observed with respect to the prevalence of untreated coronal caries, filled root surfaces and root surface (Decayed or Filled Surfaces) DFS. The periodontitis prevalence estimates were closer, but the reliability statistics were relatively low. The extent of bleeding on probing was relatively under-estimated in the home-based examinations. 'Difference against mean' plots indicated that, overall, the clinic-based examinations detected more disease (although this was not observed for all clinical parameters which were measured). While clinic-based examinations will remain the preferred option, the potential loss of information associated with home-based examinations is unlikely to be great enough to preclude using them where required, although surveys with larger samples (and therefore more accurate estimates) should restrict their proportion of home-based examinations to no more than 10%. As they are less precise, surveys with samples of 300 or fewer can safely accommodate up to about one-third of their examinations being conducted in participants' homes.

Oral health status of the elderly in a residential home in Turkey

To determine the oral health status and treatment needs of elderly residents of a residential home in Ankara, Turkey. Little is known about oral health problems of elderly living in the institutions. Among 216 elderly, 193 of them were interviewed and were clinically examined according to WHO criteria. Age, gender, educational and occupational status, oral hygiene practices, dental insurance, access to dental care and systemic diseases were recorded using a structured questionnaire. Coronal and root caries, periodontal disease, dental status and related treatment needs were assessed by two calibrated dentists. The mean age of the subjects were 75.2 +/- 8.3 in males, 79.1 +/- 7.9 in females; 32.6% of subjects were dentate and the mean number of teeth was 3.7 +/- 7.0 (median = 0). A functional dentition was present in 7.3% of subjects (>or=20). The mean decayed, missing and filled teeth (DMFT) was 29.3 +/- 5.8 (median = 32) and mean root caries was 2.2 +/- 3.1 (median = 1.0). The major reason for tooth extraction was dental caries. Of the subjects, 20.7% had at least one untreated coronal caries and 18.1% root caries. The assessment of periodontal status according to CPI revealed that only four persons had nine healthy sextants with the score of '0'. Edentulousness was 67.4% while 11.9% of them lacked denture in both jaws. The results illustrated poor dental health and showed extremely high demand for the dental health services programmes for the elderly living in these institutions.

Prosthetic crowns and other clinical risk indicators of caries among old-old Swedish adults: findings from the KEOHS Project. Kungsholmen Elders Oral Health Study.

The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, community-dwelling persons over the age of 80 living in Kungsholmen, Sweden. This paper explored possible clinical risk indicators of coronal and root caries among the KEOHS subjects. In this cross-sectional study, dentate KEOHS subjects received a caries assessment using defined visual, tactile criteria. Examinations were carried out in two local clinics by standardized examiners. One hundred twenty-nine dentate persons were examined. The examination identified decayed and filled surfaces, prosthetic crowns, and missing teeth. More root than coronal surfaces had untreated decay, and secondary root caries contributed the greatest number of decayed surfaces. Ninety percent of the examined dentate subjects had at least one prosthetic crown. Root surfaces exposed to crown margins were more likely to have caries than root surfaces not so exposed, particularly among women. The presence of untreated coronal caries (yes/no) was positively associated with having untreated root caries and an intermediate number (14-20) of teeth, but inversely associated with having 4+ prosthetic crowns. Active root caries (yes/no) was positively associated with having untreated coronal caries, 14-20 teeth, and 4+ prosthetic crowns. Nearly 20% of identified root lesions were present at or below the gingival margin, and most (88%) were secondary caries associated with crown margins (65%) or other restorations (23%). Our findings suggest that some dental characteristics, including the presence of prosthetic crowns, are risk indicators for the presence of untreated coronal and root caries.

Functional status and untreated dental caries among nursing home residents aged 65 and over.

This descriptive study examined the relationship between untreated dental caries and functional status among 958 dentate nursing home residents aged 65 and over. Functional status was measured by the Physical Self-Maintenance Scale (PSMS). The PSMS assessment revealed that 32% of subjects were unable to perform all activities, and only 10% could perform all activities. Overall, 59% of subjects had untreated coronal decay and 46% had untreated root decay. In bivariate analysis, untreated coronal and root caries experiences were significantly associated with PSMS limitations, lack of dental care utilization, sex, and number of remaining teeth. Stratified analysis suggested an interaction between functional status and dental care utilization. Among subjects who had received dental care in the preceding year, PSMS status was not significantly related to untreated caries experience; but among subjects who had not received care, PSMS status was significantly related to untreated caries experience. In logistic regression analysis of untreated root decay, a significant interaction was found between PSMS status and dental care utilization. However, in logistic regression analysis of untreated coronal caries, no significant interaction was found; significant independent effects were found for dental care utilization and number of remaining teeth, but not for PSMS status.