Root surface and coronal caries in adults with type 2 diabetes mellitus

OBJECTIVES: To determine the effect of type 2 diabetes mellitus (DM) on coronal and root surface caries and to investigate some factors suspected of being related to or interacting with DM, that may be associated with coronal and root surface caries. METHODS: A stratified cross-sectional study was conducted in 105 type 2 diabetic patients and 103 non-diabetic subjects of the same age and gender. Coronal and root surface caries, exposed root surfaces, periodontal status, stimulated salivary functions, oral hygiene status, oral health behaviors, and counts of mutans streptococci and lactobacilli were measured. RESULTS: Type 2 diabetic patients compared with non-diabetic subjects had a higher prevalence of root surface caries (40.0% versus 18.5%; P = 0.001), a higher number of decayed/filled root surfaces (1.2 +/- 0.2 versus 0.5 +/- 0.1; P < 0.01) and a higher percentage of generalized periodontitis (98.1% versus 87.4%; P < 0.01); but the prevalence and decayed/filled surface of coronal caries was not significantly different (83.8% versus 72.8% and 8.0 +/- 9.4 versus 6.3 +/- 7.5 respectively). The factors associated with root surface caries included type 2 DM, a low saliva buffer capacity, more missing teeth, and existing coronal caries; whereas wearing removable dentures, more missing teeth, a high number of lactobacilli, and a low saliva buffer capacity were associated with coronal caries. CONCLUSION: Type 2 DM is a significant risk factor for root surface, but not for coronal caries. Periodontal disease should be treated early in type 2 diabetic subjects to reduce the risk of subsequent root surface caries.     

广东省55~74岁人群恒牙冠根龋病抽样调查报告(2015—2016年)

目的 了解广东省55~74岁人群恒牙冠根龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省55~64岁、65~74岁各288人,男女各半,城乡各半.按照第四次全国口腔健康流行病学调查方案中临床牙列检查方法和标准,使用CPI探针检查全口恒牙冠根龋情况.计算患龋率、龋均、充填率等.结果 55~64岁人群恒牙冠龋患病率为77.08%,龋均为2.94,充填率为21.87%;根龋患病率为59.38%,龋均为1.82,残根率为46.18%,充填率为9.18%.65~74岁人群恒牙冠龋患病率为81.25%,龋均为3.45,充填率为16.40%;根龋患病率为63.19%,龋均为2.34,残根率为50.35%,充填率为9.18%.55~64岁人群中,女性冠龋患病率(x2=7.862,P=0.005)及龋均(t=2.63,P=0.009)均高于男性,差异具有统计学意义;根龋龋均在城乡分布中有差异,农村高于城市,差异具有统计学意义(t=2.12,P=0.035).65~74岁人群中,女性冠龋龋均高于男性,差异具有统计学意义(t=2.47,P=0.014);根龋患病率(x2=4.837,P=0.028)及龋均(t=2.88,P=0.004)在城乡中有差异,农村高于城市.结论 广东省老年人群牙冠及根龋患病率较高,治疗率低,大部分龋齿未得到治疗.     

Type 1 diabetes mellitus and oral health: assessment of coronal and root caries

OBJECTIVES: The oral health of a large cohort of adult insulin-dependent diabetic patients (Type 1), diagnosed 24 years previously with juvenile onset, was comprehensively assessed. This paper describes the prevalence of coronal and root caries in this adult Type 1 diabetic population and evaluates demographic, dietary, behavioral, physiologic, salivary and medical variables associated with decayed and filled surfaces in the crown (DFS) or root (RDFS). METHODS: Type 1 diabetes mellitus subjects participating in this oral health evaluation had been monitored for 6-8 years as participants in the University of Pittsburgh, Department of Epidemiology, longitudinal study of medical complications associated with diabetes. Four hundred and six diabetic subjects received a comprehensive oral health examination during one of their regularly scheduled medical visits. Oral assessments included coronal and root caries, missing teeth, edentulism, periodontal status, soft tissue pathologies, salivary function and health behaviors. Sixteen diabetic subjects and one control subject were edentulous. Coronal and root caries data from the remaining 390 dentate diabetic subjects were compared with 202 dentate nondiabetic control subjects. RESULTS: The adult Type 1 diabetic subjects were not found to have significantly higher DFS rates as compared with our control subjects or published age-adjusted NHANES III findings. Both control and diabetic subjects had low decayed to filled tooth surface ratios. A linear regression model evaluated possible associations with coronal decayed and filled tooth surfaces (DFS) within the diabetic population. Significant factors included older age, women, fewer missing teeth, more frequent use of dental floss, more frequent visits to the dentist during the last 12 months, and diabetic nephropathy. The prevalence of RDFS was higher in the diabetic subjects as compared to recruited control subjects. Neither dietary behaviors nor glycemic control were found to contribute to coronal or root caries. CONCLUSIONS: Factors associated with presence of coronal and root caries and fillings are discussed. Possible causes and implications for the association between DFS and diabetic nephropathy are provided.     

广东省35~44岁人群恒牙冠根龋病抽样调查报告(2015—2016年)

目的 了解广东省35~44岁人群恒牙冠根龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省35~44岁288人,男女各半,城乡各半.按照《第四次全国口腔健康流行病学调查方案》中临床牙列检查方法和标准,使用CPI探针检查全口恒牙冠根龋病情况,计算冠根龋患病率、龋均、充填率.结果 35~44岁组恒牙冠龋患病率为71.18%,龋均为2.76,充填率为36.78%;根龋患病率为28.47%,龋均为0.66,充填率为4.23%.冠龋患病率、龋均女性高于男性,差异有统计学意义,城乡差异无统计学意义;根龋患病率、龋均的城乡、性别差异无统计学意义.结论 广东省35~44岁成年人恒牙冠龋患病率较高,而根龋患病率虽然不高,但大部分根龋未得到治疗.     

Coronal and Root Decay Experience in Older Adults in Ontario, Canada

This paper describes the coronal and root caries experience of subjects aged 50 years and older living in four communities in Ontario, Canada. The data were obtained as part of a comprehensive epidemiologic study of the oral health and treatment needs of this population. Caries experience was defined as the number of decayed and filled coronal and root surfaces per subject. Of 907 subjects interviewed and clinically examined, 78.3 percent were dentate and retained a mean of 18.9 teeth. The mean number of coronal decayed and filled surf aces was 23.9; 95.6 percent of subjects had at least one coronal DFS. The mean number of decayed and filled root surfaces was 3.6; 70.9 percent had at least one root DFS. The percent D/DFS was 3.5 for coronal and 20.0 for root caries. In linear regression analysis the number of teeth, making regular preventive visits, being born in Canada, and educational status emerged as predictors of coronal DFS. Predictors of root DFS were the number of surf aces with recession, the number of coronal DFS, the number of teeth, age, sex, and smoking status. These variables accounted for 42 percent and 35 percent of the variance in the number of coronal and root DFS, respectively.     

ROOT CARIES IN AREAS WITH AND WITHOUT FLUORIDATED WATER AT THE SOUTHEAST REGION OF S?O PAULO STATE,BRAZIL

This study aimed to investigate root caries prevalence in areas with and without water fluoridation at the Southeast region of São Paulo State, in the adult population, employees of public and private schools, and elderly population. Epidemiological surveys were conducted according to the World Health Organization guidelines (1997), including 1,475 dentate individuals aged 35 to 44 years and 65 to 74 years, living in cities representing the southeast of São Paulo State, with (n=872) or without (n=603) fluoridated water supply. Statistical analysis was performed by Mann-Whitney and Chi-square tests at a significance level of 5%. The prevalence of root caries was 15.6% for the 35-44-year-old age group and 31.8% for the 65-74-year-old age group. There were no statistically significant differences (p>0.05) in the occurrence of root caries according to water fluoridation, although individuals living at non-fluoridated areas presented higher percentage of missing teeth; also, there was higher mean number of intact roots at fluoridated areas (p<0.05). Most individuals with gingival recession, both adults and elderly, did not have root caries experience. In this study, root caries prevalence was lower in areas with fluoridated water. Due to the reduced prevalence of edentulism and increased number of people keeping their natural teeth for a longer period, a future increase in root caries is expected, highlighting the importance of studies related to water fluoridation and its relationship with the oral health of adults and elderly, especially referring to tooth root.     

青海省人群龋病流行病学抽样调查分析

目的了解青海省人群患龋状况及龋病发病的基线资料,为口腔卫生保健工作提供依据。方法根据第3次全国口腔健康流行病学抽样调查方案,首次对青海省5、12、35～44和65～74岁4个年龄组人群的患龋状况进行流行病学抽样调查。采用SPSS13.0软件对数据进行统计分析,以患龋率、龋均和龋充填率作为统计指标。结果5岁年龄组乳牙患龋率和龋均分别为71.63%和3.30。12岁年龄组恒牙冠龋患龋率和龋均分别为22.63%和0.40。35～44岁年龄组恒牙冠龋患龋率和龋均分别为64.47%和2.06。65～74岁年龄组恒牙冠龋患龋率和龋均分别为73.89%和3.08。4个年龄组龋充填率分别为1.85%、2.53%、8.00%和3.47%。结论青海省人群龋病状况不容乐观,龋齿充填率很低,应加强口腔健康教育,采取切实有效的措施,才能降低患龋率,提高龋齿的充填率。     

北京市中年组人群恒牙龋病抽样调查报告

目的了解北京市35～44岁中年组人群恒牙龋病状况，为北京市口腔卫生保健规划提供科学依据。方法采用多阶段分层等容量随机抽样的方法，抽取北京市35～44岁城乡常住居民共792名，男女各半，按照《第三次全国口腔健康流行病学调查方案》中的方法，检查全口恒牙患龋情况。结果792名受检者恒牙龋均1．74，患龋率58．59％，城市高于农村，女性高于男性。龋齿充填率39．97％，城市高于农村。恒牙根龋龋均0．55，根龋患龋率27．15％，根龋充填率仅1．85％，城乡之间无显著性差异。结论中年组人群根龋患病情况呈现明显上升趋势，应采取综合防治措施。同时，应加大对农村地区的口腔医疗及人力资源配置。     

Root surface caries and associated factors

Abstract – The prevalence of root surfaces caries in 208 randomly selected 55, 65, and 75-yr-old Swedes was related to the frequency of coronal caries, the number of remaining teeth and to bacteriologic, salivary, and dietary variables. At least one decayed or filled root surface was found in 89% of the individuals and all of those had also experienced coronal caries. The frequency of root surface caries was positively correlated to the frequency of coronal decay and negatively correlated to the number of remaining teeth and exposed root surfaces. The study shows that the same factors which are associated with enamel caries seem to be of importance in determining the development of root surface caries. The variation in the frequency of root surface caries was best explained by the salivary levels of mutans streptococci and lactobacilli, the percentage of surfaces harboring plaque and the frequency of carbohydrate intake. Other contributory factors were the saliva secretion rate and the buffer capacity.     

2005年广东省成年人恒牙根龋病抽样调查报告

目的 了解广东省35～44岁、 65～74岁人群恒牙根面龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省35～44岁、 65～74岁城乡常住人口各720人,男女各半.按照《第三次全国口腔健康流行病学调查方案》中临床检查牙列状况的检查方法和标准,使用CPI探针检查全口恒牙根面龋病情况.数据采用SAS 8.1软件统计,计算出患龋率、龋均.结果 35～44岁组根面患龋率为31.53%、龋均为0.68;残根率为22.92%.65～74岁组根面患龋率为64.03%、龋均为2.67;残根率为52.64%.患龋率和龋均均为女性高于男性,农村高于城市.结论 广东省成年人受根面龋病患病率高,涉及面广,特别是老年人根面龋病增加迅速,大部分根面龋齿未得到治疗.     

Root surface caries and associated factors

The prevalence of root surfaces caries in 208 randomly selected 55, 65, and 75-yr-old Swedes was related to the frequency of coronal caries, the number of remaining teeth and to bacteriologic, salivary, and dietary variables. At least one decayed or filled root surface was found in 89% of the individuals and all of those had also experienced coronal caries. The frequency of root surface caries was positively correlated to the frequency of coronal decay and negatively correlated to the number of remaining teeth and exposed root surfaces. The study shows that the same factors which are associated with enamel caries seem to be of importance in determining the development of root surface caries. The variation in the frequency of root surface caries was best explained by the salivary levels of mutans streptococci and lactobacilli, the percentage of surfaces harboring plaque and the frequency of carbohydrate intake. Other contributory factors were the saliva secretion rate and the buffer capacity.     

Prevalence and intraoral distribution of coronal and root caries in middle-aged and older adults.

This work describes the prevalence and intraoral distribution of coronal and root caries in 326 predominantly white, educated, middle-aged and older adults. Study participants were recruited from Tufts Geriatric Outreach Program, Nutritional Status Study (NSS), and the Forsyth Root Caries Study. Eighty-five percent of participants reported visiting their dentist in the last year. The median number of teeth was 21 in the 65+ age-group, and 40% of participants had coronal caries and 33% had root carious lesions. The mean coronal and root caries (DFS) was higher and the proportion of decayed surfaces to all decayed and filled surfaces (%D/DFS) was lower than in other comparable studies. A comparative analysis of intraoral distribution of coronal and root caries and their relation with age is discussed.     

The prevalence and experience of oral diseases in Adelaide nursing home residents

BACKGROUND: The twenty-first century will see the evolution of a population of dentate older Australians with dental needs very different from those of older adults in past years. This study provided comprehensive information concerning oral disease prevalence in older South Australian nursing home residents. METHODS: This paper presents cross-sectional baseline results. RESULTS: Most of the 224 residents, from seven randomly selected nursing homes, were functionally dependent, medically compromised, cognitively impaired and behaviourally difficult older adults who presented many complex challenges to carers and to dental professionals. Two-thirds (66 per cent) were edentulous with many dental problems and treatment needs. Dentate residents had a mean of 11.9 teeth present, higher than previously reported. The prevalence and experience of coronal and root caries and plaque accumulation was very high in dentate residents; especially males, those admitted more than three years previously, those who ate fewer food types and those who were severely cognitively impaired. These residents had more retained roots, decayed teeth and missing teeth, and fewer filled teeth when compared with data for community-dwelling older adults. CONCLUSIONS: This study highlighted the poor oral health status of these nursing home residents and the great impact of dementia on their high levels of oral diseases.     

Coronal and root caries in Southern Chinese adults.

Southern China is the most prosperous part of China, but information useful for oral care planning is very limited. A large-scale epidemiological survey was conducted in 1996-97. The objectives of this report were to describe the coronal and root caries of the adult Southern Chinese and to analyze the influence of selected demographic and socio-economic factors on the disease pattern. A total sample of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds from 8 urban and 8 rural survey sites in Guangdong Province participated in an oral health interview and underwent clinical examination. World Health Organization examination procedures and diagnostic criteria were used. The weighted mean DMFT scores of the middle-aged and the elderly subjects were 4.8 and 16.1, respectively. People living in rural areas had a higher DMFT score than those living in urban areas (4.9 vs. 4.3 in the 35- to 44-year-olds and 16.5 vs. 14.7 in the 65- to 74-year-olds). In both age groups, MT was the major component of the DMFT score. Analysis of covariance showed that women and those who were economically less well off had higher DMFT scores in both age groups. The weighted prevalence rates of decayed/filled roots were 12% and 37%, with a mean of 0.2 and 0.7 teeth affected, in the middle-aged and the elderly, respectively. In conclusion, socio-economic factors had a considerable effect on the dental caries status of adults in Southern China.     

Dental caries among disadvantaged 3- to 4-year-old children in northern Manhattan

PURPOSE: The study was conducted to determine the prevalence of early childhood caries (ECC), untreated caries, and the ratio of posterior to anterior caries in a disadvantaged predominantly Hispanic or African-American urban population. Data are compared to NHANES III to assess the caries burden in our cohort. Comparisons are made to the aggregate and to minorities within the national database. METHODS: A retrospective chart review was conducted for children enrolled in a Head Start or day care program in the communities of Washington-Heights and Central and East Harlem and seen on the community organization's mobile dental van between 1995 and 1997. The study included only children 3 to 4 years of age at the initial examination (n=1,605). A single examiner provided all the examinations. The mean number of decayed and filled surfaces (dfs), decayed surfaces (ds) and filled surfaces (fs), the percentage of decayed of total decayed and filled surfaces (%d/dfs), decayed and filled teeth (dft), decayed teeth (dt) and filled teeth (ft), and the percentage of decayed of total decayed and filled teeth (%d/dft) were calculated. Posterior vs anterior d, f, dft, dfs and d-anterior/total d, and d-posterior/total d were tabulated. Northern Manhattan data was tabulated and compared to NHANES III (1988-1994) in the aggregate and for subpopulations categorized by gender and ethnicity. All results are also reported for children with at least one decayed or filled tooth. T-tests were used to assess for significant differences. RESULTS: There was even representation of males (50%) and females (50%). Mean dft was 1.08 overall, and 3.14 for children with dft>0. The level of untreated decay, %d/ dft, was 91%, significantly higher than the US national population which is 76% overall, and 76% for African Americans and Mexican Americans within the US national population. CONCLUSIONS: The children in this population have higher caries prevalence and a higher level of untreated caries than the national means as reported in NHANES III. The high level of untreated decay found in this particularly disadvantaged community suggests that enhanced dental services targeting the very young are needed in these communities.     

Tooth and root conditions in the middle-aged and the elderly in Hong Kong

Abstract In an oral health survey of Hong Kong Chinese conducted in 1991, a sample of 372 35–44-yr-olds and 537 noninstitutionalized 65–74-yr-olds were interviewed and clinically examined. The examination procedures, instruments, and diagnostic criteria used to detect coronal caries followed those recommended by the World Health Organization (1987). The diagnostic criteria used to assess root-surface caries were based on those used in a national oral health survey of US employed adults (National Institute of Denial Research. 1987). Calibration of examiners was conducted before the survey and the interexaminer reliability was found to be very high; the kappa statistics were 0.93 and 0.91 for the younger and older age groups, respectively. None of the 35–44-yr-olds were edentulous and 96% had 21 teeth or more. The prevalence of edentulousness among the elderly was 12%. The DMFT indices of the younger and older age groups were 8.7 and 18.9, respectively. In both age groups, MT was the major component of the DMFT index, and female subjects had a slightly higher score. The prevalences of decayed/filled roots were 7% and 26%i for the 35–44- and 65–74-yr-olds, respectively. As compared with previous surveys conducted in Hong Kong, there has been a 40% reduction in the DMFT index of the 35–44-yr-olds since 1968, but little change in the tooth and root conditions was noted between 1984 and 1991.     

Dental caries prevalence in Brazilian schoolchildren resident in Japan

The Brazilian community in Japan is the third largest of the ethnic groups within the Japanese population. However, the oral health condition of Brazilian schoolchildren resident in Japan has not been documented previously. This study was carried out to assess the prevalence of dental caries in Brazilian schoolchildren resident in Japan. The study population comprised 296 schoolchildren aged 6 to 12 years, attending Brazilian schools in Japan. Clinical examinations were performed by a single qualified examiner. The prevalence of dental caries found in this population was 64.9% (95% IC = 59.39 - 70.34%), the percentage of caries-free children being relatively high at 35.1% (95% IC = 29.7% - 40.6%). The mean decayed (D), missing (M), and filled (F) teeth (T) index at age 12 was 1.75 (95% IC = 1.03 - 2.47), and the mean dmft at age 6 was 3.50 (95% IC = 2.43 - 4.57). The proportion of treated teeth was higher than that of decayed teeth in both dentitions. With regard to the distribution of dental caries experience, only 8.4% of all schoolchildren had a DMFT > 3, suggesting a polarization phenomenon of dental caries in this population. Although the prevalence of dental caries among Brazilian school-children resident in Japan is lower than that of their Japanese counterparts, oral health programs are necessary for those children in whom the disease is prevalent and have higher treatment needs.     

Factors influencing the initiation of carious lesions in specific tooth surfaces over a 4-year period in children between the ages of 11-12 years and 15-16 years

An analysis of factors influencing the initiation of carious lesions on specific tooth surfaces over a 4-year period in children between the ages of 11-12 years and 15-16 years is presented. Approximately 1000 children, resident in the County of South Glamorgan, Wales, were assessed for caries status and oral cleanliness in 1980 when aged 11-12 years and again in 1984 when aged 15-16 years. On both occasions, the children completed detailed questionnaires on dental health-related topics. Surfaces which were sound when the children were 11-12 years were identified and subsequently awarded a score of zero if they remained sound at 15-16 years or a score of one if they had developed carious lesions or had been filled. For each child, a mean mouth caries initiation score was computed for specific groups of surfaces, namely pit and fissure surfaces in posterior teeth, approximal surfaces in posterior teeth, buccal and lingual smooth surfaces of all teeth and approximal surfaces of anterior teeth. One-way analysis of variance and multiple regression techniques revealed that a number of factors had a significant influence on the initiation of caries. The factors and their level of significance varied between the surfaces. However, relatively little (less than 6 per cent) of the total variance in caries initiation score could be explained by the identified factors. Overall, more lesions developed in pit and fissure surfaces in posterior teeth than in the other surfaces included in the analyses.     

Frequency and distribution of root filled teeth and apical periodontitis in a Greek population

AIM: To investigate the prevalence of root filled teeth and apical periodontitis (AP) in a Greek population. METHODOLOGY: A random sample of 320 patients who required full mouth periapical radiographic examination as a part of diagnostic and planning procedures were included. The age of the patients ranged from 16 to 77 years. A total of 7664 teeth were assessed and the frequency of root filled teeth and periapical status was recorded. Two observers evaluated the radiographs under standardized conditions. AP was defined as distinct periapical radiolucency or widening of the periodontal ligament space exceeding two times the normal width. Statistical evaluation of differences in proportions between groups was performed using random effects logistic regression models. RESULTS: The periapical status of 286 (3.7%) teeth was impossible to evaluate because of radiographic faults; these teeth were excluded from further analysis. A total of 1040 (13.6%) teeth had radiographic signs of AP and 680 (9.2%) teeth had been root filled. Of the root filled teeth, 408 (60.0%) had AP. There was no difference in the number of root filled teeth between males and females; the prevalence of root filled teeth increased with age. Significantly more molars (13.1%) and premolars (11.9%) than anterior teeth (5.8%) had been root filled (P < 0.001). The prevalence of AP was significantly higher (P < 0.001) in molars (23.9%) and premolars (14.0%) than anterior teeth (9.4%). CONCLUSIONS: The prevalence of AP and the frequency of root filled teeth with AP in this Greek population were higher than those found in many other European countries. The frequency of root filled teeth was comparable with findings in other epidemiological studies.     

Oral health status in an adult Swedish population. Prevalence of caries. A cross-sectional epidemiological study in the Northern Alvsborg county

The aim of the present epidemiological study was to describe prevalence, distribution and type of caries in an adult Swedish population. After stratification with respect to age (20-29, 30-39,.....greater than 79 years of age), sex and location of residence (city, village, rural region), a random sample of 967 individuals was drawn (0.75% of the total adult population greater than 19 years). The results were based on radiographic and clinical examination of 919 individuals, of whom 750 were dentate (participation rate: 95%). The examinations were carried out from November 1983 to December 1984. The caries registrations distinguished between enamel caries and root caries, subdivided into manifest and initial caries. Despite lower number of remaining teeth in older ages, the mean number of surfaces with manifest caries (DS) was relatively even in all age groups (4.1-5.1 DS), except for the youngest age group ("20-29 years": mean 3.1 DS). When the number of decayed teeth (DT) were expressed as a percentage of remaining teeth, the ratio (%) was markedly higher in the older age groups than in the younger age groups. Initial caries was more frequent in the younger age groups. In the age groups above forty years the majority of the observed carious lesions involved root surfaces. In the oldest age group ("greater than 79 years of age"), 95% of the lesions were root caries. The mean number of filled surfaces (FS) was higher among women than men, while untreated caries (DS) showed a tendency of higher values for men. No significant differences in caries prevalence related to location of residence could be demonstrated.