Predictors of Root Caries in Older Adults in US

Objectives: With the anticipated increase in the older adult population in the US and a constant rate of gingival recession surfaces (GRS), root caries (RC) prevalence is expected to increase. Although GRS is considered a risk factor for RC, attack rates may differ for lingual compared to buccal surfaces due to the reduced amount of biofilm, salivary flow, and the saliva's buffer capacity. We evaluated the association between buccal and lingual GRS and the prevalence of RC in older adults. Methods: Cross-sectional data from the Atherosclerosis Risk in Communities (Dental-ARIC study) were used. 6550 subjects aged 52-64 were interviewed/examined. Surfaces with RC, number of filled root surfaces (NFRS), buccal-surface (BRS) or lingual-surface gingival recession (LRS), gender, race, smoking status, education, income, and whether subjects had a dentist were obtained (HD). The association between RC and GRS was evaluated using logistic regression (LR), adjusting for covariates. Results: The overall RC prevalence was 7.3%. The mean number (standard-deviation) of BRS and LRS (surfaces-at-risk) were 6.7(5.9) and 4.2(4.2) respectively. The LR model showed that number of BRS (OR=1.02; 95%CI=1.01/1.03), NFRS (OR=1.08; 95%CI=1.02/1.14), males (OR=1.94; 95%CI=1.55/2.44), African-American (OR=0.3; 95%CI=0.23/0.39), middle-income(OR=2.0; 95%CI=1.53/2.61), low-income(OR=3.78; 95%CI=1.36/2.78), low-educational-level(OR=1.55; 95%CI=1.2/2.0), and HD (OR=0.47; 95%CI=0.36/0.62) were significantly associated with the presence of root surface caries.

Conclusion: Lingual GRS was not associated with root caries. Understanding the specific reasons for this lack of association could be useful for future preventive programs. The prevalence of RC was positively associated with number of buccal GRS, NFRS, being male, African-American, having a lower educational level, lower income and not having a dentist. These variables emerged as significant predictors of root caries in older adults in the US populations studied.

NIH Grant # - R01-DE11551