A Theoretical Model Development for Caries Risk Assessment

Objective: The purpose of this study was to identify risk factors associated with caries severity in Nevada youth to tailor a theoretical model for caries risk assessment.

Methods: Trained and calibrated licensed dental examiners performing oral health screenings using mobile dental clinics in northern and southern Nevada collected data from students (N=9202; 13-18 years) enrolled in middle/high schools between 2005-2006. A literature review revealed 13 select variables cited as significant factors of dental caries defined by DMFT index categories (Low:<2.6; Moderate:2.7-4.4; High:>4.5). Multiple and multivariate logistic regression analyses were used to establish significant contributors in the theoretical model.

Results: An initial exploratory multiple regression analysis identified 10 significant contributors to severity of caries as defined by DMFT indices. Living in counties with no municipal water fluoridation, increased exposure to environmental smoke, minority race, living in rural communities, and increasing age were the largest significant contributors (respectively). Exposure to tobacco, being female, lack of dental insurance, increased BMI risk, and lack of dental sealants were also significant but to a lesser extent. Non-significant factors included socioeconomic status (SES), ethnicity, and family history of diabetes.

Using DMFT categories (Low:<2.6; Moderate:2.7-4.4; High:>4.5), presence of beta weights established the relative contribution of each variable. Repeating the analysis with only significant contributors confirmed the initial findings. Results from a multivariate logistic regression formulated the first theoretical model. Once established, this process was repeated using all six years (2001-2006 academic years) to further validate the instrument.

Conclusions: Significant risk factors for inclusion in a theoretical model for a caries risk screening tool for detection of caries risk in Nevada youth was identified.

Source of Funding: Crackdown on Cancer Oral Health Surveillance Screening Program receives funding through the Trust Fund for Public Health and The Fund for Healthy Nevada, both beneficiaries of the Master Tobacco Settlement.