Factors associated with dental caries at a dental student clinic

Objective: Dental caries is often concentrated in a relatively small group of people. Identifying these people at higher caries risk would enable more targeted interventions and more effective prevention. However, caries risk assessment is often imprecise, and factors considered for assessment are often empirical and not evidence based. The purpose of this study was to identify specific factors associated with caries experience in new patients at the University of Iowa College of Dentistry.

Methods: 107 charts of new patients were selected which had a caries risk assessment code completed between July 2002 and July 2004 and had restorative treatment needs. Each of the patients received a caries risk assessment at their first restorative appointment. The caries risk assessment consisted of yes/no answers to a series of questions regarding risk factors such as past dental history, frequency of oral hygiene and dietary factors. Associations with presence of caries with the various risk factors were assessed using chi-square tests.

Results: Having had recent restorations (p=0.028), extensive past dental history (DMFS >8), (p=0.044), having white spot lesions (p=0.021), inadequate oral hygiene (p=0.017), and xerostomia (0.021) were all associated with the presence of caries. However, medicaid enrollment, the subject's sex, dietary factors, exposed root surfaces, physical or cognitive challenges, and other factors (orthodontics or removable partial dentures), were not significantly associated with caries. Extensive past dental history was the most common factor for those with extensive caries defined as 6 or more surfaces of active decay.

Conclusions: Several factors were associated with caries activity. However, several of the factors thought to be associated with caries activity were not. Further studies, including longitudinal studies with larger sample sizes, are needed to improve caries risk assessment.