Root caries experience in Germany 1997 to 2014: Analysis of trends and identification of risk factors

• Published in: Journal of dentistry 2018-11, Vol.78, p.100-105
• Main Authors: Schwendicke, Falk, Krois, Joachim, Schiffner, Ulrich, Micheelis, Wolfgang, Jordan, Rainer A.
• Format: Article
• Language: English
• Subjects: Adults; Age; Caries; Cross-sectional studies; Cross-sectional study; Curve fitting; Data collection; Demographics; Dental caries; Dentistry; Education; Elderly; Epidemiology; Gerodontology; Health services research; Indicators; Morbidity; Regression analysis; Resource allocation; Risk analysis; Risk assessment; Risk factors; Teeth; Toothbrushing; Trends
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2018.08.013

We assessed time trends in root caries experience, i.e. the sum of filled and carious root surfaces (FRS, CRS), and evaluated risk indicators of FRS/CRS in Germany. FRS and CRS from repeated waves (1997, 2005, 2014) of the nationally-representative German Oral Health Studies were analyzed in 35–44- and 65-74-year-olds (adults/younger seniors; n = 4388). Weighted means were interpolated cross-sectionally across age groups by fitting piecewise-cubic spline-curves, and population-level FRS and CRS calculated. We also projected population-level FRS and CRS to 2030. To evaluate risk indicators of FRS and CRS, zero-inflated negative-binomial regression was applied. In adults FRS increased from 1997 to 2005 at individual and population level (from a mean of 0.49 to 0.63 surfaces; from a total of 6.2 to 8.7 million surfaces) and then decreased to 2014 (to 0.16 surfaces/1.6 million surfaces). CRS constantly increased (1997: 0.37 surfaces/4.7 million surfaces; 2014: 0.94 surfaces/9.3 million). In younger seniors, FRS increased from 1997 to 2005 (from 0.67 to 1.92 surfaces; 5.0 to 17.5 million surfaces) and then decreased to 2014 (0.89 surfaces/7.5 million surfaces). CRS constantly increased (1997: 0.39 surfaces/2.9 million surfaces; 2014: 1.43 surfaces/12.1 million surfaces). Driven by demographic changes until 2030, population-level FRS and CRS is likely to increase in younger seniors, but not adults. Sex, toothbrushing behavior, age, coronal caries experience and the number of teeth with probing-pocket-depths≥4 mm were associated with FRS and CRS. While FRS does not show a clear trend, CRS has constantly increased since 1997. Concepts for preventing and managing CRS in Germany are needed. Evaluating time trends and assessing risk indicators of root caries experience is helpful to understand morbidity dynamics, plan resource allocation and identify individuals/groups at risk. While FRS shows no clear trend, CRS has increased since 1997 in Germany. Concepts for addressing the emanating treatment needs are needed.