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A retrospective analysis of caries treatment and development in relation to assessed caries risk in an adult population in Sweden.

Söderström U, Johansson I, Sunnegårdh-Grönberg K - BMC Oral Health (2014)

Bottom Line: Information concerning dental status, counselling, treatments, visits, and costs were retrieved from dental records.This study formulated two major conclusions.These groups need different strategies in disease treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Odontology/Cariology, Umeå University, Umeå, Sweden. Karin.Sunnegardh@odont.umu.se.

ABSTRACT

Background: The Public Dental Service of Västerbotten County (Sweden) recommends using population-based prevention strategies combined with an individual strategy for high-risk patients to manage caries. To facilitate this management strategy, all patients are evaluated for their risk of developing caries in the coming year using defined criteria. Using caries risk scoring over a seven-year period, the present study evaluates prophylactic measures, caries development, and non-operative treatments in adult patients.

Methods: From all adult patients (25-65 years; n = 76 320) scored with a high caries risk in 2005 (baseline) and with a dental visit in 2011, 200 subjects were randomly selected. In addition, an equally sized control group with a no/low caries risk was selected. Information concerning dental status, counselling, treatments, visits, and costs were retrieved from dental records.

Results: Over the seven-year study period, subjects with high caries risk had significantly higher caries incidence in spite of shorter recall intervals, more dental appointments, and higher costs for dental care than subjects with no/low caries risk. Non-operative measures, such as additional fluoride and individual counselling on diet at baseline (2005), was higher in the high caries risk group, whereas information about basic prophylaxis and counselling on oral hygiene showed only small differences. The frequency of non-operative measures given during the seven-year study period to patients in the high caries risk group is considered to be remarkably low and improvement, determined as reclassification from high to no/low caries risk from 2005 to 2011, was seen in only 13% of the participants.

Conclusions: This study formulated two major conclusions. First, adult patients with high or no/low caries represent different populations, that each contain distinct subpopulations, those who improve/impair or maintained their caries risk and disease progression. These groups need different strategies in disease treatment. Second, preventive measures and non-operative treatments were associated with improvements in caries risk and maintenance, but the extent to which such treatments were given to high caries risk subjects was unacceptably low. Improved adherence to the guidelines for caries treatment may reduce caries risk, visits to dental clinics, and costs for the patients.

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Caries incidence in the high and no/low caries risk groups over the seven-year study period. Data are shown as mean (95% CI) for a) new primary caries lesions reaching into the dentin and b) new secondary caries lesions.
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Fig4: Caries incidence in the high and no/low caries risk groups over the seven-year study period. Data are shown as mean (95% CI) for a) new primary caries lesions reaching into the dentin and b) new secondary caries lesions.

Mentions: Incidences of primary and secondary dentin lesions between treatment sessions, which averaged 13 months for the high and 18 months for the no/low caries risk group, were significantly higher in the high caries than in the no/low caries risk group at all time points (Figures 4a,b). However, the 2005 mean numbers for incident primary dentin lesions were lower for all subsequent years in the high caries group, and the 2007 and 2009 mean numbers for incident secondary caries lesions were lower, but this trend had reversed by 2011 (Figure 4b). In contrast, incident caries (primary and secondary) were virtually stable over time in the no/low caries risk group (Figures 4a,b). Paralleling the higher caries incidence in the high caries risk group, their mean number of intact teeth decreased by 1.4 teeth over the seven-year study period compared to 0.4 teeth in the no/low caries risk group (p < 0.001, data not shown).Figure 3


A retrospective analysis of caries treatment and development in relation to assessed caries risk in an adult population in Sweden.

Söderström U, Johansson I, Sunnegårdh-Grönberg K - BMC Oral Health (2014)

Caries incidence in the high and no/low caries risk groups over the seven-year study period. Data are shown as mean (95% CI) for a) new primary caries lesions reaching into the dentin and b) new secondary caries lesions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4209083&req=5

Fig4: Caries incidence in the high and no/low caries risk groups over the seven-year study period. Data are shown as mean (95% CI) for a) new primary caries lesions reaching into the dentin and b) new secondary caries lesions.
Mentions: Incidences of primary and secondary dentin lesions between treatment sessions, which averaged 13 months for the high and 18 months for the no/low caries risk group, were significantly higher in the high caries than in the no/low caries risk group at all time points (Figures 4a,b). However, the 2005 mean numbers for incident primary dentin lesions were lower for all subsequent years in the high caries group, and the 2007 and 2009 mean numbers for incident secondary caries lesions were lower, but this trend had reversed by 2011 (Figure 4b). In contrast, incident caries (primary and secondary) were virtually stable over time in the no/low caries risk group (Figures 4a,b). Paralleling the higher caries incidence in the high caries risk group, their mean number of intact teeth decreased by 1.4 teeth over the seven-year study period compared to 0.4 teeth in the no/low caries risk group (p < 0.001, data not shown).Figure 3

Bottom Line: Information concerning dental status, counselling, treatments, visits, and costs were retrieved from dental records.This study formulated two major conclusions.These groups need different strategies in disease treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Odontology/Cariology, Umeå University, Umeå, Sweden. Karin.Sunnegardh@odont.umu.se.

ABSTRACT

Background: The Public Dental Service of Västerbotten County (Sweden) recommends using population-based prevention strategies combined with an individual strategy for high-risk patients to manage caries. To facilitate this management strategy, all patients are evaluated for their risk of developing caries in the coming year using defined criteria. Using caries risk scoring over a seven-year period, the present study evaluates prophylactic measures, caries development, and non-operative treatments in adult patients.

Methods: From all adult patients (25-65 years; n = 76 320) scored with a high caries risk in 2005 (baseline) and with a dental visit in 2011, 200 subjects were randomly selected. In addition, an equally sized control group with a no/low caries risk was selected. Information concerning dental status, counselling, treatments, visits, and costs were retrieved from dental records.

Results: Over the seven-year study period, subjects with high caries risk had significantly higher caries incidence in spite of shorter recall intervals, more dental appointments, and higher costs for dental care than subjects with no/low caries risk. Non-operative measures, such as additional fluoride and individual counselling on diet at baseline (2005), was higher in the high caries risk group, whereas information about basic prophylaxis and counselling on oral hygiene showed only small differences. The frequency of non-operative measures given during the seven-year study period to patients in the high caries risk group is considered to be remarkably low and improvement, determined as reclassification from high to no/low caries risk from 2005 to 2011, was seen in only 13% of the participants.

Conclusions: This study formulated two major conclusions. First, adult patients with high or no/low caries represent different populations, that each contain distinct subpopulations, those who improve/impair or maintained their caries risk and disease progression. These groups need different strategies in disease treatment. Second, preventive measures and non-operative treatments were associated with improvements in caries risk and maintenance, but the extent to which such treatments were given to high caries risk subjects was unacceptably low. Improved adherence to the guidelines for caries treatment may reduce caries risk, visits to dental clinics, and costs for the patients.

Show MeSH
Related in: MedlinePlus