1
|
Varughese A, Kavitha R, Sravan Kumar Y, Venkitachalam R, Menon AS, Francis PT, Haridas K. Prevalence and severity of coronal and radicular caries among patients with type 2 diabetes mellitus: A cross sectional study. Med J Armed Forces India 2022; 78:S179-S185. [PMID: 36147423 PMCID: PMC9485771 DOI: 10.1016/j.mjafi.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 09/29/2020] [Indexed: 11/22/2022] Open
Abstract
Background Studies among type 2 diabetes mellitus patients have reported total caries experience; however the severity and clinical consequences of untreated dental caries are often ignored. Methods For this study, 150 well (I) and poorly controlled (II) diabetic participants were recruited. The spectrum of caries was evaluated using DMFT (Decayed, Missing and Filled Tooth) index, Dental Caries Severity Classification Scale, PUFA (Pulpal involvement, Ulceration, Fistula and Abscess) index, RCI (Root Caries Index) and the severity of radicular caries by Root Surface Caries Severity Index. Results The prevalence of coronal and root caries was 90.7% and 23.3%, respectively. There was significant difference among caries experiences for D, M and DMFT. In group II, severity of coronal caries and mean rank of P, F, A and PUFA scores were higher, so were prevalence of root caries and severity of RD2, RD3 and RD4. HbA1c level had positive correlation with DMFT and PUFA scores (r = 0.458 and 0.522), so was the duration of diabetes with coronal caries, DMFT, PUFA score, root caries and RCI score (r = 0.235, 0.320, 0.273, 0.308 and 0.323). Conclusion This is probably the first study to examine the severity of coronal caries, prevalence of untreated dental caries and severity of radicular caries in diabetic patients. Uncontrolled diabetes causes substantial increase in prevalence and severity of coronal and radicular caries.
Collapse
Affiliation(s)
- Anju Varughese
- Assistant Professor (Conservative Dentistry & Endodontics), Amrita School of Dentistry, Amrita Vishwa Vidyapeetam, AIMS, Kochi, Kerala, India
| | - R. Kavitha
- Assistant Professor (Conservative Dentistry & Endodontics), Amrita School of Dentistry, Amrita Vishwa Vidyapeetam, AIMS, Kochi, Kerala, India
| | - Y. Sravan Kumar
- Assistant Professor (Public Health Dentistry), Amrita School of Dentistry, Amrita Vishwa Vidyapeetam, AIMS, Kochi, Kerala, India
| | - R. Venkitachalam
- Assistant Professor (Public Health Dentistry), Amrita School of Dentistry, Amrita Vishwa Vidyapeetam, AIMS, Kochi, Kerala, India
| | - Arun S. Menon
- Professor (Endocrinology), Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetam, AIMS, Kochi, Kerala, India
| | - Paul T. Francis
- Associate Professor (Community Medicine), Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetam, AIMS, Kochi, Kerala, India
| | - Kaushik Haridas
- Assistant Professor (Conservative Dentistry & Endodontics), Amrita School of Dentistry, Amrita Vishwa Vidyapeetam, AIMS, Kochi, Kerala, India
| |
Collapse
|
2
|
Ritter AV, Preisser JS, Puranik CP, Chung Y, Bader JD, Shugars DA, Makhija S, Vollmer WM. A Predictive Model for Root Caries Incidence. Caries Res 2016; 50:271-8. [PMID: 27160516 PMCID: PMC11196012 DOI: 10.1159/000445445] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/14/2016] [Indexed: 11/19/2022] Open
Abstract
This study aimed to find the set of risk indicators best able to predict root caries (RC) incidence in caries-active adults utilizing data from the Xylitol for Adult Caries Trial (X-ACT). Five logistic regression models were compared with respect to their predictive performance for incident RC using data from placebo-control participants with exposed root surfaces at baseline and from two study centers with ancillary data collection (n = 155). Prediction performance was assessed from baseline variables and after including ancillary variables [smoking, diet, use of removable partial dentures (RPD), toothbrush use, income, education, and dental insurance]. A sensitivity analysis added treatment to the models for both the control and treatment participants (n = 301) to predict RC for the control participants. Forty-nine percent of the control participants had incident RC. The model including the number of follow-up years at risk, the number of root surfaces at risk, RC index, gender, race, age, and smoking resulted in the best prediction performance, having the highest AUC and lowest Brier score. The sensitivity analysis supported the primary analysis and gave slightly better performance summary measures. The set of risk indicators best able to predict RC incidence included an increased number of root surfaces at risk and increased RC index at baseline, followed by white race and nonsmoking, which were strong nonsignificant predictors. Gender, age, and increased number of follow-up years at risk, while included in the model, were also not statistically significant. The inclusion of health, diet, RPD use, toothbrush use, income, education, and dental insurance variables did not improve the prediction performance.
Collapse
Affiliation(s)
- André V. Ritter
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, N.C
| | - John S. Preisser
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, N.C
| | | | - Yunro Chung
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, N.C
| | - James D. Bader
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, N.C
| | - Daniel A. Shugars
- School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, N.C
| | - Sonia Makhija
- School of Dentistry, University of Alabama at Birmingham, Birmingham, Ala
| | | |
Collapse
|
3
|
Soni S, Mehta M, M AD, P R, Pallavi, Kadanakuppe S, Nagashree, B V. Root caries among type 2 diabetes mellitus patients visiting a hospital. SPECIAL CARE IN DENTISTRY 2014; 34:273-7. [DOI: 10.1111/scd.12065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sugandhi Soni
- JN Kapoor DAV Dental College and Hospital; Yamuna Nagar Haryana India
| | - Mohit Mehta
- MM College of Dental Sciences and Research; Mullana Haryana India
| | - Aruna Devi M
- VS Dental College and Hospital; Bangalore Karnataka India
| | - Radha P
- VS Dental College and Hospital; Bangalore Karnataka India
| | - Pallavi
- VS Dental College and Hospital; Bangalore Karnataka India
| | | | - Nagashree
- VS Dental College and Hospital; Bangalore Karnataka India
| | | |
Collapse
|
4
|
Abstract
The definition of osteoporosis has evolved beyond low bone mineral density to include impaired bone morphology and matrix properties. As such, the subsequent bone density insufficiencies extend beyond the skeletal risks of fracture and have implications for oral health management patients. As our population ages there is a worldwide increase in the risk of decreased bone mineral density and its subsequent morbidity. This makes age an independent risk factor for fracture and decreased bone mineral density. Multiple examinations and diagnostic tests are currently used in combination to develop an algorithm to assess osteoporotic risk. Oral health care professionals should follow these principles and caution should be used in applying a single independent assessment to determine a patient's osteoporotic or bone metabolism risk. Therapeutic approaches for osteoporosis are often divided into nonpharmacological interventions and pharmacological therapies. The periodontist and other oral health care professionals should have a full understanding of the therapeutic options, benefits and implementation of preventive therapies. Bone turnover is a coupled event of bone formation and bone resorption and it is the imbalance of this homeostasis that results in osteoporosis. Based on this uncoupling of bone resorption and formation, osteoporosis or decreased bone mineral density and osteopenia, may be a risk factor for alveolar bone loss in periodontitis. The role of prevention and maintenance with a history of periodontitis and oesteopenia extends beyond biofilm control and should include management of bone mineral density. The chronic periodontal infection in a patient with osteopenia may place the patient at greatly increased risk for alveolar bone loss, gingival recession and root caries. A key component in the management is the oral health professional's knowledge of the interrelationship between skeletal health and periodontal health.
Collapse
|
5
|
Correlates of root caries experience in middle-aged and older adults in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network. J Am Dent Assoc 2013; 144:507-16. [DOI: 10.14219/jada.archive.2013.0153] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
6
|
Thomson W, Broadbent J, Foster Page L, Poulton R. Antecedents and Associations of Root Surface Caries Experience among 38-Year-Olds. Caries Res 2013. [DOI: 10.1159/000345078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
7
|
Rodrigues JA, Lussi A, Seemann R, Neuhaus KW. Prevention of crown and root caries in adults. Periodontol 2000 2010; 55:231-49. [DOI: 10.1111/j.1600-0757.2010.00381.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
8
|
Fairhall TJ, Thomson WM, Kieser JA, Broughton JR, Cullinan MP, Seymour GJ. Home or away? Differences between home- and clinic-based dental examinations for older people. Gerodontology 2009; 26:179-86. [DOI: 10.1111/j.1741-2358.2008.00263.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
9
|
Avlund K, Holm-Pedersen P, Morse DE, Viitanen M, Winblad B. Tooth loss and caries prevalence in very old Swedish people: the relationship to cognitive function and functional ability. Gerodontology 2004; 21:17-26. [PMID: 15074536 DOI: 10.1046/j.1741-2358.2003.00003.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To analyse whether cognitive function and functional ability are related to oral health among community-dwelling older people over the age of 80 years. BACKGROUND This cross-sectional study is based on the Kungsholmen Elders Oral Health Survey (KEOHS). The study included oral examinations carried out in two local clinics by standardised examiners and interviews using structured questionnaires. MATERIALS AND METHODS Altogether 159 individuals were included in this study. Coronal caries and root caries were assessed using the National Institute of Dental and Craniofacial Research (NIDCR) diagnostic criteria. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) index and functional ability was assessed by a global measure of self-reported changes. RESULTS Older adults with a low MMSE score (< or = 23) tended to have a higher risk of coronal caries than those with higher scores. Participants with mild cognitive decline (MMSE = 24-26) and with a decrease in functional ability had a significantly higher risk of root caries. These associations changed little when adjusted by the covariates. In addition, people with a low MMSE (0-23) had a four times higher risk of not using dental services regularly. This result was unchanged after adjusting for the variables studied. CONCLUSIONS This study revealed associations between the cognitive and functional status of the individual and aspects of oral health, that may contribute to a deeper understanding of the background of oral health status in older adults.
Collapse
Affiliation(s)
- Kirsten Avlund
- Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | | | | | | | | |
Collapse
|
10
|
Pretty IA, Ingram GS, Agalamanyi EA, Edgar WM, Higham SM. The use of fluorescein-enhanced quantitative light-induced fluorescence to monitor de- and re-mineralization of in vitro
root caries. J Oral Rehabil 2003; 30:1151-6. [PMID: 14641655 DOI: 10.1111/j.1365-2842.2003.01188.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The use of fluorescein-enhanced quantitative light-induced fluorescence (QLF) in the detection of in vitro root caries demineralization and reminerlization was investigated. Fourteen previously extracted human premolar roots were selected and determined to be caries-free. Cementum was removed and nail varnish applied leaving an exposed window. Positive and negative controls were selected. During a demineralizing regimen, roots were removed at regular intervals (12, 48, 72 and 120 h) and immersed in sodium fluorescein (0.2 mg L(-1)). Following gentle rinsing, each root was examined using QLF before being returned to the demineralizing solution. Following 120 h, each tooth was sectioned through the lesion and one-half retained for transverse micro radiography (TMR) analysis. The remaining half were subjected to a remineralizing regimen undergoing the same fluorescein and QLF examinations at 7, 28 and 36 days. Results showed that QLF effectively monitored demineralization/remineralization of root dentine as represented by fluorescein penetration. TMR analysis showed good correlations with QLF (DeltaZ/DeltaQ) after demineralization (r = 0.89) and remineralization (r = 0.84). The technique could represent an in vivo method for root caries detection and classification.
Collapse
Affiliation(s)
- I A Pretty
- Department of Clinical Dental Sciences, Cariology Group, The University of Liverpool, Liverpool, UK.
| | | | | | | | | |
Collapse
|
11
|
Morse DE, Holm-Pedersen P, Holm-Pedersen J, Katz RV, Viitanen M, von Strauss E, Winblad B. Prosthetic crowns and other clinical risk indicators of caries among old-old Swedish adults: findings from the KEOHS Project. Kungsholmen Elders Oral Health Study. Gerodontology 2002; 19:73-9. [PMID: 12542216 DOI: 10.1111/j.1741-2358.2002.00073.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, community-dwelling persons over the age of 80 living in Kungsholmen, Sweden. This paper explored possible clinical risk indicators of coronal and root caries among the KEOHS subjects. DESIGN In this cross-sectional study, dentate KEOHS subjects received a caries assessment using defined visual, tactile criteria. SETTING Examinations were carried out in two local clinics by standardized examiners. SUBJECTS One hundred twenty-nine dentate persons were examined. MAIN OUTCOME MEASURES The examination identified decayed and filled surfaces, prosthetic crowns, and missing teeth. RESULTS More root than coronal surfaces had untreated decay, and secondary root caries contributed the greatest number of decayed surfaces. Ninety percent of the examined dentate subjects had at least one prosthetic crown. Root surfaces exposed to crown margins were more likely to have caries than root surfaces not so exposed, particularly among women. The presence of untreated coronal caries (yes/no) was positively associated with having untreated root caries and an intermediate number (14-20) of teeth, but inversely associated with having 4+ prosthetic crowns. Active root caries (yes/no) was positively associated with having untreated coronal caries, 14-20 teeth, and 4+ prosthetic crowns. Nearly 20% of identified root lesions were present at or below the gingival margin, and most (88%) were secondary caries associated with crown margins (65%) or other restorations (23%). CONCLUSIONS Our findings suggest that some dental characteristics, including the presence of prosthetic crowns, are risk indicators for the presence of untreated coronal and root caries.
Collapse
Affiliation(s)
- Douglas E Morse
- New York University College of Dentistry, Department of Epidemiology & Health Promotion, New York, NY 10010, USA.
| | | | | | | | | | | | | |
Collapse
|