Multicenter study on caries risk assessment in adults using survival Classification and Regression Trees

Area of Science:

• Dentistry
• Public Health
• Biostatistics

Background:

• Dental caries remains a significant global public health challenge.
• Effective preventive strategies are crucial for managing caries incidence.
• Identifying high-risk individuals is key to targeted interventions.

Purpose of the Study:

• To evaluate the efficacy of preventive therapies in reducing caries onset in adults.
• To identify patient risk factors for primary and secondary caries using survival analysis.
• To apply Classification and Regression Trees (CART) for risk stratification.

Main Methods:

• Analysis of a clinical dataset of 732 adult patients (20-64 years) from Japanese general practices.
• Utilized parameters including age, DMFT, salivary mutans streptococci (SM) and Lactobacilli (LB) counts, saliva secretion/buffer capacity, and preventive program compliance.
• Employed Classification and Regression Trees based survival analysis (survival CART) for risk assessment.

Main Results:

• Primary carious lesion incidence was influenced by SM, LB, and compliance.
• Secondary carious lesion incidence was associated with DMFT, SM, and LB.
• Survival CART identified high-risk primary caries patients with poor compliance and high SM (HR=3.66, p=0.0002).
• High-risk secondary caries patients exhibited high LB and high DMFT (>15) (HR=3.50, p<0.0001).

Conclusions:

• Preventive dental programs demonstrate effectiveness in reducing primary carious lesion incidence.
• Survival CART successfully identifies high-risk patients for both primary and secondary caries.
• Targeted interventions based on identified risk factors can improve caries prevention outcomes.