Caries Progression Rates Revisited: A Systematic Review.

Area of Science:

• Oral Health
• Epidemiology
• Pediatric Dentistry

Background:

• Dental caries progression exhibits predictable rates influenced by population severity.
• Quantifying these rates is crucial for forecasting future caries development.
• Previous research has not comprehensively synthesized caries progression data in Western children and adolescents.

Purpose of the Study:

• To systematically review and analyze caries progression rates in the primary and permanent dentition of children and adolescents in Western populations.
• To quantify caries incidence rates and increments in decayed, missing, and filled surfaces (DMFS) and decayed, missing, and filled teeth (DMFT).
• To explore factors influencing caries progression rates through meta-regression analysis.

Main Methods:

• Systematic literature search of multiple databases (MEDLINE-PubMed, Embase, CINAHL, Cochrane Library).
• Inclusion criteria: studies with at least two full-mouth dental caries examinations, minimum 3-year follow-up, first examination post-1974, second before age 22, dentine caries assessment (d3/D3), and reporting dmfs/DMFS, dmft/DMFT, or caries-free status.
• Systematic review, meta-analysis of caries incidence rate in permanent dentition, and multivariate meta-regression analyses were performed.

Main Results:

• 43 studies (56,376 participants) were included in the systematic review, and 32 studies (39,429 participants) in meta-analyses.
• Annual decline in caries-free children in permanent dentition ranged from 0.8% to 10.2%.
• Annual increments ranged from 0.07 to 1.77 DMFS and 0.06 to 0.73 DMFT. Pooled caries incidence rate was 0.11 per person-year at risk.
• Meta-regression indicated study methodologies influenced pooled rates and increments.

Conclusions:

• Caries incidence rates show promise for predicting future caries increments in populations.
• Study methodologies significantly impact pooled caries incidence rates and increments.
• Findings should inform the planning and evaluation of oral health care services for children and adolescents.