Risk indicators for root caries in older adults using long-term social care facilities in Hong Kong

To investigate risk indicators associated with root caries among the Hong Kong older adults who attended long-term care facilities regularly.

Nonfrail older adults with at least six natural teeth from 10 long-term social or residential care facilities were examined. The clinical examinations were conducted by two calibrated dentists in the institutions. Portal dental chairs, intra-oral LED lights, disposable mouth mirrors, periodontal probes and CPI probes were used in the examinations. Negative binomial regression analyses were performed to identify the risk indicators associated with root caries. Multilevel logistic regression analyses were conducted to detect the associations between DF-root and D-root, and selected person-level and tooth surface-level factors.

A total of 353 older adults (mean age 74.9 years) were examined. The prevalence of DF-root and D-root was 43.1% and 30.0%, respectively. The mean DF-root and D-root scores were 1.3 and 0.7, respectively. Relative to participants without DF-root, those with root caries experience were older and had more exposed root surfaces, and a higher proportion were partial denture wearers. There was a positive correlation between the DF-root score and the age of the participant, and with the numbers of exposed root surfaces, missing teeth and teeth with coronal caries. Higher prevalence of DF-root was observed among the older participants, and caries experience of root surfaces with greater gingival recession and visible plaque was higher. Lingual root surfaces and roots in the mandibular anterior region had the lowest rates of DF-root.

People who are older have a higher prevalence and severity of root caries. Coronal caries experience, maxillary teeth, buccal root surfaces, gingival recession and plaque on the root surface are positively associated with root caries in older adults.