Association between coronal caries and malocclusion in an adult population

Only a few but conflicting results have been reported on the association between malocclusions and caries. We investigated this association using data from the population-based cross-sectional Study of Health in Pomerania (SHIP).

Sagittal, vertical and transversal intermaxillary relationship, space conditions and sociodemographic parameters of 1210 dentate subjects (median age 30 years, interquartile range 25-35 years) were collected. Caries was assessed with the Decayed-Missing-Filled Surfaces index but analyzed as ordered outcome (four levels: sound, enamel caries, caries, tooth loss) in ordinal multilevel models, taking into account subject, jaw, and tooth level simultaneously.

Anterior open bite ≤3 mm (odds ratio [OR] = 2.08, 95% confidence interval [CI]: 1.19-3.61), increased sagittal overjet of 4-6 mm (OR = 1.31, CI: 1.05-1.64), distal occlusion of ½ premolar width (OR = 1.27, CI: 1.05-1.53) and distal 1 premolar width (OR = 1.31, CI: 1.06-1.63) were associated with adjusted increased odds for a higher outcome level (caries). Anterior spacing (OR = 0.24, CI: 0.17-0.33), posterior spacing, (OR = 0.69, CI: 0.5-0.95), posterior crowding (OR = 0.57, CI: 0.49-0.66) and buccal nonocclusion (OR = 0.54, CI: 0.33-0.87) were associated with a lower outcome level (caries).

The results from this population-based study suggest that a connection between caries and malocclusion exists to a limited extent in young adults. The associations with caries are contradictory for several malocclusion variables. Distal occlusion (OR = 1.31, CI: 1.06-1.63) and related skeletal anomalies displayed positive associations with caries whereas crowding did not. Orthodontic treatment of anterior crowding would probably not interfere with caries experience. These aspects should be considered for patient information and in treatment decisions.