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Dental caries is the most prevalent disease worldwide, with the majority of caries lesions being concentrated in few, often disadvantaged social groups. We aimed to systematically assess current evidence for the association between socioeconomic position (SEP) and caries. We included studies investigating the association between social position (determined by own or parental educational or occupational background, or income) and caries prevalence, experience, or incidence. Risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies. Reported differences between the lowest and highest SEP were assessed and data not missing at random imputed. Random-effects inverse-generic meta-analyses were performed, and subgroup and meta-regression analyses were used to control for possible confounding. Publication bias was assessed via funnel plot analysis and the Egger test. From 5539 screened records, 155 studies with mostly low or moderate quality evaluating a total of 329,798 individuals were included. Studies used various designs, SEP measures, and outcome parameters. Eighty-three studies found at least one measure of caries to be significantly higher in low-SEP compared with high-SEP individuals, while only 3 studies found the opposite. The odds of having any caries lesions or caries experience (decayed missing filled teeth [DMFT]/dmft > 0) were significantly greater in those with low own or parental educational or occupational background or income (between odds ratio [95% confidence interval] = 1.21 [1.03–1.41] and 1.48 [1.34–1.63]. The association between low educational background and having DMFT/dmft > 0 was significantly increased in highly developed countries (R2 = 1.32 [0.53–2.13]. Publication bias was present but did not significantly affect our estimates. Due to risk of bias in included studies, the available evidence was graded as low or very low. Low SEP is associated with a higher risk of having caries lesions or experience. This association might be stronger in developed countries. Established diagnostic and treatment concepts might not account for the unequal distribution of caries (registered with PROSPERO [CRD42013005947]). [ABSTRACT FROM PUBLISHER]

Objective: To determine whether coronal caries experience through to the 30s predicts root surface caries experience by age 38. Method: Prospective study of a complete birth cohort (n = 1,037) born in 1972/73 in Dunedin, New Zealand. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38. Root surface caries data were first collected at age 38. Data from ages 5 through 32 were used previously to identify low, medium and high life course trajectories of caries experience and plaque accumulation. Results: Of the 916 dentate individuals examined at age 38, 23.0% had 1+ root DFS, 17.2% had 1+ root DS and 11.4% had 1+ root FS. The mean root DS, FS and DFS were 0.6 (SD 3.5), 0.3 (SD 1.1) and 0.9 (SD 3.8), respectively. The mean Root Caries Index (RCI) score was 7.2% (SD 18.0). Age 38 coronal DMFS and root surface caries DFS were only weakly correlated (r = 0.32), but root surface caries experience was strongly associated with coronal caries trajectory, with the mean RCI in the low, medium and high caries trajectory groups being 4.4, 8.0 and 13.5%, respectively (p < 0.0001); their prevalence of 1+ root DFS was 14.5, 25.9 and 42.2% (p < 0.0001). Those in the high coronal caries trajectory were more likely to have 1+ root surface DFS (odds ratio = 3.83; 95% CI = 2.33-6.30); for the medium trajectory, the odds ratio was 1.86 (95% CI = 1.25-2.75). Conclusion: Lifelong coronal caries experience (represented by discrete longitudinal trajectories of caries experience) is indeed a risk factor for root surface caries experience by age 38. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

With clinical oral examinations not always possible in health surveys, researchers may instead be invited to add questions to a wider health survey. In such situations, an item is needed which adequately represents both clinical and self-reported oral health. This study investigated the clinical validity of Locker’s global self-reported oral health item among young middle-aged adults in populations in New Zealand and Australia. Clinical examination and self-report data (including the OHIP-14) were obtained from recent national dental surveys in NZ and Australia, and from age-38 assessments in the Dunedin Multidisciplinary Health and Development Study. National dataset analyses involved 35- to 44-year-olds. Caries and tooth-loss experience showed mostly consistent, statistically significant gradients across the Locker item responses; those responding ‘Excellent’ had the lowest scores, and those responding ‘Poor’ the highest. Periodontitis experience gradients in the NZ national sample were mainly as hypothesized; those rating their oral health as ‘Poor’ had the highest disease experience. OHIP-14 gradients across the Locker item responses were consistent and as hypothesized. The proportion of disease in the population borne by those ‘Fair’ or ‘Poor’ ranged from 26% to 72%. These findings provide preliminary support for the measure’s validity as a global self-reported oral health measure in young middle-aged adults. [ABSTRACT FROM PUBLISHER]

Background Little was known of the natural history of dental caries among older adults until recently, but reports from a number of large cohort studies have now enabled better understanding of the nature and determinants of dental caries in older people. The aim of this review is to examine and compare findings from established population-based longitudinal studies of older adults in order to determine their preventive implications.Methods The dental literature was reviewed in order to identify reports on dental caries incidence from large, population-based dental longitudinal studies of older adults (age 50+) with at least 3 years of follow-up.Results Reports were identified from four studies (in Iowa, North Carolina, Ontario and South Australia) which met the criteria; four reports dealt with coronal caries, and five with root surface caries. When annualised, coronal and root surface caries increments were combined and compared with those reported for adolescents, the caries experience of older people over time (between 0.8 and 1.2 new surfaces affected per year) exceeded that reported from cohort studies of adolescents (between 0.4 and 1.2 surfaces per year). The only caries risk factor common to all four studies was the wearing of a partial denture (for root surface caries only).Conclusions Older people are a caries-active group, experiencing new disease at a rate which is at least as great as that of adolescents.Practice implications Dentate older people should be the target of intensive monitoring and preventive efforts at both the clinical practice and public health levels. There is no easily identifable 'magic bullet' for preventing caries in that age group, but the use of evidence-based preventive interventions (such as fluoride) should suffice. [ABSTRACT FROM AUTHOR]