Caries increment and prediction from 12 to 18 years of age: a follow-up study

Abstract

Aim: This was to determine the increment of caries from 12 to 18 years of age and to explore the possibility of predicting caries increment in this period based on the caries experience at age 12 years.

Study design: Prospective longitudinal survey.

Methods: A sample of 12-year-old children (n =159) were examined in 1993 and 70% of them re-examined at 18 years of age. Bitewing radiographs were taken and a diagnostic system using five caries grades (D(1) to D D(5)) was used at both ages. Children at risk were defined as those who developed manifest caries lesions (D(3-5)FS) on approximal surfaces during the follow-up period. Possible predictors were analysed by calculation of sensitivity, specificity, efficiency of the test, proportion that tested positive and actual proportion of the population at risk.

Results: The mean caries increment (D(1-5)MFS) from 12 to 18 years of age was 4.2 (SD +/- 9.1). The percentage of caries-free adolescents at 12 and 18 years of age was 10% and 1% respectively; 25% had either a reversal or no increment in caries experience while the D(1-5)MFS increased in 65% of the adolescents. Of the increment of manifest lesions (D(3-5)FS), 18% were located in incisors/canines, 40% in premolars, 26% in first molars and 16% in second molars. Premolars had the largest proportion of the approximal surfaces with manifest caries increment. The best predictors of children at risk of approximal caries increment (D(3-5)FS) were caries experience (D(1-5)FS) on the approximal surfaces of premolars and second molars at the age of 12 years. The individuals that developed four or more manifest lesions on approximal surfaces between 12 and 18 years were the easiest to predict (sensitivity + specificity = 175%).

Conclusions: There was a considerable increment of manifest caries lesions from 12 to 18 years of age in all tooth groups. The best predictors for increment of manifest caries on approximal surfaces during the age period were approximal caries in premolars and second molars at the age of 12 years.