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Impact of detection criteria on coronal and root caries estimates in adults with and without type 2 diabetes mellitus

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Abstract

Objective

To compare caries prevalence and extent in adults with or without diabetes mellitus (DM) according to different caries detection criteria (WHO, ICDAS, and Nyvad).

Materials and methods

A cross-sectional study was carried out including 122 individuals, 44 without DM and 78 with type 2 DM. Trained and calibrated examiners performed a visual-tactile inspection to record coronal and root caries lesions (weighted kappa > 0.7). Caries prevalence and extent were calculated according to the WHO (only cavitated lesions, missing and filled surfaces), ICDAS (all non-cavitated and cavitated lesions, missing and filled surfaces), and Nyvad (only active lesions, non-cavitated and cavitated). For root caries, lesions were classified as active or inactive.

Results

A significantly higher overall caries experience (DMF-S) was observed among patients with DM when the WHO (RR = 1.37; 95% CI = 1.09–1.71) and the ICDAS (RR = 1.32; 95% CI = 1.07–1.62) criteria were adopted. No difference between groups was found when the Nyvad criterion was used, although a low study power was observed in this comparison. Estimates for root caries showed a higher prevalence (PR = 2.65; 95% CI = 1.05–6.70) and risk (RR = 6.02, 95% CI = 1.81–20.00) of total D-S among diabetic patients.

Conclusions

DM can predispose individuals to a higher number of root caries lesions, independently of their past caries experience. Missing teeth can overestimate caries extent in individuals with DM.

Clinical relevance

Individuals with DM should be monitored for the prevention and control of root caries. It is recommended to splitting missing teeth from the caries estimates in studies involving adults, particularly diabetic ones.

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Acknowledgements

The authors would like to thank the researchers, interns, and staff of the Diabetes Project, Department of Dentistry, University of Brasilia, in the name of its coordinator Dr Maria do Carmo Machado Guimarães. We also acknowledge Fundação de Apoio à Pesquisa—Distrito Federal (FAP-DF) for the funding and the Programa de Iniciação Científica (ProIC-UnB) for the scholarship provided to Bárbara Aranha Ribeiro. Nailê Damé-Teixeira thanks the UK’s Academy of Medical Sciences Newton International Fellowship program.

Funding

This project is funded by Fundação de Apoio à Pesquisa—Distrito Federal (process number: 16991.78.45532.26042017).

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Authors and Affiliations

  1. Department of Dentistry, School of Health Sciences, University of Brasilia, Brasilia, Brazil

    Bárbara Aranha Ribeiro, Camilla Pedrosa Vieira Lima & Nailê Damé-Teixeira

  2. Department of Dentistry, Catholic University of Brasilia, Brasilia, Brazil

    Camilla Pedrosa Vieira Lima

  3. Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil

    Luana Severo Alves

Authors
  1. Bárbara Aranha Ribeiro
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  2. Camilla Pedrosa Vieira Lima
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  3. Luana Severo Alves
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  4. Nailê Damé-Teixeira
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Contributions

Bárbara Aranha Ribeiro and Nailê Damé-Teixeira conceived the study. Bárbara Aranha Ribeiro performed data collection and drafted the paper. Camilla Pedrosa Vieira Lima performed data collection. Nailê Damé-Teixeira and Luana Severo Alves performed the data analysis and critically reviewed the paper. All authors gave final approval.

Corresponding author

Correspondence to Nailê Damé-Teixeira.

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Ethics approval

This research is following the guidelines for studies in humans and it was approved by the Research Ethics Committee (number: 87962818.4.0000.0030). Individuals received the basic dental treatment, and the ones without dental caries received oral hygiene instruction and professional prophylaxis.

Informed consent

All participants provided written informed consent.

Conflict of interest

The authors declare no competing interests.

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Ribeiro, B.A., Vieira Lima, C.P., Alves, L.S. et al. Impact of detection criteria on coronal and root caries estimates in adults with and without type 2 diabetes mellitus. Clin Oral Invest 26, 3687–3695 (2022). https://doi.org/10.1007/s00784-021-04339-z

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