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

  • J. DavidEmail author
  • M. Raadal
  • N. J. Wang
  • G. V. Strand


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 age12 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 (D1−D5) was used at both ages. Children at risk were defined as those who developed manifest caries lesions (D3−5FS) on approximal surfaces during the follow-up period. Possible predictors were analysed by calculation of sensitivity, specificity, and actual proportion of the population at risk. Results: The mean caries increment (D1−5MFS) 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 D1−5MFS increased in 65% of the adolescents. Of the increment of manifest lesions (D3−5FS), 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 (D3−5FS) were caries experience (D1−5FS) 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.

Key words

Adolescents Dental caries Increment Prediction Follow-up study 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Amarante E, Raadal M, Espelid I. Impact of diagnostic criteria on the prevalence of dental caries in Norwegian children aged 5, 12 and 18 years. Community Dent Oral Epidemiol 1998; Apr; 26(2):87–94.PubMedCrossRefGoogle Scholar
  2. Amarante E. Prevalence of dental caries and periodontal disease in 5-, 12-, and 18-year-old children in Bergen, Norway (M.Sc. thesis). Bergen, University of Bergen, 1995.Google Scholar
  3. Axelsson P, Paulander J, Nordkvist K, Karlsson R. Effect of fluoride containing dentifrice, mouthrinsing, and varnish on approximal dental caries in a 3-year clinical trial. Community Dent Oral Epidemiol 1987;Aug;15(4):177–180.PubMedCrossRefGoogle Scholar
  4. Batchelor PA, Sheiham A. Grouping of tooth surfaces by susceptibility to caries: a study in 5–16 year-old children. BMC Oral Health 2004 Oct 28; 4(1):2.PubMedCrossRefGoogle Scholar
  5. Bjarnason S, Kohler B, Wagner K. A longitudinal study of dental caries and cariogenic microflora in a group of young adults from Goteborg. Swed Dent J 1993;17(5):191–199.PubMedGoogle Scholar
  6. Dummer PMH, Addy M, Oliver SJ, et al. Changes in the distribution of decayed and filled tooth surfaces and the progression of approximal caries in children between the ages of 11–12 years and 15–16 years. Br Dent J 1988;May;164(9):277–282.PubMedCrossRefGoogle Scholar
  7. Eklund SA, Ismail AI. Time of development of occlusal and proximal lesions: implications for fissure sealants. J Public Health Dent 1986 Spring; 46(2):114–121.PubMedCrossRefGoogle Scholar
  8. Espelid I, Tveit AB, Mjor IA, et al. [Systems for grading occlusal and approximal carious lesions]. Nor Tannlaegeforen Tid 1990 Oct; 100(16):658–663.PubMedGoogle Scholar
  9. Glass RL. The first international conference on the declining prevalence of dental caries. J Dent Res 1982;61:1304–1383.Google Scholar
  10. Haugejorden O, Birkeland JM. Evidence for reversal of the caries decline among Norwegian children. Int J Paediatr Dent 2002;Sep;12(5):306–315.PubMedCrossRefGoogle Scholar
  11. Hausen H, Karkkainen S, Seppa L. Application of the high-risk strategy to control dental caries. Community Dent Oral Epidemiol 2000;Feb; 28(1):26–34.PubMedCrossRefGoogle Scholar
  12. Ismail AI. Clinical diagnosis of precavitated carious lesions. Community Dent Oral Epidemiol 1997;Feb; 25(1):13–23.PubMedCrossRefGoogle Scholar
  13. Ismail AI, Brodeur JM, Gagnon P, et al.Prevalence of non-cavitated and cavitated carious lesions in a random sample of 7-9-year-old schoolchildren in Montreal, Quebec. Community Dent Oral Epidemiol 1992;Oct;20(5):250–255.PubMedCrossRefGoogle Scholar
  14. Kingman A. Statistical issues in risk assessment in dentistry. In: Bader Jd (eds). Risk assessment in dentistry. Chapel Hill: University of North Carolina Dental Ecology; 1990. pp 193–200.Google Scholar
  15. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;Mar; 33(1):159–174.PubMedCrossRefGoogle Scholar
  16. Locker D, Liddell A, Dempster L, Shapiro D. Age of onset of dental anxiety. J Dent Res 1999 Mar; 78(3):790–796.PubMedCrossRefGoogle Scholar
  17. Macek MD, Heller KE, Selwitz RH, Manz MC. Is 75 percent of dental caries really found in 25 percent of the population? J Public Health Dent 2004;Winter;64(1):20–25.PubMedCrossRefGoogle Scholar
  18. Mejare I, Kallestål C, Stenlund H, Johansson H. Caries development from 11 to 22 years of age: a prospective radiographic study. Prevalence and distribution. Caries Res 1998;32(1):10–16.CrossRefGoogle Scholar
  19. Mejare I, Kallestål C, Stenlund H. Incidence and progression of approximal caries from 11 to 22 years of age in Sweden: A prospective radiographic study. Caries Res 1999;33(2):93–100.PubMedCrossRefGoogle Scholar
  20. Mjor IA, Dahl JE, Moorhead JE. Placement and replacement of restorations in primary teeth. Acta Odontol Scand 2002;Jan;60(1):25–28.PubMedCrossRefGoogle Scholar
  21. Munro BH. Statistical Methods for Health Care Research Philadelphia, Lippincott Williams & Wilkins.2005.Google Scholar
  22. Newburn E, Leverett D. Risk assessment dental caries working group summary statement. In: Bader Jd (eds). Risk assessment in dentistry. Chapel Hill: University of North Carolina Dental Ecology; 1990. pp 304–305.Google Scholar
  23. Pitts NB. Current methods and criteria for caries diagnosis in Europe. J Dent Educ 1993; 57(6):409–414.PubMedGoogle Scholar
  24. Qvist V, Thylstrup A, Mjor IA. Restorative treatment pattern and longevity of resin restorations in Denmark. Acta Odontol Scand 1986;Dec;44(6): 351–356.PubMedCrossRefGoogle Scholar
  25. Raadal M. Management of early carious lesions in primary teeth. In: Hugoson A, Falk M, Johansson S. (eds). Management of early carious lesions in primary teeth. Stockholm: Forlagshuset Gothia; 2002. pp 48–56.Google Scholar
  26. Raadal M, Espelid I, Mejare I. The caries lesion and its management in children and adolescents. In: Koch G, Poulsen, S (eds). Pediatric dentistry — a clinical approach. Copenhagen: Munksgaard; 2001. pp 173–212.Google Scholar
  27. Seppa L, Hausen H, Pollanen L, Helasharju K, Karkkainen S. Past caries recordings made in Public Dental Clinics as predictors of caries prevalence in early adolescence. Community Dent Oral Epidemiol 1989;Dec;17(6):277–281.PubMedCrossRefGoogle Scholar
  28. Skaret E, Raadal M, Berg E, Kvale G. Dental anxiety and dental avoidance among 12 to 18 year olds in Norway. Eur J Oral Sci 1999;Dec;107(6): 422–428.PubMedCrossRefGoogle Scholar
  29. Skold UM, Klock B, Lindvall AM. Differences in caries recording with and without bitewing radiographs. A study on 5-year old children in the County of Bohuslan, Sweden. Swed Dent J 1997; 21(3):69–75.PubMedGoogle Scholar
  30. Stamm JW, Disney JA, Graves RC, Bohannan HM, Abernathy JR. The University of North Carolina Caries Risk Assessment Study. I: Rationale and content. J Public Health Dent 1988 Fall; 48(4):225–232.PubMedCrossRefGoogle Scholar
  31. Statens helsetilsyn. Tenner for livet. Helsefremmende og forebyggende arbeid. IK-2659 Oslo, Statens helsetilsyn.1999.Google Scholar
  32. Statens helsetilsyn, Sosial- og helsedirektoratet. årsmelding for Den offentlige tannhelsetjenesten 2001 Oslo, Statens helsetilsyn. 2003.Google Scholar
  33. Tveit AB, Espelid I, Mjor IA, et al. [New criteria for secondary decay and marginal defects]. Nor Tannlaegeforen Tid 1990 Oct; 100(16):652–656.PubMedGoogle Scholar
  34. Verrips GH, Kalsbeek H, Eijkman MA. Ethnicity and maternal education as risk indicators for dental caries, and the role of dental behavior. Community Dent Oral Epidemiol 1993 Aug; 216(4):209–214.CrossRefGoogle Scholar
  35. von der Fehr FR. Caries prevalence in the Nordic countries. Int Dent J 1994 Aug; 44(4 Suppl 1):371–378.PubMedGoogle Scholar
  36. Wang NJ, Holst D. Individualizing recall intervals in child dental care. Community Dent Oral Epidemiol 1995; 23(1):1–7.PubMedCrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2006

Authors and Affiliations

  • J. David
    • 1
    • 2
    Email author
  • M. Raadal
    • 1
  • N. J. Wang
    • 3
  • G. V. Strand
    • 4
  1. 1.Department of Oral Sciences — PedodonticsUniversity of BrogenBergenNorway
  2. 2.Centre for International HealthBergenNorway
  3. 3.Institute of Clinical Dentistry — PedonticsUniversity of OsloNorway
  4. 4.Department of Oral Sciences — GerodontecsUniversity of BergenNorway

Personalised recommendations