Majority of New Onset of Dental Caries Occurred from Caries-Free Students: A Longitudinal Study in Primary School Students

Taro Kusama, Hidemi Todoriki, Ken Osaka and Jun Aida
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Taro Kusama: Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
Hidemi Todoriki: Tropical Biosphere Research Center, University of the Ryukyus, Okinawa 903-0213, Japan
Ken Osaka: Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
Jun Aida: Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8549, Japan

IJERPH, 2020, vol. 17, issue 22, 1-9

Abstract: We examined Rose’s axiom that a large number of people exposed to a small risk may generate more cases than a small number exposed to a high risk, using data on caries incidence. This longitudinal study was based on the records of annual dental checks conducted in primary schools in Okinawa, Japan. Participants were students aged 6–11 years at baseline in 2014, and a follow-up survey was conducted after one-year. The outcome variable was the increased number of decayed, missing, and filled teeth (DMFT). The predictor variable was the baseline DMFT score. Gender, grade, and affiliated school variables were adjusted. A negative binomial regression model was used to obtain the estimated increase of DMFT score. Among 1542 students, 1138 (73.8%) were caries-free at baseline. A total of 317 (20.6%) developed new caries during the follow-up. The predicted number of new carious teeth in a caries-free students and students with DMFT = 1 at baseline were 0.26 (95% CI, 0.22–0.31) and 0.45 teeth (95% CI, 0.33–0.56), respectively. However, among the total of 502 newly onset of carious teeth, 300 teeth (59.7%) occurred from the caries-free students at baseline. Hence, prevention strategies should target the low-risk group because they comprise the majority of the population.

Keywords: dental caries; prevention paradox; universal health coverage; population approach; longitudinal study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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