Risk indicators of root caries among elders in care facilities

Abstract

Objectives: Root caries is common among elderly people and can lead to pain and tooth loss, affecting their quality of life. The aim of this study was to investigate the risk indicators of root caries among aged attendees of long-term care or social service facilities in Hong Kong. Methods: Data were extracted from the baseline examination of elders in a clinical trial on root caries. Elders who had at least 6 natural teeth with exposed root surfaces were examined in 10 long-term care and social service facilities in Hong Kong from 2017 August to 2018 January. Oral examinations were conducted by two calibrated examiners to assess the elders' oral health status. Information on their general health status and oral health related behaviors was collected in an interview using a structured questionnaire. Multilevel logistic regression was performed, with presence of root caries at tooth surface level as the dependent variable, to investigate its associations with subject-level and surface-level factors. Results: A total of 330 elders with a mean age of 74.7 years (60-98 years) were included in this analysis. Their mean DF-root score was 0.85. After adjusting for other variables, such as age, gender, snacking frequency, use of mouthrinse and taking medicine affecting saliva secretion, the elder’s frequency of tooth brushing was significantly correlated with the risk for root caries (OR=0.59; 95% CI: 0.37-0.92). Besides, root surfaces with plaque present had a higher chance of root caries than those without plaque (OR=6.23; 95% CI: 4.20-9.25). Conclusions: Plaque on root surfaces and infrequent tooth brushing are important risk indicators for root caries among elders receiving social welfare services and/or long-term care in Hong Kong. Efforts should be made to enhance the oral hygiene of these elders.