Factors associated with dental root caries - a systematic review

Abstract

Objectives: To identify the factors associated with root caries and to describe their relationship with the presence and the extent of root caries. Methods: A search was carried out on PubMed, MEDLINE, EMBASE, and Scopus databases for paper published between January 1990 and October 2018. Observational studies that investigated at least one risk indicator of root caries on relatively healthy persons were included in this review and there was no language restriction. The exclusion criteria were: 1) studies without any statistical analysis of data on root caries; 2) sample size smaller than 100; and 3) laboratory investigations. After removing duplicated and excluding irrelvant papers, the abstract and text of potentially relevant papers were read by two reviewers independently. Information on the factors associated with the presence or extent of decayed or filled root surfaces (DF-root) and/or decayed root surfaces (D-root) were extracted. The factors were sorted into six categories, namely social-demographic background, general health, health behaviors, fluoride exposure, oral health habits, and oral health condition. Results: Quality of the 127 relevant papers were assessed and those of low methodological quality were excluded. Finally, 44 papers reporting on 40 cross-sectional studies were included. The total sample size was 78,183 participants from different countries around the world. Positive correlations were detected between root caries, and age (7 out of 11 studies), gingival recession or loss of attachment (3 out of 3 studies) and use of tobacco (4 out of 5 studies) while negative correlations were found for household income (7 out of 7 papers) and oral hygiene status (3 out of 4 studies). Mixed findings were reported for the association with the number of teeth and dental visit behaviors. Conclusions: This systematic review found a number of factors in different categories to be associated with root caries. People who are older, in lower socio-economic status or tobacco users and those with more exposed roots or poorer oral hygiene have higher risk of root caries.