Work

Caries risk trajectories in a changing oral health landscape. A longitudinal study of orthodontic patients across four decades

Year: 2025

Type: article

Abstract: OBJECTIVES: This study aimed to characterise caries risk trajectories in orthodontic patients starting treatment from the late 1980s to the present and to evaluate whether the predictive value of risk factors for incident caries experience has changed across decades (≤1995, 1996-2005, 2006-2015, ≥2016). MATERIALS AND METHODS: Panoramic radiographs taken before treatment, at debonding, and at follow-up from 710 patients treated with Herbst appliances were analysed. Outcome variables included incident caries experience; predictor variables were age, sex, caries (D3/4), and missing/filled teeth (MFT). Analyses employed univariate logistic regression, multiple supervised machine learning models, and k-means clustering. RESULTS: The proportion of patients presenting with caries at treatment start declined from 32.9 % in the earliest decade to 19.5 % in the most recent, accompanied by a significant reduction in incident caries during treatment (from 59.8 % to 27.4 %). Present caries and MFT consistently predicted incident caries experience, although their relative importance varied across decades. Machine learning models yielded moderate predictive accuracy, with performance differing over time. Unsupervised clustering identified distinct patient risk profiles that remained stable in character but shifted in prevalence across decades. CONCLUSIONS: Both caries prevalence/incidence and the predictive value of present caries and MFT changed over time. Machine learning and clustering approaches provided refined insights into risk trajectories, emphasising the need for temporally adaptive models in preventive care. CLINICAL SIGNIFICANCE: Despite overall declines, caries remains a relevant challenge in orthodontic patients. Identifying high-risk individuals in an era of a low overall caries prevalence requires vigilant, individualised monitoring.

Source: Journal of Dentistry

DOI: 10.1016/j.jdent.2025.106216

Authors: Carolina Ganss, Niko C Bock, Katja Jung, Katharina Klaus, Sabine Ruf, Nelly Schulz-Weidner

Institutions: Philipps University of Marburg, Justus-Liebig-Universität Gießen

Language: English

Topic: Dental Health and Care Utilization

Subfield: Periodontics

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,160