Root caries and risk profiles using the Cariogram in different periodontal disease severity groups

Abstract

Objectives. To study root caries and risk profiles using the Cariogram in relation to periodontal disease severity and to analyse indicators associated with high caries risk. Material and methods. A cross-sectional examination was carried out on 112 patients with periodontal disease from two government clinics in Saudi Arabia. The investigation comprised a questionnaire, bitewing radiographs, measurement of salivary secretion rate, buffering capacity and cariogenic microorganisms, and registration of periodontal status, plaque amount and coronal and root caries/fillings (DFT and RDFT). The data were then entered into the Cariogram pedagogic model to illustrate the caries risk profiles. Results. Patients were grouped according to periodontal disease severity into one of three groups: (1) gingivitis (n = 44); (2) mild-to-moderate periodontitis (n = 33); and (3) severe periodontitis (n = 35). The prevalence of RDFT in the total sample was 17%. There were no statistically significant differences between the three groups in number of root lesions or mean ‘Actual Chance to Avoid New Cavities’ (Chance-AC) according to the Cariogram. Of the total sample, 22% displayed high caries risk (Chance-AC ≤40%). The most significant risk indicators in high caries risk patients were infrequent use of fluoride and unfavourable salivary and microbial parameters. Conclusions. Root surface lesions and high caries risk were present in about one-fifth of the patients referred for periodontal treatment. A combination of risk indicators rather than a single one contributed to the increased risk. Caries and risk profiles were not significantly correlated with periodontal disease severity.

Key Words::

• periodontal disease
• risk assessment
• root caries
• Saudi Arabia

Acknowledgements

The authors thank Dr Nils Ravald from the Centre for Oral Rehabilitation in Linköping, Sweden for his valuable comments on the manuscript, Professor Abdulla Al-Yahya, Dr Thakib Al-Shaalan and Dr Abdullah Al-Direes from KSU and Major General Mohammed Al Halafi and Dr Bassam Linjawi from KFAFH in Saudi Arabia for facilitation of the project and Mr. Tommy Johnsson from the University of Gothenburg, Sweden for statistical advice. This study was part of a project supported by a scholarship from the Saudi Ministry of Higher Education. The chair-side salivary sampling kits were provided by Vivacare (Schaan, Liechtenstein).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.