Dataset Information

Dental Caries Risk in the U.S. Air Force: 2009 to 2017.

ABSTRACT:

Introduction

The Air Force uses dental caries risk assessments (CRA) to determine which active duty Air Force (ADAF) members are at high caries risk (HCR) and will benefit from additional preventive and restorative dental care. The purpose of this study is to describe the caries risk of ADAF from 2009 to 2017 and determine how demographic, military, and tobacco-use characteristics affect caries risk.

Materials and methods

Data from ~300,000 ADAF annual dental examinations from 2009 to 2017 were used. The outcome variable investigated was dental caries risk (high, moderate, or low). Independent variables analyzed were: age, sex, race, education, marital status, military rank, service years, flying status, and tobacco use. Descriptive and multivariable analyses were performed to explore associations between potential risk indicators and caries risk outcomes.

Results

From 2009 to 2013, there was a steady decline in ADAF that were diagnosed as low caries risk (LCR), from 80.3% to 67.7%. Since 2013, the prevalence of ADAF that are LCR has remained unchanged at about two-thirds of the force. The proportion of the ADAF that are moderate caries risk (MCR) increased from 15.7% in 2009 to 25.3% in 2013 and remained unchanged affecting about a quarter of the force since then. The proportion that was diagnosed as HCR increased from 3.9% in 2009 to 7.1% in 2013 and declined slightly in 2017 (6.0%). After controlling for other covariates, younger age (<20 years old: odds ratio [OR], 4.4; 95% confidence interval [CI], 3.3-5.8), less time in service (≤4 years: OR, 2.1; 95% CI, 1.7-2.6), junior rank (E-1-E-4: OR, 1.6; 95% CI, 1.3-1.8), less education (high-school graduate: OR, 2.3; 95% CI, 2.0-2.6), using tobacco (Smoker: OR, 1.6; 95% CI, 1.5-1.7), being a nonflyer (OR, 1.2; 95% CI, 1.1-1.3), being male (OR, 1.1; 95% CI, 1.1-1.2), or being black (OR, 1.2; 95% CI, 1.1-1.2) were each associated with being HCR. Among the cohort of Airmen who were LCR at baseline, the majority (75.9%) remained at low risk, but for nearly a quarter (24.1%), their risk of caries increased over 9 years. Among those who were originally MCR in 2009, 61.5% improved to LCR, whereas 4.6% progressed to HCR; among those identified as high risk for caries in 2009, a substantial majority (89.1%) improved over 9 years, but 10.9% remained unchanged.

Conclusions

The prevalence of HCR and MCR service members increased from 2009 to 2013 but has remained consistent since 2013. Overall caries risk in the Air Force is lower compared to previously published findings from 2001 to 2004. This suggests that CRA and prevention programs have been effective at helping to reduce caries prevalence among Airmen. Smoking prevalence among ADAF has also declined substantially over the past 16 years which may contribute to overall caries risk reductions. Using a CRA approach may be an effective tool for helping to identify and develop strategies to manage dental caries risk in patients.

SUBMITTER: Schindler DK

PROVIDER: S-EPMC7974017 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Fluoridation of America's drinking water was among the great public health achievements of the 20th century. Yet there is a paucity of studies from the past 3 decades investigating its dental health benefits in the U.S. POPULATION:This cross-sectional study sought to evaluate associations between availability of community water fluoridation (CWF) and dental caries experience in the U.S. child and adolescent population. County-level estimates of the percentage of population served by CWF (% CWF) from the Centers for Disease Control and Prevention's Water Fluoridation Reporting System were merged with dental examination data from 10 y of National Health and Nutrition Examination Surveys (1999 to 2004 and 2011 to 2014). Dental caries experience in the primary dentition (decayed and filled tooth surfaces [dfs]) was calculated for 7,000 children aged 2 to 8 y and in the permanent dentition (decayed, missing, and filled tooth surfaces [DMFS]) for 12,604 children and adolescents aged 6 to 17 y. Linear regression models estimated associations between % CWF and dental caries experience with adjustment for sociodemographic characteristics: age, sex, race/ethnicity, rural-urban location, head-of-household education, and period since last dental visit. Sensitivity analysis excluded counties fluoridated after 1998. In unadjusted analysis, caries experience in the primary dentition was lower in counties with ?75% CWF (mean dfs = 3.3; 95% confidence limit [CL] = 2.8, 3.7) than in counties with <75% CWF (mean dfs = 4.6; 95% CL = 3.9, 5.4), a prevented fraction of 30% (95% CL = 11, 48). The difference was also statistically significant, although less pronounced, in the permanent dentition: mean DMFS (95% CL) was 2.2 (2.0, 2.4) and 1.9 (1.8, 2.1), respectively, representing a prevented fraction of 12% (95% CL = 1, 23). Statistically significant associations likewise were seen when % CWF was modeled as a continuum, and differences tended to increase in covariate-adjusted analysis and in sensitivity analysis. These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth.