Root caries experience in Germany 1997 to 2014

Introduction: We assessed time trends in root caries experience, i.e. the sum of filled and carious root surfaces (FRS, CRS), and evaluated risk indicators of FRS/CRS in Germany. 

Methods: FRS and CRS from repeated waves (1997, 2005, 2014) of the nationally-representative German Oral Health Studies were analyzed in 35-44- and 65-74-year-olds (adults/younger seniors; n = 4388). Weighted means were interpolated cross-sectionally across age groups by fitting piecewise-cubic spline-curves, and population-level FRS and CRS calculated. We also projected population-level FRS and CRS to 2030. To evaluate risk indicators of FRS and CRS, zero-inflated negative-binomial regression was applied. 

Results: In adults FRS increased from 1997 to 2005 at individual and population level (from a mean of 0.49 to 0.63 surfaces; from a total of 6.2 to 8.7 million surfaces) and then decreased to 2014 (to 0.16 surfaces/1.6 million surfaces). CRS constantly increased (1997: 0.37 surfaces/4.7 million surfaces; 2014: 0.94 surfaces/9.3 million). In younger seniors, FRS increased from 1997 to 2005 (from 0.67 to 1.92 surfaces; 5.0 to 17.5 million surfaces) and then decreased to 2014 (0.89 surfaces/7.5 million surfaces). CRS constantly increased (1997: 0.39 surfaces/2.9 million surfaces; 2014: 1.43 surfaces/12.1 million surfaces). Driven by demographic changes until 2030, population-level FRS and CRS is likely to increase in younger seniors, but not adults. Sex, toothbrushing behavior, age, coronal caries experience and the number of teeth with probing-pocket-depths>/=4 mm were associated with FRS and CRS. 

Conclusions: While FRS does not show a clear trend, CRS has constantly increased since 1997. Concepts for preventing and managing CRS in Germany are needed. 

Clinical Significance: Evaluating time trends and assessing risk indicators of root caries experience is helpful to understand morbidity dynamics, plan resource allocation and identify individuals/groups at risk. While FRS shows no clear trend, CRS has increased since 1997 in Germany. Concepts for addressing the emanating treatment needs are needed.