Dental caries spectrum profile in Brazilian public school children and adolescents

VELASCO, Sofia Rafaela Maito; PISTELLI, Gustavo Chab; RAZERA, Fernanda Pátaro Marsola; MENEZES-SILVA, Rafael; BASTOS, Roosevelt Silva; NAVARRO, Maria Fidela de Lima

doi:10.1590/1807-3107bor-2021.vol35.0067

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Sumário

Original research, Community Dentistry • Braz. oral. res. 35 • 2021 • https://doi.org/10.1590/1807-3107bor-2021.vol35.0067 copy

Dental caries spectrum profile in Brazilian public school children and adolescents

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Abstract

Dental caries remains a major public health problem, with a higher prevalence among in adolescence. The present study aimed to assess the dental caries spectrum profile in children and adolescents in Brazilian public schools. A cross-sectional study was performed in two public schools in Brazil to examine the permanent teeth of children and adolescents. The dental caries were assessed by applying the Caries Assessment Spectrum and Treatment (CAST) instrument, and the results were distributed as per disease status (healthy/codes 0–2; pre-morbidity/code 3; morbidity/code 4–5; severe morbidity/codes 6–7; mortality/code 8) and by severity as per the CAST-F1 formula (no severity, mild, moderate, and severe). The CAST data were described by age groups (8–9 y, 10–11 y, 12–13 y, 14–15 y, 16–17 y, and 18–19 y). The Kruskal–Wallis test was used to investigate differences in CAST prevalence and severity among the groups (p < 0.05). Total 598 students were enrolled. Most of the subjects were male (53.34%) and belonged to the age group of 12–13 y (34.95%). The variables CAST 0/1 (p = 0.024), CAST (p = 0.024), and CAST-F1 (p = 0.029) showed significant differences among age groups, and the post hoc test showed the differences in these variables as per the age groups of 14–15 y and 16–17 y (CAST 0/1, p = 0.047; CAST, p = 0.047; CAST-F1, p = 0.033). The dental caries spectrum increased from 8 to 19 y with a peak in the prevalence and severity in the middle of adolescence.

Dental Caries; Child; Adolescent; Index; Epidemiology

Characteristic	Code	Description
Sound	0	No visible evidence of a distinct carious lesion
Sealant	1	Pits and/or fissures are at least partially covered with a sealant material
Restoration	2	A cavity is restored with an (in)direct restorative material
Enamel	3	Distinct visual change in enamel only; a clear caries-related discoloration is visible, with or without localized enamel breakdown
Dentine	4	Internal caries-related discoloration in the dentine; the discolored dentine is visible through the enamel that may or may not exhibit a visible localized breakdown
Dentine	5	Distinct cavitation into the dentine; the pulp chamber is intact
Pulp	6	Involvement of the pulp chamber; distinct cavitation reaching the pulp chamber, or only root fragments are present
Abscess/Fistula	7	A pus-containing swelling or a pus-releasing sinus tract related to a tooth with pulpal involvement
Lost	8	The tooth has been removed because of dental caries
Other	9	Does not match with any other descriptions

Age (y)	Female		Male		Total
Age (y)	n	%	n	%	n	%
8–9	16	2.68	18	3.01	34	5.69
10–11	68	11.37	60	10.03	128	21.40
12–13	102	17.06	107	17.89	209	34.95
14–15	63	10.54	100	16.72	163	27.26
16–17	24	4.01	27	4.52	51	8.53
18–19	6	1.00	7	1.17	13	2.17
Total	279	46.66	319	53.34	598	100.00

Age groups (y)	CAST 0/1	CAST 2	CAST 3	CAST 4	CAST 5	CAST 6/7	CAST 8	CAST	CAST (median)
8–9
mean	26.26	0.41	0.65	0.26	0.03	0.26	0.06	1.68	1
SD	2.18	1.46	1.35	0.79	0.17	0.79	0.34	2.08	1
10–11
mean	26.54	0.37	0.61	0.24	0.16	0.05	0.03	1.46	0
SD	2.06	0.84	1.30	0.76	0.76	0.26	0.22	2.06	0
12–13
mean	26.61	0.33	0.63	0.27	0.09	0.03	0.03	1.39	0
SD	2.13	0.97	1.19	0.76	0.54	0.25	0.27	2.13	0
14–15
mean	26.65	0.33	0.58	0.20	0.08	0.10	0.04	1.33	0
SD	1.93	0.96	1.27	0.70	0.40	0.50	0.25	1.91	0
16–17
mean	25.75	0.49	1.14	0.41	0.10	0.12	0.00	2.25	1
SD	2.70	1.08	1.60	0.83	0.30	0.48	0.00	2.70	1
18–19
mean	24.46	0.69	1.62	0.77	0.15	0.08	0.23	3.54	3
SD	3.31	2.21	1.45	1.36	0.38	0.28	0.83	3.31	3
p-value*	0.024	0.631	0.001	0.008	0.546	0.162	0.650	0.024
p-value**	0.047	-	0.003	0.014	-	-	-	0.047

Age Groups (y)	CAST 0 / 1	CAST 2	CAST 3	CAST 4	CAST 5	CAST 6 / 7	CAST 8	Maximum CAST
Age Groups (y)	CAST 0 / 1	CAST 2	CAST 3	CAST 4	CAST 5	CAST 6 / 7	CAST 8	(mean;SD)	(median)*
8–9
n	14	3	8	3	1	4	1	2.32; 2.34	3
%	41.18	8.82	23.53	8.82	2.94	11.76	2.94	2.32; 2.34	3
10–11
n	66	11	21	12	9	6	3	1.86; 2.20	0
%	51.56	8.59	16.41	9.38	7.03	4.69	2.34	1.86; 2.20	0
12–13
n	112	17	36	26	10	4	4	1.68; 2.04	0
%	53.59	8.13	17.22	12.44	4.78	1.91	1.91	1.68; 2.04	0
14–15
n	87	14	28	14	8	8	4	1.77; 2.18	0
%	53.37	8.59	17.18	8.59	4.91	4.91	2.45	1.77; 2.18	0
16–17
n	23	0	11	8	5	4	0	2.24; 2.20	3
%	45.10	0.00	21.57	15.69	9.80	7.84	0.00	2.24; 2.20	3
18–19
n	3	1	2	5	1	0	1	3.15; 2.27	4
%	23.08	7.69	15.38	38.46	7.69	0.00	7.69	3.15; 2.27	4

Age Groups (y)	No Severity		Mild		Moderate		Severe		CAST-F1
Age Groups (y)	n	%	n	%	n	%	n	%	mean (SD)
8–9	17	50.0	10	29.4	7	20.6	0	0.0	1.9 (3.65)
10–11	77	60.2	32	25.0	19	14.9	0	0.0	1.11 (2.45)
12–13	129	61.7	56	26.8	23	11.0	1	0.50	0.94 (2.68)
14–15	101	61.7	40	24.5	22	13.5	0	0.0	1.12 (2.65)
16–17	23	45.1	15	29.4	13	25.5	0	0.0	1.36 (2.40)
18–19	4	30.8	6	46.2	2	15.4	1	7.7	3.17 (6.97)
p-value*	1.000		0.791		0.300		1.000		0.031
p-value**									0.018

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[1] Corresponding Author: Sofia Rafaela Maito Velasco E-mail: sofiamaito@hotmail.com