Risk indicators for the presence and extent of root caries among caries-active adults enrolled in the Xylitol for Adult Caries Trial (X-ACT)

Objective: This paper uses baseline data from a randomized clinical trial to evaluate cross-sectional indicators of root caries in caries-active adults. Materials and methods: Adults (21-80 years) having at least 12 erupted teeth and between one and ten caries lesions were enrolled. Participants (n = 437) received caries exams by trained, calibrated examiners and responded to baseline demographic and medical-dental questionnaires. We examined associations between baseline characteristics and (1) the presence of any root caries using Mantel-Haenszel hypothesis tests and odds ratio (OR) estimators and (2) the number of root surfaces with caries among study participants with exposed root surfaces (n = 349) using Mantel-Haenszel mean score tests and Mann-Whitney estimators. Results/conclusions: Adjusting for study site and age, male gender [OR, 1. 72; 95% confidence interval (CI), 1. 08, 2. 78], white race (OR, 2. 39; 95% CI, 1. 43, 3. 98), recent dental visit (OR, 1. 98; 95% CI, 1. 07, 3. 66), poor self-described oral health (OR, 2. 65; 95% CI, 1. 10, 6. 39), and recent professional fluoride treatment (OR, 1. 85; 95% CI, 1. 06, 3. 25) were significantly associated with increased odds to have any root caries, and study participants with exposed root surfaces characterized by male gender [Mann-Whitney probability estimate (MW) = 0. 57; 95% CI, 0. 51, 0. 63), white race (MW, 0. 61; 0. 55, 0. 68), recent dental visit (MW, 0. 58; 0. 50, 0. 67), poor self-described oral health (MW, 0. 61; 0. 53, 0. 69), and flossing at least once per day (MW, 0. 57; 95% CI, 0. 51, 0. 62) were significantly more likely to have a greater number of root surfaces with caries than a randomly selected study participant from their respective complementary subgroups (female gender, non-white, etc.). Clinical relevance: Our findings may help identify individuals at higher root caries risk.