Caries Progression Until Adulthood: A Systematic Review of Cohort Studies

Objectives: Caries progression seems to follow universal, predictable rates, which seem to depend largely on the baseline caries levels: the higher the baseline caries levels, the higher the progression rates. Quantification of these rates would allow prediction of future caries levels. Our objectives are to describe the caries progression in the primary and permanent dentition in cohorts of young people and to establish universal progression rates.
Methods: With a systematic search in MEDLINE-PubMed, Embase, Cinahl and the Cochrane library we retrieved cohort studies reporting empirical caries progression data. The eligibility criteria were: reporting empirical data from at least 2 full-mouth dental caries examinations during a follow-up of at least three years; a first examination after 1974; a second caries examination before the age of 22; caries assessed as dentinal caries (d₃/D₃); caries reported in dmfs, dmft, DMFS, DMFT or in percentage of caries-free young people. We extracted data from studies with sufficient quality, described the results for the primary and permanent dentition and performed a meta-analysis (random effects model) for the caries-free survival regarding young people’s permanent dentition.
Results: Of the 5,615 unique studies retrieved, 38 studies were of sufficient quality and were included for systematic review. The study methods were too diverse to allow data pooling for caries progression rates for the primary dentition. For the permanent dentition, the annual decline in caries-free young people varied from 0.8% to 10.2%. The annual increments in DMFS ranged from 0.07-1.77 and in DMFT from 0.06-0.73. The meta-analysis for caries-free survival showed a decline in caries-free young people of 9.3% (7.7-11.1%) per personyear. This is equivalent to a caries progression rate of 0.11 (0.09-0.13) per personyear.
Conclusions: We described progression rates for dental caries in the permanent dentition. These can be used for planning and evaluation of oral healthcare services.