Untreated caries trajectories and health outcomes at age 45 years

Objectives: Dental caries left untreated may persist over many years, causing ongoing and worsening symptoms, but how untreated dental caries tracks over time and relates to other health problems is little understood due to a lack of longitudinal data. Objective: To investigate the effects on health and wellbeing from having long-term unmet need for dental care.
Methods: Method: The Dunedin Multidisciplinary Health and Development Study is a longitudinal study of health and development/aging among 1037 individuals born in Dunedin, New Zealand from April 1972 to March 1973. They have been repeatedly examined since birth. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32, 38, and 45. Unmet need for dental care was quantified through modelling the trajectory of the number of untreated carious tooth surfaces at each age, adjusting for tooth loss, restorations, and other potential confounders.
Results: Result: Untreated dental caries peaked during early adulthood (age 26 years) but dropped back as tooth loss and restorative care increased into middle adulthood. High counts of untreated carious surfaces were by dental plaque while limited by the loss of teeth and restorative dental care. Untreated caries experience was associated with poor oral hygiene, low socioeconomic status, parent’s poor dental health, and deciduous dentition caries experience, while it was inversely associated with dental restorations and caries-associated tooth loss. Untreated dental caries was associated with worse self-rated oral & general health, worse oral health-related quality of life, and a range of general health conditions.
Conclusions: Conclusion: Untreated dental caries is a visible marker of social inequality and poor access to health care and foreshadows future general health problems.