Dental Caries in African American Adults in Detroit

Methods: A multistage probability sample of African-American (AA) families living in the poorest 39 Census Tracts in Detroit was conducted. This study used cross sectional data collected in 2002-2003 from 1,021 caregivers (14-70 years of age; average age 29 years) of children less than 6 years old. Dental caries was measured using the International Caries Diagnosis and Assessment System (ICDAS). Caries diagnostic codes were recorded on a scale from 0 to 6 (From sound, visual changes in enamel to extensive distinct cavity with visible dentin). Analyses were conducted using SUDAAN to account for the complex sampling design.

Results: Overall 84% of adults have cavitated enamel lesions and 16% have non-cavitated lesions. Mean DMFS ± SE at two different thresholds were as follows: a) including noncavitated and cavitated lesions (47.5 ± 1.2) and b) including only cavitated lesions (28.6 ± 1.2). The most prevalent diagnostic codes were 6 (extensive cavitation 41.5%), 4 (enamel cavity 25.2%) and 2 (distinct change in enamel 14.7%). About 13% of the variability in untreated decay among caregivers was accounted for by SES indicators, oral hygiene, self-perception of oral health and an indicator of QoL. A significant decrease in untreated surfaces was observed with a positive self perception of oral health, while an increase in caries was observed with increasing levels of dental pain.

Conclusions: A high number of African-American adults in Detroit were affected by dental caries, and most often extensive cavitation. Caregivers with high positive perception of their oral health status tended to have slightly better caries status. Needs for dental care were high in this population.

Supported by NIDCR/NIH USPHS grant U-54 DE 14261-01.