PLAQUE AND GINGIVAL STATUS AS INDICATORS FOR CARIES PROGRESSION ON APPROXIMAL SURFACES

This study aimed to (1)record the plaque and gingival status on sound and carious approximal surfaces and (2) investigate whether the two pa rameters could predict approximal lesion progression. For this purpose two samples were selected among 18- to 25-year-old patients at the De ntal Faculty in Copenhagen. Sample 1 consisted of 45 patients, each ha ving an approximal posterior surface requiring operative treatment and a contralateral approximal space, where both surfaces were radiograph ically sound. Sample 2 consisted of 25 patients, each having a posteri or approximal tooth surface with an enamel/initial dentinal lesion rec orded on a bitewing. Plaque and gingival status were classified using 4-point ranked scales, The recordings were performed once on each part icipant in sample 1. The recordings in sample 2 were repeated 5 times during a 15-month period, In order to assess lesion progression in sam ple 2, two serial intraoral examinations were performed, i.e. at the b eginning and end of the study. Less than 10% of the sound and carious surfaces were recorded as plaque-free, while about 40% had a thick or heavy plaque accumulation. No significant difference was observed betw een plaque scores on sound and carious surfaces (p = 0.5), in contrast to findings representing the gingival status (p<0.001). Tooth surface s requiring operative treatment were associated with bleeding of the g ingiva after probing. In sample 2, 3 of the 25 participants did not fi nish the study. On the remaining participants caries progression was o bserved in 9 cases (41%), while no progression was observed in 13 case s. Analyses showed that there were no significant differences between plaque scores in cases with caries progression, as compared with no ca ries progression (p>0.05), Similar analyses concerning gingival status showed that bleeding of the gingiva was related to cases with progres sing caries. Analyses also disclosed no direct association between pla que and gingival status (Spearman correlation coefficient 0.39). Thus, the occurrence of plaque does not have the same predictive power as b leeding after probing in decision-malting as to whether or not a lesio n progresses.