Identification of adult populations at high risk for dental caries using acomputerized database and patient records: A pilot project

Objectives: The purpose of this study is to test the usefulness of dental i nsurance claims history supplemented with radiographic caries diagnoses, as a means of identifying caries-active and caries-inactive working adults, a s determined by bacterial levels. Computerized identification of at-risk gr oups may facilitate subject selection for clinical trials designed to test caries-preventive strategies. Methods: Two groups of subjects were initiall y selected from an insurance database based upon their dental service utili zation during a one-year period: a "low restorative" group of individuals d efined as persons who had received no restorative treatment, and a "high re storative" group comprised of individuals who had received at least three m ultisurfaced restorations. A chart review confirmed a diagnosis of caries i n the high restorative group and an absence of caries in the low restorativ e group. Subjects were then approached for saliva collection. The low and h igh restorative groups were compared for salivary mutans streptococci and l actobacilli levels, stimulated flow rate, and buffer capacity (n=48). Resul ts: The high and low restorative groups differed in mutans streptococci lev els, but not on other measures. Conclusions: A group of subjects who had re cently received multisurfaced restorations that were placed for reasons of caries had significantly higher levels of mutans streptococci and potential for continued caries activity when compared to a group of subjects who had received no restorations and were caries free.