Restoration fractures, cusp fractures and root fragments in a diverse sample of adults: 24-month incidence

Background. There are few reports in the literature regarding estimates of the occurrence of tooth fractures. Most studies have assessed tooth fractur es in people seeking dental care, which may underestimate the incidence of the problem. Methods. This study sought to estimate the incidence and prevalence of cusp and restoration fractures, as well as root fragments in participants in th e Florida Dental Care Study, a diverse representative sample of community-d welling residents of four north Florida counties made up of people who seek dental care regularly and those who do not. Participants received a dental examination and an in-person interview at baseline and at a 24-month follo w-up session. Results. At least 20 percent of the participants were diagnosed as having b ulk restoration fractures, cusp fractures or root fragments at the baseline visit. At the 24-month follow-up session, 26 percent of the participants h ad at least one new occurrence of these problems. Of those subjects present ing with tooth fracture, 25 percent had multiple teeth affected. African-Am ericans and people who sought care on a problem-oriented basis experienced twice the rate of cusp fracture and a higher rate of root fragments as did those who sought care on a regular basis. These data represent consecutive prevalence estimates rather than the true incidence, in that fractures that occurred after baseline may have been treated in the intervening 24 months . Thus, these data represent "lower-bound" incidence estimates. Conclusions, These results suggest that restoration fractures, cusp fractur es and root fragments are a significant dental health problem, and that sel ected segments of the population are at greater risk of developing these pr oblems. Clinical Implications, These data are useful for dentists in understanding the magnitude of the problem and the potential progression of fractures and root fragments.