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| Title |
Unsealed Mandibular Premolars are Less Susceptible to Occlusal caries Than Unsealed Permanent Posterior Teeth |
| Clinical Question |
In a high caries risk patient, is an unsealed mandibular premolar less susceptible to occlusal caries than other unsealed permanent posterior teeth? |
| Clinical Bottom Line |
Unsealed mandibular premolars are just as susceptible, and in some cases more susceptible, to occlusal caries over 5 years than other unsealed permanent posterior teeth. This is supported by two cross-sectional observational studies with nearly identical results with very large sample sizes from different patient groups. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 23064960 | Shaffer/2013 | Center for Oral Health in Appalachia: patients had higher dental caries prevalence than general US population N= 1,068 63% female 90% white mean age= 34.7 yrs. | Cross-Secitonal Observational Study | | Key results | The article demonstrated a comparison for caries incidence in different tooth surfaces of 1,068 patients in a patient pool that represents NHANES data. It shows a predilection for caries to occur in molar occlusal surfaces than on occlusal of premolars. Maxillary first premolars are more susceptible than mandibular first premolars. | | #2) 20613915 | Demirci/2010 | Patients attending the Department of the Faculty of Dentistry at Istanbul University, examined between 2001 and 2004. 11915 caries surfaces (or 17558 caries sites) in 2383 teeth were recorded. | Cross-Sectional Observational Study | | Key results | Occlusal fissures on the first and second molars contributed most significantly to caries frequency, from 52.7% to 66.3%, respectively. Maxillary and mandibular first and second premolars had the highest frequency of caries on the distal surfaces. | |
| Evidence Search |
("Bicuspid"[Mesh]) AND "Dental Caries Susceptibility"[Mesh] |
Comments on
The Evidence |
Both articles are cross-sectional observational studies pertaining to a population and caries incidence at a point in time. The first article has a very large patient pool. Although the patients in the study were disproportionately underserved with lower oral health, the caries distribution results were stated to mirror NHANES data, and therefore still valid. For the first study, the dental examinations were performed in the same manner on each patient in accordance with the National Center for Health Statistics Dental Examiners Procedures Manual (Section 4.9.1.3) to maximize comparability with other national data sets and yielded high-quality reproducible data. In the second article, patients were evaluated according to WHO guidelines. Perspective: Though the studies are cross-sectional observational studies, the level of evidence provided answers the clinical question sufficiently. |
| Applicability |
The dental status of the subjects in the studies was generally lower than the general US population. The patient pools were of specific populations (90% white in Appalachia, patients in Turkey) but the results were the same and mirrored those of NHANES. The information can help providers understand risk factors for specific teeth, base preventative or restorative decisions off of the data, and have a better understanding of overall caries outcomes. |
| Specialty/Discipline |
(Public Health) (General Dentistry) (Pediatric Dentistry) (Periodontics) (Prosthodontics) (Restorative Dentistry) (Dental Hygiene) |
| Keywords |
bicuspid, dental caries susceptibility, dental sealants, occlusal caries, posterior teeth
|
| ID# |
2670 |
| Date of submission: |
03/11/2014 |
| E-mail |
bakkea@livemail.uthscsa.edu |
| Author |
Andrea Bakke |
| Co-author(s) |
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| Co-author(s) e-mail |
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| Faculty mentor/Co-author |
John Roberts, DDS |
| Faculty mentor/Co-author e-mail |
jr2148327480@hotmail.com; John.Roberts@dads.state.tx.us |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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