Age-specific dental caries clusters and perceived oral health over 20 years: a novel approach to DMFT index data.

INTRODUCTION

The use of dental caries indices in oral health surveys, such as the decayed, missing and filled teeth (DMFT) index, may mask heterogeneity in both disease severity and its distribution. This study aimed to identify age-specific clusters of dental caries across a 20-year period in Brazil, assess their temporal trends and examine their associations with perceived oral health.

METHODS

Secondary data from three Brazilian National Oral Health Survey (SB Brasil) conducted in 2003 (N = 70,119), 2010 (N = 29,681), and 2023 (N = 33,229) were analysed across four age groups: children (12 years), adolescents (15-19 years), adults (35-44 years), and older adults (65-74 years). Latent Profile Analysis (LPA) was applied to DMFT components to identify dental caries clusters. Multivariable ordinal and logistic regression models examined associations between caries cluster, self-rated oral health (SROH) and oral health-related quality of life (OHRQoL).

RESULTS

LPA identified five caries clusters in children, seven in adolescents, seven in adults, and four in older adults. The low-caries-experience cluster increased consistently across children, adolescents and adults over time. Severe untreated caries clusters declined in children and adolescents, and severe tooth loss clusters decreased in adults and older adults. Worse caries clusters were consistently associated with poorer SROH and OHRQoL across all age groups and survey years. These associations were generally stronger than those observed for DMFT and DMFT components. In older adults, dental caries clusters showed greater discriminatory capacity than DMFT components.

CONCLUSION

The relationship between dental caries and perceived oral health is dynamic, age-dependent, and cluster-specific. LPA of DMFT components captured clinically meaningful heterogeneity beyond DMFT index and its components, offering a more nuanced understanding of caries severity and its impact on subjective oral health. These findings offer preliminary evidence supporting the complementary use of cluster-based approaches within dental caries indices for oral health surveillance.