Decayed, Missing due to caries, and Filled Teeth index significantly associated with UDA events

This is a retrospective cohort analysis of a clinical dataset containing 175,558 service personnel over an 11-month period. Statistical methods examined: sensitivity and specificity of the existing NATO 'Dental fitness classification system' (NATO Cat) in predicting UDA, relative risk (RR) of UDA by selected variables, Kaplan-Meier failure analysis and multivariate analysis.

The results of the study are:

A total of 16,722 UDA events were recorded, the majority (66.7%) were due to caries, periapical pathology and fractured teeth or restorations, or a combination thereof. NATO Cat yielded poor predictive sensitivity (sensitivity 10%, specificity 93%). NATO Cat 3 (RR 1.47), age group (RR 1.06-2.05), gender (RR 1.46) and DMFT category (RR 1.09-3.05) were all significantly associated with increased UDA. The RR of UDA increased by 5% (RR 1.05) for each additional DMFT increment in a logistic regression model.

Thus, after adjusting for confounding variables, DMFT was significantly associated with UDA events. This study indicates that, even when treatment need has been met, a residual risk remains that is directly related to exposure to dental disease and operative dentistry. Strategies which prevent downstream operative treatment needs and increases in DMFT may also reduce future UDA. UDA may be a useful quality outcome indicator for the success of NHS dental services in securing oral health.

Reference:

A bridge too far? The relationship between interventive operative dentistry and future dental morbidity by Mark Dermont et al. published in the British Dental Journal.

https://www.nature.com/articles/s41415-019-0147-4