University of Oulu

Laajala A, Pesonen P, Anttonen V, Laitala M-L: Association of Enamel Caries Lesions with Oral Hygiene and DMFT among Adults. Caries Res 2019;53:475-481. doi: 10.1159/000497358

Association of enamel caries lesions with oral hygiene and DMFT among adults

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Author: Laajala, Anne1; Pesonen, Paula2; Anttonen, Vuokko1,3;
Organizations: 1Department of Cariology, Endodontology and Pediatric Dentistry, Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
2Northern Finland Birth Cohorts, Faculty of Medicine, University of Oulu, Oulu, Finland
3Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Karger, 2019
Publish Date: 2022-12-13


The aim of this study was to evaluate the prevalence of enamel caries lesions and their association with tooth brushing frequency, tooth brushing quality, and past caries experience among Finnish adults. The study population comprised 46-year-old members of the Northern Finland Birth Cohort 1966 (n = 1,961). Caries lesions were examined and recorded at surface level using the International Caries Detection and Assessment System (ICDAS). The cut-off point for enamel caries was set to ICDAS score 3. The cut-off point for brushing frequency was twice daily. Visible plaque on buccal tooth surfaces represented brushing quality. Using enamel caries lesions (ICDAS1–3) as a dependent variable, an adjusted logistic regression model was conducted to investigate the association with gender, brushing frequency, visible plaque, dentin caries lesions (ICDAS4–6), teeth with restorations, extractions and fractures. Almost all participants (99%) had enamel and 40% had dentin caries lesions; the mean number of teeth with enamel caries lesions was 13.8 (SD 4.6). According to the adjusted logistic regression model, the high prevalence of ICDAS1–3 lesions was associated with having visible plaque on more than 20% of teeth and having more than 13 restored teeth. In conclusion, the prevalence of enamel caries lesions is high among the Finnish adult population. The results of this study suggest that in addition to tooth brushing frequency, the presence of visible plaque seems to be critical when evaluating the association between tooth brushing and enamel caries.

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Series: Caries research
ISSN: 0008-6568
ISSN-E: 1421-976X
ISSN-L: 0008-6568
Volume: 53
Issue: 4
Pages: 475 - 481
DOI: 10.1159/000497358
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Funding: NFBC1966 received financial support from University of Oulu Grant No. 24000692, Oulu University Hospital Grant No. 24301140, ERDF European Regional Development Fund Grant No. 539/2010 A31592. A. Laajala received a personal grant for this study from the Finnish female Dentists and Finnish Dentist society Apollonia. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright information: © 2019 S. Karger AG, Basel. The final, published version of this article is available at