title: Multicenter study on caries risk assessment in Japanese adult patients.
abstract: OBJECTIVE
  This study was conducted to identify significant risk factors for the onset and the accumulation of new caries in adult patients undergoing regular preventive therapy.
  
  
  METHODS
  The data of 732 patients from nine Japanese general dental practices were retrospectively analyzed. Classification and regression tree (CART) analysis was applied to develop a caries prediction model using the following patient parameters: age, number of teeth with caries experience (DMFT), levels of mutans streptococci (SM) and lactobacilli (LB), saliva flow rate and buffer capacity, and compliance with a preventive program. Poisson regression analysis was conducted to identify factors affecting caries accumulation within three years.
  
  
  RESULTS
  CART analysis identified patients at high risk for primary caries with an odds ratio of 3.08 (95%CI, 1.55-5.79; p=0.0018) according to SM levels and compliance; and those for secondary caries with an odds ratio of 3.69 (95%CI, 2.29-5.91; p<0.0001) according to LB and SM levels. Poisson regression analyses showed that accumulation of primary caries was affected by compliance (p<0.001), SM (p<0.001) and LB (p=0.013). Accumulation of secondary caries was affected by DMFT (p<0.001), SM (p<0.001) and LB (p<0.001).
  
  
  CONCLUSIONS
  CART is an important tool in identifying the risk of caries development in individual adult patients. Cariogenic bacteria are important factors for both the onset and accumulation of primary and secondary caries.
  
  
  CONCLUSIONS
  Participation in a regular preventive program limits the onset and the accumulation of primary caries in adult patients.
authors.affiliation: Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita 565-0871, Japan.
authors.forename: Masumi
authors.initials: M
authors.lastname: Arino
authors.affiliation: Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita 565-0871, Japan.
authors.forename: Ito
authors.initials: I
authors.lastname: Ataru
authors.affiliation: The Japan Health Care Dental Association, 1-45-15 Sekiguchi, Bunkyo-ku, Tokyo 112-0014, Japan.
authors.forename: Shozo
authors.initials: S
authors.lastname: Fujiki
authors.affiliation: The Japan Health Care Dental Association, 1-45-15 Sekiguchi, Bunkyo-ku, Tokyo 112-0014, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Sugiyama
authors.affiliation: Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita 565-0871, Japan. Electronic address: mikarin@dent.osaka-u.ac.jp.
authors.forename: Mikako
authors.initials: M
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004245:DMF Index; D003731:Dental Caries / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D003733:Dental Caries Susceptibility; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007778:Lactobacillus / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012463:Saliva / Q000378:metabolism; D012636:Secretory Rate; D013295:Streptococcus mutans / Q000302:isolation & purification
keywords: CART; Cariogenic bacteria; Compliance with a preventive program; DMFT; Primary caries; Risk assessment; Secondary caries