Beneath the surface of coronal caries: primary decay, recurrent decay, and failed restorations in a population-based survey of New England elders.

A cross-sectional study was conducted of the oral health status of a random sample of community dwelling elders, aged 70 and older, living within the six New England states. Four examining teams, each composed of a trained and calibrated dentist and a field technician, collected data during an in-home oral examination. The prevalence of carious, filled, recurrent decayed, and non-carious but failed restored coronal surfaces was recorded. For the 1,151 respondents, the mean DFT was 6.16 (SD = 6.96) and the mean DFS was 18.83 (SD = 23.37), with 37.6 percent of the sample edentulous. Eleven percent of the population had 70 percent of the coronal decay. Males (OR = 2.2, CI = 1.3-3.8) and elders with less education (OR = 1.8, CI = 1.0-3.0) were at higher risk for three or more surfaces of coronal decay. Recurrent decay was present in 16 percent of the dentate population. However, more noncarious but failed restored coronal surfaces (332) were recorded in the population of New England elders than were surfaces of recurrent decay (234). The New England elders have higher rates of decay than New England children, although the rates matched those of previous national studies. The findings signal a need to develop targeted preventive regimens for older adults and greater understanding of dental treatment needs of elders.