Retrospective assessment of caries experience among US Naval Academy midshipmen.

OBJECTIVE: To assess the 4-year caries incidence among US Naval Academy midshipmen. METHODS: Dental records (n = 300) from a total population of 1,016 midshipmen from the 2011 graduating class at US Naval Academy, Annapolis, MD, were randomly selected for review. Patients were assigned a caries risk status based on the number of caries lesions recorded at initial examination (low = 0 lesions; moderate = 1-2 lesions; high = 3+ lesions). For each risk category, caries prevalence (DMFS, DMFT) and caries incidence were calculated based on findings recorded at the initial (E1), third year (E2), and fourth year (E3) examinations. The most significant predictors for caries incidence were determined for each risk category. RESULTS: Mean DMFS and DMFT were significantly different for each risk group at each examination (low < moderate < high; one-way ANOVA, P < 0.05). Within each caries risk category, mean DMFS and DMFT increased significantly from E1 to E3 (repeated measures ANOVA, all P < 0.05). Compared with low-risk patients, total caries incidence was over 2x greater for moderate-risk and nearly 4x greater for high-risk patients (one-way ANOVA, P < 0.05). "Filled surfaces" was the most significant predictor for caries incidence among low-risk patients; among high-risk and all risk groups combined, the most significant predictors were "decayed surfaces" and "decayed surfaces plus incipient surfaces" (linear regression; all P < 0.047). CONCLUSIONS: Caries experience was consistently greater for moderate- and high-risk patients at all examinations. The magnitude of increase in caries experience was greater for moderate- and high-risk patients. Caries history and current disease status reliably predict future caries experience in this young adult population.