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17-10-2013 | Oral medicine | Article

Cavity restoration predicts dental bleeding, calculus


Free abstract

medwireNews: Dental assessment of young adults in Brazil has linked posterior restoration of cavities to an increased risk for gingival bleeding and dental calculus.

The study included 720 individuals born in 1982 in Pelotas who underwent a dental examination aged 24 years, explain Flávio Fernando Demarco (Federal University of Pelotas, Brazil) and co-authors.

The majority (69.9%) of participants had at least one restoration in their posterior teeth, with 15.2% of posterior teeth having at least one cavity without proximal involvement (class I) and 3.6% at least one cavity with proximal involvement (class II).

In addition, 37.5% of participants experienced gingival bleeding, affecting 6.1% of teeth, while 22.0% of teeth showed dental calculus.

Multivariate analysis showed that gingival bleeding was significantly predicted by the proportion of decayed teeth, with participants in the highest tertile (≥5 teeth) 2.46 times more likely to have bleeding than those in the lowest tertile (0–1 teeth).

And compared with teeth without any restorations, teeth with class I orII cavities were 1.51 and 1.76 times more likely to show gingival bleeding, the researchers report in the Journal of Clinical Periodontology.

Dental calculus was significantly predicted by socioeconomic trajectory from birth and mother’s education level at birth, as well as smoking at age 23 years (odds ratio [OR]=2.04).

Moreover, dental calculus was significantly associated with number of decayed teeth (odds ratio [OR]=1.33 and 2.30 for second and third vs first tertile, respectively), and on a per tooth basis, the presence of class I and class II cavities (OR=1.36 and 1.80, respectively).

“The worst periodontal conditions could be the result of poor hygiene maintenance, which ultimately may lead to dental caries and consequent placement of restorations,” explain Demarco et al.

However, when this inverse hypothesis was tested, the magnitude of impact of gingival bleeding and dental calculus on the presence of restorations was significantly lower than the impact of restorations on these markers of periodontal health, the researchers say.

Similarly, while poor periodontal conditions may be associated with increasing numbers of dental caries, the impact of posterior restorations on bleeding and calculus continued after adjusting for this relationship.

They therefore conclude that their results demonstrate “ that the presence of direct posterior restorations, especially those with proximal involvement, is associated with increased gingival bleeding and dental calculus accumulation.”

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lynda Williams, Senior medwireNews Reporter