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Association between caries and periodontal diseases in a sample of employed adults in Spain: a cross-sectional study

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To study whether there is an association between caries and periodontitis in a representative sample from employed Spanish adults.

Materials and methods

This cross-sectional study is part of a wide epidemiological survey (WORALTH, Workers’ ORAL healTH). Oral examination was carried out in 5130 dentate subjects. Periodontal status was assessed by clinical attachment level (CAL) and Community Periodontal Index (CPI) in index teeth. For caries, all teeth were classified as healthy, decayed (D), filled (F), or missed (M), and DMFT index and prevalence of cavitated caries were calculated. ANOVA, Chi-square tests, and regression models were performed.


DMFT increased with CAL values, being 7.8, 9.6, and 10.5 for CAL 0–3 mm, 4–5 mm, and ≥ 6 mm, respectively. After adjustment for confounders, subjects with CPI ≥ 3 showed an odds ratio of 1.6 (95% confidence interval (CI) [1.3; 1.8]; p < 0.001) for presenting cavitated caries, and patients with CAL ≥ 6 mm had 0.8 higher mean DMFT (95% CI [0.2; 1.5]; p = 0.015), and 0.3 higher mean DFR (95% CI [0.2; 0.5]; p < 0.001) than those with CAL < 6 mm.


The presence of CAL ≥ 6 m mm was associated with an increased DMFT and DFR, and the presence of CPI ≥ 3 was associated with a higher prevalence of cavitated caries in this representative sample.

Clinical relevance

There is a tendency to present higher prevalence of dental caries among patients with periodontitis. Therefore, common preventive measures in dentistry, such as oral hygiene practices, should ideally include actions aimed to prevent at the same time dental caries and periodontitis.

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This study was financially supported by Cualtis, previously named Sociedad de Prevención Ibermutuamur, a company that focuses specifically on preventing diseases and accidents, by monitoring workers’ health.

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Correspondence to Eduardo Montero.

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The authors declare that they have no conflicts of interest.

Ethical approval

The procedures performed in this study were in accordance with the Helsinki Declaration (2008) and the protocol was approved by Ibermutuamur Local Ethics Committee (Ethics approval no. 2008/1)

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Informed consent was obtained from all participants included in the study.

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Table 7 Proportionate stratified random sampling method. The proportion of individuals of each stratum is almost equal in our sample and the Spanish population (Spanish Labor Force Survey)
Table 8 Frequency distribution of regression analysis included variables

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Martínez, M., Montero, E., Carasol, M. et al. Association between caries and periodontal diseases in a sample of employed adults in Spain: a cross-sectional study. Clin Oral Invest 25, 3957–3966 (2021).

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