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Manal Alzahrani FINAL Thesis version May9th2.07 MB
Embargoed Access, Embargo ends: 06/26/2027
Thesis
Rampant caries patients: characteristics and treatment patterns at the University of Iowa College of Dentistry and Dental Clinics: a retrospective analysis
University of Iowa
Master of Science (MS), University of Iowa
Spring 2025
DOI: 10.25820/etd.007931
Abstract
Title: Treatment Patterns in Adults with Rampant Caries: A Retrospective Study
Objectives: Rampant caries is a particularly severe and aggressive form of caries characterized by rapid and widespread decay across multiple teeth. The aim of this study was to evaluate treatment patterns and identify factors associated with care completion among adult patients diagnosed with rampant caries at the University of Iowa College of Dentistry and Dental Clinics (UICOD) between 2010 and 2024.
Methods: This retrospective exploratory study included patients aged 16 years or older who initially presented with at least eight cavitated teeth, including one or more anterior teeth. Patients were classified into six treatment groups: complete dentures (CUCL), one-arch complete denture (OACD), removable partial dentures (RPD), extractions only (EO), restorative care only (REST) and less than needed treatment (LTN) Data were extracted from the AxiUm electronic health record system. Bivariate comparisons were performed using Fisher’s exact and KruskalWallis tests with Holm correction. Logistic regression and a Random Forest model were used to identify predictors of treatment completion.
Results: Out of 7,227 patients, 56% received less than needed treatment. Incomplete care was significantly associated with younger age (16–49 years), Black race, Medicaid or self-pay insurance, fewer teeth remaining at the end of care, and longer time to final treatment. The Random Forest model identified number of teeth at the end of care as the most influential predictor, followed by treatment duration, number of medications, and distance to the clinic.
Conclusions: This study highlights critical disparities and care gaps in managing rampant caries. A high rate of incomplete care was observed among patients with rampant caries, particularly among socially and medically vulnerable groups. These findings underscore the importance of vi targeted strategies to improve treatment completion, including patient education, financial assistance, culturally competent care and system-level policy reform. Addressing these disparities is essential to improving oral health outcomes in high-risk populations.
Details
- Title: Subtitle
- Rampant caries patients: characteristics and treatment patterns at the University of Iowa College of Dentistry and Dental Clinics: a retrospective analysis
- Creators
- Manal S. Al Zahrani
- Contributors
- Justine L. Kolker (Advisor)John J. Warren (Committee Member)Maria M. Hernandez (Committee Member)Shareef M. Dabdoub (Committee Member)Ariene A. Leme Kraus (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Oral Science
- Date degree season
- Spring 2025
- DOI
- 10.25820/etd.007931
- Publisher
- University of Iowa
- Number of pages
- xiv, 105 pages
- Copyright
- Copyright 2025 Manal Alzahrani
- Language
- English
- Date submitted
- 04/27/2025
- Description bibliographic
- Includes bibliographical references (pages 102-105).
- Public Abstract (ETD)
Rampant caries is a severe and fast-progressing form of tooth decay that affects multiple teeth, including the front teeth. This condition often requires extensive dental care and poses a major challenge to both patients and providers.
Our study examined how over 7,000 adult patients diagnosed with rampant caries at the University of Iowa College of Dentistry between 2010 and 2024 were treated. Using electronic health records, we tracked the types of treatments they received and looked at what factors influenced whether patients completed their care.
We found that more than half of the patients did not complete the treatment they needed. Incomplete care was more common among younger patients, those identifying as Black, and individuals with Medicaid or no insurance. The strongest predictor of treatment completion was how many teeth patients still had by the end of care.
These findings highlight major disparities in dental treatment and emphasize the need for targeted solutions, including financial assistance, patient education, and culturally sensitive care, to improve outcomes for high-risk populations.
- Academic Unit
- Oral Pathology, Radiology and Medicine
- Record Identifier
- 9984830728502771
Metrics
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