Dental caries among 12-year-old adolescents in shanghai: a cross-sectional study on prevalence, severity, and associated risk factors
7 affiliations
- 1Department of Preventive Dentistry, School of Stomatology, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
- 2Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
- 3Xuhui District Dental Centre, Shanghai, China
- 4Minhang District Dental Centre, Shanghai, China
- 5Jing’an District Dental Centre, Shanghai, China
- 6Pudong District Dental Centre, Shanghai, China
- 7Putuo District Dental Centre, Shanghai, China
Abstract
Background: This study aimed to assess the prevalence, severity, and associated factors of dental caries in permanent teeth among 12-year-old adolescents in Shanghai, China.
Methods: A cross-sectional study was conducted in 2021 among 1,305 adolescents from six randomly selected districts. Clinical examinations recorded dental caries (DMFT index), gingival bleeding, dental calculus, pit-and-fissure sealant, and dental crowding. Questionnaires collected data on sociodemographics, oral hygiene, sugar intake, and dental service use. A zero-inflated negative binomial regression model was used to identify factors associated with caries prevalence and severity.
Results: Caries prevalence was 27.9% (mean DMFT = 0.61 ± 1.26), with 72.1% caries-free and 17.1% having untreated decay. Caries burden was highly polarized: the top 10% accounted for 60% of total DMFT. In the multivariable ZINB model, female sex, dental crowding, gingival bleeding, and occasional toothache were associated with higher odds of having caries, while pit-and-fissure sealants and positive oral health attitudes were associated with being caries-free. Among affected adolescents, daily flossing, moderate-frequency sugar intake, poor self-rated oral health, and dental calculus were linked to greater caries severity.
Conclusion: Caries prevalence among 12-year-olds in Shanghai has continued to decline over the past four decades, yet substantial untreated cases and polarization remain. Future strategies should strengthen monitoring and follow-up care for high-risk adolescents, while scaling up sealant coverage and promoting healthy dietary and oral hygiene practices.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28707-0.
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BibTeX
@article{yang2026dental,
title = {{Dental caries among 12-year-old adolescents in shanghai: a cross-sectional study on prevalence, severity, and associated risk factors}},
author = {Bin Yang and Yiwei Jiang and Huning Wang and Hao Zhang and Dongxin Da and Jin Yu and Hongru Su and Hongyan Shi and Qiwen Chen and Zhengang Wu and Jiangtao You and Ying Zhang and Jing Zhu and Xiaoli Zeng},
journal = {BMC Public Health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28707-0},
url = {https://doi.org/10.1186/s12889-026-28707-0},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Dental caries among 12-year-old adolescents in shanghai: a cross-sectional study on prevalence, severity, and associated risk factors
AU - Bin Yang
AU - Yiwei Jiang
AU - Huning Wang
AU - Hao Zhang
AU - Dongxin Da
AU - Jin Yu
AU - Hongru Su
AU - Hongyan Shi
AU - Qiwen Chen
AU - Zhengang Wu
AU - Jiangtao You
AU - Ying Zhang
AU - Jing Zhu
AU - Xiaoli Zeng
PY - 2026
DA - 2026/08/10
JO - BMC Public Health
DO - 10.1186/s12889-026-28707-0
UR - https://doi.org/10.1186/s12889-026-28707-0
AB - Background: This study aimed to assess the prevalence, severity, and associated factors of dental caries in permanent teeth among 12-year-old adolescents in Shanghai, China. Methods: A cross-sectional study was conducted in 2021 among 1,305 adolescents from six randomly selected districts. Clinical examinations recorded dental caries (DMFT index), gingival bleeding, dental calculus, pit-and-fissure sealant, and dental crowding. Questionnaires collected data on sociodemographics, oral hygiene, sugar intake, and dental service use. A zero-inflated negative binomial regression model was used to identify factors associated with caries prevalence and severity. Results: Caries prevalence was 27.9% (mean DMFT = 0.61 ± 1.26), with 72.1% caries-free and 17.1% having untreated decay. Caries burden was highly polarized: the top 10% accounted for 60% of total DMFT. In the multivariable ZINB model, female sex, dental crowding, gingival bleeding, and occasional toothache were associated with higher odds of having caries, while pit-and-fissure sealants and positive oral health attitudes were associated with being caries-free. Among affected adolescents, daily flossing, moderate-frequency sugar intake, poor self-rated oral health, and dental calculus were linked to greater caries severity. Conclusion: Caries prevalence among 12-year-olds in Shanghai has continued to decline over the past four decades, yet substantial untreated cases and polarization remain. Future strategies should strengthen monitoring and follow-up care for high-risk adolescents, while scaling up sealant coverage and promoting healthy dietary and oral hygiene practices. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28707-0.
SN - 1471-2458
ER -