Browsing by Author "AlZahrani, Manal"

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Rampant Caries Patients: Characteristics and Treatment Patterns at the University of Iowa College of Dentistry and Dental Clinics: A Retrospective Analysis
(Saudi Digital Library, 2025) AlZahrani, Manal; Kolker, Justine
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 Kruskal-Wallis 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 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.
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