Incidence and Demographic, Clinical, and Occupational Patterns of Dental Caries and Gingivitis in Workers: A Retrospective Descriptive Cohort Study

Abstract

Objective: To estimate the incidence of clinically detected dental caries and gingivitis in a cohort of workers undergoing periodic occupational evaluations, and to describe crude demographic, clinical, behavioral, and occupational differences in these events. Methods: A retrospective descriptive cohort study with secondary analysis of occupational clinical records. We included 12,049 workers with at least two dental evaluations separated by a minimum of one year. Incidence rates were estimated per 1000 person-years with 95% confidence intervals (95% CIs). Crude hazard ratios (HRs) were calculated using univariate Cox models as descriptive time-to-event contrasts. Continuous variables were analyzed in 5-unit increments, and age- and sex-standardized rates were estimated in supplementary analyses. Results: After correcting person-time to person-years, the incidence of caries was 14.86 per 1000 person-years (95% CI 13.55–16.27), and the incidence of gingivitis was 4.67 per 1000 person-years (95% CI 3.95–5.49). Male workers showed higher observed incidence of caries than female workers (crude HR 1.81, 95% CI 1.32–2.48). Manual/physical workers also showed higher observed incidence of caries than office/administrative workers, whereas occupational differences in gingivitis were smaller after age and sex standardization. A graded descriptive pattern was observed with years of occupational exposure, with crude HRs of 3.61 for caries and 3.11 for gingivitis among workers with ≥10 years of exposure compared with those with <1 year. Baseline glucose showed a positive crude time-to-event contrast with caries (HR 1.04, 95% CI 1.02–1.06), and systolic blood pressure showed a positive crude time-to-event contrast with gingivitis (HR 1.07, 95% CI 1.01–1.13). Conclusions: Incident clinically detected caries and gingivitis were uncommon but showed crude differences across sex, occupational category, job tenure, and selected cardiometabolic markers. These findings may inform preventive attention and referral strategies in occupational dental surveillance, although the crude estimates should not be interpreted as causal effects.