To characterize the extent and severity of coronal caries among older US adults and document their need for prevention interventions, we systematically reviewed studies on coronal caries incidence, increment, and attack rate. We abstracted six studies and calculated summary measures using a random-effects model (95% confidence interval [95%CI]). We tested for heterogeneity and identified associated factors by examining the correlation between outcome measures and baseline population risk and study characteristics. We re-calculated summary measures after adjusting outcomes that netted out examiner reversals. Incidence and increment varied significantly by study. Adjusting studies for netting out examiner reversals reduced heterogeneity significantly. Annual attack rate among adjusted North American studies was 1.4 surfaces per 100 surfaces (95%CI = 1.0-1.9), or approximately 1 new carious surface per person per year. These rates are equal to or higher than those in children and indicate a need for caries-prevention services.
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