Prediction model of dental caries in 12-year-old children in Sichuan Province based on machine learning

doi:10.7518/hxkq.2023.2023124

Abstract

Abstract:

Objective The machine learning algorithm was used to construct a prediction model of children’s dental caries to determine the risk factors of dental caries in children and put forward targeted measures and policy suggestions to improve children’s oral health. Methods Stratified cluster random sampling was adopted in this study. In accordance with different policies and measures in Sichuan Province, 12-year-old students from 3-4 middle schools in eight cities of Sichuan Province were randomly selected for questionnaire survey, oral examination, and physical examination. Multivariate logistic regression analysis of risk factors for dental caries in 12-year-old children was conducted. The dataset was randomly divided into training set and validation set at a ratio of 7∶3. Four machine learning algorithms, including random forest, decision tree, extreme gradient boosting (XGBoost), and Logistic regression, were constructed using R version 4.1.1, and the prediction effects of the four prediction models were evaluated using the area under receiver operating characteristic curve (AUC). Results A total of 4 439 children aged 12 years were included in this study. The incidence of permanent teeth caries was 50.93%. The results of multivariate logistic regression analysis showed that body mass index, highest educational background of the father, highest educational background of the mother, whether to brush teeth, how many times a day, use of toothpaste when brushing teeth, duration of brushing teeth, mouthwash after meals, eating before going to bed after brushing teeth, sweet drinks, snacks, going to dental clinic to examine teeth, and age of brushing teeth were the factors influencing children’s dental caries (P<0.05). The AUC values predicted by random forest, decision tree, Logistic regression, and XGBoost were 0.840, 0.755, 0.799, and 0.794, respectively. In the random forest model, the variable with the highest contribution was eating before bed after brushing. Conclusion A prediction model of dental caries in children was established on the basis of random forest, showing good prediction effect. Taking preventive measures for the main factors affecting the occurrence of dental caries in children is beneficial.

Key words: children caries, machine learning, random forest, influencing factor, prediction model

CLC Number:

R 788

Yan Xinmiao, Sun Taolan, Lu Yuhang, Tan Xin, Wang Zhuo, Li Miaojing. Prediction model of dental caries in 12-year-old children in Sichuan Province based on machine learning[J]. West China Journal of Stomatology, 2023, 41(6): 686-693.

Figures/Tables 5

Tab 1

Basic information and univariate analysis of dental caries related factors in 12-year-old children in Sichuan Province

因素	总例数/［n（%）］	患龋/［n（%）］	$χ 2$ 值	P值	因素	总例数/［n（%）］	患龋/［n（%）］	$χ 2$ 值	P值
性别			0.065	0.799	饭后漱口			244.662	<0.001
女性	2 218（49.97）	1 125（50.72）			漱口	2 189（49.31）	854（39.01）
男性	2 221（50.03）	1 136（51.15）			偶尔或从不	2 250（50.69）	1 407（62.53）
BMI			18.005	<0.001	刷牙后睡前进食			346.961	<0.001
正常	3 417（76.98）	1 784（52.21）			经常吃（1周1次以上）	526（11.85）	441（83.84）
超重	607（13.67）	306（50.41）			偶尔吃（1周1次以下）	1 638（36.90）	907（55.37）
肥胖	415（9.35）	171（41.20）			不吃	2 275（51.25）	913（40.13）
父亲最高学历			89.416	<0.001	甜点心及糖果			13.603	0.018
初中及以下	2 785（62.74）	1 555（55.83）			很少/从不	987（22.23）	462（46.81）
高中、中专或大专	1 483（33.41）	659（44.44）			每月1~3次	640（14.42）	314（49.06）
本科及以上	171（3.85）	124（72.51）			每周1次	791（17.82）	383（48.42）
母亲最高学历			192.523	<0.001	每周2~6次	973（21.92）	510（52.42）
初中及以下	2 995（67.47）	1 742（58.16）			每天1次	623（14.03）	330（52.97）
高中、中专或大专	1 287（28.99）	464（36.05）			每天≥2次	425（9.57）	237（55.76）
本科及以上	157（3.54）	102（64.97）			甜饮料			15.491	0.008
是否刷牙			247.064	<0.001	很少/从不	1 237（27.87）	590（47.70）
是	4 017（90.49）	1 892（47.10）			每月1~3次	960（21.63）	491（51.15）
偶尔或从不	422（9.51）	369（87.44）			每周1次	839（18.90）	428（51.01）
刷牙次数			4.991	0.082	每周2~6次	782（17.62）	417（53.32）
每天刷2次及以上	2 575（58.01）	1 348（52.35）			每天1次	393（8.85）	197（50.13）
每天刷1次	1 686（37.98）	824（48.87）			每天≥2次	228（5.14）	138（60.53）
不是每天刷	178（4.01）	89（50.00）			零食			10.03	0.074
刷牙时使用牙膏			1.877	0.171	很少/从不	643（14.49）	317（49.30）
是	4 370（98.45）	2 232（51.08）			每月1~3次	690（15.54）	333（48.26）
否	69（1.55）	29（42.03）			每周1次	896（20.18）	440（49.11）
刷牙方法			3.589	0.309	每周2~6次	1 060（23.88）	554（52.26）
横刷法	2 166（48.79）	1 118（51.62）			每天1次	705（15.88）	390（55.32）
竖刷法	396（8.92）	202（51.01）			每天≥2次	445（10.02）	227（51.01）
转圈法	427（9.62）	229（53.63）			去牙科诊所看牙			34.562	<0.001
没有固定方法	1 450（32.67）	712（49.10）			看过	1 956（44.06）	1 094（55.93）
刷牙时长			1.411	0.494	从来没	2 483（55.94）	1 167（47.00）
1 min	891（20.07）	446（50.06）			几岁刷牙			3.995	0.046
2~3 min	2 972（66.95）	1 509（50.77）			3岁及以下	2 648（65.85）	1 372（51.81）
>3 min	576（12.98）	306（53.13）			4岁及以上	1 373（34.15）	665（48.43）

Tab 1

Tab 2

Multivariate Logistic regression analysis of caries related factors in 12-year-old children in Sichuan Province

因素	B值	SE值	Wald值	P值	OR（95%CI）值
BMI（正常为对照组）
超重	-0.202	0.107	3.552	0.059	0.817（0.662，1.008）
肥胖	-0.413	0.128	10.449	0.001	0.662（0.515，0.850）
父亲的最高学历（初中及以下为对照组）
高中、中专或大专	-0.133	0.081	2.746	0.097	0.875（0.747，1.025）
本科及以上	-1.278	0.229	31.195	<0.001	0.279（0.178，0.436）
母亲的最高学历（初中及以下为对照组）
高中、中专或大专	-0.880	0.086	105.830	<0.001	0.415（0.351，0.491）
本科及以上	-0.579	0.216	7.219	0.007	0.56（0.367，0.855）
是否刷牙（刷牙为对照组）
偶尔或从不刷牙	2.569	0.202	161.005	<0.001	13.05（8.776，19.406）
每天刷几次牙（每天刷2次及以上为对照组）
每天刷1次	-0.308	0.078	15.721	<0.001	0.735（0.631，0.856）
不是每天刷	-0.446	0.196	5.174	0.022	0.64（0.436，0.940）
刷牙时使用牙膏（是为对照组）
否	-2.379	0.355	44.870	<0.001	0.093（0.046，0.186）
刷牙方法（横刷法为对照组）
竖刷法	0.172	0.131	1.715	0.190	1.187（0.918，1.535）
转圈法	0.201	0.126	2.539	0.111	1.223（0.955，1.566）
没有固定方法	-0.145	0.083	3.081	0.079	0.865（0.736，1.017）
刷牙时长（1 min为对照组）
2~3 min	0.243	0.095	6.605	0.010	1.275（1.059，1.535）
>3 min	0.501	0.134	13.911	<0.001	1.651（1.269，2.148）
饭后漱口（漱口为对照组）
偶尔或从不	0.928	0.076	147.693	<0.001	2.53（2.178，2.939）
刷牙后睡前进食［经常吃（1周1次以上）为对照组］
偶尔吃（1周1次以下）	-1.379	0.146	89.024	<0.001	0.252（0.189，0.335）
不吃	-1.868	0.144	167.269	<0.001	0.154（0.116，0.205）
甜饮料（很少/从不为对照组）
每月1~3次	0.193	0.107	3.231	0.072	1.213（0.983，1.496）
每周1次	0.185	0.113	2.685	0.101	1.204（0.964，1.503）
每周2~6次	0.188	0.118	2.526	0.112	1.207（0.957，1.522）
每天1次	0.106	0.145	0.534	0.465	1.112（0.837，1.478）
每天≥2次	0.598	0.184	10.571	0.001	1.818（1.268，2.606）
零食（很少/从不为对照组）
每月1~3次	-0.179	0.135	1.765	0.184	0.836（0.642，1.089）
每周1次	-0.081	0.129	0.397	0.529	0.922（0.716，1.187）
每周2~6次	-0.097	0.127	0.581	0.446	0.908（0.707，1.165）
每天1次	0.057	0.138	0.170	0.680	1.058（0.808，1.386）
每天≥2次	-0.491	0.161	9.361	0.002	0.612（0.447，0.838）
去牙科诊所看牙（看过为对照组）
从来没	-0.475	0.074	41.169	<0.001	0.622（0.538，0.719）
几岁刷牙（3岁及以下为对照组）
4岁及以上	-0.176	0.077	5.287	0.021	0.839（0.722，0.974）

Tab 2

Tab 3

Fig 1

Fig 2

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模型	准确性	精确度	灵敏度	特异度	AUC
随机森林	0.779	0.739	0.854	0.706	0.840
决策树	0.662	0.618	0.818	0.509	0.755
Logistic回归	0.729	0.703	0.784	0.676	0.799
极致梯度提升	0.727	0.705	0.768	0.686	0.794

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