# Association between Live Dietary Microbes and Root Caries: A Cross-Sectional Study with a Predictive Risk Model

## TL;DR

This study explores how live dietary microbes relate to root caries and builds a model to predict risk based on dietary and health factors.

## Contribution

A predictive model for root caries risk incorporating live dietary microbe intake and other health factors is developed and validated.

## Key findings

- Higher intake of live dietary microbes was associated with lower root caries prevalence.
- The predictive model showed good discrimination and calibration in training and testing datasets.
- Factors like age, education, and dental floss frequency were also significantly linked to root caries.

## Abstract

To investigate the association between medium‑to‑high (MedHi) levels of live dietary microbe intake and the prevalence of root caries, and to develop a predictive model for estimating root caries risk.

This cross‑sectional study analysed data from participants in the National Health and Nutrition Examination Survey (NHANES) 2015–2020. Dietary intake was assessed using 24‑h dietary recalls, and root caries status was determined via standardised oral examinations. Univariate and multivariable logistic regression analyses were conducted to identify factors associated with root caries, including live dietary microbe intake. Participants were randomly divided into training and testing data sets. A least absolute shrinkage and selection operator (LASSO) regression was used to construct a predictive model, which was visualised using a nomogram and evaluated by receiver operating characteristic (ROC) curves and calibration plots.

Among 7,839 participants, MedHi live dietary microbe intake, age, education level, smoking status, dental floss frequency, and systemic conditions were significantly associated with root caries (P < 0.05). The predictive model incorporating these variables demonstrated good discrimination and calibration in both the training and testing data sets.

Higher intake of live dietary microbes was associated with a lower prevalence of root caries. Although the cross‑sectional design precludes causal inference, the findings suggest a potential link between dietary microbes and oral health. The proposed model may aid clinicians in identifying individuals at high risk and in developing targeted preventive strategies.