Nomogram prediction of severe dental caries in adolescents:A cross-sectional study

ZHANG Ming; HE Wenjuan; JIANG Hongjuan; JI Yaru

doi:10.15956/j.cnki.chin.j.conserv.dent.2025.08.003

Abstract：Objective To construct and validate a nomogram model for predicting the severity of dental caries in adolescents.Methods A total of 2 647 adolescents aged 12-18 years with dental caries from Yinchuan,Ningxia were analyzed.Candidate predictors included sociodemographic characteristics,parental health information,lifestyle and dietary habits,oral hygiene practices,and oral health behaviors.The cohort was randomly divided into a training set(n=1855)and a validation set(n=792)at a 7:3 ratio.Variable selection was performed using least absolute shrinkage and selection operator(Lasso)regression,followed by multivariable logistic regression to construct the nomogram.Model performance was assessed by the area under the receiver operating characteristic curve(AUC),calibration plots with the Hosmer-Lemeshow test,and decision curve analysis(DCA).Results Seven independent predictors were identified:parental education,smoking status,frequency of sweet consumption,self-rated oral health,previous dental visit,and toothache experience in the past 12 months.The nomogram achieved an AUC of 0.710(95％CI:0.683-0.737)in the training set and 0.746(95％CI:0.707-0.785)in the validation set.Calibration showed good agreement between predicted and observed outcomes(Hosmer-Lemeshow P=0.603 and 0.639).DCA demonstrated favorable clinical utility across a wide range of threshold probabilities.Conclusion The developed a nomogram model based on readily available sociodemographic and behavioral factors showed good discrimination,calibration,and clinical applicability for predicting severe caries in adolescents,and may support early prevention and targeted intervention strategies.