epidemiology of dental caries(5)

8/2/2019 Epidemiology of Dental Caries(5)

1/17

EPIDEMIOLOGY OF DENTAL

CARIES

Dr.Ghada MaghairehBDS,MS,ABOD


2/17

Dental caries is an ancient disease, it hasafflicted human at least from the time thatagriculture replaced hunting.

Dietary changes during the 17th centuryprincipally increased refinement and greater useof sucrose are considered chiefly responsible forthe development of modern pattern of dentalcaries.


3/17

Global Distribution

Dental caries used often to be referred to as the

disease of civilization.

This expression was used to describe theprevailing pattern of caries observed during

most of the 20th century: high prevalence of the

developed countries, low prevalence in the

developing world.


4/17

Global Distribution

There are several interrelated reasons why this historicalpattern developed.

The most obvious reason is diet; the high level ofconsumption of refined carbohydrates in developedcountries has long been synonymous with good life.

Poorer societies, however, survived on hunting and onsubsistence farming, both of which provide diet, low infermentable carbohydrates.

A related reason concerns the evolution of proliferationof cariogenic bacteria under the selective pressure ofsuitable diet.


5/17

Global Distribution

By the late 20th century, however, this traditional

pattern was changing in two ways.

First, there was evidence that the prevalence andintensity of dental caries in many developing

countries were rising sharply.

Second, change is an equivocal, marked reduction incaries experience among children and young adults

in developed countries.


6/17

Global Distribution

But even in developed countries, there are

distinct differences in caries experience from

one country to another and from region to

region within a country.


7/17

Decline in Dental Caries

The decline in dental caries was documented in

countries with national studies on dental caries.

The decline in dental caries was 32% between the first

and second survey in the US (1971-1974 to 1979-1980).

Also 36% decline was detected between the second and

third survey (1979-1980 to 1986-1987).

The decline has also been documented in primary teeth.


8/17

Decline in Dental Caries

Data from 9 different countries all appointed tothe same conclusion, namely, that cariesexperience in children has declined considerably

over generation or so.

An important aspect of caries decline is its effecton different tooth surfaces.

In US study 81% of all new carious lesions wereon occlusal surfaces and pit and fissures ofbucccal and lingual molar surfaces.


9/17

Causes of Caries Decline

Fluoride exposure

Decrease consumption of sugar Better oral hygiene

Changes in bacterial ecology of the oral cavity

Wide spread use of antibiotics


10/17

Distribution of Caries Severity

DMF index is an index to measure the

distribution of dental caries in a group of

people, society, or nations.

The phrase DMF is composed of D = decay, M

= Missing of teeth due to caries, and F = filling

of carious tooth.


11/17


There is no generally acceptable definition of severecaries.

However, DMF value of 7 or more considered severecaries in children.

In US children up to age 17, there were 27.3% ofchildren have severe caries (DMF>=7) in 1979-1980survey.

This has dropped to 17% in the 1986-1987 survey. In distributing the frequency of DMF among different

type of people we will find that 50% of all affected teethare found in about 12% of children, and over 75% of all

affected teeth are in less than 25% of children.


12/17


This concentration of disease in relatively few

children had led to the concept of targeting

public health prevention programs toward that

highly affected minority.

And has stimulated research into methods of

predicting which children are likely to be found

in the 20% or so most affected.


13/17

Determinants and Risk Factors for

Dental Caries

Age:

Mean DMF increases with age.

In the childhood there is high caries rate and inelderly there is high percentage of missing due tocaries.

However, new research demonstrated that cariousattack is likely to spread out more through outlife, and there is evidence that older adults candevelop new carious lesions.


14/17

Sex:

Females generally demonstrate higher DMF scores thando males, although this finding is not universal.

The difference is small enough to be explained by earliereruption of teeth in females, their teeth at risk in oralenvironment for longer time.

Females visit the dentist more frequently, so treatment

factor could be influencing the DMF data observed. Probably a combination of earlier tooth eruption plus a

treatment factor explains the observed differences inDMF values between males and females.

Determinants and Risk Factors for Dental

Caries


15/17

Race and Ethnicity:

Contentions that certain races enjoy a high degree of resistance todental caries have been around for a long time.

These assertions have faded as the evidence mounts that globaldifferences in caries experience are more a result of environmentthan they are of inherent racial attributes.

The overall pattern that emerges from data from different studiesis that there is no basis for believing in inherent differencebetween races and ethnicity.

Socioeconomic differences, which means differences in education,self-care, attitude, values, available income, and access to healthcare, appear to be far more important determinant.


Caries


16/17


Caries

Socioeconomic status:

Socioeconomic status (SES) is a broad measure of an individuals

background in terms of such factors as education, income,occupation, attitudes and values.

SES is a valuable measure in many health studies because it is

also closely correlated with many health-related characteristics.

In many studies differences in caries experience were found

between children in the higher and lower social classes.


17/17


Caries

Familial and genetic patterns: Familial tendencies are seen by many dentists and have

been demonstrated by research.

However, these studies do not pin down wither suchtendencies have any genetic basis or weather they onlyrepresent bacterial transmission or continuing familialdietary or behavioral traits.

Husband-wife similarities clearly have no genetic origin,and intrafamilial transmission of cariogenic bacteria hasalso been shown to occur.

epidemiology of dental caries(5)

Documents