Trends in Dental Caries

Up to 1850's Okay
1. Increased rapadly and peaked 60's
  1. Reduced in both WW1+2
    1. Now declined
Increase in 1983 in Undeveloped countries
1. Worse than in developed countries
70's- early 80's 30-50% decline
1. Except Poland, Russia, Italy+Germany.
Shift in frequancy distribution/area on tooth
1. 76% of disease in 25% of population
Roor caries on increase
1. Population living longer, keeping teeth for longer
WHY?
1. Fluoride
  1. Marthaler (1984) stated main reason for decline
    1. Russia and Germany were not using flouride, High caries rate showed
2. Dietary modifications
  1. High DMFT, high sugar diet
    1. Adding sugar to bottles decreased
      1. Sweetend dummies decreased
        Changes in formula/baby foods
3. Changes in diagnostic criteria
  1. No sharp probing of dental caries
    1. reduction in premature caries lesion treatment
      1. Practice of preventative fillings decreased
4. Social economic factors
  1. Higher social group, lower rate
    1. Overal improvement of living
5. Single parent/unemployed
  1. 3 year old increase from 4-10% in single parent/unemployed
6. Cyclical Variations
  1. Many diseases often have a prevalence which varies with time, following cyclical, rhythmical patterns
    1. But no evidence to support this
7. Dental services
  1. Increased dental manpower has contributed MINIMALLY to the decline
8. Widespread use of antibiotics
  1. Loesche (1982) Found relationship in more use of antibiotics and decline in caries.
    1. Germany and Swizerland, similar antibiotic use. Germany did not decline
9. Oral Hygiene
  1. No evidence that toothbrushing reduces caries.
    1. Increase in OH in last 2 decades, no significant decline in caries

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	Criado por Caroline Oxford mais de 11 anos atrás