Epidemiology of dental caries
- 1. EPIDEMIOLOGY OF DENTAL CARIES Dr. M. Dhivya Lakshmi. Saveetha Dental College & Hospitals
- 2. DENTAL CARIES It is defined as a microbial disease of the calcified tissues of the teeth characterized by the dimeneralization of inorganic portion and dissolution of the organic portion of the tooth. - Shafer, Hine & Levy
- 3. EPIDEMIOLOGY PRE NEOLITHIC AGE NEOLITHIC AGE
- 5. ETIOLOGY WORM THEORY: Invasion of worms into teeth
- 7. VITAL THEORY Originated like bone gangrene from within the tooth itself.
- 8. EXOGENOUS THEORIES CHEMICAL THEORY PARASITIC THEORY
- 9. ACIDOGENIC THEORY MILLER (1890)
- 10. PROTEOLYSIS THEORY GOTTILEB (1934)
- 11. PROTEOLYSIS CHELATION THEORY SCHATZ & MARTIN (1955) Products of bacterial action + enamel/ dentin/ salivary constituents chelates with calcium. Chelates can be formed at neutral/ alkaline pH Demineralization could arise without acid formation.
- 13. HOST
- 14. 1. TOOTH COMPOSITION INORGANIC MATTER ORGANIC MATTER & WATER ENAMEL 96% 4% DENTINE 65% 35% CEMENTUM 45 to 50% 50 to 55%
- 15. MORPHOLOGY
- 16. 2. SALIVA
- 17. 3. GENDER & 4. RACE
- 18. 5. AGE
- 23. 10. ORAL HYGIENE HABITS
- 25. MICROBES VS TOOTH Pre requisite Single type capable Acid production pre requisite Strep strains extracellular dextrans/ levans Organisms varying capacity
- 26. CARIOGENIC PLAQUE - PROPERTIES Rate of sucrose consumption higher Synthesize more intracellular polysaccharides More lactic acid Twice extra cellular polysaccharides Strep mutans higher Strep sanguis & Actinomyces - lower
- 29. VIPEHOLM STUDY GUSTAFFSON (1954)
- 32. CONCLUSION INCREASE IN CARB INCREASE DC
- 33. RISK OF CARIES GREATER FOOD RETAINED ON THE SURFACE
- 34. RISK OF CARIES GREATER SUGAR CONSUMED BETWEEN MEALS
- 36. RAPIDLY DISAPPEARS UPON WITHDRAWAL OF SUGAR RICH FOODS
- 37. HIGH CONCENTRATION OF SUGAR IN SOLUTION & PROLONGED RETENTION ON TOOTH SURFACES INCREASED ACTIVITY
- 38. PHYSICAL FORM & FREQUENCY OF INTAKE IS IMPORTANT
- 39. HOPEWOOD HOUSE STUDY SULLIVAN (1958) The dental status of children between 3 and 14 years of age residing at Hopewood House, New South Wales was studied longitudinally for 10 years.
- 40. DIET
- 41. INFERENCE PLACE % CARIES ACTIVITY Hopewood 53 Caries free State School Children 0.4 Caries free 75 Poor Oral hygiene & gingivitis DENTAL CARIES CAN BE REDUCED BY DIET IN INSTITUTIONALIZED CHILDREN, WITHOUT BENEFICIAL EFFECTS OF FLUORIDE & IN PRESENCE OF UNFAVOURAVLE ORAL HYGIENE.
- 42. TURKU SUGAR STUDY SCHEININ, MAKINEN (1975) STUDY PERIOD = 2 years; n = 125 SUCROSE N = 35 FRUCTOS E N = 38 XYLITOL N = 52
- 43. INFERENCE 1. A dramatic reduction in the incidence of dental caries was found after 2 years of xylitol consumption 2. Fructose was as cariogenic as sucrose for the first 12 months but became less so at the end of 24 months. 3. Chewing of xylitol gum produced an anti cariogenic effect.
- 44. SEVENTH DAY ADVENTIST CHILDREN STUDY Limitation of sugar sticky elements, highly refined starches, between meal snacking. Level of DC was much lower.
- 45. HEREDITARY FRUCTOSE INTOLERANCE Level of DC lower Vitamins A, D, K, B complex and calcium & phosphorus, fluoride, amino acid like lysin & fats has an inhibitory effect on dental caries.
- 46. OTHERS GEOGRAPHY: DMFT increasing in developing countries. SOIL: Selenium increase DC; Molybdenum & Vanadium decrease DC URBANIZATION DC increases. CLIMATE Sunlight decrease DC; Rainfall increase DC.