Epidemiology and prevention of Dental caries

1. Departement of public health dentistry
Epidemiology ,prevenTion of dental caries
Presented by,
Shiji margaret
CRRI

2. content
Epidemiology definition
Dental caries definition
Relation between diet and dental caries
Caries factors
Global distribution
Diet
Variation of caries within the mouth
Types of dental caries
Agent factors of dental caries
Risk factors
Prevention
Conclusion

3. Epi = upon
Demos = people
logy = sTUDY
Epidemiology = the science which deals
with what falls upon people…..

4. definition
The study of distribution and
determinants of health related
status or events in a specified
population and this application of
this study for the control of the
diseases

5. dental caries
It is an infectious microbial
disease of teeth that results in
the localized destruction and
dissolution of the calcified
tissues.

6. Low Caries incidence existed in
Ancient Man

7. Low caries incidence in the ancient
man is due to diet which was :
 Comparatively low in
carbohydrates.
 Natural (unrefined) diet.
 Coarse & not fully prepared
or cooked.

8. Relationship between diet and dental
caries
Bacterial enzyme + fermentable
carbohydrates = acid
Acid + enamel = dental caries

9. The classic Venne
diagram of caries.
Must have a tooth, plaque
bacteria, fermentable
carbohydrate, saliva, and
enough time in order for a
carious lesion to develop .
Caries results when all of the
factors that contribute to caries
overlap. (red color, center).
Several factors influencing each
component, ( see the diagram,)
affect the rate and severity of the
caries.
Caries Factors

10. Current global distribution
During most of the 20th
century, dental caries
pattern was :
I. High prevalence in developed
countries & higher
socioeconomic group.
II. Low prevalence in developing
countries with less economic
development.
Caries was referred to as
“a disease of civilization.”

11. Global Distribution
 The most obvious reason for this historical
pattern is diet; the high level of consumption
of refined carbohydrates in developed
countries in contrast to diets low in
fermentable carbohydrates in poorer societies
where hunting and farming are the main
source of food.

12.  High level of consumption of refined carbohydrates
in developed countries led to increase in
cariogenic bacteria.
 Diet low in fermentable carbohydrates in developing
countries surviving on farming & hunting lower level
of cariogenic bacteria.
Explanation of this pattern is :
diet

13. Diet
 Intake of refined carbohydrates especially
sucrose (sugar) is considered a strong etiologic
factor in the causation of dental caries.

14. The distribution pattern of
dental caries closely follows that
of plaque. Thus, the sites in the
mouth which are most prone to
caries are those where plaque
accumulates.
Variation of caries within the mouth:

15. I- Types of dental
caries
1)Pit & fissure caries:
It is the first to appear in
the mouth.
Pits &fissure surfaces
constitute the most
susceptible surfaces in the
mouth.

16. 2) Proximal caries:
 It is the next to appear in the
mouth.
 It is related to plaque
accumulation in the non-self
cleansing areas (beneath the
contact points).

17. 3) Cervical caries
 Is the third type of dental caries
that occurs uniformly
throughout life.
 It is related to progressive
changes in the free gingival
margin, poor oral hygiene &
decreased salivary flow
(xerostomia)

18. 4) Root caries:
 Occurs usually in old age
(60 y<).
 Root surfaces become
exposed by gingival
recession in advancing
age.
 These exposed areas
provide perfect areas for
plaque accumulation.

19. Agent Factors of Dental Caries
Microorganisms
 Mainly Streptococcus mutans are responsible for
initial development of dental caries with
contribution of other species such as:
 Lactobacillus acidophilus
 Lactobacillus casei
 Streptococcus salivarius
 Strpetococcus milleri
 Streptococcus sanguis
 Actinomycis (root caries)

20. The host Risk Factors
 1- Age.
 2- Gender.
 3- Race.
 4- Genetic & familial.
 5- Role of saliva.

21. Age
Caries was considered a
childhood disease because all
susceptible tooth surfaces
become carious during early
child years and few carious
lesions are affected during
adulthood.

22. Caries increases
progressively by age,
and the increase is
more slowly during
adult years

23. Gender
It is observed
that caries
prevalence is
higher in
females than in
males of the
same age.

24. Race
Early studies, observed that some
races as those in Africa & India, had
high degree of caries resistance
than “Europeans”.
Recently, the concept of racial
differences have been faded, and
the evidence reveals that the global
differences are the result of
environment. .

25. Familial & genetic pattern
 Dental caries has long
a g o s h o w n t o b e
grouped according to
f a m i l i e s
 Members of the same
household were found
to be alike in their
caries pattern than
b e t w e e n u n r e l a t e d
groups of individuals.

26. Such familial tendency may be due to:
1- Interfamilial bacterial transmission,
especially from mother to baby.
2- similarity in dietary & oral hygiene
habits. OR,
3- Genetic factor: as inheritance of tooth
structure (deep narrow pits & fissures) or
special arch form (irregularities &
crowding).

27. Socioeconomic status
• It is a measure of the individual’
background; education, income,
occupation, and attitudes and
values.
• It is inversely related to the status
of many disease.
• It is a powerful determinant of
caries status in any community.

28. Role of Saliva
Diluting effect on fermented food
residues.
Buffering capacity to neutralize acid
end products resulting from such
fermentation.
Provides ions for remineralization of
early carious lesions.
Provides antibacterial, antifungal and
antiviral agents.

29. Prevention of dental caries
1. Neutralize the plaque acids:
 This can be done by
adding base or adding
buffers such as sodium
bicarbonate (baking soda) to
the saliva to boost its ability
to neutralize acids.

30. 2. Improve hygiene:
 With bacterial levels low, less
acid is produced.
 Plaque layers don’t have a
chance to grow thick;
 Saliva can penetrate better to
the enamel surface through thin
layers of plaque.

31. 3. Introduce antimicrobials:
Since caries is a disease caused
by bacteria, simply eliminating the
bacteria or controlling their growth
will reduce the caries incidence.
 Chlorhexidine, xylitol, ozone,
even experimental antibodies,
have been used to control bacterial
growth

32. 4. Stimulate saliva:
 Saliva contains numerous
components - that fight tooth
decay
buffers, remineralizing minerals,
antimicrobial enzymes,
antibodies.

33. 5. Topical fluorides:
 Fluoride added to the
remineralizing incipient lesion
increases the enamel crystals’
resistance to dissolution by plaque
acids

34. DENTAL CARIES is so prevalent
that the only possible solution is
the “prevention”. The best way
to avoid getting it is to practice
good oral hygiene habits
conclusion