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Flashcards in Epimediology of dental caries Deck (67):
1

Study of health and disease in populations

Epidemiology

2

What are determinants influenced by

-Heredity
-Biology
-Physical environment
-Social environment
-Lifestyle

3

Descriptive epidemiologic studies

-Prevalence
-Severity
-Age-adjusted distribution in the population

4

Try to answer a specific question

Analytic epidemiologic studies

5

-Mail survey
-Epidemiological/screening survey
-Telephone interview

Primary data

6

-Medicaid
-Vital Statistics
-Cancer registry

Secondary data

7

Demineralization of the hard tissues of the teeth caused
by bacterial acids

Dental caries

8

What causes dental caries?

Bacterial acids

9

One of the most common diseases among 5-17 year olds

Dental caries

10

prehistoric man; low prevalence
and severity

Ancient disease

11

no change in prevalence
between the Anglo Saxon period to the Middle Ages
in British studies; mostly cervical lesions

5th - 16th Century

12

High prevalence of disease;
mostly occlusal and proximal lesions associated with changes in diet circa 1600

17th -20th Century

13

Low prevalence in
“developing” countries, high prevalence in
“developed” nations

Early 20th century

14

– Increasing prevalence in developing countries
– Decrease in caries incidence in children and young
adults in developed countries – the “caries decline

Late 20th century

15

Caries caused by a worm.
Fumigation devices used to
remove the worm.

Worm theory

16

Tooth is an integral part of the body,
vitally affected by the body. Disease
processes take place from the “inside-out”.

Vital theory

17

Tooth decay originates from within the tooth
itself

Vital theory

18

17th and 18th Centuries.
Decay arises from acids formed in the oral cavity.
Assumed that acids were inorganic

Chemical (Acid) theory

19

microorganisms
infiltrate the enamel, leading to decomposition.
Recognition that enamel is organic.

Parasitic ( Septic) theory

20

In 1881, W. D. Miller proposed that microorganisms in the oral cavity ferment
carbohydrates and produce acids that can
initiate demineralization

The chemico-parasitic theory

21

2 stages of The chemico-parasitic theory

-Decalcification of enamel
-Dissolution of softened residue

22

derived from the
fermentation of starches and sugar lodged in
the retaining centers of the teeth."

acid which affects
this primary decalcification

23

was associated with dental caries in
1914

Lead

24

Prior to World War II there were reports on
the association between

Caries, poverty and race

25

Dental caries is a ________

multifactorial
infectious disease

26

Necessary factors in dental caries

Cariogenic bacteria and fermentable carbohydrates

27

Total plaque microflora

Non-Specific Plaque Hypothesis

28

Only a few species involved

Specific Plaque Hypothesis

29

Shift in hemeostatic balance

Ecological Plaque Hypothesis

30

infectious, communicable
disease resulting in
destruction of tooth
structure by acid-forming
bacteria found in dental
plaque, an intraoral biofilm,
in the presence of sugar

Dental caries

31

The Epidemiologic Triangle

-Agent
-Host
-Environment

32

most cariogenic for
enamel

Streptococcus mutans

33

Greater ms counts greater caries prevalence

Mutans Streptococci

34

1. Ability to adhere to tooth surface
2. Produce copious amounts of acid
3. Survive at low pH

Why caries are conductive

35

Order sugars

Sucrose>Glucose>Lactose>Fructose

36

Fermentable carbohydrates

Simple surgars and complex

37

Increase in sugar consumption, increase in
caries

Vipeholm study

38

Which type of sugar consumption is the worst

Between meal ingestion

39

In the vipeholm study what happened when sticky candies were withdrawn

Increase in caries disappeared

40

--restricted diet among 81 children,
aged 4 to 9 years
-At the start of the study, 78% of the children
were caries-free
-53% continued to be caries-free at age 13.

Hopewood house study

41

Bacteria + CHO ------> acid ------>demineralization ------- caries

Equation for etiology of dental caries

42

Enzyme in equation for etiology

glycosyltransferase (GTF)

43

Aids in remineralization

Calcium/ phosphate and Acid Buffers

44

• Age
• Gender
• Race and Ethnicity
• Socioeconomic Status
•Geography

Determinants and Risk Factors fro dental caries

45

-Saliva (antibacterial, antibodies to cariogenic
bacteria, buffering )
-Plaque removal - OH
-Dietary habits
-Fluoride therapy
-Sealants
-Caries vaccine
-Antibiotics

Deterrence

46

How do we measure caries?

-Counts
-Proportions
-Rates
-Indices

47

The number of people in a population
who have a given disease at a given
point in time

Prevalence

48

measures the
frequency of all current cases of
disease (old and new)

Prevalence

49

A measure of the number of lesions/period of
time.

Incidence

50

Limited in that they only measure the numbers of new initial lesions per unit of time

Incidence

51

describe the amount -
the prevalence - of dental caries in an
individual.

DMFT and DMFS

52

Decayed (D)
Missing (M)
Filled (F)
teeth (T) or surfaces(S).

Note

53

How many surfaces do anterior teeth have

4

54

How many surfaces do molars and premolars have

5

55

Maximum value for DMF (S)

128

56

can be considered to indicate severe disease
in children up to age 17.

DMFS calues of 7 or higher

57

What percent of US children suffer from severe
caries.

20%

58

-provides past history only.
-does not provide rate of lesion
development.
-does not indicate if caries is active or
inactive.
-does not provide the frequency of
occurrence of new lesions

Limitations of prevalence

59

D+M+F =

Prevalence

60

D/DMF =

Untreated caries

61

F/DMF =

Treated caries

62

M/DMF =

Tooth fatality

63

Bring attention to the individuals with the
highest caries values in each population
under investigation.

Significant Caries Index (SiC Index)

64

In the SiC index Individuals are sorted
according to their

DMFT values

65

The mean DMFT for
this subgroup is
calculated. This value is
the

SiC Index

66

Two overarching goals of healthy people

-Increase quality and years of healthy life
-Eliminate health disparities

67

What is the practical significance of the
epidemiology of Dental Caries

-Planning, funding, and delivery of services
-Training: numbers and type of professionals