Epidemiology of Dental Caries

Question 1

What is epidemiology

Answer 1

the orderly study of diseases/other conditions at population level, not individual level

Question 2

Uses of dental epidemiology

Answer 2

1. measure dental disease
2. identify factors that cause dental disease
3. assess oral health needs
4. help planning and delivering services
5. evaluate effectiveness of new treatments/materials

Question 3

Definition, function and examples of an index

Answer 3

an instrument that enables quantification of a disease

1. measure changes within groups
2. measure differences between groups
3. standardise disease measurement

DMF/dmf > used to measure prevelance and severity of dental caries in a population

Significant Caries Index > brings attention to individuals with highest caries values in a population by calculating their DMFT

International Caries Detection and Assessment System (ICDAS) > aids assessment of the degree of caries progression in a tooth - uses 2 codes per tooth surface - 1 code for restorative status of tooth - 1 code for caries status

Question 4

Epidemiological surveys used in Scotland to measure dental caries

Answer 4

1. National dental inspection programme (2003>present)
2. Scottish adult oral health survey (2016-2018)
3. Scottish health survey
4. Grampian adult dental health survey 2010

Question 5

National Dental Inspection Programme

Answer 5

> conducted by Scottish dental epidemiology coordinating committee

> informs parents/carers about the oral health status of their children

> informs the government, health boards and other organisations of the prevalence of oral disease at national and local levels

> primary 1 and primary 7 aged schoolchildren

> % with no obvious decay is on the rise

> mean DMFT is on the decline

Question 6

Key terms in measurement of disease

Answer 6

1. prevalence
2. incidence
3. trends

Question 7

Epidemiological methods for studying dental caries

Answer 7

1. descriptive
   > who, where, when
   > e.g., cross-sectional studies
2. analytical
   > causes, effects
   > e.g., observational longitudinal, experimental, systematic reviews

Question 8

Example of cross-sectional study looking at diet and caries

Answer 8

> Granath 1978
caries in 500 swedish 4 year olds
low sugar meals = less caries
high sugar meals = more caries

Question 9

example of longitudinal study looking at diet and caries

Answer 9

> Tristan de cunha
found that before 1940 participants diet was low in sugar and therefore low caries
after the opening of a trade store which offered cariogenic diet, there was a steady increase in caries
studied between 1937 and 1966

Question 10

example of an experimental/interventional study of diet and dental caries

Answer 10

1. vipeholm study
   > 964 institutionalised participants
   > controls given no sugar
   > test groups given sucrose, bread, chocolate, caramel, or toffees
   > frequency more important than quantity
   > liquid not as cariogenic as sticky foods
   > caries formed even in absence of sugar
2. turku sugar study
   > finland
   > 125 participants
   > followed over 25 months
   > 3 test groups (sucrose, fructose, xylitol)
   > assessed DMF statistics
   > 85% reduction in caries in xylitol group