Lecture 3

Question 1

epidemiology

Answer 1

study/analysis of patterns, causes, and effects of health and disease conditions in defined populations. Cornerstone of public health.

Question 2

caries process

Answer 2

dynamic sequence of biofilm interactions that can occur over time on and within a tooth surface

shift in balance between protective and destructive factors in favor of demineralization

Question 3

How does fluoride work topically?

Answer 3

Plaque on teeth is the reservoir for fluoride

Positive ions come off: calcium, phosphate, carbonate

Fluoride will attach to a demineralized area and brings in the positive ions

Question 4

Nowadays what else is included in substrate, host, and time?

Answer 4

community level influences, family level influences, and child level influences

Question 5

What is the Stephan curve?

Answer 5

• When pH goes below 5.5, (happens usually after you eat) it takes about 20 min to get back up to about 5.5
When you are below 5.5 your teeth are getting attacked by acid

demin and remin balance

Question 6

prevalence

Answer 6

caries at one point in time

Question 7

incidence

Answer 7

new carious lesions over a specific time period

Question 8

trends

Answer 8

change of differences in prevalence or incidence over time; may also be reported by location, by age, by gender, by socioeconomic status, by ethnicity, by educational attainment

Question 9

demographics

Answer 9

population represented by age, sex, ethnic/racial group, SES

Question 10

How are differences assessed?

Answer 10

demographics, geographical location, and trends influenced by sampling, methods used to collect data, and analytical techniques

Question 11

What were the outcomes of trends associated in study with percentage of children aged 2-4 who ever had caries in primary teeth?

Answer 11

• Disease increased during most recent times
• More males than females
• Every 10 years we tend to see tooth decay go down, this study was different (it compared 1988-1994 w/ 1999-2004)
• More disease in underserved ethnic populations
• In white population, there was significant increase.
• If you had decay, then you would most likely have decay again
In the last 10 years, this trend has gone down again.

Question 12

describe adult caries experience

Answer 12

over 90% of adults have caries, DMF increases w/ age mostly due to M, and more adults are retaining teeth

Question 13

gender/familial trends

Answer 13

females have greater DMF scores, which may be a function of treatment seeking

research is ongoing related to genetic factors but environments/psychological factors play a major role

Question 14

root caries

Answer 14

about 25% of people older than 18 show root caries

root caries increase w/ age, related to root exposure, medications, and numbers of retained teeth

Question 15

economics

Answer 15

cost of dental care - $110 B, 4% of total health care cost

dental disease at #3

use of fluoride was noted to have saved about $40 billion between 1960 and 2000

Question 16

caries risk assessment

Answer 16

analysis of probability that the number, size, or activity of lesions will change over a specified period of time (standardized way to look at risk)

Question 17

What are some obstacles of caries risk assessment?

Answer 17

only 14% of dentists do CRA, most use observation/experience

reimbursement, no universally accepted system

Question 18

CAMBRA

Answer 18

really only for kids

Question 19

ADA CRA

Answer 19

checklist of 19 factors associated with caries, adult and child versions, no published studies on validity, no published ADA guidelines

Question 20

Should sealants be placed on early (noncavitated) lesions?

Answer 20

yes, to reduce the percentage of lesions that progress in children, adolescents, young adults, and adults