epidemiology and prevention of dental caries

35
Departement of public health dentistry Epidemiology ,prevenTion of dental caries Presented by, Shiji margaret CRRI

Upload: shiji-antony

Post on 15-Jan-2017

1.367 views

Category:

Education


1 download

TRANSCRIPT

Page 1: Epidemiology and prevention of Dental caries

Departement of public health dentistry

Epidemiology ,prevenTion of dental caries

Presented by,Shiji margaretCRRI

Page 2: Epidemiology and prevention of Dental caries

contentEpidemiology definitionDental caries definitionRelation between diet and dental cariesCaries factorsGlobal distributionDietVariation of caries within the mouthTypes of dental cariesAgent factors of dental cariesRisk factorsPreventionConclusion

Page 3: Epidemiology and prevention of Dental caries

Epi = uponDemos = peoplelogy = sTUDYEpidemiology = the science which deals with what falls upon people…..

Page 4: Epidemiology and prevention of Dental caries

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

Page 5: Epidemiology and prevention of Dental caries

dental caries

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

Page 6: Epidemiology and prevention of Dental caries

Low Caries incidence existed in Ancient Man

•Examination of ancient skulls

shows that:

Page 7: Epidemiology and prevention of Dental caries

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.

Page 8: Epidemiology and prevention of Dental caries

Relationship between diet and dental caries

Bacterial enzyme + fermentable carbohydrates = acid

Acid + enamel = dental caries

Page 9: Epidemiology and prevention of Dental caries

The classic Vennediagram 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

Page 10: Epidemiology and prevention of Dental caries

Current global distributionDuring most of the 20th

century, dental cariespattern 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.”

Page 11: Epidemiology and prevention of Dental caries

Global DistributionThe 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.

Page 12: Epidemiology and prevention of Dental caries

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

Page 13: Epidemiology and prevention of Dental caries

DietIntake of refined carbohydrates

especially sucrose (sugar) is considered a strong etiologic factor in the causation of dental caries.

Page 14: Epidemiology and prevention of Dental caries

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:

Page 15: Epidemiology and prevention of Dental caries

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.

Page 16: Epidemiology and prevention of Dental caries

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).

Page 17: Epidemiology and prevention of Dental caries

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)

Page 18: Epidemiology and prevention of Dental caries

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.

Page 19: Epidemiology and prevention of Dental caries

Agent Factors of Dental CariesMicroorganismsMainly Streptococcus mutans are responsible

for initial development of dental caries with contribution of other species such as:

Lactobacillus acidophilus Lactobacillus caseiStreptococcus salivariusStrpetococcus milleriStreptococcus sanguisActinomycis (root caries)

Page 20: Epidemiology and prevention of Dental caries

The host Risk Factors

1- Age. 2- Gender. 3- Race. 4- Genetic & familial.5- Role of saliva.

Page 21: Epidemiology and prevention of Dental caries

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.

Page 22: Epidemiology and prevention of Dental caries

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

Page 23: Epidemiology and prevention of Dental caries

GenderIt is observed that caries prevalence is higher in females than in males of the same age.

Page 24: Epidemiology and prevention of Dental caries

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. .

Page 25: Epidemiology and prevention of Dental caries

Familial & genetic patternDental caries has

long ago shown to be grouped according to families

Members of the same household were found to be alike in their caries pattern than between unrelated groups of individuals.

Page 26: Epidemiology and prevention of Dental caries

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).

Page 27: Epidemiology and prevention of Dental caries

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.

Page 28: Epidemiology and prevention of Dental caries

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.

Page 29: Epidemiology and prevention of Dental caries

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.

Page 30: Epidemiology and prevention of Dental caries

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.

Page 31: Epidemiology and prevention of Dental caries

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

Page 32: Epidemiology and prevention of Dental caries

4. Stimulate saliva:

Saliva contains numerous components - that fight tooth decay buffers, remineralizing minerals, antimicrobial enzymes, antibodies.

Page 33: Epidemiology and prevention of Dental caries

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

Page 34: Epidemiology and prevention of Dental caries

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

Page 35: Epidemiology and prevention of Dental caries

THANK U…