Epidemiology of

Dental Caries
BY: DR. ANOSHA
RIAZ
Introduction:

 Oral health problems revolve around dental caries predominantly.

 Dental caries is often referred to as pandemic disease, with
characteristics of high proportion of untreated caries causing pain,
functional restrictions, distress, premature tooth loss, malnutrition
and ultimately less growth and development
 Dental caries can be prevented if factors causing it can be
identified so that better preventive activities can be planned and
executed.
What is epidemiology?

 Epidemiology is the basic science of preventive and social

medicine.
DEFINITION:
“The study of the distribution and determinants of
health-related states and events in populations, and the
application of this study to control health problems”
What are Dental Caries?

 There are many definitions of dental caries. However, it is largely

accepted as:
“a multifactorial disease initiated by interactions between
fermentable carbohydrates, acidogenic bacteria, and numerous host
factors, i-e saliva, that results in localized dissolution and destruction of
calcified tissues of the teeth”
Etiology of
Dental
Caries
Theories of Causation:

Endogenous Theories

Humoral
Vital Theory
Theory
 Endogenous Theories:

Humoral Theory:
According to Galen: “Dental Caries is produced by internal action of
acid and corroding humors”
According to Hippocrates: “In favoring of concept of humoral
pathology, also referred to the accumulated debris around teeth and
to their corroding action. He also stated that the stagnation of juices
in the teeth was the cause of toothache”
Endogenous Theories:

Vital Theory

According to this theory “ Tooth decay

originated like bone gangrene, from within the
tooth itself”
Theories of Causation:

Exogenous Theories
Chemical (Acid) Parasitic (Septic) Miller’s Chemo-parasitic
Theory (Acidogenic
Theory Theory Theory)

Proteolysis
Proteolysis
Chelation
Theory
Theory
Epidemiological
Triad of Dental
Caries
 Epidemiological triad:
Host Factors Agent Factors Environmental Factors
1. Tooth Micro-organisms 1. Diet
2. Saliva (Plaque forming 2. Geographic variations
3. Age, Race & Sex streptococci,
3. Soil
4. Familial Heredity Streptococcus mutans)
4. Urbanization
5. Developmental disturbances
5. Climate
6. Economic Status
6. Social Factors
7. Concomitant Disease
7. Industrial Hazards
8. Oral Hygiene Habits
Factors
Associated with
Dental Caries
Dental Caries occurs due to association
of 4 factors

susceptible tooth
surface

diet rich in
carbohydrates bacteria

duration of
exposure to
bacteria
Factors
affecting the
carious
phenomenon
Incidence And
Prevalence of
Dental Caries
Incidence of Caries:

 According to WHO, caries is the most prevalent non communicable

disease globally. In 2015, the “Global Burden of Disease Study”
established its high prevalence ranking it “first” for decay of
permanent teeth (2.3 billion people) and 12th for deciduous teeth
(560 million children)
 It affects humans of all ages in all parts of the world, because it
involves an inter-play of social, behavioral, cultural, dietary and
biological risks that are associated with its initiation and progress.
Prevalence Estimate of Caries In
Pakistan:

43%

37%

7% 7%

Punjab Sindh KPK Baluchistan

Measurement of Caries Incidence:

 DMFT is a widely used and accepted method of measuring dental

caries at the community level.
 It can only detect cavitated lesions and cannot account for incidence
 DMFT stands for
D >> Decayed
M >> Missing
F >> Filled
Prevention
of
Dental Caries
Prevention of Dental Caries:

1.Primary Prevention
Prevention of disease initiation

2.Secondary Prevention
Prevention of disease progress and recurrence

3.Tertiary Prevention
Prevention of loss of function
Levels of Prevention:

Services provided Services provided Services provided by

the Dental
by Individual by Community Professional
Levels of Primary Prevention
Prevention
Preventive Health promotion Specific protection
Services
Services provided Diet planning, demand for preventive Appropriate use of fluoride. Ingestion
by individual services, periodic visits to the dental of sufficient fluoridated water.
office Appropriate use of fluoride
prescriptions. Use of fluoride
dentifrice. Oral hygiene practices.

Services provided Dental health education programs, Community or school water

by the promotion of research and lobby fluoridation, school fluoride mouth
efforts rinse, tablet and sealant programs
community
Services provided Patient education, plaque control Topical application of fluorides,
by Dental program, diet counselling, recall and fluoride supplements and rinses, pit
reinforcement, dental caries activity and fissure sealant
Professional test
Levels of Secondary Prevention Tertiary Prevention
Prevention
Preventive Early diagnosis and prompt Disability Rehabilitation
Services treatment limitation

Services Self examination and referral Use of dental Use of dental services
provided by services
individual
Services Periodic screening and referral, Provision of Provision of dental
provided by the provision of dental services dental services services
community
Services Complete Examination, prompt Complex Removable and fixed
provided by treatment of incipient lesions, restorative prosthesis, minor
preventive resin restoration, simple dentistry, tooth movements,
Dental restorative dentistry, pulp capping pulpotomy, root implants
Professional canal therapy,
extractions
Thank You!
Any Questions