Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002.
ABSTRACT Dental caries is a common chronic disease that causes pain and disability across all age groups. If left untreated, dental caries can lead to pain and infection, tooth loss, and edentulism (total tooth loss). Dental sealants are effective in preventing dental caries in the occlusal (chewing) and other pitted and fissured surfaces of the teeth. Enamel fluorosis is a hypomineralization of enamel related to fluoride exposure during tooth formation (first 6 years for most permanent teeth). Exposure to fluoride throughout life is effective in preventing dental caries. This is the first CDC Surveillance Summary that addresses these conditions and practices.
1988-1994 and 1999-2002.
The National Health and Nutrition Examination Survey (NHANES) is an ongoing survey of representative samples of the civilian, noninstitutionalized U.S. population aged >/=2 months in NHANES 1988-1994 and all ages during 1999-2002. The dental component gathered information on persons aged >/=2 years.
During 1999-2002, among children aged 2-11 years, 41% had dental caries in their primary teeth. Forty-two percent of children and adolescents aged 6-19 years and approximately 90% of adults had dental caries in their permanent teeth. Among children aged 6-19 years, 32% had received dental sealants. Adults aged >/=20 years retained a mean of 24 of 28 natural teeth and 8% were edentulous. Among persons aged 6-39 years, 23% had very mild or greater enamel fluorosis. Disparities were noticed across all age groups, among racial/ethnic groups, persons with lower education and income, and by smoking status. From 1988-1994 to 1999-2002, four trends were observed: 1) no change in the prevalence of dental caries in primary teeth among children aged 2-11 years, 2) a reduction in prevalence of caries in permanent teeth of up to 10 percentage points among persons aged 6-19 years and up to six percentage points among dentate adults aged >/=20 years, 3) an increase of 13 percentage points in dental sealants among persons aged 6-19 years, and 4) a six percentage point reduction in total tooth loss (edentulism) among persons aged >/=60 years.
The findings of this report indicate that the dental caries status of permanent teeth has improved since the 1988-1994 survey. Despite the decrease in caries prevalence and severity in the permanent dentition and the increase in the proportion of children and adolescents who benefit from dental sealants, disparities remain.
These data provide information for public health professionals in designing interventions to improve oral health and to reduce disparities in oral health, for researchers in assessing factors associated with disparities and dental caries in primary teeth, and in designing timely surveillance tools to monitor total fluoride exposure.
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ABSTRACT: Lead remains a significant pollutant. It has acute toxic and chronic effects on many tissues and accumulates in teeth and bones. The researchers for this study investigated the association of blood lead levels with the extent/severity of caries as measured by the number of decayed/filled teeth of children aged 24-72 months using data from NHANES III (the Third National Health and Nutrition Examination Survey), accounting for the excess zero caries in the analysis and using less than 2 µg/dl as the reference blood lead level (n = 3,127). Zero-inflated negative binomial regression models indicated unadjusted extent/severity mean ratios of 1.79, 1.88 and 1.94 for the number of decayed/filled teeth in children whose blood lead levels were 2-5, 5-10 and >10 µg/dl, respectively, compared with children having <2 µg/dl blood lead levels. The results did not attenuate when other variables were added to the model for the 5-10 and >10 µg/dl levels of exposure. The adjusted extent/severity mean ratios were 1.84, 2.14 and 1.91, respectively, for the categories. This study indicated a strong association of blood lead levels with increasing numbers of carious teeth in children aged 24-72 months. These findings support other studies in an innovative analysis handling cases of children with no caries. The findings may inform caries risk assessment. © 2014 S. Karger AG, Basel.Caries Research 10/2014; 49(1):26-33. DOI:10.1159/000365297 · 2.50 Impact Factor
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ABSTRACT: The authors have presented a technique of full occlusal rehabilitation in a case of severe dental fluorosis. In this technique, maxillary and mandibular anterior teeth were simultaneously prepared and restored first. This was followed by simultaneous preparation of maxillary and mandibular posterior teeth that were restored in canine guided occlusion. The technique and sequence followed here is unique and is not available in dental literature. This technique reduces number of appointments while fulfilling all objectives. Periodontal follow-up over 3 years was satisfactory. A restorative treatment protocol has been devised for fluorosis which will act as a guide for the dental practitioners.
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ABSTRACT: Objective To examine dental caries development and caries risk factors among preschool African American children from low-income families in Detroit, Michigan, over a 4-year window.Methods Data came from a representative sample of 1021 children (0–5 years) and their caregivers in Detroit. The baseline participants in 2002–2003 (W1) were re-examined in 2004–2005 (W2) and 2007 (W3). Caries was measured using the International Caries Detection and Assessment System. Bivariate and multivariate analyses for repeated data were conducted to explore associations between caries increment outcomes and demographics, access to dental care, oral health-related behaviours, and social and physical environments.ResultsThe mean number of new noncavitated caries lesions (NCCL) was 2.8 between W1 and W2 and 2.6 between W2 and W3, while the mean number of new cavitated caries lesions (CCL) was 2.0 and 2.0, respectively, during the same time periods. In younger children (<3 years old in W1), higher number of new NCCL than new CCL was observed in both W1–W2 and W2–W3. The risk of new NCCL was associated with child's soda intake and caregiver's age. For the risk of new CCL, significant risk factors included baseline NCCL, baseline CCL, as well as child's age. Baseline caries and child's soda intake were also associated with the risk of developing new decayed, missing and filled tooth surfaces.Conclusions Higher number of new NCCL relative to CCL was developed among low-income African American children during early childhood. New caries development was associated with baseline caries and child's soda intake.Community Dentistry And Oral Epidemiology 11/2014; 43(3). DOI:10.1111/cdoe.12140 · 1.94 Impact Factor