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Udgivelsesdato: null-null Only very few longitudinal studies on dental caries are available in adults and elderly. Therefore, the aim of the present study was to describe the patterns of lesion progression in a group of adult and elderly Chinese followed over a 10-year period of time. In 1984, 587 persons aged 20-80 years were examined and by 1994, 440 of these were still available and re-examined by the same two examiners. All restorations, periodontal conditions and dental caries were recorded for all teeth and surfaces. Only caries data are reported here. Dental caries on coronal surfaces was classified as sound, non-cavitated, cavitated without or with pulp involvement or filled. On root surfaces, lesions were classified as sound, active caries or restored. Prior to analysis of the data, a series of drop-out analyses was carried out showing that most of the drop-outs were above 60 years of age at baseline, and death of participants was the major drop-out reason. A total of 2,114 teeth were lost, 36% of which had a deep dentin lesion at baseline. The distribution of persons according to number of new lesions/restorations over 10 years was highly skewed in all age groups, the prevalence increasing with age. Molars had the highest risk of becoming carious/restored over the 10-year period, and a remarkably low proportion of teeth had the same caries diagnosis after 10 years, indicative of lesion progression. When comparing the 1984 DFT/DMFT with the figures for 1994, there were no statistically significant differences indicating that the period and cohort effects cancel out each other. There was a significant increase with age of the number of new DFT. It can be concluded that dental caries is a major health problem in contemporary adult and elderly Chinese populations, and that caries incidence increases with old age.

In 90, 60- to 80-year-old patients with teeth retained in both jaws (mean 20.4 +/- 4.3), a total of 1,092 root surface lesions were recorded. Of these 156 were diagnosed as active caries lesions, whereas 509 were considered inactive, and 427 were filled. About 60% of the elderly had one or more active lesions and 79% had fillings. Seventy percent had more than 8 filled or carious (active or inactive) surfaces. The percentage of carious and filled root surfaces in relation to surfaces at risk demonstrated that the buccal surfaces of lower molars and premolars and upper canines were the most severely affected (RCI = 70%) with fillings predominating on easily accessible surfaces. A constant relationship between active and inactive lesions was found on all other surfaces but third molars and upper incisors. The data suggest that active and inactive root caries lesions must be diagnosed as separate entities if the dynamic nature of root surface caries is to be explored in epidemiological studies and clinical trials.

The study compared visual inspection, conventional film radiographs, xeroradiographs, and digitized radiographs for the detection of caries in occlusal surfaces without cavitation. 166 extracted premolars and permanent molars without macroscopic cavitation were included. Eight observers assessed five grades of occlusal caries by visual inspection and by the three imaging techniques. Histologic sections (700-1,000 microns) served as validating criterion for the presence and depth of carious lesions, 82 teeth being found carious (27 with deep dentinal involvement) and 84 being scored as sound. Approximately 20% of the dentinal carious lesions were detected by visual inspection and 40% by conventional film radiography (both with a minimal number of false-positive observations). By xero- and digital radiography, an increasing number of false-positive scorings was seen. By digital radiography the true-positive detection rate was similarly increased to 60%. The predictive values of a positive test were, on average, 0.85 for visual inspection, 0.89 for film, 0.78 for xero-, and 0.82 for digital radiography and for a negative test 0.56, 0.61, 0.61, and 0.69, respectively. However, digital radiography was able to detect over 70% of deep dentinal lesions in contrast to 45% by the other two imaging methods, without an increase in false-positive diagnoses of truly caries free teeth, compared with the other techniques.

Udgivelsesdato: 1990-Jun The aim of the present study was to assess the dental health situation of a relatively urban population in Guinea-Bissau, West Africa. A total of 312 persons aged 12, 30-39 and 50-59 years, respectively, were examined for dental caries, oral hygiene, periodontal pockets, gingival recession and mobility of the teeth present. The state of their oral hygiene was very poor. Although most persons examined had a relatively high number of teeth present a substantial number of these teeth had carious lesions, many of which were rather deep. Teeth with increased mobility were seen in a number of individuals but it appeared that periodontal breakdown was not the major cause of tooth mortality in the majority of the population. The results suggest that future dental health care strategies should focus on the development of a new type of dental health worker. This health worker should be capable of performing simple extractions, simple restorative treatment and intercepting early ongoing carious lesions using modern biologically-founded principles and appropriate technology.