Based on Community Oral Health (Pine ) Essential Dental Public - PowerPoint PPT Presentation

Based on Community Oral Health (Pine ) Essential Dental Public Health(Daly) By Dr. Asgari & Dr. Soheilipour

Overview  About WHO  Burden of Oral Diseases  Epidemiology of dental caries  Definition  Distribution  By geography, age, gender, race/ethnicity, SES  Determinants  Food cariogenicity, diet  Prevalence and extent of Oral Diseases in Iran  Conclusions

Learning Objectives At the conclusion of this module, the participant will be able to:  Define epidemiology  Define dental caries  Describe the dental caries index  Describe the epidemiology of dental caries  Describe factors related to dental caries

About World Health Organisation (WHO)  The World Health Organization ( WHO ) is a specialized agency that is concerned with international public health. It was established on 7 April 1948 , with headquarters in Geneva, Switzerland.  It is responsible for:  providing leadership on global health matters  shaping the health research agenda  setting norms and standards  articulating evidence ‐ based policy options  providing technical support to countries  monitoring and assessing health trends

WHO regional offices WHO eastern Mediterranean Region WHO African Region WHO South-East Asian Region WHO Western Pacific Region WHO Region of the Americans WHO European Region

Policy Basis for the WHO Oral Health Programme  Oral health is integral and essential to general health  Oral health is a determinant factor for quality of life  Oral health ‐ general health  Proper oral health care reduces premature mortality

Oral health is integral and essential to general health Oral health means more than good teeth; it is integral to general health and essential for well ‐ being. It implies being free of:  chronic oro ‐ facial pain  oral and pharyngeal (throat) cancer  oral tissue lesions  birth defects such as cleft lip and palate, and  other diseases and disorders that affect the oral, dental and craniofacial tissues, collectively known as the craniofacial complex. The World Oral Health Report 2003

What is the burden of oral disease?  Dental caries and periodontal diseases and oral and pharyngeal cancers have historically been considered the most important global oral health problems in both industrialized and increasingly in developing countries.  In many developing countries, access to oral health services is limited and teeth are often left untreated or are extracted because of pain or discomfort.  Throughout the world, losing teeth is still seen by many people as a natural consequence of ageing. World Health Organization Report

What is the burden of oral disease?  The impact of oral diseases in pain, suffering, impaired function and reduced quality of life, is both extensive and expensive.  Treatment is estimated to account for between 5 ‐ 10% of health costs in industrialized countries, and is beyond the resources of many developing countries.  Traditional treatment of oral disease is extremely costly, the fourth most expensive disease to treat in most industrialized countries. In many low ‐ income countries, if treatment were available, the costs of dental caries alone in children would exceed the total health care budget for children. World Health Organization Report

Dental Caries  Epidemiology The orderly study of diseases and other condition in human population where the group rather than the individual is the unit of interest and their causes or influences in well ‐ defined populations. Epidemiology is the study of the  D istribution and  D eterminants of  D isease/health in a population

How to count dental caries for a population?  DMF index (permanent teeth) : The number of Decayed, Missing and Filled Teeth (DMFT) or Surfaces (DMFS)  Def, df indices (Deciduous teeth)

Human Teeth with Dental Caries Dental enamel caries Dental enamel demineralization Medical university of south Calorina/SC Geriatric Education Centre

Close-up Photograph of Root Caries Dental enamel Root surface Root caries Medical university of south Calorina/SC Geriatric Education Centre

Brief History of Dental Caries 9  Throughout most of 1900’s  Dental caries experience  seen primarily in high ‐ income countries  low prevalence in low ‐ income world  likely related to diet  Late 1900’s  Dental caries experience  increase in some (not all) low ‐ income countries  decrease in high ‐ income countries among  children  young adults Medical university of south Calorina/SC Geriatric Education Centre

Distribution: Dental Caries  Geographic  Age  Gender  Race / ethnicity  Socioeconomic status  Familial patterns Medical university of south Calorina/SC Geriatric Education Centre

International Prevalence of Dental Caries  Dental caries is still a major oral health problem in most industrialized countries, affecting 60 ‐ 90% of schoolchildren and the vast majority of adults. The World Oral Health Report 2003

International Prevalence of Dental Caries  Dental caries is still a major oral health problem in most industrialized countries, affecting 60 ‐ 90% of schoolchildren and the vast majority of adults.  It is also a most prevalent oral disease in several Asian and Latin American countries, while it appears to be less common and less severe in most African countries. The World Oral Health Report 2003

International Prevalence of Dental Caries  Dental caries is still a major oral health problem in most industrialized countries, affecting 60 ‐ 90% of schoolchildren and the vast majority of adults.  It is also a most prevalent oral disease in several Asian and Latin American countries, while it appears to be less common and less severe in most African countries.  In light of changing living conditions, however, it is expected that the incidence of dental caries will increase in many developing countries in Africa, particularly as a result of a growing consumption of sugars and inadequate exposure to fluorides. The World Oral Health Report 2003

International Prevalence of Dental Caries  Traditional treatment of oral disease is extremely costly, the fourth most expensive disease to treat in most industrialized countries. In many low ‐ income countries, if treatment were available, the costs of dental caries alone in children would exceed the total health care budget for children The World Oral Health Report 2003

WHO Region specific weighted DMFT among 12 ‐ yar ‐ olds (Global weighted DMFT= ( ∑ {DMFTi x Populationi}) / Total) WHO Regions DMFT 2004 2011 AFRO 1.15 1.19 AMRO 2.76 2.35 EMRO 1.58 1.63 EURO 2.57 1.95 SEARO 1.12 1.87 WPRO 1.48 1.39 Global 1.61 1.67 http:www.whocollab.od.mah.se/ countriesalphab.html#Top // Oral Health Database , Malmo University

Global DMFT for 12-year-olds - trends Global DMFT Publication Year 2.43 Leclercq et al, 1987 1985 Leclercq et al, 1987 2.78 1981 CAPP (www.mah.se/capp) 1.74 2001 1.61 Bratthall, 2005 2004 1.67 Natarajan, 2011 2011 http:www.whocollab.od.mah.se/ countriesalphab.html#Top // Oral Health Database , Malmo University

Dental caries levels (DMFT) of 12 ‐ year ‐ olds worldwide (July 2003)

Dental caries levels (DMFT) of 35 ‐ 44 ‐ year ‐ olds worldwide (July 2003)

Changing levels of dental caries experience (DMFT) among 12 ‐ year ‐ olds in developed and developing countries

Oral Health trends in the UK…..

Oral Health trends in the UK…..

Frequency distribution of dental caries according to various tooth location permanent dentition

Deciduous dentition

Distribution of dental caries according to tooth surface  Occlusal > interproximal >buccal

Distribution: Age  DMF scores increase with increasing age  DMF index is cumulative  ( D ecayed can become F illed, and then M issing through time)  Whole tooth missing due to dental caries is equal to a count of 4 or 5 surfaces in the DMFS index  Cohort effect

Distribution: Gender  Females generally have higher DMF scores  Probable treatment effect  females usually have higher “Filled” component  Earlier tooth eruption among females  Cannot say females are more susceptible to dental caries

Distribution: Race ‐ Ethnicity  Little evidence for inherent differences in dental caries susceptibility across race ‐ ethnicity.  Differences in socioeconomic status associated with race ‐ ethnicity in the U.S. are probably more important.

Distribution: Socioeconomic Status  SES relates to a person’s background ‐ values  Education  Income  Occupation  Most recent data suggest that DMFS scores are inversely related to SES

Distribution : Familial Patterns 9  “My family has bad teeth” May be a function of  Bacterial transmission  Family habits/ culture  diet  behavioral traits  Genetics (e.g., salivary flow, composition)  Additional research is needed