Determination of the prevalence and intensity of dental diseases. A method for determining the intensity of caries of permanent teeth in children during the period of mixed dentition. Important indicators when collecting information

The article presents the results of a dental examination of 625 children living in the city of Ufa. The survey used a questionnaire for parents, which included questions about awareness of oral hygiene issues, risk factors for dental diseases, and diet. The results of epidemiological dental examinations indicate a fairly high (according to WHO criteria) prevalence of caries in both temporary and permanent teeth of 6, 12 and 15 year old children in the city of Ufa, a high prevalence of periodontal diseases and dental anomalies. As a result of the dental examination and questionnaire, a high prevalence of major dental diseases in children and a low level of dental education of parents were established, which requires improvement of existing preventive measures in this population group.

prevalence

periodontal diseases

dental anomalies

survey

oral hygiene

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The main task of the state and, first of all, its healthcare services is to ensure the health of the nation, organize and implement the most effective programs for the prevention of major and most widespread diseases.

Dental status is one of the main indicators of the general condition of the body, and the development of a system of measures aimed at reducing dental morbidity rates should be an integral part of programs for improving the health of the nation.

The dental aspect of public health is characterized by two main indicators - prevalence and intensity, reflecting quantitative signs of diseases of the teeth, gums, level of hygiene, etc.

Currently, dental morbidity in our country among the child population is quite high, and further deterioration should be expected unless the conditions influencing the development of oral diseases are changed in a favorable direction and the quality of dental care, which depends on many objective factors, is not improved. and subjective factors.

One of the pressing health problems is the issue of assessing the quality of dental care provided to the population. This is especially true for the provision of dental therapeutic care to children, in particular in the treatment of such common diseases as dental caries and periodontal diseases. When assessing the quality of dental care, environmental and epidemiological factors must be taken into account.

Identification and elimination of etiological factors, targeted impact on the stages of development of pathology, allows you to obtain the maximum therapeutic and preventive effect, and, therefore, will have a positive impact on the quality of dental care.

At the same time, epidemiological studies conducted in various cities of Russia show an increase in the prevalence and intensity of dental caries depending on age and the epidemiological situation.

An epidemiological survey of the child population is the main point in the analysis of dental morbidity, which is necessary to compare morbidity in different regions, determine the quality of dental care, plan preventative treatment programs and evaluate their effectiveness. The main goal of prevention is to eliminate the causes, conditions for the occurrence and development of diseases, as well as increase the body’s resistance to the effects of adverse environmental factors.

The purpose of the study was a study of the dental status of children living in the city of Ufa, with the aim of improving the quality of dental care.

Material and methods of examination

To assess the condition of teeth, the indicators recommended by the WHO expert committee were used.

The prevalence of dental caries was determined using the formula:

Number of people with caries

Prevalence = ———————————————— x 100%

Total number of examined

The intensity of dental caries during the period of temporary dentition was determined using the KP index, during the period of mixed dentition using the KP+KPU index, and during the period of permanent dentition - KPU. To assess the prevalence and intensity of dental caries in children aged 12 years, we used the criteria recommended by the WHO Regional Office for Europe (T. Martthaller, D. O'Mullane, D. Metal, 1996).

The condition of periodontal tissues was studied using the periodontal index KPI (Leus P.A., 1988). The hygienic state of the oral cavity in children was assessed using the Fedorov-Volodkina index and the simplified oral hygiene index (IGR-U) (J.C. Green, J.R. Vermillion, 1964). Anomalies of teeth, dentition, jaws and occlusion were considered according to the classification of the Department of Orthodontics and Children's Prosthetics of the Moscow State Medical and Dental University (1990).

The survey used a questionnaire that included questions about children’s awareness of oral hygiene, risk factors for dental diseases, and diet.

Results and discussion

The overall prevalence of caries in primary teeth in 625 children aged 6–15 years was 57.86±1.56%, the intensity of caries in primary teeth was 2.61±0.6. The overall prevalence of caries in permanent teeth in 625 children aged 6 to 15 years was 71.45±1.31 %, and the intensity of caries of permanent teeth is 2.36±0.52. At 6 years of age, the prevalence of caries in primary teeth was 92.19%±2.94. At the age of 12 years, it was 16.4±3.18 %, and at 15 years old it is 4.02±1.92%. A different trend was observed in the prevalence of caries in permanent teeth: from 6 to 15 years of age there was a gradual increase in the process, so if at 6 years the prevalence was 18.64±3.75%, then by 12 years it was 84.28±3.27%, which corresponds to a high prevalence of dental caries. By the age of 15, the prevalence reaches its maximum value - 88.21±3.3%.

Table 1 shows average data on the prevalence and intensity of caries in permanent teeth among key age groups in the city of Ufa.

Table 1

Prevalence and intensity of caries in permanent teeth among key age groups in children in the city of Ufa (according to WHO criteria)

Analysis of the survey results shows that with age there is a tendency for caries of permanent teeth to increase - from 18.64±3.75% among 6-year-olds to 88.21±3.3% among 15-year-olds. In 12-year-old children, the average intensity of caries in permanent teeth is 2.83±1.58. In the structure of the KPU index in 12-year-old children, the “U” component (teeth removed due to caries and its complications) appears, which increases with age; the “K” component (caries) predominated, which was equal to 1.84 ± 0.14, while the “P” component (filling) is only 0.98 ± 0.09. At the age of 15, the “P” component predominates and is equal to - 2.25 ± 0.15, and component “K” - 1.67 ± 0,13. Among the identified dental disorders, periodontal diseases occupy second place. Analysis of the results shows a high prevalence of periodontal diseases, which increases with age. 53.44% of 6-year-old children show signs of periodontal disease. In 12-year-old children, the prevalence of periodontal disease is 80.28%. 19.72% of children are at risk of the disease. The intensity of periodontal lesions in 12-year-old children was 1.56. Among 15-year-old children, the prevalence rises to 85.5%. 14.5% have a risk of developing the disease. The intensity of periodontal diseases increases to 1.74. 65.26% of 12-year-old children have a mild degree of periodontal damage and need training in the rules of oral hygiene, 15.02% of children have a moderate degree of periodontal damage, and these children need professional oral hygiene. Among 15-year-old children, these values ​​are 66.0% and 19.5%, respectively.

The average value of the Fedorov-Volodkina index in the temporary dentition of 6-year-old children was assessed as an unsatisfactory level of oral hygiene.

The average value of the Green-Vermillion index in children in the mixed dentition was 1.48, in the permanent dentition - 1.56. Also, in children, both in the mixed and permanent dentition, increased deposition of tartar was noted.

When examining children in the city of Ufa, the age-specific dynamics of the prevalence of dental anomalies and deformities were studied. At the age of 6 years, the lowest prevalence of 40.05 ± 2.56% of anomalies in the dental system was found. Growth continues up to 12 years, where the maximum prevalence of dentoalveolar anomalies and deformities was found to be 77.20 ± 2.75%. At 15 years of age there is a slight decline to 75.50±3.01%. We compared the prevalence of dental anomalies and deformities between boys and girls. The overall prevalence for girls was 71.63±1.23%, and for boys 68.21±1.42% (P>0.05); there were no significant differences in the prevalence of pathologies in the dental system in boys and girls. When studying age-related dynamics in boys and girls, no significant differences were revealed (Table 2).

table 2

Prevalence of dental anomalies and deformities depending on gender in children living in the city of Ufa

We conducted a survey of 614 parents of schoolchildren living in the city of Ufa in order to determine the level of sanitary and hygienic knowledge, frequency and reasons for seeking dental care, and medical activity in the prevention of dental diseases.

When asked at what age it is necessary to brush a child’s teeth, only 18.79% of parents answered that teeth should be brushed from the moment teeth emerge. 39.24% believe that teeth should be brushed from the age of 2, 25.44% - from the age of 3, 20.53% of the surveyed parents answered that teeth should be brushed from the age of 4 and older.

Of the answer options proposed in the questionnaires regarding the hygiene products used by the child, 99.52% of the surveyed parents indicated that they use a toothbrush and toothpaste for oral care, of which 45.93%, in addition to basic hygiene products, use additional products (chewing rubber bands, mouthwash, toothpicks, floss). 0.32% of children do not brush their teeth. Oral care is carried out twice a day by 51.14% of children, once a day by 47.55%, after each meal by only 0.98%. 0.33% of children brush their teeth occasionally.

As for the frequency of visits to the dentist by a child, 23.62% visit the dentist once every six months or more often, 2.26% of people answered that they do not visit the dentist at all. The majority of parents, 55.66%, go to the dentist when their child has a toothache. Once a year - 16.69%, once every two years only 1.77% of respondents.

The information we received about preventive measures has a certain theoretical and practical interest. 51.27% of the surveyed parents answered that the dentist did not tell them about the need for preventive measures for the child, the remaining 48.78% of the parents answered that yes, the dentist did.

66.19% of people believe that their child needs measures to prevent dental diseases, 17.7% of parents answered no, and 16.19% do not know. 77.72% of parents are ready to participate in activities to prevent dental diseases, the remaining 22.28% are not. 33.38% of parents always follow the doctor’s recommendations for the prevention of dental diseases, 47.59% do not always fully and not always in a timely manner, 9.05% do not have enough time, 8.84% do not have enough money for effective hygiene products oral cavity, 0.78% of parents believe that the doctor is not competent enough, and 0.35% do not believe in prevention. When asked which methods of health education you trust most, the answers were distributed as follows: an individual conversation with a doctor - 88.76%, television and radio programs - 2.83%, 4.74% - read literature and health bulletins, 3.68% listen to lectures by specialists at the clinic.

Thus, we have identified a low level of sanitary and hygienic knowledge among parents, insufficient medical activity of parents regarding the preservation of dental health in the child, and insufficient work by dentists on hygienic education and health education of the population on the prevention of dental diseases. On the other hand, a high level of public trust in information received from dentists was revealed. A dentist must know about oral hygiene products, be able to give recommendations on the correct choice and use of products in accordance with their dental status, and must instill in patients a motivated attitude towards oral hygiene as an integral part of the health of the body.

Thus, the high prevalence of major dental diseases requires the modernization of existing preventive programs for organized groups of the population.

Bibliographic link

We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"

Prevalence of caries - This is a percentage indicator of the ratio of the number of subjects with at least one clinical sign of dental caries (caries, filled or extracted teeth) to the total number of subjects.

Caries intensity is an indicator of the sum of clinical signs of dental caries, calculated for each patient.

Index CPU (Fig. 131) - the sum of carious (C), filled (P) and extracted (U) teeth in one examined patient is determined by the number of teeth affected by caries.

For this purpose, the WHO Expert Committee on Dentistry (1962) proposed using the index for adults CPU.KPU index – the sum of carious (C), filled (P) and extracted (U) teeth in one examined patient; for children with temporary or primary dentition – kp index(k – carious, p – filled); for children with mixed bite – index KPU+kp.

To facilitate a comparative assessment of the incidence of caries in different parts of the world, WHO in 1980 proposed to distinguish 5 degrees of incidence depending on the CP in children 12 years of age:

1) very low – from 0 to 1.1;

2) low – 1.2 – 2.6;

3) moderate – 2.7-4.4; 4) high – 4.5-6.5;

5. very high – 6.6 and above.

To obtain reliable data when determining the prevalence and intensity of dental caries, population groups should be examined taking into account age and gender, climatic and geographical and socio-economic conditions. Typically, children aged 5-6 years, 12 years, 15 years old, adults 35-44 and 65 years old are examined. The most representative age groups of the population are 12- and 15-year-old children.

Increase in intensity or incidence. It is determined in the same person or cohort of those examined after a certain period of time (1, 3, 5, 10 years). The difference in the value of the indicator between the first and second examinations is the increase in the intensity of caries.

With the help of an epidemiological dental examination, it is possible to determine the prevalence and intensity of major dental diseases, the quality of oral sanitation, and the effectiveness of preventive measures.

M. Banchev (1963), Sh. 3. Kantorovskaya, I. N. Tekucheva (1969), N. Anholeer (1973), K.-O. Neubert, F. Gotsch (1974) note the greatest damage to primary teeth between the ages of 5 and 9 years and note that temporary frontal teeth are more often affected in the upper jaw, and temporary molars in the lower jaw. According to these authors, by the age of 7, the prevalence of caries in these teeth reaches 94% or more.

Of the primary teeth, the second molars (usually the lower jaw) are most often affected by caries, then the central incisors and first molars. The lateral incisors and very rarely the canines are affected somewhat less frequently.

K. S. Tristen (1974) indicates the predominance of so-called fissure caries in temporary molars at the age of 2 - 3 years. At the age of 4 - 5 years, the proportion of caries in such localization decreases almost by half; 1/3 of all carious cavities are localized on contact surfaces.

According to N. S. Yagya (1969), the first place in the localization of carious cavities in primary teeth is occupied by contact surfaces, then chewing and cervical surfaces. In permanent teeth, according to this author, caries predominates on the chewing surface, then on the contact surface, and lastly in the cervical area. However, after 17-18 years, caries of the chewing surface gives way to contact surfaces. This situation is well illustrated by Fig. 3.

Modern nutritional principles are to blame for such an intensive spread of caries, when from a young age children consume large amounts of sweets, drink sweet juices and compotes, and prefer fast foods that do not saturate the growing body with a sufficient amount of useful minerals “responsible” for the health of our teeth.

Research statistics

Statistics from caries research indicate that the incidence rate among the Russian population is high. Moreover, both adults and children suffer from this disease. Recent studies have found that most people get sick at an early age. The spread among children is so great that almost every child aged three years suffers from caries, and from 2 to 4 teeth are affected at the same time. Over time, the situation only gets worse, since many parents mistakenly believe that it is not at all necessary to treat baby teeth, they say, baby teeth are temporary and will fall out sooner or later. In fact, caries should be treated in any case, since in the future the permanent teeth will also suffer.

Statistics also show that at the age of six years, children’s permanent teeth, most often the first molars, are already affected. That is, in the absence of timely treatment, there is a threat of loss of molars already at such a young age.

Prevalence

The older the age group studied, the higher the prevalence and intensity of caries. Among children aged 12 years, the prevalence ranges from 61% to 96%. As for the adult population, the spread of the disease is 100%. That is, almost every resident of Russia suffers from this insidious disease.

Most often, natural pits and depressions on the surface of the teeth are affected, as well as hard-to-reach places - chewing surfaces, fissures, necks of teeth, blind pits, interdental spaces. Moreover, according to statistics, the upper teeth are affected more often than the lower teeth. It is curious, but of the upper teeth, the front ones are more likely to suffer from caries, and of the lower teeth, on the contrary, the back ones. At the same time, there is no difference between men and women - both one and the other are equally susceptible to caries.

Intensity

To assess the intensity, the so-called caries index is used - an indicator of the intensity of the development of the disease in each individual patient:

• for adults they are expressed by the total number of extracted, filled and carious teeth;
• for children are expressed by the total number of filled and carious teeth.

In order to calculate the index of the prevalence and intensity of caries among the people being examined, you must first determine the individual index of each individual person, and then calculate the arithmetic mean in the group.

Experts say that with the existing counting system, caries indices are somewhat underestimated, since they do not take into account the early forms of development - in the spot and superficial stages. Therefore, existing statistics look more optimistic than they actually are. In fact, the prevalence and intensity of caries in Russia is almost 100% among all age groups. It’s just that early forms that can be successfully treated are more common among children and adolescents.

Owners of patent RU 2428100:

The invention relates to medicine, in particular to therapeutic dentistry, and is intended to determine the intensity of carious lesions in permanent teeth in children during the period of mixed dentition. The level of intensity of caries in permanent teeth in children is determined by determining the KPUp index. The number of carious and filled fissures on the occlusal surfaces of the first permanent molars is determined. The index of caries intensity of permanent teeth is calculated using the formula: where IKpz is the intensity of caries of permanent teeth; KPUp ​​- the sum of carious and filled surfaces of permanent teeth; n is the number of first permanent molars. The method makes it possible to increase the accuracy of assessing the intensity of caries in permanent teeth and the effectiveness of treatment and preventive measures in children aged 6-12 years by taking into account the number of carious lesions on different surfaces of one tooth. 2 tables

The invention relates to medicine, namely to therapeutic dentistry, and can be used to determine the intensity of carious lesions in permanent teeth in children aged 6-12 years.

Fissure caries represents a significant problem in modern dentistry, since it is the earliest and most common form of destructive damage to the hard tissues of permanent teeth in childhood.

The share of caries on the chewing surfaces of permanent teeth prevails among carious lesions in other localizations. It is maximum in children 6-7 years old and tends to gradually decrease with age, but is accompanied by dysfunction of the dental system due to the destruction and early loss of the first permanent molars.

The effectiveness of the prevention and treatment of caries is assessed using indicators of the prevalence of the carious process, the intensity of caries of teeth and surfaces, the increase in intensity, the level of caries intensity, the level of dental care, etc.

The priority is to determine the intensity of dental damage in order to develop adequate treatment and preventive measures.

There is a known method for determining the intensity of caries in children during the period of mixed dentition using the index KPU+kp, expressed as an absolute value, where KPU is the sum of carious, filled and removed permanent teeth, and kp is the sum of carious and filled temporary teeth.

The KPU+KP indicator characterizes the activity of carious lesions in the oral cavity in children and is the basis for planning prevention programs in the regions.

However, using this index, it is impossible to assess the intensity of caries of erupting permanent teeth and the degree of their need for treatment and preventive measures, as well as the effectiveness of the preventive measures taken.

There is a known method for determining the intensity of caries of permanent teeth using the KPUz index, which is the sum of carious (C), filled (P) and removed permanent teeth in one individual.

During an epidemiological survey, the intensity of caries in each age group of people is determined by calculating the average KPU using the formula ΣKPU/n, where n is the number of subjects.

Depending on the values ​​of the KPU index, five levels of intensity of dental caries are distinguished: very low, low, medium, high and very high (Table 1).

However, the accuracy of assessing the intensity of caries using the KPUz index suffers because the number of carious lesions on different surfaces of one tooth is not taken into account.

As a prototype of a method for determining the intensity of caries of permanent teeth, the surface caries intensity index (SCI) was taken as the sum of all caries-affected and filled surfaces of teeth, since the SCI value more accurately reflects the local activity of the carious process and the caries susceptibility of various surfaces of the teeth.

If there is an extracted tooth, the KPUp index takes into account the sum of its surfaces, so each removed front tooth corresponds to 4 surfaces, and to each lateral tooth there are 5 surfaces.

At the same time, the index under consideration is not accurate enough, since it does not take into account the existence of several carious cavities or fillings within one tooth surface, and therefore does not allow an objective assessment of the activity of dental caries.

To increase the accuracy of determining the intensity of caries of permanent teeth, determine the value of the KPUp index, and also count the number of carious and filled fissures on the occlusal surfaces of the first permanent molars and calculate the intensity of caries using the formula:

IKpz - intensity of caries of permanent teeth;

KPF - the number of carious and filled fissures of the first permanent molars;

KPUp ​​- the sum of carious, filled surfaces and removed permanent teeth;

n is the number of first permanent molars affected by caries (if the first permanent molar is removed, then it is not taken into account in the n value).

The proposed index of the intensity of caries of permanent teeth IKpz with the greatest accuracy and reliability characterizes the intensity of carious lesions of permanent teeth and the effectiveness of ongoing treatment and preventive measures in children aged 6-12 years.

The ICpz index can be either an individual or an average value, determined during an epidemiological survey in groups of 6- and 12-year-old children using the formula ΣIkpz/n, where n is the number of subjects.

The interpretation of the IKpz index values ​​corresponds to the criteria for caries intensity proposed by WHO (Geneva, 1995) (Table 1).

Examples of specific implementation.

Patient Angelcheva V.A., 6 years old, medical record No. 31446.

According to an objective examination, in tooth 26 a carious lesion is determined in the medial vestibular fissure of the first order and the medial fissure of the second order (2 fissures), on teeth 36 and 46 the distal and lingual fissures of the first order are affected (4 fissures).

Index values:

3. KPF=6 (2+4=6 fissures of the chewing surfaces of the first permanent molars are affected by caries).

4.

The values ​​of the KPUz and KPUp indices correspond to the average level of caries intensity, however, according to the IKpz index, the intensity of caries in the child is high.

Patient Sitnikova V.A., 6 years old, medical card No. 67450.

According to an objective examination, in teeth 16 and 26, carious lesions of the medial-vestibular fissures of the first order (2 fissures) are determined, in tooth 36 the distal fissure of the first order is affected (1 fissure).

Index values:

1. KPUz=3 (3 first permanent molars are affected by caries).

2. KPUp = 3 (3 chewing surfaces of the first permanent molars are affected by caries).

3. KPF=3 (2+1=3 fissures of the chewing surfaces of the first permanent molars are affected by caries).

4.

The values ​​of the indices KPUz, KPUp, IKpz correspond to the average level of caries intensity.

Comparing the results of determining the intensity of caries of permanent teeth using various indices in two 6-year-old children in examples 1 and 2, one can see the same values ​​of the indices KPUz and KPUp, which correspond to the average level of intensity of caries of permanent teeth in an ambiguous clinical situation in the oral cavity. On the contrary, the indicator of the proposed ICpz index indicates a high level of intensity of fissure caries of permanent teeth in patient V.A. Angelcheva, clearly reflecting the condition of the occlusal surfaces of the first permanent molars.

Patient Muratova N.M., 12 years old, medical record No. 4376.

According to an objective examination, in tooth 16 a carious lesion of the medial vestibular fissure of the first order (1 fissure) is determined, in tooth 26 there is a carious lesion of the medial vestibular fissure of the first order and a medial fissure of the second order (2 fissures), in tooth 36 fillings are determined in the distal, lingual fissures of the first order, carious lesions of the distal fissures of the second order (4 fissures), tooth 46 was removed.

Index values:

1. KPUz=4 (3 first permanent molars are affected by caries and 1 tooth is removed).

2. KPUp = 8 (3 + 5 (5 chewing surfaces of extracted tooth 46) = 8 chewing surfaces of the first permanent molars are affected by caries).

3. KPF=7 (1+2+4=7 fissures of the chewing surfaces of the first permanent molars are affected by caries).

4.

The values ​​of the KPUz and KPUp indices correspond to the average level of caries intensity, but the IKpz index indicates a very high intensity of fissure caries of permanent teeth in this 12-year-old child.

A dental examination of 24 children aged 6 and 7 years was carried out before and after treatment and preventive measures.

The initial indicators of the KPUz and KPUp indices were the same and equal to 1.2±0.2 and characterized a low level of caries intensity in permanent teeth.

The value of the ICpz index was higher and amounted to 1.47±0.2, but did not differ significantly (P>0.05) and also corresponded to a low level of caries intensity.

A year after the treatment and preventive measures, the values ​​of the KPUz and KPUp indices increased to 2.3±0.2 (P<0,001), но по-прежнему соответствовали низкому уровню интенсивности кариеса.

However, the value of the proposed IKpz index (3.2±0.02; P<0,001) через 12 месяцев соответствовало среднему уровню интенсивности кариеса, с большей точностью отражая активность кариозного поражения постоянных зубов (Табл.2).

Thus, the proposed method for determining the intensity of caries of permanent teeth (index ICpz), in the absence of dynamics in the indices KPUz and KPUp, shows a significant increase in the intensity of fissure caries of permanent teeth, which is important for clinical practice and determines its technical result.

Literature

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A method for determining the intensity of caries of permanent teeth in children during the period of mixed dentition by determining the KPUp index, characterized in that the number of carious and filled fissures of the first permanent molars is additionally calculated and the index of caries intensity of permanent teeth is calculated using the formula:

where IKpz is the intensity of caries of permanent teeth;
KPF - the number of carious and filled fissures of the first permanent molars;
KPUp ​​- the sum of carious filled surfaces and removed permanent teeth;
n is the number of first permanent molars.

No matter how doctors try to overcome periodontal disease, the teeth of the inhabitants of the Earth still remain in danger. Unique therapeutic agents and materials have already been created, excellent diagnostic and treatment methods have been developed, but people suffer no less than past generations.

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from Crimean Medical University. Institute in 1991. Specialization in therapeutic, surgical and orthopedic dentistry including implantology and implant prosthetics.

I believe that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then treatment may indeed not come to the point - it won’t be necessary. Microcracks and small caries on teeth can be removed with regular toothpaste. How? The so-called filling paste. For myself, I highlight Denta Seal. Try it too.

If we look at medical statistics, the data will be completely disappointing: caries is the most common dental disease, a constant companion for both adults and children.

Public catering should be primarily blamed for the prevalence of the disease. Children have many temptations. They want to try a large abundance of sweets that attract with their beautiful packaging, located in store windows, drink drinks without understanding that they contain harmful chemicals, and snack on fast food that lacks beneficial microelements that can support the health of teeth and enamel.

Every dentist works tirelessly all day long to treat tooth decay in all new patients. But these procedures do not reduce the incidence rate. To help the population, all over the world, scientists and doctors constantly keep strict records of patients, noting areas of particularly frequent complaints.

Statistics

In order to get a true picture of caries data, information about its prevalence, intensity of manifestation, and duration is recorded. Every person who comes to the dentist with this problem is registered.

In order to be able to process all the information for further combating the disease, the following factors are monitored and studied:

• how the mechanism of the onset of the disease occurs, and then it develops in individual manifestations;
• what was the starting point for the onset of the disease, what were the causes;
• who in the population is at risk, and how to divide people according to the degree of morbidity so that more effective assistance can be provided in the future;
• how to predict a possible outbreak among the population in any area in order to prevent disaster with preventive care and properly selected treatment;
• check and evaluate methods of combating it that are carried out among the population;
• examine patients who have received treatment, but the disease has reappeared, in order to correct mistakes, and also, based on them, develop new directions, using already existing ways of prevention and treatment.

During mass examinations, dentists always focus on the age category. In this case, children always find themselves under close attention due to the fact that each, as well as adults, has a tendency to caries very individually, but they have their own characteristics: temporary and permanent teeth.

The following pattern has been revealed: baby teeth most often suffer from this disease. In this regard, it was decided to separate children – patients of dental clinics – into a separate category of patients.

But everyone who belongs to the adult population was also assigned to a specific subgroup. As a result, there were three of them:

• young, that is, teenage;
• average;
• elderly.

In order to fully understand the situation why the problems are getting worse, influence factors such as external and internal are taken into account. When collecting data about those being treated, their place of residence, climate, and whether it is suitable for a given individual, the state of water in the area, the presence of the necessary sunlight, and diet are recorded.

Especially finding out what kind of food a person prefers is given the most attention, since other foods contribute to the appearance of various dental damages. An incorrectly planned diet most often provokes a deficiency of vitamins and nutrients in the body, which leads to a weakened immune system, and then to a number of diseases.

What forms does the disease take?

Tooth damage can occur in everyone, with varying intensity and course. Much in this case depends on external influences, the body’s ability to resist and other individual characteristics.

But there are still general signs of caries, which are divided into separate categories:

1. Spicy. All its signs appear quickly, one to two weeks is enough. Sensitivity to various food irritants appears.
2. Chronic. The affected area loses its natural shine and acquires a lighter shade. Yellow or brown spots begin to appear. The process itself develops over a long period of time.
3. Flowering. It is very dangerous because it progresses very quickly, managing to destroy the enamel in many places at the same time.

Children's baby teeth suffer to the same extent as adults, so caries in young patients is classified using the same methods. In children's dental practice, records are also kept on such parameters as gradation of intensity, priority of contacting a doctor, whether there were complications or not. But special attention must be paid to baby teeth and permanent teeth.

Childhood caries is a common disease. Statistics show that adults are less likely to suffer from this disease. Most often, this is due to an unbalanced menu, especially if there are no foods rich in calcium, and there are too many sweet dishes, as well as poor oral hygiene. As a result, the enamel darkens, acquiring a yellowish tint, spots, plaque, and then holes appear.

For baby teeth, special treatment rules and our own methods have been developed, so the treatment here is slightly different from those methods when a permanent tooth needs help.

How to identify the distribution zone

WHO, in order to give a correct assessment of dental damage, uses such parameters as the intensity of tooth decay, the prevalence of the disease, and the increase or decrease in intensity. In this case, a certain time period is taken.

To determine how far the disease has spread, a certain ratio is used. It is indicated as a percentage.

When making the required calculations, we first take into account those patients whose teeth were susceptible to caries, even at the very initial stage, and then the total number of all people who visited the dental office.

From the given formula you can find out the incidence rate:

(s/c) / (o/h)) x 100%.,

where s/c – patients with caries; o/h – total number of those examined.

After calculations, the overall picture becomes clear, which indicates the following level in percentage terms:

• up to 30 is considered low;
• from 31 to 80 will be average;
• a level exceeding 80 indicates a high indicator.

If it is necessary to identify healthy clinic visitors, the indicator can also be calculated using the same formula, which will look like this: (p/h) / (o/h) x 100%.,

where p/z are healthy patients, o/h is the total number of people examined.

After calculations, the level of how the disease has spread is studied:

• the level is low, which means that more than 20% of the total number of people examined were patients without caries;
• average level – from 5 to 20%;
• the level is high – up to 5%.

It should be borne in mind that all results are required mainly in order to increase the level of preventive measures. But all data received from different places is necessarily processed, compared, and then an intensive search is carried out aimed at eradicating the problem.

When receiving data, there is a nuance that is closely related to the nature of the disease: any person who goes to the hospital with caries automatically remains in the category of dental patients. Even if it was an isolated incident many years ago. Therefore, the spread of the disease is a sedentary parameter, and in order to solve this issue, a large group of patients is involved, covering all age categories in several regions.

Medical assessment

In ridding the population of caries, it is important not only the presence of the disease itself. Assessing its intensity is also necessary and will help improve the level of medical services.

WHO representatives helped determine the intensity of the disease. It is they who own the summable index of damaged teeth - “KPU”, that is, “K” are affected teeth, “P” are already cured, with fillings, “U” are teeth that could not be cured, so they were removed. And you can calculate the intensity of caries by adding up all this data and then dividing by the total number of people who visited dentistry: “K” + “P” + “U” / o/h.

For small patients who have baby teeth, there is an index - “KP”, that is, “K” means diseased teeth, “P” means with fillings. If teeth are being replaced at this time, the index changes - “KPU” + “KP”.

When a mass study of the intensity of the disease in children begins, they take into account the age of 12, when the permanent teeth are already completely intact.

Various degrees of intensity

Each patient has his own increase in caries activity, which is necessarily recorded. Also, the number of healthy teeth affected by the disease over a certain period of time does not go unnoticed. Therefore, regular visits to the dentist are important, and if the disease progresses, every six months or more often.

The increase in diseases is taken as the difference between the indicators of the PCI index, taking into account previous examinations. This makes it more effective to plan treatment methods and take into account prevention.

Based on this, scientist T. Vinogradova determined the order of development of activity according to three types.

When the treatment is effective and the caries itself weakens, which is calculated by the formula: (Mk - M) / Mk) x 100%, where “Mk” is the increase in the disease in patients who did not undergo treatment, “M” is the increase in the disease when dental procedures were produced.

Degree of service to the population

Data on dental services in individual territories are subject to research. The important data here is:

• number of patients in need of assistance;
• access to treatment;
• number of work rooms;
• ratio of dentists to population in a certain area;

An indicator of over 75% indicates a good level, 50–74% indicates a satisfactory level, 10–49 percent indicates insufficient, and below 9% will be unsatisfactory.