ABSTRACT
Dental caries is initiated via the demineralization of dental hard tissue by organic acids from the fermentation of dietary sugar by odontopathogenic bacteria in dental plaque (1). Even though the prevalence of dental caries has decreased through the use of fluorides in most developed countries, the disease remains a major public health problem (2). In the recently published Australian child dental health survey (2), 40.2% of 6-year-olds showed signs of dental caries compared to 48.6% of 12 year olds. Untreated, clinically detectable decay in the combined deciduous and permanent dentition was present in 35.3% of children 5 to 15 years of age, with the greatest severity occurring in the youngest ages (e.g., 9.1% of 5-year-olds had four or more teeth with untreated decay). The level of disease in these high-risk children has decreased only slightly in recent years (e.g., the proportion of 6 year olds with four or more decayed, missing, or filled teeth [DMFT]decreased by only 3.7% between 1989 and 1996). Therefore, although the caries incidence among the general population of children has improved, there still is a significant percentage of high-risk children that require further targeting. Recent dental health surveys in young Australian adults (2) have indicated that the gains in oral health made in
childhood are not necessarily carried into later years, as these age cohorts exhibit higher percentages of individuals with high rates of caries incidence. For example, 78% of young adults selected from the electoral roll in Adelaide showed signs of tooth decay with a mean DMFT index of 3.66, with over 10% of these individuals exhibiting a DMFT of 8 or more (2). Demographic changes and changing patterns of oral disease are resulting in larger numbers of older Australians that are increasingly dentate and at high risk of dental caries. A recent survey of Adelaide nursing home residents (2) showed that 34% of the residents were dentate, with 41% of their teeth showing signs of active decay with a mean DMFT of 23.7.
