Читать книгу Caries Excavation: Evolution of Treating Cavitated Carious Lesions - Группа авторов - Страница 29

It is technically and behaviourally possible to keep healthy primary teeth healthy. Unfortunately, this is not the reality in many world communities. Frencken [34] reported that “(severe) early childhood caries ([S-]ECC) is prevalent in many countries with large populations in deprivation. Epidemiological surveys from Brazil, Canada, Vietnam, China, Switzerland, and Thailand show alarming results. High prevalence figures for S-ECC for 38% (Canada) and 44.1% (Thailand) of 3-year olds have been reported while the prevalence of ECC was 24.8% in Switzerland and 74.4% in Vietnam among 1- to 6-year olds. The mean dmft-score for 1- to 6-year olds was 3.6 in China and 3.9 in Canada” [31]. The heterogeneity of data collection methods between these studies notwithstanding, these figures show that something is drastically wrong in many world communities despite some improvements achieved over the last 3 decades in other countries and communities [27].

One of the risk indicators for developing dental caries is the level of deprivation. The major driver of deprivation is the availability of funds/income. Therefore, a country’s caries-related data from the WHO database have been linked to their gross national income. Table 2 shows that cavitated dentine carious lesions in 5- and 6-year-old children are prevalent in all countries but that there was a difference in the severity of cavitated dentine carious lesions across the groups of income countries. The lowest median dmft count was found in the high-income group (2.0) compared to 3.9 and 4.1 in the upper-middle- and lower-middle-income groups, respectively. The percentage of the d-component was high in all income groups in each country [30]. These findings confirm the outcome of the study by Kassebaum et al. [31] and paint a poor picture of the dental caries situation in youngsters in world communities.

Fortunately, good news can also be reported. Although considered poor, the current dental caries situation may not be as bad as 40 years ago. Table 3 shows trends in the prevalence of cavitated dentine carious lesions and the mean dmft scores in 5 countries. In all countries, the prevalence and mean dmft scores decreased remarkably over time. The highest reduction rate in the prevalence of cavitated dentine carious lesions was reported for the UK and Sweden: 46 and 45%, respectively, over 40 years [30]. Dentine carious lesions are now concentrated in a minority of children in these and perhaps more countries. Trend studies show the importance of monitoring the disease situation in a country/community regularly.