Читать книгу Caries Excavation: Evolution of Treating Cavitated Carious Lesions - Группа авторов - Страница 32

Using the data of the WHO database, the median mean DMFT score among 35- to 44-year-old adults was high in the high-income group (13.5) and low in the low-income group (3.1; Table 6). Unfortunately, only a small number of countries was included in the low-income group. The mean percentage of the D-component was low (9.6%) in the high-income group and high (53.6%) in the low-income group.

Although there have been few trend studies, they show a clear picture. The mean number of teeth present among 50-, 60-, and 70-year olds from Sweden increased from 21.5 to 26.1 among 50-year olds and from 13.3 to 20.7 among 70-year olds between 1973 and 2003 [41]. Among 50-year-old Swedish women, the mean number of teeth increased from 14.6 in 1968/69 to 27.3 in 2004/05. The percentage of edentulous women decreased from 18.2 to 0.3 between 1968/69 and 2004/05 [42]. This pattern has also been reported in the UK, Canada, and Australia [43].

The prevalence of root carious lesions in subjects aged over 60 years in Japan was 39% in 2006, with poor oral hygiene and a low salivary flow rate being potential risk factors [40]. More recently, in southern Brazil, approximately 36% of dentate individuals had carious lesions and/or restorations that affected, on average, 5.0 teeth [41]. In an older age group of over 80-year-old Swedish elders, untreated coronal dentine carious lesions were present for between 36 and 56% of the subjects, while between 54 and 75% had untreated root carious lesions [42]. A review on this topic is available from Tonetti et al. [44].

The fact that people are getting older with more natural teeth than in previous times increases the risk for carious lesion development, both in crown and root surfaces, because of an increase in the number of teeth and improvement in living conditions. This risk implies that adequate care needs to be organised on the basis of realistic treatment options that include the possibility to deliver care at home and in institutions where many elderly people remain for longer. This implies that the care, including restorative treatments, needs to be mobile. An example of such an approach is atraumatic restorative treatment (ART) [45, 46].