Читать книгу Caries Excavation: Evolution of Treating Cavitated Carious Lesions - Группа авторов - Страница 33

Dental caries is a behavioural/life-style disease which is preventable in nature through diet (sugar-free consumption) control and daily plaque removal with a toothbrush and fluoride toothpaste. Despite being preventable, dental caries is widespread and untreated dentine carious lesions in permanent and primary dentitions are ranked number 1 and 10, respectively, on the list of most prevalent medical diseases and conditions [47].

Pits and fissures in occlusal first molars and pits in buccal mandible first molars are the tooth types and sites that are the most susceptible for developing dentine carious lesions. In children at high risk for carious lesion development, these tooth types and sites need to be monitored well.

Progress has been made in oral health over the last 3–4 decades, but the extent to which the reduction in prevalence and severity of dental caries is applicable to countries around the world is unknown as many countries do not carry out epidemiological surveys or do not publish the results in the English-language dental literature. However, monitoring and comparing trends in caries prevalence and severity requires studies to have the same outcome measures and use the same assessment instruments.

Considering the need and importance for monitoring dental caries over time, only validated carious lesion assessment indices/systems should be used. Not all currently used indices/systems have sufficient validation. The CAST instrument is an exception, but it requires further testing for its applicability in different age groups.

Generally speaking, dental caries is an age-related and a life-long disease. Despite progress made in improving oral health, the fact that people are living longer and that more teeth remain at risk at old age than before does not reduce the burden of dental caries in society. This conclusion calls for the introduction of a massive behavioural/preventive programme that targets parents and dental/medical professionals, and should start at mother and child health care centres and continue throughout the primary educational system. Dental practitioners should leave their comfort zone of the dental surgery and make themselves available for providing care at the community level, while oral health care financial systems should allow for a gradual shift from predominantly rewarding curative care (damage repair) to preventive and promotional oral healthcare.