Factors influencing the incidence of caries. Primary prevention of dental caries. Dental caries statistics. There are three types of KPU index

In the dental service, much attention is paid to caries intensity indicators. Based on them, you can consider how actively and effectively measures are being taken to maintain oral health.

According to the WHO classification, several statistical values ​​of carious lesions are assessed:

• prevalence percentage;
• intensity of dental caries (expressed in KPU);
• its growth;
• decrease in growth.

Statistical indicators are directly related to age. The older the persons being sanitized, the higher the prevalence and intensity of the course of carious disease will be.

Oksana Shiyka

Dentist-therapist

Note! In addition to carious indicators, there are periodontal indicators (CPI), identification of enamel damage not due to caries (according to Kuzmina), calculation of the level of dental care - allows you to find out the need for sanitation.

Why do we need statistics on the prevalence and intensity of caries?

Based on statistical data, we can draw a conclusion about the prevalence of caries. The indicator is based on the number of patients examined with. For example, of 100 people examined, 90 have carious lesions or fillings. This means that the prevalence of caries will be 90%. A completely healthy oral cavity for those who have never had caries. These statistics show the need of the population for dental care and how effectively prevention is carried out.

The intensity of caries is the ratio of carious, filled and extracted teeth of a particular patient. The indicator allows you to judge the quality of care provided and get an idea of ​​the upcoming volume of medical dental or orthopedic care.

Based on statistical data, the Ministry of Health receives information not only about the quality of services and the health of the population, but also about how much medical staff will be needed and how much finance to allocate for the needs of the dental sector in the next reporting period.

Forms of the disease in children and adults

Regardless of age, caries develops as follows and has the following:

• begins at the stain stage - roughness appears on the enamel;
• develops to the surface - affects tooth enamel, but does not yet reach dentin;
• passes into the middle - forms a cavity in dentin;
• formation of a deep lesion.

There are several types of caries:

• multiple – affects several teeth at once;
• fissure – based in natural depressions;
• interdental - it is provoked by food particles stuck in a difficult-to-clean space;
• circular - thins the enamel around the tooth, closer to the gum, can appear on several teeth at once;
• cervical - bacteria destroy the enamel near the gums;
• root - often associated with gum problems;
• secondary - develops under or next to the filled area.

In children, the process develops more rapidly than in adults, because the immune system has not yet fully matured, and it is more difficult for it to fight bacteria. In addition, children's enamel is thinner, so it is more susceptible to damage.

Estimation of caries prevalence

When calculating the indicator, three numbers are taken into account:

• number of people examined;
• previously sanitized (i.e. those who have fillings in their mouth - cured caries);
• healthy.

After that, it is calculated according to the formula: patients with caries are divided by the number of examined persons and multiplied by 100%. If the patient's mouth has at least one tooth treated for caries, it is considered previously sanitized, not healthy. Example: 200 people were examined, 100 of them have fillings, and 40 had no problems with this disease at all. We count: 160/200*100%=80%.

The resulting prevalence result is correlated with WHO standards:

• increased – 81%-90%;
• average – 31%-80%;
• reduced – 0%-30%.

Oksana Shiyka

Dentist-therapist

Important! The prevalence of caries is calculated as a percentage of the number of patients suffering from this disease to the examined persons.

The prevalence shows the extent of the disease, but it does not show the severity of the disease in a particular patient or in a group of people with caries. This is shown by the following statistical element.

Disease intensity

The penetration of caries into permanent teeth is indicated by the index KPU (carious teeth, filled, extracted). For milk teeth, kp is written - in lowercase letters, but means the same thing - carious and filled teeth. Extracted temporary teeth are not marked because their replacement is part of the natural process of life and they are extremely rarely lost due to caries. You can find the designation KPUp - the last letter is used to designate cavities or surfaces, since there are several of them on a tooth:

• on the crown;
• cervical, basal department;
• on the root.

An additional carious cavity does not always form in a different place on the tooth; it can appear on the other side of the filling. For example, an area on the vestibular (outer) side is filled, and caries has developed on the lingual (back) wall. To indicate caries during the period of change of occlusion, if it is present on milk and permanent teeth, the index KPU + kp is used. If a carious tooth has a filling, it is considered carious. The fate of demineralized enamel (the very beginning of the carious process) is not included in the CPU index. Calculated for 28 teeth - third molars (wisdom teeth) are not included.

The results obtained are added up and the KPU index is calculated, which is also considered the intensity of dental caries. For example, K=1, P=2, U=1. In total 4. The result obtained is checked against the WHO table, and it is important to take into account the age of the patient being examined.

Age	Intensity
	Very low	Low	Average	High	Very high
12	0 – 0,1	1,2 – 2,6	2,7 – 4,4	4,5 – 6,5	6,6 +
34 – 40	0 – 0,5	1,6 – 6,2	6,3 – 12,7	12,8 – 16,2	16,3 +

Oksana Shiyka

Dentist-therapist

Important! If Y (deletion) predominates in the KPU, this is an alarming indicator.

Modern dentistry is aimed at maximizing the preservation of one’s teeth, so a large number of extracted teeth makes one think about the quality of care provided.

Intensity increase

This indicator is calculated for each individual person, coupled with the dynamics of previous carious lesions. The period varies – 6 months, a year or more. For the study, the past CPU and the current one are compared. For example, in 2017 the patient had a KPU = 2, and in 2018 his KPU = 3. The increase was 1 carious, filled or extracted tooth.

Oksana Shiyka

Dentist-therapist

Important! With effectively carried out preventive measures, the growth of caries is not observed or slows down.

The increase in intensity is calculated only if additional carious cavities have formed during the period taken for the study. The indicator is especially relevant for patients with an active course of the disease or for those who have problems with internal organs. They can be examined every six months to prevent a strong increase in the intensity of caries.

Methodology for determining reduction

The reduction (decrease) of the disease is determined over time. To do this, take the control and experimental groups and calculate the average increase in the indicator. If it decreases, a percentage is displayed. For example, the control group was taken in 2016, the increase in a year was 2.0, and the experimental group had an annual increase of 1.0. The reduction in this case is 50%.

The following measures influence the increase in the reduction level:

• carrying out preventive measures;
• improving the quality of medical care provided;
• training in proper cleaning;
• improving lifestyle;
• increasing self-awareness of the population and regular visits to the dentist.

It turns out that for comparison we take not the intensity of the carious process, but its increase over a certain period. KPU, like the number of filled or extracted teeth, cannot decrease, but the increase in intensity may decrease. If the disease does not affect other teeth, their number does not increase, we can talk about a reduction (decline) in the growth of caries.

Epidemiological indicators

Caries epidemiology is a branch that studies how common and intense dental caries is. Helps to understand the level of dental health of the population, but not only. Main goals:

• identifying the percentage of caries prevalence and the intensity of its course;
• establishing the quality of care provided;
• identifying the population's need for dental care;
• comparison of the number of sick people in different areas;
• planning medical rates (+ how much dental personnel will be needed to train), equipment and financial support for providing dental care;
• the ability to track the effectiveness of preventive care over time using several examinations;
• determining the scope of work for those companies that produce pastes, rinses and other items for maintaining dental hygiene.

To conduct a study, it is important to observe all the nuances.

Condition	Explanation
Selecting a specific age group	In 6-year-olds, the condition of baby teeth is examined; in 12-year-olds, teeth are not completely formed, but the development of caries can be assessed over time; in 15-year-olds, the condition of the periodontium is visible; 33-45 years old - judge the state of dental health in the adult population; from 65 years of age are considered to establish the volume of dental care for the elderly.
Selection of specialists conducting the study	They undergo special training to equally evaluate the results they see.
Availability of equipment	Instruments for visual inspection – dental mirror and probes (sharp angled and periodontal button); means to ensure sterility (antiseptic solution, disinfection container, disinfected cotton swabs); a map where the results of the study will be recorded.

For objectivity of observation, it is recommended to recruit an equal number of people of both sexes into the group. If the migrant population in the region of interest exceeds 30%, then the intensity and prevalence of caries in them is assessed separately from the indigenous population.

Conclusion

Caries is an insidious disease that almost everyone has. To combat it, objectively assess what is happening and competently plan the allocated funds and medical rates, statistical indicators are used.

Epidemiological research is carried out to determine the quality of care provided, plan new activities and evaluate the effectiveness of existing ones. Indicators of prevalence and intensity allow you to see the scale of the problem and adjust the tasks leading to its elimination. When carrying out prophylaxis, growth is reduced and its reduction may be noted. These values ​​can only be revealed in the dynamics of the disease over a certain period.

The carious process is a disease that affects dental tissues, characterized by their destruction with the formation of cavities. In the modern world, every person has met him at least once. The disease is widespread due to the unbalanced diet of a large population.

Several indicators are used for epidemiological studies: incidence, caries prevalence and intensity. They compare different regions, with the help of this the quality of treatment and prevention of the disease is determined, and an individual treatment plan is drawn up for the patient.

What are caries statistics?

The prevalence and intensity of caries, its increase are the main statistical indicators of the disease. Prevalence is expressed as a percentage and is found using an algorithm. The number of people with carious lesions of dental tissues is divided by the number of subjects, and the data obtained is multiplied by 100.

The disease index shows the development of the disease individually for each patient. It is determined by the number of affected and already treated teeth. To calculate the index of a group of people, it is necessary to determine individual indices and then find their arithmetic mean.

However, scientists suggest that the figures for the intensity of the disease calculated using the existing algorithm do not correspond to reality. They do not take into account the disease in the early stages of development, therefore they are somewhat underestimated, not reflecting the real intensity of caries.

The increase in incidence is determined individually for each person after a certain period of several years. The increase in dental caries is the difference between the results of the first and second examination.

Reduction of caries - reducing the increase in the intensity of the disease. It is calculated using the following algorithm: the index of increase in the intensity of dental caries in the group where preventive measures were carried out is subtracted from the index of increase in the control group.

Forms of the disease in children and adults

There are several types of disease according to the rate of development:

At the same time, acute caries has many varieties. According to the intensity and degree of destruction of dental tissues in adults and children, the following forms of acute caries are distinguished:

• compensated;
• subcompensated;
• decompensated.

Assessment of caries activity according to the WHO method is complex and should be explained in increasingly clear language. The compensated type of acute caries is characterized by slow development. The patient's dental tissues undergo minor destruction, which does not cause discomfort.

The subcompensated form of caries is characterized by an average flow rate. This form of the disease is more active than the previous one, but sometimes the disease can go unnoticed.

Decompensated is the most dangerous type of acute form of the disease; it is often called blooming or multiple. Dental tissues are destroyed in the shortest possible time; within a month they can completely decompose. Usually several chewing elements are affected at once. The decompensated form of caries is characterized by severe destruction of internal dental tissues.

Estimation of caries prevalence

To ensure an objective assessment of the prevalence of the disease, all cases of the disease, starting from childhood, are taken into account. Current WHO statistics are as follows:

• in preschool children, the prevalence is about 86%;
• in schoolchildren, the prevalence of dental caries reaches 84%;
• in adults it reaches almost 100%.

Disease intensity

To assess the intensity of caries, the KPU index is important - the sum of carious, filled and extracted teeth in one patient. Each letter of the abbreviation corresponds to the status of the chewing element. To evaluate several people, the average KPU index is divided by the number of subjects. Currently it is about 7 USD.

It is difficult to assess the intensity of caries according to the WHO scale, since there are indicators exclusively for people aged 12 and 35-40 years. However, according to a rough estimate, today, both among adults and children, caries prevalence rates reach almost 100%.

Intensity Gain

Growth data is calculated individually. WHO recommends assessing the condition of teeth for the intensity of caries in accordance with the following requirements:

• 3 years – assessment of primary teeth;
• 6 years - the first indigenous;
• starting from 12 years – permanent teeth.

In children, the increase in the intensity of caries is determined at intervals of one year. In adults - from five to ten years.

Methodology for determining reduction

Reduction – reducing the increase in the intensity of caries. The method for determining reduction is as follows: a group of people is created who undergo preventive measures (for example, fluoridation of enamel) and a control group.

Then, after some time, the reduction rate is calculated. To determine it, the index of increase in the control group, where the subjects did not change their habits, is subtracted from the index of increase in the intensity of the disease in the group where preventive measures were regularly carried out.

Clinical examination according to the degree of caries activity

Patients under dispensary observation are divided into 4 categories according to the degree of caries activity in order to increase efficiency:

• almost healthy;
• with a compensated form of caries;
• with subcompensated caries;
• with decompensated caries.

1 subgroup undergoes a scheduled preventive examination once a year. Subgroup 2 is observed once every six months. Subgroup 3 – once every 3-4 months, 4 – once a month.

With the help of clinical examination and dividing patients into groups, the number of molars removed and cases of complications are reduced. This clinical examination technique helps reduce the need for treatment of acute caries by 43.5 percent. Also, with the division according to the degree of disease activity, the number of fillings installed and the amount of work of the dentist decreases.

Dentists have been talking about the dangers of caries and the importance of its prevention for decades. At the same time, there is a need to somehow measure the effectiveness of preventive and therapeutic work. To do this, doctors carefully collect data. Experts have also developed a special coefficient that can be used to track and identify the intensity of the spread of dental caries. Read more in today's material.

Why are statistics on the prevalence and intensity of caries kept?

Modern medicine does not skimp on conducting various studies that help not only to understand the scale of a particular problem, but also to organize preventive work and evaluate its effectiveness. This also applies to the prevalence of caries: dentists from different countries provide statistical data on the frequency of detection of the disease, its course, the age, social status of patients and even concomitant diseases.

Such statistical studies allow us to analyze the situation and draw the following conclusions:

• how different factors influence the formation and development of carious lesions,
• Which population groups are at greatest risk of developing dental caries?
• how to develop a strategy to reduce the likelihood of developing the disease not only in risk groups, but also in social and age groups less susceptible to caries,
• how effective are the methods of preventing and treating the disease,
• how to properly provide medical care to patients with identified diagnoses, as well as create new diagnostic and treatment methods.

When developing methods for treating and preventing caries, doctors rely on two indicators - the prevalence and intensity of the disease. In this case, different criteria for the disease are analyzed.

Why caries is a serious threat to society: interesting statistics

According to WHO data collected over the past few decades, the incidence of caries in people in different countries and regardless of their standard of living, living conditions and education is 80-98% (although in Africa and Asia the problem is less common, but in America, on in the north and in the polar region it is more common).

In recent years, the statistics among children suffering from this pathology have increased very significantly - among young patients aged six and seven years, the prevalence of carious lesions of varying depths is up to 90%. About 80% of teenagers also have dental problems of a carious nature at the time of graduation. But this is not the only thing that worries doctors. Nowadays, the prevalence of periodontal diseases is gaining momentum - most often problems arise in two age groups: 15-19 years (55-89%), 35-44 years (65-98%). Data collected in 53 countries.

On a note! An interesting study in 2016 was conducted by GfK experts in 17 countries. Experts have found that the biggest concern among the population of Japan and Korea is aging and the appearance of wrinkles. But Russia turned out to be the only country where the problem of missing and lost teeth due to dental diseases has become one of the main causes of concern among residents of different cities.

And researchers from the University of Washington were even able to calculate that the number of cases of toothache that appeared due to caries increased from 164 to 220 million from the 1990s to 2013. And these are only cases registered by doctors!

Criteria for caries

Here, doctors highlight several important points. Let's look at each of them in detail.

1. By stage of development

Like any other disease, carious lesions begin with mild forms and gradually develop into a severe, complicated diagnosis. In this regard, dentists distinguish the following stages of the disease:

• initial: it is also called the stain stage, when the enamel demineralizes, causing white rough spots to appear on it and the natural shine disappears,
• superficial: caries begins to destroy tooth enamel, but does not yet penetrate into softer tissues - dentin,
• medium: the area of ​​destruction affects the dentin,
• deep: caries spreads to the internal tissues of the tooth, the pulp or root, complications begin that are not always treatable and lead to tooth loss.

2. By place of origin

Localization of the lesion also requires special study. According to this criterion, doctors distinguish several types of caries:

• multiple: diagnosed on several teeth at once, most often neighboring ones,
• fissure: localized in the recesses between the chewing cusps of premolars and molars,
• interdental: it can be found between adjacent teeth, in a space difficult to reach with toothbrushes,
• circular: affects the enamel along the entire circumference of the crown near the gums, as a rule, it is diagnosed on several adjacent teeth at once,
• cervical: destroy the protective surface of the tooth near the gums, but not around the circumference, but from one edge,
• root: destruction occurs deep under the gum, which makes it difficult to diagnose this type of caries; it often occurs against the background of gum disease,
• secondary: destruction begins next to or under the filling and indicates that the doctor did a poor job of removing previously affected enamel or dentin.

3. By type of teeth

Treatment and prevention of caries also depends on which teeth the lesion develops on: milk or permanent teeth. Temporary teeth have thinner enamel, while the child’s immunity has not yet developed to fully protect itself from bacteria, so “milk” caries develops more quickly, and children suffer from carious lesions more often than adults.

Disease intensity

Caries intensity (IC) is a concept that shows the degree of damage to crowns according to the indices KPU, KP, KPU+KP in one person. In this case, the letters in the abbreviations mean the following:

• K - caries on permanent teeth,
• P - fillings on permanent teeth,
• Y - extracted permanent teeth,
• j - caries on baby teeth,
• n - fillings on baby teeth.

Important! When identifying the intensity of the disease using indices, its initial stage is not taken into account. Moreover, if at the time of the examination the patient had a complete replacement of teeth, then the KPU or KPUp indices are applied to him; if the change of teeth is not completed, then the doctor focuses on the KPU + KP indices, and if the baby teeth have not yet begun to fall out, then the KPU index is used.

The total intensity is calculated as the sum of all teeth (except for “eights”) that have ever been affected by caries (including filled and removed ones). The intensity of the disease on the root or crown is calculated separately. IC can be calculated both for one examined person and for a group similar in some way (for example, for children, for pregnant women, etc.).

For a person who has nothing to do with medicine, it is difficult to operate with such abbreviations and concepts, but these designations help dentists keep statistics that are very useful for their activities, which report on the effectiveness, or vice versa, on the ineffectiveness of work in each specific region of the country, on the needs for dental industry.

Different damage coefficients: how they differ

When examining, dentists operate with two concepts KPU(s) and KPU(p). They reveal the general picture of human morbidity and detail it.

Thus, KPU(z) is the sum of affected, filled and removed units due to caries in one patient, divided by the total number of teeth in the mouth (except for “eights”).

KPU(p) is the sum of affected, filled and removed dental surfaces in one patient, also divided by the number of all surfaces. To calculate the CP(n) of incisors, four surfaces are taken into account (frontal, lingual and two lateral), and for molars five surfaces are taken into account (the chewing surface is added to the previous four). For example, if a patient has two damaged surfaces on one tooth and has a filling, then that tooth receives 3 units.

For children, during the change of temporary teeth to permanent ones, the indices KPU(p) and kp(p) are calculated, that is, the surfaces of the crowns are summed up, and only those teeth that were removed from the jaw before the due date are considered removed, that is, before the roots are reabsorbed.

Attention! To more accurately assess the condition of the affected teeth, doctors calculate the KPP indicator. Often on one unit there are, for example, two diseased surfaces and one filling. In this case, the IR will be three units. This method allows for better analysis at low disease intensity.

What is the KPU index?

In modern dentistry, there are five levels of IR. For comparison, you can see how the PCI index changes in patients of different ages, for example, 12 and 35 years (the first and second value, respectively):

• very low level:<1,1 и <1,5,
• low level:<2,6 и <6,2,
• average level:<4,4 и <12,7,
• high level:<6,5 и <16,2,
• very high level: >6.6 and >16.3.

As you can see, there are a lot of people with a high intensity of caries at the age of 35. And yes, there are a lot of teenagers.

Often, along with the CPU indexes, doctors also calculate the increase in the disease. This is an indicator of the change in the number of carious units over a certain period of time (most often a year) in one patient. The increase can be positive if the number of affected teeth has increased, or negative if it has decreased or reduced to zero.

Prevalence of the disease

The prevalence of caries (PR) is the percentage of patients who have been diagnosed with at least one sign of this lesion at any stage, to the total number examined. In children 12-13 years old (the age when the replacement of primary teeth should be completed), the prevalence of the disease can be low (less than 30%), medium (31-80%) and high (81-100%).

Estimation of caries prevalence

In addition to the direct indicator of the Republic of Kazakhstan, there is also a reverse one. It shows the percentage of people examined who did not have caries identified to the number of patients with this diagnosis. Accordingly, in this vein, the RK can be high (the number of those free from the disease is less than 5%), medium (5-20%) and low (more than 20% of those examined did not have caries).

Assessment of the Republic of Kazakhstan is needed in order to have a picture of the incidence in a particular region, in certain age or social groups. In particular, in our country, this disease has a high rate in most regions, and in some – very high. For example, among preschoolers, the RK is 84%, and the IC according to the kpu(z) index is 4.83.

Interesting! In those Russian regions where the fluoride content in tap water exceeded 0.7 mg/l, the number of people with identified caries was much less than in regions where water fluoridation was insufficient. This trend is especially clearly illustrated by survey indicators of different children's age groups - 6, 12 and 16 years old. In adults, the destruction of enamel is influenced by additional factors (bad habits, pregnancy, stress, harmful working conditions, etc.).

Epidemiological indicators

The epidemiology of caries is a concept in statistical medical research that shows how widespread and intense this disease is in a country and its regions. In addition, it shows how well medical care is provided to the population and how much their needs for this help are covered. In addition to dental clinics, this statistics is very useful for educational institutions that train specialists of one profile or another: it is important for them to understand how many medical personnel are required in order to fully provide medical care to the population.

Also, manufacturers of hygiene products (toothpastes, brushes, rinses, etc.) are interested in indicators of the epidemiology of caries in order to determine the scope of work and the direction of research in the field of prevention of this disease. The same applies to companies producing equipment and materials for dental clinics. Their developments are aimed at improving the quality of diagnosis and treatment of the disease.

When identifying RC, the indicators of patients of the same age group are taken into account, while the indicators of different groups are not summed up or mixed. Children with baby teeth stand apart: they have their own risk factors. People with permanent teeth are conventionally divided into several categories: children from 12-15 years old, young (from 16 to 30 years old), middle-aged (30-45 years old), mature age (45-60 years old) and elderly (over 60 years old).

When analyzing the situation in a particular region, factors that provoke the development of the disease are taken into account, including the following: the presence of daylight hours per year, the strength of solar radiation, the presence of microelements in drinking water (calcium, phosphorus, fluorine, zinc and others) responsible for healthy functioning of tooth enamel and dentin.

The factor of unbalanced diet, stress and sedentary lifestyle is also assessed. All this affects the metabolism, and hence the delivery of useful substances to the tissues of the teeth. Do not discount the lack of oral hygiene, as well as bad habits (alcohol, drug addiction and smoking).

How research is carried out

For the research data to be reliable, it is important to meet the following conditions:

• age groups: it is important to conduct research for each age group separately, because it has its own characteristics and its own tasks. So, for example, in children, the intensity of the disease is observed in dynamics, in young people, periodontal disease is observed, and for older patients, the problems of prosthetics are more relevant than treatment,
• indicators of objectivity: it is important to take them into account when conducting the survey itself. For example, it is important that an equal number of people of both sexes are examined, so that data on the indigenous population is processed separately from data on visitors (relevant for regions where there are many enterprises operating on a rotational basis),
• qualifications of specialists: a very important point that ultimately affects all statistical data, because the quality of the examination depends on the level of training of the dentist,
• technical equipment of the clinic: this aspect also affects the quality of the examination,
• computer program: it is needed for multi-level data processing and provision of statistical reports to higher organizations and the Ministry of Health.

Medical examination and prevention

Based on the data obtained on the prevalence and intensity of the above pathology, the Ministry of Health carries out preventive work with the population. It is expressed both in an information alert about the danger of the disease and methods of preventing it, and in practical actions: including a routine examination by a dentist for children of different ages (the second year of life, before receiving a ticket to kindergarten, before starting school, etc. ), scheduled examinations of employees of enterprises and institutions, students, government employees, etc.

In addition, the clinical examination of the population is also responsible for the prevention of dental diseases. In addition, during medical examination it is very convenient to collect statistical information and analyze the dynamics of the prevalence and intensity of dental disease.

Video on the topic

1 Cherkasov S.M. Analysis of the prevalence of diseases of the dental system that shape the demand for dental services. Scientific journal "Fundamental Research", 2014.

The opinion that bad teeth are a disease only of modern people is incorrect.

Caries has become widespread back in Neolithic times. Since then, medicine has continued to fight the disease.

Prevalence And intensity act as the main indicators of carious lesions.

It is important to clearly know how these indicators are calculated, on what they depend.

Importance of problem research

The study of the etiology and pathology of caries is still one of the main priorities modern dentists, because statistics allow us to draw conclusions about successes in the fight against the disease and develop new preventive measures.

Analytical indicators of carious lesions are necessary for:

• deep learning etiology and pathogenesis;
• carrying out population differentiation by the nature of the risk of the disease;
• development preventive measures;
• assessments existing preventive methods, their effectiveness;
• assessing the relevance of carious pathologies for certain groups of people.

When making calculations, experts rely on odds, obtained within the scales:

1. person;
2. tooth;
3. dental surface;
4. focus of the disease.

The following criteria are used to evaluate the process: prevalence And intensity.

Prevalence and intensity of caries

According to statistics, no residents were protected from dental diseases underdeveloped countries, nor those who inhabit modern megacities, where the latest achievements of science and medicine are present. Even in developed centers, the prevalence rate does not decrease below the figure of 77%. This is the case in industrial Western European and American cities. Here, this figure reaches 95% .

Photo 1. Indicators of the prevalence of caries in Russia, taking into account the age of those examined. According to statistics, after 35 years, almost every person in the country has dental problems.

In pre-war Europe, according to statistics, caries suffered almost 100% population: 97% all residents children's age And 98% youth.

Despite the fact that caries does not make any difference in age, scientists have come to the conclusion that this disease is still characteristic of predominantly to young people. The older the study group, the higher the prevalence and intensity.

In Russia, caries is common 100%: every adult Russian needs the help of dentists to varying degrees.

The favorite target of pathogenic bacteria is natural depressions and irregularities on the surface of the tooth, also places that are difficult to completely clean with a brush: fissures, necks, interdental space, the so-called blind fossae.

Important! The upper jaw suffers to a greater extent than the lower one, and from above they take the main blow front teeth, and below - chewable and root.

There is also no gender difference for bacteria: both men and women need fillings equally.

Index as an indicator of the degree of development of the disease

When assessing the intensity of lesions using a special caries index. This is an indicator of the degree of development of the disease each individual person. Approach to adults and children different:

• the total number of teeth removed, filled and in need of treatment - for the adult population;
• the total number of cured and untreated teeth - in children.

The prevalence and intensity index among the studied population is determined according to certain rules. First they calculate individual index each member of the group, and then calculate average.

Photo 2. To obtain statistical data, the dentist examines each individual participant and records the problems identified.

Prevalence is low up to thirty percent, the average reaches and eighty, and high and one hundred percent.

When determining intensity, experts rely on the following indices:

1. Intensity of lesions baby teeth. Two indicators are used here: KP(z) and KP(p) - the sum cured And those in need in fillings of teeth and surfaces, respectively. The principle of calculation here is the same: the indicators for each representative of the group are determined, all the numbers are added together and then divided by the number of subjects.
2. Intensity of lesions permanent teeth. These are KPU(z) indices - here we are talking about the amount those in need of treatment, cured And torn out human teeth and CPU (n). The latter implies the sum of all surfaces that need treatment or on which fillings are placed. An extracted tooth counts as five surfaces.

Reference. When calculating, they neglect early forms of the disease(spot stage, superficial caries). Therefore, experts are critical of the existing statistics system, because it represents a more optimistic picture than what actually is.

Practice shows that in Russian realities people suffer from caries all ages, it’s just that children and adolescents are most often diagnosed early forms, which, being noticed in time, successfully liquidated.

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Growth rate

Speaking about statistics, they also rely on growth index. This indicator is calculated from the difference in the CPU indices for a certain observation period - from six months to several years.

The lower limit is standard year: During this time, new lesions develop in an ordinary citizen who is considered healthy.

In relation to people suffering from various pathologies of internal organs, as well as especially rapidly developing carious lesions, it is established six months period.

Definition of reduction

Reduction in growth indicates percentage difference for two homogeneous quantities. Usually, the increase in the intensity of lesions on the dental surface is compared between representatives of the preventive and control groups.

Epidemiology indicators

Modern scientists have no doubt that caries takes first place by popularity among diseases. Even in economically developed countries in nine out of ten people the mouth needs sanitation. Over time, the size of the teeth and their shape change, as well as the resistance of the enamel to internal and external threats.

Photo 3. A dentist conducts a preventive examination of a small patient in order to identify and treat caries in the early stages.

Experts note that with the development of scientific and technological progress the natural protection of tooth enamel weakens, this is also due to numerous additives in modern nutrition, and with ecology, and with harmful working conditions, in which a huge number of people are forced to work. With the achievements of science, nature and man himself are changing, but the environment is changing. much faster how people manage to adapt to it. Tooth enamel simply does not have time to develop enough to acquire proper stability.

The intensity and prevalence of caries are considered the main sources of statistics for this disease. Data are regularly collected on the frequency and rate of the course of the disease for all age groups of patients, depending on the influence of external and internal factors on their dental system. Thanks to the quantitative accounting of disease outbreaks, scientists can conduct scientific research, and dentists can carry out preventive and curative work in the fight against caries.

For dentistry, caries is considered an urgent problem that has to be dealt with daily. However, working with the disease separately, it is impossible to achieve positive results in the form of reducing mass outbreaks of lesions. This is why disease statistics are kept all over the world.

The collected data help not only to increase the professional level of dentists, but also to introduce the latest methods of diagnosis and treatment into practice. As a result, dental caries statistics help to improve the quality of dental services.

To establish a diagnosis, the dentist interviews the patient and records all the information in the medical record - the main document for recording the doctor’s work. When treatment ends, the card remains with the dentist for five years, then is archived for 75 years. Thanks to a well-coordinated storage system, it is possible to track and collect statistical data on the development of caries at any time.

Main tasks of statistics

Dental research relies on statistical data on caries, its prevalence, intensity and duration in different patients. When collecting information, the following tasks are set:

• studying the mechanism of origin and development of the disease in its individual manifestations;
• studying the origin of the disease in general: the conditions and causes of its occurrence;
• division of the population according to the degree of risk of developing the disease;
• drawing up future forecasts of the development of the disease for planning preventive care and adequate provision of dental services to the population;
• assessment of the effectiveness of created preventive and therapeutic methods;
• determining the degree of development of the disease in the examined group of patients in order to correct errors that have appeared and plan new directions in methods of prevention and treatment.

Important indicators when collecting information

When conducting mass examinations, dentists take into account, first of all, the age of the patients. Children have different susceptibility to caries, and they also have two types of teeth: temporary and permanent. It is known that baby teeth are more susceptible to caries. Accordingly, children belong to a separate, pediatric group of patients. In addition to this age group, there is a group of adults, consisting of three subgroups: young (adolescent) age, middle and old.

The next point when collecting information on the spread of caries is external and internal influencing factors. This includes the patient’s place of residence: whether the climate is suitable for his health, whether there is enough sunlight, whether the drinking water contains the required amount of minerals, micro and macroelements.

The patient's diet also plays an important role in the occurrence of dental damage. An unbalanced diet is the cause of a deficiency of vitamins and minerals in the body. As a result, a person’s immunity weakens, often causing illness. Other causes of the disease can be found in the article.

Prevalence of the disease

According to the list of terms used by WHO - the World Health Organization, four main parameters are used to assess dental damage: the intensity of dental caries, its prevalence, increase and decrease in intensity over a specific period of time.

Disease prevalence is a calculation of a certain ratio, expressed as a percentage. The calculations take the number of patients in whom at least one sign of tooth damage was noticed during examination, and the number of all patients examined. Formula for calculating the required number: ((patients with caries)/(total number of patients examined))×100%.

The incidence of caries depends on the result obtained: up to 30% - low, from 31% to 80% - average, more than 80% - high.

In some cases, a term is used that is more suitable in meaning for the purposes of statistics of the manifestation of the disease - patients without caries. As a result, the inverse prevalence indicator is calculated according to the formula: ((patients without caries)/(total number of examined patients))×100%.

A low level of disease prevalence means that patients without caries make up more than 20% of the total percentage of those examined, medium – from 5% to 20%, high – up to 5%.

Conservative, sedentary parameter

In each region, research results are used to a limited extent, only to increase the level of preventive measures against caries. All obtained indicators of the prevalence of the disease are compared with each other in different regions, aiming at mass eradication of the problem.

This state of affairs is associated with the specifics of the disease - if a person begins to have dental damage, he will forever remain in the group of patients. Even if it was a long time ago, and caries was stopped or cured. Accordingly, disease prevalence is a sedentary, routine parameter. That is why assessing the effectiveness of preventive measures is only possible by comparing large groups of patients of different ages and from different places of residence.

Disease intensity

To solve statistical problems, it is necessary to take into account not only the fact of the development of the disease. To improve the level of dental services, an assessment of the intensity of caries is needed.

To calculate the degree of intensity of the disease, scientists from WHO came up with a special index of the sum of damaged teeth - SPU, where K - teeth affected by caries, P - filled teeth, U - teeth removed. The intensity of dental caries is calculated according to the formula: ((K+P+U)/(total number of surveyed)).

Children with temporary (baby) teeth are given the index kp, where k is teeth affected by caries, p is filled teeth. For children whose temporary teeth are being replaced by permanent ones, the intensity of the disease is calculated using the KPU+KP index.

In mass studies of the intensity of the disease in children, it begins to be calculated from about 12 years of age, when the replacement of temporary teeth with permanent ones has ended. Such restrictions are considered the most informative, since the level of caries damage to primary teeth is a relative concept and not a constant one. WHO identifies five degrees of disease intensity, which can be found in the table:

Intensity waxing and waning

The increase in caries activity is studied for each patient individually. Dentists examine how many healthy teeth have been affected by the disease over a certain period of time. Typically, the doctor examines the patient every two to three years, in case of sudden deterioration - every three to six months.

The increase in morbidity is the difference in the indicators of the PCI index between the last examination of the patient and the previous one. Thanks to these studies, the dentist can plan a method of treatment and a method of prevention, based on the needs of each patient.

Based on this, the scientist T.F. Vinogradova identified three types of activity in the development of the disease, which can be found in the article.

If prevention and treatment help, the activity of the caries lesion begins to weaken - the reduction of the disease. This information is measured using the formula: ((Mk-M)/Mk))×100%.

Mk is the increase in the disease in patients before preventive and curative work, M is the increase in the disease after undergoing dental procedures.

Degree of provision of dental services to the population

In certain areas of public service, the following indicators of the provision of dental services are investigated:

• the number of people who sought help;
• availability of services;
• providing dentists with jobs;
• the ratio of the number of dentists to the number of people living in a particular area;
• providing the population with dental chairs.

In large-scale studies of the provision of dental services to the population, in certain regions, several groups of patients are simultaneously examined, each of which should contain at least 20 people. Formula for identifying the level of dental care (USL): 100%-((k+A)/(KPU))×100, where k is the average number of teeth affected by caries, without treatment, A is the average number of extracted teeth without restoring their functions with the help of prostheses. If the indicator is more than 75%, then the USP is good, 50% -74% - satisfactory, 10% -49% - insufficient, less than 9% - poor.

Tell us in the comments, how is the quality of dental services in your city?

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