John D. Suomi

Epidemiology and Public Health Aspects of Caries and Periodontal Disease

This paper will present (1) a review of the epidemiology of dental caries and periodontal disease, (2) a discussion of some of the economic and social costs of these diseases, and (3) a short review of public health approaches related to the prevention and control of these diseases. EPIDETMIOLOGY OF DENTAL CARIES AND PERIODONTAL DISEASE.-Dental caries and periodontal disease are today and probably have always been the most common oral diseases. Though one is a disease of tooth structure and the other of the structures supporting the teeth, the organisms involved in the etiology of both diseases attach to the tooth pellicle and organize to form dental plaque. While there are other similarities between the two diseases, it would be well to review briefly some of the major epidemiologic characteristics of each. The advent of dental caries as a significant health problem appears to be fairly recent in the history of man.1 Virtually unknown in ancient times, the prevalence of caries has increased with time until it has become almost ubiquitous in modern man. Its prevalence world-wide is uneven with the disease being relatively rare in a few parts of the world and rampant in others. For example, decayed, missing, and filled teeth values (DMFT) for youths 13 to 14 years of age in five countries included in an international collaborative study of oral health manpower systems revealed a wide divergence in scores.9 Youths examined in Sydney, Australia, showed an average DMFT score of 6.7 compared with a score of 12.6 for youths in Trondelag, Norway. Values for similarly aged youths in Japan, West Germany, and New Zealand were 7.5, 8.8, and 10.7 respectively. MIajor variations in disease attack rates also occur within single countries and populations. Currently,