How fast does caries progression

Volume 41, Issue S7. Previous Article Next Article. Clinical Relevance. Regulatory Statement. Conflict of Interest. Article Navigation. Research Article September 01 This Site. Google Scholar. S Paris S Paris. Oper Dent 41 S7 : S35—S Get Permissions. Cite Icon Cite. Figure 1.

View large Download slide. View large. View Large. Figure 2. Figure 3. Figure 4. Search ADS. Caries assessment and restorative treatment thresholds reported by Swedish dentists. Changes in the treatment concept of proximal caries from to in Norway. Dental caries is a transmissible infectious disease: The Keyes and Fitzgerald revolution.

Microbial ecology of dental plaque and its significance in health and disease. Recent advances in dental caries research. Bacteriological findings and biological implications.

The role of sugar in the aetiology of dental caries. Sugar and the antiquity of dental caries. Mechanistic aspects of the interactions between fluoride and dental enamel.

Risk factors for dental caries in young children: A systematic review of the literature. Caries incidence and lesion progression from adolescence to young adulthood: A prospective year cohort study in Sweden. Behaviour of approximal carious lesions assessed by clinical examination after tooth separation and radiography: A 2.

Treatment of deep caries lesions in adults: Randomized clinical trials comparing stepwise vs. Efficacy of sealing proximal early active lesions: An month clinical study evaluated by conventional and subtraction radiography. A 2-year clinical evaluation of sealed noncavitated approximal posterior carious lesions in adolescents. Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. The incipient carious lesion as observed in shadowed replicas 'en face pictures' and ground sections 'profile pictures' of the same teeth.

What constitutes dental caries? Histopathology of carious enamel and dentin related to the action of cariogenic biofilms. Reliability of visual examination, fibre-optic transillumination, and bite-wing radiography, and reproducibility of direct visual examination following tooth separation for the identification of cavitated carious lesions in contacting approximal surfaces.

An in vivo comparison of radiographic and directly assessed clinical caries status of posterior approximal surfaces in primary and permanent teeth. Plaque and gingival status as indicators for caries progression on approximal surfaces. Incidence and progression of approximal caries from 11 to 22 years of age in Sweden: A prospective radiographic study.

Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Caries infiltration with resins: A novel treatment option for interproximal caries. Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: Efficacy after 1 year. Randomized controlled clinical trial on proximal caries infiltration: Three-year follow-up.

Infiltration and sealing versus fluoride treatment of occlusal caries lesions in primary molar teeth. The evaluation of resin infiltration for masking labial enamel white spot lesions. Durability of esthetic improvement following Icon resin infiltration of multibracket-induced white spot lesions compared with no therapy over 6 months: A single-center, split-mouth, randomized clinical trial.

Minimally invasive resin infiltration of arrested white-spot lesions: A randomized clinical trial. A scanning electron microscopic study of early subsurface bacterial penetration of human molar-fissure enamel. Costs and effectiveness of treatment alternatives for proximal caries lesions. Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. Caries lesions after orthodontic treatment followed by quantitative light-induced fluorescence: A 2-year follow-up.

Operative Dentistry, Inc. Send Email Recipient s will receive an email with a link to 'When and How to Intervene in the Caries Process' and will not need an account to access the content. Recipient Optional Message: Optional message may have a maximum of characters. View Metrics.

Citing articles via Web Of Science Latest Issue Alert. In addition to these development, others antibacterial components are added inside restorative dentistry materials formulations. Substances such quaternary ammonium methacrylates, dodecyl amine, bipyridine, tannic acid derivatives, polyhexanide, amphiphilic lipids, silver, sodium chloride gluconate, have been show improve the antibacterial effect and also shown ability to reduce restauration roughness, plaque retention and biofilm formation [ 18 ].

Fluoride shows a decisive role in reducing the progression of caries lesions or dissolution of the enamel, acting as a cariostatic element, interfering in the dynamic balance of the interface between the mineral surface and the oral fluids, reducing the surface tension of the dental surface and, consequently, the adhesion of the microorganisms to the same.

It also has an anti-enzymatic and antimicrobial effect and, at high concentrations, bactericidal effect [ 7 ]. When sugar is converted to acids by the dental plaque, it reaches a critical pH for the dissolution of the apatite-based minerals, but due to the presence of fluorine, a certain amount of these minerals is simultaneously replaced in the form of fluorapatite.

This action of fluoride depends on the salt used, concentration, duration and frequency of application. There is a consensus among researchers that the mechanism of action of fluoride is due to the supply in high frequency and low concentration, being important its presence in constant levels in the buccal cavity [ 3 ]. The concentration of fluoride in fluoride dentifrices varies from 0. Some studies have found that below ppm F- there is no scientific evidence of a preventive effect.

An example of this is the study carried out by Ammari et al. They concluded that a dentifrice of ppm of fluoride was not effective in preventing dental caries in the permanent dentition, contrary to the concentration of ppm of fluoride or higher.

Another form of fluoride application, is through mouthwash solutions. In addition to the daily use of fluoride dentifrices, fluoride gels are important for patients with high risk of caries and initial caries lesions, as well as for patients with ruptured caries, xerostomia, irradiated, orthodontic or hypersensitive [ 21 ]. In active-caries patients, it is essential to increase treatment with fluoride until the situation is under control.

This fact can be explained by the fact that dentin suffers twice as much demineralization as enamel, being considered more susceptible to caries [ 22 - 24 ]. Some clinical data [ 24 - 26 ] suggest that more fluoride would be needed to control root caries than that used for enamel caries.

In addition, the difference in fluoride effect on dentin compared to enamel explains why the combination of professional application of fluoride with regular daily use of toothpaste with standard fluoride would be more effective to control caries in dentin [ 27 ], but not in enamel [ 28 ].

Once a highly cariogenic microbiota is established, the chances of this microbiota suppression are more difficult [ 28 ]. Notwithstanding, it is known that reducing the frequency and sucrose amount in the diet is easier to reduce S. Strict control of sucrose consumption may significantly influence the levels of mutans streptococci infection, but that control should be continuous [ 30 ].

This control was achieved not only by informing patients about the deleterious effects of sucrose consumption, but through detailed work on diet analysis and control, including: Instruction not to eat foods with sucrose between meals, and reduction of sucrose concentrations ingested during main meals; Delivery of a detailed worksheet on sucrose concentrations in various food products; Request for the registration of all foods eaten during the day [ 7 ].

Patients who present xerostomia are a challenge for the dental surgeon, since the salivary stimulus can be considered preventive measure to caries disease.

However, some patients with a moderate decrease in salivary secretion saliva stimulated between 0. Artificial saliva may help some patients, but relief of symptoms is usually temporary and patients may find these products unpleasant. Thus, it is important to check the pH of any saliva because very acidic products have been produced, and these would be an inadequate choice for dentate patients [ 30 - 32 ].

Other possibility, is the chewing gum use. Increased understanding of the complex biofilm that exists on tooth surfaces may hold the key to more effective control of dental caries by dentists. Since caries can be reversible or irreversible, it is necessary to focus on prevention. And for this, early detection and understanding of its progression mechanism are essential. As well as the domain and knowledge of possible effective alternatives to arresting dental caries disease.

It is important that there is more investment in clinical follow-ups and that the different alternatives proposed in this study are correctly indicated and monitored in vivo attempt effective results that can be better analyzed and compared over the years.

J Interdiscipl Med Dent Sci 6: DOI: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Select your language of interest to view the total content in your interested language. Home Publications Conferences Register Contact. Greater China - Mainland. Greater China - Taiwan. Italy - Italia. Malaysia Bahasa.

Norway - Norge. Philippines English. Poland - Polska. Republic of Singapore English. South Africa. Sweden - Sverige. Switzerland Suisse. Switzerland Schweiz. United Kingdom. United States. Search Search. Dental Caries Cavities. What Is It? Symptoms Early caries may not have any symptoms. Diagnosis A dental professional will look for caries at each visit, regardless of whether it is a routine visit or an appointment made by the patient because of pain.

Expected Duration White spots, indicating early caries that has not yet caused cavitation, may be reversed if acid damage is stopped and the tooth is given a chance to repair the damage naturally. Prevention Cavities can be prevented by reducing the amount of plaque and bacteria in the mouth and with careful attention to diet.

These reported on 1, caries events for a total of 10, participants with a total follow-up time of 22, person-years. The studies were weighted by the number of total person-years.

The weight of the studies ranged from 6. The unadjusted increment in DMFS per year of follow-up was 0. Adjusting for the various groups indicated that the estimate of the annual increment in DMFS ranged from 0.

The unadjusted increment in DMFT per year of follow-up was 0. After adjusting for groups 1 and 2, adding group 3 decade and preventive intervention showed a large decrease of the estimate to 0. The estimate of the annual increment in DMFT was highly influenced by covariates. Appendix Tables 10 to 12 provide the full output of the meta-regression analyses, and Appendix Table 13 gives a description of the covariates used in these analyses.

This study revealed that the caries incidence rate of the permanent dentition is a promising caries progression rate in populations of children and adolescents as its use is rather new and it seems fairly stable. Hence, they suggested to report caries progression in longitudinal studies in incidence rates. We found a pooled caries incidence rate of 0. The uncertainties around our estimate were small, although it was somewhat influenced by the risk of bias and relevance of evidence of the included studies.

The meaning of this caries incidence rate is that per year, 11 persons will develop dentine caries for the first time newly diseased per persons who were caries free at the beginning of that year. The meaning of the results found in these analyses was inconclusive; the uncertainties around the estimates were increased by the diversity of the study methods of the studies involved.

Nevertheless, the linear increments we found are consistent with the findings of Broadbent et al. First, there were wide variations in study methods.

For future research, adequate study designs and standardized methods of data collection are desirable. Harmonization of study designs can contribute to reduction of the uncertainties that the meta-regression analyses demonstrated. The inclusion of both intervention and observational studies might cause some confusion. Our aim was to find data on caries progression in studies with follow-up for cohorts with or without a collective, uniform preventive intervention.

We corrected for such interventions in the meta-regression analyses if they had been provided to all or part of the study population regardless of individual indications and were considered additional to care as usual. Yet, we found that this did not explain the variation in outcomes. This might be due to the fact that the cohort participants could also have received preventive interventions as most of them had access to regular dental care.

Second, the filled component of the DMF index was probably influenced by lesion thresholds of dentists to intervene restoratively. These thresholds vary between countries and decades Innes et al.

Third, the assessment of dental caries is complex and methods for assessment were varied, such as use of bitewing radiographs and drying of teeth. This would have resulted in differences in the diagnosis of dental caries. However, these differences were probably reduced as the included studies used the same methods for the baseline and follow-up measurements. Fourth, meta-analyses were not possible for the primary dentition as a result of the limited number of included studies and the inconsistent results due to exfoliated teeth.

A follow-up of 3 y might not have been necessary for the primary dentition, since caries lesions in primary teeth generally progress faster than in permanent teeth. To avoid the exfoliation problem in the primary dentition, it could be considered to follow up from ages 3 to 5 y. However, this precludes insights into caries progression in children ages 5 to 12 y. A solution is not to ignore past caries experience in exfoliated teeth in longitudinal studies.

This can be achieved by calculating the total number of decayed, extracted, and filled primary surfaces or teeth ever observed in a participant at baseline and at follow-up Ruff Finally, another source of bias may have been the inclusion of studies with only results of complete cases i.

This might have caused a selective follow-up. Nonetheless, we needed complete cases to determine the number of events for the caries incidence rates. Our findings for the permanent dentition provide indications for caries progression rates in populations. These rates could be used for planning, targeted use of preventive care, and evaluation of preventive oral health care services.

They provide a starting point for further research. They could also be used by general dental practitioners for reflections on the caries progression rates in their patient populations. In this systematic review, we described caries progression rates in the primary and permanent dentition.

Pooled caries progression rates were not achievable for the primary dentition due to the limited number of included studies and the nonstandardized approaches of exfoliated teeth. For the permanent dentition, our pooled findings on caries progression in populations were a caries incidence rate of 0.

So far, the caries incidence rate measure rarely has been used in longitudinal oral health research but seemed fairly stable and therefore most promising. When using our progression rates for the prediction of caries increments, caution is justified because these measures were influenced by methods of the studies included.

For better insight into caries progression rates in populations and usefulness for policy makers, more standardization of measuring and study methods in epidemiological research is essential. Hummel, contributed to conception, design, data acquisition, analysis, and interpretation, drafted and critically revised the manuscript; N.

Akveld, contributed to design, data acquisition, analysis, and interpretation, critically revised the manuscript; J. Su, contributed to data analysis and interpretation, drafted and critically revised the manuscript.

All authors gave final approval and agree to be accountable for all aspects of the work. We thank Tessa van Geijn for her help with the revision of the final draft of the manuscript. A supplemental appendix to this article is available online. National Center for Biotechnology Information , U. Journal of Dental Research. J Dent Res. Published online May 9. Hummel , 1, 2 N. Akveld , 1 J. Bruers , 1, 3 W. Author information Copyright and License information Disclaimer. Email: ln.

This article has been cited by other articles in PMC. Abstract Caries progression seems to follow universal, predictable rates, depending largely on the caries severity in populations: the higher the caries severity, the higher the progression rates.

Keywords: epidemiology, DMF index, incidence, longitudinal studies, child, adolescent. Methods We defined progression rate as the mean caries increment in a population not in a caries lesion during a certain time period. Table 1. Open in a separate window. Study Selection Two researchers R.

Quality Assessment of Study Methods The quality of study methods for the included publications was assessed independently by the same 2 investigators using the scoring form shown in Appendix Table 1. Data Processing The year in which the study started, together with the number of years of follow-up, was used to classify the decade in which the study had been performed s, s, s, s, or s.

Meta-Analysis and Meta-Regression Analyses These analyses were carried out for the permanent dentition. Results Study Selection We identified 12, records through database searching.