Epidemiology of oral diseases

Recent epidemiologic findings for coronal and root surface caries, enamel fluorosis, and the periodontal diseases are reviewed. Incidences of coronal caries in children have continued to decline (at an accelerated rate in some populations) during the 1980s. Two possible reasons other than fluorides for these trends are a change in providers' criteria for treatment of pit and fissure caries and the use of dental sealants. Further declines are anticipated, particularly if benefits resulting from preventive programs can be extended to lower socioeconomic groups. The study of root caries has evolved to include concerns of standardized measurement, documentation of incidence in addition to prevalence, and use of multivariate analyses to identify potential explanatory variables. Evidence supports an increase in the prevalence of enamel fluorosis, generally of the milder forms; use of fluoride supplements and toothpastes at an early age may be risk factors for this condition. The prevalence of severe periodontal disease in the general population is low. Initial assessments of risks for periodontal disease progression have identified a number of potential factors that are related to the diseases in a complex way. Significant analytic advances have been made to aid in risk-factor identification.