Who Needs More than 1,000 ppm? The Epidemiology of High-Risk Populations

Good oral health is necessary to overall health and well-being. Most oral diseases, and in particular dental caries, are entirely preventable. However, in 2010, 3.9 billion people were globally affected by oral conditions, and the global prevalence of untreated caries in permanent teeth was 35.3%. The contemporary thinking is that dental caries starts as an infectious disease which then becomes a chronic disease. Public health measures and other caries-preventive approaches have resulted in dramatic reductions in dental caries across populations. However, in a given population, not all individuals have experienced these successes uniformly. High-risk populations, defined as those with a 'higher-than-expected risk', exist for most diseases and conditions including caries. The global scientific literature suggests that these are the following: (1) minorities, (2) individuals with low-socioeconomic status and (3) other vulnerable populations such as the very young and elderly who continue to battle with oral health disparities by experiencing higher oral disease levels including dental caries. As the science and resources exist to prevent caries, it is essential to identify and target these high-risk individuals and populations.