10. Concepts of oral health: our challenges

untreated dental caries (primary)

• 10th most common disease

• 621 mil ppl worldwide

• remains static in 1990s, 2010s

HK caries: 5 yr olds

• not normally distributed

• need to target lower numbers

• mostly untreated

  • >95% of dental caries in children in hk

dental caries most prevalent disease (permanent)

• 35% of global pop

• 2.4 billion ppl

prevalence of untreated caries

• bad in primary

  • but loses deciduous teeth

• prevalence > as permanent teeth grows out

• then dip bc teeth extracted/ treated

• not that decreased prevalence, but have been removed

12 yo

• not norm dis

• 80-20 phenomenon

  • ~80% caries found in 20% of pop?

• lower bc lost deciduous teeth

  • most restored and filled due to HK schools dental service program

dental caries: adults (35-44yo)

• high DMFT %

  • 2021 94.5%

  • nearly everyone experienced dental caries at some point

  • i.e. not good at preventing tooth decay

• dentists x focused on preventative care

  • only spotting caries + fillling

  • not looking at cause

• can get in roots if exposed

  • by 35, > 5% get decay in root and not treated

    • >prevalence possibly due to periodontal disease, exposing tooth

aging pop: 65-74yo

ing pop: 65-74yo

• hk super aged

  • >complex caries, hard to manage

    • little saliva to prevent

• coronal caries, root caries, polymed

  • they are all frail

• majority keeping 20/> teeth = success

• prevalence

  • nearly 100% dmft

  • 1 in 2 have untreated caries

  • increasing no. of ft over yrs

    • gov introduced elderly dental assistance program

• 1/3 teeth extracted

• ~15% teeth filled

• missing teeth num decrease as filling them more

• root caries increased

  • >1/4 have root caries

    • mostly untreated

periodontal disease

• takes the to develop, increase in early adulthood

  • drops later bc teeth extracted

HK oral hygiene: 5yo

• don’t measure pockets

• look at how clean teeth are bc if teeth not clean, then will have periodontal disease

  • only 10% no visible dental plaque

  • others → get gum disease later in life

• majority parents say kids brushing

  • plaque levels not good = not monitored/ effective

12yo periodontal

• 85% have visible plaque

• not norm dis

• x look at gum pockets

  • but 2/3 the put probe in, gum bleeds → inflamed

• 20% alr have calculus

• focus on caries and filling it, not on gum disease/ preventative care

35-55yo periodontal disease

• ~20% had calculus

• shallow pocket = 43%

• deep pocket = 15% → extensive periodontal disease

• mostly posterior

  • >% with periodontal disease in 2021 vs 2011

• better diagnostic methodology

65-74yo periodontal disease

• 70% have pockets = increasing

• holding onto real teeth > = > chance to develop periodontal diseases

(oral cancer)

• not very common

• > common in men

  • smoking and drinking