Oral epidemiology is the area of public health that deals with the distribution and the impact of oral diseases on the human population. In this section, emphasis is placed on the relevance of epidemiology to clinical practice and information about the prevalence, incidence and trends of dental caries in the United States is presented. The term DMF (decayed, missing, and filled) teeth/surfaces is introduced, along with variations and limitations of the DMF index, and an explanation of how to calculate DMF scores.

Clinical Significance Snapshots

What is the practical significance of the epidemiology of Dental Caries? As a dental practitioner why should this interest me?

Information that reports the amount of any disease in a population is of tremendous importance in planning, funding and delivery of health services so that enough healthcare professionals of the correct skill sets are trained, enough clinical centers are built, and that new and improved materials and clinical techniques are developed through adequately funded research programs. Access to care is a critical issue for oral health – many of the US population are currently unable to receive the dental care they need. Having knowledge of this need for care helps health planners create preventive programs to avoid disease in the first place (e.g., water fluoridation, availability of low sugar foods and beverages) and to ensure that enough dentists are produced to provide services, and that those services are adequately funded through private or public systems.

What is the value of a dental index to me in dental practice?

Recording of a patient’s health status is important, not only to plan any treatment currently needed, but also to assess a patient’s changes in disease status and their response to treatment over time. The dental chart of cavities and restorations is similar to an index, and while it is not quantified numerically, it does allow comparison over time. As early carious lesions are reversible and typically should be treated not by restorative means, but by preventive means such as fluoride agents and dietary modification, the methods of measurement and recording of the lesions is critically important. The DMF Index does not differentiate between early and late stage lesions, but new caries assessment indices having that capability, such as the ICDAS (International Caries Diagnosis and Assessment System), are being introduced into dental school curricula.