External Modifying Factors Involved in Dental Caries
Introduction
Awareness of the multifactorial nature of dental caries is of fundamental importance.
Figure 48 illustrates the interdependence of most of the determinate variables
associated with dental caries. Besides etiologic, preventive, and control factors, many
other factors may modify the prevalence, onset, and progression of dental caries. Such
factors may be divided into external (environmental) and internal (endogenous)
factors (to be discussed in chapter 3).
Factors that have proved, in cross-sectional studies, to be significantly associated with
increased prevalence of a specific disease are termed risk indicators (RIs). Factors
that have proved, in well-controlled prospective studies, to increase significantly the
risk for onset or progression of a specific disease are termed risk factors (RFs) and
prognostic risk factors (PRFs), respectively. The RF and PRF are often expressed as
the odds ratio for the onset or progression of a specific disease.
Among external modifying RIs, RFs, and PRFs for dental caries are fermentable
carbohydrates, poor socioeconomic status, systemic disease, medication that impairs
salivary function, and irregular dental care attendance habits.
