Key-risk surfaces

Key-risk surfaces
As mentioned earlier, depending on the age and caries prevalence of the population, there may be pronounced variations in the pattern of both lost teeth and decayed or filled surfaces. Figure 130 shows caries prevalence and the pattern of decayed or filled surfaces in 12-year-old children in the county of Varmland, Sweden, in 1964, 1974, 1984, and 1994. The molars are clearly the key-risk teeth. In a toothbrushing population, the key-risk surfaces are the fissures of the molars and the approximal surfaces, from the mesial aspect of the second molars to the distal aspect of the first premolars. Integration of mechanical plaque control by self-care and the use of fluoride toothpaste, supplemented at needs-related intervals by professional mechanical toothcleaning, fluoride varnish, and chlorhexidine varnish should therefore target these key-risk teeth and surfaces, according to the principles discussed earlier in this chapter.
As shown in Fig 130, the mean caries prevalence in 1964 was around 40.0 decayed or filled surfaces, generally involving all the approximal surfaces and occlusal surfaces of the molars and premolars, but also some buccal and lingual surfaces. One mandibular first molar was missing, extracted because of caries. During the following 10 years, toothbrushing and fluoride toothpaste were introduced. As a result, the number of decayed or filled surfaces decreased to about 25.0. The reduction was mainly in carious lesions on the approximal surfaces of the incisors and the buccal and lingual surfaces of the molars and premolars. The separate effects of the toothbrush versus fluoride toothpaste are difficult to estimate. 
In 1975, a needs-related plaque control program (both professional and home care) combined with use of fluoride toothpaste and application of fluoride varnish was gradually introduced targeting the key-risk surfaces of schoolchildren. The number of decayed or filled surfaces decreased to 3.0: The reduction occurred on the approximal surfaces of the molars and the premolars. The remaining caries, it is suggested, represents mainly overtreatment of first molar fissures.
Our preventive program for the occlusal surfaces of the molars was initiated in 1984. 
In 1994, caries prevalence was less than 1.0 decayed or filled surface. It is predicted that, in 1999, the first group of 19 year olds to have followed the integrated preventive program from birth will have less than 1.0 approximal decayed or filled surface, of which the filled component should account for less than 0.3, because approximal carious lesions without cavitation into the dentin can be treated noninvasively, without restoration. 
Figure 131 shows the mean pattern of manifest caries or restorations with or without initial caries (enamel caries) included on the posterior approximal surfaces of a randomized sample of 19 year olds from four counties in Sweden (Forsling et al, 1999). The distal surface of the mandibular right first molar is clearly the most frequently decayed. This is probably because most people are right-handed, and it is well known that in right-handed people the mandibular right linguoapproximal surfaces show the greatest tendency to plaque accumulation and gingivitis. 
That the distal surfaces of the second premolars constitute a relatively high percentage
of carious surfaces may be explained as follows: The wide mesial surfaces of the first
molars are frequently carious and exposed to cariogenic microflora when the second
premolars erupt. In caries-susceptible (C2 or C3) individuals, it is difficult to achieve
successful arrest of such enamel lesions during the short period of eruption (1 to 2
months) of the second premolars, and lesions are sometimes unrestored. Until
completion of secondary maturation of the enamel, the environment is extremely
unfavorable for the newly erupted distal surfaces of the second premolars.
Figures 132, 133, 134, 135, and 136 show the pattern of intact, decayed, filled, and
missing surfaces occlusally, mesially, distally, buccally, and lingually in a randomized
sample of 50 year olds in 1988 in the county of Varmland, Sweden (Axelsson et al,
1988, 1990). While almost no intact occlusal surfaces exist (Fig 132), close to 100%
of the lingual surfaces of the mandibular incisors are intact (Fig 136). The lingual
surfaces constitute the highest percentage of intact surfaces, closely followed by the
buccal surfaces (Fig 135). Of the approximal surfaces, the mesial and distal surfaces
of the first molars and maxillary premolars have the lowest percentage of intact
surfaces (5% to 10%), followed by the mesial surfaces of the second molars and the
distal surfaces of the second mandibular premolars (Figs 133 and 134). The gracile
mandibular incisors have by far the highest percentage of intact approximal surfaces
(about 70%).
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One one hand, Yay! Bed! on the other, Boo! Crafty Toddler who will do anything to delay failnlg asleep.We used to have a similar set up to you but now that we have moved out to the burbs and into one of those brick shoeboxes, instead of Calder’s room being right off the kitchen, it is now right off of EVERYTHING. After I put him in bed I usually end up sitting in the living room watch mah stories at 11 volume. 11 out of 50. Not the cool Spinal Tap 11. If I do try to do something that makes even remotely the slightest noise, What you doing Momma!? Don’t eat wifout me! I help wash the dishes! The only chore I CAN do is folding laundry because this pretty my silent.GAHHHHHH!Leah recently posted..brigidTwitter: Reply:October 27th, 2011 at 1:35 pmThe bathroom’s right near his bedroom so if I try to take a shower while he’s not asleep yet he keeps up a running patter. You in the shower, mama? You all clean? Mama, you’re DIRTY. Gettin’ clean in the shower? Bath today? I want a bath! Are you clean? mama? Mama? You all clean now? We have tentative plans to for reals swap his room and the office. The office is a bit bigger/differently laid out and also right next to the living room. Fret, fret. Fret.

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Cleaning pets tooth and orals are really iantrompt and needs to be done without no fail once a while, or that would lead to many health related troubles on your pets. Its should be noted that is is the only oral cleanings they get and they don’t have the regular brushing and flossing as we do. Tooth and oral cleanings are done once a while with a reputed pet clinic, and that time anesthesia is done, at least in most cases as full participation of the pet is otherwise required for the successful completion of the procedure. One could even make use of dental scalars for dogs to get a good dental cleaning for ones pet, that would go pretty easy as the person would be much acquainted with own pet.

Fell out of bed feeling down. This has brhietengd my day!

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Holy Molar! That is a great dental craft. We have a Monkey Mouth play dough toy that my kids enjoy using in this same way. Never thgouh of using marshmallows. My son goes to the dentist for the first time next week so I may have to steal this idea!

There are people who go after your haminuty [who] tell you the light in your heart is a weakness. Don’t believe it. It’s an old tactic of cruel people to kill kindness in the name of virtue. There’s nothing wrong with love. From the movie Doubt

Jen, so glad it arrived! Yay. I would love to know what you think of the fdining on the back of the pin. I like the safety pins embedded in the pin, but those fdinings work too. Would love to know your preference. Anyway, I’m glad you like it! Lenette, I LOVE spring and am so happy to be having some pretty, warm days!! It’s pretty here again today!Marqueta, I love the hand cream. It’s perfect. It’s in the fridge and I’ve been using it! Makes me think of you. How I wish I could name trees like Thomas can. He’s a true nature man. Yes, I’m thankful that my hair has continued to grow. I’m sure my supplements help. I’ve had some thinning, but mostly I’m just so thankful it continues to grow.

Dear Lyn, Those are the very best kind of outings. Nothing to datrsict from the main thing, which is being together and enjoying the great outdoors. My package arrived today. Thank you for wrapping it so beautifully! The cabbage rose pin is lovely. I periodically host in a historical village and will enjoy wearing this one myself on the next occasion. It will be great on a denim jacket, white lace shirt, a vintage apron, etc.etc. I like knowing that you made it. Take extra good care.Jen

Dear Lynn,What a wonderful exnrpieece! We still have some snow here, but your trees look a lot like ours. How nice that the Carpenter knows his trees; I definitely have to work on my tree identification this year! There are so many that don’t grow in Idaho.And your hair has been growing, hasn’t it? Love,Marquetap.s. Sardines are a standby for me during morning sickness! [url=]umeybudpkbe[/url] [link=]cylasdluqg[/link]

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Articles for theme “caries”:
Key-risk teethThe factors determining future tooth loss are related to age, dental caries, periodontal  diseases, iatrogenic root fractures, trauma, orthodontic therapy, and so on. Therefore, it may be argued that it is difficult to analyze the true reasons for tooth loss in the adult, particularly in the elderly. The reasons for tooth loss may vary not only among different age groups but also among different populations and countries, depending on differences in prevalence of dental caries and periodontal diseases as well as the availability of resources for dental care.
Individual RiskBy combining etiologic factors, caries prevalence (experience), caries incidence (increment), external and internal modifying risk indicators, risk factors, and prognostic risk factors, as well as preventive factors, caries risk may be evaluated at the individual level, as no risk (C0), low risk (C1), risk (C2), and high risk (C3). As discussed earlier in this chapter, these conditions may vary in different age groups.  Therefore, the criteria for C0, C1, C2, and C3 should be defined for at least the following general groups: preschool children (primary teeth), schoolchildren (permanent teeth), adults, and the elderly.
Risk GroupsRisk age groupsRecent studies have shown that carious lesions are initiated more frequently at specific ages. This applies particularly to children but also to adults. In children, the key-risk periods for initiation of caries seem to be during eruption of the permanent molars and the period during which the enamel is undergoing secondary maturation.  In adults, most root caries develops in the elderly, partly because of the higher prevalence of exposed root surfaces.
Prediction of Caries Risk and Risk ProfilesIntroductionFor successful prevention and control of dental caries in both children and adults,  some basic principles must be adopted: For example, the higher the risk of developing caries (new carious surfaces) in most of the population, the greater the effect of one single preventive measure. This may be illustrated by the Swedish experience, where 30 to 35 years ago, caries prevalence was extremely high. Almost every child developed several new lesions every year, mainly because of very poor oral hygiene.
Tooth-related factorsPhysical characteristics of the teeth may increase the risk for caries: tooth size, tooth morphology, cusp and fissure patterns, enamel structure (defects, opacities, mottling, and roughness of the surface), the morphology of the cementoenamel junction, and exposed root surfaces. In addition, the chemistry of the enamel, dentin, and root cementum may influence caries susceptibility. Studies to date indicate that large teeth in crowded mouths are more likely to develop caries, but this cannot be predicted on an individual basis.