Risk Groups – Risk age groups

Risk Groups
Risk age groups
Recent 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. 
Key-risk age group 1: Ages 1 to 2 years Studies by Kohler et al (1978, 1982) showed that mothers with high salivary MS levels frequently transmit MS to their babies as soon as the first primary teeth erupt, leading to greater development of caries. Other studies have shown that 1-year-old
babies with plaque and gingivitis develop several dental carious lesions during the following years, while babies with clean teeth and healthy gingivae, maintained by regular daily cleaning by their parents, remain caries free (Wendt et al, 1994). It was also shown that the practice of giving infants sugar-containing drinks in nursing bottles at night increases the development of caries (Wendt and Birkhed, 1995). 
In another investigation, Grindefjord et al (1995) studied the relative risk (odds ratio) that 1-year-old infants would develop caries by the age of 3.5 years: Those with poor oral hygiene, bad dietary habits, salivary MS, little or no exposure to fluoride, and parents with a low educational level or an immigrant background were at 32 times greater risk than were children without the corresponding etiologic and external risk factors. The importance of establishing good habits as early as possible, and of postponing or preventing bad habits, should not be underestimated.
In addition, the enamel of erupting and newly erupted primary and permanent teeth is at its most caries-susceptible stage until completion of secondary maturation (Kotsanos and Darling, 1991). In 1- to 3-year-old infants, the specific immune system, particularly immunoglobulins in saliva, is immature. Poor oral hygiene will therefore favor the establishment of cariogenic microflora such as MS. 
On average, the permanent teeth in particular erupt 6 to 12 months earlier in girls than they do in boys (Teivens et al, 1996). On this basis, the first-priority risk age groups are expectant mothers and 1 to 2 year olds, starting with girls (Fig 125). To prevent postnatal transmission of cariogenic bacteria and poor dietary habits from mother to child, expectant mothers who are at risk should be offered a special preventive program comprising intensified plaque control (mechanical and chemical) and reduction of sugar intake, to reduce the number of cariogenic microflora.
Key-risk age group 2: Ages 5 to 7 years (eruption of first molars) The pattern and amount of de novo plaque reaccumulation on the occlusal surfaces of the permanent first molars, 48 hours after professional mechanical toothcleaning, was studied in relation to eruption stage by Carvalho et al (1989). Plaque reaccumulation is heavy on the occlusal surfaces of erupting maxillary and mandibular molars, particularly in the distal and central fossae and related fissures. This is in sharp contrast to the fully erupted molars, which are subjected to normal chewing friction.
Abrasion from normal mastication significantly limits plaque formation, and this explains why almost all occlusal caries in molars begins in the distal and central fossae during the extremely long eruption period of 14 to 18 months. In contrast, fissure caries is very rare in premolars, which have a brief eruption period of only 1 to 2 months. 
In addition, the enamel of erupting and newly erupted teeth is considerably more susceptible to caries until secondary maturation is completed, more than 2 years after eruption. However, the caries-reducing effect of fluoride is also about 50% greater in erupting and newly erupted teeth than it is in teeth that have undergone secondary maturation. 
The next high-risk age is, therefore, from 5 to 7 years, during eruption of the first
molars (the key-risk teeth), starting with girls (see fig 125). Intensified mechanical
plaque control twice a day with fluoride toothpaste should be performed by the
children’s parents, particularly on the erupting first molars. Home care should be
supplemented at needs-related intervals by professional mechanical toothcleaning and
fluoride varnish. In the most caries-susceptible children, glass-ionomer cement should
be used in the fissures, as a slow-release fluoride agent.
Key-risk age group 3: Ages 11 to 14 years (eruption of second molars)
Normally, the second molars start to erupt at the age of 11 to 11 1/2 years in girls and
at around the age of 12 years in boys. The total eruption time is 16 to 18 months.
During this period, the approximal surfaces of the newly erupted posterior teeth are
undergoing secondary maturation of the enamel and are also at their most caries
susceptible. Therefore, 11 to 14 year olds have not only, by far, the highest number of
intact tooth surfaces, but also the greatest number of surfaces at risk.
Integrated plaque control measures and use of fluoride agents should therefore be
intensified on the approximal surfaces of all the posterior teeth and the buccal
surfaces of the second molars, starting with 11 to 11 1/2-year-old girls (see Fig 125), to
protect intact tooth surfaces and to remineralize incipient lesions. If this program is
maintained throughout the secondary maturation period, and needs-related self-care
habits are established, there is a high probability that the remaining intact tooth
surfaces will remain intact for the individual’s entire life.
Key-risk age groups in young adults and adults
Under certain circumstances, young adults (19 to 22 year olds) may also be regarded
as a risk age group. Most have erupting or newly erupted third molars without full
chewing function but with highly caries-susceptible fissures and mesial surfaces until
completion of secondary maturation of the enamel. In addition, many young adults
leave home to study or work elsewhere, with ensuing changes not only in lifestyle but
also in dietary and oral hygiene habits. They may also be exposed to peer pressure
toward good or bad habits.
Another risk age group among adults is the dentate elderly, most of whom have
multiple restorations with plaque-retentive margins as well as root surfaces exposed
by periodontitis. Regular use of medication with depressive effects on the saliva and
poor oral hygiene and dietary habits further increase the risk for development of
secondary caries and root caries.
Views: 1628 | Comments: 9 Send reply
Thelna,Baie dankie vir al die moitee wat jy met my 2 uitstallings gehad het.Jy het voorwaar vreeslik baie talent van Ons Vader ontvang en n oog vir kleding en ek het baie by jou geleer. Ek gaan my bes doen om jou nie teleur te stel nie. Dit was heerlik om saam met jou te kon werk.Liefdetjies soos altyd Joan xoxo:-)

Lili I’m trying in my own small way to reach whveeatr audience could benefit from my naive take on life and spirit. The possibility that there must be someone out there who would benefit keeps me going. Will

ThelnaBaie geluk met n stunning wsbiete. Alles is baie mooi, jou decor staan uit soos altyd. Baie geluk met jou uitstallings ek kan sien en het geweet dit gaan n groot suskses wees.Michelle

Brushing is tough at every age! I have the advantage with the lttile guy that he watches his older siblings brush their teeth, and he wants to be like them, so he wants the toothbrush but he doesn’t want *me* to have the toothbrush, which, as it turns out, makes brushing his teeth rather challenging. My current solution is having two toothbrushes on hand one for him and one for me. This has worked for a while, but lately he’s been wanting both, so I expect I’ll soon have to go to three toothbrushes one for both of his hands and one for me to use to actually brush his teeth. I’m looking forward to seeing all three toothbrushes shoved in his lttile mouth at one time I’m sure it’ll happen. Photo opp! http://okcsejycm.com [url=http://hnqzxably.com]hnqzxably[/url] [link=http://fzpodpfe.com]fzpodpfe[/link]

Does your friend like vatnige? I am working on a blog entry about vatnige baby showers and hope to have it up tomorrow. You can make the invites and decorations from vatnige images of baby things it is so much fun. Do a search on flickr for vatnige baby to get in the mood. The colors are so wonderful!! Old made in japan baby planters are in the same colors and are darling with little floral arrangements for each table. Do you have glass luncheon plates with the little cups that sit on top? The handles on the cups look adorable with a little pink bow tied on. Bingo with gummy bears is fun and yummy too! Watch for my blog entry for more. Hope it helps Kristin

Good luck. I am too old for that. I was too old when mine were born. 8 hours at 6 weeks. 13 hours at 12 weeks. End of story. So when one of them is sick or something and wakes me up now, I heonstly think I’m going to die. How parents do it every day and every day is beyond me.HOWEVER, you have to do what works for you… not what anyone else tells you–not even the doctor. (Most doctors did not agree with me for my sleep-through-the-night plan.)

Hi Chloe, Patrick:Just read this blog and enjoyed Owen’s acnits and the update on his statistics. He’s going to be a big boy!! Can’t wait to hear what he will be up to once he starts walking everywhere that’s when the fun and games really start Mamma.Miss you all so much. Look forward to seeing you in the fall. Love you, Nannaxxxxxxxxxxxx http://xdmffkyobhg.com [url=http://yrbptkdlt.com]yrbptkdlt[/url] [link=http://aadfqxt.com]aadfqxt[/link]

This Dental Hygienist thanks you for your pro-active attutide towards dentistry. Devin will probably have few troubles if any in the chair . I’m sorry that you need a root canal usually after you have a run of work done, you will reach a plateau. I wish you luck. Oh, the easiest way to floss your son’s teeth is to have him lay back with his head in your lap, like on the sofa. That way, you can see, and take care of the deed without throwing your back out.

I missed seven years of dsetint visits because of lack of insurance, and then, when I got insurance, FEAR. Finally, I decided I had to go do it for my son. We all went. The first drill, as they say, is the deepest. It gets easier after that Son loves the dsetint. I love feeling like I’m doing right by my teeth and son. I still don’t love the drill. http://qyczeok.com [url=http://kcbkijg.com]kcbkijg[/url] [link=http://ccvaksinjaz.com]ccvaksinjaz[/link]

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Articles for theme “caries”:
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.
Systemic and immunologic factorsOf the chronic systemic diseases, by far the most important risk factor and prognostic risk factor for dental caries is Sjogren’s syndrome, because of its extremely depressive effect on both the salivary secretion rate and the quality of the saliva. Indirectly, reduced SSR is associated with other chronic diseases in which medical management involves regular use of drugs with side effects on the salivary system. Some other general chronic diseases, such as leukemia, acquired immunodeficiency syndrome, diabetes mellitus, and Down’s syndrome, impair the immune system generally or specifically.
ConclusionsIntroductionThe most important internal modifying factors related to dental caries are salivary  hypofunction, some chronic diseases, impaired host factors, and unfavorable macroanatomy and microanatomy and eruption stage of the teeth that favor plaque retention. Of utmost importance is impaired salivary function, particularly stimulated salivary secretion rate. Salivary factorsSalivary secretion rate, the buffering effect, and possibly the in vivo concentrations of some salivary constituents, such as fluoride, hypothiocyanite, and agglutinins (possibly including IgA), seem to be the most important determinants of caries susceptibility and/or activity.
Exposure of root surfacesIn the young, healthy adult, root surfaces, like the cementoenamel junctions, are not exposed to the oral cavity. At the population level, the prevalence of exposed root surfaces is strictly age related and is attributed to the long-term effects of trauma from toothbrushing (buccal surfaces) and gingival recession associated with periodontal disease. With the decline in prevalence and severity of enamel caries, and hence the preservation of an intact dentition into old age, root caries is becoming an increasing problem in clinical practice.