Vol. 44, No. 2, 2010
Issue release date: May 2010
Free Access
Caries Res 2010;44:141–150
(DOI:10.1159/000308091)
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Using Universal Patterns of Caries for Planning and Evaluating Dental Care

Sheiham A. · Sabbah W.
Department of Epidemiology and Public Health, University College London, London, UK
email Corresponding Author


 goto top of outline Key Words

  • Dental care planning
  • Dental caries patterns
  • DMF indexes
  • Epidemiology trend lines

 goto top of outline Abstract

There are universal patterns of caries, in terms of prevalence, incidence, frequency distribution and rates of progression, in permanent teeth that can be considered working rules that can be applied when planning dental care. The universal patterns are: (1) caries levels follow trend lines; therefore, knowing the caries level at one age can be used to predict the levels at later ages in that cohort by looking at the trend line for that cohort; (2) the distribution of dental caries of a population exhibits the following characteristics: as the mean DMFT increases, the percentage of caries-free individuals falls and the caries distribution widens; this changing relationship between the mean DMFT and prevalence is not limited to a subgroup of the population who already have had some caries experience; (3) there is a specific mathematical relationship between the mean DMFT and mean DMFS; (4) there is a hierarchy of caries susceptibility by tooth type and sites on teeth; for a given DMFT or DMFS, there is a specific intra-oral pattern of caries by tooth type; (5) changes in mean DMFT scores for individuals and groups are not linear, but ‘stepped’; there are groupings of teeth and tooth sites that may have similar ‘resistance’ to caries; (6) as the mean DMFT declines, the posteruptive time for initiation of caries increases and the progression rate of caries through enamel decreases. This is true regardless of the presence of fluoride. Any improvement in dental health will cause this effect.

Copyright © 2010 S. Karger AG, Basel


 goto top of outline References
  1. Armfield J, Spencer J, Slade G: Changing inequalities in the distribution of caries associated with improving child oral health in Australia. J Public Health Dent 2009;69:125–134.
  2. Batchelor PA: The scientific basis for the modelling of caries preventive strategies; PhD thesis, University of London, 1998.
  3. Batchelor PA, Sheiham A: The limitations of a ‘high-risk’ approach for the prevention of dental caries. Community Dent Oral Epidemiol 2002;30:302–312.
  4. Batchelor PA, Sheiham A: Grouping of tooth surfaces by susceptibility to caries: a study in 5–16 year-old children. BMC Oral Health 2004;4:2.
  5. Berman DS, Slack GL: Dental caries in English school children. A longitudinal study. Br Dent J 1972;133:529–538.
  6. Bohannan H: Caries distribution and the case of sealants. J Public Health Dent 1983;43:200–204.
  7. Broadbent J, Thomson M, Poulton R: Progression of dental caries and tooth loss between the third and fourth decades of life: a birth cohort study. Caries Res 2006;40:459–465.
  8. Broadbent J, Thomson M, Poulton R: Trajectory of patterns of dental caries experience in the permanent dentition to the fourth decade of life. J Dent Res 2008;87:69–72.
  9. Burt BA: The future of the caries decline. J Public Health Dent 1985;45:261–269.
  10. Carlos J, Gittelsohn AM: Longitudinal studies of the natural history of caries. II. A life-table study of caries incidence in the permanent teeth. Arch Oral Biol 1965;10:739–751.
  11. Chen X, Wang Y: Tracking of blood pressure from childhood to adulthood: a systematic review and meta regression analysis. Circulation 2008;117:3171–3180.
  12. Cypriano S, Hoffmann R, Sousa M, Wada R: Dental caries experience in 12-year-old schoolchildren in southeastern Brazil. J Appl Oral Sci 2008;16:286–292.

    External Resources

  13. Demers M, Brodeur JM, Simard PL, Mouton C, Veilleux G, Fréchette S: Caries predictors suitable for mass-screenings in children: a literature review. Community Dent Health 1990;7:11–21.
  14. Dummer PMH, Oliver SJ, Hicks R, Kingdon A, Addy M, Shaw WC: Factors influencing the initiation of carious lesions in specific tooth surfaces over a 4-year period in children between the ages of 11–12 years and 15–16 years. J Dent 1990;18:190–197.
  15. Grainger RM: Epidemiological data; in Chilton NW (ed): Design and Analysis in Oral and Dental Research, ed 1. Philadelphia, Lippincott, 1967, pp 311–353.
  16. Hannigan A, O’Mullane DM, Barry D, Scafer F, Roberts AJ: A caries susceptibility classification of tooth surfaces by survival time. Caries Res 2000;34:103–108.
  17. Hintze H: Caries behaviour in Danish teenagers: a longitudinal radiographic study. Int J Paediatr Dent 1997;7:227–234.
  18. Holst D, Schuller A: Oral health changes in an adult Norwegian population: a cohort analytical approach. Community Dent Oral Epidemiol 2000;28:102–111.
  19. Hujoel PP, Lamont RJ, De Rouen TA, Davis S, Leroux BG: Within-subject coronal caries distribution patterns: an evaluation of randomness with respect to the midline. J Dent Res 1994;73:1575–1580.
  20. Järvinen S: Epidemiologic characteristics of dental caries: relation of DMFS to DMFT. Community Dent Oral Epidemiol 1983;11:363–366.
  21. Javali SB, Pandit PV: Use of the generalized linear models in data related to dental caries index. Indian J Dent Res 2009;18:163–167.

    External Resources

  22. King M, Shaw L, Murray J: Caries susceptibility of permanent first and second molars in children aged 5–15 years. Community Dent Oral Epidemiol 1980;8:151–158.
  23. Knutson JW: Epidemiological trend patterns of dental caries prevalence data. J Am Dent Assoc 1958;57:821–829.
  24. Kortis DC, Poulsen S, Kingman A: An evaluation of Knutson’s formula for estimating age-specific DMF teeth. Community Dent Oral Epidemiol 1978;6:191–194.
  25. Lawrence HP, Benn DK, Sheiham A: Caries progression in 12–16-year-old schoolchildren in fluoridated and fluoride deficient areas in Brazil. Community Dent Oral Epidemiol 1997;25:402–411.
  26. Lith A, Lindstrand C, Grondahl HG: Caries development in a young population managed by a restrictive attitude to radiography and operative intervention. II. A study at the surface level. Dentomaxillofac Radiol 2002;31:232–239.
  27. Marthaler TM: A standardized system of recording dental conditions. Helv Odont Acta 1966;10:1–18.
  28. Massler M, Pindborg J, Mohammed C: A compilation of epidemiologic studies in dental caries. Am J Public Health Nations Health 1954;44:1357–1362.
  29. McDonald SP, Sheiham A: The distribution of caries on different tooth surfaces at varying levels of caries – a compilation of data from 18 previous studies. Community Dent Health 1992;9:39–48.
  30. Mejare I, Källestål C, Stenlund H: Incidence and progression of approximal caries from 11 to 22 years of age in Sweden: a prospective radiographic study. Caries Res 1999;33:93–100.
  31. Mejare I, Källestål C, Stenlund H, Johansson H: Caries development from 11 to 22 years of age: a prospective radiographic study. Prevalence and distribution. Caries Res 1998;32:10–16.
  32. Mejare I, Stenlund H, Zelezny-Holmlund C: Caries incidence and lesion progression from adolescence to young adulthood: a prospective 15-year cohort study in Sweden. Caries Res 2004;38:130–141.
  33. Pereira S, Tagliaferro E, Cortellazzi K, Ambrosano G, Mialhe F, Meneghim M, Pereira A: Estimates of DMFT index using teeth most affected by dental caries in twelve-year-old children. Rev Saude Publica 2009;43:179–182.
  34. Pitts NB: Monitoring of caries progression in permanent and primary posterior approximal enamel bitewing radiography: a review. Community Dent Oral Epidemiol 1983;11:228–238.
  35. Poulsen S, Horowitz HS: An evaluation of a hierarchical method of describing the pattern of dental caries attack. Community Dent Oral Epidemiol 1974;2:7–11.
  36. Rose G, Day S: The population mean predicts the number of deviant individuals. Br Med J 1990;301:1031–1034.
  37. Schwarz E, Vigild M, Skak-Iversen L: Danish child oral health status in two decades of organized child oral health care; in Friis-Hasché E (ed): Child Oral Health Care in Denmark. Copenhagen, Copenhagen University Press, 1994, pp 38–44.
  38. Seppä L, Kärkkäinen S, Hausen H: Caries trends 1992–1998 in two low-fluoride Finnish towns formerly with and without fluoridation. Caries Res 2000;34:462–468.
  39. Tan EH, Batchelor P, Sheiham A: A reassessment of recall frequency intervals for screening in low caries incidence populations. Int Dent J 2006;56:277–282.
  40. Vehkalahti MM, Soloavaara L, Rytomaa I: An eight-year follow-up of the occlusal surfaces of first permanent molars. J Dent Res 1991;70:1064–1067.
  41. Viegas AR: Simplified indices for estimating the prevalence of dental caries – experience in children seven to twelve years of age. J Public Health Dent 1969;29:76–91.

 goto top of outline Author Contacts

Aubrey Sheiham
Department of Epidemiology and Public Health, University College London
1–19 Torrington Place
London WC1E 6BT (UK)
Tel. +44 20 7679 1700, Fax +44 20 7813 0280, E-Mail a.sheiham@ucl.ac.uk


 goto top of outline Article Information

Received: November 4, 2009
Accepted after revision: February 25, 2010
Published online: April 10, 2010
Number of Print Pages : 10
Number of Figures : 7, Number of Tables : 0, Number of References : 41


 goto top of outline Publication Details

Caries Research

Vol. 44, No. 2, Year 2010 (Cover Date: May 2010)

Journal Editor: Beighton D. (London)
ISSN: 0008-6568 (Print), eISSN: 1421-976X (Online)

For additional information: http://www.karger.com/CRE


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