Epidemiology
Worldwide, most children and an estimated ninety percent of adults have experienced caries, with the disease most prevalent in Asian and Latin American countries and least prevalent in African countries.[83] In the United States, dental caries is the most common chronic childhood disease, being at least five times more common than asthma.[84] It is the primary pathological cause of tooth loss in children.[85] Between twenty-nine and fifty-nine percent of adults over the age of fifty experience caries.[86]
The number of cases has decreased in some developed countries, and this decline is usually attributed to increasingly better oral hygienepractices and preventive measures such as fluoride treatment.[87] Nonetheless, countries that have experienced an overall decrease in cases of tooth decay continue to have a disparity in the distribution of the disease.[86] Among children in the United States and Europe, twenty percent of the population endures sixty to eighty percent of cases of dental caries.[88] A similarly skewed distribution of the disease is found throughout the world with some children having none or very few caries and others having a high number.[86] Australia, Nepal, and Sweden have a low incidence of cases of dental caries among children, whereas cases are more numerous in Costa Rica and Slovakia.[89]
The classic "DMF" (decay/missing/filled) index is one of the most common methods for assessing caries prevalence as well as dental treatment needs among populations. This index is based on in-field clinical examination of individuals by using a probe, mirror and cotton rolls. Because the DMF index is done without X-ray imaging, it underestimates real caries prevalence and treatment needs.[62]
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