Children ages 5 to 17 are experiencing less caries. It can be noted that the number of caries-free children is increasing and the average number of decayed, missing, and filled tooth surfaces (DMFS [for permanent teeth] or dmfs [for primary teeth]) is decreasing. In the 1971 to 1974 survey, only 26% of the children were caries-free, but by 1988 to 1991, 54.7% were caries-free. Likewise, in
1971 to 1974, children averaged 7.1 DMFS; this decreased to 2.5 in 1988 to 1991, a 65% reduction.
However, over 45% of the total group ages 5 to 17 did have caries in the latest survey, and the percentage of caries-free children increased with age within the group. Fewer adolescents (12 to 17 years) than children (5 to 11 years) were caries-free (33% to 74%). Thus by age 17, almost three out of every four adolescents have experienced caries.
Also, of the 2.5 DMFS for the years 1988 to 1991, almost 80% were filled surfaces, with the remaining 20% primarily being decayed surfaces. The affected DMFS surfaces were: (1) occlusal, 1.4; (2) facial or lingual, 0.8; and (3) mesial and distal, 0.3. 31 This indicates that occlusal surfaces were five times more likely to be involved than proximal surfaces. 12 This also indicates that sealant usage could be a significant method to further reduce caries in children.
Although the percentage of children with sealants almost doubled between the 1986 to 1987 and 1988 to 1991 surveys, only one of five children had sealants at the latter period.
The decayed, missing, or filled permanent teeth (DMFT) averaged 1.6 for the 1988 to 1991 survey. Of these teeth, 21% were decayed, 78% filled, and 1% missing.
When comparing the ds/dfs and DS/DMFS per person, the primary tooth ratio was twice that of the permanent tooth ratio, suggesting less treatment of primary teeth. 12
All of these figures and comparisons indicate a continuing decline in caries in the permanent dentition of children.
Still, caries continues to affect millions of U.S. adolescents and adults. Almost 94% of dentate adults showed evidence of coronal caries and almost 23% showed root caries in the 1988 to 1991 survey The total DMFS for all adults was about 50, while for dentate adults it was about 40; for the latter group almost 22 of the surfaces were decayed or filled, with most of those (19) being filled surfaces .
Also for dentate adults, the average number of root-surface carious lesions was 1, and half of those lesions were not filled. The prevalence of caries in adults increased markedly with age 21 (Table 1-2, as it relates to root caries only), and when all caries is considered, the aggregate caries increment may be higher in people over 55 years old than in children.