Oral epidemiology
The Oral Epidemiology ( compound from oral "mouth on" (from lat. Os "mouth"), Greek. Epi ", via" demos "people" and -logie "teaching") is an academic sub-discipline of epidemiology , which especially concerned with the causes and consequences as well as the spread of tooth, mouth and jaw diseases in the population. The Institute of German Dentists (IDZ), a joint institution of the German Chamber of Dentists and the National Association of Statutory Health Insurance Dentists , has so far produced five “oral health studies” on the subject, most recently in 2016.
Oral epidemiology activities
The studies on oral epidemiology are based on the guidelines of the WHO and international oral epidemiology and aim to promote health in terms of oral health. The focus is on studying the development of caries and periodontal diseases , edentulousness and the provision of implants . It examines the prevalence and incidence of oral manifestations and adheres to the Oral Health Impact Profile (OHIP-G14), a survey instrument for measuring oral health -related quality of life. Using the Extent and Severity Index (ESI), a statistical calculation of the extent and intensity of dental diseases is carried out. Incidentally, it adheres to the specifications of the epidemiological methods and study types .
Definition of oral health
The Fédération Dentaire Internationale (FDI), the world dental association, presented its new definition of “dental health” as an essential basis for general health and well-being during its world conference in Poznań (Poland) in September 2016 . The definition has been adopted by over 200 national dental associations and is being adopted in dentistry worldwide.
“Dental health is multifaceted and includes, although not exclusively, the ability to speak, smile, smell, taste, touch, chew, swallow, and express emotions through facial expressions with confidence and without pain or discomfort, and without disease of the craniofacial Complex to convey.
Oral health
- is a fundamental component of health and physical and mental well-being, with a continuum that is influenced by the values and behaviors of individuals and communities;
- reflects the physiological, social and psychological properties that are essential for quality of life;
- is influenced by a person's constantly changing experience, feelings, expectations and adaptability. "
DMS IV
The fourth and so far last oral health study (DMS IV) shows the results on oral disease prevalence, risk groups and the degree of dental care in Germany in 2005. Over 4500 people from all social classes and age groups were questioned in a representative survey and examined from a dental perspective. The DMS studies are based on the WHO guidelines for "oral health surveys". There, the incidence of dental caries , periodontal diseases and tooth loss are recorded and the type and scope of dental care is derived.
The data material is evaluated according to the following behavioral parameters:
- Dental and oral hygiene ,
- Eating habits,
- Use of dental services
-
socio-demographic aspects such as
- Age,
- Gender,
- Educational status
- Regional area
The morbidity indicators are classified in the context of international oral epidemiology and health reporting .
DMS V
The fifth oral health study (DMS V) was carried out from 2013 onwards in accordance with the budget resolutions of November 2012 of the representative assembly of the National Association of Statutory Health Insurance Dentists and the general assembly of the German Dental Association . The results were presented to the public on August 16, 2016.
DMFT index
DMFT is an abbreviation for assessing the state of health or illness of human teeth, which means:
- D = decayed (carious)
- M = missing
- F = filled (filled - with a tooth filling)
- T = tooth
An index of 1 means that out of 28 permanent teeth - wisdom teeth are not included - 1 tooth is either carious, filled or missing.
The DMFT index for Germany is 1.14 for 15-year-olds (as of 2009), for 35- to 44-year-olds 14.5, for 65- to 74-year-olds 22.1 (as of 2005)
dmft index
The same index can be used for milk teeth, whereby this index is designated with lower case letters to distinguish it from permanent teeth.
The dmft index for Germany for children aged six to seven is 1.87 (as of 2009)
rating
A DMFT index below 1.2 is referred to as very low, between 1.2 and 2.6 as low, 2.6 to 4.4 as moderate and above 4.5 as high.
variants
Norway uses an MFT index that does not record carious teeth.
Sweden uses a DFT index that does not track missing teeth.
criticism
The DMF index is criticized in that, for example, a patient with five carious teeth and one missing tooth has an index = 6. If the carious defects of the teeth are repaired with fillings and the missing tooth is replaced, the index does not change, although there is no longer any need for treatment. This patient's index can only increase, for example if more teeth become carious or are removed. At the same time, teeth lost or fractured as a result of accidents are also included in the index.
DMFS index
The DMFS index is similar to the DMFT index, whereby the "S" stands for surface, for a tooth surface. Front teeth have 4 surfaces, molars and premolars 5 surfaces, wisdom teeth are not taken into account, i.e. a maximum of 128 healthy tooth surfaces in a fully toothed set of 28 teeth. The DMFS index is more informative than the DMFT index, but it is much more complex to collect.
ICDAS
While DMFS counts the destroyed, missing or supplied surfaces (decayed, missing, filled surfaces), the ICDAS, developed by an international commission of experts, is used to diagnose existing caries quantitatively (not according to the otherwise common “yes-no principle”). ICDAS stands for International Caries Detection Assessment System and consists of 7 codes that correlate with the depth of caries.
IDCAS criteria: The perfectly cleaned tooth surface is examined visually with the aid of a periodontal probe. If in doubt, the lower degree of caries is selected.
| ICDASCode | example | consequence |
|---|---|---|
| 0 | Tooth surface healthy. The melting ratios have not changed | no |
| 1 | Discoloration only visible on the dried tooth | Oral hygiene instruction, intensive prophylaxis |
| 2 | Opaque or brown discolored but not defective enamel surface | Oral hygiene instruction, intensive prophylaxis, microinvasive therapy |
| 3 | Small enamel defect, the defect seems to be visually / tactilely limited to the enamel | Oral hygiene instruction, intensive prophylaxis, minimally invasive filling |
| 4th | Gray-opaque shimmering cavity, possibly with a small opening in the enamel | Normal filling |
| 5 | Clear dentine caries with enamel breakdown <50% of the surface | Normal filling |
| 6th | Excessive dentine caries with enamel collapse> 50% of the surface | Cusp coverage, onlay, crown |
In addition to the condition of the tooth surface, ICDAS also describes the type of filling therapy
| ICDAS code | Description of the measure carried out on the tooth |
|---|---|
| 10 | partially sealed |
| 20th | completely sealed |
| 30th | Tooth-colored plastic filling |
| 40 | Amalgam filling |
| 50 | Steel crown |
| 60 | Gold or porcelain restoration |
| 70 | broken restoration - material does not matter |
| 80 | temporary restoration |
| 90 | can not be assessed |
CPI index
The Community Periodontal Index (CPI) shows the severity of periodontal diseases in grades 1–4.
Periodontal Screening Index (PSI Code)
The periodontal screening index (PSI code) is based on the CPI index.
Prosthetics and depression
At the 56th GMDS and 6th DGEpi annual conference in 2011, a combined psychiatric / oral epidemiological study of the relationship between (dental) prosthetic care and depression was presented.
history
In 1981 the World Health Organization (WHO), together with the World Dental Association FDI ( Fédération Dentaire Internationale ), formulated global oral health goals for the first time for the year 2000. On the occasion of the FDI General Assembly in Sydney in 2003, these goals were set by an international working group of representatives the FDI, the WHO and the International Association for Dental Research (IADR) taken up again and revised for the new millennium by 2020 ("Global Goals for Oral Health"; Hobdell et al. 2003).
See also
Individual evidence
- ↑ DMS IV - Abstract (PDF; 74 kB)
- ↑ DGZMK to DMS IV
- ↑ a b Statistical Yearbook of the German Dental Association 2011/2012, p. 165
- ↑ a b OECD: Health at a Glance 2009 OECD Indicators: OECD Indicators . OECD Publishing, 2010, ISBN 978-92-64-08108-6 , pp. 34 ( books.google.de ).
- ↑ ICDAS
- ↑ DGZMK - Periodontal Diseases, accessed September 14, 2012
- ↑ GMDS / DGEpi Annual Meeting 2011: Dose Response Effect of Psychopathological Findings on Prosthetic Status - The Study of Health in Pomerania, accessed September 14, 2012
- ↑ DGMZK on DMS IV
