3.1 Dental Caries Disease Process
The dental caries disease process can be characterized as follows:
- The disease manifests itself on the tooth surface as a caries lesion.
- The disease is dynamic, but not continuous. The process can progress or regress at any time.
- The disease is site specific. It occurs in areas in which plaque accumulates for long enough (e.g., the pits and fissures of teeth).
- In the early stage, the disease is reversible (i.e., before cavitation occurs).
- The disease is chronic. In most people, the progression from sound tooth structure to a cavitated lesion (i.e., cavitation) takes several years; however, during the period when the permanent teeth are erupting, lesions can progress much faster.
- The disease can be arrested at any point.
- About 90 percent of caries lesions are found in the pits and fissures on the occlusal surfaces of permanent posterior teeth, with molars being the most susceptible.
- A tooth is most susceptible to the disease while it is erupting and during the first few years afterwards.
- Certain populations (e.g., children from certain minority and racial groups, children from families with low incomes, children with special health care needs) experience higher rates of dental caries and more severe caries lesions, compared with their counterparts (e.g., whites, children from families with higher incomes, children without special health care needs), as shown in the table below.
Notes: DMFS is decayed, missing and filled dental surfaces. FPL is federal proverty threshold or level.
Source: Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, Eke PI, Beltrán-Aguilar ED, Horowitz AM, Li CH. 2007. Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Statistics (248):1–92.
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