Prevalence of noncavitated and cavitated carious lesions in 5-year-old head start schoolchildren in Alachua County, Florida

PURPOSE: The diagnosis of early carious lesions is essential for nonsurgical management of dental caries. This report describes the prevalence of early noncavitated and cavitated carious lesions in the primary dentition of 5-year-old Head Start schoolchildren in Alachua, Fla. METHODS: As part of the Fluoride Varnish Study conducted at the University of Florida, modified caries diagnostic criteria-which differentiated caries lesion activity and severity-were developed for the primary teeth. Dental examinations were conducted on 221 children ages 5 years by 2 calibrated examiners. RESULTS: Overall, 86% of the children had experienced noncavitated or cavitated caries lesions in the primary dentition. Prevalence of cavitated dentinal lesions was 48%, and prevalence of active noncavitated enamel lesions was 71%. The mean number of active noncavitated enamel lesions (mean +/- SEM: 2.91 +/- 0.21) was slightly higher than the mean number of cavitated dentinal lesions (2.52 +/- 0.31). The mean number of restored surfaces was 1.24 (+/- 0.42), and only 8% of the children had 1 or more restored surfaces. Noncavitated lesions were most common on occlusal surfaces, especially in mandibular second molars. African-American children had a higher prevalence of noncavitated lesions (81%) than whites (69%) or others (33%; P<.0001). Prevalence of cavitated lesions was 49% for African Americans, 46% for whites, and 48% for others. CONCLUSIONS: This study shows that noncavitated enamel and cavitated dentinal lesions are common in this study population's primary dentition. There is a need for preventive measures and treatment of decay in these children living in low-income families.     

2005年广东省成年人恒牙冠龋病抽样调查报告

目的 了解广东省35～44岁、 65～74岁人群恒牙龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省35～44岁、 65～74岁城乡常住人口各720人,男女各半.按照《第三次全国口腔健康流行病学调查方案》中临床检查牙列状况的检查方法和标准,使用CPI探针检查全口恒牙牙冠龋病情况.数据采用SAS 8.1软件统计,计算出患龋率、龋均.结果 35～44岁组恒牙患龋率为63.89%、龋均为1.99;患龋率和龋均均为女性高于男性,农村高于城市. 65～74岁组患龋率为74.17%、龋均为3.37;患龋率和龋均均为农村高于城市.结论 广东省成年人群龋病患病率较高,人群大部分龋齿未得到治疗.     

2005年广东省成年人恒牙根龋病抽样调查报告

目的 了解广东省35～44岁、 65～74岁人群恒牙根面龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省35～44岁、 65～74岁城乡常住人口各720人,男女各半.按照《第三次全国口腔健康流行病学调查方案》中临床检查牙列状况的检查方法和标准,使用CPI探针检查全口恒牙根面龋病情况.数据采用SAS 8.1软件统计,计算出患龋率、龋均.结果 35～44岁组根面患龋率为31.53%、龋均为0.68;残根率为22.92%.65～74岁组根面患龋率为64.03%、龋均为2.67;残根率为52.64%.患龋率和龋均均为女性高于男性,农村高于城市.结论 广东省成年人受根面龋病患病率高,涉及面广,特别是老年人根面龋病增加迅速,大部分根面龋齿未得到治疗.     

Distribution and volumetric assessment of initial approximal caries lesions in human premolars and permanent molars using computer-aided three-dimensional reconstruction

Serial sections from 21 extracted premolars and permanent molars, divided into three age groups (group 1, 10–19 years; group 2, 20–39 years; group 3, 50–69 years.), were viewed by polarized light microscopy for reconstruction of the caries lesions. The volumes of the lesional body and the transparent zone, and the volumes of early dentinal lesions were calculated; and an enamel demineralization index (EDI) and an enamel–dentine demineralization index (EDDI), representing the volumetric ratio of the body of the lesion to the translucent zone, and the body of the lesion to the volume of the early dentinal lesion, respectively, were determined. The method showed that there are three typical sites of individual initial caries lesions at the approximal surface: within the contact area, in the subcontact area, and in the cervical area. Volumetric assessment demonstrated a larger volume of the body of the lesion in older teeth with a smaller volume of the translucent zone relative to the lesional body. From these results it can be concluded that there are usually more than one individual initial caries lesions at the approximal tooth surface. Calculation of demineralization indices demonstrated different features for small lesions with pronounced transparent zones and for large lesions with small transparent zones. The computer-assisted three-dimensional reconstruction technique and the volumetric assessment are of value in investigations of the micromorphology and progression of natural caries lesions in permanent teeth.     

The prevalence of clinically undetected occlusal dentine caries in Scottish adolescents

During the third examination of a 3-year anti-caries dentifrice study, bitewing radiographs were read to detect occlusal, as well as approximal caries lesions in 2623 subjects aged 14-15 years. These analyses showed that 1.4% of 2107 upper molars and 7.2% of 2288 lower molars (P less than 0.001), previously scored as clinically 'sound', were carious at a radiographic Grade '3' score (dentinal involvement), and 0.2% had radiographic pulpal lesions. However, for teeth which had been deemed as having a 'suspicion' of caries clinically, but which a 0.6 mm blunted probe would not enter, 29.1% of lower molars had definite radiographic evidence of dentinal caries as compared to only 7.6% of upper molars (P less than 0.001), and a further 0.5% exhibited pulpal extension. In addition, 23.9% of lower premolars also showed dentinal involvement in this group. Overall, 12.1% of lower molars and 3.1% of upper molars showed definite radiographic evidence of occlusal caries in the absence of a firm clinical indication. Thus, the use of bitewing radiographs would appear to be a most helpful adjunct to clinical caries diagnosis, not only of approximal lesions, but also for the detection of early occlusal caries, in these days of generally available topical fluoride.     

Caries experience in a child population in a deprived area of Brazil,using ICDAS II

The aim of the present study was to assess the caries experience of children aged 6 to 7 years old in a socially deprived suburban area of Brazil’s Federal District, using the ICDAS II system and to investigate determinants of dental caries. The survey was carried out in six public schools by three calibrated examiners, on a sample of 835 children. ICDAS II codes had to be converted into dmf/DMF components at surface and tooth levels, resulting in unfamiliar caries variables, to enable some meaningful reporting of the findings. The prevalence of dental caries, including enamel and dentinal carious lesions, in primary teeth was 95.6% and in permanent teeth it was 63.7%. Mean values of d₂mf₂-t (enamel and dentinal lesions), d₃mf₃-t (dentine lesions), D₂MF₂-T and D₃MF₃-T indices were 6.9 ± 3.8, 3.2 ± 3.4, 1.7 ± 1.6 and 0.2 ± 0.5, respectively. Enamel carious lesions predominated in the dmf-t/s and DMF-T/S indices. Seven-year-old children had statistically significantly more enamel and dentine carious lesions in permanent teeth than 6-year-old children had. Using ICDAS II, the prevalence of dental caries in both dentitions was very high. In both dentitions, the decay component predominated, with hardly any restorations or extractions observed. The new ICDAS II system leads to overvaluation of the seriousness of dental caries experience and made reporting of outcomes cumbersome. Guidelines on analysing data and reporting results should be agreed upon before this system can be used in epidemiological surveys globally.     

Dental caries in adult and elderly Chinese

This paper reports on a study of dental caries conducted among 1744 urban and rural Chinese (from 20 to 80 years old), who were selected by means of a systematic stratified sampling procedure. The prevalence of one or more decayed or filled teeth ranged from 48 to 90% in urban residents, and from 51 to 97% in rural residents, depending on age. The mean number of decayed or filled teeth ranged from 1.2 (+/- 1.9) among 20-29-year-olds, to 6.2 (+/- 5.5) among 70+-year-olds, and was highest among rural residents. Among 20-29-year-olds, the main components of the DFT were enamel lesions and fillings. Among 30-49-year-olds, the DFT consisted mainly of enamel lesions and filled teeth, as well as teeth with lesions involving the pulpal tissues. In subjects over the age of 50 years, lesions involving pulpal tissues were the predominant type, followed by root-surface lesions. In subjects below the age of 50 years, most of the caries experience derived from coronal surfaces, particularly occlusal surfaces. Root-surface caries was predominantly a feature of persons aged 50 years and above. Despite a large number of surfaces being at risk of root-surface caries, less than 10% of the surfaces were so affected. Although cross-sectional in nature, these data indicate that when the oral hygiene standards are poor, caries lesions continue to develop and progress throughout life. With age, dental caries becomes a substantial oral health problem in this population of adult and elderly Chinese, despite the availability of some dental services.     

Correlation between fissure discoloration, Diagnodent measurements, and caries depth: an in vitro study

PURPOSE: This in vitro study was performed to correlate the presence of discoloration on occlusal surfaces with its histological depth and assess its influence on Diagnodent measurements in a group of permanent and primary teeth. METHODS: Ninty-five primary and 95 permanent third molars were randomly selected from a pool of macroscopically intact teeth. One site of the fissure on each occlusal surface was selected and categorized according to its discoloration. Each site was measured 3 times with Diagnodent. The teeth were prepared histologically and evaluated according to their caries extent under a microscope (final magnification x 12.8). RESULTS: In the group of permanent teeth with dark brown or black discoloration (N=23), 13% showed dentinal caries, 57% were sound or had an initial enamel lesion, and 30% had a deep enamel lesion. In the group of primary teeth with dark brown and black discoloration (N=19), 42% presented dentinal caries, 42% showed deep enamel caries, and 16% had an initial enamel lesion. The difference between permanent and primary teeth was statistically significant (P<.05). Discolored fissures showed higher Diagnodent values than nondiscolored or opaque fissures in both groups (independent of their caries status). CONCLUSIONS: The presence of brown or dark spots on fissures were not useful for the prediction of dentinal caries for permanent teeth. In primary teeth, however, a higher correlation between fissure discoloration and dentinal lesions was found. Diagnodent tends to overscore discolored surfaces.     

The prevalence of caries and enamel defects in 229 Malaysian children 16 years after water fluoridation (a pilot study)

Two hundred and twenty-nine children aged 12-15 years who were continuous residents of Penang island, in the north of Peninsular Malaysia were examined for caries and enamel defects. Caries prevalence was 82.2% with a DMFT score of 3.4 and DMFS score of 4.9; there were very few missing teeth and very little untreated caries in the population examined. Majority of DF (decayed/filled) lesions were pits and fissures with approximal and smooth surfaces relatively caries free. The prevalence of enamel defects was 76.4% with 19.1% of all teeth examined being affected. More posterior than anterior teeth were affected by enamel defects just as there were more maxillary than mandibular teeth affected by enamel defects. Diffuse patchy opacities were the most common defect diagnosed and this was found in 60.2% of the population examined. A bilateral distribution of diffuse patchy opacities was seen in 41.5% of the population examined. Tooth surfaces with enamel defects were no more susceptible to caries than defect-free surfaces.     

Dental health in professional musicians. A radiographic study in dental conscious subjects

A study has been performed covering the oral health of 247 professional musicians in Stockholm aged 21-60 yr. In an earlier study the oral hygiene was found to be of a high standard. The following part of this study concerned dental health i.e. remaining and intact teeth, decayed and filled proximal surfaces. All registrations were made on intraoral full mouth surveys. The number of remaining teeth was large, but decreased with age. In the 51-60 age group, 24.1 teeth remained on average. The number of teeth intact ranged from 55-28% of remaining teeth in the youngest and oldest age group respectively. A total of 555 caries lesions were registered on proximal surfaces, 49.1% being primary lesions in the enamel, 21.4% primary lesions into the dentin and 29.5% secondary lesions. Only 3.3% of all filled surfaces showed secondary lesions. The number of secondary lesions increased with age. A total of 30.9% of the subjects showed no proximal lesions. It was concluded that in adults who have adopted proper oral hygiene it is possible to preserve a large number of teeth and to limit the deterioration caused by caries.     

青海省人群龋病流行病学抽样调查分析

目的了解青海省人群患龋状况及龋病发病的基线资料,为口腔卫生保健工作提供依据。方法根据第3次全国口腔健康流行病学抽样调查方案,首次对青海省5、12、35～44和65～74岁4个年龄组人群的患龋状况进行流行病学抽样调查。采用SPSS13.0软件对数据进行统计分析,以患龋率、龋均和龋充填率作为统计指标。结果5岁年龄组乳牙患龋率和龋均分别为71.63%和3.30。12岁年龄组恒牙冠龋患龋率和龋均分别为22.63%和0.40。35～44岁年龄组恒牙冠龋患龋率和龋均分别为64.47%和2.06。65～74岁年龄组恒牙冠龋患龋率和龋均分别为73.89%和3.08。4个年龄组龋充填率分别为1.85%、2.53%、8.00%和3.47%。结论青海省人群龋病状况不容乐观,龋齿充填率很低,应加强口腔健康教育,采取切实有效的措施,才能降低患龋率,提高龋齿的充填率。     

Caries incidence and lesion progression from adolescence to young adulthood: a prospective 15-year cohort study in Sweden

The objectives were (1) to assess caries development, including the incidence and rate of lesion progression, in a Swedish cohort from adolescence to young adulthood and (2) to compare the caries incidence rates in adolescents with those of young adults. The original material consisted of 536 children aged 11-13 years at baseline. This cohort had been followed through annual bitewing radiographs to 21-22 years of age. In 1998-1999, 250 of these individuals were re-examined at the age of 26-27, and the new caries data were added to the original data. The results showed that fewer new enamel lesions developed on approximal surfaces during young adulthood than during adolescence; the caries incidence rates for enamel lesions decreased from 4.3 in the age group 12-15 years to 2.7 new caries lesions/100 surface-years in the age group 20-27 years. The same applied to the rate of lesion progression, where the corresponding values from the enamel-dentin border to the outer dentin were 32.5 for the youngest and 10.9 new lesions/100 surface-years for the oldest age group. The caries incidence of outer dentin lesions on approximal surfaces was low but increased from 0.2 in the age group 12-15 years to 0.9 new outer dentin lesions/100 surface-years in the age group 20-27 years. The incidence rates varied considerably between different tooth surfaces. Also for occlusal surfaces, fewer new dentin lesions developed during young adulthood than during adolescence; the incidence was 2.0 new dentin lesions/100 surface-years in the youngest age group and 0.7 during young adulthood. At the age of 13, the proportion of DFS of occlusal surfaces predominated over DFS of approximal surfaces but at the age of 26-27 the proportions of occlusal and approximal DFS were almost equal.     

Caries prevalence and enamel defects in 5- and 10-year-old children with cleft lip and/or palate: A case-control study

Objective. To determine the prevalence of dental caries and enamel defects in 5- and 10-year-old Swedish children with cleft lip and/or palate (CL(P)) in comparison to non-cleft controls. Materials and methods. The study group consisted of 139 children with CL(P) (80 subjects aged 5 years and 59 aged 10 years) and 313 age-matched non-cleft controls. All children were examined by one of two calibrated examiners. Caries was scored according to the International Caries Detection and Assessment System (ICDAS-II) and enamel defects as presence and frequency of hypoplasia and hypomineralization. Results. The caries prevalence among the 5-year-old CL(P) children and the non-cleft controls was 36% and 18%, respectively (p < 0.05). The CL(P) children had higher caries frequency (initial and cavitated lesions) in the primary dentition than their controls (1.2 vs 0.9; p < 0.05). A significantly higher prevalence of enamel defects was found in CL(P) children of both age groups and anterior permanent teeth were most commonly affected. Conclusions. Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.     

广东省55~74岁人群恒牙冠根龋病抽样调查报告(2015—2016年)

目的 了解广东省55~74岁人群恒牙冠根龋病状况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省55~64岁、65~74岁各288人,男女各半,城乡各半.按照第四次全国口腔健康流行病学调查方案中临床牙列检查方法和标准,使用CPI探针检查全口恒牙冠根龋情况.计算患龋率、龋均、充填率等.结果 55~64岁人群恒牙冠龋患病率为77.08%,龋均为2.94,充填率为21.87%;根龋患病率为59.38%,龋均为1.82,残根率为46.18%,充填率为9.18%.65~74岁人群恒牙冠龋患病率为81.25%,龋均为3.45,充填率为16.40%;根龋患病率为63.19%,龋均为2.34,残根率为50.35%,充填率为9.18%.55~64岁人群中,女性冠龋患病率(x2=7.862,P=0.005)及龋均(t=2.63,P=0.009)均高于男性,差异具有统计学意义;根龋龋均在城乡分布中有差异,农村高于城市,差异具有统计学意义(t=2.12,P=0.035).65~74岁人群中,女性冠龋龋均高于男性,差异具有统计学意义(t=2.47,P=0.014);根龋患病率(x2=4.837,P=0.028)及龋均(t=2.88,P=0.004)在城乡中有差异,农村高于城市.结论 广东省老年人群牙冠及根龋患病率较高,治疗率低,大部分龋齿未得到治疗.     

Caries rates for the mesial surface of the first permanent molar and the distal surface of the second primary molar from 6 to 12 years of age in Sweden

The aim was to analyse the pattern of caries rates in enamel and dentin of the mesial surface of the first permanent molar (mesial 16, 26,36,46; here called 6m) and the distal surface of the second primary molar (distal 55,65,75,85; here called 05d) from 6 to 12 years of age. The material consisted of retrospectively collected bite-wing radiographs of a cohort of 374 children aged 5-7 years at baseline and followed to 11-12 years of age. The following scoring system was used: score 0 = no visible radiolucency, 1-2 = radiolucency in the outer (1) or inner (2) half of the enamel up to the enamel-dentin border, 4 = radiolucency with obvious spread in the outer half of the dentin, and 5 = radiolucency in the inner half of the dentin. Two transitions were used: state 0-2 = the time lapse from state 0 until the lesion had reached state 2, and state 2-4 = the time lapse from state 2 until the lesion had reached state 4 or 5. At the age of 9, the mean defs (decayed, extracted and filled surfaces) of 05d was 0.70 and the mean DFS of 6m was 0.19. The enamel caries rates (state 0-2) were 4.6 new lesions/100 tooth surface-years for 6m and 11.3 for 05d. The dentin caries rates (state 2-4) were 20.5 new lesions/100 tooth surface-years for 6m and 32.6 for 05d. In conclusion, the enamel caries rate for 05d was more than twice that for 6m. Both surfaces had relatively high dentin caries rates, indicating that for these surfaces between 6 and 12 years of age, the rate of progression into the dentin is generally relatively high once the lesion has reached the inner half of the enamel as judged radiographically.     

Comparison of different DIAGNOdent cut-off limits for in vivo detection of occlusal caries

This study tested recently recommended cut-off limits for the laser fluorescence based device DIAGNOdent (KaVo) for detection of occlusal caries. Two hundred and forty-eight permanent molars from 94 patients (mean age 19.2 years) of a general dental practice were included. After professional tooth cleaning, the teeth were examined visually and by the laser fluorescence method. The extent of occlusal lesions (gold standard) was determined after minimal operative intervention. Upon fissure opening, 24 teeth had enamel caries and 224 teeth revealed dentin caries, of which 58 and 166, respectively, were up to or beyond half the dentin. The optimal cut-off limits based on the highest kappa-values (0.51 and 0.54) were > 18 for superficial dentinal caries (D3) and > 37 for deep dentinal caries (D4). The comparison with DIAGNOdent cut-offs given by the manufacturer (n = 4) and those based on clinical trials with in vivo validation (n = 4) and in vitro studies with histological validation (n = 3) revealed a considerable variation in performance. Recommended cut-offs between 17 and 21 for superficial dentin lesions were in the same order of magnitude (0.48-0.51). On the D4 level, only the manufacturer's cut-off of > 34 achieved the best performance (0.51). According to the highest kappa-values and the area under the ROC curves (D3: A(z) = 0.903; D4: A(z) = 0.830), the agreement between the extent of validated caries and laser fluorescence value is still unsatisfactory.     

Predictors of tooth loss over 10 years in adult and elderly Chinese

Abstract This study describes the incidence of tooth loss over a 10–year period in a population of rural Chinese, initially aged between 20 and 80 years. Among the 587 persons who participated in a baseline examination in 1984, 440 persons were available for a follow-up study in 1994. A total of 31 persons, mainly aged 50+ years at baseline, had become completely edentulous. Between 45% and 96% of the persons lost at least one tooth, and the average number of teeth lost ranged between 1.0 and 7.2. The distribution of the number of teeth lost was skew, indicating that a minor group of subjects had a substantially higher risk of tooth loss than the majority. Logistic regression analysis identified six significant predictors of tooth loss among those who remained dentate: age, a high number of teeth with dentinal caries lesions, a high number of teeth with caries lesions of any type, presence of teeth with attachment loss 7 mm, presence of mobile teeth, and a low percentage of sites with subgingival calculus deposits. At the subject level, caries variables and periodontal disease variables seemed equally important predictors of the incidence of tooth loss over 10 years, but at the tooth level caries was a predominant cause of tooth loss in all age groups.     

Influence of posteruptive age of enamel on its susceptibility to artificial caries

Epidemiologic studies and caries experiments with animals have suggested that caries susceptibility of teeth decreases with age. Observations on the changes in the dental tissues and their environment with age have pointed out that a process commonly referred to as 'posteruptive maturation' of the dental enamel may be responsible. To test this assumption 10 unerupted third molars and 56 erupted human premolar teeth of various posteruptive ages were subjected for 130 days to an acid gel for caries-like lesion formation in vitro. Sections of the teeth were examined with polarized light and 'contour maps' were drawn with the approximate porosity of the lesions. The results were: unerupted = 833 microns (+/- 261); erupted of posteruptive age 0-3 years = 561 microns (+/- 150), 4-10 years = 470 microns (+/- 136), 11-30 years = 459 microns (+/- 192) and over 30 years = 297 microns (+/- 89). These findings show a decrease in the susceptibility of enamel to artificial caries with increasing age, which was especially marked at and shortly after eruption. This may be explained by a completion of mineralization of the outer enamel at about eruption, by a maturation process of the outer enamel posteruptively and by a reduction in the permeability of enamel occurring through to old age. The fluoride content of the mid-coronal buccal surface enamel under study was found to decrease posteruptively with age, therefore not accounting for the decreasing caries susceptibility.     

Dental fear and oral health habits among adults in Finland

A previous clinical trial showed that long-term use of saliva-stimulating polyol (xylitol and sorbitol) chewing gums was associated with arrest of dental caries in young subjects. After a 20-22-month intervention (when the subjects were 8 years old), a total of 23 primary teeth with extensive dentin caries lesions whose surface in clinical examination was found to be totally rehardened (remineralized) could be removed because the teeth were near their physiologic exfoliation time. These teeth were subjected to histologic, microhardness, and electron microscopic tests. The majority of the specimens had been remineralized from the surface by a non-cellular-mediated process within the remaining collapsed, organic extracellular matrix associated with the remaining dentinal surface. Many of the underlying dentinal tubules were filled with a matrix that had been subsequently mineralized. Dental microanalyses showed that the topmost (outer) 20-mm-thick rehardened layer of the lesions exhibited the highest Ca:P ratio, which leveled off at a depth of approximately 150 mm. The rehardened surface layer (normally <0.1 mm in thickness) was significantly (P < 0.001) harder than sound dentin and nearly as hard as sound enamel. Although the main source of the mineral present in the rehardened layer was most likely of salivary origin, some extracellular remineralization was probably mediated by odontoblasts. The results complete the clinical diagnoses of the original trial and suggest that regular use of polyol chewing gums may induce changes in dentin caries lesions, which in histologic and physiochemical studies show typical characteristics of rehardening and mineralization.     

Ten-year incidence of tooth loss and dental caries in elderly Swedish individuals

There has been a significant reduction in edentulism and the elderly retain more teeth into old age. The 10-year incidence of tooth loss, coronal and root caries was studied in a random sample of inhabitants of G?teborg, who were 55, 65 and 75 years old at baseline. Of the 208 persons examined at baseline, 102 (49%) participated in the follow-up examination: 56, 37 and 9, respectively, in the different age groups of 65, 75 and 85 years. In addition, for the purpose of time-trend comparisons, a new random sample of 98 individuals aged 55 years was examined. The mean numbers of remaining teeth were 24, 23, 17 and 14, respectively, in the age groups of 55, 65, 75 and 85. The corresponding mean numbers at baseline were 23, 19 and 17, respectively, in those subjects who were then 55, 65 and 75 years old. Forty-eight percent had lost no teeth during the 10-year period, while 13% had lost more than 2 teeth. The major reason for tooth extraction was dental caries and it was found in 60% of all cases. The incidence of coronal caries decreased, while that of root caries increased with age (p < 0.01). Comparing the same age groups, the frequency of root caries had decreased during the 10-year period. It could be concluded from this study that elderly people were determined to retain their teeth for as long as possible, but dental caries may be a problem among the very old.