The incidence of caries in children and adolescents in most European countries has been declining for some years. This has been attributed largely to the use of fluoride, mainly in toothpastes, and improved oral hygiene. In the same period the diet, including consumption of sugars and other carbohydrates has remained constant. When cavities are controlled by fluoride and regular dental care (in most European countries), moderate consumption of sugars is not a major risk factor except in individuals with high risk of decay or not using toothpaste with fluoride.
More than half of European children between 5 and 7 years do not have cavities in their baby teeth (milk). In general, those cavities are only affected to a tooth. The 'DMF-T index' which refers to the number of decayed, fallen or fillings, is used to measure the frequency of dental caries. In European children 12 years the rates began to decline during the 80's and continued to fall during the 90 to achieve the rates recommended by the WHO in 2000. The DMF-T figures for this age group range from 1 in Finland and the Netherlands, and 3 in Portugal, although they are higher in some countries of Eastern Europe. In some countries the prevalence of caries is polarizing, with 80% of cavities found in only 20% of the population. For these high-risk groups recommended specific intervention strategies.
In many countries the reduction of caries in children now extends to adolescents and youth. The older people kept their teeth longer. The risk of root caries, with receding gums can also be controlled with preventive measures described.
Tips for maintaining Dental Health
Good oral hygiene and the use of fluoride are now considered the main factors responsible for preventing tooth decay and promoting good oral health. The following tips are also important for keeping teeth caries-free.
Starting soon the care of teeth, brushing children's teeth with a fluoride toothpaste as they arise. Do not allow children to sleep while drinking from a bottle of milk, formula, juice or sweetened beverages. These sweet liquids are kept around the baby's teeth for long periods of time and can produce the 'baby bottle tooth decay.'
Brushing twice a day with fluoride toothpaste and if possible, clean between teeth with floss or toothpicks once a day. Do not eat after cleaning teeth at bedtime as salivary flow decreases during sleep.
Visit your dentist every 6 months for a check and the dentist for advice before using aesthetic products (eg. whitening teeth) that can damage the teeth.
Do not eat or drink continuously. Allow time between eating occasions for saliva to neutralize acids and repair the teeth.
People at high risk of tooth wear and erosion should take special precautions, such as:
Decrease the frequency and contact with acidic foods and beverages.
Avoid brushing teeth immediately after consuming acidic foods, drinks, citrus fruits and juices. This allows time for remineralisation to occur. The fluorinated mouthwashes and sugar-free gum may help after drinking acidic foods and drinks as they encourage remineralisation.
Sugarless gums are 'friends' of the teeth and to help increase saliva flow and clean the mouth of leftovers.
Good dental health is the responsibility of individuals, communities and governments although their relative importance varies. For example, in some European countries water fluoridation is not accepted yet in the public domain and therefore the responsibility of preventing tooth decay depends on the individuals.
Dentists play an important role in monitoring dental health and the treatment or prevention of disease. Access to good dental care, including periodic reviews, is vital. For some people, especially the depressed socioeconomic groups, access to dentists may be limited. These groups are important objectives of education programs of dental health. Schools also have an important role in educating children about the importance of good oral hygiene and diet.