Tool for dental caries prevention: assessing initial caries lesions in national surveys

Abstract Background Dental caries is the most common non-communicable disease globally, causing pain, functional and socio-economic problems, and high treatment costs. Epidemiological studies typically report on dentine caries requiring treatment. However, they overlook early-stage caries, limited to enamel, when its progression could be effectively halted through preventive measures and improved self-care. Methods We conducted clinical oral health examination for a nationally representative sample of adults aged > = 20 years (n = 1798) between January and July 2023 in Finland as part of the Healthy Finland survey. Trained and calibrated dentists examined and recorded caries findings based on International Caries Detection and Assessment System (ICDAS) as enamel caries (ICDAS 1-3) or dentine caries (ICDAS 4-6). Statistical evaluation was carried out using means (M) with standard errors (SE), and regression analyses. Results Of all participants, 75 percent had full or almost full dentition. Enamel caries was more prevalent than dentine caries (92 % and 39 %, respectively). The mean number of teeth with enamel caries was highest in the youngest age groups of 24-30 -years-olds (M = 10.1, SE = 0.5) and 31-44 -year-olds (M = 9.9, SE = 0.4), whereas the mean number of teeth with dentine caries was highest in the oldest age group, 75 years and older (M = 1.9, SE = 0.5). Regression analyses also showed that younger age was associated with a higher amount of enamel caries. Meanwhile, male sex, older age, lower education, and a native language other than Finnish or Swedish associated with both the prevalence and extent of dentine caries. Conclusions Dental caries continues to be a major public health concern. Including the assessment of enamel caries in population-based health examination surveys could support a shift in focus from the treatment of caries to its prevention, facilitate the development of preventive strategies and result in cost savings, especially in younger age groups. Key messages • Dental caries is a major public health problem, although its progression can be halted if detected at its initial stage when it is restricted only to enamel. • Incorporating enamel caries in epidemiological studies could facilitate preventive strategies and cost savings.