Changing trends in dental caries.

In underdeveloped countries the number of dental caries is increasing at a frightening rate whereas in industrialized countries the caries rate has declined by about 40% in the past 10 years. In 1982, for the first time ever, the average 12-year-old in underdeveloped countries, where 80% of the world's children live, had a higher dental caries score (decayed, missing, filled-DMF) than those in industrialized countries. The increase in caries is associated with increases in sugar consumption. By 1984, sugar consumption in underdeveloped countries is predicted to exceed that of industrialized countries. The decline in caries is associated with the widespread availability of fluoride toothpaste, changes in the pattern and quantity of sugar consumption and possibly with the frequent use of antibiotics. The declines have been greater in areas with fluoridated water supplies. The trends in rates of dental caries have important public health implications. They include the urgent need for a food policy to limit the consumption of refined sugars, policies to ensure the availability of fluoride, a reduction in the number of dentists in industrialized countries, the greater use of dental therapists and increasing the interval between dental check-ups to two years or more.