Characteristics of Adolescents Affected by Dental Caries

Characteristics of adolescents affected by dental caries Substudy of #Care4YoungTeeth<3 Relevance A modern definition of oral health includes, in addition to disease and condition status, underlying determinants, moderating factors, overall health and well-being. This means that the definition also encompasses the ability to speak, smile, smell, taste, touch, chew, swallow and express emotions,and functioning without feeling pain or discomfort.

In this study dental caries will be targeted, being widespread in the teenage population. In Northern Norway a recent publication among 16-year-olds concluded that caries (enamel caries included) constituted a major health problem and affected the total teenage population. This means that adolescence is a vulnerable period concerning initiation and progression of caries. As it is known, when caries are initiated but still has not reached dentin layer, restorations can be avoided. Seen in light of life-perspective, to target adolescence, is essential when the objective is to improve oral health into adulthood and reduce repair costs for re-doing restorations.

Caries into dentin layer is skewed distributed i.e. individuals living in vulnerable populations as in families with low income, in some immigrant minorities and where these two populations overlap, are those carrying the majority of caries burden. These groups also appears to have less benefit from universal promotive- and preventive strategies when compared to the general population.Therefore, these adolescents need both a general population-based and simultaneously an additional high-risk prevention approach. A challenge is to identify these groups, but authors have identified groups at caries risk successfully by linking caries data to socio-cultural- and socio-economic official data or to use geographic maps ("Geo-map").

Adolescence is described as a period of continued behavioral development along a pathway established in childhood, and during this period the behavior patterns differ from both childhood and adulthood. Characteristics of the period are peer interactions, frequent conflicts and opposition towards either parents, teachers or both, as well as increased risk-taking behaviors, depression and anxiety. According to Statistics Norway 2019, among the group children and adolescents living in Norway, 759 68 are immigrants and 133 315 are of immigrant origin (born in Norway, but with immigrant parents). There are reasons to believe that adolescents living in cultural minorities have a daily life different from their peers in the general population, both in respect to food/drinking habits, frequency of meals and other oral health habits influenced by culture. Time trends not only influence an oral disease alone, but also the determinants behind the disease.How do the oral diseases appear during recent years? Do any time trends appear when comparing nowadays disease status with previous corresponding data? Are during recent years background oral disease determinants changed? Which characteristics represent the high-risk individuals? Background and status of knowledge Dental Caries National oral health data reported in Norway and Sweden are limited to caries at dentin level, a system which underscores the true caries experience. However, these data give us valuable information and enable comparisons between the two neighboring countries. In 2019, 19% of Norwegian 5-year-olds, 36% of 12-year-olds and 71% of 18-year-olds experienced caries at dentin level. Geographic variations were substantial; the highest proportion of 18-year-olds (83%) from previous Finnmark county and the lowest (65%) from previous Hedmark county. Comparing 2019 statistics of young individuals with a previously evaluation of corresponding caries data up to 2005, it seems that the overall trend of caries reduction during recent years mainly has taken place before the age of 12 years. The proportion of 18-year-old with caries at dentin level in previous Finnmark county in 2019, is almost identical to the corresponding proportion registered in 2005. This means that adolescence is a caries preventive resistant period. It is worth to be mentioned that this reduction seen before 12 years of age, may in part be due to the trend change in diagnostic and treatment caries criteria which today is more conservative than before.

There are some explicable reasons why first part of adolescence is a risk period for caries. At 12 years of age, many teeth have just emerged and thus due to immature outer enamel, categorized as a caries prone age. Individuals of 12-15 years are also shown to develop more new enamel lesions on approximal surfaces when compared to young adults. The permanent second molar has its highest risk period during the first 3 years after the eruption (12-15 years). Additionally, distribution of caries (at dentin level) at approximal surfaces has shown skewness with some surfaces more caries prone than others, especially distal surface of the second permanent premolar.