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Caries prevention. A continued need worldwide.

This paper provides a global perspective of the changing prevalence, severity, distribution and pattern of dental caries. The prevalence of caries in children and adolescents has declined in most developed countries and it is now a minority of young people who experience most of the disease. All forms of caries have reduced in prevalence but pits and fissures are the surfaces most frequently involved. The caries experience and levels of edentulousness in the adult populations of developed countries have also declined. The prevalence of caries in adults is remarkably constant with age but in older subjects root caries is becoming more prevalent. However, in many developing countries the prevalence of caries in young children is high and is increasing in those populations who are adopting a cariogenic diet. In countries such as Kenya and China, caries is the major cause of tooth loss but levels of edentulousness are low. There are considerable variations in disease levels between and within countries and it is evident that lower socio-economic and certain racial groups exhibit high levels of dental caries. It is essential to sustain the benefit of fluoride to those already receiving it and encourage the use of appropriate and effective strategies and products by those who are not. Water and salt fluoridation should be implemented where deemed feasible and the use of a clinically proven and affordable fluoride toothpaste should be encouraged.