The main objective of this study was to provide data on coronal and root caries experience of 35-44 and 65-74-year-old Greeks in relation to socio-demographic parameters. Furthermore, trends in coronal caries experience of the 35-44-year-olds were investigated comparing the results of the present survey with those of a survey conducted in 1985. For this reason the sample was collected in the same manner and from the same areas as in 1985, but four new areas were also included. Although the sample cannot be characterized as random, it can be considered as illustrative of the whole population since it ensures the participation of a satisfactory size of people leaving in representative urban and rural areas of Greece.
According to the results of the study, the level of coronal caries experience in Greek middle-aged adults and senior citizens seems to be similar or lower to what is observed in most European countries [4
] the United States [17
] and Canada [18
]. However, the D and M components are relatively higher and the F component relatively lower than those reported for some of these countries [13
]. These findings may be attributed to inadequate utilization of dental services, since in a recent study it was found that a low percentage of Greek adults (39.6%) reported having visited a dentist within last year, compared to the average (62%) of the EU-25 countries [19
]. They may also reflect higher supply of and demand for radical treatment and less positive attitudes towards dental health.
The comparison of the results between the two age groups showed that similar to other studies [4
] caries experience varied by age and it was greater in senior citizens mainly because of the high number of missing teeth. It also showed that the mean number of filled teeth was much greater in adults than in senior citizens, and therefore the adults had a higher Restorative index (RI). However, 19% of the decayed teeth of the adults and 36% of those of the senior citizens remained untreated. The high percentage of untreated teeth in individuals aged 65-74-years-old may be due to difficulties in accessing dental services and lack of interest for dental health.
The finding of the multivariate analysis that the mean DMFS values of the 35-44-year-olds were significantly lower in men and in those having a higher educational attainment supports those of previous studies [15
]. Significant differences in DMFS scores according to education were also found in the 65-74-years-olds similarly to other studies [15
Comparisons of the present findings with those of 1985, that have not been published but are stored in the WHO Oral Health Data Bank [23
], indicate that there were no changes in DMFT scores of the middle aged adults over the 20
year period between the surveys (Figure
). These findings are in accordance with those observed in other countries [16
], although in some, a decline in caries experience has been reported [4
]. This decline is mainly attributed to a reduction in the number of missing teeth. In our study the MT component was slightly lower in 2005 (5.22) compared to that in 1985 (5.90) and may be this is the reason for the slight reduction in DMFT score. The mean value of decayed teeth fell considerably as compared with the 1985 study, from 4.80 to 1.70, while the mean value of filled teeth increased from 4.00 to 7.28. However, it must be considered that in 1985 the examination for dental caries was conducted with a sharp explorer [24
], whereas in 2005 the Community Periodontal Index probe was used to confirm visual evidence of caries [9
]. Therefore, an underestimation of the carious lesions in the 2005 survey is probable. The restorative index increased from 45% in 1985 [5
] to 81% in 2005, indicating a remarkable improvement in restorative care.
Mean DT, MT, FT and DMFT values of 35-44-year-old Greeks in 1985 and 2005.
Since in the survey of 1985 subjects aged 65-74-years-old had not been examined, there are not comparable data in a national level for this age group. However, there are epidemiological data for two of the areas examined in the present study, Athens and Thessaloniki. According to these data, the mean DMFT value in subjects living in Athens in 1995-96 was 23.9 [25
] and in those living in Thessaloniki in 1998-99 was 20.26 [26
]. The corresponding mean values in our study were 20.39 in Athens and 21.10 in Thessaloniki. So, it seems that a reduction in dental caries experience of the elderly has taken place in Athens and a slight increase of the DMFT score has taken place in Thessaloniki. However, it must be considered that these studies were performed by different examiners under different field conditions and therefore the possibility of variations in clinical measurements cannot be excluded.
Similar to other studies [21
] the present study showed that root caries varied by age and it was more frequent in the senior citizens. The low proportion of RFS in RDFS in both age groups showed that most of the root caries lesions were not restored, but as in coronal caries, the number of untreated lesions was much greater in the older age group, suggesting lower utilization of dental health services by the elderly. The finding that the mean RDFS scores of the middle aged adults were associated with educational level supports the view that education is a strong indicator of caries experience.
Comparisons of the root caries findings with those of other studies should be done with caution, since there is a great variation of results in the literature. This discrepancy may be due to differences in geographic location, population characteristics, diagnostic criteria and sampling procedures. It may also be attributed to the fact that root caries experience depends greatly on the number of retained teeth as well as on the number of exposed root surfaces that differ in the various studies. However, it seems that root caries experience in the subjects of the present study was similar or lower to that estimated for populations of most other countries [27
]. But contrary to some of these studies [28
], untreated caries on root surfaces (RDS) accounted for the major part of the mean root caries experience (RDFS).