Salmon gill poxvirus disease in Atlantic salmon fry as recognized by improved immunohistochemistry also demonstrates infected cells in non-respiratory epithelial cells.

Gill diseases cause serious losses in farming of Atlantic salmon and the number of agents involved increases. Salmon gill poxvirus (SGPV) and the gill disease in causes where SGPV apparently was the only disease-causing agent were initially characterized. Recently, it was further shown that SGPV can be a common denominator in widely different multifactorial gill diseases. Here, we present the challenge of diagnosing gill disease with SGPV in salmon fry of 0,3-5 grams. Apoptosis of gill lamellar epithelial cells and hemophagocytosis was also observed in fry similar to findings in smolts and grow-out fish. Using our newly developed immunohistochemistry method, we further demonstrate that some of the apoptotic epithelial cells covering the oral cavity were positive for SGPV. Thus, SGPV is not restricted to respiratory epithelium alone and may infect the fish at very early life stages. Furthermore, as the cases examined here are from Norway, Faroe Island and Scotland, we show that SGPV is more widespread than previously reported.

Recall intervals and time used for examination and prevention by dentists in child dental care in Denmark, Iceland, Norway and Sweden in 1996 and 2014.

OBJECTIVE: The purpose of the present study was to explore intervals between regular dental examination and the time dentists spent for examination and preventive dental care of children in 1996 and 2014. PARTICIPANTS AND METHODS: In Denmark, Norway and Sweden, random samples of dentists working with children were included, while in Iceland all dentists were mailed questionnaires. Complete information was provided by 1082 of 1834 dentists (64%) in 1996 and 1366 of 2334 dentists (59%) in 2014. Results were assessed using chi-square and analysis of variance with post-hoc tests. RESULTS: Some trends were consistent in all countries, but considerable differences in routines between the countries persisted during the period. The most used and maximum planned recall intervals were on average 14.8 (sd 4.8) and 18.5 (sd 4.6) months in 2014, respectively 3.1 and 3.5 months longer than in 1996 (p⟨0.05). In 2014 dentists used ample time delivering preventive care to children. Dentists reported spending significantly more time providing preventive care for caries risk children than for other children both in 1996 and 2014. Concurrent with extended intervals, dentists reported spending longer performing routine examinations in three of the four countries in 2014 than in 1996. CONCLUSIONS: This study of trends in dental care delivered by dentists during recent decades showed moves towards extended recall intervals and preventive care individualized according to caries risk. In addition, extending intervals could necessitate more time for a routine dental examination.

Fluoride and Oral Health.

The discovery during the first half of the 20th century of the link between natural fluoride, adjusted fluoride levels in drinking water and reduced dental caries prevalence proved to be a stimulus for worldwide on-going research into the role of fluoride in improving oral health. Epidemiological studies of fluoridation programmes have confirmed their safety and their effectiveness in controlling dental caries. Major advances in our knowledge of how fluoride impacts the caries process have led to the development, assessment of effectiveness and promotion of other fluoride vehicles including salt, milk, tablets, toothpaste, gels and varnishes. In 1993, the World Health Organization convened an Expert Committee to provide authoritative information on the role of fluorides in the promotion of oral health throughout the world (WHO TRS 846, 1994). This present publication is a revision of the original 1994 document, again using the expertise of researchers from the extensive fields of knowledge required to successfully implement complex interventions such as the use of fluorides to improve dental and oral health. Financial support for research into the development of these new fluoride strategies has come from many sources including government health departments as well as international and national grant agencies. In addition, the unique role which industry has played in the development, formulation, assessment of effectiveness and promotion of the various fluoride vehicles and strategies is noteworthy. This updated version of 'Fluoride and Oral Health' has adopted an evidence-based approach to its commentary on the different fluoride vehicles and strategies and also to its recommendations. In this regard, full account is taken of the many recent systematic reviews published in peer reviewed literature.

Long-term evaluation of the clinical effectiveness of community milk fluoridation in Bulgaria.

OBJECTIVE: To determine the clinical effectiveness of a community milk fluoridation programme. BASIC RESEARCH DESIGN: Parallel arm 5-year cohort study, with final cross-sectional comparisons between groups. PARTICIPANTS: 3-year-olds in 8 Bulgarian cities/towns entered the cohort study with random samples (n = 1,782) recruited at baseline in 2004. After 5 years in 2009 sub-samples (about 30%) of these now aged 8 were randomly selected in intervention sites for follow-up examination (n = 454); 276 controls were examined at the age 8 years. For cross-sectional comparisons, in 2004, 284 3-year-olds from control cities were baseline examined for caries, then 276 children at the age 8 years in 2009. INTERVENTIONS: In six intervention communities: 1,498 examined children received 0.5 mg F in 100 or 200 ml school milk or yogurt provided each school day; a further 180 received non-fluoridated milk. In two control communities, fluoride was not added to 284 children's school milk. MAIN OUTCOME MEASURES: Dental caries experience of primary, and permanent teeth. RESULTS: For primary teeth, caries increments were 46% (p < 0.001) and 30% (p < 0.01) lower in the fluoridated milk groups compared with non-fluoridated milk groups in the intervention and control communities, respectively. For permanent teeth those reductions were 61% and 53% (p < 0.001). The cross-sectional comparisons of 8-year-olds showed significant changes in dental caries experience over time; in children consuming fluoridated milk the level of dmfs fell by 43% (2004 and 2009) against 11% in the control group. Among children consuming fluoridated milk the DMFS fell 68% against rising 3% in the controls. CONCLUSIONS: Fluoridated milk delivered daily in schools in Bulgaria resulted in substantially lower caries development compared with children in schools receiving milk without added fluoride. The nation-wide experiences from milk fluoridation indicate that such a public health scheme can be effective to the global fight against dental caries of children.

School-based intervention for improving the oral health of children in southern Thailand.

OBJECTIVE: A two-year study assessed the benefit of an enhanced oral health promotion program combined with a closely supervised tooth brushing program in schools, using toothpaste containing 1,450 ppm F- and 1.5% arginine, on oral health and dental caries. METHODS: 15 southern Thailand schools and 3,706 pre-school children were recruited: 8 schools with 1,766 children as controls; 7 schools with 1,940 children in the intervention groups. Of the intervention schools five were classified as cooperative school and two as non-cooperative schools, based on the criteria of 80% participation in the prescribed tooth brushing activities. RESULTS: The DMFT and DMFS increments ("enamel and dentine") were 1.19 and 1.91 for the control group and 1.04 and 1.59 for the intervention groups. These represent 12.6% and 16.8% reductions in caries respectively. The DMFT and DMFS increments ("dentine threshold") were 0.26 and 0.44 for the control group and 0.19 and 0.29 for the intervention group, representing 26.9%, and 34.1% reductions in caries incidence respectively. For the more cooperative schools the benefits were greater: up to a 40.9% reduction in caries for DMFS ("dentine threshold"). At the 24 month examination there were significant improvements in dental plaque scores with greater improvements seen in the intervention group, greater still in the cooperative schools. CONCLUSIONS: This study documents the positive effect from use of fluoridated toothpaste (1,450 ppm F- and 1.5% arginine) administered by schoolteachers and undertaken via an enhanced school oral health program. Optimising oral health interventions for young children in Thai schools may have a significant impact on caries incidence resulting in reductions of up to 34% reductions in caries for all schools included in the study and up to 41% for the most cooperative.

Promoting oral health of children through schools--results from a WHO global survey 2012.

This paper reviews the range of school-based approaches to oral health and describes what is meant by a Health Promoting School. The paper then reports the results of a World Health Organization global survey of school-based health promotion. Purposive sampling across 100 countries produced 108 evaluations of school oral health projects spread across 61 countries around the globe. The Ottawa Charter for Health Promotion noted that schools can provide a supportive environment for promoting children's health. However, while a number of well-known strategies are being applied, the full range of health promoting actions is not being used globally. A greater emphasis on integrated health promotion is advised in place of narrower, disease- or project-specific approaches. Recommendations are made for improving this situation, for further research and for specifying an operational framework for sharing experiences and research.

The challenge for innovation in direct restorative materials.

During the past 50 years, a series of key UN conferences have established a framework to minimize human health risks from environmental exposures to key chemicals. In January 2013, more than 140 countries agreed to the text of new treaty to minimize Hg effects on the environment (the Minamata Convention). Dental caries is omnipresent around the globe, affecting 60% to 90% of school children and most adults, and producing discomfort that affects quality of life. Dental amalgam is frequently used to treat carious lesions and its use releases mercury into the environment. The best way to avoid the use of dental amalgam is to emphasize caries prevention. Alternatives to amalgam are suitable in some applications, but no replacement for amalgam has been found for large posterior restorations. For any restorative material, safety and environmental impacts are part of clinical risk assessment. Safety is freedom from unacceptable risks. Risk is a combination of probability of exposure and severity of harm. Best management practices are crucial to manage dental amalgam, but these impose additional that are disproportionately more for developing countries. The Minamata Convention seeks a phase-out of all mercury-based products except dental amalgam, where a phase-down is the present goal. For dentistry, the most important focus is the promotion of caries prevention and research on new materials.

Clinical evaluation of three caries removal approaches in primary teeth: a randomised controlled trial.

OBJECTIVE: To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques. BASIC RESEARCH DESIGN: Randomised clinical controlled trial. CLINICAL SETTING: Two standard dental clinics in 2 hospitals near Bangkok. PARTICIPANTS: A total of 276 children, aged 6-11, having dentinal caries on the occlusal and/or proximal surface extending at least one-third of dentine without signs and/or symptoms of irreversible pulpitis. INTERVENTION: Children were randomly allocated into 3 study groups with different caries removal techniques: Group 1, partial soft caries removal at enamel-dentine junction (EDJ) by spoon excavation; Group 2, complete soft caries removal by spoon excavation; and Group 3, conventional caries removal by steel burs. All cavity preparations were restored with GIC (Fuji IX, GC Corp., Japan). MAIN OUTCOME MEASURES: Clinical and radiographic evaluations were carried out at 6 and 12 months after restoration. RESULTS: After 12 months, 89, 89, and 88 restorations in Groups 1, 2 and 3 were evaluated. The cumulative survival rates of GIC restorations in Groups 1, 2 and 3 were 83%, 83%, and 89% while the cumulative survival rates of pulp were 99%, 100% and 98% respectively. There were no statistically significant differences in the survival of GIC restorations or pulp in the three groups (p > 0.05). CONCLUSION: The clinical and radiographic evaluations after 12 months indicated that partial soft caries removal at EDJ followed by GIC restoration was comparable to that of ART and conventional approaches.

Community-oriented administration of fluoride for the prevention of dental caries: a summary of the current situation in Asia.

Dental caries is the most prevalent chronic disease affecting human populations around the world. It is recognized that fluoride plays a significant role in dental caries reduction. Meanwhile, several low- and middle-income countries of Asia have not yet implemented systematic fluoride programs; contributing factors relate to misconceptions about the mechanisms of fluoride, low priority given to oral health in national health policy and strategic plans, and lack of interest among public health administrators. A workshop on the effective use of fluoride in Asia took place in Phang-Nga, Thailand, in 2011. A series of country presentations addressed some of the topics mentioned above; in addition, speakers from countries of the region provided examples of successful fluoride interventions and discussed program limitations, barriers encountered, and solutions, as well as possibilities for expanding coverage. Participants acknowledged that automatic fluoridation through water, salt, and milk is the most effective and equitable strategy for the prevention of dental caries. Concerns were expressed that government-subsidized community fluoride prevention programs may face privatization. In addition, the use of affordable fluoride-containing toothpastes should be encouraged. The workshop identified: strengths and weaknesses of ongoing community-based fluoride programs, as well as the interest of countries in a particular method; the requirement for World Health Organization (WHO) technical assistance on various aspects, including fluoridation process, feasibility studies, and implementation of effective epidemiological surveillance of the program; exchange of information; and the need for inter-country collaboration. It was acknowledged that program process and evaluation at the local and country levels need further dissemination. The meeting was co-sponsored by the World Health Organization, the International Association for Dental Research, and the World Dental Federation.

Oral health behaviour of urban and semi-urban schoolchildren in the Lao PDR.

OBJECTIVE: To describe the oral health related knowledge, behaviour, and attitude towards health of 12-year old Lao schoolchildren; analyse how health risk factors relate to socio-demographic background; and determine the relative effect of living conditions on health and risk behaviour. METHODS: Cross sectional study of 12-year old schoolchildren chosen by multistage sampling to fit the objective of the study. The final sample comprised 621 children of 2nd grade of secondary schools in Vientiane, Lao Peoples Democratic Republic. Data were collected by structured questionnaire covering behaviour, attitudes and knowledge related to oral and general health and perception of own health. RESULTS: 69% of the children reported toothache during the previous 12 months and 38% reported school absenteeism due to toothache. Nevertheless, 77% stated frequent brushing and 91% the use of fluoridated toothpaste. Only 29% reported dental visits for this period while 42% had never seen a dentist. Fear of pain, cost and distance were stated as barriers for dental visits. Knowledge on caries prevention was high, aetiology of oral disease less known, and intake of hidden sugar surprisingly frequent. Socio-economic position and attitude towards health were important predictors for oral health behaviour and risk behaviour. CONCLUSIONS: Despite regular tooth brushing practice and widespread use of fluoridated toothpaste school absenteeism due to toothache is high. Significant socio-demographic gradient exists in risk factors for oral health. To reduce oral health inequality systematic oral health promotion should be implemented through the existing school health platform strengthening healthy behaviour and focussing on risk factors for oral as well as general health.

[Family environment and dental health disparities among urban children in Burkina Faso]. / Environnement familial et disparités de santé dentaire des enfants en milieu urbain au Burkina Faso.

BACKGROUND: Dental caries is the most common multifactorial disease in children and has substantial negative impact on daily life. In sub-Saharan Africa, few data are available on the relationship between dental caries and the social and family environment of children. The objectives of the present study were firstly to assess the level of prevalence and severity of dental caries of children in Ouagadougou, the capital city of Burkina Faso and secondly to determine whether or not individual factors, family and living conditions are linked with dental health disparities within the population. METHODS: Interview and clinical data were obtained from a household-based cross-sectional survey. A two-stage stratified sampling technique was applied in four areas of Ouagadougou representing different stages of urbanization. RESULTS: The final study population included 1606 children aged 6-12 years. For the overall group the total caries prevalence rate was 48.2%. Results showed that the dental health status of the mother, social integration of the householder and socioeconomic level of the household were associated with the dental health of children. Disparities in dental health were prominent; poor dental health was relatively frequent in children from households poorly integrated into social networks with rather acceptable standard in terms of material wealth. CONCLUSION: Our study showed that individual factors as well as family-related and environmental factors had an influence on their caries experience. The rapidly changing lifestyle affects oral health and the burden of oral diseases is expected to increase initially in people of upper classes and later in disadvantaged people. Disease prevention focussing on common risk factors of chronic diseases should be enhanced. In addition, the accessibility of quality fluoride products (e.g. toothpaste, salt, water) should be facilitated as soon as possible.

Global oral health inequalities: task group--implementation and delivery of oral health strategies.

This paper reviews the shortcomings of present approaches to reduce oral diseases and inequalities, details the importance of social determinants, and links that to research needs and policies on implementation of strategies to reduce oral health inequalities. Inequalities in health are not narrowing. Attention is therefore being directed at determinants of major health conditions and the extent to which those common determinants vary within, between, and among groups, because if inequalities in health vary across groups, then so must underlying causes. Tackling inequalities in health requires strategies tailored to determinants and needs of each group along the social gradient. Approaches focusing mainly on downstream lifestyle and behavioral factors have limited success in reducing health inequalities. They fail to address social determinants, for changing people's behaviors requires changing their environment. There is a dearth of oral health research on social determinants that cause health-compromising behaviors and on risk factors common to some chronic diseases. The gap between what is known and implemented by other health disciplines and the dental fraternity needs addressing. To re-orient oral health research, practice, and policy toward a 'social determinants' model, a closer collaboration between and integration of dental and general health research is needed. Here, we suggest a research agenda that should lead to reductions in global inequalities in oral health.

Oral health in children in Denmark under different public dental health care schemes.

PURPOSE: To describe and analyse oral health of children and adolescents under two types of dental health care schemes under the Public Dental Health Service in Denmark, and to analyse possible influence of socio-economic and socio-cultural factors. METHODS: Data on children's oral health status was obtained from public oral health registers and were pooled with data from questionnaires sent to parents of the children and adolescents. The study comprised individuals aged 5, 12 and 15, in total 2168 persons, randomly drawn from four municipalities with dental care provided by salaried dentists in public dental clinics and three municipalities with dental care provided by dentists in private practice. 70% of the parents completed a questionnaire including questions on socio-economic and socio-cultural background, lifestyle-related factors, self assessment of parents' oral- and general health. After the data were merged, the final study population represented 60% of the original target population. RESULTS: The mean caries experience (DMFS+dmfs) was 2.2 and further analysis of caries experience in each age group showed no variations in relation to type of provider of dental care. However, multiple dummy regression analyses demonstrated that low education, poor general health, foreign citizenship and smoking habits of the parents were important determinants for high level of caries in their children. CONCLUSION: Occurrence of dental caries as well as changes over time in levels of dental caries of Danish children did not vary by scheme of Public Dental Health Service, i.e. whether dental health care was provided by public employed dentists or by private practitioners. However, social inequalities still relate to caries experience in children and adolescents. Adjustment of preventive oral health activities strategy seems to be needed.

Global oral health of older people--call for public health action.

BACKGROUND: The aim of this report is (1) to provide a global overview of oral health conditions in older people, use of oral health services, and self care practices; (2) to explore what types of oral health services are available to older people, and (3) to identify some major barriers to and opportunities for the establishment of oral health services and health promotion programmes. METHODS: A postal questionnaire designed by the World Health Organization (WHO) was distributed worldwide to the Chief Dental Officers or country oral health focal points at ministries of health. WHO received 46 questionnaires from countries (39% response rate). In addition, systematic data were collected from the WHO Global Oral Health Data Bank and the World Health Survey in order to include oral health information on the remaining countries. In total, the data base covers 136 out 193 countries, i.e., 71% of all WHO Member States. RESULTS: Dental caries and periodontal disease comprise a considerable public health problem in the majority of countries. Significant disparities within and between regions are observed in epidemiologic indicators of oral disease. The prevalence rates of tooth loss and experience of oral problems vary substantially by WHO Region and national income. Experience of oral problems among older people is high in low income countries; meanwhile, access to health care is poor, in particular in rural areas. Although tooth brushing is the most popular oral hygiene practice across the world, regular tooth brushing appears less common among older people than the population at large. In particular, this practice is less frequent in low income countries; in contrast, traditional oral self-care is prevalent in several countries of Africa and Asia. While fluoridated toothpaste is widely used in developed countries, it is extremely infrequent in most developing countries. Oral health services are available in developed countries; however, the use of such services is low among the older people. Lack of financial support from government and/or lack of third party payment systems render oral health services unaffordable to them. According to the country reports, health promotion programmes targeting older people are rare and this reflects the lack of oral health policies. Although some countries have introduced oral health promotion initiatives, worldwide there are few population-oriented preventive or curative activities currently implemented that focus specifically on the elderly. Barriers to the organization of such programmes relate to weak national health policy, lack of economic resources, the impact of poor oral health, and lack of tradition in oral health. Opportunities for oral health programmes for old-age people are related to updated information on the burden of oral disease and need for care, fair financing of age-friendly primary health care, integration of oral health into national health programmes, availability of oral health services, and ancillary personnel. CONCLUSION: It is highly recommended that countries establish oral health programmes to meet the needs of the elderly. Relevant and measurable goals must be defined to direct the selection of suitable interventions to improve their oral health. The common risk factors approach must be applied in public health interventions for disease prevention. The integration of oral health into national general health programmes may be effective to improve the oral health status and quality of life of this population group.

Oral manifestations among people living with HIV/AIDS in Tanzania.

BACKGROUND: This study aimed to determine the prevalence of various oral and peri-oral manifestations in people living with HIV/AIDS in Tanzania. METHODS: A cross sectional study. A total of 187 persons with HIV infection were recruited from non-governmental organisations serving people living with HIV/AIDS, 16.6% were males and females 83.4%. Information on weight and height, as well as extra oral and intra oral examinations for different manifestations were gathered. Treatment and referral for special care were offered. RESULTS: At least one oral lesion was present in 45% of the participants. Candidiasis (28.9%) and non-tender lymphadenopathy (11.8%) were the most common lesions. Candidiasis occurred most frequently on lips/mucosa, and the tongue, and pseudomembranous candidiasis was the most frequent type. Candidiasis occurred with several other conditions and was statistically significantly associated with low body mass index (BMI). CONCLUSION: This community survey carried out in an African sub-Saharan country showed that oral lesions are frequent among people living with HIV/AIDS. As emphasised by the World Health Organization Global Oral Health Programme, national HIV/AIDS programmes should incorporate oral health components.

Effective use of fluorides in the People's Republic of China--a model for WHO Mega Country initiatives.

Poor dental health has been reported in the Chinese National Surveys of Oral Health. With the changing lifestyle and growing consumption of sugars, the incidence of dental caries may well continue to rise, compounded by limited access to professional care. The increasing oral disease burden could become a major public health problem in China, leading to considerable personal and health service costs. There is a desperate need for systematic implementation of preventive programmes. Currently, China is strengthening the prevention of chronic diseases, which provides an excellent opportunity to integrate oral disease prevention into the overall non-communicable disease (NCD) prevention programmes. In order to address this growing public health problem, the World Health Organization (WHO) Global Oral Health Programme advocates the effective use of fluoride as an essential approach to prevent dental caries in the 21st century--part of the WHO Global Oral Health Strategy. Population-wide automatic fluoridation measures are considered the most effective, complemented by appropriate use of toothpastes containing fluoride. There are wide variations of fluoride levels in drinking water in China and, in many areas, the levels of fluoride in drinking water are lower than the recommended levels. The use of toothpaste containing fluoride is still too low in some areas and decreases with age. Those who live in rural areas have limited access to affordable toothpastes containing fluoride. In March 2006, as part of the WHO Mega Country Health Promotion Network initiatives, the WHO Global Oral Health Programme organised a three-day symposium in Beijing, People's Republic of China. The aim of the symposium was to bring together international experience and Chinese expertise to facilitate policy development for effective use of fluoride in China, highlighting the benefits of, and barriers to, the implementation of different fluoridation programmes at the strategic levels as well as for operational planning. This article reports the proceedings of the meeting. In summary, China is a Mega country with much diversity and disparity. The situation in China is unique with endemic fluorosis due to other non-water sources of fluoride in some areas and a considerable dental caries burden in others. It is important to regulate the appropriate exposure to fluoride to obtain the benefits and avoid adverse effects of fluorides, controlling enamel fluorosis without jeopardising the prevention of dental caries. Various complementary fluoridation programmes can be considered for different population groups with varying needs, strategies that bring about additive effects. A multi-tier policy making approach at national, regional and provincial levels can be employed, based on sound evidence. The roles of WHO, Ministry of Health and the National Committee for Oral Health (NCOH) were emphasised. Lessons learned from the Chinese experience will prove invaluable to other countries with similar socio demographic characteristics that are in the same process of developing and implementing fluoridation policies and programmes.

Caries prevalence and need for dental care in 13-18-year-olds in the Municipality of Milan, Italy.

OBJECTIVE: To assess the relationship between caries prevalence and toothbrushing and dietary habits in adolescents in the city of Milan (Italy). RESEARCH DESIGN: The study consisted of a cross-sectional survey using clustering samples. DMFT was recorded following the WHO guidelines by three calibrated examiners. A dental health questionnaire was completed by the subjects to assess their toothbrushing and oral hygiene habits. Univariate and multivariate analysis were performed. PARTICIPANTS: A sample of 1,333 students (age-range 13-18 years, 648 males and 685 females) was studied. The students came from three secondary schools located in different socio-economic and cultural areas of the city. RESULTS: Caries experience (DMFT>0) was 59.11%. A significant linear trend (p<0.01) was observed for DT>0 among the three different schools selected. The mean DMFT was 1.94 +/- 2.46 and difference observed in DT, FT and DMFT among the three schools was statistically significant (p<0.05). Eating snacks more than once a day provided a significantly higher odds ratio for DMFT>0 and for DT>0 (OR=5.24, p<0.001 and OR= 1.46, p=0.01 respectively). CONCLUSIONS: A significant trend between caries experience and socioeconomic status was observed: adolescents, attending school in a low-socio-economic areas, showed higher caries prevalence and higher levels of untreated caries than their counterparts attending schools located in medium-high socio-economic areas.

Dental caries prevalence among adults in Denmark--the impact of socio-demographic factors and use of oral health services.

OBJECTIVES: To measure the prevalence of dental caries in the Danish adult population and to analyse how the risk of dental caries is affected by age, gender, region, area, and socio-economic factors. Furthermore to assess the impact on dental caries experience of use of oral health services during childhood and adult life. BASIC RESEARCH DESIGN ANDPARTICIPANTS: A cross-sectional study of a random sample of 1,115 Danish adults in ages 35-44 years and 65-74 years. Data were collected by means of personal interviews and by clinical examinations according to criteria of the World Health Organization. Dental caries was recorded at tooth and tooth surface levels. RESULTS: At age 35-44 years the mean caries experience was 46.6 DMF-S against a mean of 104.1 DMF-S in the total sample of 65-74-year-olds. The D-component was low (35-44 years D-S = 0.9; 65-74 years D-S = 1.5). The M-component was three times higher in the elderly than in the younger age group. The multivariate analysis showed that significantly more untreated decay was found among men, in rural areas and in low income groups. A significantly higher score of filled surfaces were found among older adults and in the group with more education (12-13 years) whereas the F-component was low in the low income group. The total DMF-S was significantly higher among the elderly, persons living in Jutland and in groups with less education, while men had low DMF-S compared to women. CONCLUSION: Reducing social inequality in dental caries experience remains a challenge to oral health services in Denmark; strengthening community-oriented oral disease prevention and health promotion is needed to improve the oral health in the Danish adult population.