In high‐income countries, the oral health of the population is influenced by public health interventions, widespread use of oral care products, dental practice measures, and the cost of dental treatment. We compiled information on changes of the prevalence of proximal and upstream determinants of periodontitis, caries, and tooth loss over the last three decades to outline their potential effects on changes of oral health during this period. Information was retrieved from repeated cross‐sectional studies and from published literature. While both the prevalence of edentulism and the number of missing teeth (from the DMF‐T index) decreased, the number of sound teeth as well as the total number of teeth increased. The prevalence of severe periodontitis was unchanged, whereas the prevalence of periodontal health and moderate periodontitis may have increased to a minor extent. Concerning oral health risk factors, the proportion of individuals with tertiary education increased, while smoking prevalence declined. More and more people used oral care products. Whether one reimbursement system worked better than another one in terms of tooth retention could not be elucidated. In tooth retention, population‐wide use of fluoridated toothpastes had the greatest impact. To some extent, the higher number of teeth present may be related to the more frequent use of interdental cleaning aids and powered toothbrushes. Since there was no decrease in severe periodontitis in most cohorts, periodontal interventions probably contributed little to improved tooth retention.

中文翻译：

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公共卫生和以患者为中心的预防策略对高收入国家牙齿脱落原因牙周炎和龋齿的影响


在高收入国家，人口的口腔健康受到公共卫生干预措施、口腔护理产品的广泛使用、牙科实践措施和牙科治疗费用的影响。我们汇编了过去三十年来牙周炎、龋齿和牙齿脱落的近端和上游决定因素患病率变化的信息，以概述它们对这一时期口腔健康变化的潜在影响。信息是从重复的横断面研究和已发表的文献中检索的。虽然无牙颌的患病率和缺失牙齿的数量（来自 DMF-T 指数）均有所下降，但健康牙齿的数量以及牙齿总数却有所增加。重度牙周炎的患病率没有变化，而牙周健康和中度牙周炎的患病率可能略有增加。在口腔健康危险因素方面，受过高等教育的人比例有所增加，而吸烟率则有所下降。越来越多的人使用口腔护理产品。无法阐明一种报销制度在牙齿保留方面是否比另一种制度效果更好。在牙齿保留方面，氟化牙膏的广泛使用影响最大。在某种程度上，牙齿数量较多可能与更频繁地使用齿间清洁工具和电动牙刷有关。由于大多数队列中严重牙周炎的发生率没有减少，牙周干预可能对改善牙齿固位几乎没有贡献。