Since then, significant reductions in the prevalence of dental caries have occurred in Canada, and we have new understanding of its epidemiology, diagnosis, risk factors and prevention. Despite this improving picture and the accrued benefits of past, largely fluoride-related preventive efforts, dental caries remains a large problem for a significant proportion of the population, a potentially increasing problem for an aging population retaining more teeth and, surprisingly, in view of the overall decreased caries prevalence, a growing major cost problem for Canadians and those who insure their dental care. The demineralization is caused by acids produced by bacteria, particularly mutans Streptococci and possibly lactobacilli, that ferment dietary carbohydrates. This occurs within a bacteria-laden gelatinous material called dental plaque that adheres to tooth surfaces and becomes colonized by bacteria.
Prevalence begins soon after tooth eruption in susceptible children and increases with age.
Thus, it is no surprise to find that the posterior molar and premolar teeth that have pit and fissure surfaces are more susceptible than the anterior teeth. This change has been well documented for children and adolescents. There has also been a shift in the types of surfaces displaying decay or fillings. While it is believed that the marked improvement in dental caries status and greater tooth retention experienced by children will eventually be evident in adults, a long transition period of about 40 years will be required before improvement is evident in all adult age groups. Longer tooth retention and aging of the population have combined to increase interest in root caries.