Do you use toothpaste that contains fluoride?                                 if no add      12 pts
	Do you drink beverages that contain sugar more than 3xd?              if yes add     12 pts
	Have you had more than two cavities in the last 3 years?                if yes add     14 pts
	Do you snack on candy or other sugary food more than 2xd?          if yes add     12 pts
	Have you lost a tooth in the last 3 years due to decay?                    if yes add     12 pts
	Do you brush your teeth LESS THAN twice a day?                       if yes add       8 pts
	Does the water you drink and cook with contain fluoride?               if no add        8 pts
	Do you have your teeth professional cleaned at least once a year?    if no add       7 pts
	Do you take medicine that makes your mouth dry?                         if yes add      7 pts
	Do you clean between your teeth with dental floss 1xd?                  if no add        6 pts
	Is it uncomfortable to brush areas where you gums have receded?   if yes add      4 pts
	Now, Total up your points: _______________________

Adults are at risk for dental caries for many reasons. These include:

	The average American consumes 20 teaspoons of sugar per day.
	Aging restorations (50%) of fillings on adults are to replace old fillings.
	Root exposure due to recession (root caries progresses 2 1/2 times faster than enamel caries).
	Adults are living longer and have more physical and medical problems which reduce their ability to remove
	Adults take medications and have health problems which compromise their beneficial salivary production.
	58% are not supplied with fluoridated water or choose to drink bottled/filtered water.
	Many adults smoke, drink alcohol, have acid reflux disorder, undergo cancer therapy, or have orthodontic/prosthetic appliances.  www.oralb.com
	The enamel is stronger because of the Fluoride but once the decay gets through........the under belly of the tooth is still quite weak and the decay goes crazy. There are two groups with rampant decay:  One is the elderly and infirmed who have had good dental care over many years.  Second is where the environmental effect of minimal dental care, insufficient fluoride and excessive exposure to sugar. Age, health status and medications seem to create most problems with the former in terms of rampant decay.  There are so many medications being prescribed; most effect salivary production to a small degree.  The combination of numerous drugs reducing the amount and protection of saliva is the greatest contributor to rampant decay. Association between Dental Caries Activity and Coronary  Heart Disease Severity        The link between dental diseases and a wide range of systemic  medical conditions has recently acquired increased attention. Periodontal disease, in particular, has been implicated as a marker of cardiac disease. Dental caries, the most common oral infection,  should be considered as a potential risk factor for all systemic  diseases. Few studies have investigated this association. To investigate the potential relationship between dental caries  activity, dental plaque levels and presence of mutans streptococci (Ms) in saliva (independent variables) and coronary  heart disease (CHD) severity (dependent variable). Methods: 219 cardiac patients in a hospital cardiac clinic were included. Dental  caries activity was evaluated by the "D" or "untreated" component of the DMFT index , dental plaque was measured according to the Turesky  index, and the number (CFU\ml) of salivary Ms were measured on MSB-agar. CHD severity was assessed according to extent of vessel  blockage; function and size of left ventricle According to results of LV-Gram catheterization; Stress tests were categorized by physiological symptoms of CHD; previous hospitalization (due to CHD) was recorded. Results: Previously hospitalized patients due to CHD had 3.03 untreated carious teeth as compared with 1.84 among patients not previously hospitalized (Mann-Whitney,p=0.032). Levels of MS were lowest among patients who had no coronary blockage: 11.63 million CFU\ml, as compared to patients with single, double, or triple vessel blockage: 12.97,30.64, 21.11 million CFU\ml respectively (ANOVA, p=0.031). Plaque index levels were lowest among patients with no coronary blockage (2.80) as compared with patients with single, double or triple vessel blockage: 3.56, 3.31, 3.54 respectively (ANOVA, p=0.049). Conclusions: These data consistently indicate a potential association between dental caries activity and CHD severity and emphasize the role of preventive dentistry in the promotion of general health. H.D. SGAN-COHEN1, M.N. SELA1, M. ANGIE1, and M. MOSSERI2, 1Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel, 2Hebrew University - Hadassah School of Medicine, Jerusalem, Israel Seq #56 - Epidemiology10:45 AM-12:45 PM, Thursday, 10 March 2005 Baltimore Convention Center 331

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