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Dental Caries
The prevalence of dental caries in permanent teeth is approximately 50% in 12- to 15-year-olds and 78% in 17-year-olds. The pit and fissure surfaces of the molars are the most common site of caries.

The dynamic caries balance continues throughout adolescence, and the same factors that influence caries risk in children still exist in adolescence. Health care providers should be mindful of the following risk factors
for caries:

Inadequate access to fluoride (especially topical fluoride)
Poor oral hygiene
Frequent access to sugars (ie, snacking or drinking) and acids
(eg, soda and sour candy)
Previous caries experience
Reduced salivary flow
Special health care needs
Infrequent professional dental care

Risk factors that may first be noted in the adolescent include eating disorders (see Chapter 12: Systemic Diseases) and orthodontic appliances that make performing oral hygiene more difficult.
Nearly 80% of 17-year-olds have had at least one cavity in their lifetime.
Frequent snacking and regular exposure to acidic drinks such as soda are common risks for caries in adolescents.
A review of oral hygiene practices, diet, and fluoride intake is important at all routine visits.
Fluoride supplementation should continue until age 16 for all eligible children.
View the Chapter 13 Photo Gallery.