In his article on “Progress in th .

Hpidemiology ot’ 1kntal ( ‘arics,“ James

M. Dunning summarizes the subject a* follows:
“In a practical sense, dental caries is a multifactorial disease. 12 deliMe
balance of factors determines whether or not, disease will occur. This bala.nce
can often be manipulated to prevent dentul caries, even if the actual mechanism
or agent of the disease is not fully understood.
Multifactorial disease is best studied in groups of potentially susceptible
individuals, and epidemiology is the method of choice. There are four main
elements in the strat,egy of epidemiology. E’irst, data must be collected. Second,
hypotheses must be constructed. Third, observational studies must be conducted.
Finally, experiments or trials are necessary for clear proof of causation, or for
demonstration of the practicality of a preventive measure.”
Factors which influence dent,al caries are easily categorized into those related
to the host, those related to an agent, or those related to environment. Common
host factors are national or ethnic group, age, sex, familial heredity, emotional
disturbance, and nutrition. The “agent” of caries is perhaps best designated as
acid of bacterial origin, Two areas of environment may be considered-( 1) the
oral environment, which affects the external surfaces of the teeth, and (2)
the external environment, which affects the whole person. Local action of food-
stuffs and oral hygiene measures, with or without chemical protective agents,
provide the researchable questions for epidemiologic study in the oral environ-
ment. The external environmental factors are most easily grouped under
geographical, nutritional, and social headings. Geographically, the most severe
dental caries is seen nearer the poles and near the sea coast. Factors responsible
for these phenomena may include temperature, sunshine, relative humidity, and
distribution of natural fluoride in the water supply. Many nutritional factors
have been studied; among those that are known to be related t,o caries, fluoride
and carbohydrate most often dominate the scene. Major soil types may also
correlate with caries, but evidence is scanty. Social factors include economic
status (of importance only among very young children) and war.
In observational studies of caries, it is helpful t,o remember that severity
of disease determines the choice of measure to be used. J. -4. S.

A Method for Epidemiological Registration of Malocclusion

By A. Bjiirk, An. Krebs, and B. Solow. Acta odont. scandinav. 22: 27-41,
February, 1964.
The registration of malocclusions is divided into three parts:
A. Anomalies in the dentition (tooth anomalies, abnormal eruption,
and misalignment of individual teeth)
B. Occlusal anomalies (deviations in the positional relationship be-
tween the upper and lower dental arches)
C. Deviations in space conditions (spacing or crowding of teeth)
An indication of the need for orthodontic treatment is included in the
registration. This item cannot be recorded objectively in the same way as that
of the malocclusions, however, but must be based on an individual estimate.
-Volume 52 Reviews and abstracts 307
Number 4

Definitions of the various malocclusions and of the need for treatment used
in the registration procedure have been worked out on the basis of three pilot
studies, each on 100 children, and modified in the light of experience derived
from these studies. In order to evaluate the systematic errors of registration, the
examinations in one of these studies were performed by three dentists. In an-
other study the examinations were performed twice by the same dentist to
determine the random error of registration.
The occlusion is recorded. Incisal occlusion is judged from the most prom-
inent central incisor. Sagittal molar occlusion is evaluated with respect to the
mesial contact points of the upper and lower first permanent molars. Before
full eruption of the first permanent molars, the molar occlusion is determined
from the distal surfaces of the second deciduous molars. The position of the
third molars is disregarded in the registration of vertical and transversal
occlusion.
An account is given of a method for epidemiological investigation of the
prevalence of malocclusions. The method consists of a systematic registration of
carefully defined individual symptoms. The registration of some of the symptoms
is facilitated by using a specially designed instrument. The need for treatment
is also investigated, but this registration is subjective.
The study has been designed with a view to electronic analysis of the data.

The Bony Nasopharynx; a Roentgen-Craniometric Study

By Olav Bergland. Acta odont. scandinav. 21: Xupp. 35, 1963.

This article describes a study of the skeletal limitations of the nasopharynx

as a part of the cranium. The aim of the study was to investigate (I) variations
in the shape and size of this part of the skull and (2) its covariations with
cranial features which may influence the morphology of this region, primarily
the sagittal shape of the cranial base and the angles of the upper face.
The investigation comprised : (1) intragroup variations; (2) population
differences; (3) age changes (after about 6 years of age) ; (4) sex differences;
and (5) correlations.
Anatomically, the bony nasopharynx is bordered by the following skeletal
elements : (1) anteriorly, the structures constituting the choanal openings (the
medial plates of the pterygoid processes laterally and the dorsal border of the
vomer medially) ; (2) posteriorly, the pharyngeal surface of the body of the
sphenoid bone and of the basilar part of the occipital bone; (3) caudally, by the
posterior border of the horizontal part of the palatine bone anteriorly and by
the anterior margin of the foramen magnum posteriorly.
Geometrically, the bony nasopharynx in the median sagittal plane is shaped
like a gable. The anterior part of the gable, corresponding to the choanal struc-
tures, is formed by a line joining the landmarks staphylion (the posterior nasal
spine,) and hormion (the vomer’s dorso-rostra1 point of contact with the body
of the sphenoid bone). In man this line is approximately parallel to the main
direction of the pterygoid processes (the choanal plane).
The posterior part of the gable, corresponding to the caudal surface of the