Objectives: DMF(S) index is a summary measure of the whole dentition and originally meant for describing past and present caries prevalence in children and adolescents. Because the parameters are mixed and irreversible, a life-long cumulative DS value should describe actual caries prevalence in adulthood more accurate.

Methods: From two municipal health centers in Finland (Kemi and Vantaa), where digital patient records are used since 1989 or 1996, the dates of caries attacks, restorations and tooth extractions recorded on dental records, were data-mined from the dataset created in the course of normal dental treatment. Cumulative D values were determined in two ways: 1) As irreversible, when all repeated caries attacks were recorded and counted together, 2) As reversible when it disappeared when it was replaced by a restoration and only new attacks thereafter were recounted. Cumulative curves were also drawn for restorations and extractions from over 100 000 patients each with 1 – 40 visits in the health centers. The curves were compared by means of the log-rank test.

Results: Reversible caries showing the actual caries situation was normally 1 - 2 surfaces whereas cumulative DS reached the life-long maximum over 20 per patient. Cumulative FS reached its life-long maximum around 35 at 35 years of age. M values starts to increase from 50 years onwards.

Conclusions: Cumulative reversible D described the actual caries situation. The irreversible portion of D described the past caries attacks, but was always lower than the cumulative F which indicates that surfaces were also restored without caries, e.g. due to fractures, technical reasons, and re-restorations.

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