PURPOSE: To evaluate the clinical performance of Helioseal-F, a fluoride-containing fissure sealant, in school children at caries risk. MATERIALS AND METHODS: A caries risk assessment based on past caries experience, saliva microbial tests, buffer capacity and frequency of sugar intake was carried out in 204 healthy children, 6-7 years of age. Children exhibiting one or more risk factors were considered at caries risk (n = 121) and their permanent molars were sealed with a fluoride-containing fissure sealant, thus forming a fissure sealant group (FSG). The remaining 83 children with low caries risk received no fissure sealants and constituted a reference group (RG). Both groups were followed for 2 years. From 15 children of both groups, unstimulated whole saliva was collected 1 month after sealant placement in order to determine fluoride levels. In another 20 children, a split-mouth study design was utilized to compare the colonization of mutans streptococci adjacent to and on F-containing sealants and conventional controls. The sealants were placed by dental hygienists according to the manufacturers' instructions. RESULTS: A total of 431 fissure sealants were placed at baseline. Complete retention was found in 76.6% during the study period while 22.0% were partially lost. Six sealants (1.4%) were completely lost. The enamel caries incidence was 45% lower (P
Caries incidence during a 2-year period was studied in 4- to 5-year-old children from three areas with contrasting levels of natural fluoride (F) in the drinking water and different regimens of topical fluoride varnish applications; group A (n = 448) was from an area with a low level of F (0.1 ppm) and semi-annual applications of fluoride varnish; group B (n = 374) was from a low F area (0.1 ppm) and no fluoride varnish treatments; group C (n = 206) was from an area with optimal F (1.2 ppm) and fluoride varnish treatments. All children were clinically assessed at baseline and after 2 years according to WHO criteria. The number of salivary mutans streptococci was estimated and scored at baseline and after 2 years with the Strip mutans method. The varnish containing 0.1% F was applied every 6 months on all accessible tooth surfaces after cleaning with a pumice paste. Basic preventive care was given to all children and restorative treatment on individual indications. Higher levels (p
The prevalence and number of salivary lactobacilli was determined in all schoolchildren starting the 7th grade (12-13 yr; n = 1,578) in comprehensive school located in Kumla, Sweden between 1987 and 1998. Whole saliva samples were collected and transferred to dip-slides (Dentocult-LB) and incubated in room temperature for 7 d. Caries data were collected from the dental records and from bitewing radiographs. Both the number of lactobacilli and the prevalence of manifest caries and restorations exhibited a decreasing tendency and were significantly lower in 1998 than in 1987. The mean caries prevalence (DFS) declined from 5.2 to 1.8. In 1987, 45% of the children harboured high or very high lactobacilli counts ( > or =10(5) CFU/ml) in their saliva compared to approximately 10-15% at the later examinations. The proportion of children with no detectable counts varied between 4-29% during the study period, while children with low counts (10(3)-10(4) CFU/ml saliva) constituted a clear majority at the recent samplings. With such low levels in the population, the use of lactobacilli counts as a didactic tool in dietary counselling must be called into question.
OBJECTIVES: The aims of the present study were to describe eating, toothbrushing and smoking habits in a cohort of Swedish female adolescents, and to relate the findings to dental caries increment. DESIGN: The research took the form of a longitudinal study. SUBJECTS AND METHODS: The study sample consisted of a cohort of 162 girls under regular dental care, aged 12 years at baseline, who were followed for 3 years, from the sixth to the ninth grade. Eating, oral cleaning and smoking habits were self-reported three times per year through a questionnaire, and caries data at baseline and after 3 years were collected from dental records. RESULTS: The results showed significantly (P 95% of subjects reported that they brushed their teeth at least once a day, approximately 20% did not do it every evening, and this figure remained stable over the study period. However, snacks, soft drinks and sweets, and toothbrushing habits had no significant influence on caries development. CONCLUSION: Dietary advice for caries prevention in adolescent girls should focus on the importance of retaining regular main meals, and especially, not skipping breakfast.
The caries preventive outcome of a school-based program with salivary; lactobacillus counts as sugar-motivating tool was evaluated in six cohorts of totally 936 adolescents in a comprehensive school in Sweden. Students from a neighboring district with similar socioeconomic structure but with no corresponding dental health-promoting activities were selected as reference. The program started in the beginning of the 7th grade (13 years) and was terminated at the end of the 9th grade (16 years). Salivary lactobacilli were evaluated semi-annually with a dip-slide method and used for individual counseling. Dental caries was scored from the dental records and bitewing radiographs of each 4th participant at baseline and at 16 and 19 years of age. The number of salivary lactobacilli decreased significantly (P
The aim of this study was to compare the effect of two different dental varnishes on approximal caries incidence in teenagers with proven caries susceptibility during a 3-year period. Two hundred 13- to 14-year-old subjects exhibiting at least two approximal enamel caries lesions were selected to take part in the study. One hundred and eighty subjects participated after informed consent and were randomly assigned to two equally sized groups. One group was treated with a fluoride varnish (FV, Fluor Protector) containing 0.1% F every 3rd month and the participants of the other group were treated in the same mode with a chlorhexidine varnish (CV, Cervitec((R))) containing 1% chlorhexidine and 1% thymol. In total, each subject was treated 12 times during the experimental period. Approximal caries including enamel lesions (DMFS(appr)) were recorded from four bitewing radiographs exposed at the start and end of the study. The mean (+/-SD) caries prevalence at baseline was 2.2+/-3.4 in the FV group and 2.5+/-4.0 in the CV group. After 3 years, the average approximal caries incidence was 2.7+/-3.1 and 3.1+/-3.5 in the FV and CV groups, respectively. The differences at baseline and after 3 years were not statistically significant. In conclusion, treatments every 3rd month with either a fluoride- or a chlorhexidine/thymol-containing varnish showed a promising effect with low approximal caries incidence and progression in teenagers with proven caries susceptibility.
Development and progression of approximal caries is still difficult to prevent and control even in societies with declining caries prevalence. In this study, a test group of 115 12-yr old children were treated semi-annually with a mixture (1:1) of a varnish containing 0.1% F (Fluor Protector) and 1.0% chlorhexidine (Cervitec). A reference group of 104 children received fluoride varnish treatment (Fluor Protector) semi-annually. Approximal caries was recorded from bitewing radiographs at baseline and after 3 yr. At baseline, total decayed and filled surfaces (DFS) including enamel caries were 1.79+/-2.36 in the reference group and 2.0+/-2.77 in the test group. After 3 yr, the mean approximal caries incidence including enamel caries was 3.01+/-3.74 and 3.78+/-4.32, respectively. The differences at baseline as well as after 3 yr were not statistically significant. The results showed that both groups had a comparatively low incidence of approximal caries during the experimental period, and suggest that a mixture of fluoride and antibacterial varnish had no additional preventive effect on approximal caries incidence compared with fluoride varnish treatments alone.
OBJECTIVE: The aim of this two-year community demonstration trial was to study the caries inhibitory effects of semiannual applications of a fluoride varnish in preschool children. METHODS: Twenty-four public dental health clinics in the county of Halland, Sweden, with 5,137 preschool children, 4 and 5 years of age, were matched and equally allocated to a fluoride varnish group (n = 2,535) and a reference group (n = 2,602). The children in the fluoride varnish group were treated every six months with topical applications of a silane fluoride varnish, Fluor Protector (0.1% F), while no fluoride varnish was used in the reference group. Both groups received a basic preventive program at annual checkups consisting of dietary counseling and instructions to parents to brush their children's teeth at least once daily with fluoridated dentifrice. Caries data were collected by clinical examinations at baseline and after one and two years. RESULTS: Caries prevalence at baseline did not differ significantly between the groups. After two years, the mean caries incidence was low and no statistical difference was found in the total number of carious and filled surfaces (dfs) between the two groups. However, the incidence of approximal lesions (dfsa) was significantly lower (P or = 5 at the start of the study exhibited a statistically significant (P
The 'Cariogram' is an interactive PC program for caries risk evaluation. It takes into account the interactions between caries-related factors and expresses a graphic assessment of the risk. The aim of this study was to assess the caries risk in schoolchildren using the Cariogram and to evaluate the program by comparing the caries risk assessments with the actual change in DMF. A 2-year prospective study on 446 schoolchildren, 10-11 years old, was conducted. At baseline, data on general health, diet, oral hygiene and use of fluoride were obtained. Saliva analyses included mutans streptococci and lactobacilli counts, buffer capacity and secretion rate. DMFT and DMFS were calculated from records and bitewing radiographs. Scores were entered and caries risk was assessed. Re-examination for caries was done after 2 years. The children were divided into 5 groups according to the assessed caries risk at baseline. Where the Cariogram predicted a 0-20% (high risk), 21-40%, 41-60%, 61-80% and 81-100% (low risk) chance of avoiding new lesions, 8, 35, 42, 73 and 83%, respectively, had no new lesions 2 years later. Logistic regression analyses were carried out. When the Cariogram was included, only two factors, the Cariogram (p
In many Danish communities, school-based fluoride programs are offered to children with high caries risk in adjunct to tooth brushing. The purpose of this field trial was to compare the caries-preventive effectiveness of two different fluoride programs in 6-12 year olds.
Clinical controlled trial.
The 2-year study was conducted in Public Dental Clinics in a multicultural low-socioeconomic suburban area of Odense, Denmark with an elevated prevalence of caries compared to the city average.
1,018 children (aged 6-12 years) from 9 different schools were enrolled after informed consent and their class unit was randomly allocated to one of two fluoride programs.
One group received a semi-annual fluoride varnish applications (FV) and the other group continued with an existing program with fluoride mouth rinses once per week (FMR). All children received oral hygiene instructions and comprehensive dental care at the local Public Dental Clinics throughout the study period.
Increment of caries lesions in permanent teeth at both cavitated and initial caries levels.
The groups were balanced at baseline. After two years, 961 children (94.4%) were reexamined. The FV group showed a mean DMFS increment of 0.36 compared to 0.41 in the FMR group. The corresponding values for initial caries lesions were 0.83 and 0.91 respectively.
There were no statistically significant differences in caries development over two years among children participating in a school-based fluoride varnish or mouth rinse program.