To measure the effectiveness of fluoride varnish (FV) (Duraflor), 5% sodium fluoride, Pharmascience Inc., Montréal, QC, Canada) and caregiver counseling in preventing early childhood caries (ECC) in Aboriginal children in a 2-year community-randomized controlled trial.
Twenty First Nations communities in the Sioux Lookout Zone (SLZ), Northwest Ontario, Canada were randomized to two study groups. All caregivers received oral health counseling, while children in one group received FV twice per year and the controls received no varnish. A total of 1275, 6 months to 5-year-old children from the SLZ communities were enrolled. In addition, a convenience sample of 150 primarily non-Aboriginal children of the same age were recruited from the neighboring community of Thunder Bay and used as comparisons. Longitudinal examinations for the dmft/s indices were conducted by calibrated hygienists in 2003, 2004 and 2005.
Aboriginal children living in the SLZ or in Thunder Bay had significantly higher caries prevalence and severity than non-Aboriginal children in Thunder Bay. FV treatment conferred an 18% reduction in the 2-year mean 'net' dmfs increment for Aboriginal children and a 25% reduction for all children, using cluster analysis to adjust for the intra-cluster correlation among children in the same community. Adjusted odds ratio for caries incidence was 1.96 times higher in the controls than in the FV group (95% CI = 1.08-3.56; P = 0.027). For those caries-free at baseline, the number (of children) needed to treat (NNT) equaled 7.4.
Findings support the use of FV at least twice per year, in conjunction with caregiver counseling, to prevent ECC, reduce caries increment and oral health inequalities between young Aboriginal and non-Aboriginal children.
The treatment-mix, treatment time, and dental status of 268 male industrial workers entitled to employer-provided dental care were studied. The data were collected from treatment records of the covered workers over the 5-year period 1989-93. Treatment time was based on clinical treatment time recorded per patient visit, and the treatment procedure codes were reclassified into a treatment-mix according to American Dental Association categories, with a modification combining endodontics and restorative treatment. The mean number of check-ups followed by prescribed treatment (treatment courses) during the 5 years was 3.7 among those who had entered the in-house dental care program prior to the monitored period (old attenders). Their treatment time was stable, 57-63 min per year, while the first-year mean treatment time (170 min) of those who had entered the program during the study period (new attenders) was significantly higher (P
To investigate attrition of subjects in a longitudinal study of caries.
A radiographic study of caries and caries-associated factors was carried out in subjects, initially aged 14 years, and followed-up for six years. Attrition of subjects occurred at the last stage of the study.
A nationwide survey of subjects living in fishing, rural farming, and urban communities in Iceland.
A sub-sample of the nationwide random sample comprising 150 subjects was investigated using bitewing radiographs and a structured questionnaire to determine caries-risk factors. Subjects were re-examined at 16 years and 20 years using the same methods.
Mean caries increment from 14-16 years was 3.0 lesions (1.5 lesions/subject/year) but reduced to 2.6 lesions (0.7 lesions/subject/ year) by 20y. The proportion of subjects found to be caries-free at 14 years, 16 years and 20 years, was 29%, 17% and 10%, respectively. "Dropouts" from this study occurred mostly after 16 years. Analysis of subjects dropping out showed that they were least likely to be from the rural farming community but most likely from the fishing community. Those dropping out attended their dentist less frequently, had a higher consumption of carbonated drinks and a higher prevalence and incidence of caries by 16 years.
Subjects with high-risk behaviours, or residents in a fishing community were more likely to drop out of the study. Recognised advantages of conducting longitudinal studies of caries may, therefore, be lost.
The objective of the study was to examine the coverage of the sealing program on first permanent molars (FPMs) and second permanent molars (SPMs) and first and second premolars (FSPMs), as well as to monitor the fate of the sealed teeth over time. All patients born in 1977 who had had regular check-ups in the Varkaus Health Center, Finland (n = 166) were included in the 1996 study. Data on the annual state of each tooth had been collected retrospectively since 1983. The coverage for the sealant program was 95%, 92%, and 6% of the FPMs, SPMs, and FSPMs, respectively. Out of the FPMs sealed at age 6 years, 28% were subjected to resealing, 13% developed occlusal, and 15% proximal caries during a 13-year follow-up period. From the SPMs sealed at age 11 years, 24% were subjected to resealing, 4% developed occlusal caries, and less than 2% proximal caries during the 9-year follow-up. None of the sealed FSPMs and only 1% of the non-sealed ones developed occlusal caries during the 9-year period. The mean DMF in the study population (n = 160) at age 12 years was 0.8 (n = 124), compared to a nation-wide mean value of 1.2. A large percentage of the FPMs and SPMs were sealed and then resealed during the study period. Although the study design lacked a control group for comparison, the lower caries rates of this study compared to the results of other studies with only a single application of sealants suggest a major role for resealing.
In a long-term series analysis the study had the aim of detecting how the used socioeconomic variables were related to the caries status development in the year group leaving the organised dental care. The study included caries epidemiological records of individuals at the Public Dental Service of Göteborg, leaving the organised dental care during 1986-2000. The City of Göteborg was divided into four districts. One incidence and one prevalence caries index was used, each presented in two subgroups: individuals with no caries record and patients with 20% of the highest index values. The socio-economical variable was individuals 18-64 years of age, seeking employment, as a percentage of the corresponding group of all inhabitants. The registered values were divided into three time sections of five years each. In the first, the socio-economic value curves were almost horizontal, in the second they showed a considerable increasing and in the third a declining tendency. The result curves for the caries-free patient groups and for patients with 20% of the highest caries index values compared to the three socioeconomical time sector results, showed an almost horizontal level concerning the incidence index values, and for the prevalence index values an inclined curve structure to the incidence curves. The result curves for the incidence index with respect to the caries-free patient group showed an almost horizontal structure, while the prevalence curves inclined towards the incidence curves during the study period. The linear structure of these curves deviated considerably from the result curves for the socio-economic time series. No correlation existed between the socio-economic data and the studied caries index values. The need for determining the time length concerning caries index observations was discussed. It must be of special interest to maintain the dental health of the studied patient group and the individuals' relation to regular dental care, when as adults they meet the dental care economy.
The effect of chewing gum containing xylitol on the incidence and progression of dental caries was tested in a sample of 274 children, aged eight and nine years, of low socio-economic status and high caries rate. They were divided into two experimental groups (15% and 65% xylitol chewing gum distributed three times a day at school) and one control group (without chewing gum). The three groups were exposed to the same basic preventive program. Children who chewed gum had a significantly lower net progression of decay (progressions-reversals) over a 24-month period than did the controls. Results for the two groups chewing gum were similar. Chewing xylitol gum had a beneficial effect on the caries process for all types of tooth surfaces, and especially for bucco-lingual surfaces. The two experimental groups had a DMF(S) increment of 2.24 surfaces, compared with 6.06 surfaces for the control group. For this indicator, there was no difference between the two experimental groups. Results for the plaque index were in agreement with those of the DMF(S) increment and the net progression of decay.
The purpose of the present study was to establish whether the number of intact teeth in Helsinki schoolchildren aged 7-13 years was rationally correlated with the wartime reduction in sugar consumption and, later, with dental health education programs in Finland. The period covered is 44 years. The results show that dental health education is effective in caries prevention and that enforced programs can lead to an improvement similar to that seen during the war.
The aim of the present study was to describe the Norwegian adult population according to: 1. number of teeth present, 2. demand and utilization of dental services, 3. travel time from home to the dentist, 4. dental health behaviour, 5. fear for dental treatment. The analyses were performed on a set of national data collected in 1989, which was representative of the non-institutionalized Norwegian population 20 years and above. The sample size was 1260 individuals. About 75% of the people had 20 teeth or more present. Nine percent were edentulous. Seventy-seven percent who had demanded dental services during the last year. The average expenditure for dental treatment for those who had demanded the services during the last year was NOK 826. Fifty-three percent travelled 15 minutes or less from home to the dentist. Eighteen percent travelled 30 minutes or more. Almost everybody with their own teeth present brushed their teeth regularly once a day. Thirty-three percent of all dentate people used woodsticks regularly once a day, while 20% used toothfloss regularly. Seventy-five percent had no to mild fear of the dentist, while 7% had a strong fear. Fear of the dentist was higher among women than among men. Fear of the dentist decreased by increasing age. Few people, less than 4%, had cancelled a dental appointment because of dental anxiety. There has been an improvement in dental health and dental health behaviour in Norway during the 1970's and 1980's. These improvements are discussed with special attention paid to the findings from the present study.