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 aim of this study was to assess the number of, and time intervals between, bitewing examinations performed on a group of Swedish patients between 3 up to and including 18 yr of age and to relate them to the accumulated posterior approximal caries experience of the patients as found in the last bitewing examination before age 19. The patients showed a marked variability in approximal caries experience. 25% accounted for about 1% of the total number of carious lesions and restorations accumulated up to age 19 while 25% accounted for 60%. From age 9 up to age 18 more than 75% of the patients were subjected to at least one bitewing examination annually. Between 10 and 15 yr of age more than 90% received annual radiographic examinations. Mean number of bitewing examinations was 10.4 and the average time interval between bitewing examinations was 11.5 months. 11% of the variation in the number of bitewing examinations and 8% of the variation in average time intervals between bitewing examinations could be explained by the number of lesions and restorations in the approximal surfaces of the patients accumulated up to age 19.
This study aimed to assess radiographically the prevalence and distribution of approximal caries in Danish recruits and to estimate the rate of caries progression during the recruits' late teens. To assess caries progression radiographs taken previously (when leaving the Public Dental Health Care Service, usually at the age of 16-18) were requested. Of 676 recruits previous radiographs (taken 1-7 years earlier) were procured for 640. Approximal surfaces from 7d to 4m in the maxilla and the mandible were assessed for the absence or presence/depth of caries and restorations. Caries progression was expressed by the incidence rate indicating the number of new lesions/number of lesions with progression per 100 years. In the maxilla the average prevalence of enamel and dentine caries was 8.3 and 6.2%, respectively. Overall, 6m had the highest caries experience. In the mandible the average prevalence of enamel and dentine caries was 10.7 and 5.8%, respectively. The highest caries experience was found in 6d. Twenty percent of the recruits had no caries experience in the surfaces under study, 9% had caries experience in 1 surface, 13% in 4-5 surfaces and 25% in more than 10 surfaces. For all surfaces combined, the median incidence rate for the transition from sound to enamel caries was 2.4 surfaces per 100 years, ranging from 0.4 in mandibular 7d to 5.5 in mandibular 6d. The median rate for progression from the enamel to the outer half of the dentine was 9.2 surfaces per 100 years, ranging from 4.4 in mandibular 5m to 18.9 in mandibular 6d. The median incidence rate for progression from the outer to the inner half of the dentine was 2.3 surfaces per 100 years. However, this figure was based on a small number of events and should therefore be interpreted with caution. In conclusion, enamel and dentine caries was found in 9 and 6% of the approximal surfaces in newly called up recruits, and one quarter of the recruits had caries experience in more than 10 approximal surfaces. Generally, the development of new approximal lesions and the progression of enamel caries was a slow process during the late teens.
BACKGROUND: The prevalence of overweight and obesity in children is steadily increasing in many countries. Dental caries and obesity are both multifactorial diseases and are associated with dietary habits. OBJECTIVE: The purpose of this study was to investigate the relationship between body weight status in adolescents and snacking habits in early childhood to approximal caries prevalence at 15 years of age. METHODS: This study is part of a series of surveys of oral health in children followed from the ages of 1 year to 15 years. Body adiposity status was estimated at 13.5-16.4 years using the International Obesity Task Force cut-off values [age-specific body mass index (isoBMI)]. Information about snacking habits in early childhood was collected from interviews conducted at 1 year and 3 years. Approximal caries information was obtained from bitewing radiographs at 15 years. Data related to isoBMI and approximal caries were available in 402 teenagers. RESULT: Adolescents with isoBMI > or = 25 (n = 64) had an approximal caries prevalence that was a mean of 1.6 times higher than those with isoBMI
Coinciding with the decline in caries prevalence observed among children and adolescents, changes in the distribution and progression rates of the disease have been found. The aim of this study was to assess occlusal and approximal caries behaviour and disease distribution within a group of Danish teenagers, and to determine whether the presence of occlusal fillings at baseline could be used as predictor for caries behaviour. The material used was bitewing radiographs taken twice in 197 adolescents, at the age of 14.5 years (first examination) and approximately 3 years later (second examination). Of the occlusal surfaces assessed at both examinations, 93% remained unchanged, 1% developed new carious lesions, and 6% had been filled during the study period. All occlusal dentinal lesions found at the first examination and left unrestored during the study period did not appear to have progressed. Of the approximal surfaces, 86% remained unchanged, 9% developed caries, 2% showed caries progression, and 2.5% had been filled during the study period. 22% of the approximal enamel lesions found at the first examination progressed into the dentine during the study period. 18% of all the children were responsible for 50% of the total number of new lesions and fillings. The proportion of children exhibiting new lesions at the second examination was almost evenly distributed among children with and without occlusal fillings at the first examination. In the group of children with occlusal fillings at baseline, significantly more individuals than in the other group showed new fillings and lesions with and without progression. It is concluded that the progression percentage for approximal enamel lesions to penetrate into the dentine was low, that the distribution of new carious lesions and fillings among the children was polarized, and that the presence of occlusal fillings at baseline could not be used to identify children with a specific caries behaviour.
OBJECTIVES: The objective was to assess the dependence of the caries status of the adjacent approximal surface on the incidence of approximal caries. METHODS: At baseline, the material consisted of a cohort of 536 Swedish children. The individuals were followed through annual bitewing radiographs from the age of 11-13 to 21-22 years. A radiographic scoring system was used to assess the caries status of the surfaces: scores 0 and 1 = sound surface to score 4 = caries in the outer half of the dentine. A model was used to calculate the dependence of the caries status of adjacent approximal tooth surfaces. The unit of analysis was a pair of adjacent approximal surfaces and in all, 12 pairs of posterior approximal surfaces were analysed. RESULTS: The individual caries rates of the 24 posterior approximal surfaces ranged from 1.3 to 8.3 new caries lesions per 100 tooth surface-years. The caries rate of an approximal tooth surface depended on the caries status of the adjacent surface: a sound surface next to a sound surface had a relatively small risk of developing caries, while the risk increased 1.6-32.3 times if the adjacent surface was in a caries state as judged radiographically. The distal surface of the first molar developed caries more often than the mesial surface of the second molar. CONCLUSIONS: The caries rate of an approximal tooth surface was 1.6-32.3 times higher if the adjacent surface was in a caries state compared to when the latter was sound.
BACKGROUND: Oral health status of individuals aged 3-80 years in the city of Jönköping, Sweden, has been assessed in a series of epidemiological studies over a 30-year period. AIM: To analyse the changes in caries prevalence and caries distribution in child population sample groups, based on studies performed in 1973, 1978, 1983, 1993, and 2003. DESIGN: Each time point included 500 randomly sampled individuals, divided into age groups of 3, 5, 10, 15, and 20 years. Results. Thirty-five per cent of 3-year-olds were caries free in 1973, compared with 69% 30 years later. Decayed and filled primary (dfs) and permanent surfaces (DFS) were reduced by 50-80% between 1973 and 2003. Adolescents aged 10 and 15 years exhibited the most pronounced reduction in DFS on the occlusal surfaces. By 2003, 90% of the proximal carious lesions in 15-year-olds were initial carious lesions. In 2003, about 60% of 15-year-olds had a DFS of or = 26. CONCLUSIONS: Despite the dramatic decline in the prevalence of caries, caries remains a health problem among children, particularly those of preschool age. Continuous epidemiological studies are recommended to evaluate preventive measures.
The aim of this study was to compare the success of operative caries therapy of primary molars in two cohorts, one of children born in 1971, Cohort '71, and the other of children born in 1981, Cohort '81, followed up from the age of 3 to 8 years. There were significantly fewer caries lesions to treat in Cohort '81 than in Cohort '71. In Cohort '71, silver amalgam was used while in Cohort '81 silver amalgam was inserted in 65% and glass polyalkeonate cement (GPA) in 35%. Significantly fewer restorations were replaced in Cohort '81 than in Cohort 71, 49 v. 106. When the proportion of replacements was studied in relation to the number of proximal caries lesions, the percentage of replacements in Cohort '71 was 17% and in Cohort '81 14%, the distal surface of the lower first molar showing the same proportion in both cohorts, 21%. Of all replacements in Cohort '81, 41% were performed in the high caries prevalence group. In Cohort '81, 22% of all silver amalgam and 6% of all GPA fillings were replaced. The number of extracted primary molars decreased significantly, from 4% in Cohort '71 to 2% in Cohort '81. The success rate of the operative caries therapy did not increase much. Instead, cost benefits were found in decreasing caries prevalence and later onset of manifest caries.
Two cohorts of 17-yr-olds treated in a municipal child dental service in 1978-79 and 1984-85 had bitewing radiographs taken at the examination before the last course of treatment in the service. All radiographs were read by one examiner, who did not know to which cohort the individual belonged. The subsequent treatment was recorded from the treatment records by another examiner, who was unaware of the results of the radiographic examination. According to radiographic scores, the proportion of decayed or filled (DFS) approximal surfaces had decreased from 23.2% to 17.4% during the period (difference: 25%). The proportion of unfilled surfaces which were decayed (DS) had remained almost constant, while 9.6% of the surfaces were filled (FS) in 1978-79 compared to 3.1% in 1984-85 (difference: 68%). Thus, in spite of a 25% decrease in total caries experience (DFS), a reduction of 68% would be claimed if fillings (FS) were interpreted as expression of disease prevalence. The risk of an approximal surface being filled decreased to about one fifth from 1978-79 to 1984-85, and the risk of being filled was nearly three times as high for approximal surfaces of children who already had approximal fillings at the time of examination. Thus, both the year of examination and the subject's previously received treatment seemed to influence the treatment strategy of the dentist.