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
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.
Three hermetics are assessed: chemically hardened Delton, light-hardened Estiseal, and composite Evikrol. The study was carried out in 126 children aged 6 years. The decrease of the increment of dental caries depends on the retention of hermetics on the occlusion surface of the teeth, and the efficacy of caries prevention in permanent teeth is much higher if hermetic sealing of fissures and fossae is combined with local fluorine prophylaxis and oral hygiene. All types of hermetics can be used to prevent permanent teeth caries, but chemically hardened ones should be preferred.
The state of the occlusal surfaces of the first permanent molars (FPMs) in a representative group of subjects from seven to 15 years of age was followed retrospectively year by year. Data were taken from oral health records. Standardized charts include information on dental check-ups, oral health status, and the treatment given. The state of each occlusal surface was classified into four categories: (1) sound but unsealed, (2) sealed, (3) filled, or (4) decayed. An overall annual attack rate for all occlusal FPM surfaces was 5.9% per year, and for approximal surfaces, 1.3%. Occlusal caries attacks had been most prevalent between seven and nine years of age, whereas new approximal lesions had been most frequent from ages 11 to 13. The FPMs that had been sealed at the age of seven developed fewer caries than did any other group during the follow-up.
The Saskatchewan Health Dental Plan (SHDP) is a publicly funded dental insurance program for children between the ages of five and 16 years residing in the province. In 1981, fissure sealants were added as a covered expense. Until September 1, 1987, sealants and other dental treatments covered under the SHDP were provided to schoolchildren by dental therapists in dental clinics established in elementary schools throughout the province. After September 1, 1987, the provision of dental services was transferred to private practitioners in the province. The objectives of this study were to (1) estimate the retention rates of sealants after one, two, and three years of placement; and (2) conduct a longitudinal followup of sealed and unsealed sound teeth to measure the effectiveness of sealants in reducing dental caries incidence. Relative to the first objective, a cohort of children was identified and comparisons were carried out for the periods of 1982-83, 1982-84, and 1982-85. For the last objective, a longitudinal evaluation of effectiveness was carried out only for children five to seven years of age in 1981. Saskatchewan children, who experienced higher caries prevalence than children in the United States, had the highest caries increments on occlusal surfaces of posterior teeth. About 79 percent of the sealants applied by dental therapists were retained three years after application. Sealed teeth experienced 46 percent less caries than unsealed teeth four years after the application of sealants.(ABSTRACT TRUNCATED AT 250 WORDS)
The aim of this study was to evaluate the salivary status, prevalence of caries and the status of primary dentition, when primary teeth were exfoliated, in 41 patients, 18-24 years of age, with type 1 diabetes since childhood in comparison with age- and sex-matched non-diabetic controls. The blood glucose and glycosylated haemoglobin concentration (HbA1c), dosage of daily insulin and retinal fundus photography was recorded for the diabetic group. According to the concentration of HbA1c, the diabetic patients were divided into well and poorly controlled groups. The study was based on three intra-oral photos, dental examination including intra-oral radiographs, flow rate and buffering capacity of the saliva and amount of Streptococcus mutans and Lactobacilli. Retrospective data regarding the primary dentition was found in the dental files of each patient, and are based on the last registration for respective tooth before exfoliation. The patients with type 1 diabetes, without any relationship to metabolic control, displayed more initial buccal caries compared to healthy controls (p
Collecting data for dental caries studies is costly. In countries where uniform patient records are available for virtually the whole population, it is tempting to use them as a data source. Our aim was to compare data collected from patient records to those obtained by trained examiners. In 1992 and 1995, dentists who were specially trained and calibrated examined random samples of 12- and 15-year-olds living in two towns in Finland. The dental record of each child was obtained from public dental clinics, the dental status was entered into a computer file, and the DMFS value was calculated. Data were available for 824 children. In the two data sets, 1.3% of the tooth surfaces were recorded differently (DMF vs. sound) with the related kappa value being 0.70. In two thirds of the discrepancies, the reason was that a filling was marked in only one of them, which confirms the known difficulty in discerning a white filling. For 48% of the subjects, the DMFS values calculated from the two sets of data were equal. The difference was 1 and 2 surfaces for 28 and 11%, respectively. Public health dentists had almost equally often registered more and less DMF surfaces compared to trained examiners. The results suggest that data collected from public health records are not decisively inferior to those obtained from examinations by trained examiners. In large enough settings, data obtained from patient records could possibly be used as a replacement for separate surveys.
In order to evaluate trends in caries experience, a 20% random sample of 12-yr-old residents of Reykjavik, Iceland (252 children) was examined clinically and radiographically in 1991 under conditions consistent with those of the survey conducted in 1984. In addition to caries data, frequency of toothbrushing and use of fluoride dentifrice were recorded. The mean DFT and DFS were 3.0 and 4.1, respectively. The decrease in caries experience reached 60% with an annual fall in DFS of nearly 10%. During the 7-yr period between examinations the decline in DFT and DFS scores averaged 5.2 and 8, respectively, the annual reduction amounting to 0.7 DF teeth or 1.1 DF surfaces per child. The ratio of approximal/occlusal caries and the proportion of approximal caries were similar in both surveys. Fourteen percent of the children were free from manifest caries in 1991, but only 2% in 1984. Polarization between low and high prevalence individuals had intensified. Ninety-five percent of the children brushed their teeth regularly and 97% reported using a fluoride dentifrice.
The aim was--in a longitudinal respect--to study whether 15-year-old children, in caries-free groups, and groups with high frequency of carious lesions, had a stable caries development from 15 to 19 years of age, when they left the organised Public Dental Care. Caries index values were analysed for the period 1986/7-1990/1 for patients born 1971-72 and residing in Göteborg. The groups of caries-free children seemed to be stable in their dental health in about 60-70% according to the prevalence indices used; and about 80% according to the incidence index DS-a. The caries prevalence index mean values of the 15-year-old patient groups with high frequencies of lesions showed between 1.5 to 3.5 percentile units higher mean values when the individuals were 19 years of age. However, the corresponding caries incidence index values were as low as half the size, indicating a possible treatment effect of the caries prevention programme used. Related to the DFS-a index, the 20% groups with the highest caries index values were registered for about 80% of all approximal lesions, of special interest for dental care costs.
The aim of the present study was to assess the caries-preventive effect of topical application of Duraphat on the occlusal surface of newly erupted first permanent molars. A base-line examination was performed on children aged 5 years and 9 months. The children were randomly divided into a Duraphat group and a control group. In accordance with the anatomy of the fissure system, the molars were divided into shallow and deep fissures, respectively. From the time of eruption, 381 molars were examined every 3rd month during 24 months. Duraphat was applied every 6th month, altogether four times. The results showed that in the Duraphat group 35% of the fissures were decayed compared with 80% in the control group. Caries reduction amounted to 56%, and the caries-preventive effect was found in molars with shallow and deep fissures.