In cross-sectional studies conducted in 1967, 1971, 1976, 1980, 1987, 1992, 1997 and 2002, 4-year-old children in Umeå, a city in northern Sweden, were examined for dental caries and background factors such as oral hygiene habits, use of fluorides, and sugar consumption. The same methods and criteria have been used in each of the studies from 1967 to 2002. The number of children with caries had declined from 87% in 1967 to 42% in 1987, but then the decline levelled out. In 2002, 46% of the children had caries with a mean dmfs value of 2.0 +/- 3.6. Six percent of the children had 10 or more dmfs. Immigrant children had a higher caries prevalence (p
The aim of the study was to examine the prevalence of dental caries in 4-year-olds in the town of Umeå in 1987, and compare that data with data from 4-year-olds examined in 1967, 1971, 1976 and 1980/81, using the same diagnostic methods and criteria. The reduction in the mean dmfs value amounting to 75% between 1967 and 1980/81 did not continue up to 1987, but there was an increase in the number of children without caries from 50% in 1980/81 to 58% in 1987. There was also an increase in the proportion of children with 10 or more dmf-surfaces during the same period. The mean value for dmfs remained the same in these years. An analysis was made of the correlation between the frequency of tooth-brushing, use of fluoride toothpaste, snack consumption and the dmfs-value in 1987. A statistically significant difference in mean values for dmfs was found between children who had their teeth brushed greater than or equal to 2/day and less than or equal to 1/day. When fluoride toothpaste was used, the difference was less pronounced. There was no statistically significant difference in the mean intake frequency of snack products among children with and without caries, but a higher proportion of caries-free children was found among those with a low intake frequency of such products.
Four-year-old children in the city of Umeå, northern Sweden, have been the subjects for studies of dental caries at regular intervals between 1967 and 1997. Similar methods and criteria were used in all studies and the children were selected from the same catchment areas. The results of this study signified a shift in the trend towards a declining caries prevalence among 4-year-old children. There was a slight non-significant increase in the number of children with caries as well as in the mean dmft and dmfs values between 1992 and 1997. The mean dmfs value was 7.8 in 1967 and declined to 4.5 in 1971. It was 2.9 in 1976 and 2.0 in 1980 and 1987, 1.8 in 1992 and increased to 2.0 in 1997. Ten percent of the children were immigrant or refugee children in 1997 compared to 6% in 1992 and they had a significantly higher caries prevalence than children with a Swedish background (p
The dental health of 4-year-old children in the city of Umeå, northern Sweden, has been followed in cross-sectional studies conducted in 1967, 1971, 1976, 1980, 1987 and 1992. Similar methods and criteria were used. Dental caries and background factors (fluoride usage, toothbrushing frequency and diet) were recorded. In 1971, 1987 and 1992 signs of tooth trauma and presence of malocclusion were also recorded, the latter also in 1976. The present paper summarizes the results of these studies. Between 1967 and 1992 the mean dmfs values declined from 7-8 to 1-8. The decline was greatest between 1967 and 1980 and then levelled off. Toothbrushing frequency was similar over the years, but parental help with brushing was more common in the more recent studies. The use of fluoride toothpaste increased. About 30% of the children had experienced tooth trauma. A unilateral crossbite was recorded in 18% and 16% of the children in 1971 and 1992, respectively, and an anterior open bite in about 35% and 41%, respectively; both types of malocclusion were related to a dummy- or finger-sucking habit.
The aim was to assess how accurately some commonly used risk factors/risk markers (predictors) for caries development could identify children with and without approximal caries as judged from bitewing radiography. Two hundred and sixty-seven consecutive 5-year-old children from two Swedish cities participated. Three experienced dentists examined the children. The predictors were the overall dmfs (decayed, missing and filled surfaces) value (canines and molars), the number of occlusal dmfs, the frequency of intake of between-meal sugary products, visible plaque on free smooth surfaces of second primary molars, toothbrushing habits and (before bitewing examination) an overall judgement by the examining dentist. The mean dmfs value without bitewing examination was 0.40 (SD = 1.22). Twelve percent of the children had at least one dentin lesion and 33% at least one enamel lesion that were detected from bitewing examination only. The gain from adding bitewing examination to clinical examination amounted to a mean of 1.2 approximal enamel and/or dentin lesions. The ability to correctly identify children with approximal caries from the predictors was limited; sensitivity ranged from 0.27 to 0.75 and specificity ranged from 0.41 to 0.93. The single best predictor was the dentist's overall judgement with an average precision of 73%; average sensitivity for the presence of enamel and dentin lesions was 0.48 and for the presence of dentin lesions 0.66. The rest of the predictors added little to the predictive power. It is concluded that 33% of the 5-year-olds, representing a low caries prevalence population, benefited from bitewing examination. The ability to identify these children from the predictors was, however, limited.
The aim of the present study was to suggest a causal model of dental caries and to discuss some quantitative interpretations of this model. Three age groups of children (4, 8 and 13 yr) from three different areas in Sweden were included. The caries status of the children was examined. A 7-day record (4-and 8-yr-olds) and a dietary history (13-yr-olds) were used to estimate food intake. Sociodemographic data and data of caries preventive measures were obtained from parents/children. A causal model of dental caries is suggested and some quantitative interpretations are made by means of path analyses. Hypothetical examples of results of changes in caries determinants are given.
This paper describes risk factors for dental caries identified among 491 2-year-olds in the city of Umeå, Sweden. The study was performed as a risk screening for dental caries according to a method developed for use by dental assistants. The sugar consumption was high, 80% of the 2-year-olds had sweets once a week or more and 25% had sweet beverages once a day or more frequently. In addition, 14% of the children had a meal at night and most common were formula, bovine milk or breastmilk. The majority of the parents brushed the child's teeth at least daily using fluoride toothpaste. Among the children 6% had a chronic somatic disorder and 6% had an intolerance towards specific foods, milk being the most common. The high level of sugar consumption indicates that improved dental health education focusing on the importance of limiting sugar consumption is needed among parents with young children.