Evidence for dental caries decline among children in an East European country (Hungary)

In Central and Eastern Europe oral health systems are in transition due to the economic and political changes. The aim of the present study was to highlight the long-term trend in dental caries prevalence of Hungarian children. A WHO National Pathfinder Survey of oral health status was conducted in 1996 which included 6-year-olds (n = 900) and 12-year-olds (n = 900). Similar surveys were performed in 1985 (age 6-7, n = 895; age 12, n = 893) and in 1991 (age 5-6, n = 898; age 12, n = 898) and the surveys were based on the same sites and examination criteria. Clinical data were collected by trained dental examiners according to the WHO Basic Methods. In 1996, 73% of 5-6-year-olds and 84.5% of 12-year-olds were affected by dental caries. At age 5-6 the mean dmft was 4.5 and at age 12 the DMFT was 3.8. In both groups, the d/D-components were high (5-6 years: dt/dmft = 89%; 12 years: DT/DMFT = 45%). For children aged 5-6, the mean caries experience increased from 1991 (3.7 dmft) to 1996 (4.5 dmft) (P<0.01) whereas DMFT of 12-year-olds declined from 5.0 in 1985 and 4.3 in 1991 (P<0.01). The differences in caries experience by urbanization level were reduced over time. In 1996, 72% of 12-year-olds had gingival bleeding (CPI scores 1+2), and 23% had moderate/severe malocclusion. In conclusion, in order to meet the need for dental care in schoolchildren in Hungary health authorities are encouraged to revitalize the school dental services. Implementation of community-based health promotion is needed to control oral disease in Hungarian children.     

Some factors associated with the caries decline among Norwegian children and adolescents: age-specific and cohort analyses

The purpose of this study was to evaluate factors related to the caries decline in children between 1966 and 1983. The decline started in the late sixties for the 8- to 11- and the 17-year-olds, and after 1971 for the remaining age groups. Regression analyses confirmed a significantly different start of the decline. Fluorides in school-based programmes, lozenges, and toothpaste, as well as education and sale of antibiotics were significantly (p< or =0.01) related to the caries decline in partial correlation analyses. Fluoride toothpaste was only significantly related to the decline in the last part of the period of observation. Supervised fluoride rinsing and brushing programmes at school may explain most of the decline before 1971. The later decline may be related to all fluoride agents and to education. Use of fluorides and other preventive efforts aimed at pre-school children may have contributed to the continual decline in the number of fillings in the permanent teeth of the youngest cohorts.     

Suggestive evidence for dental caries decline among children in Hungary

J Evid Base Dent Pract 2001;1:20-1     

The decline in dental caries among Belgian children between 1983 and 1998

OBJECTIVES: to investigate cross-sectionally a probable dental caries decline in Belgian 12-yr-olds and to analyse some factors that may be associated with dental caries during the study period. METHODS: In the region of Brussels, children in the 7th grade at the same schools were sampled in 1983 (n=533) and 1998 (n= 496). DMFT, DMFS and dental fluorosis were clinically recorded. Data on children's home-based and professional dental health care habits were registered. RESULTS: Caries-free children increased from 4% to 50%. A reduction of the mean number of teeth attacked by dental caries from 7.5 to 1.6 and of tooth surfaces from 11.5 to 2.5 (P<0.001) was observed. Early signs of dental fluorosis were identified in 5% in 1983 and 30% of the subjects in 1998. Multiple linear regression analyses revealed that tooth brushing with fluoridated toothpaste, dental appointments and dental fluorosis were significantly related to dental caries reduction. CONCLUSIONS: A remarkable decline in dental caries was observed during the 15-yr period. The factors related to the children's home-based and professional dental health care were associated with the observed decline.     

The decline in dental caries among 12-year-old children in Germany between 1994 and 2000

OBJECTIVE: To determine the prevalence of dental caries in 12-year-old-children in 11 of the 16 German Federal States over time following the introduction of intensive preventive measures. DESIGN: Cross sectional oral health surveys of children aged 12 years were performed in 1994-1995, 1997 and 2000. SUBJECTS: After random selection 18,459 (1994-1995), 22,908 (1997) and 24,679 (2000) children were examined in schools. METHOD: DMFT and fissure sealants were recorded following WHO criteria. Caries was diagnosed at the caries into dentine (D3) threshold using visual method without radiography or fiber-optic transillumination. RESULTS: The mean DMFT scores for Germany decreased from 2.44 in 1994-1995 to 1.81 in 1997 and 1.24 in 2000. In 1994-1995 31.1% of 12-year-olds had no caries experience (DMFT = 0). The corresponding figures were 42.5% in 1997 and 55.3% in 2000. The average Significant Caries Index (SiC index) dropped from 5.25 in 1994-1995 to 4.29 in 1997 and to 3.30 in 2000. The results in different federal states showed a wide variation in caries prevalence. In the first examination, mean DMFT scores between 2.10 and 3.54 were found, while after the third evaluation corresponding values between 1.03 and 1.95 were observed. In 1997 on average between 0.20 and 2.00 teeth with fissure sealants per child were found, the corresponding values in 2000 were between 2.13 and 2.83. CONCLUSION: The results of our study show considerable inequalities in oral health in the various federal states. Nevertheless, oral health in Germany improved considerably between the years 1994 and 2000.     

Reasons for the caries decline in Slovenia

In 1987, 1993 and 1998, nationwide surveys on the prevalence of dental caries were carried out in Slovenia. Sampling and examinations were performed according to WHO standards. The age groups 6, 12, 15, 18, 35-44 and 65 years or older were studied. In each age group, 200 persons or more were examined on each occasion. The results showed that the proportion of caries-free children and adolescents increased considerably over the 12-year period between the first and the last survey (from 6% to 40% for 12-year-olds). In the same period, the mean DMFT values decreased as follows: from 5.1 to 1.8 for 12-year-olds, from 10.2 to 4.3 for 15-year-olds, from 12.9 to 7.0 for 18-years-olds, from 20.5 to 14.7 for 35-44-year-olds, and from 27.0 to 22.5 for subjects aged 65 years or more. The notable improvement of dental health can be explained by the preventive programmes in operation in various periods. The most recent decline was most likely due to supervised brushing (with concentrated fluoride gel) taking place some 16-18 times a year in primary schools attended by children aged 7-15 years, improved oral hygiene, and a comprehensive programme of applying fissure sealants, particularly on first molars.     

Analysis of the ups and downs of caries experience among Norwegian children aged five years between 1997 and 2003

OBJECTIVE: To study caries trends and investigate the possible reasons for changes among 5-year-old Norwegian children in the period 1997-2003. In this cross-sectional analytical time trend study at district, county, and national levels, aggregated data from the Public Dental Services (PDS) and official statistics were used, i.e. number of children and percentage receiving treatment, sale of fluoride tablets, socio-economic background, caries prevalence, and d3mft scores. RESULTS: Caries prevalence increased from 30% in 1997 to just over 40% in 2001, but by 2003 it had dropped to 36%. The corresponding mean number of d3mft were 1.1, 1.6, and 1.4 at national level. Caries prevalence and experience varied considerably between counties and between dental districts throughout the observation period. Multivariate analyses at county level indicated a significant negative association (p < 0.05) between caries prevalence, the sale of fluoride tablets, and net mobility. The impacts of the predictor variables education, income, infant mortality, proportion of immigrants, and the percentage of children treated varied but were rarely significant. CONCLUSIONS: The increasing trend in the prevalence of caries among 5-year-old Norwegian children in the period 1997 to 2001 has reversed. The deterioration in dental health of 5-year-olds after 1997 was associated with a reduction in the sale of fluoride tablets, whereas increased sales of fluoride tablets after 1998 reflect improved caries prevention among preschool children and may explain the improved caries status of these children in 2003.     

Dental caries among children in institutions for orphans

Epidemiological studies show that the level of dental care for children-orphans in institutions inadequate. Dominated by untreated and remote carious permanent teeth. If the traditional dental treatment difficult to implement need to develop special programs for the prevention of dental caries.     

Changing time trend in caries prevalence in Norwegian children and adolescents

Abstract The purpose of the present study was to determine whether or not the decline in caries prevalence had continued among Norwegian 5-, 12- and 18-yr-olds from 1985 to 1991. The analysis was carried out at national, county and dental district level based on the annual census reports from public dental officers. Caries decline continued at national level. Some counties exhibited increases from 1 year to the next, more so in the last 3 years than in the first 3 years of observation, but not consistently. There was stronger evidence for a leveling out or reversal of caries trend at district than at county level. Reversal affected more 5- than 15-yr-olds and more 12- than 18-yr-olds. The chief dental officers in districts reporting a reversal of trend in caries prevalence and in comparison districts showing continued caries decline were interviewed by telephone concerning factors which might explain the observed caries trend. The interviews revealed no obvious explanation why caries prevalence increased in some dental districts while it continued to decline in others. It is concluded that a reversal in caries trend has occurred in some Norwegian dental districts between 1985 and 1991 and that there is a need for a more detailed study of the situation.     

Five-year follow-up caries study among Nigerian children

Eighty-five children (age in 1981, 3-9 yr) examined in the 1981 survey in Ile-Ife, Nigeria, were seen again in 1986. In addition cross-sectional caries data in a small sample of 6-14-yr-olds were compared with data obtained in 1986. Results show that caries prevalence rate and the average number of DMFT increased slightly in the urban area, but was still very low. Both caries prevalence and the average number of DMFT decreased in rural areas because attrition proceeded faster than did caries.     

Effect of mouth rinsing and toothbrushing with fluoride solutions on caries among Norwegian schoolchildren

ABSTRACT The caries experience and the plaque and gingival conditions of 14-year-old children participating in fortnightly fluoride (0.2% NaF) mouth rinsing (88 subjects) were compared with observations in children performing supervised toothbrushing with a fluoride (0.5% NaF) solution 4–5 times per year (n= 90). Most of the children, 84 and 90% respectively, had participated in these programs for the previous 6 years. Caries was assessed only on radiographs. The mean number of decayed surfaces was 5.8 (s.d. = 4.1, n= 88) and 5.4 (s.d. = 4.1, n= 90). The mean numbers of decayed and filled surfaces were 19.3 ± 9.2 and 27.9 ± 10.2 for subjects with rinsing or brushing. This significant difference could not be ascribed to sex, social class, years of residence in the towns, number of dentists performing the previous treatments, toothbrushing habits, use of fluorides at home, or amount of plaque. All children had gingivitis. There were no differences in the mean number of Plaque Index score 2 or the number of Gingival Index score 2 between the children with the different preventive programs. The girls ‘oral hygiene was better than the boys’, but the gingival conditions were the same. Sex, social class, and toothbrushing techniques tended to have a slight influence on the amount of plaque.     

Enamel defects and dental caries among Southland children

The aim of this study was to examine the prevalence, severity and associations of enamel defects and dental caries in a probability-based sample of 9- and 10-year-old children living in fluoridated Invercargill and the non-fluoridated towns of Gore, Winton and Queenstown, in Southland, New Zealand. DESIGN: The study was a cross-sectional survey of enamel defects and their associations in a random sample of 9- and 10-year-old children. METHOD: Parents of 600 children were sent a postal survey questionnaire which sought information on sociodemographic characteristics and fluoride exposure from different sources. Consent for dental examinations was also obtained and the children were examined in schools by the principal investigator (TDM). The Developmental Defects of Enamel (DDE) index was used to assess 10 index teeth, which were examined wet and uncleaned. An examination for caries was also carried out. Data were recorded electronically on a laptop computer, and images were taken of each child's anterior teeth using a digital camera. After univariate and bivariate analysis of the data, multivariate modelling was used to control for confounders and derive odds ratios for the prevalence of enamel defects. RESULTS: Four hundred and thirty-six children (mean age of 9.8 years) were examined, giving an effective participation rate of 74.5 percent. At the time of examination the majority of children had a mixed dentition with 77.1 percent of the children having experienced dental caries. Two-thirds of the sample had had deciduous caries experience, with a mean 4.4 surfaces affected. The prevalence of enamel defects of any type among these children was 51.6 percent, with that of demarcated opacities being 38.8 percent, and that of diffuse opacities being 24.1 percent; 5.5 percent had one or more hypoplastic defects. Diffuse opacities were more frequent among children who had lived all their lives in a fluoridated area (OR = 2.23; 95 percent CI 1.37, 3.63). Most of the diffuse opacities affected less than one-third of the labial surface of the index teeth, and the maxillary central incisors were the most commonly affected tooth. CONCLUSIONS: This study suggests that the prevalence of diffuse opacities among children who have lived their whole lives in a fluoridated area has not increased. The benefits of water fluoridation as a public health measure remain, with children continuously exposed to fluoridated water during their life having half the dental caries experience of those who have not. While this benefit also exacts a "biological price" in terms of a greater prevalence of diffuse opacities, the clinical, social and public health significanceof those opacities remains unclear.     

Prevalence of dental caries among school children of Moodbidri

This survey was carried out among 2902 children aged between 5 and 12 years attending 13 primary schools in various areas of Moodbidri, in Udupi district. The oral health status was assessed using the simplified WHO Oral Health Assessment Form. The caries prevalence was found to be 76.9%. The mean DMFT was 0.78 and the mean deft was 3.48. Although the mean DMFT score between males and females did not show any significant difference, the mean deft was found to be higher among males compared to females. It was also found that the mean DMFT score increased with age whereas the mean deft score decreased with age.