Three-year Root Caries Increments: Implications for Clinical Trials

Seven hundred and ninety-six adult subjects (mean age, 39.9 years) received visual-tactile examinations for root caries over a three-year period. All subjects were employed or were the spouses of employees and resided in fluoride-deficient communities on Long Island, New York. During the three-year observation period, 81.4 percent of the subjects did not develop root caries. The 18.6 percent who developed root caries averaged 0.8 DFS/year. The subjects' ages and baseline root DFS status were associated with the development of a root DFS increment. The older the patient, especially aged 45 and older, the greater was the risk of developing root lesions or having root fillings placed. Subjects who had a root DFS score at baseline also were more likely to experience a root DFS increment. It is recommended that when designing clinical trials of agents purported to inhibit root caries, preselection criteria for the study population should consider the subjects' ages and past history of root lesions.     

Educating Dentists about Fissure Sealants: Effects on Knowledge, Attitudes, and Use

This study evaluated the effects of three modes of education on dentists' knowledge, attitudes, and use of pit and fissure sealants. A randomly selected group of dentists was invited to participate in a sealant education initiative. During a 12-month period, a total of 662 dentists either (1) attended continuing education courses, (2) received written materials and videotapes by mail, or (3) received only written materials by mail. A comparison group (n = 337) received no materials until after the education phase and evaluation had been completed. Pre- and postintervention surveys were used to measure changes in knowledge, attitudes, and sealant use. Response rates to the two surveys were 62 percent and 76 percent, respectively. Preintervention values for knowledge scores, an attitude scale, and sealant use were similar among the four groups. At followup, the three education groups had significantly higher knowledge scores than the comparison group. Attitude values for all but one group were not significantly different, and sealant use by all groups was identical. The numbers of respondents not using sealants declined slightly between surveys in the three education groups while rising slightly in the No-Education Group. Because program outcomes were similar to those of another sealant initiative, it can probably be concluded that continuing education will increase dentists' knowledge about sealants, but have little effect upon their attitudes or their use of the technique. The changes observed in this investigation may be due to the particular capacity for cognitive and affective changes of participants, characteristics of the technology being promoted, and external forces in the professional environment.     

The Surface-Specific Caries Pattern of Participants in a School-Based Fluoride Mouthrinsing Program with Implications for the Use of Sealants

This paper describes the surface-specific changes in the DMFS after seven years of a school-based mouthrinsing program occurring in the elementary schools of the fluoride-deficient Three Village Central School District, Long Island, New York. The effectiveness of mouthrinsing was evaluated annually by comparing the caries prevalence of a random sample of participants to that of Three Village elementary schoolchildren examined in 1975, prior to the beginning of the program. Because sixth-grade children rinsed the longest and had the longest exposure to the caries challenge, only sixth-grade children who participated in the program are included in the analysis. Overall, they experienced a 50 percent reduction in dental caries; the reduction was not uniformly experienced by all surfaces. Proximal surface caries showed the greatest rate of change but the least absolute change, because the amount of proximal carious lesions was low initially. Occlusal surfaces showed the greatest absolute reduction in dental caries, whereas buccolingual surfaces had the lowest percentage reduction. The majority of the decayed or filled surfaces, 94 percent, involved pits or fissures. Therefore, it was concluded that the combined use of sealants and weekly fluoride rinsing could produce a virtual elimination of dental decay in elementary schoolchildren.