Caries treatment through 30 years in children and adolescents in Asker, Norway

Abstract Asker is a capital suburb where a preventive philosophy has guided the public dental health services for decades. In the period studied the child population aged 3–13 yr increased from 3208 to 6008. In the school age groups 7–15 yr practically all children in the community have participated in the dental service programs. The objective of the paper is to present retrospectively the changes in caries status of children under near optimal dental health care conditions and to expose reported preventive activities. A considerable increase in the proportion of “caries free” pre-school children occurred in the period 1976–88. A maximum was reached in the latter part of the eighties, where after a leveling off is suggested. For school children a rapid increase in “caries free” children took place for the lowest grades, starting before 1976. The higher grades came later and at a slower pace. The great number of fillings inserted in 1966–72, oscillating around 60 surfaces for the nine school years, decreased rapidly during the following decade and seems now to have settled around a total average of five to six surfaces. This implies a reduction of 90% in 20 yr. In most age groups these changes started before 1970. The major part of the caries decline occurred in the seventies and a leveling off is apparent during the eighties. The average number of filled surfaces per year has fallen from 6.6 in the 1955 birth cohort to 0.7 in the 1977 cohort, a reduction of 89% in 22 yr. The average number of filled surfaces (FS) in 15-yr-olds leaving compulsory school decreased during the period 1980–92 from 16.5 to 4.8. In 1980 20% of the children left school with more than 20 filled surfaces, as compared to only 3% in 1992. Operative treatment need has been reduced to a fairly low level among school children and adolescents, but caries is definitely not eradicated. The “caries free” situation is not permanent, but treatment need becomes evident at a later age and is more modest than before. The remarkable reduction and delay of the caries problem is most likely the result of several factors, fluorides seemingly playing the major role.