Longitudinal caries prevalence in a comprehensive, multicomponent, school-based prevention program (original) (raw)
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The efficacy of a school-based caries preventive program: a 4-year study
International Journal of Dental Hygiene, 2006
Abstract: This longitudinal study aimed at testing the efficacy of a school-based caries preventive program, by comparing dental caries status of two groups, a study group (436 children) and a control group (420 children) over a period of 4 years. The study group received a preventive program which consisted of intensive oral hygiene instructions sessions, and supervised daily tooth brushing using fluoridated tooth paste in schools. The control group received only oral hygiene instructions sessions. Annual dental examination to record dental caries status, using Decayed Missed Filled Teeth Index (DMFT) and deft, was conducted for both groups over a period of 4 years. At the end of the fourth year the efficacy of the program was tested by comparing the DMFT and deft indices for the two groups using Pearson chi-square test and Cochran–Mantel–Haenzele test. The level of significance was set at P < 0.05. The results after 4 years showed that the caries status of the children in the study group was better than that of the control group. The difference was statistically significant (P-value 0.001). The estimates of relative risk values also showed that children in the control group are 3.1 and 6.4 times at higher risk of having dental caries than those in the study group for age group 12 and 6 respectively. This study proves that supervised daily tooth brushing using fluoridated toothpaste is successful in controlling dental caries in children.
Fluoride Use in Caries Prevention in the Primary Care Setting
Pediatrics, 2020
Dental caries remains the most common chronic disease of childhood in the United States. Caries is a largely preventable condition, and fluoride has proven effectiveness in caries prevention. This clinical report aims to clarify the use of available fluoride modalities for caries prevention in the primary care setting and to assist pediatricians in using fluoride to achieve maximum protection against dental caries, while minimizing the likelihood of enamel fluorosis. Fluoride varnish application is now considered the standard of care in pediatric primary care. This report highlights administration, billing, and payment information regarding the fluoride varnish procedure. Dental caries (ie, tooth decay) is an infectious disease caused by bacteria on the tooth surface metabolizing carbohydrates and producing acid, which dissolves tooth enamel. If unchecked, this process continues through the tooth and into the pulp, resulting in pain and tooth loss. This can further progress to local infections (ie, dental alveolar abscess or facial cellulitis), systemic infection, and, in rare cases, death. Dental caries in the United States is responsible for many of the 51 million school hours lost per year as a result of dental-related illness, which translates into lost work hours for the adult caregiver. 1 Early childhood caries is the single greatest risk factor for caries in the permanent dentition. Good oral health is a necessary part of overall health, and studies have demonstrated adverse effects of poor oral health on multiple chronic conditions, including diabetes control. 2 Therefore, failure to prevent caries has health, educational, and financial consequences at both the individual and societal levels. Dental caries is the most common chronic disease of childhood, 1 with 59% of 12-to 19-year-olds having at least 1 documented cavity. 3 Caries is a "silent epidemic" that disproportionately affects poor, young, minority populations and children living below 100% of the poverty level. 1 In the United States, 25% of 2-to 5-year-old children from low socioeconomic and minority groups experience 80% of dental disease. 4 Among 3-to 5year-olds, untreated dental decay was significantly greater for non
Water Fluoridation and Dental Caries in U.S. Children and Adolescents
Journal of Dental Research, 2018
Fluoridation of America's drinking water was among the great public health achievements of the 20th century. Yet there is a paucity of studies from the past 3 decades investigating its dental health benefits in the U.S. population. This cross-sectional study sought to evaluate associations between availability of community water fluoridation (CWF) and dental caries experience in the U.S. child and adolescent population. County-level estimates of the percentage of population served by CWF (% CWF) from the Centers for Disease Control and Prevention's Water Fluoridation Reporting System were merged with dental examination data from 10 y of National Health and Nutrition Examination Surveys (1999 to 2004 and 2011 to 2014). Dental caries experience in the primary dentition (decayed and filled tooth surfaces [dfs]) was calculated for 7,000 children aged 2 to 8 y and in the permanent dentition (decayed, missing, and filled tooth surfaces [DMFS]) for 12,604 children and adolescents aged 6 to 17 y. Linear regression models estimated associations between % CWF and dental caries experience with adjustment for sociodemographic characteristics: age, sex, race/ethnicity, ruralurban location, head-of-household education, and period since last dental visit. Sensitivity analysis excluded counties fluoridated after 1998. In unadjusted analysis, caries experience in the primary dentition was lower in counties with ≥75% CWF (mean dfs = 3.3; 95% confidence limit [CL] = 2.8, 3.7) than in counties with <75% CWF (mean dfs = 4.6; 95% CL = 3.9, 5.4), a prevented fraction of 30% (95% CL = 11, 48). The difference was also statistically significant, although less pronounced, in the permanent dentition: mean DMFS (95% CL) was 2.2 (2.0, 2.4) and 1.9 (1.8, 2.1), respectively, representing a prevented fraction of 12% (95% CL = 1, 23). Statistically significant associations likewise were seen when % CWF was modeled as a continuum, and differences tended to increase in covariate-adjusted analysis and in sensitivity analysis. These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth.
Caries Research, 2016
This paper describes an innovative public health intervention, called ‘Smile Grenada', targeting the oral health of children in Grenada utilizing the resources of a US dental school, several oral health care companies, local governmental and public health authorities, and Grenadian school personnel. Methods: Preintervention visual/tactile caries examinations were collected from 1,092 schoolchildren (mean age 9.9 years, standard deviation, SD = 3.7) in 2010. The intervention included: (1) classroom-based toothbrushing with fluoridated toothpaste, (2) fluoride varnish applied by trained dental students, teachers and local providers 3 times a year and (3) glass ionomer sealants placed on first permanent molars in children aged 6-8 years. Postintervention data were collected in May, 2013 (n = 2,301, mean age 9.8 years, SD = 3.7). Decayed and demineralized surfaces were examined for the whole sample and decay/demineralization and sealant retention on 6-year molars were examined separ...
Clinical Oral Investigations, 2001
The aim of this 2-year prospective randomized clinical study was to evaluate the efficacy of a prevention program for schoolchildren with high caries risk. A sample of 419 subjects was divided into a test (T, n=259) and control group (C, n=160). Four times a year, the test group received professional tooth-cleaning and application of a 0.1% fluoride varnish as well as motivation and instruction in oral hygiene. The control group received only oral hygiene instruction and took part in supervised toothbrushing once a year. At baseline and after 2 years, the D 3 , 4 MFS and the incipient lesions (D 1,2 ) were recorded. After 2 years, 318 subjects (T=187, C=131) were included in the data analysis. The baseline D 1,2 was 6.18 (T) and 5.50 (C), the D 3 , 4 MFS 2.13 (T) and 2.08 (C), respectively. No statistically significant difference was found for the baseline values. At the final examination, the D 1,2 increment was 3.96 in the test and 6.53 in the control group, showing a statistically significant difference (P<0.001). No such difference was found for the D 3 , 4 MFS increment (T: 2.22; C: 2.61). The results indicate that it might not be possible to prevent cavities in high caries risk children by means of the described program.
Recent Dental Caries and Treatment Patterns in US Children
Journal of Public Health Dentistry, 1986
This reportt presents dental caries and treatment patterns found in a longitudinal study of US children between 1978 and who were geographically dispersed across several fluoridated and nonfluoridated sites. The analyses include first-and fifth-grade children examined annually for four years in the National Preventive Dentistry Demonstration Program and who did nor receive effective preventive procedures. The results indicate that in association with the caries decline in US children, treatment ratios increased by over 20 percent during the study period. FSIDFS ratios averaged 79 percent for the four gradelfluoridation status cohorts analyzed and were significantly higher in fluoridated than in nonfluoridated sites. The singlefissured surface was the dominant treatment or disease area observed and these surfaces tended to be restored early. In assessing tooth-surface status changes annually, tooth surfaces were more than twice as likely to change from sound to filled than from sound to decayed between yearly examinations at fluoridated sites. The lower levels of decay and higher degree of restorative care observed were nor observed in lower SES and black children nearly to the extent as those for higher SES and white children in the population. The dental profession should shift its emphasis from the early restoration of fissured-surface defects to an expanded use of sealants for those with reduced decay and focus resources on a minority of the population with high caries levels who receive limited care.
Caries prevention in high-risk preschool children in the United States
2005
Dental caries is a common infectious disease affecting young children living in low-income families in the United States. Efficacious, safe, feasible and cost-effective caries prevention methods for these children are essential. Several studies have shown the efficacy of fluoride varnish and xylitol to improve the oral health of children. The efficiency of caries prevention programs including the use of fluoride varnish or xylitol chewing gum in early childhood has not been well documented in communities with private dental services. The purpose of this study was to determine the caries prevalence and distribution in the primary dentition, and to evaluate the effectiveness of two prevention programs, including applications of fluoride varnish and the use of xylitol chewing gum in randomized groups of preschool children attending Head Start school programs in Northern Florida. The caries preventive effect of fluoride varnish in the primary dentition was evaluated in a sample of 4–6 y...
International dental journal, 2009
The evaluation of long-term effects five years after the completion of a school-based caries prevention programme combined with fluoride mouth rinse (FMR) and targeted sealant application (TS). 46 subjects in the FMR+TS group and 55 subjects in the FMR group, who were 20 -21 years old, were analysed. They had participated in each 11-year programme, underwent a dental examination at the age of 20 years and answered a self-administered questionnaire. The caries prevalence and mean DMFT were calculated, and differences between the two groups were analysed by the chi2 test and Mann-Whitney test, respectively. Logistic and multiple regression analyses were performed using sex, group, and five questionnaire items as independent variables. The caries prevalence and mean DMFT (SD) was 28.3%, 1.56 (3.00) in the FMR+TS group and 60.0%, 2.20 (2.44) in the FMR group, and the difference was significant respectively. In the logistic regression analysis the odds ratio of the FMR+TS group to the FM...
Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years
JAMA, 2021
IMPORTANCE A 2014 review for the US Preventive Services Task Force (USPSTF) found that oral fluoride supplementation and topical fluoride use were associated with reduced caries incidence in children younger than 5 years. OBJECTIVE To update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. DATA SOURCES Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to September 2020); surveillance through July 23, 2021. STUDY SELECTION Randomized clinical trials (RCTs) on screening, preventive interventions, referral to dental care; cohort studies on screening and referral; studies on diagnostic accuracy of primary care oral examination or risk assessment; and a systematic review on risk of fluorosis included in prior USPSTF reviews. DATA EXTRACTION AND SYNTHESIS One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. RESULTS Thirty-two studies (19 trials, 9 observational studies, and 4 nonrandomized clinical intervention studies [total 106 694 participants] and 1 systematic review [19 studies]) were included. No study evaluated effects of primary care screening on clinical outcomes. One study (n = 258) found primary care pediatrician examination associated with a sensitivity of 0.76 (95% CI, 0.55 to 0.91) and specificity of 0.95 (95% CI, 0.92 to 0.98) for identifying a child with cavities, and 1 study found a risk assessment tool associated with sensitivity of 0.53 and specificity of 0.77 (n = 697, CIs not reported) for a child with future caries. No new trials of dietary fluoride supplementation were identified. For prevention, topical fluoride compared with placebo or no topical fluoride was associated with decreased caries burden (13 trials, n = 5733; mean caries increment [difference in decayed, missing, and filled teeth or surfaces], −0.94 [95% CI, −1.74 to −0.34]) and likelihood of incident caries (12 trials, n = 8177; RR, 0.80 [95% CI, 0.66 to 0.95]; absolute risk difference, −7%) in higher-risk populations or settings, with no increased fluorosis risk. Evidence on other preventive interventions was limited (education, xylitol) or unavailable (silver diamine fluoride), and no study directly evaluated primary care dentistry referral vs no referral. CONCLUSIONS AND RELEVANCE There was no direct evidence on benefits and harms of primary care oral health screening or referral to dentist. Dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.
International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children, 2014
Singapore is unique in that it is a 100% urban community with majority of the population living in a homogeneous physical environment. She, however, has diverse ethnicities and cultures as such; there may be caries risk factors that are unique to this population. The aims were to assess the oral health of preschool children and to identify the associated caries risk factors. An oral examination and a questionnaire were completed for each consenting child-parent pair. One hundred and ninety children (mean age: 36.3 ± 6.9 months) were recruited from six community medical clinics. Ninety-two children (48.4%) were caries active. The mean d123 t and d123 s scores were 2.2 ± 3.3 and 3.0 ± 5.6, respectively. Higher plaque scores were significantly (P < 0.0005) associated with all measures of decay (presence of decay, dt, ds). The risk factors for severity of decay (i.e., dt and ds) include child's age, breastfeeding duration, and parents' ability to withhold cariogenic snacks fr...