Need for professional prophylaxis prior to an acidulated phosphate fluoride (APF) topical fluoride gel-tray application was assessed by comparing 3 years’ caries increments in three groups of school children. The children were initially 10–14 years old and resided in a fluoride-deficient community (F ≤ 0.1 ppm). All received bi-annual APF topical fluoride gel-tray treatments performed in the children’s schools by hygienist-assistant teams using portable equipment. Group I had a hygienist-administered prophylaxis with a fluoride-free prophylaxis paste prior to the fluoride treatment, and served as the positive control. Group II brushed and flossed their teeth under supervision, and group III had no toothcleaning prior to the topical fluoride treatment. Of 1,453 children examined at baseline, 949 were available for the final examination. There were no statistically significant differences between the 3 years’ DMFS or DMFT increments of groups II and III compared to group I. This result indicates that a meticulous, professionally administered prophylaxis may not be necessary before patients are given a topical fluoride treatment.

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.

The caries prevalence of 7th- to 9th-grade junior high school students (approximate age 12–15 years) who had previously participated in a weekly 0.2% neutral NaF mouthrinsing program as elementary school children was compared with that of similarly aged children from the same schools who were examined before the mouthrinsing program began. After participation in the program for 5–7 years, the mean DMFS score for children in these grades had decreased from 7.37 to 3.89, a reduction of 47.2%. The greatest reduction, 78.9%, occurred in proximal surfaces. The inception of an effect only after the program was instituted, the dose-related response, and the specificity of the response to treatment support the conclusion that a posttreatment fluoride effect is responsible for the declining caries prevalence.

The effect on caries prevalence of the permanent dentition was evaluated after 5 years of weekly rinsing (130 scheduled rinses) with a 0.2% neutral NaF solution. The program was conducted in the Three Village Central School District, New York, U.S.A. (F less than or equal to 0.1 part/10(6). First to sixth grade children who rinsed from 1 to 5 years respectively had a caries prevalence reduction of 45.3% (DMFT) and 47.4% (DMFS) compared to baseline scores of children who were examined before the rinsing program began. The highest caries reduction, 81.3%, was found on proximal surfaces. Two variables influenced the cariostatic benefits associated with fluoride rinsing. The younger that children entered the program and the longer that they rinsed, the greater were the accumulated benefits.