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

Carvalho, Joana Christina; Nieuwenhuysen, Jean-Pierre Van; D’Hoore, William

doi:10.1034/j.1600-0528.2001.00009.x

Cited by 61 publications

(50 citation statements)

References 15 publications

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“…7 Occlusal caries accounts for the majority of affected tooth surfaces in adolescents and adults. [8][9][10][11] It is, therefore, apparent that preventing dental caries on the occlusal surfaces of FPMs is a key objective in preventative dental care. These surfaces represent the surfaces most susceptible to decay and are present in susceptible children.…”

Section: Teeth At Risk Of Dental Cariesmentioning

confidence: 99%

Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay

Chestnutt

Hutchings

Playle

et al. 2017

Health Technol Assess

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Background Fissure sealant (FS) and fluoride varnish (FV) have been shown to be effective in preventing dental caries when tested against a no-treatment control. However, the relative clinical effectiveness and cost-effectiveness of these interventions is unknown. Objective To compare the clinical effectiveness and cost-effectiveness of FS and FV in preventing dental caries in first permanent molars (FPMs) in 6- and 7-year-olds and to determine their acceptability. Design A randomised controlled allocation-blinded clinical trial with two parallel arms. Setting A targeted population programme using mobile dental clinics (MDCs) in schools located in areas of high social and economic deprivation in South Wales. Participants In total, 1016 children were randomised, but one parent subsequently withdrew permission and so the analysis was based on 1015 children. The randomisation of participants was stratified by school and balanced for sex and primary dentition baseline caries levels using minimisation in a 1 : 1 ratio for treatments. A random component was added to the minimisation algorithm, such that it was not completely deterministic. Of the participants, 514 were randomised to receive FS and 502 were randomised to receive FV. Interventions Resin-based FS was applied to caries-free FPMs and maintained at 6-monthly intervals. FV was applied at baseline and at 6-month intervals over the course of 3 years. Main outcome measures The proportion of children developing caries into dentine (decayed, missing, filled teeth in permanent dentition, i.e. D4–6MFT) on any one of up to four treated FPMs after 36 months. The assessors were blinded to treatment allocation; however, the presence or absence of FS at assessment would obviously indicate the probable treatment received. Economic measures established the costs and budget impact of FS and FV and the relative cost-effectiveness of these technologies. Qualitative interviews determined the acceptability of the interventions. Results At 36 months, 835 (82%) children remained in the trial: 417 in the FS arm and 418 in the FV arm. The proportion of children who developed caries into dentine on a least one FPM was lower in the FV arm (73; 17.5%) than in the FS arm (82, 19.6%) [odds ratio (OR) 0.84, 95% confidence interval (CI) 0.59 to 1.21; p = 0.35] but the difference was not statistically significant. The results were similar when the numbers of newly decayed teeth (OR 0.86, 95% CI 0.60 to 1.22) and tooth surfaces (OR 0.85, 95% CI 0.59 to 1.21) were examined. Trial fidelity was high: 95% of participants received five or six of the six scheduled treatments. Between 74% and 93% of sealants (upper and lower teeth) were intact at 36 months. The costs of the two technologies showed a small but statistically significant difference; the mean cost to the NHS (including intervention costs) per child was £500 for FS, compared with £432 for FV, a difference of £68.13 (95% CI £5.63 to £130.63; p = 0.033) in favour of FV. The budget impact analysis suggests that there is a cost saving of £68.13 (95% CI £5.63 to £130.63; p = 0.033) per child treated if using FV compared with the application of FS over this time period. An acceptability score completed by the children immediately after treatment and subsequent interviews demonstrated that both interventions were acceptable to the children. No adverse effects were reported. Limitations There are no important limitations to this study. Conclusions In a community oral health programme utilising MDCs and targeted at children with high caries risk, the twice-yearly application of FV resulted in caries prevention that is not significantly different from that obtained by applying and maintaining FSs after 36 months. FV proved less expensive. Future work The clinical effectiveness and cost-effectiveness of FS and FV following the cessation of active intervention merits investigation. Trial registration EudraCT number 2010-023476-23, Current Controlled Trials ISRCTN17029222 and UKCRN reference 9273. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 21. See the NIHR Journals Library website for further project information.

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Section: Teeth At Risk Of Dental Cariesmentioning

confidence: 99%

Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay

Chestnutt

Hutchings

Playle

et al. 2017

Health Technol Assess

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“…Thus, the use of a method capable of identifying spot lesions and their progression over time in an epidemiological level may be relevant considering the objective to be achieved in a study. The need for operative treatment at the population or individual level may be measured by the DMF index (11)(12)(13). While this information is in itself important, when evaluated alone, it perpetuates the over past concept that the caries process should be treated by restorations and extractions only.…”

Section: Introdutionmentioning

confidence: 99%

Differential Impacts of Caries Classification in Children and Adults: A Comparison of ICDAS and DMF-T

et al. 2016

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The aim of this study was to describe and compare findings regarding the prevalence and severity of dental caries when using ICDAS and DMFT/dmft in an epidemiological study with children and their mothers. This cross-sectional study evaluated 150 preschoolers and their mothers. Data were collected with ICDAS and then transformed into DMFT/dmft. ICDAS scores related to caries were analyzed according to three different cut-off-points: CP1 (0-healthy/1-6-caries), CP2 (0-1-healthy/2-6-caries) and CP3 (0-2-healthy/3-6-caries), representing the D/d of DMFT/dmft. ICDAS codes regarding restorations, except sealants, were considered the F/f and the code 97 as the M/m of DMFT/dmft index. Prevalence of caries and its severity with ICDAS were 92%, 84% and 31.3% in children and 97.3%, 96.6% and 80% in adults according to CP1/CP2/CP3, respectively. Admitting CP3 as the standard for data transformation of ICDAS in DMFT/dmft, it was observed that DMFT/dmft index would underestimate 60% of non-cavitated lesions in children and 16.6% in adults. The DMFT/dmft underestimated the presence of disease to disregard non-cavitated lesions for the pediatric population evaluated. The choice of which is the best index for epidemiological surveys will depend on the purpose of the research and the target population: if it is to estimate the needs of the population to determine clinical care in children and adults, the DMFT/dmft may be sufficient. However, if the objective is to have a more comprehensive diagnosis of caries at the population level in order to develop preventive strategies, to halt and reverse the disease, the detection of non-cavitated-lesions becomes important, mainly in young children.

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“…Some recent studies have shown that people in developing countries were found to have high caries prevalence for all age groups compared with developed countries (Bolin et al, 1996;Carvalho et al, 2001;Christensen et al, 2003;Gibson et al, 1999;Güçiz and Gökalp, 2008;Sheiham, 2005;Unlüer et al, 2007). According to those studies conducted in a developing country to estimate prevalence and severity of oral and dental health problem, more than half of the individuals had dental caries and the prevalence of normal population without a toothbrush was 15.9%, the toothbrushing rate 2 to 3 times daily was 22.2 and 27.6% in adults and geriatric peoples, respectively Güçiz and Gökalp, 2008;Unlüer et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…It is a well known fact that, brushing teeth significantly reduces the risk of dental caries and as the frequency of toothbrushing decreased, the tooth decay increased (Carvalho et al, 2001;Gibson and Williams, 1999). According to a recent study (Fujita et al, 2009) lower frequency of daily tooth brushing was related to higher prevalences of diabetes mellitus, hypertension and high triglyceride (TG) and/or low high density lipoprotein cholesterol (HDL-C).…”

mentioning

confidence: 99%

The relationship between high incidence of deep neck infection and toothbrushing frequency

Bakır¹,

Ahmet²,

Halis³

et al. 2012

Afr. J. Microbiol. Res.

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This study aimed to investigate and compare the frequency of toothbrushing and dental health status between Deep neck space infection (DNSI) patients with dental origin and healthy population. 64 participants were included in this study in the form of two groups. The first group consisted of 34 DNSI patients with dental onset, and the second group consisted of 30 participants (control group). Study was carried out in two separate categories: the frequency of toothbrushing and assessment of dental health status. Toothbrushing frequency was evaluated with a questionnaire. Dental health status was assessed for periodontal and dental disease by periodontist according to the some widely used indicators; DMFT scores, Plaque Index score, Gingival Index score and Sulcus Bleeding Index score. Present study showed that the majority had brushed their teeth occasionally. In DNSI group, the percentage of never toothbrushing was very high and regular toothbrushing rate was so low. DNI group has higher scores than the control group and this indicates poor oral hygiene. Our results showed that, oral health was impaired and regular toothbrushing seems to have been neglected in DNSI group. In our opinion, this negligence is a very important contributory factor towards the more occurrence of deep neck abscess.

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

Abstract: 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.

Cited by 61 publications

References 15 publications

Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay

Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay

Differential Impacts of Caries Classification in Children and Adults: A Comparison of ICDAS and DMF-T

The relationship between high incidence of deep neck infection and toothbrushing frequency

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