Caries experience of children in primary schools with long-term tooth brushing programs: A pilot Australian study.

OBJECTIVE: The aim of this study was to evaluate a primary school-based tooth brushing (TB) program conducted in a low socio-economic area of Queensland, Australia, to determine its effectiveness in reducing caries. METHODS: Records kept at the central dental clinic of the district were used to analyse the caries experience (decayed, missing, filled teeth [dmft/DMFT]) and caries prevalence in children from two schools with long-term TB programs (TB) (N=1191) and three Non-TB schools (N=553). The schools were matched by socio-economic indices. RESULTS: Historical records showed that the baseline caries experience in all TB and Non-TB primary schools were similar at each primary school year. After a mean period of 5-9 years of the TB program, the caries experience (mean decayed, missing, filled teeth, dmft/DMFT) and prevalence were lower for TB group than Non-TB group. In the primary dentition, the overall mean dmft (±standard deviation) of TB group (2.53±3.00) was significantly lower than the Non-TB group (3.06±3.30) (P<.001). Similarly, in the permanent dentition, the overall mean DMFT of TB group (0.47±1.05) was reduced significantly compared to the Non-TB group (1.15±1.72) (P<.001). The overall caries prevalence in the TB group was 68% compared to 78% in Non-TB (P<.001). Overall, the mean annual DMFT increments of children in the TB schools were also significantly less compared with children in the Non-TB schools (P<.001). CONCLUSION: A long-term primary school TB program significantly reduced caries experience and caries prevalence in an optimally fluoridated (1-ppm), very low socio-economic district.

A controlled study of risk factors for enamel hypoplasia in the permanent dentition.

PURPOSE: The purpose of this study was to investigate risk factors for enamel hypoplasia (EH) and enamel opacity (EO) in the permanent teeth of healthy schoolchildren from a nonfluoridated community in Australia. METHODS: Children with EH (N=104) or EO (N=104) were compared with matched controls without enamel defects (N=105). Subjects who previously resided in on optimally fluoridated town provided data on the effects of drinking fluoridated water. RESULTS: The main risk factors for EH were low socioeconomic status (P < .04), respiratory infections (P < .001), exposure to cigarette-smoking (P = .001), asthma (P = .007), otitis media (P = .01), urinary tract infection (UTI; P = .03) and chickenpox (P = .001). Combinations of either chickenpox and UTI or chickenpox and exposure to cigarette-smoking were associated with relatively high numbers of EH. While use of adult toothpaste (1000 ppm) at 0 to 3 years old increased risks for EH, there were less EO in children who used child toothpaste (300 ppm fluoride, 86% vs. 95%; P = .02) or who drank optimally fluoridated water compared to those who did not (4% vs. 29%; P < .001). CONCLUSIONS: Children with low socioeconomic status, histories of respiratory or chickenpox infections, exposure to cigarette-smoking, urinary tract infections, otitis, and use of adult toothpaste are predisposed to enamel hypoplasia. By contrast, drinking optimally fluoridated water at 0 to 3 years old reduces the risk for enamel opacities.

Clinical detection of caries in the primary dentition with and without bitewing radiography.

BACKGROUND: Inadequate detection of caries in the primary dentition due to non-use of bitewing radiography is commonly encountered in paediatric practice. The present study investigated the increased benefits of using bitewing radiography in addition to the visual-tactile examination technique for detection of primary dentition caries in a non-fluoridated community, and determined the prevalence of "hidden" occlusal caries in the primary dentition. METHODS: Primary teeth were scored for caries at the restorative threshold using a visual-tactile technique followed by bitewing radiographic examination in a sample of 611 schoolchildren aged 6.4 +/- 0.5 yrs to 12.1 +/- 0.8 yrs residing in a non-fluoridated city. RESULTS: Overall, at the restorative threshold, the visual-tactile technique could detect 62 per cent of occlusal caries compared to 74 per cent for bitewing radiography (p < 0.001). The prevalence of "hidden" occlusal caries was 12 per cent. In contrast, for primary molar proximal surface caries, the visual-tactile technique could detect only 43 per cent of caries compared with 91 per cent for bitewing radiography (p < 0.001). CONCLUSIONS: In the primary dentition, use of bitewing radiography increases the detection rate of proximal surface caries substantially. It is recommended that bitewing radiography be included as part of the routine examination of children with proximal surfaces that cannot be visualized.