Caries In First Permanent Molars Research Articles

Eruption and caries status of first permanent molars in children aged 6–7 years in Shijingshan District, Beijing, China

BackgroundDental caries is still a major disease that affect the oral health of people in China. First permanent molars (FPMs) are the most caries-susceptible teeth among school-aged children. The aim of this study was to investigate the eruption and caries status of first permanent molars in children aged 6–7 years in Shijingshan District, Beijing, China, to provide information for oral health promotion.Methods The study was a cross-sectional survey conducted in 6-7-year-old first grade children from public elementary schools in Shijingshan District, Beijing. Participants were invited to receive a clinical oral examination. The eruption status and caries experience of FPMs were recorded. Questionnaires assessing children’s sociodemographic information and oral health-related behaviors were completed by the children’s parents or guardians.ResultsA total of 3,176 children, including 1,644 boys (51.8%) and 1,532 girls (48.2%) were included in the oral examination and questionnaire. Eruption status of FPMs was as follows: 37.5% fully erupted, 28.3% partially erupted, 34.2% not erupted. Girls had more erupted FPMs than boys (70.1% VS 61.8%, P < 0.001). The prevalence of dental caries in FPMs was 5.5% (174/3,176) in studied children. The mean decayed missing filled teeth score of FPMs was 0.11 and the mean decayed missing filled surface score of FPMs was 0.19. Binary Logistic regression analysis demonstrated that girls had more tooth decay than boys and father’s educational background also associated with the caries experience of the studied children (P < 0.05).ConclusionsAround two-thirds of FPMs were fully erupted or partially erupted among children aged 6–7 years old in Shijingshan District, Beijing. Approximately 5% of the newly erupted FPM established dental caries. Effective intervention should be applied in this age group for oral health promotion.

Risk factors associated with occlusal caries in first permanent molars in a school program

Aim: Evaluate the longitudinal status of dental caries in the occlusal surface of first permanent molars (FPM) and to identify risk factors for the progression to cavitated caries lesions in a school oral health program. Methods: Children who were enrolled in the program between September 2017 and October 2019, 5 to 10 years-old, presenting the four FPM were included. Four calibrated examiners assessed dental caries according to Nyvad criteria. Descriptive analysis included frequency, mean, and standard deviation calculations. Chi-square test was used in the bivariate analysis and, logistic regression adjusted for cluster effect was used to identify significant risk factors for cavity among the following independent variables: gender, age in the baseline, deft, upper/lower molar, initial caries score, Molar Incisor Hypomineralization (MIH), fluorosis, occlusal sealing. Odds ratio (OR) and respective confidence intervals (CI) are presented. Results: From 174 children enrolled in the program between 2017/2019, 120 were reevaluated in 2022. Eleven (2.6%) FPM in 11 children (9.2%) presented cavitated caries in the follow up examination. Significant risk factors for cavity were caries experience in the primary teeth (OR = 5.59; CI: 1.4 – 22.3) and the presence of MIH (OR = 5.33; CI: 1.6 – 18.1). Most of the active lesions in the follow up were considered active in the baseline examination. Conclusions: The progression to cavity was relatively low, significantly influenced by past caries experience and MIH.

Assessment of caries diagnostic threshold of DMFT, and ICDAS II in the estimation of caries prevalence rate in first permanent molars among students of College of Dentistry-Hawler Medical University.

Background: Dental caries is a common chronic infectious disease resulting from tooth-adherent cariogenic bacteria primarily S. Mutans, which metabolize sugars to produce acid, demineralizing the tooth structure over time. First permanent molars (FPMs) have a key role in establishing dental occlusion. They are very prone to caries because of their anatomical structure and early eruption. Hence, the estimation of dental caries in FPMs at individual and community levels could help understand the pattern and severity of dental caries. Aim: The current study aimed to evaluate the caries prevalence of FPMs amongst the students of collage of dentistry/HMU. The rate of decay between male and female, maxillary and mandibular FPM teeth. Method: This study was carried out among the students of Hawler medical university/college of dentistry. The total number of samples was (100) samples. The age of the students ranged from (18-24 years) of age. Clinical examinations were carried out under artificial light using dental mirrors and dental probe/explorers. Dental caries was diagnosed on teeth number (3, 14, 19, and 30), according to the criteria of DMFT index looking for missing, filling, decayed teeth. then ICDAS to further classify the amount of dental caries later the collected data was analyzed by using SPSS. Results: in this study the difference in decay between maxillary and mandibular teeth was significant with the P value being (0.27). Between genders the P value was (0.38) and between age groups was (0.30) their result being insignificant, according to chi-square test. Conclusion: this study indicates that; the rate of decay is more in mandibular FPMs in comparison to maxillary FPMs. While the difference between the male, female and different age group in caries prevalence are non-significant, hence, more education about the aforementioned problems is necessary. Keywords: Caries Diagnostic Threshold, Prevalence Rate.

Microbial Relationship of Carious Deciduous Molars and Adjacent First Permanent Molars.

(1) Epidemiological studies have shown that deciduous molar caries are related to and more severe than permanent molar caries. This study aimed to investigate whether caries subtypes in deciduous molars were associated with caries in first permanent molars and to explore taxonomic and functional profiles of the microbiota involved in different subtypes. (2) 42 mixed-dentition children were recruited and were divided into DMC (carious deciduous molars but caries-free first permanent molars; n = 14), C (carious deciduous and first permanent molars; n = 13), and control (n = 15) groups. Metagenomic sequencing was performed for supragingival plaque samples obtained separately from deciduous and first permanent molars. (3) The microbiota of deciduous molars in the DMC and C groups differed not only in species-based beta diversity but also in compositional and functional profiles. In the C group-like subtype, 14 caries-related species and potential pathways were identified that could be responsible for the caries relationship between the deciduous and permanent molars. In the DMC group-like subtype, the overall functional structure, the levels of Leptotrichia wadei, Streptococcus anginosus, and Stomatobaculum longum and KOs in sugar transporters and fermentation, quorum sensing, and TCA cycle in their first permanent molars surprisingly resembled those of the C group rather than the control group. This suggested that these clinically sound first permanent molars were at a greater risk for caries. (4) Classification of deciduous molar caries according to the microbiota could serve as a caries risk predictor for adjacent first permanent molars.

Caries Severity, Decayed First Permanent Molars and Associated Factors in 6-7 Years Old Schoolchildren Living in Palermo (Southern Italy).

To date, there are very few epidemiologic studies on caries disease in 6-7 year old children living in Sicily (Southern Italy). The first permanent molar (FPM) is the most commonly affected tooth in this target population, and a one-unit increase in the number of decayed FPMs is predictive of caries in other teeth and in adulthood. The primary aim of this research is to estimate the prevalence of caries in 6-7 year old schoolchildren living in Palermo and, as a secondary aim, to estimate the prevalence of affected FPMs. It was designed as a cluster cross-sectional survey on 995 children from 16 schools, selected based on their geographical location, in one of the eight city districts. Caries data were recorded using the International Caries Detection and Assessment System for each tooth surface. The relation between socio-economic status, behavioural determinants, and clinical information and the number of teeth with initial caries (IC), moderate caries (MC), or extensive caries (SC) was analysed through the ordinal logistic regression. Among the 995 schoolchildren, 662 (66.5%) had at least one lesion and 742 (74.6%) had FPMs. Of the latter, 238 (32.0%) were affected by IC, 86 (11.6%) were affected by MC, and only 3 (0.4%) were affected by SC. During multivariable analysis, there was evidence of an increased risk of MC and SC related to the deprivation of the district in which the children lived and went to school, as well as to the protective role of parental education and employment. The same significant determinants were found for IC and MC FPMs. The study showed the important role of socio-economic determinants, unhealthy behaviours, and social deprivation related to the increased risk of moderate and extensive caries in 6-7 year old schoolchildren. Investigating this target population is very important, as early development of caries in FPMs may have serious consequences in the prognostics of oral health in an adult.

Dental caries prediction and the indication of pit and fissure sealant in children first permanent molars: A prospective study

ObjectivesTo evaluate predictors for caries incidence on first permanent molars and to assess the accuracy and efficiency of these predictors for the indication of pit and fissure sealants. Methods: This 7-y cohort study started in 2010 with a sample of 639 children (1–5 years) from Southern Brazil. Dental caries was assessed using the ICDAS. Maternal education, family income, parental perception on child oral health and severe dental caries experience were collected at baseline and used to test the prediction of dental caries. Predictive values, accuracy and efficiency were estimated for each possible predictor. Results449 children were re-assessed at follow-up (70.3% retention rate). The baseline characteristics showed similar risks for dental caries incidence in first permanent molars. Low family income and poor parental perception of child oral health were moderately accurate in correctly identifying sound children who would not need to receive pit and fissure sealant. However, all the adopted criteria have lower accuracy incorrectly identifying children who later developed dental caries in first permanent molars. ConclusionsDistal and intermediate factors were relatively accurate in determining caries risk incidence on children's first permanent molars. The criteria adopted were more accurate in identifying sound children than those who need to receive pit and fissure sealant. Clinical relevanceOur findings reinforce the idea that investing in strategies that take into account common risk factors still represents the best option for dental caries prevention. However, adopting only these parameters is not enough to indicate pit and fissure sealants.

Clinical status and assessment of caries on first permanent molars in a group of 6- to 13-year-old Tunisian school children.

The present survey aimed to highlight the clinical status of first permanent molars (FPMs) among a group of children aged between 6 and 13 years in public primary schools in Tunisia and to determine the association between FPMs' dental caries, gingival bleeding, malocclusion, dental fluorosis, and enamel defects. The survey involved a cross-sectional study based on a dental examination conducted in public primary schools in Monastir Tunisia. A dental caries assessment was performed on FPMs using the International Caries Detection and Assessment Systemclassification; the number of carious lesions in permanent and temporary dentition was established using the decayed/missing/filled teeth (DMFT)index. The Gingival Index and the Dental Aesthetic Index were used to determine the occurrence of gingival bleeding and malocclusions. Dean's index and the modified Development Defects of Enamel index were used to define the enamel defects. The χ2 test was used to assess the difference between more than two groups, and the level of statistical significance was set at .05%. A total of 545 children and 2080 FPMs were examined. The prevalence of dental caries in FPMs was recorded to be 35.8%. The overall mean DMFTindex of the study population was 1.62 and the mean DMFT index was 1.41. The proportion of carious FPMs increased significantly with the age of the children (p < .05). The mandibular first permanent molar presented higher caries prevalence than its maxillary counterpart (p < .05). The presence of surfaces affected by molar incisor hypomineralization was recorded in 4.3% and the presence of surfaces affected by fluorosis was recorded in 4.6% of FPMs. No association was reported between FPMs' dental caries, gingival bleeding, malocclusion, and enamel defects (p > .05). Although the prevalence of caries in FPMs was considered moderate, health promotion programs should be implemented on a large scale to decrease the prevalence of dental caries among school children.

Prevalence of caries in first permanent molar among children in Saudi Arabia: a retrospective study.

This study investigated the prevalence of dental caries in first permanent molars among children aged 7-14 years in Saudi Arabia. This retrospective cross-sectional study included 6,089 panoramic radiographs of boys and girls aged 7-14 years who visited Riyadh Elm University Dental Hospital in Riyadh. All the panoramic radiographs were examined by five calibrated examiners for caries, filling, missing, and pulp therapy in the first permanent molars (FPMs). The Chi-square test was applied at a p<0.05. A total of 24,356 FPMs were evaluated from the panoramic radiograph, 69.5% of FPMs were sound, 22.5% were carious, and 7.3% were treated. The prevalence of decayed FPMs was 30.5%. A statistically significant difference in the status of FPM was observed across genders. Caries in the mandibular FPM was significantly higher than those in the maxillary FPM at p<0.05. The prevalence of caries in the FPM was relatively high, and females had more decay than males. Additionally, the mandibular FPMs showed higher levels of caries than the upper FPMs.

Association between dental caries and molar-incisor hypomineralisation in first permanent molars: A hierarchical model.

To assess whether the prevalence of dental caries is associated with the presence of molar-incisor hypomineralisation (MIH) in first permanent molars (FPMs). A cross-sectional study was conducted with a sample of 5368 FPMs from 1342 children aged 8-10 years from Florianopolis, Brazil. Dental caries was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index and MIH was assessed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The sociodemographic data were obtained with a questionnaire sent to caregivers. A hierarchical repeated measures Poisson regression, considering dependency among observations, was performed, since the unit of analysis was the tooth. The presence of MIH was associated with a 6.15 times higher prevalence of dental caries in FPMs (PR: 6.15; 95%CI: 4.18-9.04). A monthly family income ≤2 minimum wages and the caries experience in the primary teeth were also significantly associated with greater prevalence rates of dental caries in FPMs. The presence of MIH showed a significant association with the prevalence of dental caries in FPMs. Thus, dentists should be alert to cases of MIH. Once the condition is detected, preventive measures should be taken to prevent enamel breakdown and the development of dental caries lesions.

Sealant Utilization and its Influence on Caries Reduction in First Permanent Molars in Saudi Female School Children

Purpose: This study aimed to assess the utilization of fissure sealants and their influence on caries reduction in first permanent molars (FPMs) among 6-9 years old female schoolchildren in Dammam, Eastern Province of Saudi Arabia. Materials and Methods: First to fourth grade female children from public schools in Dammam participated in this cross-sectional study. Dental caries and fissure sealants in FPMs were examined clinically using the World Health Organization guidelines. In addition, the parents of the participants responded to a self-reported questionnaire. Results: The study analyzed the data of 449 children. Almost 44.3% of the participants had at least one FPM affected with caries. There were 8.7% of the participants who had fissure sealants in at least one FPM, and out of these, only 2.2% had four FPMs filled with sealants. A significantly greater proportion of participants with sealed FPMs had no caries than the lower proportion of participants without sealants who had caries (P=&lt;0.05). The use of sealants increased significantly from first grade (10.3%) to second grade (30.8%), third grade (38.5%), and fourth grade (20.5%) (P=0.006). High monthly family income (P= 0.047) and having insurance (P=0.017) were significantly associated with increased sealant application. Nearly 21.9% of participants’ parents were aware of caries protective effects of dental sealants. Conclusion: The application of sealants was significantly associated with reduced caries in FPMs. Class year, monthly family income, and insurance were significantly associated with having sealants. Caries prevention programs for children should incorporate sealant application.

Perbedaan Keparahan Karies Gigi Molar Pertama Pada Anak Usia 6-9 Tahun Dengan 10-12 Tahun : Kajian Pada Radiograf Panoramik Di Rsgm-P Fkg Universitas Trisakti Periode 2017-2019 (Laporan Penelitian)

Background: First permanent molars play very important roles in the oral cavity. Therefore, tooth loss of these teeth due to caries has major impacts on oral health in the future. Panoramic radiographs have been used routinely in the oral health examinations and have accuracy comparable to intraoral radiographs in detecting carious lesions of posterior teeth. There have been no studies regarding the difference in the severity of caries in first permanent molars using panoramic radiographs before in Indonesia. Objective: The objective of this study was to determine the difference in the severity of first permanent molars caries in children aged 6-9 years and 10-12 years based on panoramic radiographs at the RSGM-P FKG Trisakti University for the period 2017-2019. Methods: The sample of this study were 680 panoramic radiographs of children aged 6-9 years and 10-12 RSGM-P FKG Trisakti University for the period 2017-2019. In this study, an ICCMS index was used to determine the severity of caries in first permanent molars. Result: The Mann Whitney U test used to determine the difference in the severity of caries showed that there was a difference in the caries severity of first permanent molars in children aged 6-9 years and 10-12 years (p &lt;0.05). Conclusion: There was a difference in the caries severity of first permanent molars in children aged 6-9 years and 10-12 years based on panoramic radiographs at RSGM-P FKG Trisakti University for the period 2017-2019.

Visual Examination, Fluorescence-Aided Caries Excavation (FACE) Technology, Bitewing X-Ray Radiography in the Detection of Occlusal Caries in First Permanent Molars in Children.

To compare the effectiveness of visual examination, radiographic examination and fluorescence-aided caries excavation (FACE) in detecting occlusal caries in first permanent molars in 150 children aged 6-14 years with intact occlusal surface with caries lesions without cavitation, or with darkened or deep fissures that had no clear diagnosis. Two dentists independently performed a visual oral examination, FACE and bitewing radiography. The inter-rater reliability of each detection method was determined and their specificity and sensitivity. All caries detection methods showed high inter-rater reliability with absolute agreement between raters above 90%. Most caries lesions were detected by visual (75.8%) and FACE (79.1%), while only 28.8% of lesions were detected by radiography. Detection by visual examination was strongly correlated with detection by FACE (X2=37.9, Phi=0.498, p<0.001). A lower, yet statistically significant, correlation was found between visual examination and X-ray radiography (X2=5.53, Phi=0.190, p<0.001). FACE had higher sensitivity (87%) and specificity (65%) for detecting occlusal caries in comparison with radiography (60% specificity and 55% sensitivity). Although visual examination remains the best method to detect occlusal caries in young permanent molars in children, FACE is an effective and accurate diagnostic tool that may aid in detection and treatment decisions.

A cost minimisation analysis of two dental sealing methods in an outreach dental program

ObjectiveTo conduct economic evaluation of two sealing methods (placement of resin sealant or glass ionomer ART sealant) in preventing pit and fissure caries in permanent first molars (PFMs) in schoolchildren. Materials and methodsAn outreach dental program was conducted in two randomly selected primary schools, one was covered by the national government-funded dental sealing service (group 1) and the other was not (group 2). Resin or ART sealant (sealant using glass ionomer material with the aid of the finger-press technique) was applied to all of the eligible PFMs in group 1 and group 2 students (grade 1 or 2), respectively. All the applications was provided at school. The cost for sealant application was recorded for each method. After 18 months, a cost minimisation analysis was performed based on the efficacy results of the two methods. Results and conclusionIn total, 445 sealants were applied to 126 children in group 1, and 668 sealants were applied to 203 children in group 2. Dental caries incidence was 29.4 % in group 1 and 28.6 % in group 2 after 18 months. Logistic regression analysis showed no statistically significant difference (p = 0.552) between the two groups. Cost minimisation analysis was used to evaluate the economic performance. The analytical model showed that the ART sealant was economically better than resin sealant. Sensitivity analysis showed that the life expectancy of the equipment/instrument used in sealant applications was the major parameter affecting the cost. The cost of using ART sealant over the study period was lower than that of using resin sealant. Overall, ART sealant is a less costly alternative for pit and fissure caries prevention in outreach dental services. Clinical significanceWhile pit and fissure sealing using ART sealant was as effective as using resin sealant in dental caries prevention, the cost of using ART sealant was lower than that of using resin sealant. Therefore, ART sealant could be a good alternative to resin sealant for pit and fissure caries prevention in outreach dental services for rural populations who have the greatest need.

The Influence of Age on the Development of Dental Caries in Children. A Radiographic Study.

Dental caries is a chronic disease that can be influenced by a multitude of factors. Poor oral hygiene and unhealthy eating habits are the most incriminating factors in the onset of dental caries, but age has been proven to impact the disease. The aim of this study was to find correlations between age and the evolution of dental caries in the first permanent molars in children. The retrospective study was conducted based on 400 panoramic radiographs, belonging to Romanian children between the ages of 6 and 14 years. All first permanent molars were investigated, and the carious lesions were classified according to their depth. The chronological age was calculated by subtracting the patient’s date of birth from the date when the radiograph was performed, while for the assessment of dental age, the Demirjian method was used. The gender of the patients did not significantly influence the number of superficial, medium, and deep carious lesions. Most of the identified carious lesions were superficial. Regarding correlations between age and dental caries, there was an association between the decrease in the chronological age and the increase in the number of superficial carious lesions on the first permanent molars and also an association between the increase in the chronological age or dental age and the increase in the number of medium and deep carious lesions on the first permanent molars. Age can impact the development of dental caries in first permanent molars.

The Impact of Early Childhood Factors on Dental Caries Incidence in First Permanent Molars: A 7-Year Follow-Up Study

The development of dental caries in first permanent molars has been extensively investigated. However, studies are inconclusive in determining the influence of contextual and individual factors on dental caries incidence in this group of teeth. The aim of this study was to evaluate the influence of contextual and individual factors on dental caries incidence in first permanent molars. This 7-year cohort study was conducted with children (1–5 years of age) who had been assessed initially in a survey performed in 2010. Dental caries was assessed at the baseline through the International Caries Detection and Assessment System (ICDAS). Contextual and individual variables were collected at baseline and included the presence of cultural community centers in the neighborhood as well as demographic, socioeconomic, psychosocial, and biological characteristics. A multilevel Poisson regression model was used to investigate the influence of individual and contextual characteristics on dental caries incidence in first permanent molars (relative risk [RR] and 95% confidence interval [CI]). Of the 639 children examined at baseline, a total of 449 were reassessed after 7 years (70.3% retention rate). Children who lived in neighborhoods with cultural community centers had a lower risk of dental caries in first permanent molars at the follow-up (RR 0.78; 95% CI 0.62–0.99). Children from families with a low income (RR 1.34; 95% CI 1.03–1.76) and poor parental perception of children’s oral health (RR 1.56; 95% CI 1.18–2.06) were associated with a higher risk of dental caries in first molars. In conclusion, individual and contextual determinants showed an important role in the incidence of caries in first permanent molars.

An evaluation of the Cariogram as a predictor model

As dentistry moves towards earlier detection of lesions and a more preventive rather than restorative approach, it is essential to improve the predictive values of new screening and diagnostic methods. This study was conducted to evaluate the accuracy of the Cariogram in predicting the occurrence of caries in first permanent molars. Thirty children aged 8 years were included who were divided in two groups depending on presence of carious or non carious first permanent molars. Their Cariograms were plotted and the likelihood of caries as indicated by the Cariogram was compared to the actual occurrence of caries in first permanent molars. Results revealed that the Cariogram had a diagnostic accuracy of 63.33% thus emphasising the need for better prediction models.

Permanent First Molars Clinical Status among School Children Aged 8-12 Years in Kathmandu

Introduction: Common oral diseases affecting school children are dental caries, gingivitis and malocclusion. Teeth mostly affected by dental caries in permanent dentition of children are the permanent first molars. Permanent first molars are key factors in occlusion and are most susceptible to dental caries. They maintain arch perimeter and provide best anchorage. Loss of these teeth leads to various problems like space management, tooth migration, problem in mastication and malocclusion.&#x0D; Objective: To assess the clinical status of first permanent molars among 8-12 year school children of Kathmandu.&#x0D; Methods: A cross-sectional study was done among 220 schoolchildren of age 8-12 years randomly selected from 2 private and 2 public schools of Kathmandu. Dental caries, gingival and oral hygiene status were measured by Decayed Missing Filled teeth (DMFT) index, Gingival index and Oral hygiene index-Simplified (OHI-S) respectively. Data was entered in Epidata 3.1 and analyzed in SPSS version 20.&#x0D; Results: The prevalence of dental caries in first permanent molars for study population was 54.5%. Mean DMFT score of first permanent molars was 0.96+1.2. Out of 867 molars examined, 197 (22.7%) were decayed. 98.5% of molars were erupted. Among the total study population, 184 (83.6%) had fair oral hygiene and 203 (83%) had gingivitis.&#x0D; Conclusions: This study shows the need to improve oral health status of first permanent molars of school children through promotion of dental health awareness and curative public health measures at school level.

Measurement of the Maximum Occlusal Bite Force and its Relation to the Caries Spectrum of First Permanent Molars in Early Permanent Dentition.

To determine the maximum occlusal bite force (MOBF) of the complete spectrum of dental caries in first permanent molars (FPMs) in children aged 7-9 years. A cross-sectional study was conducted on 123 children. The evaluation of the caries spectrum of FPMs was carried out using the Caries Assessment Spectrum and Treatment index (CAST). The MOBF was measured in the FPM region using the portable occlusal force gauze. Independent sample t-test and one-way analysis of variance test were performed to compare MOBF with CAST scores of FPMs. Based on the CAST scores, FPMs were categorized into three groups, group 1: healthy (score 0, 1, 2), group 2: premorbid (score 3), group 3: morbid (score 4, 5). A significantly lower MOBF was observed (167.56 N ± 49.77) in the morbid stage (group 3) than in the premorbid stage (group 2: 291.57 N ± 56.64), and healthy (group 1; 320.93 N ± 54.23). Intergroup comparison also revealed that FPMs in the healthy stage was associated with a higher bite force compared to those in the premorbid and morbid stages (p<0.001). The mean MOBF decreased with the progression of the caries spectrum of FPMs in early permanent dentition.

Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and adolescents.

Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and adolescents.

Effectiveness of fluoride varnish on caries in the first molars of primary schoolchildren: a 3-year longitudinal study in Guangxi Province, China

To evaluate the effectiveness of 5% sodium fluoride varnish on caries in first permanent molars and to assess the suitability of using this method to control caries among children in rural areas of Guangxi province, China. A total of nine schools with 32 classes were selected by simple random sampling. There were 999 students in the experimental group and 1,004 in the control group. The experimental group received oral health education and topical application of 5% sodium fluoride varnish, while the control group received oral health education only. Dental examinations were performed in November 2014 and November 2017, and the modified International Caries Detection and Assessment System (ICDAS-II) was used to record the caries status of the first permanent molars. The data were entered into SPSS 22 for statistical analysis. A total of 1,748 students (853 in the experimental group and 895 in the control group) completed the study. After 3years of intervention, the experimental group had a lower prevalence of caries, a lower caries increment, a lower decayed, missing and filled teeth (DMFT) index and a lower decayed, missing and filled surfaces (DMFS) index compared with the control group (respectively: 58.9% vs 65.5%, 34.8% vs 42.1%, 1.38 vs 1.59 and 2.06 vs 2.38). All the differences were statistically significant (P<0.05). In this study population, twice-yearly application of 5% sodium fluoride varnish and oral health education were more effective for preventing caries in first permanent molars than oral health education alone. The implementation of fluoride varnish application as a public health measure in schools in rural areas is recommended.