DMFT Increments Research Articles

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

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. 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. 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 5-9years 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). 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.

Caries Incidence Among Obese Adolescents: A 3-year Prospective Study.

To determine the incidence of caries in a 3-year follow-up of obese adolescents. Seven-hundred eighty five 13-year-old school children were selected randomly. Caries was recorded according to WHO criteria and body mass index was assessed in a medical evaluation. With appropriate sample weighting, relationships between caries and other variables were assessed using the chi-squared test, Kruskal-Wallis H-test, and multivariable logistic regression. At baseline, 185 (24.2%) adolescents presented with caries, having mean DMFT and DMFS scores of 0.9 ± 2.0 and 2.4 ± 3.6, respectively. The accumulated incidence of caries during the 3-year period of study was 16.5%, with mean DMFT and DMFS increments of 0.8 ± 0.2 and 1.1 ± 3.3, respectively. Obese and overweight adolescents had a 3.7 times (95% CI = 1.3-6.8) greater chance of developing caries after adjusting for socioeconomic status, gender, use of fluoridated dentifrice, and past caries experience. Obese and overweight adolescents were at a higher risk of developing new caries in a 3-year-follow-up.

The Caries Management System: are preventive effects sustained postclinical trial?

ObjectivesTo report, at two and 4 years post‐trial, on the potential legacy of a 3‐year randomized controlled clinical trial (RCT) of the Caries Management System (CMS) at private general dental practices. The CMS was designed to reduce caries risk and need for restorative care.MethodsNineteen dental practices located in city, urban, and rural locations in both fluoridated and nonfluoridated communities participated in the RCT. Eight practices were lost to follow‐up post‐trial; however, baseline mean DMFT balance between CMS and control practices was maintained. At the control practices, caries management following usual practice continued to be delivered. The patient outcome measure was the cumulative increment in the DMFT index score, and the practice outcome measures included the practice‐mean and practice‐median increments of patient DMFT index scores. In covariable analysis (patient‐level unit of analysis), as the patients were clustered by practices, mean DMFT increments were determined through multilevel modeling analysis. Practice‐mean DMFT increments (practice‐level unit of analysis) and practice‐median DMFT increments (also practice level) were determined through general linear modeling analysis of covariance. In addition, a multiple variable logistic regression analysis of caries risk status was conducted.ResultsThe overall 4‐year post‐trial result (years 4–7) for CMS patients was a DMFT increment of 2.44 compared with 3.39 for control patients (P < 0.01), a difference equivalent to 28%. From the clinical trial baseline to the end of the post‐trial follow‐up period, the CMS and control increments were 6.13 and 8.66, respectively, a difference of 29% (P < 0.0001). Over the post‐trial period, the CMS and control practice‐mean DMFT increments were 2.16 and 3.10 (P = 0.055) and the respective increments from baseline to year 7 were 4.38 and 6.55 (P = 0.029), difference of 33%. The practice‐median DMFT increments during the 4‐year post‐trial period for CMS and control practices were 1.25 and 2.36 (P = 0.039), and the respective increments during the period from baseline to year 7 were 2.87 and 5.36 (P < 0.01), difference of 47%. Minimally elevated odds of being high risk were associated with baseline DMFT (OR = 1.17). Patients attending the CMS practices had lower odds of being high risk than those attending control practices (OR = 0.23, 95% CI = 0.06, 0.88).ConclusionIn practices where adherence to the CMS protocols was maintained during the 4‐year post‐trial follow‐up period, patients continued to benefit from a reduced risk of caries and, therefore, experienced lower needs for restorative treatment.

The Role of Behaviour in Inequality in Increments of Dental Caries among Finnish Adults

Background: Evidence from cross-sectional studies implies that dental behaviours partially explain inequalities in oral health. Objective: To assess whether dental behaviours completely eliminate inequality in increments of dental caries in a sample of Finnish adults. Methods: The baseline data were collected from the Health 2000 survey, a nationally representative survey of 8,028 individuals aged 30 years or older living in mainland Finland. Four years later, 1,248 subjects were invited for oral re-examination, and 1,049 agreed to participate (84% response rate). At baseline, participants provided information on demographics, education and dental behaviours (dental attendance, tooth brushing with fluoride toothpaste, sugar consumption and daily smoking). Oral examinations at baseline and follow-up were identical. Results: Adults with basic education had significantly greater increments of DMFT (incidence rate ratio 1.41, 95% CI 1.07-1.85) and DT (incidence rate ratio 2.23, 95% CI 1.27-3.90) than those with high education. Adjusting for single behaviours attenuated but did not eliminate education inequality in DMFT and DT increments, tooth brushing having the greatest impact on inequality. Simultaneous adjustment for all behaviours eliminated the significant relationship between education and caries increment. Conclusions: Accounting for important dental behaviours appears to explain all education inequality in dental caries in Finnish adults. The results should be interpreted with caution when applied to less egalitarian populations.

Sugar-sweetened beverages and dental caries in adults: A 4-year prospective study

ObjectivesTo explore the association between frequency of consumption of sugar-sweetened beverages (SSB) and caries increment over 4 years in adults. A second objective was to explore whether the association between frequency of SSB consumption and caries increment varied by socio-demographic characteristics and use of fluoride toothpaste. MethodsData from 939 dentate adults who participated in both the Health 2000 Survey and the Follow-Up Study of Finnish Adults’ Oral Health were analysed. At baseline, participants provided information on demographic characteristics, education and dental behaviours, including two questions on frequency of SSB consumption. The 4-year net DMFT increment was calculated using data from baseline and follow-up clinical oral examinations. The association was tested in negative binomial regression models and the moderating role of sex, age, education and use of fluoride toothpaste was examined by adding their two-way interaction with SSB consumption to the main effects model. ResultsA positive association was found between frequency of SBS consumption and 4-year net DMFT increment, regardless of participants’ socio-demographic and behavioural characteristics. Adults drinking 1–2 and 3+ SSB daily had, respectively, 31% (Incidence Rate Ratio: 1.31; 95%CI: 1.02–1.67) and 33% (IRR: 1.33; 95%CI; 1.03–1.72) greater net DMFT increments than those not drinking any SSB. None of the four two-way interaction terms was significant (all p>0.05). ConclusionThere seems to be a dose–response relationship between frequency of SSB consumption and caries increment in adults. That association was consistent across socio-demographic characteristics, and more importantly, use of fluoride toothpaste. Clinical significanceDrinking sugar-sweetened beverages on a daily basis is related to greater caries risk in adults.

A comparison of the anticaries effect on the primary dentition of two dentifrices containing 250 ppm and 1450 ppm fluoride

The purpose of the study was to compare the anticaries effects of two dentifrices containing sodium fluoride with fluoride concentrations of 250 ppm and 1450 ppm on the primary dentition of kindergarten children. A total of 319 children participated in the study (155 in the low-fluoride and 164 in the high-fluoride group) and brushed their teeth daily under supervision in their kindergartens. The children were examined by one dentist trained according to the procedures of O'Mullane et al., and carious lesions were recorded at the cavitation level according to the WHO criteria. At the final examination after 22 months, the groups comprised 83 (low-fluoride group) and 89 (high-fluoride group) children. The differences in mean dmfs and dmft increments between the two groups were not statistically significant. In both groups about 57% of the children remained caries free. Excluding these children from the analyses, the mean dmfs increment was significantly lower in the high-fluoride group, but not the mean dmft increment. The mean dmfs increment excluding occlusal surfaces was significantly lower in the high-fluoride group.

フッ化物局所応用ならびに飲料水中フッ素による永久歯う蝕予防効果の比較

The purpose of this study was to compare the caries prevalence and incidence between 6-year-old lifelong residents in a natural fluoride area (0.74-1.10ppm F: NF group) and participants in school-based fluoride mouthrinsing (FR group) or usage of SnF2 dentifrice (FD group). The FR group rinsed daily with 0.05% NaF solution for 3.5 years and the FD group used 0.41% SnF2dentifrice for 3 years beginning at the age of six.Mean DMFT in the NF group (n=58) from the age of 6 to 9 was significantly lower (p<0.05, p<0.01) than that of both the FR (n=78) and the FD group (n=73) at all of the ages examined. Only 1-year mean DMFT increments from the age of 6 to 7 in the NF group (0.24±0.67) were significantly different (p<0.01) from the FR group (0.67±0.98) and the FD group (0.71±0.89). No statistical differences of mean DMFT increments, however, were found between any pairs of study groups after 2 or 3 years from the baseline. Incremental DMFT rates on first molars in the NF group were significantly lower (p<0.05, p<0.001) than those in the FR or FD group both after 1 and after 2 years.The results of the present study demonstrate that lifelong residents in a natural fluoride area experienced significantly fewer caries than those who received topical fluoride application. However, the differences of caries increments between the FW group and the FR or FD groups diminished with the passage of time.

Snack Food Intake of Adolescents and Caries Development

The relationship between the frequency of eating various snack foods, socioeconomic variables, and an increment in caries was studied in 143 adolescents. There were negative correlations between DMFT increments and the frequency of apples, fruit juice, and sugarless gum intake, and a positive association of DMFT increments with chocolate candy intake and spending money.

Effect on caries of self‐application of a zirconium silicate paste containing 9% stannous fluoride

Abstract A 2‐year clinical trial was conducted using an adolescent population from a low‐fluoride area to evaluate the anticaries effect of self‐applications of zirconium silicate paste containing 9 % stannous fluoride. Three study groups totaling 464 children, with an initial average age of 12.8 years, completed the study. The control group brushed with a non‐fluoride zirconium silicate paste (Zircate Prophylaxis Paste®) once each year; the first experimental group brushed with zirconium silicate paste containing 9 % stannous fluoride (Zircate Treatment Paste®) once each year; and the second experimental group brushed every 6 months with Zircate Treatment Paste. After 2 years, the DMFT and DMFS increments were virtually identical for the control group and the group that received one application of fluoride paste per year. The group that received two applications of fluoride paste per year had a DMFT increment that was about 24 % less than that of the control group; however, the DMFS increment was only 5 % less. These differences were not statistically significant at the P= 0.05 level.

Clinical Evaluation of Three Concentrations of Sodium Fluoride in Dentifrices

The anticaries efficacy of three levels of sodium fluoride incorporated in dentifrices was compared with that of a control dentifrice. DMFT and DMFS increments after one and two years show that all three levels of sodium fluoride reduce caries Incidence.

Self-Preparation Stannous Fluoride Prophylactic Technique in Preventive Dentistry: Report after Two Years

A study was done on 18- to 22-year-old enlisted men in the US Navy to test the cariostatic potential of a self-preparation stannous fluoride prophylaxis technique. An improved treatment method was sought because of the time required for professional application of the three-agent stannous fluoride treatment used in the Navy’s preventive dentistry program. Results after two years showed significant reductions in DMFS and DMFT increments in the treated groups when compared to the control groups.