Prevalence Of Sealants Research Articles

Exploring Recent Decreases in First Molar Sealants among US Children

Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner’s replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.

Households\u2019 age, country of birth, and marital status, stronger predictor variables than education in the prevalence of dental sealants, restorations, and caries among US children 5\u201319\u2009years of age, NHANES 2005\u20132010

BackgroundThe aim of this study is to use data representative of the U.S. population to determine if households (HHs) age, birth country, and marital status, are strong predictors as HHs education for dental sealants, restorations, and caries in children 5 to 19 years of age.MethodsA cross sectional analysis was performed with oral health data from three waves of the National Health and Nutrition Examination Survey (NHANES 2005 to 2010). The sample size consisted of children 5 to 19 years of age (n = 9151) and households > 18 years of age (n = 31,034). Dependent variables included the number of children with dental sealants, restorations, and caries. HHs independent variables consisted of gender, age, race, country of birth, HHs education level, marital status, and HHs spouse education. Multivariate regression analysis models were adjusted for HHs citizenship, health insurance, family size, and children age categories.ResultsThe prevalence of children 5–19 years of age with dental sealants, restorations, and caries was 31.3, 43, and 15.8% respectively. The odds of children having sealants were higher among HHs with a college education or above OR 2.05 [1.54.-2.73] vs. HHs with a < 9th grade, in HHs ages 39–49 (OR 1.78 [1.41–2.24) vs. 18–29 years of age, and in HHs spouses with a college education and above OR 1.71 [1.14–2.56] vs. HHs with a < 9th grade. The odds of having at least one restored tooth were higher in children from HHs born in Mexico 1.74 [1.44–2.10] vs. US born. The highest odds for caries were among children from HHs that were never married 1.91 [1.47–2.48] vs. married HHs. In HHs with a college education the odds for caries in children were 0.31 (0.22–0.43) for college and above, and 0.78 (0.60–1.01) for some college.ConclusionsThe odds of children having dental sealants were higher in HHs with a college education, however, HHs ages 30–49 provided higher odds for sealants than spouses with college education. HHs birth place increased the odds of children with restorations more than HHs education. Children from HHs that never married had higher odds of experiencing dental caries. Recognizing the impact of these HHs characteristics could augment efforts in the prevention of adverse oral health outcomes in U.S. children.Households’ age, country of birth, and marital status, stronger predictor variables than education in the prevalence of dental sealants, restorations, and caries among US children 5–19 years of age, NHANES 2005–2010.

Prevalence of Dental Caries and Fissure Sealants in the First Permanent Molars among Male Children in Riyadh, Kingdom of Saudi Arabia.

AimsTo evaluate the prevalence of dental caries and the presence of fissure sealants on the first permanent molars (FPMs) among 6 to 9 years old primary school boys in Riyadh, Kingdom of Saudi Arabia.Materials and methodsThe carious status and the presence of fissure sealants on the FPMs were examined in 1844 schoolboys, aged 6-9 years (the first three grades), from 17 randomly selected primary schools in Riyadh city, Kingdom of Saudi Arabia.Chi-square test was used to assess the significance of differences in prevalence and proportions.ResultsA total of 5394 FPMs were assessed in the 1844 children. Eighty-three point five percent of children were caries free. Only 0.8% of the children had at least one fissure sealant applied. At tooth level, the decayed FPMs counted for 10.6%. There was obvious underuse of fissure sealants on the FPMs; 0.5% (n = 25). The caries prevalence in the mandibular FPMs (14.4%), was significantly higher than in the maxillary FPMs, 7.7% (p < 0.01). The proportion of carious FPMs increased with age of the children significantly (p < 0.01). There was no significant difference in the proportion of the presence of fissure sealants among the three different grade/age groups (p > 0.05).ConclusionCaries prevalence in the FPMs was moderate but serious amongst this cohort of young students. This was opposed with very low use of fissure sealants.Clinical significanceCareful examination of the first permanent molars among children is mandatory because of their high caries susceptibility. It is important to increase public and dental professionals’ awareness of the effectiveness of fissure sealants and encouraging more placement.How to cite this article: Aldossary MS, Alamri AA, Alshiha SA, Hattan MA, Alfraih YK, Alwayli HM. Prevalence of Dental Caries and Fissure Sealants in the First Permanent Molars among Male Children in Riyadh, Kingdom Saudi Arabia. Int J Clin Pediatr Dent., 2018;11(5):365-370.

A survey of fissure sealants and dental caries prevalence in the first permanent molars among primary school girls in Riyadh, Saudi Arabia.

Objectives:To investigate the prevalence of caries and fissure sealants on the first permanent molars (FPMs) among 6–9-year-old girls in Riyadh, Saudi Arabia.Materials and Methods:The FPMs of 17,891 school girls from 120 randomly selected public primary schools were evaluated by visual and tactile examination for the carious status and the presence of fissure sealants. Chi-square test was used to analyze the data at level of 5%. Results:A total of 58,140 FPMs were assessed in the 17,891 children. Nearly 64.6% of the children were caries free. Only 1.3% of the children had at least one fissure sealant applied. At tooth level, the decayed FPMs counted for 24.6%. There was obvious underutilization of fissure sealants on the FPMs; 0.8% (n = 478). The caries prevalence in the mandibular FPMs (33%) was significantly higher than in the maxillary FPMs, 18.2% (P < 0.01). The proportion of carious FPMs increased with age of the children significantly (P < 0.01). There was no significant difference in the proportion of the presence of fissure sealants among the three different grade/age groups (P > 0.05).Conclusions:Caries prevalence in the FPMs was high and serious among this cohort of young students. This was contrasting the very low prevalence of fissure sealants.

Oral health status of children in Los Angeles County and in the United States, 1999-2004.

To ascertain and compare the oral health status and related sociodemographic risk indicators in children in Los Angeles (LA) County with children in the United States. Data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 were used to calculate prevalence estimates for children aged 2-13 years living in LA County and in the United States. Sociodemographic indicators were evaluated using multiple logistic regression modeling. Overall, children in LA County were more likely to experience dental caries than children in the United States in 1999-2004. In the primary dentition, nearly 40% of preschool children residing in LA County had dental caries compared to 28% of same-age children in the United States. Among children aged 6-13, 44% living in LA County had dental caries in the permanent dentition compared to 27% in the United States. Mexican American children in LA County had higher caries experience in permanent teeth (but not in primary teeth) than US Mexican American children. Among children aged 6-9 years, there was no difference in the prevalence of dental sealants in permanent teeth between those living in LA County and in the United States. However, among children aged 10-13 years, dental sealants were more than twice as prevalent in US children (40.8%) than in LA County children (17.5%). Among LA County children, the adjusted odds of having caries experience or untreated dental caries in permanent teeth were not higher among children from lower income families than in lower income children in the United States. Children residing in LA County had less favorable oral health than children in the United States in 1999-2004. The usual sociodemographic caries risk indicators identified among children in the United States were not consistently observed among children in LA County. Unlike in the wider United States, poverty was not a risk indicator for dental caries in older children in LA County.

Mundgesundheit und Mundgesundheitsverhalten von Schülern mit Behinderungen aus Weimar Stadt und Land

IntroductionAim of the study was the assessment of current data on oral health of students with disabilities from the city and the district of Weimar.IntroductionMaterial and Method: In total 604 students with intellectual disabilities (ID), sensory disabilities (SD) and other impairments (OI) were examined. Caries was scored by using WHO standard criteria (1997). Prevalence of fissure sealants was recorded. Periodontal health was assessed by the periodontal screening index (PSI). Oral health behaviour of students with disabilities, parental school education and occupation were asked questionnaire based. Oral health data of students with and without disabilities were compared descriptively for the age groups 5–10 yrs., 11–14 yrs. and 15–23 yrs.ResultsStudents with disabilities had a higher caries prevalence than healthy students (67.7 % vs. 52.5 %; p = 0.000). Caries experience in the primary dentition was lower in students with disabilities than in healthy students (1.0 ± 2.0 dmft vs. 1.3 ± 2.1 dmft; p = 0.000). However, in the permanent dentition healthy students had a lower caries experience (0.5 ± 1.3 DMFT) than students with disabilities (1.8 ± 3.1 DMFT; p = 0.000). The care index was not different between students with (66.2 %) and without disabilities (69.3 %). Students with ID revealed a higher caries prevalence and experience (58.2 %, 2.7 ± 3.9 DMFT) than students with SD (34.5 %, p = 0.004; 0.8 ± 1.4 DMFT; p = 0.001) and student with OI (46.5 %; p = 0.028; 1.7 ± 2.9 DMFT; p = 0.003). The prevalence of fissure sealants was 35.8 % in students with disabilities; on average one tooth was sealed.The highest prevalence of fissure sealants was present in students with OI (39.2 %) and the lowest (24.5 %) in students with ID. Nearly half of the parents with students with disabilities 48.3 % responded to the questionnaire. Students aged 6–10 yrs. with ADHS medication revealed more severe periodontal health compared to students without this medication (PSI 0.7 ± 0.6 vs. 0.3 ± 0.6; p = 0.012).Students of mothers with lower education had a higher caries experience than those of mothers with higher education level (1.6 ± 2.2 DMFT vs. 1.0 ± 2.7 DMFT; p = 0.014).ConclusionStudents with disabilities living in the city and district of Weimar were disadvantaged regarding their oral health compared to their healthy contemporaries. Improvement of group and individualized preventive care, particularly using of fissure sealants, is needed. Furthermore, networking of local partners for initiation of new preventive care strategies is crucial. Cooperation of all partners could be enhance oral health of individuals with disabilities.

Prevalence of Fissure Sealants in Portuguese Adolescents.

Prevalence of Fissure Sealants in Portuguese Adolescents.

Changes in Caries Experience, Untreated Caries, Sealant Prevalence, and Preventive Behavior Among Third-Graders in New York State, 2002-2004 and 2009-2012.

This study assessed changes in caries experience, untreated caries, sealant prevalence, and preventive behavior among third-grade children in New York State to monitor progress toward state health objectives. We analyzed children's data from the 2002-2004 (n=10,865) and 2009-2012 (n=6,758) New York State Oral Health Survey. We calculated differences in weighted percentages and 95% confidence intervals for caries experience, untreated caries, sealant prevalence, and preventive behavior. We used logistic regression procedures to assess the independent effects and interaction terms on dental caries experience. The percentage of children with dental caries and untreated caries decreased from 54.1% and 33.0% in 2002-2004 to 45.2% and 23.6% in 2009-2012, respectively. While this decrease was not uniform across income subgroups, the prevalence of sealants, a key measure of the use of preventive services, increased significantly from 16.7% to 36.0% among lower-income children. Measurable improvement in reducing dental caries prevalence among third-grade children has been made in New York State, but this improvement was not uniform across subgroups. Specifically, disease prevalence among lower-income children remained high, underscoring the need to strengthen existing programs and identify additional policy and programmatic interventions.

Prevalence of dental caries and fissure sealants in a Portuguese sample of adolescents.

IntroductionThe aims of this study were to assess the prevalence of dental caries and the DMFT index, as well as the distribution pattern of pit and fissure sealants on permanent teeth in a Portuguese sample of adolescents, and to assess whether the existing usage of sealants and socio-demographic factors are correlated to caries prevalence on the examined sample.Materials and MethodsA cross-sectional study was designed with a sample of 447 adolescents aged 12 to 18 years old, attending a public school in Sátão, Portugal. A self-administered questionnaire with questions about oral health behaviours and socio-economic status was answered by adolescents in the classroom. Clinical examination of oral health status and assessment of fissure sealants were accomplished by only one trained member of the research team.ResultsWe obtained a DMFT index of 3.32 (2.92), which indicates a moderate level of prevalence of dental caries. When considering a DMFT = 0, we found significant statistical differences between the parents´ level of education (≤ 4th grade = 26.3 vs 5th–12th grade = 18.8 vs <12th grade = 43.3, p = 0.001), gender (male = 27.3 vs female = 19.6, p = 0.04), age (≤15 years = 27.1 vs <15 years = 18.5, p = 0.02), presence of fissure sealants (yes = 30.6 vs no = 13.5, p = 0.001) and experience of dental pain (no = 25.4 vs yes = 16.8, p = 0.02). When analyzing the prevalence of fissure sealants, we verified that 58.8% of adolescents had at least one fissure sealant applied. Significant statistical differences were found when analyzing the presence of fissure sealants related with parents´educational level (<9th grade, OR = 1.56 CI95% = 1.05–2.54), gender (female, OR = 1.86 CI95% = 1.19–2.98), experience of dental pain (yes, OR = 0.62 CI95% = 0.39–0.97) and presence of dental caries (yes, OR = 0.35 CI95% = 0.19–0.65).ConclusionsThe moderate level of caries prevalence reveals the need of improvement of primary prevention interventions among Portuguese adolescents. The establishment of a more targeted preventive program with better and more effective oral health education is essential, having into account socio-demographic aspects.

Oral health status of students with and without disabilities in Erfurt, Germany

The aim of this study was to make a comparison of the oral health status of students with and without disabilities (Sw/D, Sw/oD) aged 6-18 years from the city of Erfurt. 328 students with mental retardation (MR), physical disability (PD) and hearing impairment (HI) were examined according to WHO standard (1997). The control group consisted of 400 age-matched Sw/oD. Data analysis was performed in age groups 6-12 and 13-18 years. Caries prevalence of 6- to 12-year-old Sw/D (68.7%) was significantly higher than in Sw/oD (57%) (p=0.019).The caries experience of Sw/D was 2.3 dmft/0.5 DMFT and 1.6 dmft/0.4 DMFT of Sw/oD. PD had a lower restorative index than other Sw/D (p ≥ 0.023). There was no difference in caries prevalence and caries experience among 13- to 18-year-old Sw/D (51%; 1.9 DMFT) and Sw/oD (59%; 2.1 DMFT). MR had a lower prevalence of fissure sealants and less sealed teeth (p ≤ 0.042) and their periodontal health was inferior compared to other Sw/D. Intensive preventive measures should be intensified to compensate for oral health inequalities, particularly in MR.

Zahngesundheit erster Molaren bei westfälischen Migranten und deutschen Schülern

The aim of this study was to assess the health status of the occlusal surface on the first molars of Westphalian students, of whom 41.0% were immigrants. The prevalence and retention of fissure sealants (FS) and caries experience was scored for 161 students aged 8 and 10 years. Logistic regression analysis was used to predict the influence of sex, ethnicity, and retention of FS on the occlusal caries risk of the first molars. There was no difference in caries prevalence and experience in 8-year-old German students and immigrants (5.6%/10.5%; 0.07 DMFT/0.21 DMFT), both parameters were significantly higher in 10-year-old immigrants than in German students (25.5%/9.5%; 0.55 DMFT/0.11 DMFT). The prevalence and number of molars with FS was not different between German students and immigrants at 8 years (39.1%, 1.28 FS; 33.8%, 0.94 FS) and at 10 years of age (47.4%, 1.68 FS; 39.4%, 1.17 FS). The occlusal caries risk of first molars without FS was significantly higher in 8-year-old immigrants than in German students (OR 4.62). FS should be used more frequently in daily dental practice. To improve the quality of FS, stricter implementation of guideline-based standards is required.

The Importance of Substate Surveillance in Detection of Geographic Oral Health Inequalities in a Small State

Considering that 42% of children and adolescents and 91% of dentate adults experience dental caries, oral disease is a public health problem. Although the population's oral health is improving, certain subgroups remain at increased risk for dental disease. To assess the oral health status at the substate level and explore the possibility of geographic oral health inequalities in New Hampshire while building upon existing surveillance data sets. We used the Third Grade Oral Health and NH Behavioral Risk Factor Surveillance System surveys. We ensured the availability of substate level data and compared county/region specific estimates. New Hampshire. Adults and third-grade students in public schools. The prevalence of dental caries, untreated caries, and dental sealants among children; and the insurance status, utilization of dental services, and edentulism among adults. Of the 10 counties, the northernmost Coos County had consistently worse outcomes when compared with other counties. Only 64% of adult Coos County residents reported a dental visit in the past year; of these, 66% reported dental cleaning. Among adults 65 years and older, 29% were edentulous. In comparison with the state overall, these estimates were 76%, 77%, and 19%, respectively. Coos County third-grade students had the highest prevalence of dental caries experience (64% compared with 44% in New Hampshire) and untreated caries (31% compared with 12%), and only 24% had dental sealants (state prevalence is 60%). Overall oral health status in our state is favorable and comparable with the nation, yet significant geographic inequalities exist among children and adults. The oral health status of disparate groups can be improved using tailored interventions such as community water fluoridation or expansion of school-based dental sealant programs. Surveillance at the substate level is an essential part of the planning, targeting, and progress monitoring.

Caries experience in the permanent dentition among first- and second-grade schoolchildren in southeastern Estonia

Objective. This study aims to assess the caries experience among first- and second-grade children in the elementary schools of southeastern Estonia. Materials and methods. A representative sample of 485 children was studied. The mean age of children in the first grade was 7.8 years (SD = 0.35) and in the second grade 8.8 years (0.38). The clinical examinations using ICDAS criteria were completed by four calibrated examiners. The inter- and intra-examiner consistency of the examiners was high (surface and tooth-based kappa >0.9). Results. The mean caries experience of dentinal caries lesions was 0.8 (D4–6MFT) and 1.6 (D4–6MFS) among the first graders and 1.1 (D4–6MFT) and 1.6 (D4–6MFS) among the second graders. The mean caries enamel lesions among the first graders was 1.6 (D1–3T) and 2.2 (D1–3S) and among the second graders 2.1 and 3.0, respectively. The most affected surfaces were the occlusal surfaces of the lower first molars. The prevalence of sealants was very low—only 2.4% of the first molars were sealed among the first graders and 3.9% among the second graders. There were no statistically significant differences in caries experience or in the provision of restorative treatment between the schools. Conclusions. Caries experience is high in southeastern Estonia. Preventive programs are urgently needed.

Prevalence of sealants in relation to dental caries on the permanent molars of 12 and 15-year-old Greek adolescents. A national pathfinder survey

BackgroundThe use of sealants as an effective measure for the prevention of pit and fissure caries in children has been well documented by several studies; either they are used on an individual or on a public health basis. In order to plan and establish a national preventive program with sealants in a community, it is mandatory to know the epidemiological pattern of caries along with other variables influencing their use and effectiveness. Aims: To assess the utilization and distribution pattern of pit and fissure sealants on the first and second permanent molars of Greek adolescents and to evaluate whether the existing usage of sealants and some socio-demographic factors are correlated to caries prevalence on the population examinedMethodsA stratified cluster sample of 2481 Greek adolescents was selected according to WHO guidelines (1224 twelve and 1,257 fifteen-year-old), living in urban and rural areas in 11 districts within the country. Five calibrated examiners carried out clinical examinations, recording caries experience at the dentine threshold (BASCD criteria) and presence or absence of sealants along with Socio-demographic indicators associated with oral health. Mann Whitney and Pearson's chi-square non parametric tests were utilized for assessing the data. The level of significance was p < 0.05.ResultsSealants utilization varied considerably within the different districts, with 8,3% of the 12 and 8,0% of the 15-year-old adolescents having at least one sealed molar. Sealants reduced DMFS scores by 11% in the 12-year-olds and by 24% in the 15-year-olds, while 15-year-old adolescents from rural areas had a statistically significant (p = 0.002) less chance of having sealants (71%) compared to children from urban areas. Girls had higher chance to receive sealants in both age groups (26% for the 12 and 19% for the 15-year-old) as well as patients that visited the dentist for prevention compared to those visiting the dentist because they thought they needed a restoration or because they were in pain.ConclusionsThe finding that sealants reduced DMFS scores despite their very low utilization, along with the high prevalence of dental caries found on the occlusal surfaces of the posterior teeth of Greek adolescents, is calling for a national preventive program with sealants which could eliminate caries to a larger extent.

Effectiveness of preventive oral health care in Hispanic children living near US–Mexico border

The effect of preventive oral healthcare on dental caries in Hispanic children in a school district near the US-Mexico border in Texas was studied. We collected socioeconomic and demographic data for enrolled students through a written survey of parents. The information was linked to screening data for students in the same school that had been collected during a previously completed teledentistry demonstration project. The presence of dental sealants served as a proxy for preventive oral healthcare. We compared the effect of sealant presence on caries. The student population was 97.5% Hispanic and 82% were economically disadvantaged. Forty-four percent of the children in our study sample had caries. The prevalence of sealants was 19%; 32% is the national average. The results of regression models confirm the hypothesis that preventive services significantly reduce the occurrence of dental caries (OR = 0.241, P < 0.01). Higher household income (OR = 0.437, P < 0.05) and parent health insurance (OR = 0.497, P < 0.05) were also associated with reduced caries incidence. Our study suggests that preventive services reduce the incidence of caries in Hispanic children in the study population.

Changes in the Oral Health of US Children and Adolescents and Dental Public Health Infrastructure Since the Release of the Healthy People 2010 Objectives

We examined progress in US children's oral health and dental public health infrastructure since the Healthy People 2010 Oral Health Objectives were issued. We summarize trends in the prevalence of dental caries and dental sealants on the basis of national and state-specific data. Trends in state oral health program activities, funding, and staffing were derived from annual surveys. The prevalence of dental caries in primary teeth of children aged 2-4 years increased from 18% in 1988-1994 to 24% in 1999-2004. Racial disparities persisted in that age group, with caries significantly more prevalent among non-Hispanic black and Mexican American children than among non-Hispanic white children. Caries prevalence in primary teeth of non-Hispanic white children aged 6-8 years remained unchanged, but increased among non-Hispanic black and Mexican American children. State-specific prevalence of caries among third-graders ranged from 40.6% to 72.2%. Caries in permanent teeth declined among children and adolescents, while the prevalence of dental sealants increased significantly. State oral health programs' funding and staffing remained modest, although the proportion of states with sealant programs increased 75% in 2000 to 85% in 2007 and the proportion with fluoride varnish programs increased from 13% to 53%. Progress toward improving the oral health of America during the past decade has been mixed. Greater attention to the oral health of young children is clearly needed, and child health professionals can be valuable partners in the effort. With continued high prevalence of a largely preventable disease, ongoing problems with access to basic oral health services, and increased national attention to health care reform, there is a clear need and opportunity for governments to make serious and sustained investments in dental public health.

Relationship between caries prevalence and fissure sealants among 12-year-old German children at three educational strata

To investigate the relationship between caries prevalence and fissure sealants among 12-year-old German children at three educational levels. In 1998 a cross-sectional investigation which comprised 60% of the 12-year-old children was performed in Heidelberg, Germany. The children attended three types of schools: Gymnasium, Hauptschule, and Realschule. The children received a dental examination. Teeth with caries experience were recorded according to WHO criteria, and teeth with a fissure sealant were also noted. The mean number of fissure sealed teeth per child was 2.49 (Gymnasium), 2.31 (Realschule) and 1.17 (Hauptschule). In children who attended a Gymnasium the mean DMFT scores were the lowest (0.87 in children with fissure sealant and 1.31 in children without fissure sealant). The corresponding values for children who attended a Realschule were distinctly higher. The highest mean DMFT scores (2.14 and 3.48, resp.) were observed in children who attended a Hauptschule. The proportion of caries-free children was higher in all three types of school when fissure sealants were present. In spite of a high prevalence of fissure sealants there is an unequal caries experience among 12-year-old children from different educational strata. To improve this situation, persons important to promotion of dental health should do all their part to ensure that fissure sealants are applied to permanent teeth as early as possible, especially when children have caries experience in their primary dentition.

Association of caries experience in 12-year-old children in Heidelberg, Germany, and Montpellier, France, with different caries preventive measures.

In Germany and France, different approaches to oral health promotion have been chosen. It was the aim of the present study to assess whether different preventive measures were positively or negatively associated with caries experience in 12-year-old children in Heidelberg, Germany, and in Montpellier, France. In the school year 1998/99, 12-year-old children were examined in Heidelberg (n=864) and in Montpellier (n =828). D3+4MFT, D3+4MFS (D3+4=dentinal caries), prevalence of fissure sealants and use of fluorides were recorded. The mean D3+4MFT scores of the pupils in Heidelberg and Montpellier were 1.56 and 1.42, the proportion of caries-free children being 43.5% and 46.9%, respectively. In 63.2% of the children in Heidelberg and in 6.8% of the children in Montpellier, at least one fissure sealed tooth was found. Fluoridated salt was used by 38.8% of families of the 12-year-olds from Heidelberg and the corresponding value was 73.3% in Montpellier. Topical fluorides were applied by 39.9% of the children in Heidelberg, but only by 5.4% of pupils in Montpellier. Multiple regression analysis revealed that, in Heidelberg, fissure sealants and the combination of topical fluorides and fluoridated salt were negatively associated with the D3+4MFT values, while in Montpellier the frequency of dental visits was positively associated with the D3+4MFT scores. A further decrease in the caries experience of 12-year-old children may well be obtainable by enlarging the share of marketed fluoridated salt in Heidelberg, by increasing the application of fissure sealants in Montpellier, and by extending the use of topical fluorides in both cities.

Prevalence and attitudes to fissure sealants in the general dental service in England

Objectives. The study objectives were to investigate changes in the prevalence of fissure sealants over a 5-year period among a comparable group of 14–15-year-old regular dental attenders registered with general dental practitioners in 1989 and 1994, and to investigate attitudes towards this form of care amongst general dental practitioners in 1994. Methods. Random samples of 14–15-year-old pupils were selected from school lists in three areas in England (Doncaster, Hereford/Worcester and Wycombe) in 1989 and 1994. Once parental consent had been gained to examine the children, the Dental Practice Board (DPB) indicated which subjects were ‘regular attenders’, only these subjects were included in the study. All the subjects in each area were examined by a single trained and calibrated examiner using a standardized technique. In 1994, a group of randomly selected dentists in each area completed a telephone questionnaire assessing attitudes and treatment patterns regarding fissure sealants. Results. In 1989, 2836 letters were posted to parents asking for consent to examine their child and 2174 positive responses were received (response rate 77%). Of the 1919 children examined, 459 were classed as regular attenders, 140 in Doncaster, 159 in Hereford/Worcester and 160 in Wycombe. In 1994, 2560 consent letters were distributed to children in school to pass to their parents and 1587 positive responses were received (response rate 62%). Of the 1388 children examined, 891 were classed as regular attenders, 294 in Doncaster, 318 in Hereford/Worcester and 279 in Wycombe. Large rises in sealant prevalence were observed in all areas, but particularly in Doncaster where sealant prevalence increased from 13% in 1989 to 50% in 1994. In Hereford/Worcester it increased from 25% to 47% and in Wycombe it increased from 16% to 30%. There was also a fall in mean DMFT in all areas. In Doncaster it fell from 2·97 in 1989 to 1·82 in 1994, in Hereford/Worcester it fell from 2·60 to 1·83 and in Wycombe it fell from 1·86 to 1·29. In all three areas the changes in sealant prevalence and DMFT were statistically significant. The questionnaire revealed positive attitudes towards fissure sealants and their usage as well as a number of areas of concern that could potentially hinder sealant usage. Conclusions. Dramatic increases in sealant prevalence and considerable reductions in dental caries among these regularly attending adolescents have been demonstrated. Some concerns were highlighted regarding sealant usage, which may be prejudicing further increases in their application.

Prevalence and attitudes to fissure sealants in the general dental service in England.

The study objectives were to investigate changes in the prevalence of fissure sealants over a 5-year period among a comparable group of 14-15-year-old regular dental attenders registered with general dental practitioners in 1989 and 1994, and to investigate attitudes towards this form of care amongst general dental practitioners in 1994. Random samples of 14-15-year-old pupils were selected from school lists in three areas in England (Doncaster, Hereford/Worcester and Wycombe) in 1989 and 1994. Once parental consent had been gained to examine the children, the Dental Practice Board (DPB) indicated which subjects were 'regular attenders', only these subjects were included in the study. All the subjects in each area were examined by a single trained and calibrated examiner using a standardized technique. In 1994, a group of randomly selected dentists in each area completed a telephone questionnaire assessing attitudes and treatment patterns regarding fissure sealants. In 1989, 2836 letters were posted to parents asking for consent to examine their child and 2174 positive responses were received (response rate 77%). Of the 1919 children examined, 459 were classed as regular attenders, 140 in Doncaster, 159 in Hereford/Worcester and 160 in Wycombe. In 1994, 2560 consent letters were distributed to children in school to pass to their parents and 1587 positive responses were received (response rate 62%). Of the 1388 children examined, 891 were classed as regular attenders, 294 in Doncaster, 318 in Hereford/Worcester and 279 in Wycombe. Large rises in sealant prevalence were observed in all areas, but particularly in Doncaster where sealant prevalence increased from 13% in 1989 to 50% in 1994. In Hereford/Worcester it increased from 25% to 47% and in Wycombe it increased from 16% to 30%. There was also a fall in mean DMFT in all areas. In Doncaster it fell from 2.97 in 1989 to 1.82 in 1994, in Hereford/Worcester it fell from 2.60 to 1.83 and in Wycombe it fell from 1.86 to 1.29. In all three areas the changes in sealant prevalence and DMFT were statistically significant. The questionnaire revealed positive attitudes towards fissure sealants and their usage as well as a number of areas of concern that could potentially hinder sealant usage. Dramatic increases in sealant prevalence and considerable reductions in dental caries among these regularly attending adolescents have been demonstrated. Some concerns were highlighted regarding sealant usage, which may be prejudicing further increases in their application.