Significant Caries Index Research Articles

A 4-year assessment of a new water-fluoridation scheme in New South Wales, Australia

To monitor the changes in dental caries prevalence of 5- to 7-year-old children living in a fluoridated area, a newly fluoridated area and in an area without water fluoridation, in NSW, Australia. Dental caries prevalence was recorded for 5- to 7-year-old children, living in the three study locations, by six trained and calibrated examiners in 2008, 2010 and 2012. A questionnaire recorded demographic data, toothbrushing behaviour and sugary drink consumption. Caries experience was measured using the decayed, missing, and filled teeth (dmft) index for primary teeth, the percentage of children who were caries free and the significant caries index. Univariate analysis was undertaken to determine independent predictors of caries. The caries prevalence changed over time. In 2008, the mean dmft index was 1.40 for the fluoridated area, 2.02 for the area about to fluoridate and 2.09 for the unfluoridated control. By 2012, these mean dmft scores were 0.69, 0.72 and 1.21, respectively. In the two areas where children received fluoridated water, the significant caries index was 2.30 for the fluoridated area and 2.40 for the newly fluoridated area. The significant caries score for children in the unfluoridated location was 3.93. Multivariate analysis showed that over time the differences in dental caries prevalence between the established fluoride area and the newly fluoridated area diminished. However, children in the unfluoridated control area continued to demonstrate significant differences in the mean number of decayed teeth compared with children in the fluoridated comparator sites, and the proportions of children free from decay were significantly higher in the fluoridated areas than in the unfluoridated area. Fluoridation of public water supplies in Gosford and Wyong offers young children better dental health than those children who do not have access to this public health measure.

Elimination of 'the Glasgow effect' in levels of dental caries in Scotland's five-year-old children: 10 cross-sectional surveys (1994-2012).

BackgroundSocioeconomic inequalities in health within Glasgow, Scotland, are among the widest in the world. This is largely attributed to socio-economic conditions. The ‘Glasgow Effect’ labels the finding that the high prevalence of some diseases cannot be fully explained by a conventional area-based socio-economic metric. This study aimed to investigate whether differences in dental caries between Glasgow’s resident children and those in the Rest of Scotland could be explained by this metric and whether differences were of fixed magnitude, over time.MethodsScotland’s National Dental Inspection Programme (NDIP) cross-sectional data for five-year-old children in years: 1994, 1996, 1998, 2000, 2003, 2004, 2006, 2008, 2010, and 2012 (n = 92,564) were utilised. Endpoints were calculated from the mean decayed, missing and filled teeth score (d3mft) and percentage with obvious decay experience. Socioeconomic status was measured by DepCat, a Scottish area-based index. The Glasgow Effect was estimated by the odds-ratio (OR) of decay for Glasgow versus the Rest of Scotland adjusted by age, gender and DepCat. Inequalities were also assessed by the Significant Caries Index (SIC), SIC 10, and Scottish Caries Inequality Metric (SCIM 10).ResultsDecay levels for deprived Glasgow children have reduced to be similar to those in the Rest of Scotland. In 1993, OR for d3mft > 0 for those living in the Glasgow area was 1.34(1.10, 1.64), p = 0.005. This reduced below unity in 2012, OR = 0.85(0.77, 0.93), p < 0.001. There were downward trends (p < 0.001) in absolute inequality measured by SIC and SIC 10 in each of the geographic areas. The SCIM 10 demonstrated further reductions in inequality across the population. The downward trends for all the inequality measures were larger for Glasgow than the Rest of Scotland.ConclusionsOver the interval, Glasgow has eliminated the earlier extra health inequalities. When comparing ‘like for like’ by socioeconomic status there is now no higher level of dental caries in the Greater Glasgow area.

Dental caries and the associated factors influencing it in tribal, suburban and urban school children of Tamil Nadu, India: a cross sectional study.

BackgroundThe study was planned to assess the prevalence of dental caries among tribal, suburban and urban children of Tiruchengode and Erode of Tamil Nadu state, India. The objective of the study was to assess the association of dental caries with family background, dental service availability, transportation and knowledge on preventive dental measures among these three groupsDesign and methodsCross-sectional study. A total of 1028 school children in the age range of 9-12 years from various government schools located in Palamalai and Kolli Hills (tribal), Tiruchengode (suburban) and Erode (urban), Tamil Nadu, were included in the study. Decayed, filled, and missing teeth (DMFT), decayed and filled teeth (dft) and Significant Caries Index were recorded. A specially prepared questionnaire was used to record all the data regarding oral hygiene practices, socioeconomic background, dental treatment availability, parent’s education level were used for the study. ANOVA t-test and post hoc test were used for comparing quantitative variables between the 3 subgroups.ResultsThe tribal school children had 89.3% caries prevalence, where as it was 77% in suburban and 55% in urban school children. The mean DMFT score among tribal, suburban and urban school children were statistically significant different (P=0.001) between the three groups. There was a highly significant difference (P=0.001) in the mean DMFT score based on brushing frequency. There was a statistically significant difference (P=0.018) in the mean DMFT scores in the urban group based on the mothers education status. There were no statistically significant differences in the mean DMFT scores based on the presence or absence of television in their house and the parents’ income.ConclusionsOral hygiene practices, dietary habits and access to dental care services played an important role in prevalence of dental caries. It was observed that the socioeconomic status, parents’ educational status and mass media influenced the oral health of these children but without a significant contribution.Significance for public healthIt was observed from the present study that the socioeconomic status, parents’ educational status, media and family structure influence the oral health of children in under-privileged communities. Oral hygiene practices, dietary habits and access to dental care services also play an important role in the prevalence of dental caries among children. Children of government schools in Tamil Nadu, India, don’t get adequate information on oral health, related diseases and methods of prevention. Oral health education and health promotion should be mandatory for all school children.

ORTODONTİK TEDAVİ GÖREN BİREYLERDE SIGNIFICANT CARIES INDEX UYGULAMASININ ÇÜRÜK RİSKİ ÜZERİNE ETKİSİ: PİLOT ÇALIŞMA

Aim: The effect of Significant Caries Index application on the caries risk of undergoing orthodontic treatment patients. Material and Method: Ninety subjects who were undergoing fixed orthodontic treatment were evaluated for this study. All patients were treated with a 0,018 inch slot preadjusted fixed orthodontic appliances. An examiner used the Gorelick index for assessment of white spot lesion on the buccal surface of teeth before (T1) and after (T2) treatment. The WHO (World Health Organization) criteria and bitewing radiographs were utilized to diagnose the carious status of the subjects. Subjects were divided into three groups (G1,G2,G3) according to Significant Caries Index. Results: 72 patients completed study (38 female, 34 male) whose mean age 14.7±1.63 at T1. The mean DMFT index was 3.18 and the SiC was 5.00. The mean DMFT increase was found 0.14 for all subjects. The prevalence of white spot lesion is 16.6% at T1, 59.6% of patients presented white spot lesion at T2. White spot lesion incidence was found 40%. No significant differences was found between risk groups which is formed according to Significant Caries Index, in terms of DMFT increase, occurrence and severity of white spot lesion (p>0,05). Conclusion: It was found that Significant Caries Index application are not play a decisive role on the formation of white spot lesion and DMFT index change in patients with undergoing orthodontic treatment

Oral health status of 12-year-old male schoolchildren in Medina, Saudi Arabia

Studies from Saudi Arabia have reported that the prevalence of dental caries among children is relatively high compared with other developing countries The aim was to determine the oral hygiene status and significant caries (SiC) index of 12-year-old males in Medina . In a cross-sectional, analytical study 360 students participated from 4 boys' schools. Dental caries, plaque, gingivitis, fluorosis and malocclusion were recorded using standard methods and indices. The mean DMFT score was 1.53 (SD 1.88). Caries prevalence was low (57.2%) but the mean SiC index was relatively high [3.63 (SD 1.66)]. The prevalences of plaque and gingivitis were high (82.8% and 70.8% respectively). Lower molars had the highest rate of caries. No children presented with dental fluorosis and 82.5% had a class I jaw relationship. Oral hygiene awareness programmes at schools, together with brushing and flossing programmes, are recommended in order to maintain and improve the oral health of young children in Medina.

Global burden of dental condition among children in nine countries participating in an international oral health promotion programme, 2012–2013

The Live.Learn.Laugh. phase 2 programme is a unique global partnership between FDI World Dental Federation and Unilever Oral Care which aims to provide measurable improvement of oral health on a global scale through encouraging twice-daily brushing with a fluoride toothpaste. It was based on international recommendations using the principles of health promotion within school for the implementation of preventive health strategies. This paper is an overview of the dental caries condition of children from 2012 to 2013 in nine countries included in four World Health Organisation (WHO) regions. A cross-sectional study was conducted in each country before the implementation of health-promotion measures focused on twice-daily toothbrushing with fluoride toothpaste. The sample was based on stratified sampling according to the WHO pathfinder recommendations. From a total of 7,949 children examined, there were 517 children (1-2 years of age), 1,667 preschool children (3-5years of age) and 5,789 schoolchildren (6-13years of age). The prevalence and severity of primary dental caries, early childhood caries and temporary dental caries were described using decayed, filled teeth (dft), permanent decayed, missing, filled teeth (DMFT) indices and the significant caries index (SCI). The major findings were a high prevalence of caries, identification of high-risk groups and inequality in the distribution of the severity of dental conditions. Aggregated data from this overview should provide justification for implementing an oral health programme. The main point is the need to retain and expand the community fluoridation programme as an effective preventive measure. At the individual level, the aggregated data identify the need for more targeted efforts to reach children early - especially among specific high-risk groups.

Factors underlying the polarization of early childhood caries within a high-risk population.

BackgroundEarly childhood caries (ECC) are particularly prevalent in disadvantaged populations, and socioeconomic factors are associated with the polarization of disease. A previous study showed that even within a homogenous low-income population disease is polarized, indicating that other factors apart from income may contribute to disease susceptibility.MethodsThis study used a hierarchical approach to identify factors associated with polarization of ECC in low-income subjects. This cross-sectional study was conducted retrospectively using a cohort of 244 children (aged 48–72 months) with family incomes not exceeding double the minimum wage (U.S. $8,208.00/year), living in neighborhoods on the outskirts of São Luís, Maranhão, Brazil. The sample was divided into three groups based on the Significant Caries (SiC) Index: no caries group, few caries group (mean 1.38 lesions), and a high caries group (mean 3.82 lesions). Hierarchical multinomial logistic regression analyses were performed based on a theoretical model.ResultsTwenty-eight (11.5%) of the 244 children presented with high caries. Age (p = 0.026; prevalence ratio (PR) = 1.10; 95% confidence interval (CI) 1.01–1.20) and frequency of sucrose consumption - p = 0.001; PR 4.65 (95% CI 1.83–11.84) were associated with increased risk of ECC.ConclusionsIn the high caries group, greater consumption of sucrose between main meals may explain why, in a group of children with homogenous social and health conditions, some had more caries than others.

Socio-demographic profile of child and adolescent users of oral health services in Victoria, Australia.

The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.

Trends in dental caries among Brazilian schoolchildren: 40 years of monitoring (1971–2011)

The study aimed to estimate the prevalence, severity, and inequality in the distribution of dental caries in schoolchildren from Florianópolis, Santa Catarina, Brazil, in 2011, and to compare the results with data from previous studies carried out since 1971. All 12- and 13-year-old schoolchildren enrolled in a public school were eligible. Dental caries were assessed according to the World Health Organisation diagnostic criteria. Decayed, missing and filled surfaces and teeth (DMFS/DMFT) indexes, the Significant Caries Index (SiC) and the Gini coefficient (to assess inequalities in the distribution of dental caries) were estimated. The response rate was 82.3% (n = 130). The prevalence of dental caries decreased from 98.0% (95% CI 96.0-100.0) in 1971 to 36.9% (95% CI 28.5-45.3) in 2011. The mean DMFT ranged from 9.2 in 1971 to 0.7 in 2011. The mean DMFS index was 1.2 (95% CI 0.8-1.6) in 2011. The Gini coefficient was 0.624 in 2002 but increased to 0.725 in 2011; the Lorenz curve showed that 70-75% of dental caries attacks was restricted to 20% of the population in 2011. A reduction of 41.2% in the mean SiC index was observed between 2002 (3.4, 95% CI 3.0-3.8) and 2011 (1.9, 95% CI 1.6-2.1). An effective decline in the prevalence and severity of dental caries in schoolchildren was observed throughout 40 years of monitoring. However, a small proportion of the population has experienced most of the caries burden in the recent years studied.

Dental caries in inland Brazilian adolescents and its relationship with social determinants

AIM: To identify the prevalence of dental caries in inland Brazilian adolescents, and to analyze the influence of socio-demographic and clinical variables, and access to dental service on caries experience. METHODS: This study had a non-probabilistic sample comprising 504 adolescents aged 12 years, attending public schools in the city of Nova Friburgo, mountain region of Rio de Janeiro, Brazil. The World Health Organization (WHO, 1997) criterion was used by previously calibrated examiners to report dental caries. Variables were obtained by means of a semi-structured questionnaire applied to the adolescents' parents. RESULTS: The D3MFT mean was 1.90 and the Significant Caries (SIC) Index was 4.54, mainly represented by the carious component. Multiple logistic regression analysis revealed that parents with over 8 years of schooling (OR=0.579), absence of pain (OR=0.396) and not visiting the dentist (OR=0.270) might suggest protective factors against the disease; the possible risk factors were male gender (OR=1.982) and pain, extraction and others were reasons for consultation (OR=2.435). CONCLUSIONS: Although the prevalence of caries was slightly below the national mean, polarization of the disease was clearly observed. Education and no access to the dentist led to protection against the disease. These results may contribute to planning of oral health actions directed towards this target population for the control of caries.

Prevalence of dental caries among school children of Bharatpur city, India.

Background:Healthy teeth and oral tissues and the need for oral health care are important for any section of society. Dental caries is an infectious microbial disease of multifactorial origin in which diet, host, and microbial flora interacts over a period of time in such a way so as to encourage demineralization of the tooth enamel with resultant caries formation. Dental caries, the product of man's progress towards civilization, has a very high morbidity potential and thus, is coming into focus of the mankind.Aims and Objectives:To assess the prevalence of dental caries among 12-15 year old government and private school children of Bharatpur city.Materials and Methods:This was a cross-sectional study carried out on total 1400 school children, of which 700 school children were from government schools and 700 were from private schools. Simple random sampling methodology was used to select the sample. The subjects were examined for dental caries according to WHO 1997 assessment form. Significant Caries Index was also used to assess the prevalence of dental caries.Results:The prevalence of dental caries was found higher among government school children, that is, 53%, when compared to private school children, that is, 47% and this difference was found to be statistically significant. The mean decayed, missing, and filled teeth were found to be higher in government school children (7.61 ± 2.86) as compared to private school children (4.76 ± 2.42).Conclusion:Dental caries was found to be the major public health problems among both the government and private school children of Bharatpur city, which need immediate attention. Regular dental checkups and practice of routine oral hygiene procedures will enable them to lead a healthier life.

Relationship of Perceived Stress and Dental Caries among Pre University Students in Bangalore City.

Stress can increase the susceptibility to dental caries by four possible mechanisms. Studies show that adolescents tend to more likely develop negative body image, disturbed eating behaviours and high levels of stress. Students report stress, taking and studying for exams being the greatest source of academic stress due to competition and the large amount of content in less time. The objectives were to analyze the caries experience in relation to perceived stress during preuniversity examination period, to estimate the prevalence of dental caries and to calculate SiC (significant caries index) among preuniversity students in Marathahalli, Bangalore city, India. This cross-sectional, correlational study involved 210 students (Response rate = 65.37%). The questionnaire consisted of demographic details and Perceived Stress Scale (PSS). Dental caries status was evaluated using the WHO (1997) caries diagnostic criteria for decayed, missing, and filled teeth (DMFT: Dynamical mean field theory). Prevalence of dental caries was 50.48%. Mean DMFT was 1.74 and Sic index was 4.56. The correlation between PSS and caries experience was found to be weak (r=0.389) (p<0.001). Academic stress appears to affect oral health, shown by higher caries experience in high perceived stress score individuals.

“Oral Hygiene Practice and Health Status among Adolescent Girls - A Rural School Based Study”

India has a high prevalence of dental caries ranging from 60 to 75%. The World Organization goal for Health for All was to lower the DMFT (Decay Missed Filling Teeth) score to less than 3. The objectives of the present study were to observe oral health status, hygiene practice and their relationship among adolescent girls in Tarakeswar block. This cross sectional study was done on 132 rural girls selected by systematic sampling and assessed by DMFT score and SiC index (Significant Caries index). Dental caries index was 37.1%, mean DMFT score was 0.78 and Sic index was 2.02 among the study population. Gum problems were significantly associated with difficulty in biting and chewing food, malalignment and knowledge of tooth decay cause. DMFT status was significantly associated with frequency of brushing and methods of tooth cleaning. Promotion of school dental health programmes by teachers would go a long way in achieving good oral health status.

12세 아동의 우식경험영구치 Significant Caries(SiC) Index에 대한 조사 연구

Objectives : The purpose of the study is to investigate the significant(SiC) index of the 12 year old children's permanent teeth caries experience. A total of 428 children aged 12 years old were recruited from metropolitan city(215 children) and rural area(213 children) in this study. SiC index was obtained from DMFT index. Data were analyzed by gender, region, and DMFT. Methods : DMFT index and Sic index were analyzed and compared by pit and sealant fissure treatment, dental caries, gender, and areas. A total of 428 children aged 12 years old were recruited from metropolitan city(215 children) and rural area(213 children) in this study. Results : Boy students(6.73) tended to have a higher SiC index than girl students(7.84). There were significant differences(p<0.05). DMFT index in urban area was 2.59, and that in rural area was 3.35. In SiC index, rural children showed a higher index(7.77) than urban children(6.72).There existed a significance between DMFT index and SiC index(p<0.05). Conclusions : It is important to educate and to develop the oral disease prevention program for the high risk group children. This study showed the relationship between DMFT index and SiC index in 12 year old children in urban and rural areas.

Santé dentaire et facteurs associés dans un service de santé au travail du Nord (France)

Few data are available concerning the dental health of adults in France. This study was designed to describe dental status, oral health behaviour and factors associated with caries among workers followed by an occupational health service in Northern France. A representative sample of workers was selected between May and July 2006. Data were collected by occupational health physicians using a questionnaire completed during a face-to-face interview and a dental examination. After descriptive analysis of the variables, two groups were defined according to the degree of caries as assessed by the Significant Caries Index. Factors associated with the degree of caries were investigated using logistic regression adjusted to age. 420 workers with a mean age of 34.6(±10.4) years were included. The mean DMFT (Decayed Missing Filled Teeth) score and the mean number of decayed teeth were 8.9 (± 6.5) and 1.3 (±2.8), respectively. Three independent factors associated with high caries rates were identified: level of education less than Baccalaureate (ORa = 1.85; p < 0.05), regular consumption of sweet snacks and/or sweet drinks (ORa = 2.01; p < 0.05) and a last dental visit motivated by pain or a reason other than preventive care (ORa = 1.89; p < 0.05). This study showed a high need for care and oral health education in this population of workers. More oral health education programmes should be set up in the adult working population by occupational health services.

Caries prevalence of children and dolescents

The aim of this study was to present epidemiological parameters of caries prevalence in children and adolescents in index age groups on a national and regional level in Bosnia and Herzegovina (BH). The study was conducted during 2004 year for children aged 6 and 12, and during 2007 for adolescents aged 15. An oral health survey was performed on a total number of 1,240 children and adolescents in line with World Health Organization methodology and criteria. Results for caries prevalence and treatment needs were presented and discussed in this paper. Mean dmft (decay, missing, filled teeth for primary dentition) for children aged six was 6.7 (SD±3.9) in that the decayed teeth constituted the major part of the index (88.8%), followed by extracted teeth (8.9%) and a small percentage of filled teeth (2.3%). In 12-year-olds DMFT (Decay, Missing, Filled Teeth for permanent dentition) was 4.2 (SD±2.9), Significant Caries index (SiC) was 7.7 (SD±2.9), the decayed teeth constituted the major part of the index (45.4%), followed by 42.1% of FT and 12.5% of extracted teeth. Among 15-year-olds the DMFT was 7.6 (SD±4.1), SiC was 9.2 (SD±1.2), and filled teeth constituted the major part of the index. The present study provides some evidence of relatively high caries prevalence and severity in comparison with Western European countries. It is necessary to devote more attention to the oral health of children and adolescents. Community based oral health promotion, preventive programs and preventive oriented public dental health care services should be made available and accessible to all children in Bosnia and Herzegovina.

Correlation between dental caries and nutritional status: preschool children in a Brazilian municipality

INTRODUCTION: Dental caries and nutritional status in children in preschool age are serious public health problems, with multifactorial etiology, with diet as a common risk factor. OBJECTIVE: This cross-sectional study assessed the relationship between dental caries and nutritional status of preschool children attending public schools in a city in the State of Sao Paulo. MATERIAL AND METHOD: The study population was comprised of 3-5 year-old preschool children (n = 229) attending public schools, in which dmft (decay, missing, filled, teeth) was used for dental caries assessment and Body Mass Index (BMI) was used for nutritional status in accordance with the recommendations of the World Health Organization. Statistical analysis was performed in a descriptive way through absolute and relative frequencies and Spearman Correlation test and Kruskal Wallis (P&lt;0.05). RESULT: A dmft of 1.65 (2.87) and a SiC index (Significant Caries Index) of 4.88 (3.20) have been found, indicating polarization of dental caries. It was observed that 66.81% of children presented with nutritional status within the normal range and children with malnutrition had a mean dmft of 4.0 (3.66), which is two times higher than the other categories of nutritional status. No statistically significant correlation has been found by correlating dmft and components with Body Mass Index. CONCLUSION: This research did not identify a significant correlation between the occurrence of dental caries and nutritional status of preschool children, researches should be conducted to elucidate this relationship.

Inequality in dental caries distribution at noncavitated and cavitated thresholds in preschool children

To evaluate the inequality in dental caries distribution according to different thresholds assessed using the International Caries Detection and Assessment System (ICDAS) and to investigate the associations of socioeconomic factors with caries lesions at both noncavitated and cavitated thresholds. Study subjects were recruited in Santa Maria, Brazil, during the National Day of Children's Vaccination, and 639 children aged 12-59 months were included. Fifteen calibrated examiners performed the examinations using ICDAS criteria. Inequality in dental caries distribution was measured using the Gini coefficient, and the Significant Caries Index was calculated for several thresholds of ICDAS. Poisson regression analysis was used to assess the associations of socioeconomic factors with the highest caries scores. The inequality in the distribution of dental caries was lower when precavitated caries were included; the Gini coefficient decreased from 0.77 to 0.60 when noncavitated caries lesions were included in the analyses. Moreover, the inequalities were higher in the younger than in the older children for all thresholds. Socioeconomic factors were significantly (P < 0.001) associated with caries when an ICDAS score of 3 was considered as the cut-off point. Children whose mothers did not complete primary education (P < 0.001) and those with low household income (P < 0.001) were more likely to have increased dental caries. Caries lesions were more equally distributed when noncavitated lesions were included in the dental survey. Socioeconomic factors are found to be associated with the inequalities in caries distribution in this age group.

Comparison and Relative Utility of Inequality Measurements: As Applied to Scotland’s Child Dental Health

This study compared and assessed the utility of tests of inequality on a series of very large population caries datasets. National cross-sectional caries datasets for Scotland’s 5-year-olds in 1993/94 (n = 5,078); 1995/96 (n = 6,240); 1997/98 (n = 6,584); 1999/00 (n = 6,781); 2002/03 (n = 9,747); 2003/04 (n = 10,956); 2005/06 (n = 10,945) and 2007/08 (n = 12,067) were obtained. Outcomes were based on the d3mft metric (i.e. the number of decayed, missing and filled teeth). An area-based deprivation category (DepCat) measured the subjects’ socioeconomic status (SES). Simple absolute and relative inequality, Odds Ratios and the Significant Caries Index (SIC) as advocated by the World Health Organization were calculated. The measures of complex inequality applied to data were: the Slope Index of Inequality (absolute) and a variety of relative inequality tests i.e. Gini coefficient; Relative Index of Inequality; concentration curve; Koolman & Doorslaer’s transformed Concentration Index; Receiver Operator Curve and Population Attributable Risk (PAR). Additional tests used were plots of SIC deciles (SIC10) and a Scottish Caries Inequality Metric (SCIM10). Over the period, mean d3mft improved from 3.1(95%CI 3.0–3.2) to 1.9(95%CI 1.8–1.9) and d3mft = 0% from 41.1(95%CI 39.8–42.3) to 58.3(95%CI 57.8–59.7). Absolute simple and complex inequality decreased. Relative simple and complex inequality remained comparatively stable. Our results support the use of the SII and RII to measure complex absolute and relative SES inequalities alongside additional tests of complex relative inequality such as PAR and Koolman and Doorslaer’s transformed CI. The latter two have clear interpretations which may influence policy makers. Specialised dental metrics (i.e. SIC, SIC10 and SCIM10) permit the exploration of other important inequalities not determined by SES, and could be applied to many other types of disease where ranking of morbidity is possible e.g. obesity. More generally, the approaches described may be applied to study patterns of health inequality affecting worldwide populations.

Dental Caries Experience in Croatian Schoolchildren in Primorsko-Goranska County: A Pilot Study

Dental caries as an infectious disease is still a major oral public health issue. As documented in some recent studies, it has been recognized as the most common chronic childhood disease.The aim of this study was to evaluate caries prevalence, DMFT and dmft scores, as opposed to caries free children at the age of 6 years from a well developed western region of Primorsko-Goranska county. The purpose was also to evaluate a Significant Caries Index (SiC) and a Restoration Index (RI) in the same study sample of 6 year olds.Data for a sample of 1,825 (868 girls and 957 boys) children was collected and analyzed by using Chi-square and Mann-Whitney U Tests.Results showed that the mean dmft was 4.68 +/- 4.19, and the mean DMFT was 0.22 +/- 0.69. D/d component constituted a major part of caries score (DMFT/dmft) in both primary and permanent dentitions in the population of 6 years old children. Caries prevalence was 74.5 in primary dentition and 11.9 in permanent dentition. Significant Caries Index value (SiC) was 0.66 for permanent and 9.6 for primary teeth, respectively. The Restoration Index (RI) was 20.1 for primary and 39.5 for permanent dentition.The results obtained in this study revealed that dental caries still appears to be quite a significant problem among 6 year olds. However, collected data, particularly considering the SiC Index, can be used for further planning of preventive and restorative dental treatments as well as setting up future goals for the prevention of dental caries in Croatian school children of Primorsko-Goranska county.