Treatment practices in caries prevention for 6-year-olds in Finland

To evaluate caries-preventive treatment practices in relation to caries state and eruption of first permanent molars (FPMs) among 6-year-olds (n = 3489) examined and treated in public dental clinics in Helsinki during 1992.

The study subjects were selected on the basis of their caries state using a two-point study design: the high-caries group (n = 99) had the greatest number of DT + dt, the cavity-free group (n = 32) had neither past nor present caries. Evaluation of dentists' caries-preventive treatment decisions was based on data from detailed personal oral health records.

In total, 22% of the high-caries patients (mean DT + dt 8.7; range 4-18) had been judged by their dentists as high-risk patients. Eruption of FPMs had no influence on dentists' judgement on caries risk. A subject's number of DT + dt had no influence on the intensity of preventive treatment given, but those with a high-risk judgement from a dentist received more preventive measures per visit than did other high-caries patients. For high-caries patients with erupting FPMs, three visits in 10 included preventive intervention other than sealants, compared to nine in the cavity-free group. Intensity of oral hygiene instruction correlated with presence of erupting FPMs, yet 86% of the patients with erupting FPMs had received no oral hygiene instruction.

Dentists should be encouraged to use standardized criteria, including data on caries state and eruption stage, in judging each patient's risk of caries to provide intensified caries-preventive treatment to those most in need.