Dental care of six-year-old high-caries patients in relation to their cooperation

To evaluate caries occurrence in, and dental care given to, 6-year-old high-caries patients in relation to their cooperation as judged by the dentist.

Retrospective evaluation study.

Children selected on the basis of their high number of decayed teeth (dt + DT). Data from personal oral health records.

High-caries children aged 6 years (n = 97) clinically examined and treated in public dental clinics in Helsinki, Finland, with mean dt + DT = 8.7, range 4-18.

Data covering ages 3 to 7 years: utilization of dental services, operative and preventive treatment by visit.

Treatment strategy for the 6-year-old high-caries patients was not preventive-oriented. High-caries patients had three to four times as many visits as all 6-year-old children on average, but the visits had mostly served for operative treatment. Dentists had judged 34% of the high-caries patients to be non-cooperative. These patients had more past and present caries in their deciduous teeth (P < 0.01), more dental visits (P < 0.01), and received more demanding treatment (P < 0.001) than the cooperative high-caries patients. Caries preventive treatment given to all high-caries patients was rare, number of preventive interventions per patient and per visit (intensity) tended to correlate negatively with patients' cooperation (r = -0.12 and r = -0.23). Treatment courses were completed in 39% among the non-cooperative and in 63 per cent among the cooperative high-caries patients (P < 0.05).

Dentists should be encouraged to integrate preventive interventions more closely into the treatment of non-cooperative high-caries children.