Caries and the planning of dental treatment for five-year-old children

A survey was conducted to assess the prevalence of dental caries in the primary teeth and first permanent molars of five-year-old children and the occurrence of spaces between their primary molars. The representative sample investigated consisted of 965 children attending compulsory kindergarten in Jerusalem. 84% of the children were found to have carious teeth. Average d.i.f. was 4.7 (+/-3.6). The rate of decay was found to be the same in males and females. 30% were found to have eight or more carious teeth and a large number of extractions had to be carried out in this group. Most of the children examined did not have spaces between their primary molars, a fact that necessitated the use of diagnostic radiographs for all cases of extensive treatment. 77% of the children still had no permanent molars. Of those whose permanent molars had erupted, 73% had no caries. A definite association was found to exist between the prevalence of caries in primary teeth and its prevalence in permanent molars. On the basis of the findings it is concluded that compulsory kindergarten is a suitable frame-work for the commencement of organised dental services. Most of the services required may be provided by general dental practitioners who have received some additional specialised training to equip them to treat children. For problematical children--with particular medical or behavioural problems--more specialised treatment can be provided through medical centres in which paedodontic specialists and more sophisticated equipment are available. Currently available manpower in the dental profession is apparently not sufficient and considerable thought will have to be devoted to solution of this problem.