Related Experiment Videos
Clinical outcomes of risk-based caries prevention in preschool-aged children
Kaisu Pienihäkkinen1, Jorma Jokela
1Institute of Dentistry, University of Turku, Turku, Finland. kaipie@utu.fi
Insights
Risk-based dental caries management in young children is effective. This approach, targeting individuals at high risk, significantly reduced cavities compared to routine prevention, proving practical and efficient.
Area of Science:
- Pediatric Dentistry
- Public Health
- Caries Management
Background:
- Dental caries is a prevalent issue in young children.
- Routine prevention strategies may not be optimally effective for all individuals.
- Identifying and managing caries risk factors early is crucial for long-term oral health.
Purpose of the Study:
- To compare the outcomes of risk-based dental caries management with routine prevention in young children.
- To assess the practicality and efficiency of a risk-based approach in pediatric dental care.
Main Methods:
- A 3-year prospective study involving 525 children aged 2 years at baseline.
- Two groups were compared: risk-based prevention (n=299) and routine prevention (n=226).
- Risk-based prevention utilized screening for mutans streptococci and incipient caries, with targeted interventions including fluoride and chlorhexidine varnish applications.
Main Results:
- The risk-based prevention group showed a significantly lower proportion of children with cavitated caries or fillings.
- The intervention was most effective in the high-risk category, with a number needed to treat of 2.0 to prevent restorative treatment by age 5.
- Screening accuracy in the routine prevention group was deemed acceptable.
Conclusions:
- Risk-based management of dental caries is a practical and efficient strategy for young children.
- Targeting preventive interventions to individuals identified as high-risk leads to better outcomes.
- This approach allows for more efficient allocation of dental resources.
Objective:
The aim of this study was to evaluate outcomes in young children of risk-based management of dental caries in comparison with routine prevention.
Methods:
The study was carried out in two municipal health centers in Central Finland. The risk-based prevention group consisted of 299 children from Vanha Korpilahti, and the routine prevention group of 226 children from Saarijärvi. The children were 2 yr old at baseline, and they were followed up for 3 yr. All children received regular annual oral health care. In the risk-based prevention group, the presence of mutans streptococci (MS) in plaque (Dentocult-SM strip mutans -test, Orion Diagnostica, Espoo, Finland) and incipient caries lesions were the screening criteria. Additional prevention was targeted at MS-positive subjects twice a year, consisting of health education and application of fluoride varnish. For those who had incipient lesions, 'the high-risk category', additional prevention was given four times a year and this included also chlorhexidine varnish treatments.
Results:
The screening and the preventive measures were successfully carried out by specially trained dental assistants. The proportion of children with cavitated caries or fillings was significantly lower in the risk-based than in the routine prevention group. The treatment effect was strongest within the high-risk category: two subjects had to be treated with intensive care for 3 yr to avoid restorative treatment of dental caries by the age of 5 yr in one subject (number needed to treat (NNT) = 2.0; 95% CI 1.4-3.8). The accuracy of screening was evaluated in the routine prevention group and found acceptable.
Conclusions:
The results indicate that in young children, risk-based management of caries seems practical, and prevention of caries can be targeted efficiently to individuals at risk.