[Dental group prophylaxis - for children only?]

In Germany, caries in 12-year olds have declined by 70 % in the last decade. This was the result of a variety of preventive measures such as salt fluoridation, group related prevention in schools and kindergartens, and individualized preventive measures offered in dental offices. On a national scale, salt fluoridation seems to be the measure with the highest efficacy and efficiency. Firstly, it has the potential to reach the entire population, and secondly it is highly cost-effective. The cost-benefit ratio for salt fluoridation ranges from 25 to 80, e. g. for one Euro spent on prevention, 25 to 80 Euro can be saved in therapy. However, salt fluoridation alone cannot stop caries, and it is not at all effective in preventing gingivitis and periodontitis. Therefore, additional measures have to be taken. The cost-benefit ratio for group-related prevention ranges from 2.4 to 19.5 and for individualized prevention from 0.7 to 2.1. Besides the better cost-effectiveness, group-related prevention has the advantage of advanced target group attainment. For example, it is easy to reach children in schools whereas it is difficult to review them in a dental office. Therefore, group related-prevention should have priority. This should not be restricted to children and adolescents, seniors can also be attended in groups. In Germany, about 950,000 people live in old people's homes, and additionally about 570,000 people in nursing homes. This population often suffers from severe oral health problems such as caries, periodontitis, and diseases involving the mucosa. Taking into account that the number of elderly institutionalized people is increasing in Germany, the establishment of group-related prevention for this part of the population seems to be an important goal in health policy.