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On caries prevalence and school-based fluoride programmes in Swedish adolescents
1Department of Cariology, Faculty of Odontology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Swedish Dental Journal. Supplement
|November 8, 2005
Summary
Dental caries prevalence in adolescents is underestimated as enamel lesions are often unreported. School-based fluoride varnish and fluoride mouth rinse (FMR) programs are effective for preventing approximal caries in 13-16 year olds.
Area of Science:
- Public Health Dentistry
- Pediatric Dentistry
- Caries Prevention
Background:
- Dental caries on approximal tooth surfaces remains a significant issue for adolescents in industrialized nations.
- Current official caries data in Sweden often underestimate prevalence by excluding enamel lesions.
- The effectiveness of school-based fluoride programs requires ongoing evaluation.
Purpose of the Study:
- To investigate if caries prevalence in adolescents is underestimated in official records.
- To evaluate the impact of discontinuing a school-based fluoride mouth rinse (FMR) program.
- To assess new models for school-based fluoride (F) varnish and FMR programs for caries prevention in 13-16 year olds.
Main Methods:
- Comparative analysis of caries recordings by general dentists versus calibrated external dentists.
- Randomized controlled trials (RCTs) evaluating fluoride varnish and FMR programs in schools.
- Longitudinal assessment of caries incidence and progression over three years.
Main Results:
- Adolescents' own dentists consistently underreported caries compared to calibrated dentists, with approximal enamel lesions forming the majority (>80%) of unreported lesions.
- Cessation of FMR for three years in a low-caries prevalence group showed no statistically significant increase in caries incidence.
- School-based fluoride varnish applied twice annually demonstrated significant caries prevention, particularly in high-risk areas (Prevented Fraction [PF] up to 69%).
- Supervised school-based FMR, administered 12 times per year, also showed effectiveness (PF 59%).
Conclusions:
- Epidemiological caries data should include approximal enamel lesions to accurately reflect true prevalence.
- Discontinuation of FMR in low-caries groups did not significantly increase caries incidence over three years.
- School-based fluoride varnish (twice yearly) and supervised FMR (12 times yearly) are effective strategies for preventing approximal caries in adolescents aged 13-16.
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