Effect of intensified caries prevention on approximal caries in adolescents with high caries risk

The aim of this study was to evaluate the effect of two preventive programs carried out in Public Dental Clinics for children with high caries risk. From all the 13-year-olds living in Kuopio (n = 871), 323 (37%) were selected as a high-risk group on the basis of the level of salivary mutans streptococci or DS score. They were randomly divided into two groups. The first group continued with the preventive care they had received before the study. The dentists treating the children in the second group were specifically informed about their high caries risk, and instructions concerning intensified prevention were given. For comparison, half of the 13-year-olds with low caries risk were included in the study (group 3, n = 248). No special instructions concerning these children were given. After 2 years, approximal caries increment in the two risk groups was three times that of the low-risk group (2.6, 2.3 and 0.7 in groups 1-3, respectively). There was no significant difference between the two risk groups in spite of the fact that significantly more preventive procedures were provided for group 2 than for group 1. The results indicate that assessment of the subjects as high and low-risk groups was successful, but caries prevention targeted for the risk groups failed to lower the rate of caries to the same level as that of the children with an anticipated low risk. For children at high risk, the intensified prevention program monitored by dental authorities was no more successful than prevention planned by individual dentists.