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Evaluation of a caries prevention programme for preschool children in Switzerland: is the target group being reached?
Anina Mühlemann1, Stefanie von Felten2
1Master Programme in Public Health, University of Zurich, Zurich, Switzerland.
Insights
Zurich
Area of Science:
- Public Health
- Pediatric Dentistry
- Epidemiology
Background:
- Zurich implemented a free dental check-up program for 2-year-olds in 2010 to reduce early childhood caries.
- The program aims to reach high-risk children before the mandatory kindergarten dental examination.
Purpose of the Study:
- To evaluate if the Zurich prevention program effectively reaches children at high risk for caries.
- To assess the program's impact on subsequent oral health outcomes.
Main Methods:
- Retrospective cohort study of children born between July 2013 and July 2014 in Zurich.
- Socio-economic and dental health data were analyzed using generalized linear models.
- Factors associated with toddler check-up attendance and caries experience were identified.
Main Results:
- Only 54% of eligible children attended the toddler check-up; lower attendance was linked to non-Swiss origin and lower socioeconomic status.
- Children at higher risk for caries were less likely to attend the toddler check-up.
- Toddler check-up attendance showed a non-significant trend towards lower caries experience but a significant increase in treatment degree at kindergarten age.
Conclusions:
- The current prevention program in Zurich does not effectively reach children most in need.
- Targeted interventions are required to improve access for high-caries-risk toddlers.
- Enhanced outreach strategies are crucial for the program's success in reducing early childhood caries.
Background:
With the goal of reducing the prevalence of early childhood caries, the city of Zurich, Switzerland, started a specific prevention programme in 2010. All 2-year-olds are invited to a free dental check-up at a local public dental health service before the first legally mandated yearly dental check-up for school children between 4 and 5 years of age (at kindergarten). However, for the success of this prevention programme, it is of particular importance that children at high risk of caries are reached. The objective of our study was to assess the effectiveness of the prevention programme in (1) reaching the children who needed it the most and (2) improving subsequent oral health.
Methods:
This retrospective cohort study included all children born between July 1, 2013 and July 15, 2014 who had lived in Zurich between the ages of 23 and 36 months. Socio-economic data were extracted from official school records, and dental health data from public dental clinic records. Binomial and quasi-binomial generalised linear models were used to identify the socio-economic factors associated with toddler check-up attendance and to assess the associations between attendance and caries experience (dmft [Formula: see text] 1) as well as degree of treatment (proportion m+f out of dmft) at the kindergarten check-up, adjusting for socio-economic factors.
Results:
From a total of 4376 children, 2360 (54%) attended the toddler check-up (mean age 2.4 years) and 3452 (79%) had a dental examination at kindergarten (mean age 5.3 years). Non-Swiss origin of the primary caretaker, presence of older siblings, low amount of savings and allocation to certain public dental clinics were associated with a lower odds of attendance. Factors associated with a higher odds of caries experience were similar to those associated with a lower odds of attendance at the toddler check-up, but additionally included low income. Attendance at the toddler check-up was non-significantly associated with a lower odds of caries experience at kindergarten (adjusted OR 0.84, 95% CI from 0.70 to 1.01), but was significantly associated with a higher degree of treatment at this stage (adjusted OR 2.41, 95% CI from 1.79 to 3.24).
Conclusions:
Our study suggests that children with a high caries risk are less likely to attend the toddler check-up. Greater effort should be put into reaching these children.
