Quality assurance in prevention

The successful prevention of caries in Sweden, as in many other countries, is an example of what might he obtained when a systematic and complete program is adopted. Fluoride programs, mechanical cleaning of the teeth, and improved nutrition and eating habits have been the most important fundamentals for the positive results. A diminished use of tobacco, with a reduced frequency of periodontitis as one of the consequences, has been successful in some groups in the population but less so in others. There is, however, evidence now in Sweden of a less active preventive approach concerning caries prophylaxis among some parents today than a generation ago. Thus, there are obvious reasons to continue with oral preventive programs, preferably integrated with general health programs. For acceptable quality in preventive programs to be obtained, concrete goals must be formulated. These should be based upon scientific findings. Those in the society who should be given priority in the program must be identified by epidemiological studies. Systems for follow-up of the preventive measures should be integrated into the programs when they are initiated. Total quality assurance programs should include parameters which describe the resources and the process needed to obtain the formulated goals. The qualifications of those involved in the process are among the most important resources for success.