OBJECTIVE: The aim of this study was to evaluate outcomes in young children of risk-based management of dental caries in comparison with routine prevention. METHODS: The study was carried out in two municipal health centers in Central Finland. The risk-based prevention group consisted of 299 children from Vanha Korpilahti, and the routine prevention group of 226 children from Saarijärvi. The children were 2 yr old at baseline, and they were followed up for 3 yr. All children received regular annual oral health care. In the risk-based prevention group, the presence of mutans streptococci (MS) in plaque (Dentocult-SM strip mutans -test, Orion Diagnostica, Espoo, Finland) and incipient caries lesions were the screening criteria. Additional prevention was targeted at MS-positive subjects twice a year, consisting of health education and application of fluoride varnish. For those who had incipient lesions, 'the high-risk category', additional prevention was given four times a year and this included also chlorhexidine varnish treatments. RESULTS: The screening and the preventive measures were successfully carried out by specially trained dental assistants. The proportion of children with cavitated caries or fillings was significantly lower in the risk-based than in the routine prevention group. The treatment effect was strongest within the high-risk category: two subjects had to be treated with intensive care for 3 yr to avoid restorative treatment of dental caries by the age of 5 yr in one subject (number needed to treat (NNT) = 2.0; 95% CI 1.4-3.8). The accuracy of screening was evaluated in the routine prevention group and found acceptable. CONCLUSIONS: The results indicate that in young children, risk-based management of caries seems practical, and prevention of caries can be targeted efficiently to individuals at risk.
OBJECTIVE: The aim of this study was to evaluate outcomes in young children of risk-based management of dental caries in comparison with routine prevention. METHODS: The study was carried out in two municipal health centers in Central Finland. The risk-based prevention group consisted of 299 children from Vanha Korpilahti, and the routine prevention group of 226 children from Saarijärvi. The children were 2 yr old at baseline, and they were followed up for 3 yr. All children received regular annual oral health care. In the risk-based prevention group, the presence of mutans streptococci (MS) in plaque (Dentocult-SM strip mutans -test, Orion Diagnostica, Espoo, Finland) and incipient caries lesions were the screening criteria. Additional prevention was targeted at MS-positive subjects twice a year, consisting of health education and application of fluoride varnish. For those who had incipient lesions, 'the high-risk category', additional prevention was given four times a year and this included also chlorhexidine varnish treatments. RESULTS: The screening and the preventive measures were successfully carried out by specially trained dental assistants. The proportion of children with cavitated caries or fillings was significantly lower in the risk-based than in the routine prevention group. The treatment effect was strongest within the high-risk category: two subjects had to be treated with intensive care for 3 yr to avoid restorative treatment of dental caries by the age of 5 yr in one subject (number needed to treat (NNT) = 2.0; 95% CI 1.4-3.8). The accuracy of screening was evaluated in the routine prevention group and found acceptable. CONCLUSIONS: The results indicate that in young children, risk-based management of caries seems practical, and prevention of caries can be targeted efficiently to individuals at risk.
Authors: Andrea M de Silva; Shalika Hegde; Bridget Akudo Nwagbara; Hanny Calache; Mark G Gussy; Mona Nasser; Hannah R Morrice; Elisha Riggs; Pamela M Leong; Lisa K Meyenn; Reza Yousefi-Nooraie Journal: Cochrane Database Syst Rev Date: 2016-12-22
Authors: Klaus Pieper; Simone Dressler; Monika Heinzel-Gutenbrunner; Anne Neuhäuser; Matthias Krecker; Klaus Wunderlich; Anahita Jablonski-Momeni Journal: Int J Public Health Date: 2011-09-13 Impact factor: 3.380
Authors: M Fontana; R Jackson; G Eckert; N Swigonski; J Chin; A Ferreira Zandona; M Ando; G K Stookey; S Downs; D T Zero Journal: J Dent Res Date: 2010-12-20 Impact factor: 6.116
Authors: Andrea M de Silva; Shalika Hegde; Bridget Akudo Nwagbara; Hanny Calache; Mark G Gussy; Mona Nasser; Hannah R Morrice; Elisha Riggs; Pamela M Leong; Lisa K Meyenn; Reza Yousefi-Nooraie Journal: Cochrane Database Syst Rev Date: 2016-09-15