A comparison of 3-year-olds' caries experience in 1973, 1981 and 1989 in a Hertfordshire town, related to family behaviour and social class.

The teeth of three samples of 3-year-old children were examined in the same fashion over two 8-year periods in a predominantly 'middle-class' town in Hertfordshire. After correcting for the changing social class structure of the town, mean dmft fell by 60% over the first period and by 29% over the second period, so the rate of improvement is decreasing. Improvements in caries levels have taken place in all the social classes except for a slight deterioration in social classes IV + V between 1981 and 1989. Ninety-six per cent of social class I + II children, but only 72% of social class IV + V children were caries-free. After falling from 8% to 1% between 1973 and 1981, the proportion of children with rampant labial caries increased to 4% in 1989. More children now visit a dentist for a check-up before the age of 4 years, more start toothbrushing at an earlier age and with greater frequency, and more are given fluoride supplements. Generally, infant feeding practices have continued to improve, although more mothers reported using a comforter bottle. Some of these practices are still strongly class-related, with manual social class families adopting less favourable behaviour. In inner city areas, family preventive behaviour and dental health is likely to be poorer.