Influence of oral hygiene on early enamel caries.

For 548 children aged 4-16 years, mean (+/- SD) age 10.3 +/- 2.7 at visit 1, the dental status was recorded at four consecutive 6-monthly visits. Simultaneously oral hygiene was scored according to a modified patient hygiene performance (PHP) index after application of disclosing solution and before the dental examination. The following cariogenic changes could be observed: initiation (white spot formation), progression (cavitation), stabilisation and regression (disappearance of a white spot). The PHP score was examined in relation to these changes in smooth surfaces, as well as in fissures. For fissures when oral hygiene worsened, stabilisation of a white spot increased significantly. Also, regression of a white spot into sound enamel increased with poor oral hygiene, but the significance was only marginal. White spots turning into cavities, however, did not change with poor oral hygiene. It was speculated that under low oral hygiene conditions the remaining plaque of children receiving intensive fluoride treatment can bind fluoride to the fissure surfaces, thereby promoting enamel maturation concomitant with stabilisation and regression of white spots, which in an earlier study were also found to be dependent on posteruptive age.