Prevention of early childhood caries--results of a fluoride toothpaste demonstration trial on Chinese preschool children after three years.

OBJECTIVES: This field demonstration trial evaluates the long-term effects of introducing daily toothbrushing with fluoride toothpaste in a Chinese kindergarten (test group) compared to caries development in children who had no organized preventive program (control group).
METHODS: In the test group teacher-supervised toothbrushing was initiated with 1,000 ppm MFP toothpaste in addition to oral health education activities. Test and control children were examined at baseline (n = 289, aged 3 years) and annually thereafter.
RESULTS: After three years, 251 children (87%) were still in the trial. Caries development (dmfs) calculation included only those children who were present at both baseline and subsequent annual examinations. At baseline the mean dmfs was 4.8 in the test group and 6.5 in the control group (NS). After three years the caries increment was 6.2 and 8.4 in the test group and the control group, respectively (P < .05). Adjusting for reversals, the net caries increment was 3.6 and 6.3, respectively (P < .01). Additionally, multiple linear regression analysis indicated that both baseline dmfs, the program and plaque level had a significant effect on the net caries increment. The use of hierarchical caries severity zones was useful for the identification of those children most at risk for further caries development.
CONCLUSIONS: We conclude that a daily toothbrushing with limited involvement of professional staff was feasible in a Chinese kindergarten and that caries development was significantly slowed in the test children. Caries severity zones may possibly assist in determining levels of intervention.