Evaluation of a preventive program aiming at children with increased caries risk using ICDAS II criteria.

OBJECTIVES

A selective intensified prevention (SIP) was introduced at individual schools in deprived areas in Marburg County (Germany) in 1995. The outcome of the program was evaluated in sixth graders (mean age: 12.06 years) in comparison to a control region.

MATERIALS AND

METHODS

Caries experience was recorded by applying International Caries Detection and Assessment System (ICDAS) II criteria. Tooth brushing habits and other independent variables were examined psychometrically. To compare the mean caries scores, non parametric tests were applied. The influence of various independent variables on caries experience was assessed by stepwise backward logistic regression analysis. The matching criteria age, gender, ethnicity and maternal education were used to parallelize the samples.

RESULTS

ICDAS scores of 2-6 were detected uniformly more often in the control region than in the test group. Combining ICDAS scores 3-6, children from the control region (mean D(3-6)MFT: 1.73) showed roughly double the caries experience compared to the test group (mean D(3-6)MFT: 0.88, p < 0.005). The D(5,6)MFT score of the test group amounted to 0.50, and the corresponding value of the reference group was 0.77 (p = 0.043). Multivariate analysis disclosed fissure sealants, early start of tooth brushing and topical fluoride application to be associated with the prevention of dental caries. High frequency of sugar intake was associated with the presence of dentine lesions.

CONCLUSIONS

The results of our study confirm the positive effect of SIP on the dental health of 12-year-old pupils living in deprived areas.

CLINICAL RELEVANCE: On the basis of ICDAS II, targeted preventive measures can be applied in children with increased caries risk. Frequent applications of fluoride varnish inhibit the progression of initial lesions in this group.