The Effect of a Needs-Related Caries Preventive Program in Children and Young Adults – Results after 20 Years

The risk for caries development in children varies significantly for different age groups, individuals, teeth, and surfaces. Thus from a cost-effectiveness point of view, caries preventive measures must be integrated and based on predicted risk from age group down to individual tooth surfaces. Based on this philosophy and experiences from continuously ongoing research on evaluating and reevaluating separate and integrated caries preventive measures, as well as methods for prediction of caries risk, a needs-related caries preventive program was introduced for all 0–19-year-olds in the county of Värmland, Sweden, in 1979. The goals for the subjects following the program from birth to the age of 19 years were

Improved ability of biological and previous caries multimarkers to predict caries disease as revealed by multivariate PLS modelling

<p>Abstract</p> <p>Background</p> <p>Dental caries is a chronic disease with plaque bacteria, diet and saliva modifying disease activity. Here we have used the PLS method to evaluate a multiplicity of such biological variables (n = 88) for ability to predict caries in a cross-sectional (baseline caries) and prospective (2-year caries development) setting.</p> <p>Methods</p> <p>Multivariate PLS modelling was used to associate the many biological variables with caries recorded in thirty 14-year-old children by measuring the numbers of incipient and manifest caries lesions at all surfaces.</p> <p>Results</p> <p>A wide but shallow gliding scale of one fifth caries promoting or protecting, and four fifths non-influential, variables occurred. The influential markers behaved in the order of plaque bacteria > diet > saliva, with previously known plaque bacteria/diet markers and a set of new protective diet markers. A differential variable patterning appeared for new versus progressing lesions. The influential biological multimarkers (n = 18) predicted baseline caries better (ROC area 0.96) than five markers (0.92) and a single lactobacilli marker (0.7) with sensitivity/specificity of 1.87, 1.78 and 1.13 at 1/3 of the subjects diagnosed sick, respectively. Moreover, biological multimarkers (n = 18) explained 2-year caries increment slightly better than reported before but predicted it poorly (ROC area 0.76). By contrast, multimarkers based on previous caries predicted alone (ROC area 0.88), or together with biological multimarkers (0.94), increment well with a sensitivity/specificity of 1.74 at 1/3 of the subjects diagnosed sick.</p> <p>Conclusion</p> <p>Multimarkers behave better than single-to-five markers but future multimarker strategies will require systematic searches for improved saliva and plaque bacteria markers.</p

Prevalência de estreptococos do grupo mutans em crianças de 12 a 31 meses de idade e sua associação com a freqüência e severidade de cárie dental Prevalence of mutans streptococci in 12-31-month-old children and its association with frequency and severity of dental caries

Avaliaram-se os níveis salivares de estreptococos do grupo mutans (GM) e a prevalência de cárie dental em 142 crianças, de 12 a 31 meses de idade, da cidade de Piracicaba - SP. Ao exame clínico, foram diagnosticadas as lesões de cárie iniciais (mancha branca) e cavitadas de todas as superfícies dentárias. GM foram detectados em 80,3% (n = 114) das crianças estudadas, sendo que 21,8% (n = 31) delas apresentavam altos níveis salivares desses microrganismos. Os níveis salivares de GM foram dependentes do número de dentes irrompidos na cavidade bucal (<FONT FACE="Symbol">c</font>2 = 19,03; p < 0,001). Observou-se associação positiva entre os níveis salivares desses microrganismos e o número de crianças com cárie dental (<FONT FACE="Symbol">c</font>2 = 28,67; p < 0,001). Além disso, observou-se uma correlação positiva entre os níveis de GM na saliva e o número de lesões diagnosticadas, sendo maior o coeficiente de correlação quando as lesões iniciais foram consideradas (r = 0,537; p < 0,001). Os dados mostram uma alta prevalência de GM em crianças com 12 a 31 meses de idade e sua associação positiva com a freqüência e severidade da cárie dental.<br>The prevalence of mutans streptococci (MS) was evaluated in samples of unstimulated saliva from 142 12-31-month-old children. Initial and manifest caries of all teeth surfaces were recorded. Mutans streptococci were detected in 80.3% (n = 114) of the studied children, and 21.8% of all children (n = 31) presented high levels of these microorganisms. The salivary levels of mutans streptococci depended on the number of erupted teeth (<FONT FACE="Symbol">c</font>2 = 19.03; p < 0.001). There was a positive association between the number of caries affected children and the salivary levels of MS (<FONT FACE="Symbol">c</font>2 = 28.67; p < 0.001). In addition, there was a positive correlation between the salivary levels of these microorganisms and the number of caries lesions which was higher when initial caries were considered (r = 0.537; p < 0.001). These data show a high prevalence of mutans streptococci in children with 12 to 31 months of age and its positive association with the frequency and severity of dental caries