Risk-based early prevention in comparison with routine prevention of dental caries: a 7-year follow-up of a controlled clinical trial; clinical and economic aspects

BACKGROUND: The results in an earlier study with 2–5-year-old children indicated that, in comparison with conventional prevention, a risk-based prevention programme was effective in reducing dental caries in a low-caries community. The aim of the present study was to examine the clinical and economic findings seven years after the cessation of the targeted programme, from the perspective of public health care. METHODS: The present material was collected from the dental records of the public health care centres, and included all dental visits after the 5-year examination until the 12-year examination. The groups were compared in relation to clinically detected caries at the age of 12 years, the number of dental visits needed from 5 to 12 years of age, and the estimation of running costs during these years. Statistical analyses included univariate analysis of variance, and calculation of absolute risk reduction and number needed to treat (NNT) values. RESULTS: At the age of 12 years, DMF was significantly related to the risk category determined ten years earlier, in both study groups. In the risk-based group, the absolute risk reduction for caries in permanent dentition was 0.13 (95% confidence interval 0.06 – 0.21), and the associated NNT value was 8 (95% confidence interval 5 – 17). The total number of preventive, as well as restorative visits was lower in the risk-based than in the routine prevention group. The findings indicate that early risk-based prevention can be correctly targeted, clinically effective, and economically profitable also from the long-term point of view. CONCLUSION: Early prevention of dental caries also has long-term benefits in a 7-year follow-up perspective. This seems to hold true as regards targeting, as well as clinical and economic effectiveness. Success in risk-based prevention enables successful work division, and consequently, economic effectiveness

Dental Fear: One Single Clinical Question for Measurement

A new dental fear measurement instrument, the Short Dental Fear Question (SDFQ), was developed and tested for clinical practice purposes. The correlations of the SDFQ with the Dental Anxiety Scale (DAS) and the Dental Fear Survey (DFS) were tested in 15-16-year-old adolescents. The Spearman correlations (rs) between the dental fear measurement instruments were: SDFQ – DFS: rs = 0.79, n = 26; DFS – DAS: rs = 0.72, n = 26; SDFQ– DAS: rs = 0.69, n = 27. DAS and DFS mean scores were clearly higher in the SDFQ fear group than SDFQ in the relaxed group. The SDFQ is a short and compact instrument which might be convenient for the measurement of dental fear in clinical practice