In the late seventies an increasing number of children showing extensive and severe idiopathic hypomineralization of the enamel of incisors and permanent first molars was reported within the Public Dental Services in Sweden. An epidemiologic study was initiated to analyze the prevalence, extension and severity in Swedish children born in 1970 and in the years before and after. 2252 children born in 1966-74 were examined according to well defined criteria on enamel hypomineralization. It was found that 15.4% of the children born in 1970 showed such changes. The corresponding figures for children born in 1966, 1969, 1971, 1972 and 1974 were 6.3, 7.3, 7.1, 5.2 and 4.4, respectively.

The aims of this study were 1) to investigate whether oral hygiene and dietary habits established at 1 year of age are maintained at 2 years of age and 2) to analyze caries-related factors with regard to oral health between the age of 1 and 3 years by using the salutogenic theory-that is, focusing on behavioral factors that do not result in impairment of health. Altogether 289 children were examined at 1, 2, and 3 years of age, and their parents were interviewed about the children's oral hygiene and dietary habits at 1 and 2 years of age. The result shows that caries-related habits, such as oral hygiene and dietary habits, established during infancy are maintained throughout early childhood. The principles of the salutogenic theory were found to be applicable when studying caries-related habits and oral health. Thus, if a dietary risk behavior is established at 1 year of age, the chance of remaining caries-free until 3 years of age is highest if good oral hygiene habits, including the use of fluoride toothpaste, are present at 2 years of age. We therefore conclude that comprehensive knowledge of a child's future dental health can be obtained by using chairside information-that is, interview of the parents and clinical examination of the children.

In order to map variations in the operative treatment threshold for occlusal caries, a pre-coded questionnaire was sent to a random sample of 759 dentists in Norway, 923 in Sweden, and 173 in the Danish Public Dental Health Service inquiring about caries and treatment strategies. A further intention was to explore the type of operative treatment and filling material dentists in Scandinavia would use given an occlusal lesion in the lower 2nd molar in a 20-year-old. It is found that close to 70% of dentists in the 3 countries would put off carrying out operative treatment of occlusal caries until they registered a moderately sized cavity and/or any radiolucency in dentin. In Sweden, 26.7% of dentists and in Denmark 24.3% would postpone operative treatment until the lesion had a large cavity and/or until radiolucency could be observed in the middle third of the dentin; in Norway, only 11.5% of dentists indicated this. The majority of dentists in all 3 countries preferred to drill only the carious part of the fissure, though in Norway more dentists (30.9%) would tend to drill the whole fissure compared to their Swedish (23.4%) and Danish (9.5%) colleagues. The majority of Danish dentists (52.4%) suggested amalgam for restoring the occlusal surface, while 19.9% of Norwegian and 2.9% of Swedish dentists would use amalgam. Composite was the first material of choice for 71.5% of the Swedish dentists, the remaining 25.6% suggesting conventional glass ionomer cement, light-cured 'glass ionomer cement', or a combination of glass ionomer cement and composite. The corresponding values for the Norwegian dentists were 39.1% and 41.0%, respectively, and for the Danish dentists 29.2% and 18.4%. In Scandinavia, the leading strategy for occlusal caries seems to be to postpone operative treatment until a definite cavity or radiolucency in the outer third of dentin can be observed, and to carry out operative treatment only of the part of the fissure that is carious. Composite resin is the predominant material of choice in Sweden, while in Denmark the majority of dentists preferred amalgam. Composite, or composite in combination with glass ionomer cement material, was the choice of almost 80% of Norwegian dentists.

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