Systematic community-based oral health promotion should be strengthened and preventive-oriented oral health care systems are needed, including promotion of further self-care practices and the use of fluoridated toothpaste.

Systematic community-oriented oral health promotion programmes are needed to target lifestyles and the needs of children, particularly for those living in rural areas. A prevention-oriented oral health care policy would seem more advantageous than the present curative approach.

Objectives: To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience. Design: Cross‐sectional study, oral epidemiological survey based on WHO methodology, clinical examinations. Setting: National survey by National Committee for Oral Health. Subjects: Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5, 12, 15, 18, 35–44 and 65–74. Each age group consisted of 23,452 participants, i.e. total of 140, 712 individuals. Results: At age 5, 76.6% were affected by dental caries and mean dmft was 4.5. Mean DMFT varied from 1.0 in 12‐year‐olds, 1.4 in 15‐year‐olds, 1.6 in 18‐year‐olds, 2.1 in 35–44‐year‐olds to 12.4 in 65–74‐year‐olds. In adults, caries experience was higher in females than in males. The effect of urbanisation on caries prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old‐age people of rural areas. At national level, changes in dental caries prevalence of 12‐and 15‐year‐olds were small. However, some provinces with extensive oral health programmes (e.g. Love Teeth Day) showed declining caries experience whereas provinces with limited preventive activities had increasing levels of caries. For all age groups, gingival bleeding and calculus were most frequent. Severe periodontal conditions were relatively rare. Conclusion: The systematic implementation of preventive oral care and community‐oriented health programmes are needed for the continuous promotion of oral health in China.

Long-term use of xylitol-containing chewing-gum can reduce the growth of mutans streptococci in saliva and dental plaque, and lactobacilli-type bacteria in saliva, even if xylitol is used only on school days. The results also suggest that xylitol gum use can have a long-term, delayed growth-retarding effect on these micro-organisms, since reduced bacterial growth was still observed 15 months following the termination of xylitol use. The results indicate a close biochemical relationship between xylitol and mutans streptococci, and suggest that a similar relationship may exist regarding aerobically cultured aciduric bacteria present in saliva.

The use of fluoride toothpaste in Beijing appears to have increased during the past decade. In addition to mass communication comprehensive school-based oral health programmes are needed to continuously promote the use of fluoride toothpaste among schoolchildren.