For school-age children, in whom caries activity has declined considerably, the efficiency of bitewing radiographs in diagnosing approximal lesions requires reevaluation. Therefore parallel clinical and radiographic examination of approximal surfaces were carried out in 317 14-year-old children. To assess the degree of agreement between both methods sensitivity and negative predictive value were determined. At the same time previously published data of children aged 8 through 12 years were reassessed. From the results it is concluded that omission of radiographic examination will not result in a substantial loss of information under the age of 12, but above this age it is advisable to include radiographic diagnosis for approximal surfaces.
Three micromethods for the estimation of Streptococcus mutans and lactobacilli were compared. A micropipette method was selected because of its ability to detect low levels of the organisms and its high agreement with the conventional plating method and efficient use of agar medium. The trypticase yeast cystine sucrose bacitracin agar was found to be superior to the mitis salivarius bacitracin agar. Stimulated saliva of 144 Tanzanian children from the rural and urban areas in Morogoro was investigated for S. mutans and Lactobacillus counts. Both organisms were observed in all Tanzanian children. The mean S. mutans and Lactobacillus counts were 5.0 ± 0.9 and 4.5 ± 0.9 log cfu/ml saliva, respectively. S. mutans counts greater than 106 cfu/ml saliva were observed in 25% of the urban children and in 5% of the rural children. The caries prevalence was rather low and weakly correlated with the S. mutans and Lactobacillus counts. The Tanzanian children with a high S. mutans count but with a low caries experience were considered as caries-inactive at present, but at risk of developing dental caries by changing dietary habits.
A 4‐yr mixed‐longitudinal study to determine the prevalence of caries in 7–13‐yr‐old Tanzanian children was started in 1984. The parameters considered were age, locality, Socio‐economic Status, and sex. Locality was composed of urban (Morogoro town), rural (Morogoro District), and rural areas in the District with an average fluoride level of 0.5 ppm or more in all drinking water present. SES was established based on the occupation of the father or mother and on housing conditions. Overall, the reproducibility of the dental conditions studied (D2MT/S and D3MT/S) was high, with lower scores for the conditions including early enamel lesions (D2MT/S). The reproducibility of the SES scoring system was high (χ= 0.96 and χ= 0.90), but the association over the 2 yr of measurement (1984 and 1988) was weak (r = 0.50). There were no restorations found. The percentage of children with caries increased with increasing age from 12–17% at age 7 to 37% at age 13. The statistical tests (ANOVA) revealed an age effect for all conditions studied in 1984, 1986, and 1988 and a locality effect in 1988 only. The mean D3MT‐scores varied between 0.15 and 0.24 at age 7 to 0.76 at age 13, while the mean D3MS‐scores varied between 0.27 and 0.31 at age 7 to 1.18 at age 13. In general, the caries prevalence observed was low. Children living in naturally fluoridated rural areas had significantly lower caries scores than children in non‐fluoridated areas.
In caries prevalence studies it is common practice to use bite-wing radiographs for the diagnosis of approximal caries. In many populations there is a tendency for caries levels in children to decrease over the last 10–15 years. The aim of the present study was to investigate the necessity of routine bite-wing radiographs in a low caries population. A clinical and radiographical dental examination was carried out in a group of 174 Dutch schoolchildren in 1979, using Marthaler’s reduced-count method. Clinical and radiographical data were analysed independently. The loss of information by omitting the radiographical findings of the approximal surfaces was assesed. It is concluded that in 8-year-old children in the Netherlands, there is no need for radiographical examination of approximal surfaces in caries prevalence studies, given the improved oral health over the last decade.
In 1969, 1972, 1975, 1978 and 1981 dental examinations have been carried out in The Hague on cohorts of children of kindergartens and elementary schools at the occasion of the start of a long-term dental health education campaign. In 1984 a follow-up part of the cohort examinations was conducted on 5-, 7- and 10-year-old schoolchildren. In 1984 further improvement in dental health of 5-, 7- and 10-year-old children was found. In the 5-year-old children the average d3mfs was 1.61. The average D3MFS scores of the 7- and 10-year-olds were 0.82 and 2.18. Of the 5-, 7- and 10-year-old children 64.6, 73.1 and 41.4% were caries-free. No gingivitis was found in 88.3, 65.7 and 54.7% of the children at 5, 7 and 10 years of age. The percentage of caries-free children during the 15-year period (1969–1984) increased in 5- and 7-year-old children from 1 and 2% to 65 and 73%, respectively. Explanations for the improvement of dental health are discussed.
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