On the basis of ICDAS II, targeted preventive measures can be applied in children with increased caries risk. Frequent applications of fluoride varnish inhibit the progression of initial lesions in this group.
Aim: To evaluate intra- and interexaminer reproducibility of ICDAS-II on occlusal caries diagnosis when different time intervals were allowed to elapse between examinations. A subsidiary aim was to determine whether collapsing the codes would influence this reproducibility. Methods: The occlusal surfaces of 50 permanent posterior teeth were investigated by 3 trained examiners using ICDAS-II at baseline, 1 day, 1 week and 4 weeks after baseline. Results: Weighted kappa values for intra- and interexaminer reproducibility were 0.76–0.93. Conclusion: The time span did not have a major impact on assessing intra- and interexaminer reproducibility. Collapsing ICDAS-II codes had no impact on examiner reproducibility.
Aim Selective intensified prevention (SIP) was introduced by the Dental Public Health Service in Marburg County in 1995. SIP is offered at individual schools in underprivileged districts including enhanced health education and oral hygiene instructions as well as fluoride varnish applications four times per year. The aim of this study was to evaluate the effect of the programme in 12-year-old children in comparison to a control region. Subject and Methods The intervention group consisted of children attending schools in socially deprived areas in the county of Marburg-Biedenkopf who had participated in the preventive programme for 6 years. Control group subjects were recruited from schools in socially deprived areas in the county of Osnabrück with no school-based topical fluoridation programme. Caries experience was recorded using the criteria of the International Caries Detection and Assessment System (ICDAS II). Other variables such as oral hygiene behaviour, knowledge of dental health and dental fear were examined psychometrically. The statistical evaluation was performed by SPSS 17.0. To compare the mean caries scores of various subgroups, non-parametric tests were performed. Results In Marburg 236 children were examined, and 689 were participating in the control region. The samples were parallelized by constructing matched pairs with children from the control region. After matching the data of 210 children in each region, a total of 420 were involved in the statistical evaluation. Combining ICDAS scores 3 to 6 children from the control region (mean D 3-6 MFT: 1.73) showed roughly double the caries experience compared to the test group (mean D 3-6 MFT: 0.88, p<0.005). Concerning health knowledge, Marburg pupils did not exhibit superiority but dental fear was reported to a lesser extent. Conclusion The results of our study confirm a caries preventive effect of SIP. The intervention group showed better oral health in all dental outcome variables reviewed. Both groups showed similar results regarding dietary habits, prophylaxis knowledge and oral hygiene. This leads to the conclusion that the effect of the preventive programme is primarily based on the application of fluoride varnish.
Our study investigated the effect of a selective intensive prevention (SIP) programme on dental health of pupils in comparison to a control group. While no differences were observed in respect to dental health of first graders, the DMF-T values of fourth and 6 graders participating in SIP were significantly lower. Concerning the psychometric variables only few differences were found. The fourth and 6 graders in the test group reported less dental fear than the pupils in the control group.
In Lower Saxony, a regional public health project on a pathogen-specific surveillance of Enteritis infectiosa was carried out from 1994 to 2000. In a separate reporting procedure thirteen health departments transmitted data on the specific pathogen collected from laboratory reports for a joint analysis. The results were distributed among the participants, providing them with information on the situation and trends in their districts and in addition giving them the possibility to compare their data with those of other districts. The incidence of Enteritis infectiosa was 199 reported cases per 100,000 person years. Salmonella was reported most frequently (51 %; S. enteritidis: 33 %, S. TYPHIMURIUM: 14 %, 111 other serotypes: 4 %), followed by Campylobacter (18 %), Rotavirus (17 %), Yersinia enterocolitica (6 %) and Adenovirus (5 %). The incidences of Salmonella and Yersinia enterocolitica were found to be nearly constant over the project period while the incidences of Campylobacter, Rotavirus and Adenovirus increased. This, however, may be due to intensified diagnostics and better reporting behaviour rather than to a real increase. The incidence rates and their trends differed from other German states. This observation emphasizes the need for a regional analysis of infectious disease surveillance data.
In Lower Saxony, a regional public health project for an enlarged surveillance of viral hepatitis was carried out from 1999 to 2001. Five district public health authorities collected additional information on notified viral hepatitis cases in a standardised way, particularly regarding risk factors. In the survey, 270 hepatitis (hep.) cases were investigated, among them hep. A 51 (18.9%), hep. B 87 (32.2%) and hep. C 132 (48.9%). The proportion of chronic cases and healthy carriers was as follows: hep. A 0%, hep. B 47.1% and hep. C 79.5%. In approximately 50% of the cases of all three forms risk factors could be identified. The most frequent risk factors were in hep. A visits to foreign countries (29.4%), contacts to infected individuals (17.6%) and attendance at public institutions or care facilities (13.7%), in hep. B visits to foreign countries (24.1%), contacts to infected individuals (19.5%; sexual contacts 16.1%) and medical treatments (19.5%) and in hep. C injecting drug use (31.1%) and medical treatments (18.2%; 9.8% blood transfusion in the past in combination with chronic hep. C). The results are in accordance with current data under the new infection protection law, where reporting of chronic cases was mostly abolished. In the survey, the well-known risk factors were confirmed, but some risks were reported more frequently than in other surveys, e. g. sexual behaviour for hep. B or injecting drugs for hep. C.
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