Changes in prevalence of approximal caries in 17‐year‐olds and related restorative treatment strategies over a 6‐year period

Abstract

Two cohorts of 17-yr-olds treated in a municipal child dental service in 1978-79 and 1984-85 had bitewing radiographs taken at the examination before the last course of treatment in the service. All radiographs were read by one examiner, who did not know to which cohort the individual belonged. The subsequent treatment was recorded from the treatment records by another examiner, who was unaware of the results of the radiographic examination. According to radiographic scores, the proportion of decayed or filled (DFS) approximal surfaces had decreased from 23.2% to 17.4% during the period (difference: 25%). The proportion of unfilled surfaces which were decayed (DS) had remained almost constant, while 9.6% of the surfaces were filled (FS) in 1978-79 compared to 3.1% in 1984-85 (difference: 68%). Thus, in spite of a 25% decrease in total caries experience (DFS), a reduction of 68% would be claimed if fillings (FS) were interpreted as expression of disease prevalence. The risk of an approximal surface being filled decreased to about one fifth from 1978-79 to 1984-85, and the risk of being filled was nearly three times as high for approximal surfaces of children who already had approximal fillings at the time of examination. Thus, both the year of examination and the subject's previously received treatment seemed to influence the treatment strategy of the dentist.

Decline in dental caries and public oral health care of adolescents

“…This con-firms the findings of Heidmann et a]. (8) and is in accordance with the knowledge of caries distribution in the teenage dentition (9)(10)(11)(12).…”

“…In recent years, treatment strategies have changed (8) as the slow progression of caries and ways of arresting lesions (9,(13)(14)(15) have become more widely known. This should have been reflected as an intensification of fluoride therapy, especially in high-risk patients.…”

Caries management: technical solutions to biological problems or evidence‐based care?

“…Continuing education also plays a key role. This is illustrated by the dramatic change in the propensity to restore approximal surfaces with various radiographic diagnoses that was observed between 1978/1979 and 1984/1985 among 17‐year‐olds in a Danish municipality (8) (Fig. 2).…”

Caries Development from 11 to 22 Years of Age: A Prospective Radiographic StudyPrevalence and Distribution

“…Over the past decade the criteria for the treatment of approximal caries lesions in young permanent teeth have shifted in several European countries from a restorative approach to remineralizing strategies [Holst et al, 1986;Heidmann et al, 1987Heidmann et al, , 1988Nuttal and Pitts, 1990]. The rationale behind this more conservative philosophy is not only the relatively slow rate of caries progression through the enamel [Pitts 1983;Shwartz et al, 1984a], an increased awareness of the restricted life of restorations [Paterson, 1984;Qvist et al, 1986a, b] and concern about saving tooth substance, but also the risk of a false positive diagnosis when caries prevalence decreases [Gröndahl, 1986].…”