Influence of Different Variables on the Inter-Municipality Variation in Caries Experience in Danish Adolescents

Abstract

This investigation sought to estimate the influence a number of variables had on the inter-municipality variation in caries experience across Denmark. Unit of measurement was the municipality with public clinics. Mean DMF-S and %DMF-S = 0 of 15- and 18-year-olds in 1999 were obtained from 204 and 143 municipalities, respectively, out of a total number of 206 municipalities with public clinics. The independent variables were: cost per child per year; children/dentist ratio; auxiliary personal/dentist ratio; fluoride concentration in the water supply [F]; average personal income; % of mothers of the 15- and 18-year-olds with ≤10 years education (EDU-15 or EDU-18); proportion of immigrants; and size of the municipality. Multiple regression analyses disclosed that [F] (p < 0.001) and EDU-15 (p < 0.001) were significant variables among the 15-year-olds explaining 45% of the variation in mean DMF-S and 31% of the variation in % DMF-S = 0. With respect to the 18-year-olds, [F] (p < 0.001) and average personal income (p < 0.001) explained 53% of the variation in mean DMF-S and 30% of the variation in %DMF-S = 0. Few municipalities were characterized as outliers with significantly lower or higher observed caries experience than expected. It is concluded that there is room for other explanatory factors – first and foremost the professional effort made in the individual Public Dental Health Service to control caries.

Outcomes of a Non-Operative Caries Treatment Programme for Children and Adolescents

“…Thus, in 1999, 18-year-olds in Nexö had the lowest mean DMF-S and the highest percentage of 18-year-olds with DMF-S = 0 among all municipalities in Denmark [Ekstrand et al, 2003b]. The mean DMF-S among 18-year-olds (both at the total cohort and subcohort levels) was less than 2, and more than 50% of the 18-year-olds in the total cohorts/subcohorts had a DMF-S = 0 (medians 0) as stated as operational goals.…”

“…However, by interviewing the chief dental offi cers in the involved municipalities and by collecting data from different national data banks, it was possible to obtain relevant information about background variables and elements in the preventive programmes used during 1988-1999. It is important to note that the background for running the PDHSC for all municipalities with public clinics has been the same over the years; the municipalities make dental clinics available, staff the clinics and pay all the running costs. Ekstrand et al [2003b] confi rmed that three structural variables -cost per child per year, number of children per dentist and number of staff per dentist in the municipalities -did not play any role in explaining the observed intermunicipality variation in caries experience, which was 1.2-15.5 DMF-S among 18-year-olds in 1999.…”

“…All the involved municipalities used sealants, and no difference was seen with respect to indications for the use of fi llings. Ekstrand et al [2003b] showed that the intermunicipality variation in mean DMF-S among 18-year-olds in 1999 in Denmark was from 1.23 to 15.54 (mean 6.5), and in %DMF-S = 0, it was 3-55% (mean 18%). They also found that only two background variables, F water and the average personal income, played signifi cant roles, explaining 53 and 30% of the intermunicipality variation in mean DMF-S and %DMF-S = 0 among 18-year-olds in Denmark in 1999.…”

“…70% of the total number of municipalities with public clinics) which had forwarded caries data on 18-year-olds in 1999 to the Danish National Board of Health. The background variables (described in more detail by Ekstrand et al [2003b]) were: cost per child per year (mean for 1995-1999); child/dentist ratio (mean for 1987, 1990, 1993, 1996 and 1999); auxiliary personnel/dentist ratio (mean for 1987, 1990, 1993, 1996 and 1999); fl uoride concentration in the water supply (F water ) (mean for 1989-1998); personal income (mean for 1989-1998); mothers' education (percentage of mothers of 18-year-olds in 1999 with ^ 10 years of education); proportion of immigrants and their descendants (median for 1989-1999); size of municipality (mean total number of 0-to 18-year-olds in the municipality in 1989 and 1999).…”

Een omslag in cariësbehandeling bij kinderen: ‘Gewoon Gaaf’

“…Diverse onderzoeken hebben aangetoond dat de Gewoon Gaaf-aanpak tot goede resultaten leidt (Carvalho et al, 1992;Ekstrand et al, 2000;Ekstrand et al, 2003;Hausen et al, 2007;Curtis et al, 2008;Fejerskov 2013;Ng et al, 2014;Vermaire et al 2014).…”