RELATIVE CONTRIBUTION OF DENTAL SERVICES TO THE CHANGES IN CARIES LEVELS OF 12-YEAR-OLD CHILDREN IN 18 INDUSTRIALIZED COUNTRIES IN THE 1970S AND EARLY 1980S

The contribution of health services to improvements in health is conte ntious. The main aim of the present study was to assess the relative c ontribution that dental services may have made to the changes in denta l caires (decayed, missing or filled permanent teeth) level of 12-year -old children in some industrialized countries in the 1970s and early 1980s. A secondary aim was an analysis of the association of the chang es in caries levels with broad socioeconomic factors. In this study ag gregate (ecological) data from 18 industrialized countries were analyz ed at a national level. Data were obtained from published papers and o fficial publications and included 3 kinds of variables: caries, presen ce of dental service and broad socioeconomic factors (including fluori dated toothpastes). Dental services explained 3% of the variation in c hanges in 12-year-old caries levels in the 1970s and early 1980s perio d whereas broad socioeconomic factors (including or excluding fluorida ted toothpastes) explained 65%. The findings suggest that dental servi ces were relatively unimportant in explaining the differences in chang es in 12 year-old caries levels in the 1970s and early 1980s in the 18 countries. The view that fluoride in toothpaste was the only importan t cause of the declines in decayed, missing or filled permanent teeth in industrialized countries was questioned. A possible important contr ibution of the dental services to the declines was a change in the dia gnostic and treatment criteria of caries.