FACTORS FOR CHANGES OF CARIES PREVALENCE AMONG ADOLESCENTS IN GERMANY

Data on caries prevalence among adolescents in East and West Germany b efore and after unification (1990) were compared with changes in etiol ogic and preventive parameters. The postwar increase of total sugar co nsumption resulted in an increase of caries prevalence among adolescen ts in both East and West Germany until 1970. Parallel to the introduct ion of preventive measures, especially systemic fluoridation, the nati onal caries level in East Germany stabilized at 4-5 DMFT (in 13-14-yea r-olds) with significant regional differences. The introduction of flu oridated toothpaste after 1973 in West Germany was followed by a carie s decline in children (1970s) and in adolescents (1980s) from very hig h caries levels (8.8 DMFT in 13-14-year-olds in 1983) to moderate leve ls (5.1 DMFT in 1989). The sudden increase from 10% to 90% fluoridated toothpaste in East Germany in 1990 was also accompanied by a caries d ecline in adolescents. Group prevention, which included fluoride varni sh programs and the introduction of free prevention (brushing instruct ions, fluoridations, sealants) at private dentists for 6-19-year-olds since 1983, seems to be responsible for the latest caries reductions a ll over Germany.