CARIES TREATMENT THROUGH 30 YEARS IN CHILDREN AND ADOLESCENTS IN ASKER, NORWAY

Asker is a capital suburb where a preventive philosophy has guided the public dental health services for decades. In the period studied the child population aged 3-13 yr increased from 3208 to 6008. In the scho ol age groups 7-15 yr practically all children in the community have p articipated in the dental service programs. The objective of the paper is to present retrospectively the changes in caries status of childre n under near optimal dental health care conditions and to expose repor ted preventive activities. A considerable increase in the proportion o f ''caries free'' pre-school children occurred in the period 1976-88. A maximum was reached in the latter part of the eighties, whereafter a leveling off is suggested. For school children a rapid increase in '' caries free'' children took place for the lowest grades, starting befo re 1976. The higher grades came later and at a slower pace. The great number of fillings inserted in 1966-72, oscillating around 60 surfaces for the nine school years, decreased rapidly during the following dec ade and seems now to have settled around a total average of five to si x surfaces. This implies a reduction of 90% in 20 yr. In most age grou ps these changes started before 1970, The major part of the caries dec line occurred in the seventies and a leveling off is apparent during t he eighties. The average number of filled surfaces per year has fallen from 6.6 in the 1955 birth cohort to 0.7 in the 1977 cohort, a reduct ion of 89% in 22 yr. The average number of filled surfaces (FS) in 15- yr-olds leaving compulsory school decreased during the period 1980-92 from 16.5 to 4.8, In 1980 20% of the children left school with more th an 20 filled surfaces, as compared to only 3% in 1992. Operative treat ment need has been reduced to a fairly low level among school children and adolescents, but caries is definitely not eradicated. The ''carie s free'' situation is not permanent, but treatment need becomes eviden t at a later age and is more modest than before. The remarkable reduct ion and delay of the caries problem is most likely the result of sever al factors, fluorides seemingly playing the major role.