OCCLUSAL DENTAL-CARIES INCIDENCE AND IMPLICATIONS FOR SEALANT PROGRAMS IN A US COLLEGE-STUDENT POPULATION

Given the decline in dental caries incidence in preteens and young tee nagers in the United States, a study of the incidence of dental caries in young adults (17-23 years) was conducted fo provide a descriptive epidemiologic picture of this ''new'' natural history of dental caries in the late and post-teenage years. A retrospective study was perform ed analyzing the detailed dental records of the four-year college expe rience in the class of 1989, US Coast Guard Academy. Occlusal caries i ncidence, in the absence of associated proximal caries, was shown fo b e moderately common in molars (11.9%) and rare in premolars (0.8%). In contrast to previous studies' findings, demographic indicators, socio economic status indicators, and prior caries experience were poor pred ictors of occlusal caries incidence; targeting a universal sealant pol icy in this population therefore would be done best by tooth type rath er than patient type. A preliminary cost-comparison model projected ov er a 40-month period, suggests that the cost of initiating a universal molar sealant policy in this population would be 92 cents per year pe r student greater than the cost of restoring occlusal caries in the pr esence of sound proximal surfaces. This cost comparison suggests that it would be advantageous to initiate such a policy.