PREVENTION OF EARLY-CHILDHOOD CARIES - RESULTS OF A FLUORIDE TOOTHPASTE DEMONSTRATION TRIAL ON CHINESE PRESCHOOL-CHILDREN AFTER 3 YEARS

Objectives: This field demonstration trial evaluates the long-term eff ects of introducing daily toothbrushing with fluoride toothpaste in a Chinese kindergarten (test group) compared to caries development in ch ildren who had no organized preventive program (control group). Method s: In the test group teacher-supervised toothbrushing was initiated wi th 1,000 ppm MFP toothpaste in addition to oral health education activ ities. Test and control children were examined at baseline (n=289, age d 3 years) and annually thereafter. Results: After three years, 251 ch ildren (87%) were still in the trial. Caries development (dmfs) calcul ation included only those children who were present at both baseline a nd subsequent annual examinations. At baseline the mean dmfs was 4.8 i n the test group and 6.5 in the control group (NS). After three years the caries increment was 6.2 and 8.4 in the test group and the control group, respectively (P<.05). Adjusting for reversals, the net caries increment was 3.6 and 6.3, respectively (P<.01). Additionally, multipl e linear regression analysis indicated that both baseline dmfs, the pr ogram and plaque level had a significant effect on the net caries incr ement The use of hierarchical caries severity zones was useful for the identification of those children most at risk for further caries deve lopment Conclusions: We conclude that a daily toothbrushing with limit ed involvement of professional staff was feasible in a Chinese kinderg arten and that caries development was significantly slowed in the test children. Caries severity zones may possibly assist in determining le vels of intervention.