Effect of a school-based preventive program with salivary lactobacillus counts as sugar-motivating tool on caries increment in adolescents

The caries preventive outcome of a school-based program with salivary lacto bacillus counts as sugar motivating tool was evaluated in six cohorts of to tally 936 adolescents in a comprehensive school in Sweden. Students from a neighboring district with similar socioeconomic structure but with no corre sponding dental health-promoting activities were selected as reference. The program started in the beginning of the 7th grade (13 years) and was termi nated at the end of the 9th grade (16 years). Salivary lactobacilli were ev aluated semi-annually with a dip-slide method and used for individual couns eling. Dental caries was scored from the dental records and bitewing radiog raphs of each 4th participant at baseline and at 16 and 19 years or age. Th e number of salivary lactobacilli decreased significantly (P< 0.05) in all cohorts but one during the program. There was no significant difference in the increment of caries (DFS) between the participants from the study and r eference schools. either at che end of die program or at 19 years of age. T he increment of proximal enamel caries was slightly lower in the study grou p compared with the reference group (P< 0.05) at the final registration. Co nsidering the time and efforts spent, the results did not seem to justify a school-based intervention with lactobacillus counts as a sugar-motivating tool in an adolescent low-caries population.