Skip to main content

Advertisement

SpringerLink
Log in

Long-term effect of intensive prevention on dental health of primary school children by socioeconomic status

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

Children in a German region took part in regular toothbrushing with fluoride gel during their time in primary school after having received a preventive program in kindergarten. The study aimed at determining the dental health of the students as a function of prevention in kindergarten and at school while taking into account their socioeconomic status and other confounders.

Materials and methods

The subjects were in six groups: groups 1 and 2, intensive prevention in kindergarten with and without fluoride gel at school; groups 3 and 4, basic prevention in kindergarten with and without fluoride gel at school; groups 5 and 6, no organized prevention in kindergarten with and without fluoride gel at school. Two dental examinations were performed for assessing caries experience and calculating caries increment from second grade (7-year-olds) to fourth grade (9-year-olds). A standardized questionnaire was used to record independent variables. To compare caries scores and preventive measures of various subgroups, non-parametric tests and a binary logistic regression analysis were performed.

Results

A significant difference was found in the mean decayed, missing, and filled tooth/teeth (DMFT) depending on socioeconomic status (no prevention in kindergarten, fluoride gel at school in children with low SES: DMFT = 0.47 vs. DMFT = 0.18 in children with high SES; p = 0.023). Class-specific differences were no longer visible among children who had taken part in an intensive preventive program combining daily supervised toothbrushing in kindergarten and application of fluoride gel in school.

Conclusions

Early prevention, focusing on professionally supported training of toothbrushing in kindergarten and at school, has a positive effect on dental health and is able to reduce class-specific differences in caries distribution.

Clinical relevance

Early training of toothbrushing and fissure sealing of first permanent molars are the most important factors for the dental health of primary school children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gibson S, Williams S (1999) Dental caries in pre-school children: associations with social class, toothbrushing habit and consumption of sugars and sugar-containing foods. Further analysis of data from the National Diet and Nutrition Survey of children aged 1.5-4.5 years. Caries Res 33(2):101–113. https://doi.org/10.1159/000016503

    Article  PubMed  Google Scholar 

  2. Harris R, Nicoll AD, Adair PM, Pine CM (2004) Risk factors for dental caries in young children: a systematic review of the literature. Community Dent Health 21(1 Suppl):71–85

    PubMed  Google Scholar 

  3. Reisine ST, Psoter W (2001) Socioeconomic status and selected behavioral determinants as risk factors for dental caries. J Dent Educ 65(10):1009–1016

    PubMed  Google Scholar 

  4. Winter J, Glaser M, Heinzel-Gutenbrunner M, Pieper K (2015) Association of caries increment in preschool children with nutritional and preventive variables. Clin Oral Investig 19(8):1913–1919. https://doi.org/10.1007/s00784-015-1419-2

    Article  PubMed  Google Scholar 

  5. Curnow MM, Pine CM, Burnside G, Nicholson JA, Chesters RK, Huntington E (2002) A randomised controlled trial of the efficacy of supervised toothbrushing in high-caries-risk children. Caries Res 36(4):294–300. https://doi.org/10.1159/000063925

    Article  PubMed  Google Scholar 

  6. Jackson RJ, Newman HN, Smart GJ, Stokes E, Hogan JI, Brown C, Seres J (2005) The effects of a supervised toothbrushing programme on the caries increment of primary school children, initially aged 5-6 years. Caries Res 39(2):108–115. https://doi.org/10.1159/000083155

    Article  PubMed  Google Scholar 

  7. Marinho VCC, Worthington HV, Walsh T, Chong LY (2015) Fluoride gels for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 6:CD002280

    Google Scholar 

  8. Pieper K, Winter J, Krutisch M, Völkner-Stetefeld P, Jablonski-Momeni A (2016) Prevention in kindergartens with 500 ppm fluoride toothpaste—a randomized clinical trial. Clin Oral Investig 20(6):1159–1164. https://doi.org/10.1007/s00784-015-1604-3

    Article  PubMed  Google Scholar 

  9. WHO (1997) Oral health surveys, Basic Methods 4th Edition. Genf

  10. International Caries Detection and Assessment System (ICDAS) Coordinating Committee (2009) Criteria Manual. Bogota, Colombia and Budapest www.icdas.org

    Google Scholar 

  11. Neuhaus KW, Ellwood R, Lussi A, Pitts NB (2009) Traditional lesion detection aids. Monogr Oral Sci 21:42–51. https://doi.org/10.1159/000224211

    Article  PubMed  Google Scholar 

  12. Löe H, Silness J (1963) Periodontal disease in pregnancy. Acta Odont Scand 21(6):533–551. https://doi.org/10.3109/00016356309011240

    Article  PubMed  Google Scholar 

  13. Ramfjord SP (1959) Indices for prevalence and incidence of periodontal disease. J Periodontol 30(1):51–59. https://doi.org/10.1902/jop.1959.30.1.51

    Article  Google Scholar 

  14. Cohen J (1968) Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 70(4):213–220. https://doi.org/10.1037/h0026256

    Article  PubMed  Google Scholar 

  15. Fleiss JL (2003) The measurement of interrater agreement. In: Fleiss JL, Levin B, Paik MC (eds) Statistical methods for rates and proportions, 3rd edn. Wiley, New Jersey, pp 598–626. https://doi.org/10.1002/0471445428.ch18

    Chapter  Google Scholar 

  16. Pieper K, Dressler S, Heinzel-Gutenbrunner M, Neuhäuser A, Krecker M, Wunderlich K, Jablonski-Momeni A (2012) The influence of social status on pre-school children’s eating habits, caries experience and caries prevention behavior. Int J Public Health 57(1):207–215. https://doi.org/10.1007/s00038-011-0291-3

    Article  PubMed  Google Scholar 

  17. Winkler J, Stolzenberg H (1999) Social class index in the Federal Health Survey. Gesundheitswesen 61:178–183

    Google Scholar 

  18. Ahrens W, Bellach BM, Jöckel KH (1998) Messung soziodemographischer Merkmale in der Epidemiologie, editor: Robert Koch Institut RKI Schriften 1/98. MMV Medizin Verlag München

  19. Micheelis W, Schiffner U (2006) Ausschöpfungsquoten und Ausfallgründe. In: Institut der Deutschen Zahnärzte (ed) Vierte Deutsche Mundgesundheitsstudie (DMS IV). Deutscher Zahnärzte-Verlag, Köln, pp 49–54

    Google Scholar 

  20. Jordan AR, Micheelis W (2016) Ausschöpfungsquoten und Ausfallgründe. In: Institut der Deutschen Zahnärzte (ed) Fünfte Deutsche Mundgesundheitsstudie (DMS V). Deutscher Zahnärzte-Verlag, Köln, pp 62–67

    Google Scholar 

  21. Pierce KM, Rozier RG, Vann WF Jr (2002) Accuracy of pediatric primary care providers’ screening and referral for early childhood caries. Pediatrics 109(5):E82–E82. https://doi.org/10.1542/peds.109.5.e82

    Article  PubMed  Google Scholar 

  22. Verrips GH, Kalsbeek H, Eijkman MA (1993) Ethnicity and maternal education as risk indicators for dental caries, and the role of dental behavior. Community Dent Oral Epidemiol 21(4):209–214. https://doi.org/10.1111/j.1600-0528.1993.tb00758.x

    Article  PubMed  Google Scholar 

  23. Marshall TA, Eichenberger-Gilmore JM, Broffitt BA, Warren JJ, Levy SM (2007) Dental caries and childhood obesity: roles of diet and socioeconomic status. Community Dent Oral Epidemiol 35(6):449–458. https://doi.org/10.1111/j.1600-0528.2006.00353.x

    Article  PubMed  Google Scholar 

  24. Santamaria RM, Basner R, Schüler E, Splieth CH (2015) Inequalities in dental caries experience among 6-year-old German children after the caries decline. Acta Odontol Scand 73(4):285–291. https://doi.org/10.3109/00016357.2014.939711

    Article  PubMed  Google Scholar 

  25. Ferrazzano GF, Sangianantoni G, Cantile T, Ingenito A (2016) Relationship between social and behavioural factors and caries experience in schoolchildren in Italy. Oral Health Prev Dent 14(1):55–61. https://doi.org/10.3290/j.ohpd.a34996

    PubMed  Google Scholar 

  26. Vargas CM, Crall JJ, Schneider DA (1998) Sociodemographic distribution of pediatric dental caries: NHANES III, 1988–1994. J Am Dent Assoc 129(9):1229–1238. https://doi.org/10.14219/jada.archive.1998.0420

    Article  PubMed  Google Scholar 

  27. Mejàre I, Axelsson S, Dahlén G, Espelid I, Norlund A, Tranæus S, Twetman S (2014) Caries risk assessment. A systematic review. Acta Odontol Scand 72(2):81–91. https://doi.org/10.3109/00016357.2013.822548

    Article  PubMed  Google Scholar 

  28. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Mäkelä M, Worthington HV (2008) Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev 8:CD001830

    Google Scholar 

Download references

Funding

This study was funded by elmex research/Colgate-Palmolive Europe sàrl (GASAS-1005X). elmex research/Colgate-Palmolive Europe sàrl played no role in the design, execution, analysis, interpretation of data, or writing of the study.

Author information

Authors and Affiliations

  1. Department of Paediatric and Community Dentistry, Philipps-University Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany

    Julia Winter, Anahita Jablonski-Momeni & Klaus Pieper

  2. Willingen, Germany

    Annett Ladda

Authors
  1. Julia Winter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anahita Jablonski-Momeni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annett Ladda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Klaus Pieper
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julia Winter.

Ethics declarations

Conflict of interest

J. Winter reports a grant from GABA International AG/Colgate-Palmolive Europe sàrl, during data evaluation and writing of the report. A. Jablonski-Momeni reports grants from GABA International AG/Colgate-Palmolive Europe sàrl, during the conduct of the study. A. Ladda declares that she has no conflict of interest. K. Pieper reports grants from GABA International AG/Colgate-Palmolive Europe sàrl, during the conduct of the study. K. Pieper reports reimbursement of travel expenses for ACFF meetings from Colgate-Palmolive Europe sàrl.

Ethical approval

The study was approved by the Ethics Committee of the Faculty of Medicine, University of Marburg, Germany (file number: Study 146/10, chairman: Prof. G. Richter).

Informed consent

Informed consent was obtained from all parents whose children participated in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Winter, J., Jablonski-Momeni, A., Ladda, A. et al. Long-term effect of intensive prevention on dental health of primary school children by socioeconomic status. Clin Oral Invest 22, 2241–2249 (2018). https://doi.org/10.1007/s00784-017-2318-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-017-2318-5

Keywords

Search

Navigation