Clinical Oral Investigations

, Volume 22, Issue 6, pp 2241–2249 | Cite as

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

  • Julia Winter
  • Anahita Jablonski-Momeni
  • Annett Ladda
  • Klaus Pieper
Original Article



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.


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.


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.


Caries increment ICDAS Primary school children Preventive program Fluoride Fissure sealants 



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.

Compliance with ethical standards

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.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Paediatric and Community DentistryPhilipps-University MarburgMarburgGermany
  2. 2.WillingenGermany

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