Sibilla Bjarnason

High caries levels: problems still to be tackled

According to the World Health Organization more than 60% of European countries have achieved the goal of no more than 3 DMFT at the age of 12 years. The others, including the newly independent Baltic states, still have high caries levels. Data from recent studies show that mean caries prevalence among 12-year-olds in Latvia, Lithuania, and Estonia was 5.8, 4.9, and 4.6, respectively. Absence of caries was recorded in 5% of Latvian and Estonian and 12% of Lithuanian 12-year-olds. Fifteen-year-old Latvians and Lithuanians averaged 8.1 and 7.0 DMFT, which, owing to the absence of radiographic examination, may be a substantial underestimation of real caries levels. The possible adverse effects of the privatization of dental care and the benefits of increased access to fluoride dentifrice in these countries have not yet been evaluated. The extremely poor oral hygiene seen in epidemiologic surveys indicates that fluoride dentifrices may not be widely used. The caries levels in the Baltic states resemble those commonly encountered a couple of decades ago in the Nordic countries. Data from two follow-up studies in Iceland show 66% and 52% decline in caries prevalence for 12- and 15-year-old children, respectively, over a period of 7 years. However, the caries experience of the 15-year-olds in the latter study was similar to that of 12-year-olds 10 years earlier, both in mean caries score (DMFS 11.3 and 12.1) and frequency distribution. Nor has the proportion of occlusal and approximal DF values changed in spite of frequent use of fissure sealants. While caries has become mainly a pit and fissure phenomenon in 12-year-olds, 44.3% of Swedish 19-year-olds reportedly have approximal lesions, and, when enamel lesions are recorded, approximal caries dominates the DFS scores. Analyses of trends in Nordic countries show that, despite a substantial decline in caries prevalence, vigilance is required to prevent a delayed caries development in the future adult population.

Sugar consumption and caries experience in 12- and 13-year-old Icelandic children

Dietary habits with regard to sugar consumption and caries experience were studied in a group of 275 Icelandic children aged 12 and 13 years. The pattern of meals and sugar-containing food intake frequency were assessed by means of a dietary questionnaire. All dental examinations were performed by one examiner, using standardized methods and diagnostic criteria. Only 75% of the children had three regular meals daily. Breakfast and lunch were the most frequently omitted meals. Sweet buns were consumed by 32% of the children with meals and by 58% between meals, whereas soft drinks were consumed by 42% and 46%, respectively. Eighty-three per cent of the children reported eating sweets daily. The most popular products included confectionery, buns, cakes, and soft drinks, which constituted 53% of the intake with meals and 68% of that between meals. A higher caries incidence was associated with frequent intake of buns and cakes with meals and confectionery.