ABSTRACT
BACKGROUND: The Seine-Saint-Denis Council planned in 1984 a prevention strategy program among schoolchildren which consisted in a health educational campaign and fluoridation therapy. The purpose of this paper was to present the evolution of dental caries among 11-year-old children from a low-income country after 8 years of prevention and to discuss further orientations in prevention. METHODS: Two cross-sectional surveys were conducted in 1984 and 1992 on, respectively, 1,907 and 2,771 schoolchildren attending primary schools of the department. The DMF index, summing up the total number of decayed, missing or filled permanent teeth was used to assess dentition status. RESULTS: The DMF index ranged from 3.38 in 1984 to 1.99 in 1992, a 41% decrease. This decrease was associated with a change of the distribution in DMF, the percentage of caries-free children increasing from 19% to 42% after 8 years. 83% of the decayed teeth were first molars. In 1992, only 24% of children received comprehensive care. In both surveys, the prevalence of dental caries was related to socio-economic status. CONCLUSIONS: Prevention strategy in this low-income county, led to improved dental health among children. However, the study design did not allow for evaluation of the impact of preventive measures on the evolution of dental caries prevalence. The community program contributed to improved dental health in most children even if it could not prevent the development of dental caries in very low-income children with severely decayed teeth and no access to dental care. Further steps in order to improve prevention, including use of sealants among these children, are under evaluation.
