Changes in dental fluorosis and dental caries in Newburgh and Kingston, New York.

OBJECTIVES: This study sought to determine whether the prevalence of dental fluorosis and dental caries had changed in a fluoridated community and a nonfluoridated community since an earlier study conducted in 1986. METHODS: Dental fluorosis and dental caries data were collected on 7- to 14-year-old lifelong residents (n = 1493) of Newburgh and Kingston, NY. RESULTS: Estimated dental fluorosis prevalence rates were 19.6% in Newburgh and 11.7% in Kingston. The greatest disparity in caries scores was observed between poor and nonpoor children in nonfluoridated Kingston. CONCLUSIONS: The prevalence of dental fluorosis has not declined in Newburgh and Kingston, whereas the prevalence of dental caries has continued to decline.

Caries prevalence, treatment level, and sealant use related to school lunch program participation.

A total of 2,753 schoolchildren (8-11 years old) from two school districts received visual-tactile examinations for caries. The school districts were approximately 15 miles apart and located in fluoride-deficient (F less than 0.3 ppm) Long Island, New York. The higher socioeconomic community (HSES) had 9.2 percent of its students enrolled in the free or reduced-payment school lunch program; the lower socioeconomic community (LSES) had 50.3 percent enrolled. The LSES community had a higher caries prevalence, more untreated lesions, fewer caries-free children, and fewer children treated with sealants. School lunch programs provide an index to identify communities for dental programs.

Clinical study of the anticaries efficacy of three fluoride dentifrices containing anticalculus ingredients: three-year (final) results.

A 3-year double blind clinical trial was conducted to compare the caries inhibition of an A.D.A.-accepted fluoride dentifrice to the caries inhibitions provided by three fluoride dentifrices containing anticalculus agents. All dentifrices used a compatible silicon dioxide abrasive system. The initial mean age of the subjects was 9.9 yrs and they resided in F-deficient (F less than 0.3 ppm) communities on Long Island, NY. Caries activity in all groups was low with the average annual increment being less than one surface. There were no statistically significant differences in any of the dental parameters tested, DMFS, DMFT, and buccolingual, mesiodistal and occlusal surface increments. It was concluded that the presence of anticalculus agents, specifically soluble pyrophosphates, zinc chloride and zinc oxide, do not interfere with the caries inhibition benefits of fluoride in a compatible dentifrice formulation.

Three-year root caries increments: implications for clinical trials.

Seven hundred and ninety-six adult subjects (mean age, 39.9 years) received visual-tactile examinations for root caries over a three-year period. All subjects were employed or were the spouses of employees and resided in fluoride-deficient communities on Long Island, New York. During the three-year observation period, 81.4 percent of the subjects did not develop root caries. The 18.6 percent who developed root caries averaged 0.8 DFS/year. The subjects' ages and baseline root DFS status were associated with the development of a root DFS increment. The older the patient, especially aged 45 and older, the greater was the risk of developing root lesions or having root fillings placed. Subjects who had a root DFS score at baseline also were more likely to experience a root DFS increment. It is recommended that when designing clinical trials of agents purported to inhibit root caries, preselection criteria for the study population should consider the subjects' ages and past history of root lesions.

Three-year root caries increments: an analysis of teeth and surfaces at risk.

Seven hundred and ninety-six adult subjects (mean age 39.9 years) received visual-tactile examinations for root caries over a three-year period. All subjects were employed or the spouses of employees and resided in fluoride-deficient communities on Long Island, New York. Incremental caries data were analyzed to provide descriptive information about the susceptibility of individual teeth and surfaces to root caries. Molars were most prone to root caries/fillings, followed in decreasing order by premolars, canines and incisors. While canines and incisors had a nearly identical increment, since there are half as many canines as incisors in a mouth, canines are actually twice as susceptible to root caries/fillings. Facial surfaces comprised 53 percent of the increment followed by distal, lingual and mesial surfaces. Approximately 70 percent of the DFS for facial and lingual surfaces were fillings, compared to approximately 50 percent for mesial and distal surfaces, suggesting that part of the increment for facial-lingual surfaces may be treated abrasion areas rather than caries.

Caries inhibition of mixed NaF-Na2PO3F dentifrices containing 1,000 and 2,500 ppm F: 3-year results.

The 3-year DMFS increments of 2,509 children were compared. Group 1 used a conventional Na2PO3F dentifrice (1,000 ppm F) and served as the active control. Groups 2 and 3 used mixed-fluoride dentifrices containing equimolar amounts of NaF and Na2PO3F, providing total fluoride concentrations of 1,000 and 2,500 ppm F, respectively. Dentifrice use was unsupervised in the subjects' homes. There were no statistically significant differences (F-test) between the 3-year DMFS increments of the dentifrice groups, nor were there any significant differences between the dentifrice groups when the analysis included subject compliance and caries risk.

Longitudinal study of the caries susceptibility of occlusal and proximal surfaces of first permanent molars.

Ten- to 13-year-old children were examined annually for three years to determine the caries activity in the proximal and occlusal surfaces of first permanent molars. Almost every tooth with an unsound (carious or filled) proximal surface also had an unsound occlusal surface. Caries scores in proximal surfaces remained relatively constant and low. The percentage of teeth with occlusal caries or fillings increased throughout the study, even though the teeth had been erupted for seven to ten years by the end of the study. Within the age range studied, the time that teeth were in the mouth had little effect on the vulnerability of occlusal surfaces to caries attack.

Examiner consistency and group balance at baseline of a caries clinical trial.

Two experienced investigators (G.L. & H.H.) independently examined 629 children in grades 6-9 (ages 10-17 yr) for baseline DMFS data in a clinical trial of a caries preventive. The examiners used the same written and visual (slides) criteria for dental caries diagnosis, but did not standardize or calibrate their methods before or during the survey. Results showed overall mean DMFS scores for Examiners 1 and 2 that were remarkably similar, 8.35 and 8.16, respectively; coefficients of variation were identical, C.V. = 87%. The reliability coefficient for the two sets of data showed that only 4% of the variability in DMFS scores was due to examiner inconsistency and other measurement errors. The findings indicate that, without undergoing clinical calibration, the two experienced examiners attained a high level of agreement in scoring dental caries merely by adhering to clearly defined written and visual criteria. Only the 308 children in the 6th grade (ages 10-14 yr) participated in the study (children in grades 7-9 were a reference population). Participants were randomly assigned to one of two treatment groups. The allocation procedure produced mean DMFS scores for Groups I and II of 7.87 and 6.17 (Examiner 1) and 8.07 and 6.41 (Examiner 2), respectively. The mean scores differed by about 21% (II compared with I) for each examiner. Both differences were clinically and statistically significant (P less than 0.05). Randomized assignment had generated an imbalance of baseline DMF scores by group.

Comparison of dental students' academic performance using honors/pass/fail and letter grades.

Performance in a second-year course in pedodontics/orthodontics for three classes of students at the State University of New York at Stony Brook School of Dental Medicine who received grades under an honors/pass/fail system was compared to that of three academically comparable classes that received letter grades. The average scores from the pedodontic/orthodontic section of the Part II National Board examination also were compared. The dental students taught under the letter grade system achieved a small but statistically significant higher grade point average in the dental course than the students taught under the honors/pass/fail system. The difference between the National Board scores was not statistically significant. It was concluded that while the letter grade system provided incentive for the students to perform at a higher level than those under the honors/pass/fail system, it did not influence their performance on the National Board examination.

The surface-specific caries pattern of participants in a school-based fluoride mouthrinsing program with implications for the use of sealants.

This paper describes the surface-specific changes in the DMFS after seven years of a school-based mouthrinsing program occurring in the elementary schools of the fluoride-deficient Three Village Central School District, Long Island, New York. The effectiveness of mouthrinsing was evaluated annually by comparing the caries prevalence of a random sample of participants to that of Three Village elementary schoolchildren examined in 1975, prior to the beginning of the program. Because sixth-grade children rinsed the longest and had the longest exposure to the caries challenge, only sixth-grade children who participated in the program are included in the analysis. Overall, they experienced a 50 percent reduction in dental caries; the reduction was not uniformly experienced by all surfaces. Proximal surface caries showed the greatest rate of change but the least absolute change, because the amount of proximal carious lesions was low initially. Occlusal surfaces showed the greatest absolute reduction in dental caries, whereas buccolingual surfaces had the lowest percentage reduction. The majority of the decayed or filled surfaces, 94 percent, involved pits or fissures. Therefore, it was concluded that the combined use of sealants and weekly fluoride rinsing could produce a virtual elimination of dental decay in elementary schoolchildren.