**9. Conclusion**

374 Contemporary Approach to Dental Caries

(p ≤ 0.05) level of significance to assess distribution of data. The measurements were

The mean age of the 145 children at the baseline was 6.5 years old, while during final examination was 9.5 years old. After 3 years follow up mean dmf/s and DMFT/S (Table I). DMFT scores showed increased 0.1 a 0.9 with differences statistically significantly. The percentage of caries-free children is showed in Table 2. At the be beginning of the study 93% of the children was caries-free for permanent teeth, decreasing to 57% while only 17% was

Mean (SD) Mean (SD) Mean (SD) Mean (SD)

dmft=0

Year no. % no. % no. % no. % no. % 2007 111 77 34 23 10 7 135 93 34 23 2008 116 80 29 20 36 25 109 75 27 19 2009 118 81 27 19 51 35 94 65 24 17 2010 110 76 35 24 63 63 82 57 25 17

2007-2008 765 51 0.07 2008-2009 1403 37 0.03 2009-2010 1698 31 0.02

dmft≠0 dmft=0 DMFT≠0 DMFT=0 DMFT=0

New decay permanent teeth

Cumulative Incidence

analyzed using Wilcoxon test was used with a level of significance of p ≤ 0.05.

healthy in both dentitions at the end of the study. Cumulative incidence was 0.39.

Year dmft dmfs DMFT DMFS

2007 4.2 (3.8)A 10.2 (12.1)AB 0.1 (0.4)A 0.1 (0.5)A 2008 4.2 (3.2)A 10.3 (10.4)A 0.5 (1.0)B 0.6 (1.5)B 2009 3.8 (2.9)B 9.3 (9.20)B 0.7 (1.2)C 0.9 (1.7)C 2010 2.8 (2.4)C 6.3 (6.60)C 0.9 (1.3)D 1.4 (2.2)D

Table 1. Caries experience of the study population in a three-year long follow up

Table 2. Percentage of children with caries and caries-free for dentition

Table 3. Caries incidence changes from first to third year for study group

teeth

Period Caries-free permanent

\* Groups with different letters are significantly different ( p ≤ 0.05).

**8. Results**

According to 1999-2004 survey in the United States, the mean dfs for children 2-8 years was 3.7, although for 6-11 years of age was 4.30 and 1.84 for dft. The same study reported 51.17% caries prevalence in primary dentition for 6-11 years old children. However, caries experience for permanent teeth was 21% while DFS index was 0.65. Additionally, a prevalence of 10.16%, 0.19 DFT and 0.29 DFS were reported in children from 6 to 8 years old (Dye, et al., 2010; National Institute of Dental and Craniofacial Research, 2011).

In 2004, 5 years-old children in the United Kingdom showed a 1.55 dmft, later in 2009, 33% from 12-years-old children had a mean DMFT>0 and the decay experience average was 0.74, showing that the proportion of children without decay has risen to 61% (Drugan & Downer, 2011).

Reports from Värmland, Sweden indicate that 76% of 6 years-old children are caries free in primary dentition, while 7,8,9 and 10 years old children were 98%, 96%, 94% and 92% caries free for permanent dentition, respectively. (Axelson, 2004). In Europe, some reports have indicated a 79-93% dmfs or DMFS, or equal to zero (Marthaler, et al., 2004)

In 2001, caries prevalence in Chinese children aged 5-6 years was 78 -86%, and dmft was 4.8 - 7.0. A lower prevalence of caries was reported (41-42%) in 12 years old children, and a 0.9% DMFT, according to WHO criteria (Wong, et al., 2001).

The results of this study, showed a high caries prevalence and also higher dmft, dmfs, DMFT and DMFS index compared with well developed countries such as United States, United Kingdom, Sweden and other countries in Europe, but similar to those in China.

It seems that the efforts to diminish dental caries through the evaluated preventive and educational program have do not had the expected impact though these children are under salt fluoridation program. It is necessary to reconsider the implementation of additional measures according to caries risk group as has been reported previously, as well as to evaluate the cost and the effectiveness of mouthwashes.
