Comparison of Two Oral Health Indices in Nevada Youth

Objectives: MeanDMFT (decayed, missing, filled teeth) to establish the severity and prevalence of caries has been an accepted practice in the dental community since introduced by Klein and Palmer in 1938. MeanDMFT value does not accurately reflect the distribution of the population; thus potentially leading to incorrect conclusions that caries for the whole population is controlled. To help bring attention to those at greatest risk, experts at the 2000 World Health Assembly (WHA) introduced a new index: Significant Caries Index (SiC). The purpose of this study was to compare these two measures. Methods: An oral health initiative using trained licensed dental examiners has been conducted since 2001 in middle/high schools in Nevada. Data collected in 2007/2008 academic year (N=7418) was used to compute MeanDMFT and SiC Indices. SiC indices is computed using the top 1/3 subgroup (N=2232) presenting with the highest DMFT scores. Descriptive statistics/t-tests were used to compare the results between MeanDMFT and Mean SiC Index. T-tests were used to compare differences in demographic variables within each measure. Results: Significantly higher Mean SiC index (M=6.94;SE=0.062) vs. MeanDMFT (M=2.94;SE=0.039) (p<0.01) were observed. Significant differences between those with and without sealants in both the SiC Indices (sealants applied=6.40,SE=0.074;sealants not applied=7.25,SE=0.080) and the MeanDMFT (sealants applied=2.45,SE=0.046;sealants not applied=3.51,SE=0.064). Significant differences were found between those living where municipal water is fluoridated in both the SiC Indices (fluoridated=6.34,SE=0.083;non-fluoridated=7.19,SE=0.074) and the MeanDMFT (fluoridated=2.39,SE=0.051;non-fluoridated=3.39,SE=0.056). Finally, significant differences were found between gender in MeanDMFT (females=3.04,SE=0.055;males=2.83,SE=0.055); however no significant differences were found in SiC Indices (girls=6.90,SE=0.075;boys=6.85,SE=0.084). Conclusion: The results indicate a significantly skewed distribution regarding caries prevalence in Nevada youth. The SiC Index reveals a subgroup with a substantially higher caries prevalence and severity. Using both indices will help identify children with highest DMFT scores so more specific targeted preventive actions can be implemented.