Filling Therapy vs. Caries Findings in PDS for Young Adults

Objective: To compare the number of fillings made with the actual caries findings for young adults attending the public dental service in Helsinki, Finland. Methods: Cross-sectional data covered all 19- to 36-year-olds (n=25,656) receiving comprehensive dental care in the Public Dental Service (PDS) in Helsinki, Finland, in 1999. That age group was entitled to receive dental care at highly subsided fees regardless of the provider. In 1999, 44% of all 19- to 36-year-old Helsinki residents visited a dentist, 25% in the PDS, 12% in private clinics and 7% in the Students' Health Service. Data on diagnoses and treatments in the PDS came from computerized patient files, recorded by visit. Data covered caries diagnoses recorded as DMFT and DT indices, number of visits (NoV), and filling therapy as number of fillings made (NoF). Age was determined to the nearest year and categorized into 19 to 25 (n=7,170), 26 to 30 (n=7,732) and 31 to 36 (n=10,761). Statistical evaluation was by chi-square test and ANOVA. Results: Mean DMFT was 11.8 (SD=6.7); 7.6 for 19- to 25-year-olds, 11.1 for 26- to 30-year-olds, and 15.2 for 31- to 36-year-olds; mean DT was 1.6 (SD=2.4), for the three age groups: 2.0, 1.7, and 1.3, all age differences p<0.001. Mean NoV was 3.4 (SD=2.7) and of NoF 1.6 (SD=2.1) with no age differences. Of the DT=0 cases, 18% had received fillings; by age group: 19%, 25%, and 34%. Among those with their DT=3+, mean NoF was 3.7 (SD=2.8); 12% had received no filling therapy, and 24% had 1 to 2 fillings. For all DT=3+ cases, the mean difference DT-NoF was 1.5 (SD=3.5), for the three age groups 2.0, 1.5, and 1.0. Conclusions: The present findings indicate serious under-treatment among caries-cases and over-treatment among non-caries-cases, probably due to replacement of fillings.