Baseline Caries Experience and Preventive Outcome on First Molars

Objectives: The purpose of the study was to compare the effectiveness of clinical preventive interventions on the prevention of occlusal caries in permanent first molars and as part thereof to also investigate the caries experience at baseline. Methods: A selected group of 85 grade 1 and 2 school children between 6-8 years of age, with 4 clinically healthy first permanent molars and with a perceived high caries risk, were exposed to: (1) conventional light cured resin fissure sealant (n=30); (2) no intervention / control group (n=30); (3) daily school-based toothbrushing with a fluoridated dentifrice (n=25). The dmft/DMFT at baseline was recorded and the groups followed up for caries development on the occlusal surfaces of the first molars after 6-, 12-, 18-, and 24 months using the WHO (1997) criteria. Results: The mean dmft/DMFT for all individuals was 5,87 ± 4,75 (median: 5) and the mean dmft/DMFT for only those with caries was 7,07 ± 4,32 (median: 7). Eighty two percent of the children had experienced caries, with 93% of the caries with a severity of >3 lesions per individual found in 60% of the sample. The occlusal caries protection rate after 2 years was 88% for the fissure sealant group, 78% for the toohbrushing group while 56% of the control group did not develop occlusal caries on the first permanent molars. The difference between the fissure sealant and control group was statistically significant (chi square: p = 0,012). Conclusions: The caries experience data indicated the presence of a definite high caries risk. A clear preventive benefit for both fissure sealant and toothbrushing groups compared to the control group was illustrated. The findings further underlined the merit of such preventive programmes especially in communities with high caries risk.