Abstract
In this prospective study, the effectiveness of an oral health promotion program at a dental clinic was evaluated. Fifty-three patients in their thirties who complied with the recommended maintenance schedule of every 3 months were observed for 8 years. They received oral health instruction consisting of instruction in plaque control, scaling, PMTC and professional fluoride application after the examination, which included assessment of dental caries and periodontal disease using CPI and bleeding on probing, every 3 months. At the first visit, subjects were divided into 3 groups according to their periodontal condition ; group A : healthy periodontal tissue or slight periodontal disease (CPI=0, 1), B : some calculus with no periodontal pockets (CPI=2), C : some periodontal pockets (CPI=3, 4). Of a total of 53 patients, 6 were classified into group A, 46 were classified into group B and only one was classified into group C. The patient in group C underwent complex periodontal treatments, then came back to this program. The other patients participated in this program after the examination. During the 8 year maintenance period, 80 new dental caries were found, and 4 teeth were lost due to reasons other than caries or periodontal diseases, such as occlusal trauma and root fracture. The mean DMFT increased from 13.0 to 14.5 for 8 years. The bleeding on probing was 48.5% at the initial examination, however, it decreased 3 years later and was stable at 20 to 25% after that. The CPI code of the patients aged 35 to 39 of 5 years later was compared with that of the patients aged 35 to 39 at the initial examination. The patients with CPI code 3 or 4 decreased from 61.5% to 19.2%. In contrast, the patients with CPI code 0 to 2 increased 38.5% to 80.7% (p<0.01). Eight years later, most periodontal tissues had been kept good condition. The drop-out rate in the maintenance program was less than 10%. The results demonstrated that the oral health promotion program of treatment every 3 months was effective in improving periodontal condition and preventing tooth loss, and this system was well accepted by patients. The findings in this study will provide useful information for the new family dentist system introduced in the Japanese health insurance system and will contribute to achieve 8020 (keeping 20 teeth until age 80).
