Abstract
In order to prevent dental caries of the primary teeth, an administrative service combined with professionally applied topical fluoride gels (PATFG) and fluoride toothpaste for home use (FTP) was implemented in Mishima Town of Niigata Prefecture in the fall of 1994. The service targeted children aged 1 to 3 years. The PATFG was practiced every 6 months periodically. Fluoride tooth paste was given to every child at the one-year-old examination and his/her mother was instructed to use it once a day. A trained dentist practicing his clinic in this town examined the dental caries status of subjects at the 3-year-old examination in 1990-1998 and preschool examination in 1997-2001. The purposes of this study were to determine the effectiveness of the service, compare the acceptability between PATFG and FTP, and also to estimate the additive effect of FTP to PATFG. The caries prevalence surveyed in 1990-95 was 42-47% in 3-year-old children who did not receive the PATFG and FTP service. In 1997-98, however, the prevalence rate decreased and showed 17% in 3-year-old children who received this service. The prevalence in preschool children also decreased from 73% in 1997-98 to 51% in 2000-01. The mean dft of preschool children who participated in the service was 1.54. On the other hand, a mean dft of more than 3 was found in other groups who could not participate in the service or participated partially. The acceptability in PATFG was superior to that in FTP, because the rate of children who received PATFG twice a year periodically was 83.6% against 55.2%, which was the rate of children using FTP every day. Out of 97 children receiving PATFG regularly, 61 using FTP every day showed a lower caries prevalence, both at the 3-year-old examination and preschool examination, when compared to the children (n=29) without FTP. However, significance was only found in the results at the preschool examination. It might be considered that the difference in caries status expanded from the age of 3 and reached a level of significance at the preschool age. In the stepwise multiple regression analysis, the dft at the preschool examination was adopted as the dependent variable and 8 independent variables were included. The result showed that only the independent variable of 'no use of FTP during 1-3 years old' was significant. The independent variable of 'the experience of PATFG' was not selected. We considered that this variable could not contribute to the analysis because a high rate of children received PATFG. In conclusion, these results suggested that the PATFG plays an important role and the FTP plays an additional role in administrative service for dental caries prevention in primary teeth.