Abstract
The prevalence of dental caries in 3-year-old infants in Okayama prefecture was 32.3% in 2002. This prevalence was about 10 fold higher than that of 1.5-year-olds in 2001. Effective intervention is required to control the incidence of caries. In Japan, municipalities (cities, towns and villages) have conducted many oral health care programs. However, there are few reports evaluating these programs. Ensuring the effectiveness of these programs is an integral part of the planning and executing community-based interventions. The purpose of this study was to evaluate the effectiveness of community-based oral health programs on reducing the incidence of dental caries in 3-year-old infants. A total of 78 municipalities in Okayama prefecture were included in this study. The municipalities were categorized into two groups according to the execution or absence of each intervention, and the dental caries incidences were compared between these groups. Odds ratios of dental caries prevalence were estimated for each intervention. All data were obtained from the year reports of nursing mothers and infants of Okayama prefecture. Caries prevalence was calculated from 30,514 infants who had had a periodical health check at age 3 (15,379 infants in the fiscal year of 2001 and 15,135 in 2002). In regions with the topical fluoride application program conducted by municipalities, the prevalence of dental caries was statistically lower than those without the program (odds ratio; 0.75-0.84). The regions with a dental caries risk assessing program showed a statistically higher prevalence than those without the program (odds ratio; 1.07-1.14). The execution of oral health education or a commendation for no decay infants at 3 years old had no clear effect on controlling a high caries prevalence. In the regions with an action policy on oral health (inquired in 1999), the incidences of dental caries in 2002 and 2003 were higher than in regions without an action policy. The results showed that the topical fluoride application program could be the best measure for reducing the incidence of dental caries among 3-year-old infants. But the caries risk assessing programs had no effect on caries prevalence. Topical fluoride application programs should have priority over other community-based intervention programs for infants' dental caries.
