In Tanohata village in Iwate Prefecture, we carried out the “Health Pioneer Town Project”, a health project administered dy the National Health Insurance, for 5 years between 1993 and 1997.In this project, fluoride mouth rinsing and fissure sealing of the first molars were practiced in school children. To evaluate the effects of this project, the author compared the prevalence of caries both before and after the project, and also analyzed its health economic effects by cost-benefit analysis.Regarding the prevalence of dental caries, the caries prevalence rate in primary and junior high school children markedly decreased from 69.7% to 39.6%, and the DMFT index also decreased from 3.43 to 1.36 rernarkably. In the cost-benefit analysis, the direct cost of fluoride mouth rinsing and fissure sealing was regarded as the primary cost, and the indirect cost of the practice and continuation of the project was regarded as the secondary cost. The primary cost per child per year was 233.4 yen for fluoride mouth rinsing and 726.8 yen for fissure sealing, and the secondary cost was 2703 yen. The benefit element was the reduction in the caries treatment cost. Assuming all teeth with caries treated, the treatment cost per case was standardized based on dental.insurance points. The reduction in the caries treatment cost per child per year was 2,846.9 yen in all. the primary and junior high school children, When the primary cost alone was evaluated, the cost-benefit ratio was 3.0. When the secondary cost was included, the cost-benefit ratio was 2.3.To test this analysis, the actual total dental treatment cost between the 1993 fiscal year and the 1997 fiscal year in students insured with the National Health Insurance was compared with the total caries treatment cost obtained by standardization, When the secondary cost was included, the cost-benefit ratio based on the actual total dental treatment cost was 1.2, and that based on the standardized total caries treatment cost was 2.6.This improvement in the prevalence of dental caries and the results of the health economic analysis show adequate benefits of caries prevention by fluoride mouth rinsing and fissure sealing supported by a health project of the National Health Insurance.

A statistical survey was conducted to review 75 children (77 cases) who underwent dental treatment under general anesthesia in the Pediatric Department of the Iwate Medical University Hospital of Dentistry between 1986 and 1996. The results were as follows:The number of decayed teeth was highest in children with deciduous dentition, with a mean number of 12.4 per child.The number of teeth receiving restorations in a case was highest for resin filling with a number of 6.8 for deciduous teeth and 5.8 for permanent teeth. The mean number of teeth receiving pulp treatment during each case was 0.5.Posttreatment complications were noted in 99% of cases with the falling of filling materials being the most frequent problem.Developement of new caries was noted most frequently in the permanent teeth of children with permanent dentition who had deciduous dentition on initial examination with an incidence of 147%. Permanent first molars were the most frequently affected.As a result of active pulp treatment, optimal preservation of teeth was attained, resulting in restoration of not only occlusion but also esthetics. Therefore, it was concluded that because of the possibility of posttreatment troubles and the development of new caries, dental treatment under general anesthesia should be performed in conjunction with periodic examination, oral hygiene instruction and preventive treatment.

The number of adults undergoing treatment at the Department of Orthodontics, Iwate Medical University Hospital, has increased dramatically. It is important to take careful consideration of periodontal tissue in adults with orthodontia. We orthodontically treated an adult who had on anterior crossbite with gingival recession of the lower left central incisor associated with traumatic occlusion.

The 41-year-1-month-old woman initially was treated using an expansion plate in the maxilla to correct the anterior crossbite by flaring the maxilly incisors and reducing traumatic occlusion, A Hawley’s retainer was placed in the mandible to stabilize periodontal tissue at the lower incisor.The lamina dura at the lower left central incisor disappeared temporally with tooth alignrnent, but was observed clearly in retention in a dental rediograph.

This suggests that a careful preparation of periodontal tissue is required during the initial treatment. case report of anterior crossbite with traumatic occlusion

Increasing numbers of adults are undergoing orthodontic treatment. Such orthodontia is complicated, involving biological, periodontic, economic, emotional,and other problems involved in daily life。 We present a case of a 25-year-old female with open・bite and a periodontic problem who had been treated elsewhere. The patient requested orthodontia, and orthodontic teeth movement was performed to eliminate the esthetic problem which was the patient’s rnain complaint. Treatment was successful and resulted in good occlusion and healthy periodontal tissue. The successful treatment of patients with multiple problems can be achieved with a multiple-view approach. Orthodontia as part of integrated treatment can significantly enhance favorable results. The intent of this report is to provide insight into the use of adult orthodontia in managing complicated problems.