Effectiveness of Preventive Methods in High/Low Caries Risk Children

Objectives: This controlled clinical trial assessed the effectiveness of preventive methods for sound occlusal surface of permanent first molars in 6-8-year old schoolchildren at high (HR) and low (LR) caries risk, living in a low caries prevalence area (Piracicaba, Brazil). Methods: A total of 268 children were followed-up for eighteen months after being allocated in six groups according to caries risk and treatment as follows: Groups HRC and LRC (children at HR and LR receiving oral health education each three months - control group); Groups HRV and LRV (HR and LR receiving oral health education plus varnish application biannually) and Groups HRS and LRS (HR and LR receiving oral health education plus a single resin modified glass ionomer sealant application in the beginning of the study). The baseline and follow-up examinations were performed by the same calibrated dentist in outdoor setting, under natural light, using CPI probes and mirrors, after toothbrushing and air-drying. The DMFS and dmfs were used to record dental caries. The data were analyzed using the Kruskal-Wallis followed by Dunn and Friedman tests at 5% significance level. Results: After eighteen months, the means DMFS increments (standard deviation) were 0.61 (1.20), 0.26 (0.63), 0.16 (0.52), 0.13 (0.41), 0.04 (0.21), 0.04 (0.29) for the HRC, HRV, HRS, LRC, LRV, LRS groups, respectively. The means increments (standard deviation) of cavitated lesions on the occlusal surfaces were 0.34 (0.62), 0.22 (0.58), 0.02 (0.15), 0.13 (0.41), 0.04 (0.21), 0.00 (0.00) for the HRC, HRV, HRS, LRC, LRV, LRS groups, respectively. According to risk, there was only a statistical difference between HRC and HRS (p<0.05). Conclusion: The inclusion of sealants application in a preventive strategy could be a good approach for caries risk children.