Later effects of school-based caries preventive programs

Objectives: Purpose of this study is to assess the later effects of school-based combined program of targeted sealant (TS) for 1st molars with high risk of pit and fissure caries and fluoride mouth rinse (FMR) conducted between preschool and junior high school ages until 20 years of age. Methods: Forty-six persons from TS+FMR program participants and 55 persons from FMR program were screened for dental caries at the age of 20. Also, they were asked to fill out the questionnaire to obtain information about tooth brushing and flossing habits, and history of regular dental check-up. Dental caries prevalence rate and mean number of DMFT in the two programs were compared. Also, logistic regression analysis (dependent variable: caries-free or not) and multiple regression analysis (dependent variable: number of DMFT) were performed using 7 independent variables: gender, program and 5 answers from the questionnaire. Results: Caries prevalence rate was 28.3% and 60.0% in TS+FMR program and FMR, respectively, and the difference was statistically significant (chi-square test; p<0.001). Prevalence rates gained from these programs showed 30-60 points lower than that of Japan National Dental Health Survey (JNDHS). Mean number of DMFT was 1.56 (SD; 3.00) and 2.20 (SD; 2.44) in TS+FMR program and FMR, respectively. The difference (29.1%) was also statistically significant (Mann-Whitney test; p<0.05). When compared with mean DMFT in JNDHS, present subjects had 5.8 and fewer DMFT. In the analysis based on tooth type, statistically significant difference was found in only the first molars between 2 programs. Logistic regression analysis indicated that ‘program' of the independent variables had statistically significant effect. Conclusion: The present study suggests that targeted sealant program in addition to fluoride mouth rinse in school ages is more effective for caries prevention, especially for 1st molars, and can continue the effectiveness until adult ages.