Testing of Dental Caries Preventatives by Deciduous Molar Count

Reduced tooth loss is the ultimate measure of effectiveness in treating dental decay. It is unambiguous, easily understandable and readily measured. Deciduous molars erupt in years 2-3 and are shed in years 9-12. Premature loss can occur as a result of dental decay.Objectives: To evaluate deciduous molar tooth loss as an outcome variable for evaluation of dental caries preventatives. Method: In a study of 632 children (ForsythKids program)evaluated for tooth decay and tooth presence from grades 1 through 3 (ages 7, 8 and 9y), 435 (3,304 molars) were treated by application of an occlusal sealant (Fuji IX, GC America) and a fluoride varnish (Cavity Shield, Omnii Pharm.). 197 children (1,385 molars) were evaluated but did not return for treatment. 6 months later, missing teeth were counted again in both groups. Results: Over the intervening 6 months, 230 deciduous molars were lost. 39% were decayed or filled at baseline and 61% were not (and presumably lost to normal exfoliation) 9.89% of the untreated molars and 2.81% of the treated molars were lost, a highly significant difference (p< 0.001, OR=3.8). Comparable responses were found when data was subset by grade. To minimize the contamination by naturally exfoliated teeth, evaluation was restricted to 1312 molars that were decayed or filled at baseline. In this subset, 12% of the 405 untreated molars were lost and 5% of the 907 treated molars were lost (p<0.001, OR=2.8). The most frequently lost teeth were maxillary and mandibular first molars. Conclusions: The effectiveness of caries preventatives may be demonstrated in 6-month study of children in the age range 7 to 9 years by counting the number of deciduous molars.

We acknowledge financial support from the Delta Dental Service of Massachusetts, Bingham Trust, the Belzekian Foundation, the Cape Cod Foundation, and the Massachusetts Access Program.