Community Dental Caries Prevention System Integrated Population Strategy and High-risk Strategy

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<Subjects and Methods> Of 1,820 eighteen-month-old children who underwent a health checkup provided by the city of Nagasaki in 2004, 638 were eligible to join the caries-prevention program as High-Risk group defined by this study. In this program, we administered periodic preventive management for 2 years, including an oral checkup, monitoring MS acquisition using Dentocult SM[○!R], applying topical fluoride, and counseling. The eligible children were also sent nine oral health leaflets. <Results> 1. The participation rate was 20.7%. 2. Caries incidence at 3-year-old children were 31.2% for the Low Risk group, and 55.0% for the High Risk group. 3. There was no statistical difference of caries incidence of 3-year-old between participants group and non-participants group of High Risk children. 4. We reevaluated this value using case control, that is, each non-participant child had the same sex, risk score, CO (caries observation) as matched participant child. However there was no statistical difference among the two groups. 5. Among the participants group, the logistic regression was used to test multivariable associations (CO, Risk score, participation times, Maximum value of Dentocult SM) with caries incidence at 3-year-old. Having CO at 1.5-year-old and the Maximum value of Dentocult SM during the program were statistically associated with the caries incidence at 3-year-old in the participants group. <Discussion> 1. The low participation rate to the caries prevention program for the High Risk children indicates that the preventive program which needs autonomy may not suitable for the High Risk children. 2. The one of considerable reason why no statistical difference of caries incidence of 3-year-old between participants group and non-participants group of High Risk children is that the most children discontinued this preventive program. The High Risk children may need the more intensive preventive care.