European Archives of Paediatric Dentistry

, Volume 14, Issue 2, pp 59–64 | Cite as

Caries experience in primary teeth of four birth cohorts: a practice-based study

  • T. Käkilehto
  • J. Siiskonen
  • H. Vähänikkilä
  • S. Salo
  • L. Tjäderhane
  • V. AnttonenEmail author
Original Scientific Article



To investigate the survival of caries-free primary teeth in four age cohorts in the city of Kemi, Finland, as well as association of survival of primary teeth among boys and girls and among high and low caries risk individuals.

Study design

This was a practice-based follow-up study based on dental records.


The data were collected from the electronic oral health patient records of the municipal health centre of the city of Kemi, covering four different birth cohorts (1985, 1990, 1995 and 2000). The total number of children was 4,488.


Kaplan–Meier curves were drawn to illustrate the survival of caries-free primary molars . Statistical difference between the groups was analysed using the log-rank test and Cox proportional hazards regression analysis. The retrospective caries risk definition for individuals was based on the early restorations in the first permanent molars.


In the earlier cohorts, primary molars survived caries-free for a shorter period than in the later cohorts (p < 0.001). However, in the 2000 cohort, the survival curve, having shown at the beginning only some caries incidence, bended strongly downwards at the age of 8 years. The survival time of the primary molars remaining caries-free was shorter for those with high caries risk (p < 0.001) as well for boys compared with girls in all cohorts (p = 0.001).


The course of the survival curve of the 2000 age cohort indicates a halt in the improvement of dental caries prevalence, but the follow-up period was too short to allow monitoring the progress further. Continuing oral health promotion to all children, and particularly risk individuals must be emphasised.


Primary teeth Survival Kaplan–Meier Caries 



We want to thank Dr Tiina Joensuu for providing us with information about oral health care in the city of Kemi. In addition, we want to express our gratitude to Mr Jari Päkkilä for his support in producing statistical analyses.


  1. Alm A, Wendt L, Koch G, et al. Caries in adolescence—influence from early childhood. Community Dent Oral Epidemiol. 2012;40:125–33.PubMedCrossRefGoogle Scholar
  2. Armfield J, Stewart J, Spencer A. The vicious cycle of dental fear: exploring the interplay between oral health, service utilization and dental fear. BMC Oral Health. 2007;7:1.PubMedCrossRefGoogle Scholar
  3. Dawson-Saunders B, Trapp RG. Basic and clinical biostatistics. 2nd ed. New York: McGraw-Hill Companies; 1994. pp. 186–206.Google Scholar
  4. Gordon P. Craniofacial growth and development. In: Welbury RR, editor. Paediatric dentistry. New York: Oxford University Press; 2001. p. 12.Google Scholar
  5. Hausen H, Kärkkäinen S, Seppä L. Caries data collected from public health records compared with data based on examinations by trained examiners. Caries Res. 2001;35:360–5.PubMedCrossRefGoogle Scholar
  6. Härkänen T, Larmas M, Virtanen J, Arjas E. Applying modern survival analysis methods to longitudinal dental caries studies. J Dent Res. 2002;81:144–8.CrossRefGoogle Scholar
  7. Helminen SE, Vehkalahti M, Murtomaa H. Dentists’ perception of their treatment practices versus documented evidence. Int Dent J. 2002;52:71–4.PubMedCrossRefGoogle Scholar
  8. Joensuu T. Cumulative costs of caries prevention and treatment in children with special reference to work division and cohort effect. Finland: University of Turku; 2009.Google Scholar
  9. Käkilehto T, Salo S, Larmas M. Data mining of clinical oral health documents for analysis of the longevity of different restorative materials in Finland. Int J Med Inform. 2009;78:68–74.CrossRefGoogle Scholar
  10. Lahti S, Rusanen J, Kärkkäinen S, et al. GIS and areal variation in dental caries—contribution of socio-economic factors among 6-year-olds in Kemi, Finland. Nord Geo Pub. 2005;33:1–7.Google Scholar
  11. Marthaler T. Changes in dental caries 1953–2003. Caries Res. 2004;38:173–81.PubMedCrossRefGoogle Scholar
  12. Meurman P, Pienihäkkinen K. Factors associated with caries increment: a longitudinal study from 18 months to 5 years of age. Caries Res. 2010;44:519–24.PubMedCrossRefGoogle Scholar
  13. Milén A. Role of social class in caries occurrence in primary teeth. Int J Epidemiol. 1987;16:252–6.PubMedCrossRefGoogle Scholar
  14. Ministry of the Interior. Time period of growth of urban regions (in Finnish). 2004:14.Google Scholar
  15. Naidoo S, Myburgh N. Nutrition, oral health and the young child. Matern Child Nutr. 2007;3:312–21.PubMedCrossRefGoogle Scholar
  16. National Institute of Health and Welfare. School Health Promotion Study 2010/2011.
  17. Nordblad A, Suominen-Taipale L, Rasilainen J, Karhunen T. Oral health in public health clinics from the 1970s until the year 2000. Report 278. Helsinki: Stakes; 2004.Google Scholar
  18. Ollila P. Long-term predictive value of salivary microbiological diagnostic tests in children. Eur Arch Paediatr Dent. 2008;9:25–30.PubMedCrossRefGoogle Scholar
  19. Pitts N, Boyles J, Nugent Z, Thomas N, Pine C. The dental caries experience of 5-year-old children in England and Wales (2003/4) and in Scotland (2002/3). Surveys co-ordinated by the British Association for the Study of Community Dentistry. Community Dent Health. 2005;22:46–56.PubMedGoogle Scholar
  20. Poulsen S, Scheutz F. Dental caries in Danish children and adolescents 1988–1997. Community Dent Health. 1999;16:166–70.PubMedGoogle Scholar
  21. Poutanen R, Lahti S, Seppa L, et al. Oral health-related knowledge, attitudes, behavior, and family characteristics among Finnish schoolchildren with and without active initial caries lesions. Acta Odontol Scand. 2007;65:87–96.PubMedCrossRefGoogle Scholar
  22. Speechley M, Johnston DW. Some evidence from Ontario, Canada, of a reversal in the dental caries decline. Caries Res. 1996;30:423–7.PubMedCrossRefGoogle Scholar
  23. Stephenson J, Chadwick BL, Playle RA, et al. Modeling childhood caries using parametric competing risks survival analysis methods for clustered data. Caries Res. 2010;44:69–80.PubMedCrossRefGoogle Scholar
  24. Suominen-Taipale AL, Widström E, Sund R. Association of examination rates with children’s national caries indices in Finland. Open Dent J. 2009;3:59–67.PubMedCrossRefGoogle Scholar
  25. Suni J, Pienihäkkinen K, Alanen P. Molars remaining healthy among 1985 and 1990 cohorts in Lahti and Vantaa—analysis of survival. Finn Dent J. 2008;8:22–6.Google Scholar
  26. Vehkalahti M, Tarkkonen L, Varsio S, et al. Decrease in and polarization of dental caries occurrence among child and youth populations, 1976–1993. Caries Res. 1997;31:161–5.PubMedCrossRefGoogle Scholar
  27. Virtanen J, Bloigu R, Larmas M. Effect of early restorations of permanent molars on filling increments of individual teeth. J Dent. 1997;1:17–24.CrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2013

Authors and Affiliations

  • T. Käkilehto
    • 1
  • J. Siiskonen
    • 2
  • H. Vähänikkilä
    • 2
  • S. Salo
    • 4
  • L. Tjäderhane
    • 2
    • 3
  • V. Anttonen
    • 2
    • 3
    Email author
  1. 1.Dental Teaching UnitOuluFinland
  2. 2.Department of Cariology, Endodontology and Paedodontics, Institute of DentistryUniversity of OuluOuluFinland
  3. 3.University HospitalOuluFinland
  4. 4.OuluFinland

Personalised recommendations