Abstract
Aim
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.
Methods
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.
Statistics
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.
Results
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).
Conclusion
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alm A, Wendt L, Koch G, et al. Caries in adolescence—influence from early childhood. Community Dent Oral Epidemiol. 2012;40:125–33.
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.
Dawson-Saunders B, Trapp RG. Basic and clinical biostatistics. 2nd ed. New York: McGraw-Hill Companies; 1994. pp. 186–206.
Gordon P. Craniofacial growth and development. In: Welbury RR, editor. Paediatric dentistry. New York: Oxford University Press; 2001. p. 12.
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.
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.
Helminen SE, Vehkalahti M, Murtomaa H. Dentists’ perception of their treatment practices versus documented evidence. Int Dent J. 2002;52:71–4.
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.
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.
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.
Marthaler T. Changes in dental caries 1953–2003. Caries Res. 2004;38:173–81.
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.
Milén A. Role of social class in caries occurrence in primary teeth. Int J Epidemiol. 1987;16:252–6.
Ministry of the Interior. Time period of growth of urban regions (in Finnish). 2004:14.
Naidoo S, Myburgh N. Nutrition, oral health and the young child. Matern Child Nutr. 2007;3:312–21.
National Institute of Health and Welfare. School Health Promotion Study 2010/2011. http://info.stakes.fi/kouluterveyskysely/EN/index.htm.
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.
Ollila P. Long-term predictive value of salivary microbiological diagnostic tests in children. Eur Arch Paediatr Dent. 2008;9:25–30.
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.
Poulsen S, Scheutz F. Dental caries in Danish children and adolescents 1988–1997. Community Dent Health. 1999;16:166–70.
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.
Speechley M, Johnston DW. Some evidence from Ontario, Canada, of a reversal in the dental caries decline. Caries Res. 1996;30:423–7.
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.
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.
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.
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.
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.
Acknowledgments
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.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Käkilehto, T., Siiskonen, J., Vähänikkilä, H. et al. Caries experience in primary teeth of four birth cohorts: a practice-based study. Eur Arch Paediatr Dent 14, 59–64 (2013). https://doi.org/10.1007/s40368-013-0016-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40368-013-0016-9