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      Epidemiological investigation of caries prevalence in first grade school children in Rhineland-Palatinate, Germany

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          Abstract

          Introduction

          The annual examination of first graders’ oral health as stipulated by law aimed to reach every child in Rhineland-Palatinate (Germany) in their first year of school. We intended to evaluate the first graders’ oral health based on the examination data for 2013/2014.

          Methods

          Instructed examiners measured the d3mft(deciduous)/D3MFT(permanent) index according to World Health Organization criteria in 25,020 predominantly 6–7 year-old first-grade school children. Only caries affecting dentin was diagnosed; no radiography or fiber-transillumination was used. Out of the d3mft value, the “Significant Caries Index” (SiC) was calculated. This index identifies the dmft score of the third of the population with the highest caries experience. Descriptive analysis was performed.

          Results

          Out of the the examined children, 60.9 % were caries free. Mean d3mft score was 1.28 ± 2.27 while the mean SiC was 3.73 ± 2.51. A distinctly higher d3mft was found in the decidous molars compared to the front teeth. Boys were significantly more caries-experienced than girls ( p < 0.001).

          Conclusion

          The results of this study confirm the lasting trend towards decreasing caries prevalence in children starting school found in previous cross-sectional studies. This trend was observed in the high-risk group (obtained by SiC) as well as in the entire study population. Particular attention in caries prophylaxis should be paid to the primary molars.

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          Most cited references17

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          Microbial ecology of dental plaque and its significance in health and disease.

          P.D. Marsh (1994)
          Dental plaque forms naturally on teeth and is of benefit to the host by helping to prevent colonization by exogenous species. The bacterial composition of plaque remains relatively stable despite regular exposure to minor environmental perturbations. This stability (microbial homeostasis) is due in part to a dynamic balance of both synergistic and antagonistic microbial interactions. However, homeostasis can break down, leading to shifts in the balance of the microflora, thereby predisposing sites to disease. For example, the frequent exposure of plaque to low pH leads to inhibition of acid-sensitive species and the selection of organisms with an aciduric physiology, such as mutans streptococci and lactobacilli. Similarly, plaque accumulation around the gingival margin leads to an inflammatory host response and an increased flow of gingival crevicular fluid. The subgingival microflora shifts from being mainly Gram-positive to being comprised of increased levels of obligately anaerobic, asaccharolytic Gram-negative organisms. It is proposed that disease can be prevented or treated not only by targeting the putative pathogens but also by interfering with the processes that drive the breakdown in homeostasis. Thus, the rate of acid production following sugar intake could be reduced by fluoride, alternative sweeteners, and low concentrations of antimicrobial agents, while oxygenating or redox agents could raise the Eh of periodontal pockets and prevent the growth and metabolism of obligately anaerobic species. These views have been incorporated into a modified hypothesis (the "ecological plaque hypothesis") to explain the relationship between the plaque microflora and the host in health and disease, and to identify new strategies for disease prevention.
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            Global goals for oral health 2020.

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              Introducing the Significant Caries Index together with a proposal for a new global oral health goal for 12-year-olds.

              To describe a new index, the 'Significant Caries Index' (SiC Index) with the intention of focusing attention on those individuals with the highest caries scores in each population. Attention is drawn to the skewed distribution of dental caries within a given population, indicating that there are still large groups of individuals who have considerably more caries than the WHO/FDI target level of DMFT 3 by the year 2000. The index is calculated as follows: individuals are sorted according to their DMFT values. The one third of the population with the highest caries score is selected and the mean DMFT for this subgroup is calculated. This value constitutes the SiC Index. The SiC Index can be easily calculated and used as a measure for future oral health goals. The SiC Index should be less than 3 DMFT in the 12-year-olds in a given population and it is hoped that this global oral health goal is reached at the latest by the year 2015.
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                Author and article information

                Contributors
                00 49 (0) 6131 17 3557 , jens.weusmann@unimedizin-mainz.de
                benjamin.mahmoodi@unimedizin-mainz.de
                adrianoasso@hotmail.com
                kristian.kordsmeyer@gmx.net
                christian.walter@unimedizin-mainz.de
                willersh@uni-mainz.de
                Journal
                Head Face Med
                Head Face Med
                Head & Face Medicine
                BioMed Central (London )
                1746-160X
                2 October 2015
                2 October 2015
                2015
                : 11
                : 33
                Affiliations
                [ ]Department of Operative Dentistry, University Medical Center of the, Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
                [ ]Department of Oral and Maxillofacial Surgery, Johannes Gutenberg-University, Mainz, Germany
                Article
                91
                10.1186/s13005-015-0091-8
                4591732
                26432570
                3a774dd9-6a45-49e9-ba52-a0453e2f7302
                © Weusmann et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 April 2015
                : 24 September 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Orthopedics
                caries,childhood,epidemiology,dental health,prophylaxis
                Orthopedics
                caries, childhood, epidemiology, dental health, prophylaxis

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