口腔の健康と歯の管理

概要

Trends in oral health status of schoolchildren from Iasi, Romania

Ioan Danila, Carmen Hanganu, Lucia Barlean, Alice Murariu, Monica Parus, Livia Mihailovici, Iulia Saveanu, Teodora Timis

In 1999 the National Caries Preventive Program comprising supervised weekly mouth rinsing with
0.2% NaF was introduced in all primary schools in a deficient fluoride area, Iasi, Romania. Children
grades I to IV participated. The aim of the present study was to analyze trends in dental caries over
a ten years period (1992-2003) among children of 6 and 12 years of age. This study was carried out
in order to assess the changes in oral health status after four years of application of National Caries
Preventive Program.
All children were examined clinically at the school dental clinic, by the trained and calibrated dentist
of the school, according with the WHO criteria. No radiographs were taken. Conducted visualtactile
examinations were made, using dental explorer and mouth mirrors for the counting of
decayed, missing and filled (def - DMF) teeth (t - T) and teeth surfaces (s - S). The results of clinical
examinations were recorded by a trained assistant on standardized forms.
In children of grade I (6 years old) the mean caries indices were constant - 8.8 defs in 1992 and 2003,
but deft decreased from 5.1 in 1992 to 4.5 in 2003. The DMFT had a significant decreasing from 1.2
in 1992 to 0.11 in 2003. The DMFS also decreased over ten years, from 1.71 (1992) to 0.11 (2003). At
grade VI (12 years old) the mean caries experience was 3.92 DMFS (2003) comparing with 6.0
DMFS (1992). The DMFT index decreased from 3.0 (1992) to 2.34 (2003). Most probably this decline
cannot be attributed solely to the preventive program. Thus, even if the community of Iasi is fluoride-
deficient, the children may be exposed to fluorides unassociated with the mouth rinsing programs.
The possibility exists that some factors that influence dental caries other than the intervention
being studied may have contributed to the observed changes in caries prevalence. Changes in
diet, access to dental care, secular improvement of caries, or other factors may also have had an
effect on our data.
The efficacy of school-based fluoride mouth rinsing programs has been evaluated in different studies,
and subsequently, many states and localities adopted such programs for communities, particularly
in non-fluoridated areas. This program has appeal because costs for supplies were low and the
regimen could readily be supervised by school teachers after minimal in-service training. We will
continue the program and all the methods recommended by WHO in order to achieve its objectives
for 2010 and 2025.