Evaluation of an intensified preventive programme aimed at 12-year-olds with increased caries risk

Aim Selective intensified prevention (SIP) was introduced by the Dental Public Health Service in Marburg County in 1995. SIP is offered at individual schools in underprivileged districts including enhanced health education and oral hygiene instructions as well as fluoride varnish applications four times per year. The aim of this study was to evaluate the effect of the programme in 12-year-old children in comparison to a control region. Subject and Methods The intervention group consisted of children attending schools in socially deprived areas in the county of Marburg-Biedenkopf who had participated in the preventive programme for 6 years. Control group subjects were recruited from schools in socially deprived areas in the county of Osnabruck with no school-based topical fluoridation programme. Caries experience was recorded using the criteria of the International Caries Detection and Assessment System (ICDAS II). Other variables such as oral hygiene behaviour, knowledge of dental health and dental fear were examined psychometrically. The statistical evaluation was performed by SPSS 17.0. To compare the mean caries scores of various subgroups, non-parametric tests were performed. Results In Marburg 236 children were examined, and 689 were participating in the control region. The samples were parallelized by constructing matched pairs with children from the control region. After matching the data of 210 children in each region, a total of 420 were involved in the statistical evaluation. Combining ICDAS scores 3 to 6 children from the control region (mean D3-6MFT: 1.73) showed roughly double the caries experience compared to the test group (mean D3-6MFT: 0.88, p<0.005). Concerning health knowledge, Marburg pupils did not exhibit superiority but dental fear was reported to a lesser extent. Conclusion The results of our study confirm a caries preventive effect of SIP. The intervention group showed better oral health in all dental outcome variables reviewed. Both groups showed similar results regarding dietary habits, prophylaxis knowledge and oral hygiene. This leads to the conclusion that the effect of the preventive programme is primarily based on the application of fluoride varnish.