A differentiated approach to the dental caries prevention in children with different levels of caries risk

Relevance. Prevention of caries of the first permanent molars is one of the most relevant problems in pediatric
dentistry.

Purpose – to develop an algorithm for prevention of first permanent molars caries in children with different
levels of caries risk.

Materials and methods. The article presents the results of the implementation of the algorithm for prevention of first permanent molars caries in children with different levels of caries risk. This algorithm includes a comprehensive assessment of the values of indices dmft, DMFT, OHI-S, and the patient's health group is also taken into account. The study involved 253 children aged 6-7 years divided into 4 groups: 3 groups of children depending on the health group and the control group. 3 subgroups were identified in each group – with a low, medium, and high caries risk. We developed preventive measures schemes were for children of each group including training in oral hygiene; controlled and home toothbrushing using fluoride-containing toothpastes; applications of varnishes containing fluoride, calcium, phosphates from 2 to 3 times a year; fissure sealing of the first permanent molars. We carried out these activities were for 24 months, and then evaluated theirs effectiveness. Children in the control group were trained in oral hygiene. The clinical effectiveness of medical prophylaxis was evaluated by changes in the above clinical indicators.

Results. In group of children with medium caries risk the increase in caries was 0.09, and the reduction in caries was 89.65%. In children with a low and high caries risk no increase in caries was observed; the reduction in the intensity of caries was 100%. A significant decrease in OHI-S oral hygiene index values was noted in all groups (p < 0.05). We noted high preventive efficacy of fissures sealing in the first permanent molars. No occlusal surface caries developed in sealed fissures.

Conclusions. The application of the proposed preventive schemes in patients demonstrates high efficacy of fluoride and calcium-containing varnishes and sealing the fissures of the first permanent molars. 

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