The effect of five years' implementation of caries-preventive methods in Swedish high-risk adolescents.

AIM: To study the effectiveness of four different preventive programmes within a group of adolescents at high risk of caries. SUBJECTS AND METHODS: In 1995, a cohort of 12-year-olds was examined for caries and completed a questionnaire. Subjects identified as being at high risk were examined every year until 2000 when they were 17 years old. This high-risk group was subdivided into four groups, each individual randomly assigned to one of four preventive programmes: (A) information on tooth-brushing techniques; (B) prescription of fluoride lozenges; (C) semi-annual applications of fluoride varnish; (D) quarterly appointments where participants were given individualised information on oral hygiene and diet as well as an application of fluoride varnish. The outcomes examined were the caries increment in dentine, enamel and fillings. Poisson regression was used to assess the influence of background, preventive factors and habits. RESULTS: The number of 12-year-olds in the high-risk group was 1,134 in 1995, of which 925 were still participants in 2000. The differences between the programmes in mean 5-year increment were not significant. Less risk of caries increment was shown for those who had at least one sealant and for those who belonged to the fluoride varnish group (C). A higher risk was observed for adolescents from working-class homes, and for those who reported often eating sweets and not brushing their teeth twice a day at all examinations during the whole study period. CONCLUSIONS: The preventive programmes tested were equal in showing low efficiency in adolescents with high caries risk.