A combined approach to preventing dental caries in schoolchildren: caries reductions after one year.

A prototype school-based dental program is being conducted in a low-middle-income, urban area, as a demonstration project to test the combined effect on dental caries of several preventive measures. Procedures include ingestion of fluoridated water (1.0 ppm), topical application of acidulated phosphate fluoride, application of a pit and fissure sealant, early detection of caries and restoration of affected teeth, and dental health education (oral hygiene and dietary counseling program). The four-year project began in early 1973. A group of 1,200 children in the first and sixth grades was randomly separated into a treatment and a comparison group. All children participate in a dental health education program and consume fluoridated water. Dental care is provided on site at 18 schools, with the use of two mobile vans, saving time and expense in school hours lost and transportation costs. A hygienist coordinates the oral hygiene and dietary programs in classrooms with the help of teachers trained in workshops. Supervised toothbrushing, flossing, and use of disclosing agents are carried on in the classrooms. First-year caries increment data in permanent teeth indicate a high degree of success. Occlusal surfaces of permanent teeth in children in the treatment group, contrasted to those in children in the comparison group, showed an average reduction in caries of 84%. The encouraging results obtained at the end of one year indicate that a school-based preventive dentistry program may have great potential for preventing and controlling dental caries in schoolchildren.