School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia.
Community Dent Oral Epidemiol. 2019 Dec;47(6):470-476. doi: 10.1111/cdoe.12486. Epub 2019 Jul 21.
To report on changes in dental caries experience in children of a remote Indigenous community following 6 years of passive preventive intervention (PPI) and 2 years of active preventive intervention (API).
Five consecutive cross-sectional surveys were conducted on 4- to 15-year-old school going children between 2004 and 2017 following phases of Community Water Fluoridation (CWF), post-cessation of CWF and API. Following treatment of any cavities present, API included selective placement of fissure sealants (FS) and an annual application of povidone-iodine (PI) and fluoride varnish (FV). The World Health Organization's (WHO) "Oral Health Surveys - Basic Methods (4th Edition)" methodology was used in the first two and the International Caries Detection and Assessment System (ICDAS-II) in the latter three surveys. ICDAS-II codes of 3-6, representing advanced caries, were combined to allow comparison to the decayed component of the DMF caries index.
Age-weighted mean dmft decreased by 37.7% in the deciduous (DD) and DMFT by 35% in the permanent (PD) dentitions between the pre- and post-CWF surveys, followed by increases of 25% and 7.7%, respectively, between the 1-year and 4-year post-CWF surveys. After 2 years of API, mean dmft decreased by 14.3% and DMFT by 7.1%. Untreated dental caries however remained a concern in the DD and PD during both phases of PPI and of API. The decline in caries experience for both dentitions following 2 years of API exceeded that for the 6-year period of PPI.
The annual reductions in caries experience of 7.2% (DD) and 8% (PD) during the phase of API exceeded annual decreases of 4.7% (DD) and 4.6% (PD) during the phase of PPI. Due to remoteness, cost and logistics in ensuring long-term viability of API programmes, CWF remains necessary in this type of community.
报告在偏远土著社区进行 6 年被动预防干预（PPI）和 2 年主动预防干预（API）后，儿童龋齿经历的变化。
在社区氟化水（CWF）、CWF 停止和 API 之后，对 2004 年至 2017 年期间的 4 至 15 岁在校儿童进行了连续五次横断面调查。在治疗任何现有龋齿后，API 包括选择性放置窝沟封闭剂（FS）和每年应用聚维酮碘（PI）和氟化物漆（FV）。在前两次调查中使用了世界卫生组织（WHO）“口腔健康调查 - 基本方法（第 4 版）”方法，在后三次调查中使用了国际龋齿检测和评估系统（ICDAS-II）。将 ICDAS-II 代码 3-6（代表进展性龋齿）合并，以允许与 DMF 龋齿指数的龋齿成分进行比较。
在 CWF 前和后两次调查之间，乳牙（DD）的年龄加权平均 dmft 减少了 37.7%，恒牙（PD）的 DMFT 减少了 35%，之后分别增加了 25%和 7.7%。在 CWF 后 1 年和 4 年的调查中。在 API 后 2 年，平均 dmft 减少了 14.3%，DMFT 减少了 7.1%。然而，在 PPI 和 API 的两个阶段，DD 和 PD 的未治疗龋齿仍然是一个问题。在 API 后 2 年，两种牙齿的龋齿经验下降超过 PPI 6 年期间的下降。
在 API 阶段，DD（7.2%）和 PD（8%）的龋齿年减少率超过 PPI 阶段的年减少率（DD 为 4.7%，PD 为 4.6%）。由于偏远、成本和后勤保障 API 计划的长期可行性，在这种类型的社区中，CWF 仍然是必要的。
