[Evaluating the efficacy of selected programs for prophylaxis of caries and periodontal diseases in school children with special reference to guidelines for oral cavity hygiene].

Endeavouring to improve the oral cavity soundness in 7-8 year-old children, an attempt was made to elaborate three prophylactic-educational programs with the possibility to apply them in school conditions. The aim of the work was to evaluate the efficacy of the said programs in the field of oral cavity hygiene, the status of periodontium and dental caries, as well as to observe the moulding of consciousness and correct hygiene habits. The clinical and questionnaire studies covered 255 pupils of two elementary schools in Szczecin. For the first 2-3 years of their lives the majority of children used tap water having been fluoridated to optimal level. The pupils of both schools were receiving planned stomatological treatment and contact fluoridation. The clinical evaluation was accomplished on the basis of 18-month-long observation of the increase in the number of teeth and dental surface with caries (DMFt and DMFs), status of periodontium (ind. GI) and state of hygiene (ind. OHI-S and QH). The tooth brushing method applied by children was additionally observed. The questionnaire studies were employed for estimating the changes in the health consciousness and hygienic habits. The three selected programs were implemented in three groups of studied children (Tab. 1). Program I was based on II individual, motivating instructions of tooth brushing. The main motivating factor was each time colouring of the bacterial plaque. Programs II and III were expanded by educational activity among children and parents. Program III was additionally enriched by professional cleaning of teeth, sealing and intensive conservative treatment. The above programs were carried out in cooperation of school stomatologist, teachers and V year stomatology students and girl pupils training for hygienists. The high frequency and intensity, hardly fair hygiene of the oral cavity and improper habits, having been disclosed in 7-year-old children during preliminary examinations, indicated that there was an urgent need to intensify the educational-prophylactic-therapeutic procedures. After 18-month-long studies it appeared that program I was effective with regard to improving hygiene (reduction of ind. QH by about 13%) (Fig. 1) and the status of gums (reduction of ind. GI by about 54%) (Fig. 2), however, it failed to exert any effective influence on the reduction of caries. Programs II and III were found to be effective with respect to the improvement of hygiene (reduction of ind. QH about 18 and 20%) (Fig. 1), status of gums (reduction of ind. GI about 67 and 67%) (Fig. 2) as well as reduction of caries (about 68 and 56%). Thus, for the exploitation under school conditions each of the three evaluated programs may be engaged, but the most recommendable would be program II or III. The actual studies have also shown the possibility of obtaining a distinct improvement in hygiene in a short time, however, a longer period of time was necessary to stabilize it. Moreover, the process of introducing a correct method of brushing the teeth appeared to be relatively difficult, but it was much easier to achieve that in the children who up to now have made use of partly correct method than in those who used an incorrect one. The implementation of the selected programs had stronger influence on the correction of health consciousness and weaker on the moulding of the habits of brushing the teeth with appropriate frequency. Reverse proportional dependence was also revealed to exist between caries intensity in children studied and the education of their parents.