title: Caries prevalence and background factors in Swedish 4-year-old children - a 40-year perspective.
abstract: BACKGROUND
  Periodic and well-controlled studies of caries and background factors are important for organizing dental care and how prevention should be addressed.
  
  
  OBJECTIVE
  The aims of this study were to compare data on caries prevalence and background factors in 4-year-old children from 2007 with data collected periodically between 1967 and 2002 with the same methods and criteria, and to compare immigrant and non-immigrant children concerning caries prevalence and background factors.
  
  
  METHODS
  A cross-sectional study in 4-year-old children living in Umeå, northern Sweden (n = 218), was performed. Caries recordings included both cavitated and non-cavitated caries lesion, and bite-wing radiographs were used on indications. Data on oral hygiene, use of fluorides, general health, and medication and sugar consumption were collected using the same questions and questionnaire as in the previous studies.
  
  
  RESULTS
  In 2007, 38% of the children displayed caries compared to 46% in 2002. The distribution of decayed, missing, or filled surfaces-primary teeth values was statistically significantly different in 2007 compared to 2002 (P < 0.05). The intake frequency of sugary between-meal products was generally lower, and toothbrushing frequency was higher in 2007 compared with data from the 2002 study. In children with immigrant background, the frequency of toothbrushing was statistically significantly lower, and snacking was more common (P < 0.05). Sixteen per cent had immigrant background and 59% had caries compared to 32% in the rest of the cohort (P < 0.01).
  
  
  CONCLUSIONS
  Important changes in caries prevalence of 4-year-old children have taken place since 2002 concurrently with a decreased intake of sugary between-meal products and increased toothbrushing frequency. Immigrant background had a significant association with caries prevalence in 2007.
authors.affiliation: Department of Odontology, Paediatric Dentistry, Faculty of Medicine, Umeå University, Umeå, Sweden. christina.stecksen-blicks@odont.umu.se
authors.forename: Christina
authors.initials: C
authors.lastname: Stecksén-Blicks
authors.forename: Catarina
authors.initials: C
authors.lastname: Kieri
authors.forename: John-Erik
authors.initials: JE
authors.lastname: Nyman
authors.forename: Carin
authors.initials: C
authors.lastname: Pilebro
authors.forename: Eva
authors.initials: E
authors.lastname: Borssén
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004245:DMF Index; D019140:Dental Care for Children / Q000639:trends*; D003731:Dental Caries / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D003753:Dental Health Surveys; D004037:Diet, Cariogenic; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D006801:Humans; D015995:Prevalence; D011313:Preventive Dentistry / Q000639:trends*; D018709:Statistics, Nonparametric; D013548:Sweden / Q000453:epidemiology; D014099:Toothbrushing / Q000639:trends*