title: Inequalities in dental caries experience among 6-year-old German children after the caries decline.
abstract: OBJECTIVE
  As in many other countries, caries decline in Germany has left pockets of persisting caries prevalence. This study aims to assess the benefit of a 10-year community-based prophylaxis program, focused on regular toothbrushing with fluoridated toothpastes or gels and involving institutions noted as having the highest caries levels.
  
  
  METHODS
  The caries data (d3mft/D3MFT) was extracted from the results of the compulsory school entry examinations in Greifswald/Germany (2003/2004-2012/2013) involving ∼280 6-7-year-olds each year. Data from schools that include children with the highest caries levels and coming from low-SES families were analyzed independently and used for comparisons. Additionally, caries trends from Greifswald were compared to data from representative national surveys (2004-2009).
  
  
  RESULTS
  Data from 2871 children were available for analysis. The baseline d3mft value (2003/2004) was 3.2±3.8; the d3-component corresponded to 70% of the index. The latest caries data (2012/2013) showed a strong reduction (43.8%) in caries prevalence (d3mft=1.8±2.5). Similarly, the SiC-Index declined significantly from 2003/2004 (7.9±2.3) to 2012/2013 (4.8±2.3; p<0.001). Nevertheless, in all analyzed years the d3mft values and the SiC-Index were significantly higher in the institutions that included children coming from lower-SES families (p<0.05). The amount of caries reduction between 2004 and 2009 corresponded to 38% in Greifswald as compared to 13% in Germany.
  
  
  CONCLUSIONS
  This strategy involving a combination of regular toothbrushing and fluoride application has achieved an overall substantial caries reduction, thereby indicating that caries-control strategies for heterogeneous risk groups can be highly successful as setting approach. However, activities targeting high risk groups still need to be strengthened.
authors: Department of Preventive and Paediatric Dentistry, Ernst-Moritz-Arndt University , Greifswald , Germany.
authors: Ruth M
authors: RM
authors: Santamaria
authors: Roger
authors: R
authors: Basner
authors: Elisabeth
authors: E
authors: Schüler
authors: Christian H
authors: CH
authors: Splieth
mesh_terms: D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D005858:Germany / Q000453:epidemiology; D006293:Health Promotion; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011203:Poverty; D015995:Prevalence; D012189:Retrospective Studies; D012571:School Dentistry; D012923:Social Class; D014094:Tooth, Deciduous / Q000473:pathology; D014099:Toothbrushing; D014100:Toothpastes / Q000627:therapeutic use
chemical_list: D002327:Cariostatic Agents; D014100:Toothpastes; D005459:Fluorides
keywords: caries decline; caries prevalence; dmft; significant caries index