Hae:

Oulun yliopiston väitöskirjat

FISSURE SEALANTS IN CARIES PREVENTION, ACTA UNIVERSITATIS OULUENSIS D Medica 1078

ISBN-13:	978-951-42-6341-5
Kieli:	englanti
Kustantaja:	Oulun yliopisto
Oppiaine:	Lääketiede, farmasia
Painosvuosi:	2010
Sidosasu:	pehmeäkantinen
Sijainti:	Print Tietotalo
Sivumäärä:	124
Tekijät:	LESKINEN KAJA

20.00 €

The purpose of this study was to analyse the effectiveness and cost of fissure sealant treatment inpreventing dental caries in children in a practice-based research network using survival analysis. The survival times of first permanent molars in children were analysed in three countries: inFinland (age cohorts 1970–1972 and 1980–1982), in Sweden (1980–1982) and in Greece(1980–1982), and additionally at two municipal health centres in Finland (age cohorts 1988–1990in Kemi and 1990 in Vantaa). The study population comprised altogether 8 551 children. The data were collected manually from paper dental records (Finland, Sweden and Greece),and an automatic data-mining system for collecting data from electronic dental records was usedin the case of the two health centres in Finland (Kemi and Vantaa). Comparisons of the survivaltimes of first molars caries-free were performed between sealed and non-sealed individual teeth,and between the subjects in cases where a subject’s all first permanent molars were either sealedor non-sealed before the age of eight years. The cumulative costs of caries risk determination, useof xylitol, fissure sealant treatment, and restorations were calculated based on the data from thedigital dental records of the health centres of Kemi and Vantaa. The results stressed the importance of caries-risk assessment on a tooth and subject level, whenestimating the need for sealing treatment. Sealing of first molars of very high caries risk children(caries present in any of the permanent first molars before the age of eight years) seemed to beinsufficient to prevent further dental decay later on. Instead, sealants were beneficial in cariesprevention in medium-risk children (caries present in any of the permanent first molars betweenthe ages of eight and ten years). Low-risk children (no caries in any of the permanent first molarsbefore the age of ten years) did not benefit remarkably from sealant treatment. When sealanttreatment were targeted only at high caries risk children based on risk-determination at the age oftwo years and all their permanent first molars were sealed (Kemi), their total treatment costs laterwere higher compared to the low-risk children, who were left unsealed. Significant differences inthe survival curves of sealed and non-sealed first molars on a tooth and subject level confirmedthat a translational approach is needed to study the effectiveness of preventive dental treatment inpractice. The practice-based study model provides a good overview on the situation in real-lifecircumstances and helps to incorporate the evidence-based dentistry study results into everydaydental practice.

Takaisin