Effective Caries Prevention in a Hebridean Island Population
Background The Isle of Islay has a remote-rural population. Two dentists have been responsible for the care of the majority of the school-age children for 15 years. The island affords a unique situation to measure caries prevalence in a relatively static population. Aim This study measures the changes in the dental caries experience of five and 12-year olds exposed to a preventive-based approach to improving dental health, which included a school-based tooth-brushing programme (four to 12-year-olds). Design Data from practice-based records were collected for children aged five and 12 in the years 1999–2003 and 2012–2014. Indices including percentage of children with no obvious caries, decayed, missing or filled teeth (dmft/DMFT) and care indexes were calculated, translated into graphs and compared to Scotland's National Dental Inspection Programme (NDIP) data. Results 478 children were included in the study. The mean number in each year group for five-year-olds was 28 (SD±5.65) and for 12-year-olds was 31.75 (SD±8.30). The percentage of children caries-free increased from 39% to 85% (five-year-olds) and 31% to 97% (12-year-olds). DMFT decreased from 3.04 to 0.30 (five-year-olds) and 3.74 to 0.03 (12-year-olds). Figures for care index and percentage of first permanent molars fissure sealed were higher than national data averages. Conclusion Caries prevalence decreased in children in Islay aged five and 12 years over the period 1999–2014. There was no control group but the differences described above can be associated with the introduction of a preventive approach, however they cannot be assumed to be causative.