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Stecksén-Blicks C, Sunnegårdh K et al. Caries Res 2004; 38: 149–155

Every 4-7 yrs for a period of 35 yrs, around 100-200 4-yr-old children in Umeå were assessed for caries experience and factors relevant to it. In 1967, 83% had caries, but this figure dropped to less than 50% from 1987 onwards. Mean dmfs scores were 78 in 1967, dropping to around 2.0 from 1980, giving a mean score of 4.0-5.0 for those who were affected. Over the whole period, 80-90% reported tooth-brushing 1 or more times daily.

In 2002, most children used fluoride toothpaste. Toothbrushing frequency was significantly related to mean dmfs: seldom brushers, 4.1; once a day, 2.5; and twice or more, 1.2. Immigrant children (10% of sample from 1997) had significantly higher mean dmfs scores (6.8) than others (1.5). About 1/3 never had sugar added to food. Snacking and general health problems did not relate significantly to caries.

The authors comment regarding preventive strategies centred on high risk patients, and say their data show the need for preserving population-based strategies including parental education. They emphasise the special needs of immigrant families.