Long-term caries development in schoolchildren and the role of educational status

Objective: After the recent decline in caries, caries development has become harder to predict. The aim of this 10-year cohort study was to monitor long-term caries development with special regard to educational status in schoolchildren. Method and Materials: For 521 five- to six-year-olds (mean 5.8 ± 0.5 years) participating in the compulsory pre-school examination, the oral status and the parental educational status was recorded. In the 10-year follow-up, 170 children (5.9 ± 0.3 years at baseline, 16.5 ± 0.4 years at 10 years) could be re-examined. Associations between the children's and parental educational background with the caries increment were analyzed. Drop-outs (n = 351; 5.8 ± 0.6 years) and drop-in 10th-graders (n = 364; 16.9 ± 0.6 years) were used for comparative analyses. Results: Mean caries scores increased from 0.1 DMFS (± 0.5) to 5.0 DMFS (± 6.6), while the other 10th-graders exhibited a significantly higher DMFS (6.6 ± 8.8; P .001). In children who later attended higher education, caries levels were already significantly lower at school entry (6.1 ± 7.4 dmfs) compared to the other children (11.1 ± 11.4 dmfs; P .005). Similarly to the baseline dmft (OR 3.6), the 10-year caries increment in the permanent dentition was significantly lower when the father had a university degree (2.7 ± 3.2 ΔDMFS compared with 5.1 ± 6.6; P = .02; OR 4.6). Conclusion: The parental educational status and caries levels in the primary dentition determined strongly the long-term oral health of their children, which means that effective preventive strategies have not been implemented to compensate inequalities in health and education. Keywords: dental caries, educational status, oral health, prediction, public health, risk