Dental caries prevalence and trends in children - Pathfinder surveys in Hungary over 30 years

Review

Keywords: national oral health surveillance, dental caries, prevalence, SIC-index, care index, oral disease prevention, children

Abstract

Purpose: Whilst improved oral health in children is noted in most Western countries, it coincides with a high prevalance
of oral disease in several countries of Central and Eastern Europe. The purpose of this project is to describe the current
level of dental caries in Hungarian children between 5–6 and 12 years and to assess the long-term trends in dental
caries in the past 30 years.
Methods: A representative survey was undertaken in 2017 It was performed in accordance with the WHO Pathfinder
methodology, which also was applied in previous national oral health surveys of 1985, 1991, 1996, 2001, 2008, and 2013.
Children of 5–6 and 12 years of age were sampled systematically in all surveys over 30 years period. Relevant data were
gathered through visual clinical examinations.
Results: In 2017, 43,8% of 5–6 year-olds were free of dental caries, meanwhile, the percentage was lower in rural (34,6%)
compared with urban (49,9%) settings. In 2017, approximately 3,5 primary teeth were affected by dental caries among
children aged 5–6 years. Most of the incidents consisted of untreated caries. Dental caries occurrence was relatively
higher for children living in rural areas. At the age of 12, approximately two permanent teeth suffered from dental caries,
and the D-component of the caries index was high. In 1985, 12-year-olds had, on average, 5 teeth affected by the dental
caries, and after 30 years, in 2017, the level of caries declined to 2,3 DMFT In 1985, 7,5% of children were caries-free,
and the figure grew to 44,7% in 2017. The value of SIC index is 8,43 in 5/6 year olds, and 5,23 in 12-year-olds.
Conclusions: By the year 2000, whilst accomplishing WHO’s global goals for oral health of 12-year-olds, Hungary has
not yet manage to achieve such goals for the 5-6 year-olds group and has not succeeded in achieving much stricter European
ones. It was considered unrealistic for the country to achieve WHO’s goal for 12-year-olds by the year 2020. To
achieve an improvement of the child’s oral health, strong emphasis should be given to population-directed oral disease
prevention, which includes reduction of sugars consumption, improved oral hygiene, and implementation of public health
programs for effective use of fluoride and revitalization of school dentistry.

References

BAGRAMIAN RA, GARCIA-GODOY F, VOLPE AR: The global increase in dental caries. A pending public health crisis. Am J of Dent 2009; 21: 3-8.

BÁNÓCZY J: A cariesprevenció helyzete és módszerei Magyarországon és más európai országokban. Fogorv Szle 1992; 83: 7-16.

BRATTHALL D: Introducing the Significant Caries Index together with a new global oral health goal for 12-year-olds. Int Dent J 2000; 50: 378-384. https://doi.org/10.1111/j.1875-595X.2000.tb00572.x

CHESTNUT IG: How soon is soon enough? The challenge of implementing behaviors conducive to good oral health in at-risk infants and toddlers. Comm Dent Health 2019; 36: 89-90.

CZUKOR J: WHO epidemiológiai vizsgálatok Magyarországon 1985-ben és 1991-ben. Fogorv Szle 1994;.87:223-235.

DAVIES GM, JONES CM, MONAGHAN N, MORGAN MZ, NEVILLE J AND PITTS NB: The caries experience of 11 to 12 year-old children in Scotland and Wales and 12-year-olds in England in 2008-2009. Community Dental Health; 2012; 29:8-13.

DAVIES GM, NEVILLE J, JONES K, WHITE S: Why are caries levels reducing in five-year-olds in England? Br Dent J. 2017. 223(7):515-9. https://doi.org/10.1038/sj.bdj.2017.836

FEJERSKOV O: Concepts of dental caries and their consequences for understanding the disease. Community Dent Oral Epidemiol.1997; 25: 5-12. https://doi.org/10.1111/j.1600-0528.1997.tb00894.x

GUPTA E, INNES N, SCHULLER AA, VERMAIRE JH AND MARSHMAN Z: A scoping review of the uses of the care index in children. Comm Dent Health 2017; 34: 131-136.

HOBDELL M, PETERSEN PE, CLARKSON J, JOHNSON N: Global goals for oral health 2020. Int Dent J 2003; 53: 285-288. https://doi.org/10.1111/j.1875-595X.2003.tb00761.x

HYSI D, CAGLAR E, DROBONIKU E, TOTI C AND KUSCU OO: Dental caries experience among Albanian pre-school children: a national survey. Comm Dent Health 2017; 34: 46-49.

JONES CM, DAVIES GM, MONAGHAN N, MORGAN MZ, NEVILLE JS, PITTS NB: The caries experience of 5-year-old children in Scotland in 2013-14, and in England and Wales in 2014-15. Reports of cross-sectional dental survey using BASCD criteria. Comm Dent Health 2017; 34: 157-162.

JÜRGENSEN N, PETERSEN PE: Promoting oral health of children through schools - Results from a WHO global survey 2012. Comm Dent Health 2013; 30: 204-219.

KWAN S, PETERSEN PE: Oral health: equity and social determinants (pp159-176). In: Blas E, Kurup AS. Equity, social determinants and public health programmes. Geneva: World Health Organization, 2010.

KÜNZEL W.: Trends in coronal caries prevalence in Eastern Europe: Poland, Hungary, Czech Republic, Slovak Republic, Romania, Bulgaria and the former States of the USSR. Int Dent J 1996; 46: 204-210.

KÜNZEL W: A caries epidemiológiájának változásai és iránya Európában. Fogorv Szle 2001; 2:47-52.

LAGERWEIJ MD, VAN LOVEREN C: Declining caries trends: Are we satisfied? Curr Oral Health Rep 2015; 2: 212-217. https://doi.org/10.1007/s40496-015-0064-9

LESIC S, DUKIC W, KRISTE ZS, TOMICIC V, KADIC S: Caries prevalence among schoolchildren in urban and rural Croatia. Cent Eur J Public Health 2019; 27:256-262. https://doi.org/10.21101/cejph.a5314

MARTHALER TM: The prevalence of Dental Caries in Europe 1990-1995. Caries Res 1996; 30: 237-255. https://doi.org/10.1159/000262332

MARTHALER TM: Changes in dental caries 1953-2003. Caries Res 2004; 38: 173-181. https://doi.org/10.1159/000077752

OTTOLENGHI L, MULLER-BOLLA M, STROHMENGER L, BOURGEOIS D: Oral Health Indicators for Children and Adolescents. European perspectives. Eur J Paediatr Dent. 2007; 4:205-210.

PATEL R: The State of Oral Health in Europe. Report Commissioned by the Platform for Better Oral Health in Europe. Brussels, 2012.

PETERSEN PE, TORRES AM: Preventive oral health care and health promotion provided for children and adolescents by the Municipal dental Health Service in Denmark. Int J Paediatr Dent. 1999; 9:81-91. https://doi.org/10.1046/j.1365-263x.1999.00111.x

PETERSEN PE: Changing oral health profiles of children in Central and Eastern Europe. - Challenges for the 21st century. 2003. http://www.who.int/media/orh-_eastern_europe

PETERSEN PE, BAEZ RJ: Oral Health Surveys. Basic Methods. 2013. 5th Edition. Geneva. World Health Organization.

PETERSEN PE, LEOUS P: The burden of oral disease and risks to oral health at global and regional levels. Medicina Stomatologica 2017; 42: 7-13.

PETERSEN PE, DAVIDSEN M, JENSEN HREKHOLM O, CHRISTENSEN AI: Trends in dentate status and preventive dental visits of the adult population in Denmark over 30 years (1987-2017). Eur J Oral Sci. 2021;00:e12809 https://doi.org/10.1111/eos.12809

PIEPER K, SCHULTE AG: The decline in dental caries among 12-year-old children in Germany between 1994 and 2000. Comm Dent Health 2004; 21: 199-206.

PIEPER K, LANGE J, JABLONSKI-MOMENI A and SCHULTE AG: Caries prevalence in 12-year-old children from Germany: Results of the 2009 national survey. Comm Dent Health 2013; 30:138-142.

SCHULTE AG, MOMENI A, PIEPER K: Caries prevalence in 12-year-old children from Germany. Results of the 2004 national survey. Comm Dent Health 2006; 23:197-202.

Significant Caries Index. SIC. Data for some Selected Countries. 2009. http://www.whocollab.od.mah.se/sicdata.html

SMITH D: Are we going backwards with prevention? J Can Dent Assoc 2007; 73: 555.

SPLIETH CH, SANTAMARIA RM, BASNER R, SCHÜLER E, SCHMOECKEL J: 40-Year Longitudinal Caries Development in German Adolescents in the Light of New Caries Measures. Caries Res 2019; 53:609-616. https://doi.org/10.1159/000501263

SZŐKE J, PETERSEN PE: A gyermekpopuláció orális egészsége. Hazai helyzetkép a WHO Orális Adatbank számára 1996-ban végzett epidemiológiai vizsgálatok alapján. Fogorv Szle 1998; 91: 305-314.

SZÖKE J, PETERSEN PE. Evidence for dental caries decline in children in an East-European country (Hungary). Comm Dent Oral Epidemiol 2000; 28: 155-60. https://doi.org/10.1034/j.1600-0528.2000.028002155.x

SZŐKE J, PETERSEN PE: Changing Levels of Dental Caries over 30 Years among Children in a Country of Central and Eastern Europe. The Case of Hungary. Oral Health Prev Dent 2020; 18: 177-184.

TÓTH K: A fogszuvasodás megelőzésének korszerű módszerei. Fogorv Szle 1982; 75: 161-169.

TOUMBA KJ, TWETMAN S, SPLIETH C, PARNELL C, VAN LOVEREN C, LYGIDAKIS NA: Guidelines on the use of fluoride for caries prevention in children: an updated EAPD policy document. 2019. Eur Arch Paed Dent. 2019; 20:507-516. https://doi.org/10.1007/s40368-019-00464-2

TWETMAN S.: Prevention of Early Childhood Caries (ECC) - Review of literature published 1998-2007. European Archives of Paediatric Dentistry 2008; 9(1): 12-8. https://doi.org/10.1007/BF03321590

VRBIC V, BRBIC M, PETERSEN PE: Epidemiology of Dental Caries and Disease Prevalence among 12-Year-Olds in Slovenia Over Thirty Years (1987-2017). Oral Health Prev Dent. 2020; 18: 185-196.

WANG NJ, KÄLLESTÅL C, PETERSEN PE, ARNADOTTIR IB: Caries preventive services for children and adolescents in Denmark, Iceland, Norway and Sweden: strategies and resource allocation. Community Dent Oral Epidemiol 1998; 26: 263-271. https://doi.org/10.1111/j.1600-0528.1998.tb01960.x

WANG NJ, PETERSEN PE, SVEINSDÓTTIR EG, ARNADÓTTIR IB, KÄLLESTÅL C: Recall intervals and time used for examination and prevention by dentists in child dental care in Denmark, Iceland, Norway, and Sweden in 1996 and 2014. Community Dental Health 2018; 35:52-57.

WIDSTRÖM E, EKMAN A, AANDAHL L, PEDERSEN MM, AGUSTSDOTTIR H, EATON KA: Developments in oral health policy in the Nordic countries since 1990. Oral Health Prev Dent 2005; 3(4):225-35.

WIERZBICKA M, PETERSEN PE, SZATKO F, DYBIZBANSKA E, KALO I: Changing Oral Health Status and oral health behavior of schoolchildren in Poland. Comm. Dent. Health 2002; 19(4), 243-50.

World Health Organization: Oral Health Surveys Basic Methods. Third Edition. Geneva 1987.

World Health Organization Regional Office for Europe. Health 21. The health for all policy framework for the WHO European Region. Copenhagen: WHO. 1999.

World Health Organization Regional Office for Europe. Growing up unequal: gender and socioeconomic differences in young people's health and well-being. Health Behavior in School-Aged Children (HBSC) Study: International Report from the 2013/2014 Survey. Coppenhagen, 2018.

World Health Organization Regional Office for Europe. Preventing Tooth Decay. Fact Sheet. Fluoride and oral health, 2019. http://www.euro.who.int/en/health-topics/disease-prevention/oral-health

World Health Assembly: Resolution on oral health WHA74.5. (31st May 2021)

http://www.mah.se/CAPP/

http://www.child-smile.org.uk

www.fdiworlddental.org. Vision 2030. Delivering Optimal Oral Health for All

Published
2022-12-19
How to Cite
SzőkeJ., & PetersenP. E. (2022). Dental caries prevalence and trends in children - Pathfinder surveys in Hungary over 30 years: Review. Hungarian Journal of Dentistry, 115(4), 190-201. https://doi.org/10.33891/FSZ.114.4.190-201
Section
Original article