Dental health and need for non-operative treatment among 16-year-olds in Northern Norway

Abstract

Epidemiological data have disclosed a considerable reduction in caries prevalence among children and adolescents in Western countries including Norway for over 40 years. Concomitantly, enamel caries has received increased focus in order to give a better picture of the complete need for dental treatment, non-operative as well as operative. More recently, dental erosive wear seems to be a growing problem among the same age group. The aims of the present thesis were: • to determine the prevalence of dentinal caries and the variation in caries prevalence related to selected independent variables (sociodemography, lifestyle) in a sample of 869 16-year-olds from Northern Norway. • to estimate the prevalence of proximal enamel lesions and the need for non-operative caries treatment. • to record the quality of dental restorations. • to study the prevalence, distribution and severity of dental erosion. The thesis is based on an oral- and general health cross-sectional study (Fit Futures), with an attendance rate of 90%. The DMFT/S-values were 4.2 / 6.1. The final multivariate regression analysis indicated that use of smokeless tobacco, dental fear, self-rated dental health and proximal enamel caries showed a strong independent association with prevalence of dentinal caries. Only 6 % of the 16-year-olds were completely caries-free. Eighty-four per cent of the participants presented with proximal enamel lesions. A majority of them had either previously restored teeth (35%) or both restored teeth and untreated dentinal caries lesions (34%). Over one third (35%) of the participants with fillings presented with at least one restoration below acceptable quality level. More than one third (38%) of the adolescents showed erosive wear on at least one tooth surface, either limited to the enamel (18%), or extending into the dentine (20%). Dental caries and erosive wear are challenging conditions among North Norwegian 16-year-olds. The high prevalence of early signs of disease (proximal enamel lesions and cuppings) entails a need for non-operative treatment interventions. The DMFS-score and the high number of 16-year-olds with restorations in need of repair or replacement further indicate the importance of a non-operative treatment strategy in order to reduce the need of traditional restorative care.