A Study on the Effects of Diagnostic Criteria in Oral Examination on the Prevalence Indices of Dental Caries for School Children and Pupils

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  • 学童,生徒のう蝕有病状況指数に対する診査基準の影響に関する研究
  • ガクドウ セイトノウ ショクユウビョウ ジョウキョウ シスウ ニ タイスル シンサキジュン ノ エイキョウ ニ カンスル ケンキュウ

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Abstract

The present study was conducted in order to evaluate differences in the prevalence of dental caries using different criteria. In annual health check-ups for school children at two primary schools, a junior high school and a senior high school, dental examinations were provided using criteria of the British Association of the Study for Community Dentistry (BASCD criteria) as well as criteria of the Japanese Association of School Dentists (JASD criteria). At primary schools, the number of teeth rated as "Untreated" among the 7,606 teeth examined was 159 according to the JASD criteria and 17 according to the BASCD criteria. Thus, the number of teeth rated as "Untreated" by the JASD criteria was 9 times more than the number rated by the BASCD criteria. At the junior and senior high schools, the number of teeth rated as "Untreated" by the JASD criteria was approximately 3 times and twice more, respectively, than the number rated by the BASCD criteria. It could be assumed, in primary schools, that many of the teeth rated as dental caries by the JASD criteria were in the early stage of decay limited only within enamel, which would be rated as intact teeth by the BASCD criteria, or arrested dentin caries, also rated as intact teeth by the BASCD criteria. Among the teeth rated as 'Intact' by the BASCD criteria and 'Untreated' by the JASD criteria, 31.6% of the primary school children and 14.3% of the junior high school pupils were rated as 'Untreated' by BASCD in the examination performed the following year. This suggests that, compared to using the BASCD criteria, clinical caries examinations using the JASD criteria tended to result in a more frequent prevalence of decayed teeth rated as 'Treatment needed', leading to the early detection of more children with a high risk of dental caries. The results of this study, as a whole, show that assessments made during dental examinations of school children vary widely depending on the diagnostic criteria used, and suggest some challenges for oral health services as follows: (1) To establish continuing care to provide observation and guidance for children with a high risk of dental caries, especially in primary schools; (2) To strengthen the role of family practitioners to provide observation and preventive care; (3) To discuss the revision of diagnostic criteria for dental examination and improve the remuneration system for dental care.

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