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Dentists' decisions on caries risk and preventive treatment by dental state among 15-year-old adolescents.

OBJECTIVE
To evaluate dentists' decisions on caries risk and preventive treatment in relation to their clinical findings among 15-year-old children.


DESIGN
Two groups of children were selected on the basis of subjects' number of decayed teeth. Data were also used from personal oral health records.


PARTICIPANTS
15-year-old children (n = 132) clinically checked and treated in public dental clinics in Helsinki. The high-risk group (n = 100) had the greatest numbers of decayed teeth (DT + dt), the low-risk group (n = 32) was cavity-free.


OUTCOME MEASURES
Dental state, treatment decision, preventive and operative treatment recorded by visit, were used for assessment of caries risk and individual needs for caries prevention, and for evaluation of diversity and intensity of preventive treatment given to each patient.


RESULTS
Dentists had judged only 17 per cent of the high-risk patients (mean DT + dt 6.5; range 4-16) as being at high risk of caries. Preventive measures were given only on one out of three visits. One out of two preventive measures was application of fluoride varnish and only one out of ten was dietary counselling. Patients with more decayed surfaces had been given more diversified (P < 0.01) and more intensive (P < 0.005) preventive treatment than had those with none or only a few caries lesions. Despite this, only 4 per cent of the patients with DS = 8-27 had been given four different preventive measures, and one patient out of seven had been left without any caries-preventive intervention.


CONCLUSION
To meet individual needs of high caries-risk patients, the variety and intensity of preventive measures directed towards them need to be further improved.