Occurrence of plaque, gingivitis and caries as related to self reported frequency of toothbrushing in fluoride areas in Finland JUKKA AINAMO AND ICAARINA PARVIAINEN
Department oj Periodontology, Institute oj Dentistry, University oj Hehinki, Hetsinki, Finland Ainamo, J. & Parviainen, K.: Occurrence of plaque, gingivitis and caries as related to self reported frequency of toothbrushing in fluoride areas in Finland. Community Dent. Oral Epidemiol. 1979: 7: 142-146. Abstract - Toothbrushing is generally recommended as one of the main means of preventing dental caries and periodontal problems. The present study was an attempt to evaluate the validity of such a claim. In three Finnish towns with low (0.2 part/lO"), optimal (1.0 part/106) and high (2.5 parts/lO") fluoride content in their drinking water, about 40 ' schoolchildren were examined in each age group of 13, 14 and 15 years. A total of 365 children were first interviewed about their oral health habits, including frequency of toothbrushing.Their teeth were then scored for visible plaque (VPI),gingival bleeding (GBI) and past caries experience (DFS). The total mean scores for the children were VPI = 43 %, GBI = 40 %, and DFS = 14.5. Girls were found to brush more often than boys. About 50 % of the girls and only 10 % of the boys reported brushing their teeth more often than once daily. Among the girls the frequency of toothbrushing significantly increased from age 13 to 15. In all groups high frequencies of toothbrushing were associated with low VPI and GBI scores. No correlation was found between the frequency of toothbrushing and the DFS scores of the children. This lack of correlation persisted also after the total material was grouped according to sex, age, and fluoride content of drinking water. The results indicate that uncontrolled toothbrushing helps to prevent periodontal disorders but has no measureable effect on dental caries. o Key words: dental caries; epidemiology, oral; fluorides; gingivitis; preventive dentistry; toothbrushing. J. Ainamo, Institute of Dentistry, 24 Fabianinkatu, 00100 Helsinki 10, Finland. Accepted for publication 12 December 1978.
Toothbrushing is recommended both in official dental health education material and by many dentists as one of the main means for preventing gingivitis and dental caries. The results of numerous clinical and community trials confirm the claim that frequent toothbrushing results in lowered plaque and gingivitis scores (1,7-12,14,16,18, 21), whereas the value of uncontrolled toothbrushing in the prevention of dental caries has been questioned (2, 5, 9, 13). 0301-5661/79/030142-05 $02.50/0
In a recent report on the oral conditions of 13-, 14- and 15-year-old schoolchildren in three Finnish towns with low, optimal and high fluoride content in their drinking water, the DFS scores were found to decrease significantly with increasing fluoride content of the water supplies (15). No difference between the three towns was found with regard to visible plaque (VPI) scores, and the gingival bleeding scores (GBI) were found to be highest in the high fluoride area.
1979 Munksgaard, Copenhagen
Gingivitis, caries and toothbrushing 143 VPI 100
50 40 30 20 10 B
1 Fig. 1. Frequency of daily toothbrushing among 365 Finnish girls and boys aged 13, 14 and 15 years.
The present study was an attempt to evaluate the plaque, gingivitis and DFS scores of the same children (15) in relation to their reported frequency of daily uncontrolled brushing of their teeth.
STUDY GROUPS AND METHODS In three Finnish towns about 40 schoolchildren from each age group of 13, 14 and 15 years were chosen for the study (15). The towns and the fluoride contents of their water supplies were as follows: Jyvaskyla, about 0.2 part/lO";
Fig. 3. Reduction of visible plaque index (VPI) scores with increasing frequency of daily toothbrushing among 365 Finnish schoolchildren. Different letters indicate statistically significant differences (P