Effect of a school-based preventive program with salivary lactobacillus counts as sugar-motivating tool on caries increment in adolescents

Abstract

The caries preventive outcome of a school-based program with salivary lactobacillus counts as sugarmotivating tool was evaluated in six cohorts of totally 936 adolescents in a comprehensive school in Sweden. Students from a neighboring district with similar socioeconomic structure but with no corresponding dental health-promoting activities were selected as reference. The program started in the beginning of the 7th grade (13 years) and was terminated at the end of the 9th grade (16 years). Salivary lactobacilli were evaluated semi-annually with a dip-slide method and used for individual counseling. Dental caries was scored from the dental records and bitewing radiographs of each 4th participant at baseline and at 16 and 19 years of age. The number of salivary lactobacilli decreased significantly (P < 0.05) in all cohorts but one during the program. There was no significant difference in the increment of caries (DFS) between the participants from the study and reference schools, either at the end of the program or at 19 years of age. The increment of proximal enamel caries was slightly lower in the study group compared with the reference group (P < 0.05) at the final registration. Considering the time and efforts spent, the results did not seem to justify a school-based intervention with lactobacillus counts as a sugar-motivating tool in an adolescent low-caries population.