Caries Prevalence and Use of Dental Services in Finnish Children and Adolescents in 2009

Background: Since 1973, in Finland, practically all children and adolescents have been and are treated in the Public Dental Service (PDS). Since 2002, due to decreasing edentulousness, the PDS has been obliged to provide access also for adults and elderly people needing care. Aim: The main aim of this study was to survey the use of dental services and numbers of dental visits among 0-17-year-old Finnish children and adolescents and, specifically, to assess the traditional oral health index scores (percentages of caries-free, mean d/D and dmft/DMFT values) in the index age groups of the 5-, 12-, and 17-year-olds in 2009. Additional aims were to compare caries prevalence between different regions and between densely and sparsely populated areas, and to make comparisons with the situation six years earlier. Methods: The triennial special survey data on the performance of the PDS in 2009 collected by the PDS chief dentists from municipal databases and patient records were analysed. The participating PDS units (health centres) covered 86% of those under the age of 18 years in Finland. Data consisted of numbers of patients, types of dental visits, numbers of examined and caries prevalence (% dmft/DMFT=0, mean d/D and dmft/DMFT) in the index age groups of 5-, 12-, and 17-yearolds in each PDS unit. Chi-square, t-test, ANOVA and Bonferroni’s post hoc tests were used in the analyses. Results: Most children and adolescents (70%) had made dental visits in 2009. Visits were more usual in the older (7-17 years; 76.8%) than the younger group (0-6 years; 55.3%). In comparison with earlier studies, the mean D (0.3) and DMFT values (0.7) in the 12-year-olds had improved considerably. However, the overall proportion of caries-free (26.0%) individuals was lower than in 2003. Similar changes could be seen in the 5and 17-year-olds. A small number of the youngsters still had high mean DMFT values. Conclusions: Annual visits are no longer the standard procedure in children’s and adolescents’ dental care and dental hygienists have taken over most of the work. Oral health was found to be on the same good level as in the neighbouring Nordic countries. In this situation, a needs-based enrolment system and teamwork seem to be justified.