Methodological and biological factors explaining the reduction in dental caries in Jamaican school children between 1984 and 1995.

OBJECTIVE To assess the methods used and results found in two surveys, one conducted in 1984 and the other in 1995, that indicated a large reduction in the prevalence and severity of dental caries among children in Jamaica, with special attention focused on methodological differences between the two surveys and the biological factors that may explain the large reduction in caries. METHODS In 1984 a modified "pathfinder" methodology was used to measure the prevalence and severity of dental caries in 6-, 12-, and 15-year-old children in Jamaica. A similar survey was conducted in 1995. A comparison of the two surveys showed an 84% reduction in the severity of dental caries at age 12. Both surveys used the same diagnostic criteria and clinical procedures, but the 1984 survey included a higher proportion of rural residents than did the 1995 one. RESULTS The data show an epidemiological transition between 1984, when dental caries was highly prevalent and severe, and 1995, when the disease was less prevalent and was concentrated in a smaller proportion of the population. CONCLUSIONS Most of the reduction in dental caries between 1984 and 1995 is attributable to the introduction, in 1987, of salt fluoridation. While the 1995 survey included fewer rural areas than the 1984 survey did, that does not invalidate the observed reduction in dental caries. The use of fluoride toothpaste and dietary fluoride supplements as well as access to dental health promotion and preventive and curative services do not seem to be major contributors to the reductions observed.