The expanded use of dietary fluoride supplements, school-based fluoride mouth-rinse programs, professional topical fluoride applications, and fluoride toothpastes also has contributed to this reduction.’ For example, over one fourth of the school districts in the United States offer schoolchildren the opportunity to participate in a fluoride mouth-rinse program .
Children ages 5 to 17 are experiencing less caries. In comparing the results of four U.S. surveys it can be noted that the number of caries-free children is increasing and the average number of decayed, missing, and filled tooth surfaces (DMFS [for permanent teeth] or dmfs [for primary teeth]) is decreasing. In the 1971 to 1974 survey, only 26% of the children were caries-free, but by 1988 to 1991, 54.7% were caries-free. Likewise, in 1971 to 1974, children averaged 7.1 DMFS; this decreased
to 2.5 in 1988 to 1991, a 65% reduction.
However, over 45% of the total group ages 5 to 17 did have caries in the latest survey, and the percentage of caries-free children increased with age within the group. Fewer adolescents (12 to 17 years) than children (5 to 11 years) were caries-free (33% to 74%). Thus by age 17, almost three out of every four adolescents have experienced caries. Also, of the 2.5 DMFS for the years 1988 to 1991, almost 80% were filled surfaces, with the remaining 20% primarily being decayed surfaces. The affected DMFS surfaces were: (1) occlusal, 1.4; (2) facial or lingual, 0.8; and (3) mesial and distal, 0.3.
This indicates that occlusal surfaces were five times more likely to be involved than proximal surfaces.This also indicates that sealant usage could be a significant method to further reduce caries in children. Although the percentage of children with sealants almost doubled between the 1986 to 1987 and 1988 to 1991 surveys, only one of five children had sealants at the latter period.