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PURPOSE: To determine the prevalence, severity and caries burden among children residing in eastern Trinidad. MATERIALS AND METHODS: This is a cross-sectional study comprising probability, stratified, and proportionate-to-size sampling. Seven hundred and eleven school children aged six, 12 and 15 years were examined between November 1999 and January 2000 by two calibrated dentists using World Health Organization (WHO) assessment criteria. RESULTS: Overall mean DMFT and dft scores were 1.29 +/- 2.3 and 1.78 +/- 3.1 while 30.4% were caries-free. At ages six, 12 and 15 years, mean DMFT scores were 0.08 +/- 0.38; 2.18 +/- 2.49; 2.66 +/- 3.0 while dft scores were 3.74 +/- 3.63; 0.14 +/- 2.65; 0. Significant Caries Indices (SiC) for permanent and primary teeth were 3.75 and 5.28. Children of parents/carers with university education had the lowest DMFT/dft scores (1.0 +/- 2.47/0.83 +/- 1.58), treatment need (23.8%), and comprised the highest proportion of caries-free (76.2%) population. The values for father/male carer were statistically significant (p < 0.005). All four first permanent molars were decayed in 8.76%. First permanent molars were most frequently decayed in 12-year-olds (55.4%) and 15-year-olds (50.0%). Untreated caries and first permanent molar decay among six-year-olds were 84% and 8.3% respectively. Tooth mortality was 0.978 and 0.964 in permanent and primary teeth. The Restorative Indices for permanent and primary teeth were 0.02134 and 0.0213. CONCLUSION: Based on WHO severity criteria for the respective ages, caries experience is low in Eastern Trinidad. The mean DMFT is much lower than recently reported country data for 12-year-olds. However, the incidence is increasing. The SiC suggests that a small proportion of the population accounts for most of the decayed teeth.

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The prevalence, severity, and distribution pattern of early childhood caries (ECC) among Anguillian children aged 24-71 months are described. The results show that teeth and surfaces affected by caries vary by age, suggesting that age and morphological considerations play a role in the etiological models proposed to explain susceptibility.

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The study was conducted to estimate the prevalence and severity of Early Childhood Caries (ECC) in infants aged 2 to 5 years. The teeth of 523 children aged between 24 and 71 months from all 18 primary and pre-schools (census) were assessed by one calibrated examiner (AA) following parental consent. Tooth-surfaced based data were collected for each child using the NIDCR diagnostic and scoring criteria and the WHO codes for teeth with non-cavitated lesions. A 15-item questionnaire on flouride exposure as well as the use of feeding bottles and pacifiers was completed by parents and gaurdians. The overall prevalence of ECC and Severe-ECC was 46 percent and 35 percent, respectively. It decreased with age and did not differ significantly with gender. Early childhood Caries prevalence was determined with and without non-cavitated lesions and by sextant. The mean dmft of infants without non-cavitated lesions was 1.68 (SD= 3.22) of which 1.08 teeth (SD= 2.01) were molars. The mean dmft with non-cavitated lesions was 2.57 (SD= 3.86) of which 60 percent represented untreated decayed teeth. The ECC prevalence was highest in the molar (32.5 percent) followed by upper (17.4 percent) and lower anterior (4.4 percent) sextants, respectively. A slightly higher proportion of children with ECC (55 percent) did not have non-cavitated lesions while 51 percent had non-cavitated lesions based on the affected molars. The highest site-specific prevalance (53.43 percent) occurred in the molar teeth of children aged 60 to 71 months. Children aged 48 to 59 months and the highest site-specific caries prevalence in the upper and lower anterior sextants (34.84 percent and 10.83 percent) for those with and without non-cavitated lesions. This is the first ever population-based study using the NIDCR criteria developed in 1998. The prevalence and severity of ECC in Anguilla is high. A high proportion of children had maxillary anteriors and molars as the only affected teeth. Oral health promotion programmes should be extended to preschools. Flouride exposure in 2 to 5-year-old children should be augmented in order to reduce the high prevalence of ECC. (AU)

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Initial results from 11 of the 18 countries involved in an ongoing regional study are presented. The levels of flouride in various water sources in the Caribbean were hitherto unknown. This study provides the first comprehensive documentation of the regional distribution of natural flouride levels in water by spatial location, source and approximate population coverage. The aim is to discuss the public health implications as well as the significance in caries-prevention. A total of 594 water samples were collected from 9 different sources in 11 countries during the dry and wet seasons using a standard protocol. Flouride levels were determined using the ion-selective electrode. Duplicate analysis was conducted on 25 percent randomly selected samples in each batch. Detectable levels were classified in mg/ based on a five-point ordinal scale as flouride-free (< 0.1); low (>0.1-0.3); sub-optimal (0.3-0.6); optimal (> 0.6-0.7); and high (> 0.7), respectively. Flouride levels ranged from 0.01 to 2.9 mg/l. Most samples (61.3 percent) were flouride-free while 16.2 percent and 9.64 percent contained optimal and high levels, respectively. Areas with levels above 0.7 mg/l were recorded in 7 countries while trace amounts of flouride were recorded for all samples obtained from Cayman Islands, Monsterrat and St. Vincent. The significant variations in flouride levels recorded in samples obtained from the same location underscore the need for routine flouride analysis, especially in areas with high levels. Natural flouride levels in regional water sources are generally below the optimal required for maximum caries reduction with minimal prevalence of enamel flourosis in tropical environments. Localized deflouridation of water supplies should be considered in areas with flouride levels in excess of 2 mg/l if a high prevalence of moderate and severe enamel flourosis is detected among residents. Given the current water sources, supply and distribution systems and respective populations served, the findings of this study indicate that water flouridation is not a feasible or cost-effective option for caries prevention in the region. Further research on the availability of non-dairy flouride sources is required. (AU)

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The study was conducted to determine the oral health status of children with HIV/AIDS and to develop a model for appropriate, effective and cost-effective prevention-oriented intervention based on the findings. Outcome measures included caries experience, caries prevalence, periodontal health, oral lesions, oral hygiene, human resource requirements and cost of care. The teeth of 30 children aged 7 months to 15 years were examined using the National Institute for Dental and Craniofacial Research criteria for Early Childhood Caries and the Modified WHO criteria for caries status. Periodontal health was assessed using the Periodontal Screening Record (12 to 15-year-olds) and oral hygiene was evaluated, based on the presence or absence of plague and/or calculus. About 34.48 percent of children required treatment, including one child with gross oral neglect. The mean DMFT and dmft were 1.10 and 2.37, respectively, indicating higher severity in the primary teeth. While 55.17 percent of all the children were caries free, a higher proportion of children aged 2-5 years were caries free (68.42 percent) compared with children aged six to 15 years (40.0 percent). Although 83.77 percent of all the teeth were sound, all the decayed teeth were untreated, indicating a virtually non-existent utilization of dental services. There were no restored teeth but 21.86 percent of all teeth were either decayed or missing due to caries. Of the decayed teeth, 29.7 percent were permanent while the primary teeth accounted for 68.3 percent. Restoration was required in 66.7 percent of the decayed teeth while 33.3 percent needed to be removed and 70 percent of all children requiring treatment accounted for all the extractions (33.34 percent of all teeth). The caries and oral hygiene status as well as periodontal health of the children were better than that reported for 6, 9, 12 and 15 year-old children in the general population (DMFT 4.9 and 14 percent caries-free at age 12 years). Although both caries prevalence and severity are low, base on the WHO criteria, a small proportion of children (34.48 percent) accounted for a high burden of disease. The findings indicate that it is possible to maintain good oral hygiene, periodontal health and low caries status in children with HIV/AIDS provided their oral health is routinely monitored. (AU)

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