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Risk factors of early childhood caries were studied on 406 children of 12-47 months age. The results showed that pathological pregnancy, sleeping with bottle of blend or sweet liquid, use of candy and caramel on sticks and sour-sweet fruit juices were significant factors leading to early childhood caries. During simultaneous action of all these risk factors domination belonged to use of sour-sweet fruit juices. The probability of caries occurrence at simultaneous action of all these risk factors was equal to 62%.

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In transversal epidemiologic study of 960 children of the age 7-14 years dynamics of occlusal caries in permanent molars depending on the occlusal morphology was established. The diagnostic scale of Espelid et al. was used to diagnose occlusal caries and the classification of Hirano and Aoba was used in the analysis of occlusal morphology. The results of the study showed that with age the share of occlusal surfaces of caries is increasing, the share of deep fissures is decreasing and the share of shallow fissures in first and second permanent molars remains unchanged. Occlusal morphology should be taken into consideration when elaborating a strategy for prevention of occlusal caries in children.

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The purpose of this survey is to establish the effectiveness of the treatment of early childhood caries using compomers. The target group consists of 28 children aged from 20 to 47 months and presenting "early childhood caries". The team has done 126 fillings of vital frontal and distal teeth (61 of frontal and 65 of distal teeth) using the Glasiosite compomer by Voco. Fillings are evaluated immediately after polishing and after six after twelve months. Evaluation is achieved according to the Ryge classification scale, which reflects the type, the clinical status and the development of the filling. The information is processed through alternative analysis at importance level p<0.05. Our survey shows that most of the fillings can be classified as perfect. The remaining fillings made within the period of the survey are classified as satisfactory and do not need to be replaced. No unsatisfactory filling was found. Based on the features of the above compomers and the results of our survey we recommend them for filling of vital teeth of up to three-year old children.

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AIM: The purpose of this study was to follow up the changes of the level of demineralization and the area of white spots during treatment with 0.42% fluoride gel. METHODS: 182 white spots in 27 children (aged 7 to 16) were followed. Two groups were formed - a control group (70 spots) and an experimental group (112 spots). The level of demineralization was assessed by a colour test using 2% methylene blue. Area changes were measured in square millimetres. The initial area was taken to represent 100%. Four applications at 1-week intervals were made. Changes were assessed at the end of months 1, 2, 6, and 12. RESULTS: The colour test showed a decrease in the respective values during the study. The decrease was greater in the experimental group reaching statistically significant difference after the 1st month. There was a slight decrease in the average area of the spots in the control group. At the end of the study the area was reduced to 92.01% of the initial area. The average area in the experimental group at the end of the study was 28.16% of that at baseline. CONCLUSION: These results show the high efficaciousness of the treatment of incipient caries with 0.42% fluoride gel.

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AIM: The study aims at following up the dynamics of caries activity (As) and caries reduction (Rs) of first permanent molars (M1) in group prophylaxis with 0.42% fluoride gel in groups with relatively low caries risk. METHODS: A three-year-long study on 213 7-year olds from Plovdiv was carried out. Children were assigned to two groups - an experimental group and a control group. The children in both groups had no clinical caries on M1 (DMFS = 0) and dft < the means for seven-year olds in Plovdiv. The screening procedure excluded children who were undergoing orthodontic treatment. Eight applications of 0.42% fluoride gel each at 3-month intervals were made in the experimental group. RESULTS: In the first two years caries activity was significantly higher in the control group. In the third year, after discontinuing gel application caries activity in the experimental group slightly increased while that in the control group decreased. No statistically significant differences were found. Caries reduction was highest in the first year (73.12%) with slight decline in the 2nd year (71.12%). In the 3rd year caries reduction was only 17.07%. Despite this, Rs of M1 as measured for the whole period at the end of the 3rd year was 61.93%. CONCLUSION: The first permanent molars are susceptible to caries attack even in groups with relatively low caries risk. The results of this study demonstrate the high effectiveness of prophylaxis using fluoride gel.

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AIM: The purpose of the present study was to examine the opinion of dentists from Plovdiv about the problems connected with treating caries of children one to three years of age. METHODS: The study included 129 dentists from Plovdiv. It was carried out by a direct group inquiry. A special questionnaire was prepared. The data obtained were analysed by non-parametrical and graphical analysis. RESULTS: The results showed that 49.60% of the inquired dentists did not treat one- to three-year-old children. 21.70% of them referred to psychological problems among children as a preventive reason; 14.00% - lack of suitable methods; 10.00% felt they were not well-trained in this field and 19.40% answered that they did not take pleasure in working with this group of patients. The greatest difficulties in treating children were met by the dentists general practitioners and those without specialty. CONCLUSION: The results of this study prove the necessity of additional qualification for the general practising dentists together with the development of methods for dental caries treatment that are easy to use in early childhood.

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INTRODUCTION: The peculiarities of early childhood require specific approaches to dental caries treatment. The necessity of discussing this problem has justified the undertaking of this study. AIM: The aim was to determine caries incidence rate and the need for its treatment in children aged 12 to 47 months. MATERIAL AND METHODS: The study included 370 children from Plovdiv. It was conducted in accordance with the World Health Organization requirements for epidemiological study of dental caries. Three age groups were formed: group I (12-23 months), group II (24-35 months), and group III (36-47 months). Dental caries on a cavitation level was diagnosed by means of a probe and a mirror. The indicators of caries incidence--total and separately by active and treated caries, as well as the percentage of surfaces with active caries were determined. RESULTS: Caries incidence rate in group I was 0.54, in group II--1.45 and in group III--1.85. A rapid increase of these values was observed between I and II group--P < 0.001. In all age groups the active caries incidence, as well as the percentage of surfaces with active caries were considerably higher than that of treated caries incidence, P < 0.001. CONCLUSIONS: In the studied populations dental caries is treated only in a very small number of cases. Further studies are necessary for determining the causes for this--causes attributable to the parents, as well to the practising dentists.

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INTRODUCTION: Knowledge of the caries-affected teeth and dental surfaces at a specific age can be of great importance for the effective prevention and treatment of dental caries. AIM: The purpose of the study was to determine caries incidence by tooth types and tooth surfaces, totally and separately by jaws in children from 12 to 47 months of age. MATERIAL AND METHODS: The study was representative and was conducted in accordance with the World Health Organization requirements for epidemiological study of dental caries. It comprised 370 children from 12 to 47 months of age, selected by a random sampling method. Three age groups were formed: group I (12-23 months), group II (24-35 months), and group III (36-47 months). Dental caries on a cavitation level was diagnosed by means of a probe and a mirror. RESULTS: In children from groups I and II the highest caries incidence rate was found to be on the vestibular surfaces of the central and lateral incisors of the upper jaw, followed by the caries on the occlusal surfaces of the molars of both jaws. In group III this trend changed--the highest caries incidence level was observed in the molars of the lower jaw, followed by the incisors of the upper jaw. CONCLUSION: The study results enhance the knowledge of early childhood caries. The data can be used to design preventive programs and develop methods for caries treatment targeting children of these age groups.

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INTRODUCTION: The polarization of dental caries is a notion defined as a small percentage of persons with high dental caries rate and a large percentage of caries-free persons. This phenomenon has not been studied sufficiently in children aged 12 to 47 months which has justified the undertaking of this study. AIM: To determine the percentages of persons with different levels of caries incidence and the percentages of their carious and filled teeth (dft) of the total number of dft in the respective age group. MATERIAL AND METHODS: The study is representative and was conducted in accordance with the World Health Organization requirements for epidemiological study of dental caries. It comprises 370 children from 12 to 47 months of age selected by a random sampling method. Three age groups were formed: group I (12-23 months), group II (24-35 months) and group III (36-47 months). Dental caries on a cavitation level was diagnosed by means of a probe and a mirror. In all groups we further divided the subjects into subgroups of different level of dft (carious and filled teeth): subgroup I--dft = 0 (caries free), subgroup II--dft = 1, subgroup III--dft = 2 and subgroup IV--dft > or = 3. RESULTS: Marked dental caries polarization is observed in all studied age groups--a large percentage of persons free of caries and a small percentage of persons with high dental caries rate--P < 0.001. In one-year-old children 8.33% are carriers of 63.08% of the total dft in that age group, in two-year-old children 18.33% are carriers of 81.50% of the total dft in that age group, and in three-year-old children 25.38% are carriers of 74.58% of the total dft of that age group. CONCLUSION: This study support the assertion that early childhood caries affects predominantly high-risk individuals, which requires differentiated approach to caries prevention and treatment.

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INTRODUCTION: The investigations of in vitro models precede the clinical studies. Using these studied we can investigate the effect upon the enamel of different agents for local application. AIM: The purpose of this study was to investigate the ultrastructural changes in a normal and partially demineralized enamel after 0.42% fluoride gel application in vitro using scanning electron microscopy. MATERIAL AND METHODS: The experiment was performed on 20 premolars extracted for orthodontic indications. Symmetrical specimens were prepared, as one half served as a control, while the other one was treated with fluoride gel. The specimens were examined with electron microscope at different magnifications. RESULTS: The findings show that fluoride gel applications affect the processes of mineralization and remineralization. CONCLUSIONS: This gives us the ground for applying fluoride gel in the clinical practice for prevention and treatment of caries incipiens.

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AIM: The purpose of the present study was to establish caries incipiens prevalence of the permanent teeth by dental surfaces (Is). Caries incipiens is examined totally and separately by macula cariosa alba and macula cariosa fusca by jaws and regions. MATERIAL AND METHODS: The sample is random and comprises 600 children of 7, 12 and 14 years of age. Caries incipiens is diagnosed visually-tactile by means of a probe and mirror. The data is analyzed statistically with Excel 7.0. Statistical significance was defined as 0.05, two-tailed. RESULTS: Caries incipiens prevalence is highest at 7 years and does not change considerably with increase of age. In all age groups macula cariosa fusca prevalence is higher than that of macula cariosa alba (P < 0.001). The highest prevalence of macula cariosa fusca is found occlusally in all age groups in both jaws. Overall compared to the upper jaw prevalence rates in the lower jaw are higher. CONCLUSION: The obtained results are of importance in designing and applying preventive programs.

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INTRODUCTION: The necessity of refreshing the data determines the purpose of the present study--to study the incidence and prevalence of dental caries in 1997 and to compare the results with the results of previous studies. METHODS: The study of dental caries is clinico-statistical and comprises 200 12-year-old children from Plovdiv. The sample selection is random. The diagnosis of dental caries is visual-tactile. The incidence (DMFT) and prevalence of dental caries is determined by person (Ep). The results are compared with the results of studies of children of the same age group carried out in 1981, 1989, 1992. RESULTS: The incidence of caries in 12-year old children from Plovdiv is 3.03 and the prevalence rate by persons is 80.0%. Comparing the results with previous studies shows a trend of steadily decreasing values with 1992 exhibiting the lowest levels of these indicators. A trend of increasing DMFT and Ep between 1992 and 1997 is observed. CONCLUSIONS: The trends of incidence and Ep in 12-year old children in Plovdiv show the favorable effect of the preventive programs till 1992 and the necessity of undertaking urgent measures for overcoming the unfavorable trends set in the last years.

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The transition of active ingredients from the prophylactic agents into the saliva leads to an increase of its mineralizing potential. The aim of the present study was to measure the quantity of phosphor in the saliva after application of a gel containing both fluoride and phosphate ions. The quantity of phosphor is measured photometrically according to the Chen method. Results show a sharp increase in the quantity of phosphor in the saliva after application. It gradually decreases with time and after 2 hours it reaches the initial level.

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INTRODUCTION: As a result of the anticaries prevention programs the percentage of persons with high level of DMFT decreases and the percentage of persons free of caries increases. This demands the formulation of a new approach in determining the strategies and priorities of the preventive programs and the amount of the needed dental services. MATERIAL AND METHODS: A clinico-statistical study of dental caries comprising 600 children of 7, 12 and 14 years of age (300 boys and 300 girls) from Plovdiv was carried out in 1997. The diagnosis of dental caries was visual-tactile. In every age group the percentages of persons with different levels of DMFT were determined. The findings were compared with the results gathered in 1992. RESULTS: It was found that with age the percentage of persons free of caries decreased and the percentage of the persons with high level of DMFT increased. In 1992 15.07% of 12-year-old children were carriers of 59.26% of the total number of DMFT, while in 1997 10.00% were carriers of 25.75% of the total number DMFT. CONCLUSIONS: The most pronounced polarization of dental caries was found in the 7-year-old children group. In Plovdiv the polarization of dental caries in the 12-year-old children group was less pronounced in 1997 than in 1992.

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INTRODUCTION: The decline in dental caries prevalence in many countries of the world in the last decades requires the adoption of new approaches towards determination of prevention strategies. The individuals and groups at high risk of developing caries should be differentiated from the rest of the population with the aim of carrying out selective prevention. Of particular interest is the determination of the risk of developing caries before it is clinically manifested as this would allow execution of a timely and adequate prevention. The aim of the present study was to determine the prevalence of caries incipiens on the teeth and on the dental surfaces in 7-, 12- and 14-year-old children and to compare it with the prevalence of clinical caries in the same population groups. METHODS: The study is representative by design and compares 600 children aged 7, 12 and 14 years from Plovdiv. The study is designed and carried out in compliance with the guidelines of WHO for conducting clinico-statistical study of dental caries. The diagnostic procedure of caries incipiens is visual-tactile. The test of vital staining with 2% water solution of Methylene Blau was also used. RESULTS: Caries incipiens prevalence was found to be higher than that of clinical caries in 7-year-old children (P < 0.001). In 12- and 14-year-old children the ratio of caries incipiens to clinical caries shifts in favour of clinical caries (P < 0.001). CONCLUSIONS: The higher prevalence of caries incipiens compared to clinical caries in 7-year-old children (P < 0.001) justifies its more extensive investigation as a predictive factor for developing caries in the 7-12 years age range groups.

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INTRODUCTION: The first permanent molars (M1) are especially sensitive to caries attack immediately after eruption. The questions concerning the effect of preventive methods during this period in groups at low risk of caries are insufficiently studied. The aim of the study was to examine the effect of caries prevention of M1 in the first year after eruption by means of fluoride gel in groups with low risk of caries. METHODS: A clinical study including 213 seven-year-old children from Plovdiv was conducted in the course of one year. The children were assigned to two groups--experimental and control. In both groups children without clinical caries on M1 were included. The sampling procedure excluded subjects with multiple and diffuse obturations of the deciduous teeth, inadequate oral hygiene or undergoing orthodontics treatment. In the experimental groups four applications with 0.42% fluoride gel were performed at three months intervals. RESULTS: At the end of the study period the prevalence rate of caries on teeth and on dental surfaces was higher in the control group (P < 0.001). Caries reduction in the experimental group was 73.81% on the teeth and 73.12% on the dental surfaces. CONCLUSIONS: The results of our study show that immediately after eruption the first permanent molars are susceptible to caries in individuals at low risk of caries. This necessitates prevention activity during this period irrespective of the presumed risk. The fluoride gel applied by the author shows high anticaries activity on M1 in the first year after the eruption.

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The incidence of dental caries /Is/ on deciduous molars in 1216 children aged 3 to 8 from Plovdiv has been studied. The results showed highest Is in the fissures of m1 and m2 and lowest Is on the smooth surfaces. The incidence of dental caries is getting higher with statistically significant differences in the lower jaw up to the 6th year and in the upper jaw up to 7th year of age. Is in the lower jaw is higher than that of the upper jaw only in the fissures.

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An assessment of the oral hygiene and periodontal health was made in 1596 school children (777 boys and 819 girls) aged 7-14 years from randomly selected classes and schools in Plovdiv, Bulgaria. The oral hygiene status of the school children assessed by the plaque indexes (PLI) of J. Greene and J. Vermillion, and that of J. Silness and H. Löe was found to be rather poor. The relative share of subjects with plaque index of 0.00 to 1.00 was found to increase with age for both sexes. The relative share of children with chronic catarrhal gingivitis was 42.61 +/- 2.34 indicating the necessity of active prophylaxis and treatment of the disease. A tendency was observed towards an increase of the disease incidence in comparison with data obtained in a 1983 study. A correlation between the hygiene status and chronic gingival inflammation in 14-year-old school children was found.

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