Needs related programs always must be based on riskprediction.
Therefore prevention has to be focused on
"Key Risk" groups, - individuals, - teeth and - surfaces
from cost/effectiveness point of view. A needs - related
preventive program for children and young adults was
introduced in the County of Värmland, Sweden and evaluated
yearly in a computerated epidemiology system.
During the first 20 years, the caries prevalence as well as
incidence was reduced with more than 90%. Already in
the year 2000 85% of the 12-year-olds were caries free
and exhibited as an average only 0.3 DFS.
In a 30 years needs-related study in adults, who were
treated by a dental hygienist, the average number of lost
teeth per subject per 30 years was only 0.4 and 0.7 in the
50-65 and 66-80 year olds. The periodontal attachment
level was maintained during the 30 years irrespective of
age and as an average the 50-80 year olds developed less
than one new DS per 30 years. Based on the experiences
from this ongoing study a needs related preventive program
was introduced for all the adult populatiion and
evaluted every 5 years in randomized samples o f 35-, 50-
, 65- and 75 year olds. During the first 10 years the percentage
of edentulous 50 and 65 year olds was reduced
from 7%and17% to 4% and 7% respectively and the
mean number of remaining teeth (3rd molars excl.) was
encreased from 22.8 to 25.6 in the 65 year olds.