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Objectives: To report on the dental caries experience in schoolchildren from a region with a needs-based dental service compared with a region with a demand-led dental service., Design: Cross-sectional study with clustered sampling., Setting: Urban primary schools in Dublin (Ireland) and Freiburg (Germany)., Participants: 12-year-old schoolchildren., Method: A trained and calibrated dentist examined a representative, random sample of schoolchildren under the same standardised conditions. Social class was recorded using the 'Goldthorpe-Social-Class-Schema'. Dental caries was recorded using WHO criteria., Results: Atotal of 567 schoolchildren were examined, 332 in Ireland and 249 in Germany. For Ireland the mean DMFT in SC-1 (highest social class) was 0.28, in SC-2 (middle social class) it was 1.1 and in SC-3 (lowest social class) it was 0.94. For Germany the mean DMFT in SC-1 was 0.31, in SC-2 it was 0.61 and in SC-3 it was 1.33., Conclusions: This study demonstrated the existence of social gradients in dental caries levels in both samples but the magnitude of the difference varied across the two populations and appeared to be smaller in the needs-based dental service.

Objectives: To compare dental caries levels of schoolchildren stratified in different social classes whose domestic water supply had been fluoridated since birth (Dublin) with those living in an area where fluoridated salt was available (Freiburg)., Methods: A representative, random sample of twelve-year-old children was examined and dental caries was recorded using World Health Organization criteria., Results: A total of 699 twelve-year-old children were examined, 377 were children in Dublin and 322 in Freiburg. In Dublin the mean decayed, missing, and filled permanent teeth (DMFT) was 0.80 and in Freiburg it was 0.69. An examination of the distribution of the DMFT score revealed that its distribution is highly positively skewed. For this reason this study provides summary analyses based on medians and inter-quartile range and nonparametric rank sum tests. In both cities caries levels of children in social class 1 (highest) were considerably lower when compared with the other social classes regardless of the fluoride intervention model used. The caries levels showed a reduced disparity between children in social class 2 (medium) and 3 (lowest) in Dublin compared with those in social class 2 and 3 in Freiburg., Conclusions: The evidence from this study confirmed that water fluoridation has reduced the gap in dental caries experience between medium and lower social classes in Dublin compared with the greater difference in caries experience between the equivalent social classes in Freiburg. The results from this study established the important role of salt fluoridation where water fluoridation is not feasible.

Aim: To compare prevalence of dental fluorosis (DF) in permanent teeth in children whose domestic water supply was fluoridated since birth with that in a community where fluoridated salt was available. A second aim was to analyse the relationship between DF prevalence and reported use of fluoride toothpaste in early childhood., Study Design: Cross-sectional study., Methods: A representative, random sample of 12-year-old children was examined in water fluoridated Dublin (Ireland) and non-water fluoridated Freiburg (Germany), where fluoridated salt was available. DF was recorded using the Dean's Index. The child's early experience of toothpaste use was recorded using a questionnaire., Results: 377 children in Dublin and 322 children in Freiburg were examined. In Dublin 11.7% of the whole sample had a 'Questionable' level of DF, 9.8% had 'Very Mild', 3.7% had 'Mild' and 0.3% had 'Moderate' fluorosis. The corresponding percentages in Freiburg for all children were 10.9%, 4.0%, 3.4% and 0%. The results suggest that children in Dublin started brushing their teeth at an older age than in Freiburg, but no difference in DF levels was found between 'early' and 'late' users., Statistics: Fisher's test revealed that the difference in DF levels between the two populations was statistically significant (p=0.03)., Conclusions: The prevalence of aesthetically important DF ('Mild' and 'Moderate') was low and similar in both communities and considerably lower than the expected level at water fluoridation concentrations of 1 ppm. However, the prevalence of 'Very Mild' fluorosis was twice as frequent in Dublin than in Freiburg.