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Little new evidence on the prevalence of injury to the anterior teeth of children has been reported in the past five years and, in South Africa, trauma to the teeth of children in different ethnic groups has not been compared respectively. The purpose of this investigation was to determine the prevalence of dental trauma using well-defined criteria and to sample a specific age-group. Five regions were chosen and 1035 children in the eleven-year age-group were examined. No statistical significance was found between the ethnic groups related to the amount of injury sustained. For all groups, boys received more injuries than girls. The most common injury was fracture of the enamel of the maxillary central incisor. With 15 percent of the children receiving some level of trauma by age eleven years, this is one of the main dental treatment needs for South African children.

Dental caries prevalence (percentage caries-free) and experience (DMFS) were recorded, in 414 12-yr-old Indian and 401 white children living in adjacent urban communities with the same fluoride concentration in the drinking water (0.21-0.33 ppm) using WHO (11) criteria. Details of social factors: education level, family income, home space and occupants and parental occupation were obtained by questionnaire. Dental caries was significantly worse in the Indian children with regard to numbers caries-free (30%--white and 40%--Indian) and DMFS mean (sd) (3.65 (3.98) and 2.66 (3.49) working group, respectively). Social class, white or blue collar, family income and room to person ratio were significantly associated with dental caries in the white children but there were no significant associations in the Indian children. Multiple regression analysis showed race and sex to be significant factors.

A data base containing information on dental caries, oral hygiene, gingival state, Streptococcus mutans and lactobacillus counts, and salivary flow rate and buffer capacity in some 2800 4-5-yr-old South African children was created in 1984. The children were equally distributed in four groups; rural black, urban black, urban Indian, and urban white. In this study, the data were used for simple linear correlations between all the factors including caries as well as stepwise multiple regression analyses between caries prevalence and the independent factors in each of the four groups. The highest r value obtained in the single correlations was 0.56 for dmfs/lactobacillus count in the white group. The overall pattern of the groups did not vary much. In the stepwise multiple regression analyses, lactobacilli entered first in all groups. S. mutans and oral hygiene interchanged as Nos. 2 and 3, and gingival state or buffer capacity came out as No. 4. The highest percentage of caries variability explained by these regressions was 25%, in the urban black group, while the lowest was 12%, in the indian group. It was concluded that our generally accepted etiologic factors are unsatisfactory to explain variation in caries in observational studies, which among other things might be ascribed to the inadequate way these factors generally are measured or estimated.

A total of 1036 Indian children were examined to determine the mean ages of eruption for the first permanent molars, and the permanent central and lateral incisors. The youngest observed age for the eruption of any permanent tooth was 5.00 years for girls and 4.94 for boys. Mandibular teeth erupted earlier than maxillary teeth and teeth in females erupted between 1 and 6 months earlier than in males. Comparison of the results of the present study to one in South African black children showed that Indian children's teeth erupt some 3.5-7 months later than those of black children, a difference that was statistically significant.

As part of a series of frequent epidemiological field studies to determine caries prevalences in the primary dentition of young South African children, 1436 children of 1-4 yr of age from five ethnic groups were examined. Using WHO diagnostic criteria decayed, missing, and filled surfaces were determined with mirror and probe and caries free, dmfs, dfs, ds, mfs, and dmft scores were calculated. The investigation has shown that urban coloured and Indian children have the highest caries prevalences and urban white children have the lowest. It is suggested that the percentage of caries-free children should be used to set goals for reduction in caries.

Dental caries, debris (DI-S) and sugar intake were determined for 766 rural Black, urban Black, coloured, Indian and White children, using standardized techniques. In general sucrose intake, both quantity and frequency was low in rural Black children yet these children had relatively few caries-free individuals and higher than expected mean dmft scores. Comparison with earlier studies in the same localities has shown a worsening of dental caries in all groups except the White, in which the situation has improved. Sucrose consumption declined in rural Black, and White groups, remained steady in urban Black children and increased in coloured and Indian groups.

Sucrose has been thought to cause dental caries; sweets and snacks being primarily responsible, together with plaque and their respective interactions. Dietary questionnaires revealed that in 3 to 5 yr olds, protein in black, colored, Indian, and white groups provided 12 to 15% of total intake, fats 10 to 17%, and carbohydrates 69 to 78%. At 16 to 17 yr old, patterns remained essentially similar. Sucrose provided about one-quarter of intake, sweets and snacks less than one-tenth, but dental caries prevalence increased rapidly from black to white. This raised several questions regarding current concepts of caries causation. Are genetic, immunological and other dietary factors also responsible for caries levels experienced?

Frequency of intake of sucrose and its total consumption have been implicated as major causative factors in the pathogenesis of dental caries. In the absence of contrary information, it seems that the figure of five sugar exposures per day is a prudent one for the practitioner to recommend to young patients.

Mean daily milk, lactose and energy intakes were measured in groups of South African school pupils of 9-16 years. Recommended dietary allowances (RDA) were not reached by any of the groups. In comparison, groups of Canadian, Nigerian and German schoolchildren of similar ages fell into two categories, namely high milk consumers and low milk consumers. Lactose and energy intakes for high consumers were 77% of the RDA, compared with 30-40% for low consumers. The lactose contribution to daily energy intake for Canadian children was 10.7% and for South African groups about 5%. Thus for South African children lactose contribution to total sugar intake may be half that of Canadian children. Exact proportions need to be defined.