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Biomedical subjects

R A Frew

Publications and source records attributed to R A Frew.

5 recordsLinked to original sources
PubMed1990

Evaluation of a school-based fluoride mouthrinsing and clinic-based sealant program on a non-fluoridated island.

For many years the children of Guam have experienced a high prevalence of dental caries. Surveys conducted on the fluoride-deficient island found that caries levels were double those of US mainland children. In 1976 a school-based fluoride mouthrinse program was initiated involving over 22,000 children in grades kindergarten through eight in weekly rinses with 0.2% neutral NaF. A clinic-based dental pit and fissure sealant program was added in 1984 to the fluoride mouthrinse program. Over 15,000 children participated annually in the sealant program where more than 75,000 teeth were sealed the first year. After 8 yr of fluoride mouthrinsing (1976-1984) mean DMFS scores were 1.79 surfaces per child lower compared to baseline, a decrease of 0.22 DMFS per child per year. During this period proximal DMFS scores decreased 61%, buccal-lingual surfaces 31%, and occlusal surfaces 7%. After 2 yr of fluoride mouthrinsing and sealant application combined overall DMFS scores decreased an additional 2.34 surfaces per child, a reduction of 1.17 DMFS per child per year. Most of this decline took place on pit and fissure surfaces. For the 10-yr period a reduction of 4.13 DMFS per child was seen--a decline from 7.06 DMF at baseline to 2.93 DMF surfaces per child in 1986. This long-term evaluation indicates that dental sealants when used in combination with fluoride mouthrinse were particularly effective in lowering the prevalence of dental caries. Schoolchildren in participating grades on Guam now have dental caries rates close to those of US schoolchildren.

Adolescent↗
PubMed1988

Evaluation of a clinic-based sealant program.

In 1984 a comprehensive sealant program was initiated for Guamanian children in grades one through eight. The goal of the program was to reduce caries rates in children on the fluoride-deficient island to a level at or below US mainland scores. At the initiation of the program, decayed, missing, and filled surfaces (DMFS) scores on Guam were approximately double those for US mainland children under 17 years of age. For the clinic-based preventive program, children in grades one through eight were bussed to one of two public health clinics for preventive services. These services included oral health education, toothbrushing instructions, and sealant application. Baseline and follow-up dental examinations (DMFS) were conducted in 1984 and 1986 on 1,061 and 987 children respectively, in grades one through eight to evaluate program impact. From 1984 to 1986, after the advent of a pit and fissure sealant program where over 15,000 children annually had sealants applied to their teeth, DMFS scores decreased 45 percent. The entire reduction in DMFS scores occurred on pitted and grooved surfaces and the effect reduced the DMFS by 2.4 surfaces/child in two years. The overall participation rate for both the elementary and middle schools was 80 percent and the first annual follow-up showed an overall sealant retention rate of 94 percent.

Adolescent↗
PubMed1986

Sealants: changing patterns.

Although the use of and the attitude toward sealants as a caries-preventive method have improved in the 8-year period between 1974 and 1982, the acceptance still is low, considering the potential value of sealants to patients who are at risk for occlusal caries. More efforts should be directed toward both increasing dentists' and patients' understanding and appreciation of the procedure in preventing caries. It is possible that such a "good sell" has been done with fluorides and oral hygiene that patients do not understand the added value of sealants for the prevention of occlusal caries. Dentists appear to underrate the value of sealants and overrate the value of oral hygiene procedures in the control of caries. Given that some dentists have less-than-positive attitudes toward sealants, it may not be enough to wait for the transmission of knowledge regarding sealants to proceed through the practicing dentist to the patient. Both patient and dentist groups need further appreciation of the value of this procedure if the control of occlusal caries is to be maximized.

Adolescent↗