[Implementation and evaluation of a childhood dental health program in a community: twenty-year observational data].

PURPOSE To evaluate a long-term community-based childhood dental health program comprising of caries screenings of one- and two-year old kindergarten and pre-school children as well as in groups aged 1.5- and 3-years. Fluoride treatment was introduced to 1.5-year, 2-year, 3-year screening from 1995, 1-year screening from 1997, and kindergarten/pre-school children from 2002 in Kyowa town, Makabe, Ibaraki (Kyowa district of Chikusei city) . Tests for caries prediction and caries bacteria load were also introduced from 1990 and 1995, respectively. To evaluate improvement in the dental health program between 1984 and 2004, we compared the prevalence trend for dental caries in Kyowa town with that in 7 other adjacent communities within the same public health center area, the Ibaraki prefectural average and data for all Japan. Between 1984 and 2004, the prevalence of dental caries declined by 59% for 3-year children with a large decrease from 1995, and by 57% for 1.5-year children. Decline during the twenty years ranked first and second among the communities, respectively, and was also larger than the prefectural and national averages. For 3-year children, the reduced prevalence of dental caries may have been enhanced by the introduction of fluoride treatment in 1995. A community-based dental health program including fluoride treatment for 1- and 2-year old kindergarten/pre-school children as well as for those aged 3- and 1.5 years may have had a larger impact on reducing dental caries in Kyowa town than in other communities, Ibaraki prefecture and all Japan.