Community Dent Oral Epidemiol 2001; 29: 55–61 Copyright C Munksgaard 2001 Printed in Denmark . All rights reserved ISSN 0301-5661 Joana C. Carvalho 1 , Jean Pierre Van Nieuwenhuysen 1 The decline in dental caries and William D’Hoore 2 1 School of Dentistry and 2 School of Public Health, Catholic University of Louvain, among Belgian children between Brussels, Belgium 1983 and 1998 Carvalho JC, Van Nieuwenhuysen JP, D’Hoore W: The decline in dental caries among Belgian children between 1983 and 1998. Community Dent Oral Epidemiol 2001; 29: 55–61. C Munksgaard, 2001 Abstract – Objectives: to investigate cross-sectionally a probable dental caries de- cline in Belgian 12-yr-olds and to analyse some factors that may be associated with dental caries during the study period. Methods: In the region of Brussels, children in the 7th grade at the same schools were sampled in 1983 (nΩ533) and 1998 (nΩ 496). DMFT, DMFS and dental fluorosis were clinically recorded. Data on chil- dren’s home-based and professional dental health care habits were registered. Re- sults: Caries-free children increased from 4% to 50%. A reduction of the mean number of teeth attacked by dental caries from 7.5 to 1.6 and of tooth surfaces Key words: dental caries; dental health care; from 11.5 to 2.5 (P0.001) was observed. Early signs of dental fluorosis were epidemiology; schoolchildren identified in 5% in 1983 and 30% of the subjects in 1998. Multiple linear regression Joana C. Carvalho, Av. Jupiter 91A, bte 1, analyses revealed that tooth brushing with fluoridated toothpaste, dental ap- B-1190 Brussels, Belgium pointments and dental fluorosis were significantly related to dental caries reduc- Tel/Fax: π322 346 06 79 e-mail: joana.carvalho/padt.ucl.ac.be tion. Conclusions: A remarkable decline in dental caries was observed during the 15-yr period. The factors related to the children’s home-based and professional Submitted 29 April 1999; accepted 30 May dental health care were associated with the observed decline. 2000 In the last decades a large number of scientific re- ports have documented a remarkable reduction in dental caries among schoolchildren in many Euro- pean countries (1, 2). The factors mostly associated to the reported reduction are the regular use of fluoride in one or more forms and the implementa- tion of public health policies in the different coun- tries (1, 2). Other factors such as socio-economic status, life-style behaviours, knowledge on oral health promotion, standard of oral hygiene and quality of public dental services are also related to this achievement. The merits of changes in sugar consumption or distribution of cariogenic micro- organisms are currently considered of very little importance (3, 4). In order to assess trends in dental health, cross- sectional surveys have been recommended to and carried out on a regular basis in countries with comprehensive public dental health care services and to some extent in countries with predomi- nantly private dental care (1–4). 55 In Belgium, the delivery of dental health care is essentially private for citizens of all ages. Belgium is a federal state divided into ten provinces and with a population of 10 million inhabitants. There are three regional authorities of Flanders, Wallonia and Brussels and three language communities, i.e. Dutch-, French-, and German-speakers, repre- senting 57%, 42% and 1% of the population, respec- tively. The water supply is not artificially fluorida- ted and most of the municipalities have very low levels of fluoride in drinking water (5). There are no collective preventive dental procedures for children and adolescents. According to Belgian law any ope- rative treatment must be carried out by private prac- titioners or university clinics. The ratio dentist/ population is 1 dentist per 1350 inhabitants. A limited number of epidemiological studies on dental caries in Belgian schoolchildren have been performed (5–8). Besides these studies, one investi- gation on caries prevalence trends between 1967 and 1983 indicated a caries reduction of 47% (9).