Effect of“Campaign for Tooth Brushing after Lunch”at Junior High Schools Using a Fluoride Toothpaste on the Prevention of Dental Caries

Effect of“Campaign for Tooth Brushing after Lunch”
at Junior High Schools Using a Fluoride Toothpasteon the Prevention of Dental Caries
Atsushi Takayanagi1），Mami Endoh2）
1）

Takayanagi Dental Clinic
Division of Special Needs and Geriatric Dentistry, Department of Physical Functions, Kyushu Dental University

2）

Abstract： Junior high school students have a low rate of tooth brushing after lunch and a high infection rateof dental caries, as compared to elementary school students. Therefore, a“Campaign for toothbrushing after lunch”was performed at junior high schools, and the effect of this campaign whichused a fluoride toothpaste on the prevention of dental caries was evaluated. In the campaign,brushing instruction was not given, toothbrushes and fluoride toothpastes for tooth brushing afterlunch were distributed to the schools, and an attempt was made to create an environment whichmakes it easy for the students to brush their tooth after lunch. As a result, in the groups thatparticipated in the campaign, the increase in caries incidence was reduced by 48.1% (p<0.05), compared to that in the previous year when the campaign was not performed.
Key words : school dental health, fluoride toothpaste, junior high school student, tooth brushing after lunch

Objective

toothpastes is stipulated as a dental caries preven-

In Europe, dental caries in adolescents andtion policy for school age children, and in our coun-younger children has rapidly reduced, and WHO

try as well, dental caries in school age children hashas listed widespread use of fluoride toothpastes

been dramatically reduced in recent years. Fur-as a main reason for the reduction1）. The effect ofther, as seen in “the survey of the dental diseases

fluoride toothpastes on the prevention of dental3）(2011)”, the DMFT (decayed, missing, and filled

caries has been confirmed in systematic reviewsteeth) index for 12-year-old students has been

as well2）. In the national health promotion policy

reduced to 1.4 teeth.

“Health Japan 21”, spreading the use of fluoride

school students and older students, the incidence

However, in junior highof permanent tooth caries is greater than that inelementary school students, and thus the prevention of dental caries in students 12 and older is an【correspondence】
Atsushi Takayanagi
Takayanagi Dental Clinic
14-4 Naka3 Satte City, Saitama 340-0115 Japan
E-mail：hamigakigaku@gmail.com

important goal for school dental health. Further,looking at the actions for health that people themselves take, in the elementary school students, therate of tooth brushing after lunch is high, whereas,in the junior high school students, the rate of tooth̶ 66 ̶ヘルスサイエンス・ヘルスケアVolume 14，No.2（2014）brushing after lunch is markedly reduced. To dealbrushing. The campaign was continued for one

with this situation, a campaign for promoting toothyear. 15 students who could not continue the cam-brushing after lunch at junior high school was con-paign due to the change of school during the cam-

ducted as one of the school health activities. Then,

paign or who could not be examined for caries

the effect of the tooth brushing after lunch using aduring the campaign were excluded. The inci-

fluoride toothpaste on the prevention of dental

dence rate of caries in the 182 students who werecaries was evaluated.

subjects during the campaign was determinedfrom the results of the dental health examinations,

Subjects and Methods

mandated by School Health Safety Law, carried

From two junior high schools which hadout on these students before and after the cam-approved of the goals of the“Campaign for toothpaign. The results of dental examination of thebrushing after lunch”, 197 students (109 students

participating students were processed so as not toin the second year and 88 students in the firstcontain information by which the individual stu-year) were selected as subjects, and the campaign

dents could be identified, and then provided by thewas performed for them. To give them motiva-school. These results and the changes in caries

tion to brush their tooth after lunch, toothbrushes

incidence in the school year before the campaign(Clear Clean Multi-CareTM) and two-agent type

was performed were compared to evaluate thefluoride toothpastes (containing NaF and MFP, F

effect of the campaign for tooth brushing afterTM

concentration 950 ppm) (Clear Clean Plus ) werelunch on the prevention of dental caries. In a sta-distributed to the schools participating in the cam-tistical analysis, Mann-Whitney U test was used,paign to promote the tooth brushing after lunch atand the statistical software SPSS was used.

school. The toothpastes were additionally distributed every three months so that the students

Results

could continue the tooth brushing after lunch for

The increase in caries incidence in the year of

one year. When distributing the toothpastes andthe present campaign and the increase observed

toothbrushes, instruction in the proper brushingin the previous school year as the control groups

method etc. was not made, except for the instruc-are shown in Tables 1 and 2. In the one year oftion to use 1 g of the fluoride toothpaste per

the campaign, dental caries increased by 0.24 teeth

Table 1 Average DMF index increase in one year from the first year to second year of junior high school

Table 2 Average DMF index increase in one year from the second year to third year of junior high school̶ 67 ̶Effect of“Campaign for Tooth Brushing after Lunch”at Junior High Schools Using a Fluoride Toothpaste on the Prevention of Dental Caries

Table 3 DMF increase in one year for all junior high school students

on average in the first year students, and dental

in dental plaque or Hap plate to be higher than acaries increased by 0.28 teeth in the second year

one-agent fluoride toothpaste, and has high recalci-students. On the other hand, among the students

fication effect upon enamel in the initial stage ofin the one year before the campaign was per-caries6，7）.

formed who were used as the control groups, theIn the present campaign, the caries suppression

caries increase in the first year students and therate was extremely high, even taking the use ofsecond year students was 0.47 and 0.54, respective-

the two-agent type toothpaste into consideration.

ly. The caries increase in all the subjects is shown

One of the reasons for this is likely that thein Table 3.

The caries suppression rate of thisgroups of subjects in this campaign were limited

campaign was 48.1%, which shows that dental

to students in the first and second years of juniorcaries was significantly reduced during the cam-high school, which correspond to the eruption peri-paign (p<0.05).

od of the second molar that is a favored site fordental caries, so that this is a period during whichDiscussion

the fluoride toothpaste can have great effect.

WHO has reported that the use of a fluoride

Zero et al. have shown that, in brushing using atoothpaste is the most important measure for pre-fluoride toothpaste, the amount of the toothpaste

vention of dental caries1）.

used is important8）.

Horowitz et al. have

Further, Koga et al. havereported that the tooth brushing using fluoride-

reported that, for enhancing the fluoride uptake infree toothpaste had no effect on the prevention ofenamel from an NaF-containing toothpaste having

dental caries even when brushing instruction by

1,000 ppm F, the amount of the toothpaste used isexperts was given so that no plaque remains

preferably 1 g or more9）.

4）unbrushed .

Tsutsui et al. have reported that

Furthermore, junior high school students are ofthey evaluated the health activities performed inan age when they are left to carry out oral healththe elementary schools, and found that the brush-

activities independently. They are engaged in aing after school lunch using no toothpaste exhibit-

wide variety of things in their daily life, and hence

ed no clear effect on the prevention of dental

are apt not to strictly observe a dental hygiene

caries5）.

procedure. It often is difficult to get such individ-

Marinho VC et al. have determined that theual students to change their daily routines by giv-

caries suppression rate of a fluoride toothpaste ising them health instruction. In the present cam-2）

paign, a dental caries prevention effect could be

25%, making this calculation by meta-analysis .

In the present campaign, a two-agent type fluo-

obtained just by giving an instruction as to theride toothpaste was used, and it has been reported

amount of the toothpaste to use, without givingthat the fluoride toothpaste causes fluoride uptake

instruction regarding the brushing method.

̶ 68 ̶Weヘルスサイエンス・ヘルスケア

Volume 14，No.2（2014）

considered that it is important to give healthinstruction that is likely to be followed. Anotherkey feature of the campaign was that brushingmaterials were distributed to everyone in thegroups, creating an environment that made it natural for the subjects to brush their tooth after
lunch. This suggests that if junior high school students are placed in a situation where it is very
easy for several of them to brush their teeth
together, they will be motivated to act accordingly.
Conclusiona campaign to promote tooth brushing after
lunch among junior high school students was performed by distributing toothbrushes and fluoride
toothpastes to the students.

As a result, theircaries increase was reduced by 48.1% in the one
year of the campaign, compared to that of juniorhigh school students in the previous year.
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̶ 69 ̶

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