Quarter of a century of change: caries experience in Australian children, 1977–2002

Background:  The establishment of the evaluation programme of the Australian School Dental Scheme has led to continuous surveillance of child oral health extending from 1977 to the present day. The aims of this study were to examine the state of child oral health in Australia in 2002 and to explore longer term trends across the quarter of a century of recorded surveillance activity. Methods:  Caries data were obtained for children who were enrolled in the School Dental Services of each state and territory for the years 1977–2002. Data collection derived from routine examinations within the School Dental Service with oral examinations carried out by dentists and dental therapists. Results:  There were considerable declines in caries experience between 1977 and the mid to late 1990s, with mean decayed, missing and filled deciduous teeth (dmft) for 6‐year‐old children decreasing from over 3 in 1977 to approximately 1.6 in 1996, and permanent 12‐year‐old decayed, missing and filled teeth (DMFT) decreasing from 4.8 in 1977 to 0.89 in 1998. However, since the mid to late 1990s, deciduous 6‐year‐old dmft has increased by 24 per cent and 12‐year‐old DMFT has increased by almost 15 per cent. Reductions in caries experience of those children with the most disease have also ceased, and between 1999 and 2002 an increase in the Significant Caries Index occurred. Conclusions:  Improvements in the oral health of Australian children halted during the mid 1990s, after which caries experience has increased. It is important that we understand the changes taking place and their causes, so that action can be taken to halt any further possible declines in child oral health.