Geo-mapping of time trends in childhood caries risk a method for assessment of preventive care

The study population consisted of 9,973 (2006) and 10,927 (2010) children between 3 to 6years of age (~77% of the eligible population) from whom caries data were obtained. Reported dmfs>0 for a child was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish (66 parishes in the region). Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI ArcGIS system. Parish-level socioeconomic data were available.The overall proportion of caries-free (dmfs=0) children improved from 84.0% in 2006 to 88.6% in 2010. The ratio of maximum and minimum (parish-level) smoothed relative risks (SmRRs) increased from 1.76/0.44=4.0 in 2006 to 2.37/0.33=7.2 in 2010, which indicated an increased geographical polarization of early childhood caries in the population. Eight parishes showed evidential, positional changes in caries risk between 2006 and 2010; their corresponding SmRRs and statistical certainty ranks changed markedly. No considerable parallel changes in parish-level socioeconomic characteristics were seen during the same time period.Geo-maps based on caries risk can be used to monitor changes in caries risk over time. Thus, geo-mapping offers a convenient tool for evaluating the effectiveness of tailored health promotion and preventive care in child populations.The prevalence of dental caries has declined globally over the past decades but all children have not benefited from the improved oral health. Widening inequalities between social classes and certain minority ethnic groups are evident [1-5]. Caries risk assessment (CRA) is an essential component in the decision-making process for the prevention and management of the disease [6]. For individuals, background data on host factors, diet and oral hygiene are commonly merged with findings from a clinical examination while CRA in populations most often rely on