Clinical Study on the Oral Health of Québec Elementary School Students in 2012-2013

At the request of the Ministère de la Santé et des Services sociaux, the Institut national de santé publique du Québec conducted a study entitled Étude clinique sur l’état de santé buccodentaire des élèves québécois du primaire 2012-2013 (ÉCSBQ) [clinical study on the oral health of Québec elementary school students in 2012-2013]. This study assessed the oral health status of Grade 2 and Grade 6 students in Québec and highlighted trends in their oral health since the late 1990s.

For the first time in Québec, ÉCSBQ 2012-2013 used a new visual assessment system, making it possible to study not only non-reversible dental caries, which have been the focus of attention to date, but also reversible dental caries. Reversible dental caries, also known as non-obvious dental caries, are lesions that are limited to the early stages of the disease and that can be reversed through preventive action. As for non-reversible dental caries, they occur in three forms: untreated later-stage lesions (also called obvious dental caries), teeth that have been extracted due to caries and fillings on teeth due to caries.

There has been no significant improvement in the health of Grade 2 students’ primary teeth.

  • In 2012-2013, 53% of Grade 2 students had non-reversible dental caries on their primary teeth, compared to 56% in the late 1990s.
There has been a substantial improvement in the health of Grade 6 students’ permanent teeth.
  • In 2012-2013, 36% of Grade 6 students had non-reversible dental caries on their permanent teeth, compared to 59% in the late 1990s.

Many more Grade 6 students now have sealed permanent teeth.

  • In 2012-2013, 58% of Grade 6 students had at least one sealed permanent tooth, compared to only 29% in the late 1990s.

Almost all students in Grades 2 and 6 have reversible dental caries on their primary and/or permanent teeth.

  • In 2012-2013, 85% of Grade 2 students and 89% of Grade 6 students had reversible dental caries on at least one primary or permanent tooth.

Most non-reversible dental caries are observed among a minority of students in Grades 2 and 6.

  • In 2012-2013, nearly one quarter of Grade 2 students had 76% of non-reversible dental caries observed on the primary teeth of students in that grade.
  • In 2012-2013, just over one tenth of Grade 6 students had 63% of non-reversible dental caries observed on the permanent teeth of students in that grade.
  • Like other health problems, non-reversible dental caries are encountered more frequently among students in less privileged socioeconomic groups.

In light of these findings, it is important to note that:

  • Dental caries on primary teeth can have numerous short- and long-term consequences. In addition to causing pain, they can have an adverse effect on pronunciation and the positioning of permanent teeth. In severe cases, they can cause infections and even slow a person’s growth by affecting his or her diet. Moreover, dental caries are very costly to repair. Therefore, they must be attended to.
  • The improvement in the health of Grade 6 students’ permanent teeth can be explained partly by the large proportion of students who have at least one sealed tooth. Dental sealant is a thin layer of plastic that protects a tooth’s uneven surfaces and helps to prevent decay.
  • Reversible dental caries are common. However, affected teeth can become healthy again through preventive action by individuals, dentists and dental hygienists or even preventive measures targeting the general public.
  • To reduce social inequalities in oral health, authorities must continue to take socioeconomically vulnerable populations into account in implementing public dental health measures.
  • To preserve the gains achieved and to continue making progress in oral health, steps should be taken to strengthen effective action aimed at:
  • ensuring optimal exposure to fluoride, available in various forms;
  • reducing consumption of sugar in food and beverages;
  • ensuring the use of dental sealants among elementary and secondary school students;
  • promoting good oral hygiene habits at home;
  • finding ways to make tooth brushing feasible in childcare facilities and elementary and secondary schools.