Four–year–old children in the city of Umeå, northern Sweden, have been the subjects for studies of dental caries at regular intervals between 1967 and 1997. Similar methods and criteria were used in all studies and the children were selected from the same catchment areas. The results of this study signified a shift in the trend towards a declining caries prevalence among 4–year–old children. There was a slight non–significant increase in the number of children with caries as well as in the mean dmft and dmfs values between 1992 and 1997. The mean dmfs value was 7.8 in 1967 and declined to 4.5 in 1971. It was 2.9 in 1976 and 2.0 in 1980 and 1987, 1.8 in 1992 and increased to 2.0 in 1997. Ten percent of the children were immigrant or refugee children in 1997 compared to 6% in 1992 and they had a significantly higher caries prevalence than children with a Swedish background (p<0.001). In 1997, 58% of the children had one or more daily intakes of sugary snacks such as buns, cakes sweets, soft drinks, etc. There was an increasing consumption of sweets and soft drinks between 1987 and 1997.

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