Children's caries history predicts future tooth decay

Having a history of dental caries significantly increases a child's chances of developing further caries, indicate study results.

Children with initially nonprobeable dark lesions at their first check-up had an almost 50% increased risk for caries development compared with their peers who had no color-changes or white lesions only.

"The results obtained in this study demonstrate that both the subject's caries experience and the condition of the individual tooth should be taken into consideration in determining the caries risk of a particular occlusal site," say Daniel Fine (University of Medicine and Dentistry of New Jersey, Newark, USA) and colleagues.

The study involved a total of 227 children aged 10-18 years from Newark, New Jersey. The children, all of whom had 20 teeth or more - including at least one permanent molar - underwent two visual-tactile dental examinations in which the dentist counted decayed, missing, and filled surfaces (DMFS) and graded them accordingly. A score of 0 denoted no probeable lesion or color change, a score of 1 denoted a subtle white lesion, and a score of 2 indicated dark grey or brown nonremovable discoloration.

At the first visit, 68.7% of children had at least one probeable caries lesion, and just 3.0% of children had no caries, restorations, missing teeth, or nonprobeable white or dark lesions, note Fine and co-authors.

While patient age, gender, and ethnic group had no significant effect on the risk for developing subsequent caries, an increased DMFS score was associated with a significantly increased caries risk.

Specifically, each one-unit increase in DMFS increased the subsequent caries risk 1.07-fold, report the authors in Archives of Oral Biology.

Furthermore, the 128 children who were classified as "caries active" and the 19 classified as "caries susceptible" at initial examination had respective 2.27- and 2.33-fold increased risk for developing future caries compared with the 39 caries-free children.

The initial presence of dark - but not white - spots also increased future caries risk, by a significant 1.49 times, and this risk increased to 3.38-fold in children who had dark spots and an initial DMFS score above 0.

"By performing careful examinations at regular intervals, teeth and individuals at risk can be identified," conclude Fine and co-authors.

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