Abstract
Aim: To describe the prevalence and incidence of caries in the permanent teeth in a cohort of children over a sevenyear period, with a view to establishing the pattern of caries development. Of particular interest was the disease trajectory of dentinal caries in the permanent teeth in groups defined by the presence or absence of dentinal caries in the primary teeth.
Methods: All pupils in Year 3 (aged 7 to 9 years) at state-funded primary schools in an area in the North-West of England in February 2006 were invited to take part. Intra-oral examinations, to assess oral health , were performed at four time points by trained and calibrated dentist examiners using a standardised, national diagnostic protocol. Positive consent was obtained. The study was included on the NIHR UK Clinical Research Network Study Portfolio (Ref: 10315) and ethical approval obtained (UK National Research Ethics Service Ref: 11/NE/0006). A populationaveraged model (generalised estimating equations) was used to model the longitudinal data.
Results: Clinical data were available for 6651 children. At the four examinations for 5470 (96.8%), 5476 (97.5%), 3443 (80.4%) and 2733 (82.9%) participants completed the intra- oral examination. Mean caries prevalence (% D3MFT>0) was 16.7% (n=911) at the first clinical examination (ages 7 to 9) increasing to 31.0% (n=1695), 42.2% (n=1280) and 45.7% (n= 1249) at subsequent examinations. Estimated mean values indicated a rising D3MFT count as pupils aged (consistent with new teeth emerging) which was significantly higher (4.5 times, 95% CI 3.9 to 5.2) in those pupils with caries in their primary dentition than in those without.
Conclusion: In the population studied, children who developed caries in their primary dentition had a very different caries trajectory in their permanent dentition to their caries free contemporaries. In light of these results, caries free and caries active children should be considered as two separate populations, suggesting different prevention strategies are required to address their different risk profiles.
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