Developmental defects of the enamel (DDE) commonly occur in the primary dentition. Although several cross-sectional studies have shown the association of DDE with caries, there is a paucity of longitudinal studies demonstrating that teeth with DDE are at greater risk of caries than are normal teeth. Therefore, the aim of the present study was to longitudinally track a total of 14,220 primary teeth in 725 children from a large birth cohort study, who were interviewed by telephone or home visits at 6-mo intervals. There were 74 children with at least 1 tooth with DDE. We compared teeth with and without DDE by calculating hazard ratios for caries using a Cox proportional hazards model and by plotting caries-free probabilities by child’s age for DDE categories in a Kaplan-Meier plot. Our results show that teeth with DDE had a much higher risk for caries and developed caries earlier than did teeth without DDE. The hazard ratios (95% confidence intervals) for caries were 6.0 (2.4 to 14.6; P < 0.001) for pits, 5.5 (3.8 to 7.8; P < 0.001) for missing enamel, and 4.5 (1.8 to 11.3; P < 0.002) for hypoplasia occurring with yellow-brown opacities. Kaplan-Meier survival plots of caries-free probabilities by age, depending on DDE type, suggest that all types of enamel hypoplasia are associated with a statistically significant increased risk for caries. The study provides longitudinal evidence that DDE are a strong determinant for caries in the primary dentition (ACTRN No. 012606000356561).
Knowledge Transfer Statement: The study provides longitudinal evidence that developmental defects of enamel of the primary dentition are strongly associated with increased risk of early childhood caries.
Casanova-RosadoAJMedina-SolısCECasanova-RosadoJF. 2011. Association between developmental enamel defects in the primary and permanent dentitions. Eur J Paediatr Dent. 12(3):155–158.
3.
CaufieldPWLiYBromageTG. 2012. Hypoplasia-associated severe early childhood caries: a proposed definition. J Dent Res. 91(6):544–550.
4.
ClarksonJO’MullaneDM. 1989. A modified DDE Index for use in epidemiological studies of enamel defects. J Dent Res. 68(3):445–450.
5.
Correa-FariaPMartins-JuniorPAVieira-AndradeRGOliveira-FerreiraFMarquesLSRamos-JorgeML. 2012. Developmental defects of enamel in primary teeth: prevalence and associated factors. Int J Paediatr Dent. 23:173–179.
6.
ElfrinkMEten CateJMvan RuijvenLJVeerkampJS. 2013. Mineral content in teeth with deciduous molar hypomineralisation (DMH). J Dent. 41:974–978.
7.
HeldLRueH.2010. Conditional and intrinsic autoregressions. In: GelfandADigglePGuttorpPFuentesM, editors. Handbook of spatial statistics. Boca Raton (FL): Taylor and Francis.
8.
HongLLevySMWarrenJJBroffittB.2009. Association between enamel hypoplasia and dental caries in primary second molars: a cohort study. Caries Res. 43(5):345–353.
JonesMRLarsenNPPrichardGP. 1930. Dental disease in Hawaii—odontoclasia: clinically unrecognizable form of tooth decay in the pre-school child of Honolulu. Dent Cosmos. 32(5):439–450.
11.
KanchanakamolUTuongratanaphanSLertpoonvilaikulWChittaisongCPattanapornKNaviaJMDaviesGN. 1996. Prevalence of developmental enamel defects and dental caries in rural pre-school Thai children. Community Dent Health. 13(4):204–207.
12.
KohRPukallusMKularatnaSGordonLGBarnettAGWalshLJSeowWK. 2015. Relative cost-effectiveness of home visits and telephone contacts in preventing early childhood caries. Community Dent Oral Epidemiol. 43(6):560–568.
13.
KohRPukallusMLNewmanBFoleyMWalshLJSeowWK. 2015. Effects of water fluoridation on caries experience in the primary dentition in a high caries risk community in Queensland, Australia. Caries Res. 49(2):184–191.
14.
LaiPYSeowWKTudehopeDIRogersY.1997. Enamel hypoplasia and dental caries in very-low birthweight children: a case-controlled, longitudinal study. Pediatr Dent. 19(1):42–49.
15.
LandisJRKochGG. 1977. The measurement of observer agreement for categorical data. Biometrics. 33(1):159–174.
16.
LiYNaviaJMBianJY. 1995. Prevalence and distribution of developmental enamel defects in primary dentition of chinese children 3–5 years old. Community Dent Oral Epidemiol. 23(2):72–79.
17.
LiYNaviaJMBianJY. 1996. Caries experience in deciduous dentition of rural chinese children 3–5 years old in relation to the presence or absence of enamel hypoplasia. Caries Res. 30(1):8–15.
LunnDJThomasABestNSpiegelhalterD.2000. Winbugs—a Bayesian modelling framework: concepts, structure, and extensibility. Stat Comput. 10(4):325–337.
20.
MateeMIMikxFHMaselleSYVan Palenstein HeldermanWH. 1992. Rampant caries and linear hypoplasia (short communication). Caries Res. 26(3):205–208.
21.
MilgromPRiedyCAWeinsteinPTannerACManibusanLBrussJ.2000. Dental caries and its relationship to bacterial infection, hypoplasia, diet, and oral hygiene in 6- to 36-month-old children. Community Dent Oral Epidemiol. 28(4):295–306.
22.
MonteroMJDouglassJMMathieuGM. 2003. Prevalence of dental caries and enamel defects in Connecticut head start children. Pediatr Dent. 25(3):235–239.
23.
NanciA.2008. Enamel: composition, formation, and structure. In: NanciA, editor. Ten cate’s oral histology development, structure, and function. 8th ed.St Louis (MO): Mosby. p. 141–190.
24.
NeedlemanHLAllredEBellingerDLevitonARabinowitzMIversonK.1992. Antecedents and correlates of hypoplastic enamel defects of primary incisors. Pediatr Dent. 14(3):158–166.
25.
NelsonSAlbertJMGengCCurtanSLangKMiadichSHeimaMMalikAFerrettiGEggertssonH. 2013. Increased enamel hypoplasia and very low birthweight infants. J Dent Res. 92(9):788–794.
26.
OliveiraAFChavesAMRosenblattA.2006. The influence of enamel defects on the development of early childhood caries in a population with low socioeconomic status: a longitudinal study. Caries Res. 40(4):296–302.
27.
PascoeLSeowWK. 1994. Enamel hypoplasia and dental caries in Australian aboriginal children: prevalence and correlation between the two diseases. Pediatr Dent. 16(3):193–199.
28.
PlonkaKAPukallusMLBarnettAHolcombeTFWalshLJSeowWK. 2013a. A controlled, longitudinal study of home visits compared to telephone contacts to prevent early childhood caries. Int J Paediatr Dent. 23(1):23–31.
29.
PlonkaKAPukallusMLBarnettAGHolcombeTFWalshLJSeowWK. 2013b. A longitudinal case-control study of caries development from birth to 36 months. Caries Res. 47(2):117–127.
30.
R Foundation for Statistical Computing. 2015. A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing [accessed 2016 May 27]. https://www.R-project.org/.
31.
SalanitriSSeowWK. 2013. Developmental enamel defects in the primary dentition: aetiology and clinical management. Aust Dent J. 58(2):133–140.
32.
SeowWK. 1997. Clinical diagnosis of enamel defects: pitfalls and practical guidelines. Int Dent J. 47(3):173–182.
33.
SeowWKCliffordHBattistuttaDMorawskaAHolcombeT.2009. A case control study of risk indicators for early childhood caries in australia. Caries Res. 43(1):25–35.
34.
SeowWKFordDKazoullisSHolcombeT. 2011. Comparison of enamel hypoplasia in the primary and permanent dentition of children from a low fluoride district in Australia. Pediatric dentistry. 33(3):207–212.
35.
SeowWKHumphrysCTudehopeDI. 1987. Increased prevalence of developmental dental defects in low-birth-weight children: a controlled study. Pediatric dentistry. 9(3):221–225.
36.
SlaytonRLWarrenJJKanellisMJLevySMIslamM.2001. Prevalence of enamel hypoplasia and isolated opacities in the primary dentition. Pediatr Dent. 23(1):32–36.
37.
SucklingGW. 1989. Developmental defects of enamel. Adv Dent Res. 3(2):87–94.
38.
SunderlandEPSmithCJSunderlandR.1987. A histological study of the chronology of initial mineralization in the human deciduous dentition. Arch Oral Biol. 32(3):167–174.
39.
TarginoAGRosenblattAOliveiraAFChavesAMSantosVE. 2011. The relationship of enamel defects and caries: a cohort study. Oral Dis. 17(4):420–426.
40.
Vargas-FerreiraFZengJThomsonWMPeresMADemarcoFF. 2014. Association between developmental defects of enamel and dental caries in schoolchildren. J Dent. 42(5): 540–546.
41.
von ElmEAltmanDGEggerMPocockSJGøtzschePCVandenbrouckeJP;STROBEInitiative. 2008. STROBE Initiative: the strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 61(4):344–349.
