Impact of Enamel Defects on Early Caries Development in Preschool Children

Abstract

Quantitative defects of the enamel are considered risk factors for caries development at the cavitated level. Since caries risk assessment and control should be implemented as early as possible in order to prevent operative treatment, it seemed interesting to investigate the relationship between enamel defects and caries development in the stages of progression that precede cavitation. The impact of enamel defects and selected child-mother indicators on early caries development was investigated in a cohort of Brazilian preschool children. The null hypothesis that developmental defects of the enamel and dental caries are independent and that an association between them occurs by chance was tested. The sample (n = 1,718) was made up of 2- to 5-year-olds. Developmental defects of enamel and caries on buccal surfaces were identified in 48 and 26% of the children, respectively. Bivariate analyses at the surface level showed neither an association between demarcated/diffuse opacity and caries experience (p ≧ 0.64, GLM), nor between the presence of hypoplastic surfaces and non-cavitated lesions (p = 0.29, GLM). The multivariate analyses indicated that in the mouths of individual children, hypoplastic surfaces were more likely to present filled surfaces and non-cavitated/cavitated lesions than non-hypoplastic surfaces (within-child p = 0.03, GEE). However, children having teeth with hypoplastic surfaces were not at higher caries risk than those children who did not present hypoplastic surfaces (between-child p = 0.23, GEE). The null hypothesis could not be accepted for quantitative defects such as hypoplasia, since they had a significant impact on the within-child prevalence of filled surfaces and non-cavitated/cavitated lesions.

Caries Process on Occlusal Surfaces: Evolving Evidence and Understanding

“…A certain percentage of teeth may present qualitative and/or quantitative hypomineralization such as non-fluorotic opacities, fluorotic opacities or hypoplasia. Non-fluorotic opacities and fluorotic opacities are not associated with an increased risk of caries development [Carvalho et al, 2011]. Hypoplasia may cause concerns regarding the risk of caries, tooth sensitivity, the placing of restorations and esthetics; however, a large population-based study showed that the prevalence of molar-incisor hypomineralisation in the permanent dentition was only 8.7% at child level and 5.4% at tooth level [Elfrink et al, 2012].…”

Perinatal factors associated with developmental defects of enamel in primary teeth: a case-control study

“…13 Thus, diagnosing and understanding the factors associated with DDE may contribute toward the prevention or minimization of adverse outcomes stemming from such defects. 6,14 The present study was designed to evaluate associations between developmental defects of enamel (DDE) in the primary dentition and aspects related to mothers and preschoolers in the city of Diamantina, Brazil.…”

Defeitos de esmalte não fluoróticos em crianças: aspectos clínicos e epidemiológicos

“…Estudos relataram prevalências que podem variar de 23,9% a 90,4% na dentição decídua 2,5,8,23 e de 52% a 92,1% na permanente 4,[9][10][11] . Os fatores que a desencadeiam estão relacionados principalmente a injúrias durante o desenvolvimento da estrutura dental 1 .…”

“…Em crianças com dentição permanente, a frequência da presença de defeitos de esmalte foi observada em estudos que variaram de 52% 3 a 92,1% 4,[9][10][11] .…”

“…A ocorrência de problemas pré-natais e neonatais pode aumentar o risco de presença de defeitos de esmalte em crianças 2,[5][6][7][8] . Na dentição permanente, traumas na dentição decídua são associados à presença de defeitos de esmalte [9][10][11] , assim como à experiência de cárie na dentição decídua [12][13][14][15][16] e à ocorrência de doenças sistêmicas na infância [17][18][19] . A presença de defeitos hipoplásicos tem relação com predisposição à cárie 16,20 e à sensibilidade den-tária, maloclusão e problemas estéticos, que podem promover problemas de ordem social e psicológica, interferindo na qualidade de vida das crianças 21 .…”