Enamel defects in preschool linked with early childhood dental caries
MedWire News: Developmental defects in enamel are a predisposing risk factor for early childhood caries, research shows.
The risk of children presenting with enamel defects to develop dental caries was approximately two times greater than those without defective teeth, report Aronita Rosenblatt (Federal University of Paraiba, Brazil) and colleagues in the journal Oral Diseases.
Early childhood caries are found mainly in children living in poorer communities. They are believed caused by higher sugar intake, lack of oral hygiene, lack of fluoride exposure, and enamel defects.
Teeth with enamel defects have irregular and retentive surfaces, and this can lead to an increased risk for adhesion and colonization of bacteria. In turn, this poses a higher risk for dental caries.
Previous cross-sectional studies have reported an association between dental caries and enamel defects, but little longitudinal data are available.
In this cohort, investigators tracked the relationship between enamel defects and the development of tooth decay in 275 children followed-up from birth for 54 months. The children were recruited from a Brazilian facility that provides care for poor families. Of those living in the city, many exist without access to piped water, note the researchers.
Of the 224 children who completed the study, 81.3% presented with least one tooth having a defect in enamel. Overall, 44.2% of children had dental caries. By age 54 months, 48.4% of the children with caries also had enamel defects.
The cumulative incidence of caries was 0.54 from 18 to 54 months. Enamel hypoplasia was the most frequent type of enamel defect associated with dental caries, with the use of fluoridated toothpaste lowering the risk of developing tooth decay.
In multivariate risk analysis, night-time bottle feeding, no fluoride exposure, and enamel defects were associated with the risk of dental caries at 18 months. At 24, 30, 36, and 42 months, enamel defects were the only risk factor associated with the risk for developing early childhood caries.
To prevent dental disease, Rosenblatt and colleagues suggest a "holistic approach," with health and social policies focusing on improving quality of life and the general health of socially disadvantaged populations.
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