Assessment of noncavitated and cavitated caries lesions in young children

As the prevalence of early childhood caries (ECC) is high in developing countries, sensitive methods for the early diagnosis of caries lesions are of prime importance for the establishment of preventive measures. Objectives: The aim of the present study was to investigate the increase of caries prevalence in young children after including initial lesions to WHO thresholds caries detection as well as its influence in the epidemiological profile of the studied population. Methods: A total of 351 3-4 years old preschoolers of both genders and living in an optimally fluoridated Brazilian community took part in the study. Clinical examinations were conducted by one calibrated examiner using the following criteria: World Health Organization (WHO) and WHO + Initial lesions (IL). During the examinations, mirrors, CPI probe, gauze, and artificial light were used. The intra-examiner Kappa values at tooth and surface levels were 0.93/0.87 for WHO and 0.75/0.78 for WHO+IL criteria. The data were statistically analyzed by paired t- test and McNemar's test (a = 0.05). Results: The results have shown that the number of decayed, missing and filled surfaces were significantly higher (p<0.05) when WHO+IL criteria was used. The prevalence of dental caries was about 40% and 70% for WHO and WHO+IL criteria, respectively. Statistical differences between caries free children according to the two criteria were also found. Additionally, the IL were the predominant caries lesion in the majority of teeth, particularly on the smooth surfaces. Conclusion: The WHO+IL criteria used was able to diagnose dental caries earlier in preschool children and this may provide usable information for establishing preventive measures to avoid frank cavitations.