Predictors of Dental Caries Progression in Primary Teeth

Objective: This cohort study evaluated the social, community, and individual predictors of dental caries increment in low-income African-American children less than 6 years old. Methods: This study included data from 788 dyads of children and their caregivers (77% follow-up) who were examined in 2002-03 and 2004-5. The families were assessed by calibrated dentists for severity of dental caries at both time periods using the International Caries Detection and Assessment System. The dentists had good to excellent reliability. Additionally, the caregivers answered questionnaires administered by trained interviewers. The questionnaires assessed demographic, social, behavioral, community, dietary, and individual risk factors. Results: The outcomes (total decayed, missing and filled primary tooth surfaces (dtmfs) and the dmfs excluding non-cavitated lesions (d2mfs)) were adjusted for reversals and illogical transitions. The following significant predictors of caries increment were selected by the zero-inflated negative binomial stepwise regression models which were adjusted for clustering effects and disproportionate representation: consumption of soda drinks, age of child, high weight-for-age, dental treatment visits, baseline caries levels of children and their caregivers, dental fatalism, and neighborhood advantage status were associated with high caries increment. Thee significant risk factors explained about 20% of the variation in the caries increment. Conclusion: In low-income African-American children, a focus on dietary, social and disease factors should help to identify those at high risk. This study is funded by NIDCR/NIH grant number U-54 DE 14261-01.