A Multicenter Study of Caries Experience in Disabled Brazilian Children

Objectives: To evaluate caries experience during the deciduous, mixed and permanent dentitions of disabled children and its association with demographic data.
Methods: Disabled children with different diagnosis, from both genders, aged 4-12 years were screened to participate in this study. Two-hundred patients being treated at 2 different Universities (private and public) in the Northeast region of Brazil were included in the sample. Questionnaires were used to assess demographic data, such as age, gender, social-economic factors, disabilities and treatment location. Oral exams were performed by a calibrated dentist (kappa = 0.923). Caries experience data was defined as “ICDAS_4–6LRT”, “ICDAS_4–6LRS” for “lost/restored teeth”, “lost/restored surfaces” with codes 4–6, respectively. “ICDAS_1-3E/_4-6D” defined as “dental caries involving enamel and/or dentin”; and “CI” or “caries index” consisting of the sum of all ICDAS codes for every tooth divided by the number of teeth. Statistical analysis was done using the Kruskal-Wallis and Mann-Whitney tests, and a logistic regression analysis (p≤0.05).
Results: There was a higher prevalence of males (n=110, 55%) over females (n=90, 45%) in the present sample. The most prevalent age range was 4-6 years (n=66, 33%). Most patients were diagnosed with neurologic problems as their underlying diseases (n=109, 54,5%). ICDAS codes were greater than 2 among 172 children (86%). Statistically significant differences were found between ICDAS values when comparing the 2 study locations (ICDAS_4-6LRT, p=0.02; ICDAS_4–6LRS, p=0.01; ICDAS_1-3E/_4-6D, p=0.05); 2^nd transitional and permanent dentition stages of development (ICDAS CI, p=0.08; ICDAS_4–6LRT, p=0.004; ICDAS_4–6LRS, p<0.001). Children coming from families with a minimum wage income showed a trend towards a higher non-cavitated caries experience (p=0.07). Logistic regression analysis identified age (4-6 years, x²=4.588, OR=3.228, p=0.032) as a caries-risk factor.
Conclusions: The present study showed high caries prevalence mainly among 4-6 year-old disabled children, and during the 2^nd transitional period.