Tongue Constriction and Incisor Spacing: Association With Children’s Caries Risk

Objectives: Development of a validated caries risk assessment tool is essential in targeting preventive/referral strategies in medical settings. Objective: To assess the associations of tongue constriction and spacing between central maxillary incisors with caries development by age 4.
Methods: To date, 592 primary caregiver (PCG)-child pairs (out of 1326 recruited) have been followed for 36 months to assess the caries predictive validity of a 52-item questionnaire and caries risk prediction of biological (e.g., saliva) and anatomical (e.g., tooth spacing, tongue constriction) variables. Children received caries examinations using the ICDAS criteria at 12±3 months (baseline), 30±3 months (80% retention) and 48±3 months of age (ongoing final exams). In preliminary analyses, caries experience at age 4 (dmft; d=ICDAS>3) was assessed and tested for association with several anatomic features that could be identified by medical health care providers. Odds ratios with significance levels (p<0.001) were calculated.
Results: Children with a tethered (constricted) tongue were more likely to have cavitated caries lesion experience by age 4 (52% if tongue constricted vs. 23% if tongue normal; OR 3.6, 95% CI: 2.1-5.9). There was also an association between the lack of spacing between the maxillary central incisors and caries experience on the mesial interproximal surface of these teeth at baseline (19% if no spacing vs. 5% if spacing; OR 3.9, 95% CI: 1.1-14) and this association continued to be consistently significant through the 36-month study period (OR range 1.8-2.3). Subsequent multivariable logistic regression analyses will test further the strength of these associations with the complete study dataset.
Conclusions: Children with tethered tongue were more likely to have cavitated caries lesion experience by age 4. In addition, children with no spacing between the maxillary central incisors were more likely to have interproximal caries involving maxillary central incisors.