Very Early Childhood Caries Experience in a Native American Cohort

Objectives: To characterize a Northern Plains American Indian cohort, drawn from a population at high risk for early childhood caries, with respect to caries experience, tooth eruption patterns, and putative caries risk factors during the first year of life.

Methods: Participants included 239 mother-child dyads recruited to a longitudinal study of early childhood caries (ECC), microbial transmission patterns, and associated risk factors in the first three years of life. Dental examinations relevant to the current analyses took place at target ages of 1, 4, 8 and 12 months (+/- 30 days). Covariate relationships with caries status were assessed using standard bivariate methods, including chi-square tests of association, Spearman rank correlations, and Kruskal-Wallis tests. Putative risk factors included demographic characteristics, maternal factors, and microbial outcomes. Multivariable modeling for 12-month data was carried out using logistic and negative binomial regression. Extent and location of tooth emergence were characterized. SAS 9.4 (Cary, NC) software and significance level of 0.05 were used.
Results: Cavitated lesions were first observed at 8 months, in 2.1% of children examined (5/233). At 12 months, 15% of the 233 children evaluated had cavitated lesions, none of which had been restored. No teeth were missing due to caries. White spot lesions were observed in 39.9% of children. The majority of erupted teeth (92.5%) at the age of approximately 12 months were incisors; maxillary incisors were those most affected by caries (83.5%). Evidence was found of an association between the presence of caries and increased counts of mutans streptococci and lactobacilli (p<0.001 in both instances).


Conclusions: Even at 12 months of age, this study population gave indications of high caries prevalence, as well as early tooth eruption. Caries experience was associated with higher microbial burden.