MIH, Dental Fluorosis and Caries Experience in Colombian Schoolchildren

Objectives: MIH has not been previously studied simultaneously with dental fluorosis and caries in Colombian schoolchildren (PAHO salt fluoridation: 180-220 mg F/salt Kg). This study aimed at describing the prevalence and severity of MIH, fluorosis and caries in 12 to 15-year olds from Bogotá, Colombia.
Methods: IRB and signed consents were provided. Three examiners previously trained in MIH (EAPD index) and calibrated in fluorosis (TFI) and caries (ICDAS) (inter/intra- examiner reliability Kappa values for all indexes ≥ 0.7) assessed children in school settings. Fluorosis was assessed on buccal of anterior and occlusal of posterior teeth as follows: TFI0 (sound); TFI1-2 (mild); TFI3-4 (moderate); TFI ≥5 (severe). MIH was assessed on 1st permanent molar and upper incisor teeth as follows: absence/presence (demarcated opacities, post-eruptive breakdown - PEB, atypical caries lesions, fillings) and severity: tooth-surface involvement (sound; <1/3; 1/3-<2/3; ≥2/3). Caries experience was calculated with conventional DMFS and ICDAS-merged DMFS (including initial lesions).
Results: Mean age of children (n=454) was of 13.5±1.07 years (female: 61.8%). Most were of middle-low social-economic status (71.1%) and attended private schools (68.7%). The prevalence of MIH was of 14.3%. Most showed MIH tooth-surface involvement of 1/3-<2/3 (21.5%), followed by ≥2/3 (40.0%), and <1/3 (38.5%). In total 5.7% of subjects presented the most severe MIH phenotype; 4% exhibited atypical
restorations, 1.1% PEB and 0.7% atypical caries lesions.
The prevalence of fluorosis was of 99.6%, with most presenting mild fluorosis (54.9%), followed by moderate (43.4%) and severe (1.3%). The highest TFI score found was TFI 6.
The prevalence of conventional DMFS was of 51.7% with a mean DMFS of 1.5±2.2 (D: 0.89±3.13; M: 0.21±1.03; F: 0.65±1.48). These figures increased to 88.5% and 5.5±4.7 when including initial lesions (ICDAS DMFS).
Conclusions: Colombian schoolchildren presented a high prevalence of dental fluorosis and ICDAS caries experience, with a relevant prevalence of MIH.