Primary Incisor Crowding: 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 relationship between primary incisor spacing/crowding with caries development over time. This is part of a larger study to assess the caries predictive validity of a risk questionnaire, biological variables, and anatomical variables (e.g., tooth spacing) that are easily identified by medical health care providers.
Methods: 639 children (out of 1325 recruited) received caries examinations using the International Caries Detection and Assessment System (ICDAS) at 12±3 months (baseline), 30±3 months, 48±3 months and 78±3 months of age. Bitewing radiographs were obtained at 78±3 months of age. Caries experience was assessed and tested for association with incisor spacing. Analyses were performed using GEE models for binary data.
Results: There were statistically significant associations between: 1) lack of spacing between the primary maxillary central incisors at baseline and any caries experience (dmft+DMFT>0; d/D=ICDAS≥ 3) at age 78 months [No spacing=89% vs. space=75%, p<0.001; Odds Ratio-OR (95% CI)=2.44 (1.74,3.41)]; 2) lack of spacing between the primary maxillary central incisors at baseline and caries experience on the mesial surface of these teeth by age 78 months [No space at age 12 months=26% vs. space=7%, p<0.001; OR (95% CI)=4.58 (2.36, 8.87)]; 3) primary mandibular incisor crowding (≥3 contacts closed) at baseline and any caries experience at age 78 months [Crowding=85% vs. no crowding=75%, p<0.001; OR (95% CI)=2.37 (1.75, 3.20)].
Conclusions: Children with lack of spacing between the primary maxillary central incisors or primary mandibular incisor crowding at age 12 months were more likely to have overall cavitated caries lesion experience by age 78 months. In addition, children with no spacing between the primary maxillary central incisors at age 12 months were more likely to have interproximal caries lesions involving these specific teeth over time.