Dental caries prevalence and risk predictors among Indigenous preschool children

It is thought that rates of dental caries among pre-school children differ between the Centre and Top End of the Northern Territory (NT), possibly due to differences in frequency of enamel defects, although the evidence is anecdotal. Objectives: to describe prevalence of and risk predictors for dental caries among pre-school Aboriginal children living in remote communities of NT. Methods: In 2006, oral examinations of 1-3-year-olds were conducted in 30 NT remote communities by four calibrated dental therapists who recorded tooth surfaces as: cavitated decay (d), missing due to caries (m), filled due to caries (f), non-carious opacity with no loss of enamel (o), hypoplasia with loss of enamel (h) or sound. Caries prevalence (≥1dmfs lesions) was compared among groups defined by child's age and sex and by community characteristics of location (Centre or Top End) and size (<20, 20-39 or ≥40 children in scope for study). Those characteristics together with presence/absence of o or h lesions were evaluated as risk predictors using bivariate and multivariate analysis to estimate prevalence ratios (PR). Results: Among 675 examined children, 63.8% had ≥1 dmfs (95% confidence interval [CI] = 59.2-66.5%) with greater prevalence in the Top End than the Centre (PR=1.3, 95%CI = 1.1-1.6). In bivariate analysis, caries prevalence was also associated (P<0.01) with larger community size, older age, presence of opacities and presence of hypoplasia. Top End children continued to have elevated prevalence relative to Centre children (PR=1.3, 95%CI = 1.1-1.6) after multivariate adjustment for age (P<0.01), hypoplasia (P<0.01), opacities (P<0.01) and community size (P=0.08). Conclusion: dental caries occurred frequently among these 1-3 year olds, although regional differences could not be accounted for by non-carious defects, suggesting that differential regional distribution of risk- or protective-factors may contribute to higher caries prevalence in the Top End. Supported by: NHMRC #320858. >