Prevalence and distribution of nursing bottle caries in Greifswald/Germany

Objectives: In contrast to the well documented caries decline in the permanent dentition, the caries in the primary dentition is less examined and more prevalent. Nursing bottle caries (NBS) is even an increasing problem. Thus, the aim of this study was to assess the age-related prevalence and distribution of NBS in all nursery schools and kindergartens in Greifswald/Germany. Methods: In 2006/07, 1260 children (595 female, 665 male, age 0-7, mean 3.7 yrs ± 2.2) in 20 nursery school and kindergartens in Greifswald were examined by one calibrated examiner for dmft/dmfs according to WHO criteria [1997] and for nursing bottle caries (grade 0: healthy teeth; grade 1: circular initial lesion(s) without cavitation of upper incisors; grade 2: at least one upper incisivor with a carious defect on buccal or palatinal surface plus circular demineralisation). Results: The mean dmft was 1.25 (± 2.82) and the mean dmfs 2.47 (± 6.68) with untreated, cavitated caries comprising the greatest proportion (dt 0.77; ds 1.52). The caries distribution was highly polarized (SD > 2•mean) with 79% caries-free children and 72.9% primary healthy dentitions. The overall prevalence of NBS was 13.8% (grade 1: 5.6%; grade 2: 8.2%).The prevalence of NBS increased up to age 5 (29.3% NBS; grade 1: 11.5%; grade 2: 17.8%). Until age 3 grade 1 dominated, while in 4- and 5-year-olds NBS grade 2 was more prevalent. Conclusions: These data highlight a need for more intensified caries-preventive programs targeting risk children of NBS. The high number of decayed teeth and surfaces stress the insufficiency of caries treatment in deciduous teeth.