Caries severity and associated factors in preschool children aged 3-6 years old in Campeche City, Mexico

Abstract

To identify individuals affected by severe carious lesions, according to the size of lesion, and to determine the associated factors. A cross-sectional study was carried out in 1303 children aged 3 to 6 from 10 public preschools with a public preventive dental program. Presence and severity of dental caries were diagnosed using standard criteria (magnitude of carious lesion), which contained four lesion types based on their severity or size. The mothers completed questionnaires to supply information on hygienic habits of the child, and socio-demographics and socioeconomic status variables for the family. Children were examined by one of three calibrated and standardized examiners (kappa>0.85). Adjusted ordinal logistic regression (odds proportional model) was performed to identify associations between caries severity and risk indicators. The percentages of subjects in severity groups I, II, III and IV were 77.3%, 4.8%, 12% and 5.9%, respectively. We observed that subjects with dmft>4 (sum of decayed, indicated for extraction, and filled primary teeth), presented the severest carious lesions (71.4% vs 6.7%; p<0.001). The variables associated to caries severity were: older age of the child, mother's negative attitude toward dental health, regular and inadequate level of oral hygiene, and an interaction between low socioeconomic level and presence of structural enamel defects. We observed a low percentage (17.8%) of subjects affected by severe lesion of dental caries (groups III & IV). Well-defined arrays of variables were associated with caries severity.