Developmental defect of enamel and caries experience on first permanent molar in primary school children in district of Sungai Buloh, Selangor, Malaysia

Abstract

Objective: To evaluate the prevalence and association of developmental defects of enamel (DDE) and caries experience on the first permanent molar (FPM) among children aged 7-10 years old in Selangor, Malaysia. Methods: A total of 212 students of Islamic Primary School, Sungai Buloh aged between 7 and 10 years old were randomly selected. A full intraoral examination was conducted and recorded using International Caries Detection and Assessment System (ICDAS) classification and modified DDE index primarily on the first permanent molar. Clinical photographs of FPM was taken using digital single-lens reflex (DSLR) to aid in the diagnosis of DDE. Statistical analysis was done using SPSS 24. Results: A total of 848 FPM were examined in this study; 252 FPM of children aged 7 years old, 232 FPM of children aged 8 years old, 180 FPM of children aged 9 years old, and 184 FPM of children aged 10 years old. Among them, 82.7% (n=701) were caries-free (ICDAS code 00); 11.4% (n=97) with caries severity ranging from early caries (ICDAS code 01) to severe caries (ICDAS 06); 0.9% (n=8) were filled (ICDAS code 30, 40, 60); 0.1% (n=1) with secondary caries and 4.8% (n=41) were unerupted (ICDAS code 99). The prevalence of DDE with demarcated opacity was 19.35% (n=164); diffuse opacity 2.4% (n=20); hypoplasia 0.5% (n=4), and other defects were 0.1% (n=1). The association between dental caries and DDE was statistically significant at p < 0.001 and the odd ratio (OR) was 3.48. Conclusions: The presence of DDE increased the risk of caries three times higher than without DDE. Understanding the contributing factors of the development and progression of dental caries may help clinicians to prioritise an appropriate preventive measure to those who are in need. Keywords: Developmental defect of enamel (DDE); caries; first permanent molar; International caries detection and assessment system (ICDAS); modified developmental defects of enamel index