Abstract
This study aimed to evaluate the association between the fissure depth (tooth morphology) of permanent molars and dental caries incidence with a five-year follow-up period. In total, 110 Mexican schoolchildren aged seven years were recruited at baseline, of which 88 children completed the follow-up assessments. The fissure depths of the first permanent lower molars were recorded, and dental caries [decayed, missing, and filled deciduous surfaces (dmfs) and decayed, missing, and filled permanent surfaces (DMFS)] was evaluated annually. A generalized estimating equation model was constructed for evaluating the association between dental caries and fissure depth. The initial and final DMFS scores were 0.02 (±0.2) and 1.55 (±2.49), respectively. The generalized estimating equation model showed that children with deep molar fissures were more likely to develop caries lesions, (Odds Ratio OR = 3.15, p = 0.028) compared to children with shallow fissures. Moreover, dental caries in primary teeth (OR = 1.07, p = 0.005) was associated with the development of carious lesions in the permanent dentition. Fissure depth was a useful predictor of dental caries, according to this five-year follow-up study. The detection of deep occlusal fissures in the lower first permanent molars could contribute to the identification of children at high risk of dental caries. Tooth morphology may be used to identify children at a higher caries risk, particularly in settings with limited resources.
Highlights
The incidence of dental caries has declined in some countries
The results indicated that children with deep fissures were 3.15 times (p = 0.028) as likely to develop dental caries in the permanent teeth compared to children with shallow fissures
1 quasi-likelihood under the independence model criterion (QIC) = 513.9 (Wald test = 20.9, p < 0.001), e Model 2, QIC = 508.6 (Wald test = 20.6, p < 0.001), f Model QIC = 557.5 (Wald test = 2.96, p = 0.085). In this five-year follow-up study, fissure depth in the lower first permanent molars was associated with caries incidence; children showing deep fissures were three times as likely to develop dental caries compared to children with shallow fissures, after adjusting for dmfs, age, and sex at baseline
Summary
The incidence of dental caries has declined in some countries. It is still highly prevalent [1]. Dental caries is a multifactorial, infectious, and transmissible disease, which is associated with an increase in acid-producing bacteria in the biofilm. Current clinical practice guidelines on caries prevention among schoolchildren indicate sealant and/or fluoride application [1]. The use of pit and fissure sealants is difficult in public oral health programs with limited resources, those in low-income countries. In this scenario, the identification of children at higher caries risk is of paramount importance [2,3]
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