Is severe early childhood caries predictive of caries and fluorosis in permanent teeth? Ten-year follow-up

Abstract Introduction Severe early childhood caries is defined as the presence of any sign of decay in children younger than three years. Objective This retrospective longitudinal observational study investigated caries and fluorosis in children with S-ECC from a city with fluoridated water. Material and method We included children under the age of three years who followed a maternal and child dental care program between the years of 1997 and 2003. The children were divided into 2 groups: group 1 (S-ECC) and group 2 (no caries). Guardians were contacted by telephone or mail. Caregivers completed questionnaire on socio-demographic and behavioral variables. The clinical dental examinations were performed in a dental clinic to assess caries experience and dental fluorosis. Multiple linear regression was used to determine factors associated with DMFT, and multivariate analysis by multiple logistic regression was used to determine the possible independent factors associated with the occurrence of fluorosis. Result The sample consisted of 126 patients aged 8-12 years, of whom 52.4% were male. The presence of S-ECC increased the DMFT by an average of 0.84 (p = 0.02). Both the frequency of tooth brushing and the use of standard toothpaste were protective factors from the development of caries in the permanent dentition (p &lt;0.05). Parents who reported that their children refused to brush their teeth had 70% less chance of developing fluorosis (p = 0.02). Conclusion The presence of S-ECC was a risk factor for the development of caries in the permanent dentition, but not for the development of fluorosis.【摘要】重度早期儿童龋（Severe Early Childhood Caries, S-ECC）被定义为3岁以下儿童出现任何龋损迹象。 目的 本回顾性纵向观察研究旨在探讨某氟化水源城市中罹患S-ECC儿童的龋病与牙氟中毒（dental fluorosis）情况。 材料与方法 纳入1997年至2003年间参与妇幼口腔保健项目的3岁以下儿童，将其分为两组：组1（S-ECC组）与组2（无龋组）。通过电话或邮件联系儿童监护人，由照护者填写包含社会人口学特征与行为变量的调查问卷。在牙科诊所开展口腔临床检查，以评估龋病患病情况与牙氟中毒程度。采用多元线性回归分析确定与龋失补牙数指数（DMFT）相关的影响因素，采用多元逻辑回归分析确定与牙氟中毒发生相关的独立危险因素。 结果 本研究样本共纳入126名8~12岁儿童，其中男性占比52.4%。S-ECC的存在可使DMFT平均升高0.84（p=0.02）。刷牙频率与使用标准牙膏均为恒牙列龋病发生的保护因素（p<0.05）。报告儿童拒绝刷牙的家长，其子女发生牙氟中毒的几率降低70%（p=0.02）。 结论 S-ECC的存在是恒牙列龋病发生的危险因素，但并非牙氟中毒发生的危险因素。