Bristol Dental School, Faculty of Health Sciences, University of Bristol, Bristol, UK.
Medical Research Council Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK.
Community Dent Oral Epidemiol. 2023 Oct;51(5):966-975. doi: 10.1111/cdoe.12795. Epub 2022 Oct 14.
To test whether postulated subtypes of early childhood caries (ECC) are predictive of subsequent caries experience in a population-based cohort of Swedish children.
The study included children aged between 3 and 5 years at study entry with dental records available for at least 5 years of follow-up. Dental record data were retrieved from the Swedish Quality Registry for Caries and Periodontal disease (SKaPa) for the initial and follow-up visits. Participants who had ECC at study entry were assigned to one of five ECC subtypes (termed classes 1-5) using latent class modelling of tooth surface-level caries experience. Subsequent experience of caries was assessed using the decayed, missing and filled surfaces indices (dmfs/DMFS) at follow-up visits, and compared between ECC subtypes using logistic and negative binomial regression modelling.
The study included 128 355 children who had 3 or more dental visits spanning at least 5 years post-baseline. Of these children, 31 919 had caries at the initial visit. Baseline ECC subtype was associated with differences in subsequent disease experience. As an example, 83% of children who had a severe form of ECC at age 5 went on to have caries in the permanent dentition by the end of the study, compared to 51% of children who were caries-free at age 5 (adjusted odds ratio of 4.9 for new disease at their third follow-up).
ECC subtypes assigned at a baseline visit are associated with differences in subsequent caries experience in both primary and permanent teeth. This suggests that the development and future validation of an ECC classification can be used in addition to current prediction tools to help identify children at high risk of developing new caries lesions throughout childhood and adolescence.
在一个基于人群的瑞典儿童队列中，检验早期儿童龋（ECC）的假定亚型是否与随后的龋病经历相关。
该研究纳入了在研究开始时年龄在 3 至 5 岁之间且至少有 5 年随访期可供利用的儿童。使用潜在类别模型对初始和随访时的牙齿表面龋病经验进行分析，将研究开始时患有 ECC 的参与者分为 5 种 ECC 亚型（称为类别 1-5）。在随访期间，使用龋失补指数（dmfs/DMFS）评估随后的龋病经历，并使用逻辑回归和负二项回归模型对 ECC 亚型之间的差异进行比较。
该研究纳入了 128355 名儿童，这些儿童在基线后至少有 3 次随访且随访时间至少为 5 年。其中，31919 名儿童在初始就诊时患有龋病。基线 ECC 亚型与后续疾病经历存在差异。例如，5 岁时患有严重形式 ECC 的儿童中有 83%在研究结束时恒牙出现龋病，而 5 岁时无龋病的儿童中仅有 51%（第三次随访时新发病的调整优势比为 4.9）。
在基线就诊时分配的 ECC 亚型与乳牙和恒牙的后续龋病经历存在差异。这表明，ECC 分类的制定和未来验证可以与当前的预测工具一起使用，以帮助识别在整个儿童期和青春期发生新龋病的高危儿童。
