Abstract
Aim
Estimate the prevalence of developmental defects of enamel (DDE) in the primary dentition, describe the distribution among tooth groups and investigate the association with birth weight.
Methods
A cross-sectional study was conducted with a sample of 827 children aged 2–5 years representative of the city of Canela in southern Brazil. Demographic characteristics (gender and age) and birth weight were collected from vaccination cards. The diagnosis of DDE was performed by six trained examiners following the criteria of the Federation Dentaire International. DDE were described both jointly and separately as opacity and hypoplasia. Statistical analysis involved the Chi square test, Mann–Whitney test and Poisson regression with robust variance.
Results
The prevalence of DDE was 55.1% (95% CI 51.6–58.5%), with a mean of 3.0 ± 2.2 teeth affected. Opacity was the more frequent defect (50.4%), followed by hypoplasia (15.5%). Distribution of the defects was uneven, with opacity predominant on second molars and hypoplasia predominant on canines and second molars. Children with a low birth weight did not have a greater probability of opacity (PR: 1.13; 95% CI 0.91–1.41), hypoplasia (PR: 1.33; 95% CI 0.80–2.22) or DDE (PR: 1.11; 95% CI 0.91–1.37).
Conclusion
The prevalence of DDE was high, predominant on second molars and not associated with birth weight. These findings indicate directions for future examination/diagnosis protocols and specific orientations.
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References
Alkhtib A, Ghanim A, Temple-Smith M, et al. Prevalence of early childhood caries and enamel defects in four and five-year old Qatari preschool children. BMC Oral Health. 2016;16:73.
Boeira GF, Correa MB, Peres K, et al. Caries is the main cause for dental pain in childhood: findings from a birth cohort. Caries Res. 2012;46(5):488–95.
Brazil, Health Ministry. Health Brazil 2013: an analysis of health situation and communicable diseases related to poverty. Brasília: Health Ministry, 2014 [document in Portuguese]. http://bvsms.saude.gov.br/bvs/publicacoes/saude_brasil_2013_analise_situacao_saude.pdf. Accessed 30 Apr 2017.
Butler PM. Comparison of the development of the second deciduous molar and first permanent molar in man. Arch Oral Biol. 1967;12(11):1245–60.
Caufield PW, Li Y, Bromage TG. Hypoplasia-associated severe early childhood caries—a proposed definition. J Dent Res. 2012;91(6):544–50.
Chaffee BW, Rodrigues PH, Kramer PF, Vítolo MR, Feldens CA. Oral health-related quality-of-life scores differ by socioeconomic status and caries experience. Community Dent Oral Epidemiol. 2017. https://doi.org/10.1111/cdoe12279.
Chaves AMB, Rosenblatt A, Oliveira OFB. Enamel defects and its relation to life course events in primary dentition of Brazilian children: a longitudinal study. Community Dent Health. 2007;24(1):31–6.
Corrêa-Faria P, Martins-Júnior PA, Vieira-Andrade RG, et al. Developmental defects of enamel in primary teeth: prevalence and associated factors. Int J Paediatr Dent. 2013;23(3):173–9.
Corrêa-Faria P, Paixão-Gonçalves S, Paiva SM, et al. Association between developmental defects of enamel and early childhood caries: a cross-sectional study. Int J Paediatr Dent. 2015;25(2):103–9.
Costa FS, Silveira ER, Pinto GS, et al. Developmental defects of enamel and dental caries in the primary dentition: a systematic review and meta-analysis. J Dent. 2017. https://doi.org/10.1016/j.jdent.2017.03.006.
Elfrink MEC, Schuller AA, Weerheijm KL, Veerkamp JSJ. Hypomineralized second primary molars: prevalence data in Dutch 5-year-olds. Caries Res. 2008;42(4):282–5.
Elfrink MEC, Ten Cate JM, Jaddoe VWV, et al. Deciduous molar hypomineralization and molar incisor hypomineralization. J Dent Res. 2012;91(6):551–5.
Elfrink ME, Ten Cate JM, van Ruijven LJ, Veerkamp JS. Mineral content in teeth with deciduous molar hypomineralisation (DMH). J Dent. 2013;41(11):974–8.
Elfrink MEC, Moll HA, Kiefte-de Jong JC, et al. Pre-and postnatal determinants of deciduous molar hypomineralisation in 6-year-old children. The Generation R Study. PLoS One. 2014;9:e91057.
Farsi N. Developmental enamel defects and their association with dental caries in preschoolers in Jeddah, Saudi Arabia. Oral Health Prev Dent. 2010;8(1):85–92.
Federation Dentaire Internationale-Commission on Oral Health, Research and Epidemiology. A review of the developmental defects of dental index (DDE index). Int Dent J. 1992;42(6):411–26.
Gallo EAG, Anselmi L, Dumith S, et al. Size at birth and mental health problems at 11 years of age in a Brazilian birth cohort. Cad Saúde Pública. 2011;27(6):1622–32.
Ghanim A, Manton D, Marino R, Morgan M, Bailey D. Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children. Int J Paed Dent. 2013;23(1):48–55.
Hoffmann RH, de Sousa ML, Cypriano S. Prevalence of enamel defects and the relationship to dental caries in deciduous and permanent dentition in Indaiatuba, São Paulo, Brasil. Cad Saúde Pública. 2007;23(2):435–44.
Hong L, Levy SM, Warren JJ, Brofitt B. Association between enamel hypoplasia and dental caries in primary second molars: a cohort study. Caries Res. 2009;43(5):345–53.
Jacobsen PE, Haubek D, Henriksen TB, Østergaard JR, Poulsen S. Developmental enamel defects in children born preterm: a systematic review. Eur J Oral Sci. 2014;122(1):7–14.
Li Y, Navia JM, Bian JY. Caries experience in deciduous dentition of rural Chinese children 3–5 years old in relation to the presence or absence of enamel hypoplasia. Caries Res. 1996;30(1):8–15.
Lunardelli SE, Peres MA. Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children. Braz Oral Res. 2005;19(2):144–9.
Lunardelli SE, Peres MA. Breast-feeding and other mother-child factors associated with developmental enamel defects in the primary teeth of Brazilian children. J Dent Child. 2006;73(2):70–8.
Lunt RC, Law DB. A review of the chronology of eruption of deciduous teeth. J Am Dent Assoc. 1974;89(4):872–9.
Massignan C, Ximenes M, da Silva Pereira C, et al. Prevalence of enamel defects and association with dental caries in preschool children. Eur Arch Paediatr Dent. 2016;17(6):461–6.
Massoni AC, Chaves AM, Rosenblatt A, Sampaio FC, Oliveira AF. Prevalence of enamel defects related to pre-, peri-and postnatal factors in a Brazilian children. Community Dent Health. 2009;26(3):143–9.
Massumo R, Bardsen A, Astrom AN. Developmental defects of enamel in primary teeth and association with early life course events: a study of 6–36 month old children in Manyara, Tanzania. BMC Oral Health. 2013;13:21.
Oliveira AFB, Chaves AMB, Rosenblatt A. The influence of enamel defects on the development of early childhood caries in a population with low socioeconomic status: a longitudinal study. Caries Res. 2006;40(4):296–302.
Rugg-Gunn AJ, Al-Mohammadi SM, Butler TJ. Malnutrition and developmental defects of enamel in 2-to 6-year-old Saudi boys. Caries Res. 1998;32(3):181–92.
Salanitri S, Seow WK. Developmental enamel defects in the primary dentition: aetiology and clinical management. Aust Dent J. 2013;58(2):133–40.
Sarnat BG, Schour I. Enamel hypoplasia (chronologic enamel aplasia) in relation to systemic disease: a chronologic, morphologic and etiologic classification. J Am Dent Assoc. 1941;28(12):1989–2000.
Sclowitz IK, Santos Ida S. Risk factors for repetition of low birth weight, intrauterine growth retardation, and prematurity in subsequent pregnancies: a systematic review. Cad Saúde Pública. 2006;22(6):1129–36.
Seow WK. Effects of preterm birth on oral growth and development. Aust Dent J. 1997;42(2):85–91.
Seow WK, Humphrys C, Tudehope DI. Increased prevalence of developmental dental defects in low birth-weight, prematurely born children: a controlled study. Pediatr Dent. 1987;9(3):221–5.
Targino AGR, Rosenblatt A, Oliveira AF, Chaves AMB, Santos VE. The relationship of enamel defects and caries: a cohort study. Oral Dis. 2011;17(4):420–6.
Temilola OD, Folayan MO, Oyedele T. The prevalence and pattern of deciduous molar hypomineralization and molar-incisor hypomineralization in children from a suburban population in Nigeria. BMC Oral Health. 2015;15:73.
Vargas-Ferreira F, Zeng J, Thomson WM, Peres MA, Demarco FF. Association between developmental defects of enamel and dental caries in schoolchildren. J Dent. 2014;42(5):540–6.
Vargas-Ferreira F, Salas MM, Nascimento GG, et al. Association between developmental defects of enamel and dental caries: a systematic review and meta-analysis. J Dent. 2015;43(6):619–28.
Velló MA, Martínez-Costa C, Catala M, Fons J, Guijarro-Martínez R. Prenatal and neonatal risk factors for the development of enamel defects in low birth weight children. Oral Dis. 2010;16:257–62.
Wagner Y. Developmental defects of enamel in primary teeth—findings of a regional German birth cohort study. BMC Oral Health. 2017;17:10.
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Ruschel, H.C., Vargas-Ferreira, F., Tovo, M.F. et al. Developmental defects of enamel in primary teeth: highly prevalent, unevenly distributed in the oral cavity and not associated with birth weight. Eur Arch Paediatr Dent 20, 241–248 (2019). https://doi.org/10.1007/s40368-018-0402-4
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DOI: https://doi.org/10.1007/s40368-018-0402-4