COMMUNITY RISK INDICATORS FOR DENTAL-CARIES IN SCHOOLCHILDREN - AN ECOLOGIC STUDY

A statewide survey of NC schoolchildren found wide variation in dental caries prevalence among sampled classrooms. This study examined facto rs associated with this variation using classrooms as a surrogate for the larger community, in order to identify community risk indicators ( CRI). In all, 172 classrooms (3400 students) in Grades K-6 were availa ble for analysis. Initially, 56 sociodemographic, environmental, healt h system, and clinical factors were evaluated for their association wi th caries prevalence (K-3: average dfs+DMFS; 4-6: average DMFS) using univariate and bivariate analyses. Of these, 21 factors met our criter ia for evaluation using WLS multivariate regression. For Grades K-3 (n = 108), population density, parental education, and coastal residence were negatively associated with caries scores, while age, and medical and dental Medicaid expenditures were positive. For Grades 4-6 (n=64) , age and fs:dfs ratio were positively associated with caries scores, while population density, population:dentist ratio, and years of natur al fluoride exposure were negative. CRIs for both models, when compare d to individual models, explained a substantial portion of the variati on in caries prevalence, 31% for Grades K-3 and 51% for Grades 4-6. Re sults suggest that a risk assessment model based on community rather t han individual variables is feasible and further refinement may reveal factors useful in identifying high risk communities.