Dental caries and its relationship to bacterial infection, hypoplasia, diet, and oral hygiene in 6-to 36-month-old children

Caufield et al. (1) have suggested that the acquisition of mutans streptoco cci in young children most Likely takes place during a "window of infectivi ty" from 19 to 31 months of age. Objectives and Methods: This study determi ned the prevalence of dental caries and bacterial infection in a randomly s elected sample of 199 children 6 to 36 months old from the island of Saipan in the Commonwealth of the Northern Mariana Islands, USA. The relationship s between caries and Streptococcus mutans infection, hypoplasia, diet and o ral hygiene behavior were investigated. Results and Conclusions: The overal l estimated prevalence of caries was high: 46.8% of the children had white spot lesions and 39.1% had enamel cavitation. Colonization was seen in very young children; S. mutans was detected in 25% of the predentate children. The results of multi-variable modeling support the hypothesis that bacteria l infection, diet, and hypoplasia are important in the etiology of dental c aries in this population. Adjusted for age and ethnicity, children with a h igh level of S. mutans detected were 5 times more likely to have dental car ies than children with a lower level of S. mutans detected. Hypoplasia and a high cariogenicity score (diet) were also significant independent predict ors. The odds of having any white spot lesions or enamel cavitation were 9. 6 times greater for children with any hypoplasia, and 7.8 times greater for children with high cariogenicity scores relative to those with lower score s after adjusting for level of S. mutans, age and ethnicity. Sleeping with a bottle, maternal sharing of utensils, and high snacking frequency were no t significant predictors of caries in this population.