Dental caries patterns and oral health behaviors in Arizona infants and toddlers

Objectives: The aim of this study was to use tooth eruption sequence, and a tooth- and surface-specific caries analysis method to determine: (1) the t emporal relationship between tooth eruption and caries onset; (2) the valid ity of pre-existing concepts of caries progression; and (3) the relationshi p of certain putative health behaviors with caries prevalence. Methods: A t otal of 2428 Arizona children aged 6-36-months, who were recruited from WIC programs (a federal program for low-income children at nutritional risk), health fairs and private day care centers, received visual dental caries ex aminations. Additionally, an oral health behavior survey was administered t o the parents of the 1529 children recruited from the WIC programs. Results : Dental caries was detected soon after tooth eruption, and by 34-36 months of age 25% of this population had caries. Maxillary anterior caries develo ped as early as 10-12 months of age. Fissure caries of the molars, either b y itself or with maxillary anterior caries, was seen as early as 13-15 mont hs of age. Posterior proximal caries was seen as early at 19-21 months, and only was present in conjunction with the other patterns. Over 40% of the 1 3-36-month-old children whose parents completed the survey still used a bot tle. Night-time bottle use was associated with maxillary anterior caries in 24-36-month-old children, but no association was found in younger children or with posterior caries patterns. Survey responses also showed that fewer than 15% of these children reported having had a dental visit. Conclusions : Dental caries was a significant health issue for these children under 3 y ears of age, and factors other than bottle feeding may play an important ro le in its etiology. Prevention of dental caries in children under age three will depend on a better understanding of the etiology as well as improved access to care.