The Incidence and Distribution on Smooth Surface White Spot Lesions in Children Under 6 Years

Background. The first clinical sign of enamel caries is a white spot carious lesion. Literature does not provide sufficient information on the incidence of early carious lesions in enamel of primary dentition in Polish children. Objectives. To evaluate incidence and location of white spot carious lesions on smooth surfaces in primary dentition accessible in visual examination in children below 6 years of age. Material and Methods. The study included children aged 18-71 months presenting at the Department of Paediatric Dentistry, Medical University of Warsaw. Clinical examination was performed using a flat mirror and WHO periodontal probe. Presence of white spot caries on smooth tooth surfaces, which were accessible in visual examination, visible without drying was recorded according to ICDAS II criteria. Examinations were performed by 3 calibrated dentists. Results. After calibration, kappa concordance correlation coefficient amounted to 0.96. Among all 419 examined children, white spots were observed in 47.7% of children with similar rates in girls and boys. Their incidence was 3 times higher in children aged 37-71 months (75.5%) than in the 18-36 months age group (24.5%). White spots were mainly observed on labial/buccal surfaces, specifically in canines and upper lateral incisors. Symmetrical location of white spots was observed in upper and lower teeth, as well as on the left and right side. Mean number of smooth surfaces affected by white spots in the entire study group was 2.05 +/- 2.87, and 4.30 +/- 2.75 in children with white spots. Conclusions. White spot carious lesions on smooth surfaces of primary teeth occur in almost every second child below 6 years of age, and most commonly affect canines and upper incisors. Their incidence and number increases with age.