The Association Between Developmental Defects of Enamel and Early Childhood Caries in American Indian Children: A Retrospective Chart Review

Purpose: To determine the prevalence of developmental defects of enamel (DDE) among American Indian (AI) children and whether DDE are associated with caries experience and rehabilitative treatment under general anesthesia (GA). Methods: This retrospective study reviewed charts of 557 AI children, between 12 and 84 months of age, served by one Indian Health Service clinic in Sisseton, SD, USA. Analyses included descriptive and bivariate statistics, including odds ratios (OR). P=0.05 was considered significant. Results: The overall prevalence of DDE was 32.5% (mean equals 0.87 +/- 1.59 per child). The presence of DDE was associated with significantly higher mean decayed, extracted and filled (deft) scores (7.94 +/- 5.06 versus 4.84 +/- 5.14; P<0.001), predicting adverse clinical outcomes. Children with DDE had 3.8, 4.2, and 3.4 times the odds of having caries, early-childhood-caries (ECC), and severe early-childhood-caries (S-ECC), respectively, than those without DDE. DDE were also associated with higher odds of treatment under GA (OR equals 4.4). Conclusions: DDE were prevalent in this cohort of AI children and found to be significantly associated with a higher caries burden and dental rehabilitation under GA. Early recognition of DDE in infants and toddlers along with targeted prevention programs may help reduce the incidence of caries and subsequent treatment under GA.