Apgar score and dental caries risk in the primary dentition of five year olds.
BACKGROUND
Conditions in utero and early life underlie risk for several childhood disorders. This study tested the hypothesis that the Apgar score predicted dental caries in the primary dentition.


METHODS
A retrospective cohort study conducted in 2003 examined associations between conditions at birth and early life with dental caries experience at five years. Dental examination data for a random sample of five-year-old South Australian children were obtained from School Dental Service electronic records. A questionnaire mailed to the parents obtained information about neonatal status at delivery (five-minute Apgar score, birthweight, plurality, gestational age) and details about birth order, weaning, and behavioural, familial and sociodemographic characteristics.


RESULTS
Of the 1398 sampled children with a completed questionnaire (response rate=64.6%), 1058 were singleton term deliveries among whom prevalence of dental caries was 40.1%. In weighted log-binomial regression analysis, children with an Apgar score of <=8 relative to a score of 9-10 had greater probability of dental caries in the primary dentition after adjusting for sociodemographic and behavioural covariates and water fluoridation concentration (adjusted PR=1.47, 95% CI=1.11, 1.95).


CONCLUSIONS
Readily accessible markers of early life, such as the Apgar score, may guide clinicians in identifying children at potentially heightened risk for dental caries and aid decision-making in allocating preventive services.
Sanders
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AE
Department of Dental Ecology, School of Dentistry, The University of North Carolina at Chapel Hill, North Carolina, USA. anne_sanders@dentistry.unc.edu
Slade
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GD
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D001294:Attitude to Health; D001722:Birth Order; D001724:Birth Weight; D002327:Cariostatic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D015331:Cohort Studies; D004245:DMF Index; D003733:Dental Caries Susceptibility / Q000502:physiology*; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D005457:Fluoridation; D005459:Fluorides / Q000627:therapeutic use; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007182:Income; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D012189:Retrospective Studies; D035781:Siblings; D012959:Socioeconomic Factors; D014094:Tooth, Deciduous / Q000473:pathology*; D014099:Toothbrushing; D014886:Weaning; D055815:Young Adult
D002327:Cariostatic Agents; D004040:Dietary Carbohydrates; D005459:Fluorides