Dental caries and enamel defects in very low birth weight adolescents.
OBJECTIVE
The purpose of this study was to examine developmental enamel defects and dental caries in very low birth weight adolescents with high risk (HR-VLBW) and low risk (LR-VLBW) compared to full-term (term) adolescents.


METHODS
The sample consisted of 224 subjects (80 HR-VLBW, 59 LR-VLBW, 85 term adolescents) recruited from an ongoing longitudinal study. Sociodemographic and medical information was available from birth. Dental examination of the adolescent at the 14-year visit included: enamel defects (opacity and hypoplasia); decayed, missing, filled teeth of incisors and molars (DMFT-IM) and of overall permanent teeth (DMFT); Simplified Oral Hygiene Index for debris/calculus on teeth, and sealant presence. A caregiver questionnaire completed simultaneously assessed dental behavior, access, insurance status and prevention factors. Hierarchical analysis utilized the zero-inflated negative binomial model and zero-inflated Poisson model.


RESULTS
The zero-inflated negative binomial model controlling for sociodemographic variables indicated that the LR-VLBW group had an estimated 75% increase (p < 0.05) in number of demarcated opacities in the incisors and first molar teeth compared to the term group. Hierarchical modeling indicated that demarcated opacities were a significant predictor of DMFT-IM after control for relevant covariates. The term adolescents had significantly increased DMFT-IM and DMFT scores compared to the LR-VLBW adolescents.


CONCLUSIONS
LR-VLBW was a significant risk factor for increased enamel defects in the permanent incisors and first molars. Term children had increased caries compared to the LR-VLBW group. The effect of birth group and enamel defects on caries has to be investigated longitudinally from birth.
Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio 44106-4905, USA. suchitra.nelson@case.edu
S
S
Nelson
J M
JM
Albert
G
G
Lombardi
S
S
Wishnek
G
G
Asaad
H L
HL
Kirchner
L T
LT
Singer
D000293:Adolescent; D016010:Binomial Distribution; D016022:Case-Control Studies; D015331:Cohort Studies; D004245:DMF Index; D003731:Dental Caries / Q000209:etiology* / Q000473:pathology; D003733:Dental Caries Susceptibility; D003743:Dental Enamel / Q000002:abnormalities* / Q000254:growth & development / Q000473:pathology; D019229:Dentition, Permanent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D014071:Tooth Abnormalities / Q000150:complications* / Q000473:pathology