title: A longitudinal study of occlusal caries in Newark New Jersey school children: relationship between initial dental finding and the development of new lesions.
abstract: OBJECTIVE
  Dental caries is a significant public health problem especially amongst children from low-income backgrounds. This longitudinal study examined the development of new occlusal caries in 227 Newark, NJ children ages 10-18. The role of previous caries experience and the presence of occlusal white and dark lesions in predicting the development of new lesions were examined.
  
  
  METHODS
  At each visit, the patient's teeth were given a visual-tactile examination and the subject's decayed, missing and filled (DMFS) score was determined. Next, molars lacking probeable caries or restorations were examined using transillumination for occlusal white and dark spots. This examination was repeated periodically. A Cox proportional hazard was used to analyse data concerning the development of new occusal caries in molars.
  
  
  RESULTS
  The longitudinal data indicates that patients who were caries free at visit-1 developed significantly fewer occlusal caries during the longitudinal study. The hazard ratio for subjects who had first-visit caries was 2.27 compared to caries free subjects. Intact molars with occlusal white or dark lesions had caries hazard ratios of 0.78 and 1.49 respectively, compared to molars lacking initial colour changes.
  
  
  CONCLUSIONS
  Having a prior caries history places the subject at increased risk of developing future caries. Teeth with dark lesions but not white lesions are at significantly increased risk for developing decay. White lesions may represent remineralizing or slowly progressing lesions. The results of this study can help identify patients and tooth surfaces at risk for future occlusal decay.
authors: Department of Oral Biology, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, 185 South Orange Ave, Newark, NJ 07103, USA.
authors: Kenneth
authors: K
authors: Markowitz
authors: Karen
authors: K
authors: Fairlie
authors: Javier
authors: J
authors: Ferrandiz
authors: Cibele
authors: C
authors: Nasri-Heir
authors: Daniel H
authors: DH
authors: Fine
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D003766:Dental Occlusion; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009515:New Jersey / Q000453:epidemiology; D016016:Proportional Hazards Models; D012306:Risk