Childhood Factors and Dental Caries in the Permanent Dentition: Findings of an 8-Year Study Under a Nationwide School Dental Service

OBJECTIVE: This study, using a retrospective analysis of nationwide dental records of school-going children over 8 years, aims to identify childhood factors associated with dental caries incidence in the permanent dentition up to adolescence. METHODS: Students studying in primary and secondary schools in Singapore are eligible for free basic dental care under the nationwide School Dental Service (SDS). All available dental records, general health records, and sociodemographic data from 2009 to 2017 were extracted as anonymised records, for a full cohort of 29,617 students that were enrolled in Primary 1 in 2009. Multiple logistic regression and modified Poisson regression were applied to identify risk factors for caries incidence in the permanent dentition over 8 years. RESULTS: Caries occurred in the permanent dentition of 9389 (31.7%) students in the 8 years. Risk of caries incidence in the permanent dentition was associated with baseline caries in the primary (risk ratio [RR]: 1.88; 95% CI: 1.81, 1.95) and permanent (RR: 1.54; 95% CI: 1.47, 1.61) dentition, tooth hypoplasia (RR: 1.58; 95% CI: 1.49, 1.68), and poor baseline oral hygiene (RR: 1.07; 95% CI: 1.03, 1.12). Sociodemographic predictors of caries incidence include a lower socioeconomic status, Chinese ethnicity, female gender, and enrolment in nonmainstream schools or schools in the Eastern and Western regions of Singapore. CONCLUSIONS: Both clinical and sociodemographic factors in childhood are associated with caries incidence in the permanent dentition and can be used for structuring dental service provision and identifying caries-susceptible individuals and groups for early prevention and intervention.