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Active white enamel lesion: a case-control study.

Maria Angela Fernandes Ferreira1, Dyego Leandro Bezerra de Souza, Gilmara Celli Maia de Almeida

  • 1Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. angelaf@ufr-net.br

Oral Health & Preventive Dentistry
|November 6, 2007
PubMed
Summary

Controlling plaque biofilm is crucial for preventing early-stage dental caries (white enamel lesions) in children. Poor oral hygiene, indicated by high plaque and gingival bleeding, significantly increases caries risk.

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Area of Science:

  • Pediatric Dentistry
  • Cariology
  • Public Health

Background:

  • White enamel lesions represent the initial stage of dental caries.
  • Early detection and intervention are key to preventing caries progression.
  • Understanding risk factors in pediatric populations is essential for targeted public health strategies.

Purpose of the Study:

  • To identify risk factors associated with active white enamel lesions in schoolchildren aged 7-12.
  • To conduct a case-control study in Natal, Brazil, to assess these risk factors.

Main Methods:

  • A case-control study involving 273 children with active white enamel lesions and 325 controls.
  • Matching was performed for age, gender, and school.
  • Independent variables included visible plaque index (VPI), gingival bleeding index (GBI), and various measures of decayed, missing, and filled surfaces (DMFS).

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Last Updated: Jul 10, 2026

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Main Results:

  • High VPI, GBI, DMFS, DMFS-dmfs, and number of carious surfaces were associated with increased risk in univariate analysis.
  • Logistic regression identified GBI (OR=2.14) and DMFS (OR=17.3) as independent risk factors for active white lesions.
  • Age and gender were not statistically significant risk factors.

Conclusions:

  • Mechanical plaque biofilm control is vital for preventing initial caries (white lesions).
  • Effective oral hygiene practices are paramount in reducing the incidence of early dental caries in children.
  • The findings underscore the importance of public health initiatives focused on oral hygiene education and prevention in schools.