Distribution of primary tooth caries in first-grade children from two nonfluoridated US communities

In a prospective longitudinal study, 1099 first grade children from Aiken, South Carolina, and 1086 children from Portland, Maine, were examined annually for 3 years. Caries prevalence and dmfs incidence were determined. The mean dmfs in Portland children was 2.9. In Aiken, white children had a mean dmfs of 8.4, and black children had a mean dmfs of 10.2. The mean 3-year primary tooth caries increment was 1.5 surfaces in the Portland cohort 3.3 surfaces in the Aiken white cohort and 2.8 surfaces in the Aiken black cohort. These increments were divided evenly between interproximal and fissure surfaces. Twenty percent of the children in Portland had 75% of the caries; in Aiken, 20% of the children had 60% of the caries. This distribution suggests a high-risk group that could be targeted for aggressive caries prevention efforts if risk factors can be identified.