Abstract

Background: Developmental dental defects (D3s) of enamel corre- spond to enamel alterations caused by damage of the enamel organ. Enamel D3s can be classified as demarcated or diffuse opacities or hypoplasia. It has been suggested that enamel D3s may contribute to caries development. However, this association remains unclear. Aim: To determine the association between D3s and dental caries in primary teeth and first permanent molars in 5 to 6-year-old children. Design: This cross-sectional study was undertaken in the Province of Talca, Chile following ethical approval. 347 children aged 5 to 6 years old were examined by three calibrated examiners for D3s (mDDE index) and caries (ICDAS II)(Kappa > 0.9). The Binom- inal Test was used to determine D3s and caries prevalence; the Z Test to compare localities and Fisher’s exact test to determine association between D3s and caries. Results: 50.7% of the children presented with D3s, the prevalence in primary and permanent teeth was 6% and 39.1% respectively. Caries prevalence was 55%, which was higher in rural areas (74.4%) versus urban 44.1% (P < 0.0001). Caries experience was 64.8% primary and 10.3% permanent teeth. In the primary den- tition, demarcated opacities showed an association with caries (P < 0.05 PR= 2.26) and diffuse opacities were inversely associ- ated with caries (P < 0.05 PR=0.48). Hypoplasia was not associ- ated with caries. Conclusions: Demarcated opacities were found to be related to higher caries prevalence and diffuse opacities seemed to be a pro- tective factor for caries in the primary dentition. Hypoplasia was not associated with caries. The validation of these findings in a larger population requires further research.