Clinical Oral Investigations

, Volume 22, Issue 3, pp 1579–1586 | Cite as

Risk factors associated with new caries lesions in permanent first molars in children: a 5-year historical cohort follow-up study

  • Carmen Llena
  • Elena Calabuig
Original Article



The objective of this study is to analyze the factors associated with the occurrence of caries in the permanent teeth (PT) and in the permanent first molar (PFM) 5 years after their eruption.

Material and methods

Children born in 2005 and enrolled in a community dental program were included. The inclusion criteria were: age 10 years in 2015; the availability of clinical dental history (CDH) data from before eruption of the PT and a follow-up period of 5 years after eruption of the PT. A total of 206 children were enrolled. Risk factors evaluated were: caries experience in the mother, educational level of the mother, frequent drug use, systemic diseases, eating habits, brushing frequency, presence of molar incisor hypomineralization (MIH) in PT, and caries in deciduous teeth (DT). Associations between explanatory factors and the DMF-T (decayed, missing, filled teeth in PT) and DMFT-M (DMF in PFM) indexes, independently considering cavitated or cavitated and non-cavitated caries as outcomes, were evaluated by poisson regression with robust variance analysis.


In the multivariate analysis, a cariogenic diet, especially soft drinks, was associated to high DMF-T and DMFT-M scores when both cavitated and non-cavitated caries were considered. A brushing frequency < 1 a day was significantly associated to high DMF-T scores. The presence of df-t (decayed and filled temporary teeth) score > 0 and MIH conditioned high DMF-T or DMFT-M values, considering cavitated or cavitated and non-cavitated caries.


The intake of sweets and soft drinks, brushing frequency, caries in DT, and MIH in PT were the best predictors of caries in PT.

Clinical relevance

Control of risk factors in early childhood is important for preventing caries in PT.


Cariogenic diet Dental caries Molar incisor hypomineralization Permanent first molar Risk factors 



The work was supported by the Department of Stomatology. University of Valencia (Valencia, Spain).

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

The study protocol was approved by the Clinical Research Ethics Committee of the University of Valencia (procedure number: H1454270187226). Likewise, permission was obtained from the Health Department authorities to use the information contained in the CDHs, previously anonymized by one of the investigators belonging to the medical staff of the Health Department in order to protect patient confidentiality. All the information was processed in abidance with the confidentiality regulations defined under Act 15/1999 referred to personal data protection.

Informed consent

Informed consent was obtained from the parents of all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of StomatologyFacultad de Medicina y Odontología, Universitat de ValènciaValenciaSpain

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