To use the International Caries Detection and Assessment System (ICDAS) to evaluate the prevalence of and factors associated with caries lesions in first permanent molars (FPMs) in Mexican schoolchildren aged 6–12 years with low socioeconomic status.
Methods:
A cross-sectional study was carried out with participants selected from two public primary schools. An evaluation of the caries lesions in the FPMs selected was conducted using the ICDAS. A multinomial logistic regression model was performed that included risk factors and the severity of the caries lesions.
Results:
A total of 752 schoolchildren and 3,008 FPMs were examined. Including all lesions, ICDAS 1–6, 86.7% of FPMs have caries. By severity, 17.5% early (ICDAS 1–2), 52.3% moderate (ICDAS 3–4), and 16.9% extensive (ICDAS 5–6). Poor oral hygiene (OR = 2.28 [CI 95% 1.30–4.01]), the participant’s mother presenting a low level of education (OR = 2.34 [CI 95% 1.32–4.14]), sweets consumption (OR = 4.78 [CI 95% 2.08–10.9]), and a low number of dental visits (OR = 2.41 [CI 95% 1.31–4.24]) were positively related to moderate and extensive caries lesions.
Conclusion:
The data show that current oral health programs do not detect early lesions and only detect children when they are already in the moderate/extensive risk zone. It is necessary to implement prevention activities such as the use of remineralizing agents and pit and fissure sealants. It is also necessary to teach parents/caregivers about the care of FPMs to improve oral health in child population.
MachiulskieneV, CampusG, JoanaDige I, . Terminology of dental caries and dental caries management: Consensus report of a workshop organized by ORCA and cariology research group of IADR. Caries Res, 2020; 54(1): 7–14.
2.
MarcenesW, KassebaumNJ, BernabéE, . Global burden of oral conditions in 1990–2010: A systematic analysis. J Dent Res, 2013; 92(7): 592–597.
3.
KazeminiaM, AbdiA, ShohaimiS, . Dental caries in primary and permanent teeth in children’s worldwide, 1995 to 2019: A systematic review and meta-analysis. Head Face Med, 2020; 16(1): 22.
4.
AbuaffanAH, HayderS, HussenAA, . Prevalence of dental caries of the first permanent molars among 6–14 years old Sudanese children. Int J Digit Evid, 2018; 11: 13–16.
5.
YurkstasAA. The effect of missing teeth on masticatory performance and efficiency. J Prosthet Dent, 1954; 4(1): 120–123.
6.
StoicaSN, NimigeanV, VîrlanMJR, . The pathology of the first permanent molar during the mixed dentition stage—review. Appl Sci, 2023; 13(1): 483.
7.
HeydariA, ShahrabiM, ShafizadehM, . Parental knowledge and awareness of the first permanent molar. Int J Clin Pediatr Dent, 2018; 11(5): 382–385.
8.
QueL, JiaM, YouZ, . Prevalence of dental caries in the first permanent molar and associated risk factors among sixth-grade students in São Tomé Island. BMC Oral Health, 2021; 21(1): 483.
9.
StoicaSN, MoraruSA, NimigeanVR, . Dental caries in the first permanent molar during the mixed dentition stage. Maedica (Bucur), 2023; 18(2): 246–256.
10.
ZhuF, ChenY, YuY, . Caries prevalence of the first permanent molars in 6–8 years old children. PLoS One, 2021; 16(1): e0245345.
11.
DianiL and ForchielliML. Sugar intake: Are all children made of sugar?Life, 2021; 11(5): 444.
12.
SchwendickeF, DörferCE, SchlattmannP, . Socioeconomic inequality and caries: A systematic review and meta-analysis. J Dent Res, 2015; 94: 10–18.
13.
KimJ, RoyI, Martinez-MierEA, . Impact of lack of transportation on access to dental care. Heliyon, 2024; 10(23): e40657.
14.
García-DiazR, Sosa-RubíSG, LozanoR, . Equity in out-of-pocket health expenditure: Evidence from a health insurance program reform in México. J Glob Health, 2023; 13: 04134.
15.
ChiDL, RossitchKC and BeelesEM. Developmental delays and dental caries in low-income preschoolers in the USA: A pilot cross-sectional study and preliminary explanatory model. BMC Oral Health, 2013; 13: 1–10.
16.
SinghA and PurohitBM. Malnutrition and its association with dental caries in the primary and permanent dentition: A systematic review and meta-analysis. Pediatr Dent, 2020; 42(6): 418–426.
17.
AlsuhaibaniR and AlHaidarSAM. Common dental diseases in children and malocclusion. IJMDC, 2022; 6(2): 369–372.
18.
AcharyaS and TandonS.The effect of early childhood caries on the quality of life of children and their parents. Contemp Clin Dent, 2011; 2(2): 98–101.
19.
LamloumD, DettoriM, La CorteP, . Evaluation of the caries experience in schoolchildren using the DMFT index. Medicina (Kaunas), 2023; 59(9): 1538.
20.
IsmailAI, SohnW, TellezM, . The International Caries Detection and Assessment, System (ICDAS): An integrated system for measuring dental caries. Community Dent Oral Epidemiol, 2007; 35: 170–178.
21.
Mathu-MujuKR and KennedyDB. Loss of permanent first molars in the mixed dentition: Circumstances resulting in extraction and requiring orthodontic management. Pediatr Dent, 2016; 38(5): 46–53.
22.
National Council for the Evaluation of Social Development Policy (CONEVAL). Poverty Statistics in México City. [Last accessed on 2025, Sep01]. Available from: https://sistemas.coneval.org.mx/DATAMUN/dato-actualizado?e=13&m=13014&sg=4&g=26.
23.
Mexican Association of Market Research and Public Opinion Agencies (AMAI). [Last accessed on 2026, Jan05]. Available from: https://www.amai.org/NSE/index.php?queVeo=NSEDES.
24.
MartignonS, PittsNB, GoffinG, . CariesCare practice guide: Consensus on evidence into practice. Br Dent J, 2019; 227(5): 353–362.
25.
World Health Organization: Oral Health Surveys: Basic Methods-5th edition Geneva, WHO, 2013.
26.
JettanacheawchankitS, PongpraditT, EuapokaiA, . Evaluating the effects of remineralizing agents on initial carious lesions. Can J Dent Hyg, 2025; 59(1): 18–28.
27.
KumarN, RaiK, ShettyK, . Evaluation of sealant retention and caries prevention of 2% chitosan-based pit and fissure sealants in permanent 1st molars: A randomised trial. J Oral Biol Craniofac Res, 2025; 15(6): 1490–1496.
28.
LadewigNM, CamargoLB, TedescoTK, . Management of dental caries among children: A look at the cost-effectiveness. Expert Rev Pharmacoecon Outcomes Res, 2018; 18(2): 127–134.
29.
MocaAE, VaidaLL, NegruțiuBM, . The influence of age on the development of dental caries in children. A radiographic study. J Clin Med, 2021; 10(8): 1702.
30.
ShqairAQ, PauliLA, CostaVPP, . Screen time, dietary patterns and intake of potentially cariogenic food in children: A systematic review. J Dent, 2019; 86: 17–26.
31.
AveryA, AndersonC and McCulloughF.Associations between children’s diet quality and watching television during meal or snack consumption: A systematic review. Matern Child Nutr, 2017; 13(4): e12428.
32.
MarshPD. Microbiology of dental plaque biofilms and their role in oral health and caries. Dent Clin North Am, 2010; 54(3): 441–454.
33.
MeeraR, MuthuMS, PhanibabuM, . First dental visit of a child. J Indian Soc Pedod Prev Dent, 2008; 26Suppl 2: S68–S71.
34.
NowakAJ, CasamassimoPS, ScottJ, . Do early dental visits reduce treatment and treatment costs for children?. Pediatr Dent, 2014; 36(7): 489–493.
35.
DumitrescuR, Sava-RosianuR, JumancaD, . The impact of parental education on schoolchildren’s oral health: A multicenter cross-sectional study in Romania. Int J Environ Res Public Health, 2022; 19(17): 11102.
36.
DyeBA, VargasCM, LeeJJ, . Assessing the relationship between children’s oral health status and that of their mothers. J Am Dent Assoc, 2011; 142: 173–183.
37.
ElenaB and PetrL.Oral health and children attitudes among mothers and school teachers in Belarus Stomatolgija. Baltic Dent Maxillofac J, 2004; 6: 40–43.
38.
KiuchiS, AidaJ, CoorayU, . Education-related inequalities in oral health among older adults: Comparing Singapore and Japan. Community Dent Oral Epidemiol, 2023; 51(4): 671–679.
39.
NourianA, TapakL, DaneshyarF, . A cross-sectional study of mothers’ oral health literacy on oral health status of children. Community Dent Health, 2025; 42(3): 54–63.
40.
RaghupathiV and RaghupathiW.The influence of education on health: An empirical assessment of OECD countries for the period 1995–2015. Arch Public Health, 2020; 78: 20.
