Evidence for clinical subtypes of early childhood caries

Author:

Simancas-Pallares Miguel1ORCID,Gormley Alexander2,Shrestha Poojan3,Gu Yu4,Cho Hunyong4,Spangler Hudson1,Burk Zachary1,Smith Michael5,Dashper Stuart6,Burgner David7ORCID,Zandona Andrea Ferreira8,Ginnis Jeannie9,Vann William1,Esberg Anders10,Roach Jeff9,Ribeiro Apoena9,Wu Di11ORCID,Silva Mihiri12,Holgerson Pernilla Lif13,Haworth Simon14ORCID,Johansson Ingegerd15ORCID,North Kari16ORCID,Divaris Kimon9ORCID

Affiliation:

1. Adams School of Dentistry, University of North Carolina at Chapel Hill

2. Bristol Dental School, University of Bristol

3. Adams School of Dentistry, Gillings School of Global Public Health, University of North Carolina at Chapel Hill

4. Gillings School of Global Public Health, University of North Carolina at Chapel Hill

5. Barwon Health

6. University of Melbourne

7. Murdoch Children's Research Institute

8. Tufts University, School of Dental Medicine

9. University of North Carolina-Chapel Hill

10. Department of Odontology, Umea University

11. University of North Carolina at Chapel Hill

12. University of Melbourne, Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne

13. Department of Odontology, Section of Paedodontics, Umeå University, Umeå, Sweden

14. University of Bristol

15. Umeå University

16. UNC Chapel Hill

Abstract

Abstract The current early childhood caries (ECC) case definition contains a substantial degree of clinical heterogeneity, and to address this, we sought to identify clinical subtypes of the disease. We used tooth surface-level dental caries experience from a discovery and 3 replication community-based cohorts of 3-to-5-year-old children (N=226,471). We identified five disease subtypes with distinct patterns of caries lesion intraoral distribution that largely replicated across cohorts. These subtypes were associated with established caries risk factors (e.g., history of nighttime bottle-feeding), showed familial concordance and microbiome differences, and predicted dental caries experience 7 years after subtype assignment. Notably, classification of children in these subgroups can be achieved by inspecting small sets of easily examinable tooth surfaces with reasonable accuracy. Collectively, our findings provide evidence for generalizable and clinically recognizable subtypes of ECC. Etiology, targeted prevention, and optimal management of these subtypes should be systematically investigated in future studies.

Publisher

Research Square Platform LLC

Reference56 articles.

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4. Beyond the dmft: the human and economic cost of early childhood caries;Casamassimo PS;J Am Dent Assoc,2009

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