8 - Interproximal Carious Lesion Progression in Primary Molars and Canines

Purpose: To assess the rate of interproximal caries progression in primary molars and canines.

Methods: Bitewing radiographs were reviewed of patients seen in a children’s hospital dental clinic between 2016-2024 who have at least 3 sets obtained over a 3-year period, with the first set taken at age 3-5 years. Calibrated examiners independently scored the caries stage of each tooth surface using the Mejare system (k = 0.80). Statistical analysis was performed to evaluate the progression using descriptive analysis (mean±standard deviation) and linear regression (coefficient).

Results: Tooth surfaces (n=2240) were evaluated in 112 healthy (ASA I and II) patients over a minimum of three timepoints. Surfaces with caries were associated with adjacent surfaces with caries, whereas caries-free surfaces (stage 0) were adjacent to other caries-free surfaces. Stage 0 surfaces that later developed caries required 826.5±42.6 days to progress to outer dentin (stage 4), whereas caries in the outer half of enamel (stage 1) progressed 122.9±51.5 days faster to stage 4 (P=.018), caries present in stage 2 (inner enamel) progressed 271.0±51.7 days faster to stage 4 (P < .0001), and caries at the enamel-dentin junction (stage 3) progressed 461.1±59.6 days faster to stage 4 (P < .0001). Furthermore, caries at stage 3 progressed to inner dentin (stage 5) over an average of 604.4±51.7 days.

Conclusions: These findings describe the progression of caries in primary teeth. Clinicians should implement personalized approaches for caries management strategies with consideration of caries presence, rate of progression, and surfaces involved.

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