Abstract
Caries in first permanent molars is a relevant school oral health problem, and its association with previous caries experience may vary according to enamel maturation. This study evaluated the moderating role of post-eruptive time, used as an indirect indicator of enamel maturity, in this association among schoolchildren aged 7 to 12 years, clustered within educational institutions. Poisson regression was performed using generalized estimating equations, with cluster-robust standard errors and adjustments for the design effect. The results showed that previous caries experience was associated with greater dental caries involvement, whereas post-eruptive time showed an inverse association. Furthermore, the significant negative interaction indicated that the magnitude of the association with previous caries experience progressively decreased as post-eruptive time increased, becoming statistically nonsignificant at higher levels. The findings, supported by sensitivity analyses, highlight the importance of considering post-eruptive time when assessing caries risk.
References
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[2] Z. Mahboobi, A. Pakdaman, R. Yazdani, L. Azadbakht, A. R. Shamshiri, and A. Babaei, “Caries incidence of the first permanent molars according to the Caries Assessment Spectrum and Treatment (CAST) index and its determinants in children: A cohort study,” BMC Oral Health, vol. 21, no. 1, Art. no. 259, 2021, doi: 10.1186/s12903-021-01612-1.
[3] J. C. Jiménez Núñez, S. K. Velázquez Sánchez, N. A. Alvarado León, K. L. Murillo Santos, and Á. García Pérez, “Severity and associated risk factors of caries in first permanent molars using ICDAS: A cross-sectional study of Mexican schoolchildren,” J. Adv. Oral Res., 2026, doi: 10.1177/23202068261447582.
[4] C. A. Romo-Pérez and C. Villafañe-Aguilar, “Distribution of bilateral dental caries in first permanent molars of vulnerable Colombian schoolchildren: An epidemiological analysis,” Rev. Fac. Odontol. Univ. Antioquia, vol. 38, no. 1, Art. no. e361720, 2026, doi: 10.17533/udea.rfo.v38n1e361720.
[5] J. Ochoa López, A. Cruz Gallegos, and L. Ribadeneira, “Prevalencia de caries dental en primeros molares permanentes de niños entre 6 a 9 años atendidos en la clínica odontológica de la Universidad Tecnológica Equinoccial–SERODU, periodo 2016–2017,” Kiru, vol. 15, no. 4, pp. 175–182, 2018, doi: 10.24265/kiru.2018.v15n4.04.
[6] C. A. Juárez-Medel, J. Hernández-Clemente, and E. Gutiérrez-Ventura, “Factors associated with severe permanent first molar caries among adolescents from Acapulco, Guerrero,” Rev. Estomatol. Herediana, vol. 32, no. 2, pp. 145–153, 2022, doi: 10.20453/reh.v32i2.4213.
[7] R. Alejo, “Factores de riesgo y la producción de caries en primeros molares en escolares 8 a 11 años en instituciones educativas de Cerro Colorado, Arequipa,” Rev. Cient. Andina Sci. Humanit., vol. 3, no. 1, pp. 121–130, 2022, doi: 10.57261/rcash.v3i1.47.
[8] C. A. Feldens et al., “Primary dentition caries patterns as predictors of permanent dentition caries: A prospective cohort study,” Caries Res., vol. 57, no. 2, pp. 167–176, 2023, doi: 10.1159/000529620.
[9] Y.-T. Lin, C.-C. Chou, and Y.-T. J. Lin, “Caries experience between primary teeth at 3–5 years of age and future caries in the permanent first molars,” J. Dent. Sci., vol. 16, no. 3, pp. 899–904, 2021, doi: 10.1016/j.jds.2020.11.014.
[10] S. K. Agrawal, T. Bhagat, and A. Shrestha, “Dental caries in permanent first molar and its association with carious primary second molar among 6–11-year-old school children in Sunsari, Nepal,” Int. J. Dent., vol. 2023, Art. no. 9192167, 2023, doi: 10.1155/2023/9192167.
[11] R. J. M. Lynch, “The primary and mixed dentition, post-eruptive enamel maturation and dental caries: A review,” Int. Dent. J., vol. 63, no. Suppl. 2, pp. 3–13, 2013, doi: 10.1111/idj.12074.
[12] N. Kotsanos and A. I. Darling, “Influence of posteruptive age of enamel on its susceptibility to artificial caries,” Caries Res., vol. 25, no. 4, pp. 241–250, 1991, doi: 10.1159/000261371.
[13] S. Garg, A. Dhindsa, P. Poddar, R. Sharma, and S. Singla, “Eruption status of first permanent molar and prevalence of dental caries among school going North Indian children: An epidemiological study,” J. Dent. Health Oral Res., vol. 3, no. 2, pp. 1–9, 2022, doi: 10.46889/JDHOR.2022.3202.
[14] J. H. Rivas Avila, E. F. Lares Bayona, N. Velázquez Hernández, and S. Estrada Martínez, “Prevalence of dental caries in the first molars in schoolchildren in the municipality of Durango and its relationship with socioeconomic factors,” Int. J. Health Sci., vol. 3, no. 46, 2023, doi: 10.22533/at.ed.1593462328067.
[15] R. K. Gudipaneni et al., “Assessment of caries diagnostic thresholds of DMFT, ICDAS II and CAST in the estimation of caries prevalence rate in first permanent molars in early permanent dentition—A cross-sectional study,” BMC Oral Health, vol. 22, no. 1, Art. no. 133, 2022, doi: 10.1186/s12903-022-02134-0.
[16] V. Nand, M. Memon, A. A. Jafferi, M. Ali, S. Memon, and S. Aslam, “Comparison between visual and radiographic methods using ICDAS criteria in permanent molars for detection of occlusal and proximal caries—A comparative study,” Pak. J. Health Sci., vol. 6, no. 9, pp. 140–144, 2025, doi: 10.54393/pjhs.v6i9.3171.
[17] Z. Song and R. Wang, “Fluoride varnish efficacy on first permanent molars caries prevention,” Int. Dent. J., vol. 75, no. Suppl. 1, Art. no. 104401, 2025 (conference abstract), doi: 10.1016/j.identj.2025.104401.
[18] A. Bakhshandeh and V. Qvist, “To seal or restore occlusal caries in permanent molar teeth, 11-year RCT,” Caries Res., vol. 59, no. 6, pp. 544–557, 2025, doi: 10.1159/000544980.
[19] W. J. Albornoz Flores, “Uso de sellantes en la disminución de caries en primeros molares permanentes,” Rev. Gac. Cient. HampiKuna, vol. 2, no. 1, pp. 1–8, 2026, doi: 10.46794/gahaku.2.1.2768.
[20] H. B. Saethre-Sundli, N. J. Wang, and T. I. Wigen, “Do enamel and dentine caries at 5 years of age predict caries development in newly erupted teeth? A prospective longitudinal study,” Acta Odontol. Scand., vol. 78, no. 7, pp. 509–514, 2020, doi: 10.1080/00016357.2020.1739330.
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