Severity and Associated Risk Factors of Caries in First Permanent Molars Using ICDAS: A Cross-sectional Study of Mexican Schoolchildren

Objectives: 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.