Dental caries among disadvantaged 3- to 4-year-old children in northern Manhattan

Purpose: The study was conducted to determine the prevalence of early childhood caries (ECC), untreated caries, and the ratio of posterior to anterior caries in a disadvantaged predominantly Hispanic or African-American urban population. Data are compared to NHANES III to assess the caries burden in our cohort. Comparisons are made to the aggregate and to minorities within the national database. Methods: A retrospective chart review was conducted for children enrolled in a Head Start or day care program in the communities of Washington-Heights and Central and East Harlem and seen on the community organization's mobile dental van between 1995 and 1997. The study included only children 3 to 4 years of age at the initial examination (n=1605). A single examiner provided all the examinations. The mean number of decayed and filled surfaces (dfs), decayed surfaces (ds) and filled surfaces (fs), the percentage of decayed of total decayed and filled surfaces (%d/dfs), decayed and filled teeth (dft), decayed teeth (dt) and filled teeth (ft), and the percentage of decayed of total decayed and filled teeth (%d/dft) were calculated. Posterior vs anterior d, f, dft, dfs and d-anterior/total d, and d-posterior/total d were tabulated. Northern Manhattan data was tabulated and compared to NHANES III (1988-1994) in the aggregate and for subpopulations categorized by gender and ethnicity. All results are also reported for children with at least one decayed or filled tooth. T-tests were used to assess for significant differences. Results: There was even representation of males (50%) and females (50%). Mean dft was 1.08 overall, and 3.14 for children with dft>0. The level of untreated decay, %d/ dft, was 91%, significantly higher than the US national population which is 76% overall, and 76% for African Americans and Mexican Americans within the US national population. Conclusions: The children in this population have higher caries prevalence and a higher level of untreated caries than the national means as reported in NHANES III. The high level of untreated decay found in this particularly disadvantaged community suggests that enhanced dental services targeting the very young are needed in these communities.