118 - Association Between Primary Second and Permanent First Molar Caries

Pit and fissure caries in primary second molars (PrSM) may indicate increased susceptibility to caries in permanent first molars (PeFM). However, the predictive value of tooth-specific disease patterns compared to generalized risk models remains underexplored.

The objective of this study was to evaluate the association between pit and fissure health in PrSMs and health of PeFMs with consideration of behavioral risk factors. ​

Methods:
A retrospective chart review was conducted of 200 pediatric patients aged 8–10 years treated between January 2021 and July 2025. Caries status of PrSMs (#A, J, K, T) and PeFMs (#3, 14, 19, 30) was recorded as present or absent. Behavioral risk factors included plaque presence (gauze wipe), nighttime brushing, recall compliance, and juice consumption between meals. Sealant presence on PeFMs was documented. Patients were stratified based on combinations of behavioral risk factors and corresponding caries outcomes.

Results show that only 12% of patients demonstrated ideal clinical and behavioral profiles, while 11.5% exhibited favorable outcomes despite initial PrSM caries. PeFM caries risk appeared multifactorial, with a strong association between lack of nighttime brushing, positive plaque scores, and increased caries incidence. No patients with all four behavioral risk factors presented with caries-free PeFMs, highlighting the cumulative effect of risk burden. Sealants emerged as the most consistent protective factor, with caries-free PeFMs observed even in patients with multiple behavioral risk factors. Patients lacking sealants and nighttime brushing frequently demonstrated concurrent plaque accumulation and high juice exposure, suggesting clustering of high-risk behaviors.

While PrSM caries may indicate increased susceptibility, PeFM outcomes are modifiable and strongly influenced by behavioral factors and preventive interventions. Sealants play a critical protective role regardless of baseline risk. These findings support a targeted, behavior-focused approach to caries risk assessment and emphasize the importance of early intervention to modify disease trajectories during key developmental periods.