Maxillary Anterior Caries as a Predictor of Posterior Caries in the Primary Dentition in Preschool Brazilian Children

Purpose: The purpose of this study was to assess the use of maxillary anterior (MA) caries as a predictor of posterior (PO) caries at different dmf thresholds in Brazilian preschoolers. Methods: Clinical examinations were carried out during a National Day of Children Vaccination in Diadema, S.P., Brazil. Caries experience was measured using dmfs index (WHO criteria), including white spots (D1). Odds ratio (OR), specificity (Sp), sensitivity (Se), and positive and negative prediction values (PV+, PV-) were calculated at different dmfs thresholds for maxillary anterior teeth. The area under the ROC curve (AUC) was used as a measure of the discriminant ability of MA caries on posterior caries. Results: A total of 987 children 5 to 59 months old were examined: 33% had caries; 22% had MA caries; and 68% had PO caries. In children older than 36 months, an association was found between MA and PO caries. Presence of MA caries increased the chances of children presenting PO caries at all dmfs thresholds. Predictive values (Sp, Se, PV+, PV-) varied according to dmfs thresholds. The total AUC was 0.75. Conclusions: Caries in the anterior maxillary region was positively associated with posterior caries in 5- to 59-month-old children. Early onset of caries in maxillary anterior teeth may be a good predictor of the development of caries in posterior teeth in preschoolers.