Objectives: Caries remains a significant problem in urban communities. We are conducting a large-scale longitudinal study of dental health of Newark NJ school children ages 11-17. We will determine the prevalence of caries in the community and identify teeth with early lesions that would benefit from preventive measures. Methods: 535 children were examined in a mobile dental van. Following prophlaxis charting of decayed, missing and filled teeth was performed by mirror/explorer examination. The permanent molars were dried and examined with transillumination to determine the presence of white, or brown-gray subsurface discolorations indicative of early decay. Results: Examination of molars revealed that 43.9% had probe detectable lesions and 74% had discolorations as determined by transillumination. Based on the whole mouth charting 59% of the population has at lest one decayed tooth. 32 % of the population had between 3-9 decayed surfaces and 6 % had 10 or more decayed surfaces. 2.4 % were entirely free of restorations or lesions of any kind. African American children constituted 37.4% of the population and Hispanics 53.5% while of students with 3 or more probe detectable cavities 56.4% were African American (significantly higher than expected by Chi Square analysis p = 0.0009) and 40% Hispanics (significantly lower than expected by Chi Square analysis p = 0.0009). Conclusions: The proportion of children in this population having at least one decayed tooth exceeds that reported in the recent Surgeon General's report on oral health. Also disparity exists between ethnic groups. The incidence of early decay is underestimated due to lack of radiographs. A large number of subjects had occlusal surfaces with white or dark discolorations indicating early decay. This population will be followed over a 3-year period with repeat examinations, radiographs and evaluation with various caries detector devices. This study is supported by the Delta Dental Foundation.

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