Objective: Assessment of fluoride's benefit requires caries assessment at several different levels. The purpose of this project is to report caries prevalence and incidence in the early mixed dentition. Methods: Iowa Fluoride Study subjects received both a primary dentition exam (approximately age 5) and a mixed dentition exam (approximately age 9) from either of two trained and calibrated dentists. Subjects included for these analyses were those with all permanent incisors and 1^st molars present at the age 9 exam, and also all 4 primary 2^nd molars present at both the age 5 and age 9 exams (N=490). Each tooth surface was scored as sound, d₀/D₀(questionable), d₁/D₁(incipient caries), d_2-3/D_2-3(frank caries) or filled. Caries prevalence was calculated separately for incisors and 1^st molars. Caries increment and incidence in the primary 2^nd molars was adjusted for d_2-3f reversals, and represents change in d_2-3fs over approximately 4 years. Separate calculations were made for smooth-surface, pit and fissure, and total caries experience. Results: D_2-3F prevalence for the 8 permanent incisors was only 0.4% (mean D_2-3FS =0.03). D_2-3F prevalence for the smooth surfaces of the permanent 1^st molars was only 2% (mean D_2-3FS=0.04), 21% for the pit & fissure surfaces (mean D_2-3FS=0.38), and 21% overall (mean D_2-3FS=0.41). Primary 2^nd molar caries incidence (d_2-3f) over the interval between exams was 21% for the smooth surfaces (mean d_2-3fs=0.43), 27% for the pit & fissure surfaces (mean d_2-3fs=0.49), and 32% overall (mean d_2-3fs =0.92). Conclusions: Caries prevalence in the early permanent dentition was predominantly found on the pit & fissure surfaces of the 1^st molars. Caries increment in the primary 2^nd molars, however, was found to be substantial on both the smooth surfaces and the pit & fissure surfaces. Supported by the NIDCR(R01-DE09551) and GCRCP(M01-RR00059).

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