Objectives: To describe the epidemiology of dental caries among low-income African American children 5 years old and younger in the City of Detroit.

Methods: A multistage probability sample of African- American families living in the poorest 39 Census Tracts in Detroit was conducted. This study used cross sectional data on 937 dentate children (age 0-5 years) and their main caregiver obtained in the first wave of interview and examination in 2002-2003. Dental caries was measured by the criteria developed by the International Caries Diagnosis and Assessment System (ICDAS). Caries diagnostic codes were recorded on a scale from 0 to 6 (From sound, visual changes in enamel to extensive distinct cavity with visible dentin). Analyses were conducted using SUDAAN to account for the complex sampling design.

Results: There is a linear increase in caries (both non cavitated and cavitated dentinal lesions) as child's age increases. At age 2, there is a reduction of approximately 26% in the number of children who were caries free mainly due to a large increase in cavitated lesions (Age 1: 6.6.%, Age 2: 20.4%). Surprisingly at age 5, 42% of the children had severe early childhood caries (S-ECC), 49% had early childhood caries (ECC), and only 9% did not have cavitation. More than 90% of the number of decayed and filled surfaces corresponds to untreated decay, and this percentage is higher for males (96%) than for females (86%). Cumulative logit models showed that the odds of having S-ECC/ECC increases significantly as the caregiver's perception of the child's oral health becomes poorer (Excellent Perception (OR: 0.01 95% CI: 0.01, 0.02), and Fair Perception (OR: 0.09 95% CI: 0.04, 0.2)).

Conclusion: Dental Caries in primary teeth in children 5 years of age and younger in Detroit is a major dental public health problem. NIDCR Grant #5U54DE14261

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