ABSTRACT
Aim: This prospective cohort study was to evaluate the independent and mutual effects of socioeconomic, oral health behaviors and individual clinical factors, including enamelhypomineralization, as possible risk factors for increase in caries experience in second primarymolar (SPM) over a period of 2-years. Methods: Children (n=216) aged 4-6 years were examined for hypomineralized second primary molar (HSPM) and dental caries in school settingsand were recalled every 6 months. The caregivers filled out a semi-structured questionnaireabout their socio-demographic and oral health-related behaviors. Data analysis was performedusing a hierarchical model with three levels. Multiple analyses were performed at each level andvariables with p<0.20 were tested by stepwise multiple Generalized Estimating Equation. Results:At final examination, 33.3% of the children had developed new caries lesions in SPM. The modelshowed that the number of years of mothers schooling and the caregiver´s perception about theirchildrens caries experience played a protective role in the incidence of dental caries. Children who had white spot lesions were more likely to develop new carious lesions in SPM. Childrenwith HSPM showed no higher incidence of caries in their SPM than those without HSPM.Conclusions: Clinical, socioeconomic and behavioral factors impacted on caries developmentin primary second molars. However, further studies are required to better understand the role ofHSPM in caries development in other age groups.