Permanent first molar eruption and caries patterns in American Indian and Alaska Native children: challenging the concept of targeting second grade for school-based sealant programs.

OBJECTIVE

To describe first permanent molar eruption and caries patterns among American Indian and Alaska Native (AI/AN) children in order to identify the appropriate target grade for school-based sealant programs.

METHODS

We used data from the 2011-2012 Indian Health Service oral health surveillance survey of AI/AN children in kindergarten through third grade. Children were screened by trained examiners. Cavitated lesions were classified as decayed, and teeth with any portion of the crown exposed were considered erupted.

RESULTS

We screened 15,611 AI/AN children in 186 schools. The percentage with four erupted first molars was 27 percent of kindergarten, 76 percent of first, 96 percent of second, and 99 percent of third-grade children. About 7 percent of kindergarteners had decayed, missing, or filled molars compared with 20 percent, 30 percent, and 38 percent of first, second, and third graders, respectively.

CONCLUSION

School-based sealant programs for AI/AN children should target kindergarten and first grade with follow-up programs for second-grade children.