A biopsychosocial model to predict caries in preschool children.

The purpose of the study is to assess a multidisciplinary caries-prediction model. Enrolled in the study were 184 low-income children ages 3-5 years old in two Head Start programs in Connecticut. Children were examined by a dentist at baseline and at 1 year for dental caries. Each child also provided a saliva sample to obtain a measure of S. mutans. The children's caregivers completed an interview that assessed oral health behaviors, and cognitive and socioeconomic factors. The prevalence of decay (1 dmfs) increased from 40 to 58% and the number of dmfs increased significantly from 2.5 (7.1) dmfs to 4.5 (8.8) dmfs (P < 0.001) in 1 year. S. mutans did not change significantly. Discriminant function analysis predicting change in caries in the second year from data obtained in the first year showed that S. mutans, dmfs, and toothbrushing significantly predicted caries risk (canonical correlation = 0.5571; x2 = 51; df = 3; P < 0.001). Children with higher dmfs, higher S. mutans, and whose parents reported more frequent brushing had more decay in the second year. None of the other behavioral, cognitive, or demographic factors was significant. The results emphasize the importance of early intervention in preventing dental caries in an underserved population.