The Predictive Ability of Endoscopy for Adjacent Caries of Primary Teeth in 4–5‐Year‐Old Children on the Basis of Mixed Effects Model Evaluation

Background Given their concealed location, adjacent caries of primary teeth in 4–5‐year‐old children are difficult to detect in the early stage. The intraoral camera‐based detection method is normally used to detect caries in primary teeth. However, this method largely depends on the experience and subjective judgment of the dentists. Hypothesis or Aim This study compared two intraoral camera‐based methods and eight oral hygiene habits for predicting proximal caries in 4–5‐year‐old children, aiming to develop a clinical diagnostic model. Design A retrospective analysis of intraoral camera‐based, X‐ray, and questionnaire data from 520 children identified key factors associated with caries. A mixed‐effects model was employed to construct the most predictive model. Results Among the 8320 analyzed teeth, significant predictors included visual assessment of caries on the basis of intraoral camera images, night milk consumption after 12 months of age, carbonated drinks, and snack frequency > 3 times/day. The intraoral camera‐based detection of the presence of caries was more accurate than the detection of marginal ridge changes. The area under the curve (AUC) value of the selected model (Model 4) was 0.670. The decision curve analysis (DCA) results revealed a 60% threshold probability. Conclusion Visual assessment of caries via intraoral camera images and oral hygiene habits significantly predicts primary tooth caries risk. One model (Model 4), which incorporates endoscopy and three oral health variables, provided the best predictive performance.