Distinct patterns of caries, erosive tooth wear, and hypomineralization in preschool children: a population-based study of associated factors

OBJECTIVES: To assess prevalence, severity, and co-occurrence of dental caries, erosive tooth wear (ETW), and hypomineralization in preschool children, and to analyse their associations with general health, developmental, and sociodemographic factors. MATERIALS AND METHODS: This cross-sectional study was conducted within the mandatory school entry examination in Göttingen, Germany. A total of 1,461 children aged 5-6 years underwent standardized dental examinations assessing caries (dft/DFT), ETW (Basic Erosive Wear Examination), and hypomineralization (MIH Treatment Need Index). Information on general health, developmental, and sociodemographic factors was obtained from standardized parental questionnaires and medical assessments conducted as part of the school entry examination. Associations were analysed using multivariable regression models. RESULTS: Caries experience was observed in 29.4% of children and showed a highly polarized distribution. ETW was present in 69.7% of children, generally with low severity. Hypomineralization affected 10.8% of children. No significant associations were found between the three conditions. Caries was strongly associated with migration background, low maternal education, developmental issues, and obesity. ETW showed limited associations, increasing with age and being slightly more severe in boys. Hypomineralization showed no consistent associations. CONCLUSIONS: These conditions were common but largely independent and showed differing patterns of association with sociodemographic and health-related factors. CLINICAL RELEVANCE: The largely independent occurrence of these oral conditions suggests that risk assessment and prevention should address them as distinct conditions with differing patterns of association.