About half of all carious lesions in primary teeth of German 6- to 7-year-old children remain untreated, but no data regarding the clinical consequences of untreated dental caries are available. Therefore, this cross-sectional observational study aimed to assess the prevalence and experience of caries and odontogenic infections in the primary dentition of 5- and 8-year-old German children. Dental examinations were performed in 5-year-old pre-school children (n = 496) and in 8-year-old primary school children (n = 608) living in the Westphalian Ennepe-Ruhr district. Schools and preschools were selected by sociodemographic criteria including size, area, ownership, socio-economic status. Caries was recorded according to WHO criteria (1997). The Lorenz curves were used to display the polarisation of dental caries. Caries pattern in 5-year-olds was categorized by Wyne’s (1997) definition of early childhood caries (ECC). Odontogenic infections as clinical consequence of untreated dental caries were assessed by the pufa index. The ‘untreated caries-pufa ratio’ was calculated, and the Spearman’s rank correlation coefficient (ρ) was used for evaluating the correlation between dmft and pufa scores. Categorical data were compared between groups using the chi-square test and continuous data were analysed by t-test. Caries prevalence and experience in the primary dentition was 26.2 %/0.9 ± 2.0 dmft in 5-year-olds and 48.8 %/2.1 ± 2.8 dmft in 8-year-olds. ECC type I (22 %) was the prevalent caries pattern in 5-year-olds. About 30 % of the tooth decay was treated (5y: 29.7 %/8y: 39.3 %). The Lorenz curves showed a strong caries polarisation on 20 % of the children. Pufa prevalence and experience was 4.4 %/0.1 ± 0.5 pufa in 5-year-olds and 16.6 %/0.3 ± 0.9 pufa in 8-year-olds. In 5-year-olds 14.2 % and in 8-year-olds 34.2 % of the d-component had progressed mainly to the pulp. A significant correlation between dmft and pufa scores exists in both age groups (5y: ρ = 0.399; 8y: ρ = 0.499). First deciduous molars were most frequently affected by odontogenic infections, presenting virtually all pufa scores (>95 %). Prevalence and experience of odontogenic infections and the untreated caries-pufa ratio were increasing from the younger to the elder children. Dmft and pufa scores in primary teeth predict a higher caries risk in permanent teeth. The pufa index highlights relevant information for decision makers to develop effective oral health care programs for children at high risk for caries.

Aim: Assessment of dental health in the primary dentition of preterm infants (PTI) including investigation of mother- and infant-related risk factors in a case-control study design. Material and Methods: One hundred twenty-eight infants aged 3-4 years were included. Sixty-four PTI (27 males) were randomly selected from the preterm registry of the Jena University Hospital. As a control group served 64 full-term infants (FTI) recruited from the Department of Paediatric Dentistry, matched for age and sex. Dental examinations were provided by one dentist under standard clinical conditions. Caries was scored using the International Caries Detection and Assessment System (ICDAS II) and the DMFT, gingival health using the Periodontal Screening Index, and developmental defects of enamel using the DDE index. Mother- and infant-related factors were collected via a questionnaire and from medical records. Results: The caries prevalence was 50.0% (ICDAS II >0) in PTI and 12.5% (ICDAS II >0) in FTI. The caries experience was higher in PTI (DMFT 1.0 ± 3.1) than in FTI (DMFT 0.3 ± 1.0). PTI had a higher risk of caries (OR 7.0), initial lesions (OR 6.2), DDE (OR 7.5), and gingivitis (OR 6.5) than FTI. The highest risk occurred in PTI with an extremely low birth weight (<1,000 g). A higher risk of DDE was present when mothers suffered from illness during pregnancy (OR 3.9). A higher risk of caries was revealed in infants with respiratory syndrome (OR 6.2) or when their mothers had a lower socioeconomic status (OR 6.3). Conclusions: PTI had less healthy teeth than FTI and are at a higher risk for DDE, caries, and gingivitis. The poorer dental health in PTI is associated with a low birth weight, a low socioeconomic status, and mothers' illness during pregnancy.

Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm² and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm² and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (p ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, p ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics—reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.

Children are exposed to ionizing radiation through radiographs during their development for various reasons. At present, there are no officially valid reference values for dental X-rays in children and adolescents for dental X-ray diagnostics. This study retrospectively examined 9680 extraoral dental radiographs in pediatric patients between 2002 and 2020. The aim was to analyze the radiation doses in pediatric patients, which indications were used, and whether there were specific age and gender differences. The evaluation showed that radiation doses were considered low, with dose area products of 2.2 cGy × cm² for a lateral cephalogram, 14 cGy × cm² for an orthopantomogram (OPG), and 45 cGy × cm² for cone beam computer tomography (CBCT). This corresponds to an effective dose of 1.5 μSv for a lateral cephalogram, 7 μSv for an OPG, and 33.8 μSv for CBCT. Of the 9680 images, 78% were orthopantomograms, and only 0.4% were CBCT images. OPG has become more important over the years, as reflected in the indication. Approximately one-third of all extraoral exposures are orthodontic indications. Overall, the indications were similar for both genders. According to the dental indications, boys were X-rayed slightly more frequently than girls (54.5–45.5%). A future publication of dose guide values and corresponding guidelines is of high priority.