Developmental enamel defects and hypomineralized second primary molars among preschool children in Kuwait: associations with caries severity and oral health-related quality of life.

OBJECTIVES: to determine the prevalence and distribution of developmental enamel defects (DDEs), including hypomineralized second primary molars (HSPMs) among preschool children, and to evaluate their associations with caries experience, clinical consequences of untreated caries, and oral health-related quality of life. MATERIALS AND METHODS: this cross-sectional population-based study included kindergarten children. Dental caries was evaluated using dmft/dmfs indices, and clinical consequences of untreated caries were assessed by pufa index. DDEs were recorded by the modified DDEs index, and HSPMs were diagnosed according to European Academy of Paediatric Dentistry criteria. OHRQoL was evaluated by the validated Arabic Early Childhood Oral Health Impact Scale (A-ECOHIS). RESULTS: DDEs were identified in 66.2% of children, with combination defects (29.9%) and demarcated opacities (25.5%) being the most prevalent subtypes. HSPMs were present in 20.0%. Children with DDEs had significantly higher odds of dental caries than those without DDEs (adjusted OR = 2.00; 95% CI: 1.48-2.70). Among DDEs subtypes, enamel hypoplasia (EH) showed the strongest association with dental caries (adjusted OR = 3.50) and clinical consequences of untreated caries (pufa > 0, adjusted OR = 2.34). HSPM presence was also associated with higher odds of caries (adjusted OR = 2.42). EH was also significantly associated with higher child (p < 0.001) and family A-ECOHIS scores (p = 0.01). Severe HSPMs were significantly associated with higher child and family A-ECOHIS scores (p < 0.001). CONCLUSIONS: Developmental enamel defects, particularly enamel hypoplasia and hypomineralized second primary molars, are clinically relevant conditions associated with high caries experience, clinical consequences of untreated caries and poorer OHRQoL in preschool children.