Dental caries in permanent first molars: implications for health surveillance.

OBJECTIVE: To analyze the participation of the first permanent molars (M1) in the composition of the DMFT index, with or without exposure to fluoridated water (FW), its potential implications for health surveillance. METHODS: its potential implications for health surveillance FW. Mean DMFT values and the percentage contributions of different tooth groups to these values were calculated. RESULTS: Mean DMFT values were 2.66, 2.49, and 2.21 for capitals without FW in 2003, 2010, and 2023, respectively, and 1.58, 1.36, and 0.96 for capitals with FW. Between 2003 and 2023, mean DMFT values declined by 16.2% in capitals without FW and by 39.2% in capitals with FW. In 2003, the contribution of M1 to the DMFT index was 70.51% among those exposed to FW and 63.61% among those not exposed. In 2010 and 2023, these contributions were 67.95% and 57.68%, and 63.61% and 49.23%, respectively. CONCLUSION: The controlled presence of fluoride in water contributed to an increased percentage contribution of M1 to the composition of the DMFT index, whereas this proportion decreased in the absence of this preventive measure. However, this effect was not observed for premolars and second molars. This variation is relevant to oral health surveillance strategies, particularly activities aimed at the active detection of early caries lesions and their treatment.