Longitudinal study of caries progression in 2- and 3-year-old German children Pitchika V, Kokel C , Andreeva J, Crispin A, Hickel R, Garcia-Godoy F, Ku¨ hnisch J, Heinrich-Weltzien R. Longitudinal study of caries progression in 2- and 3-year-old German children. Community Dent Oral Epidemiol 2016. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Abstract – Objective: This 2-year longitudinal study in 2- and 3-year-old kindergarten children investigated lesion progression on different surfaces of primary teeth. Methods: The study was conducted between September 2008 and September 2010 on a sample of 400 children from the Kyffha¨ user district (Thuringia, Germany). A calibrated investigator recorded (non)cavitated caries lesions according to World Health Organization (WHO), International Caries Detection and Assessment System (ICDAS) and Universal Visual Scoring System (UniViSS) criteria. Nonparametric methods and linear regression using a mixed-effects model with an unbalanced design were used for data analysis. Results: There was a significant increase in the prevalence of noncavitated caries lesions during the 2-year period, with the highest chance for change on all surfaces compared to cavitated lesions. First visible sign lesions on occlusal surfaces had the highest chance for change (estimate 0.38), whereas established lesions revealed the highest chance for change on proximal (estimate 1.05) and smooth surfaces (estimate 0.62). Proximal lesions exhibited the greatest chance for change irrespective of severity level. Conclusion: Our study demonstrated that each type of carious lesion had different changing rates. Greater lesion severity correlated with greater chances to change and receive treatment. This information is crucial for dental practitioners in decision-making processes. Vinay Pitchika 1 , Claudia Kokel 2 , Jana Andreeva 3 , Alexander Crispin 4 , Reinhard Hickel 1 , Franklin Garcia-Godoy 5 , Jan Ku¨ hnisch 1 and Roswitha Heinrich-Weltzien 2 1 Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians- Universita¨ t Mu¨ nchen, Munich, Germany, 2 Department of Preventive and Paediatric Dentistry, University Hospital of Jena, Jena, Germany, 3 Health Centre of Kyffha¨user District, Sondershausen, Germany, 4 Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians- Universita¨ t Mu¨ nchen, Munich, Germany, 5 Bioscience Research Center, The University of Tennessee Health Science Center, Memphis, TN, USA Key words: caries progression; dental caries; epidemiology; longitudinal study; noncavitated caries lesions Vinay Pitchika, Ludwig-Maximilians- Universita¨ t Mu¨ nchen, Poliklinik f € ur Zahnerhaltung und Parodontologie, Goethestraße 70, 80336 Mu¨ nchen, Germany Tel.: +49 89 4400 59447 Fax: +49 89 4400 59302 e-mail: pitchika@dent.med.uni-muenchen.de Submitted 26 December 2014; accepted 19 January 2016 Early childhood caries (ECC) is defined as the pres- ence of either a cavitated or a noncavitated carious lesion or missing/filled tooth surfaces on a pri- mary tooth in a child <72 months of age 1 . Epidemi- ological studies suggest that caries prevalence and experience are lower in industrialized nations, compared to developing nations, primarily because of better oral hygiene practices and pre- ventive measures 2,3 . Additionally, the burden of caries is concentrated in high-risk groups 4 . How- ever, recent studies show an increase in caries prevalence in developing and industrialized nations, likely because of the immigration of popu- lations from rural to urban centres and the increased consumption of bottled water instead of fluoridated tap water 5 . Dental research in the past decades tried to identify reliable caries risk factors using longitudinal studies 6–9 . High numbers of Streptococcus mutans, excessive dietary intake of cariogenic/erosive drinks, sweets and foodstuffs, poor oral hygiene and low socioeconomic status were identified as relevant risk factors, and these factors highlight the multifactorial nature of caries aetiology 10 . The core of successful caries risk assessment tools, such as Caries Management by Risk Assessment (CAMBRA) or Cariogram 11,12 , is the longitudinal recording of carious lesions, opti- mally with the inclusion of noncavitated caries lesions. Longitudinal studies have also been per- formed to monitor preventive interventions 13–18 . Several studies used cavitations or the dmf/ DMF index as a reference standard 19–21 , but the doi: 10.1111/cdoe.12219 1 Community Dent Oral Epidemiol All rights reserved Ó 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd