| Summary: | The Caries Analysis System (CAS), will examine the surface-specific caries patterns and focus on those children with disease. The CAS was utilized in a cross-sectional study to examine the caries experience of four different preschool populations: 400 Beijing children; 2118 Navajo children; 127 Apache children; and 1218 Arizona children. The CAS identified four caries patterns: maxillary anterior; fissure; posterior proximal; and posterior buccal/lingual smooth. Caries patterns varied by age. The maxillary anterior pattern developed first, becoming more prevalent until age three. The fissure pattern developed next and rapidly became the most prevalent and severe pattern. It was experienced by nearly all caries positive children. The posterior proximal pattern developed last. Caries pattern distribution varied by age with maxillary anterior caries predominant in the youngest children and fissure and posterior proximal caries predominant in the oldest children. Caries patterns were associated with caries risk. Among caries positive children, those with maxillary anterior caries had a greater prevalence of the posterior proximal pattern and buccal/lingual pattern and a greater severity of the fissure pattern. Caries patterns also varied by socio-economic risk factors such as household income. Children from high income households experienced a lower prevalence of all patterns, especially the maxillary anterior pattern. However, the severity of the patterns did not differ by income group except for the fissure pattern. A positive association was found between dmf score and pattern prevalence except for the fissure pattern. When pattern combination was examined, children with high dmf scores had all the patterns. However, at lower dmf scores children had a variety of pattern combinations allowing differences in caries risk to be detected where the dmf index could not.
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