XI

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Studies on Dental Caries XI. Sex Differences in the Caries Susceptibility of the Various Morphological Types of Permanent Teeth Author(s): Henry Klein and Carroll E. Palmer Source: Child Development, Vol. 12, No. 2 (Jun., 1941), pp. 207-216Published by: on behalf of the Wiley Society for Research in Child DevelopmentStable URL: http://www.jstor.org/stable/1125350Accessed: 03-06-2015 01:53 UTC

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STUDIES ON DENTAL CARIES XI. SEX DIFFERENCES IN THE CARIES SUSCEPTIBILITY YF THE

VARIOUS MURPHOLOGICAL TYPES OF PERMANENT TEETH'

HENRY KLEIN2 AND CARROLL E. PALIER3

In a recent study (1) it was shown that, at the same chronological age, girls have a larger total number of permanent teeth with evidence of caries experience than boys. Teeth with evidence of caries experience include those which are docayed, indicated for extraction, extracted, or filled. These are designated "DMF teeth" (2).

Observation of the numbers of erupted teeth in the two sexes shows that, at the same chronological age, girls also have a larger total number of erupted permanent teeth than boys. This latter finding arises out of the fact that girls erupt their permanent teeth at earlier chronological ages than do boys (3). At the same chronological age, therefore, the permanent teeth of girls have been exposed in the mouth (post- eruptively) to the risk of attack by caries a longer duration of time than those of boys (4).

The sex difference in numbers of DMF teeth noted above is explained by this sex difference in posteruptive tooth age. Thus, when correction is made for the tooth age difference between the two sexes it is found that both sexes show approximately the same total number of DEF permanent teeth. From this finding the conclusion has been reached that there exists (at least up to chronological age 15 years) no significant sex difference in caries susceptibility (1). These findings and con- clusions were based on a study of all the permanent teeth taken as a whole in a group of approximately 4,400 elementary school children.

It is the purpose of the present paper to consider whether or not a sex difference exists in the caries susceptibility of the individual morphological types of permanent teeth. For this purpose the material on the 4,400 grade school children is used, combined with additional observations on a group of approximately 2,000 high school children. Accordingly, the findings given here are based on the individual types of permanent teeth in a total of 6,257 girls and boys attending the grade and high schools of Hagerstown, Maryland, and environs.

FINDINGS

The age and sex distributions of the children examined are shown in Table 1. The numbers of DMF teeth of particular morphological types found in these children are given in Tables 2 and 3. The DIF values shown are averages for the single types of teeth of either the right or left sides of the mouth. The DIF values are given in this form since the caries susceptibility of the same type of tooth on each side of the mouth is about equal. It may be noted that in general the DEF values for each tooth are higher in the girls than in the boys at the same chronological age.

1Prom the Division of Public Bealth Nethods, National Institute of Health. 2Dental Officer, I. S. Public Health Service. 3Passed Assistant Surgeon, U. S. Public Realth Service.

207

CHILD DEVELOPMENT, Vol. 12, No. 2 (June, 1941)


KLEIN AND PALMER: SEX DIFFERENCES IN CARIES

Figure 1 Maxillary Ist premolars

50

a 40 S___ Boys

o rq

0 20

10

0 I I I 200 600 1000 1400

Posteruptive tooth age (years) per 100 children.

Figure 2 Maxillary 2nd premolars

50-

a 40

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S- Boys ,.

-- Girls 10-

200 400 1000 1400 Posteruptive tooth age (years)

per 100 children.

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- Boys ....Girls E 40 -

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per 100 children,

Figure 4 Maxillary lateral incisors

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- Boys ...Girls

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per 100 children.

208



Figure 5 Maxillary ist molars

100

90

a 80

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per 100 children.

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100

90

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S40 30 Boys

0----- Girls 20

10

0 200 600 1000 1400 Posteruptive tooth age (years)

per 100 children.

Figure 7 Mandibular ist molars

100

90-

80-

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50 /-

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S30 - --- Girls

20 1

10 2

o 2 w 600 1000 1400 Posteruptive tooth age (years)

per 100 children.

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100

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209



Figure 9 Mandibular canines

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Figure 10 Maxillary canines

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Figure 11 Mandibular central incisors

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per 100 children.

210



Table 1

NUMBER OF ELEMENTARY AND HIGH SCHOOL CHILDREN OF HAGERSTOWN, MARYLAND AND ENVIRONS WHO RECEIVED DENTAL EXAMINATIONS. DATA ARRANGED

BY SPECIFIED AGE AND SEX GROUPS

- hronological Aige in Years (Last Birthday) i All Sex 6 - 7 8 9 10 1 11 12. 13 1 14 15 16 17 1 819j Ages Boys 171 197 231 253 270 262 299 272 341 325 193 172 74 27 3,087 Girls 156 206 256 240 259 269 297 293 354 326 252 183 74 5 3,170 Both sexes 327 403 487 493 529 531 596 565

95 651 445 355 148 32 16,257

Estimates of the posteruptive mouth ages of the indlvidual teeth of the separate sexes were obtained by methods described in earlier com- munications (3, 4). The posteruptive tooth ages of the individual teeth for each sex, and for the several chronological age groups, are shown in Tables 4 and 5. These tooth ages represent averages for the single types of teeth of either the right or left sides of the mouth. The tooth age values are given in this form since the same type of tooth erupts at about the same time on each side. From the dat4 shown in Tables 4 and 5 it is clear that the posteruptive ages of the single types of teeth are consistently higher for the girls.

In order to compare the caries susceptibility of each type of tooth in boys and girls, the tooth-specific DEF values given in Tables 2 and 3 were plotted against the corresponding tooth age Values given in Tables 4 and 5. The results of this procedure are shown in Figures 1 through 14.

Taken altogether, the evidence presented in these several figures fails to reveal a consistent difference between the sexes in the caries susceptibility of the individual types of permanent teeth. For the maxillary first and second premolars, the maxillary central and lateral incisors, the maxillary first and second molars (Figures 1-6), the mandibular second molars (Figure 8), the maxillary canines (Figure 10), and the mandibular second premolars (Figure 14), the trend lines for boys and girls cross and recross, thus indicating no clear cut, consistent sex difference in susceptibility to caries attack. For the mandibular canines (Figure 9), and the mandibular central and lateral incisors, and the mandibular first premolars (Figures 11, 12, 13) the trend lines for boys tend to fall into a position above those of the girls. On the other hand, for the mandibular first molars (Figure 7) the trend line for the boys tends to fall a little below that of the girls.

If sex plays a role in caries susceptibility it would be expected that the trend lines for one sex would be consistently above those for the other sex. Although it is possible that a sex differential in caries susceptibility may exist for some teeth and not for others, this possibility does not appear probable. On the whole, therefore, it would appear from these findings that sex, per se, is not an important variable influencing caries susceptibility in Hagerstown school children of the chronological ages 6 through 19 years.

211



Figure 13 Mandibular 1st premolars

10 -

9

8- Ac7

- Boys 2 - Girls

1


per 100 children.

Figure 14 Mandibular 2nd premolars

S40

S30 - 0 0

20-

SBoys 10 Girls

. ! k I I I I 200 600 1000 1400


REFERENCES

(1) Klein, Henry, and Palmer, C. E.: Studies on dental caries. VII. Sex differences in dental caries experience of elementary school children. Pub. Health Rep., 1938, 53, 1685-1690.

(2) Klein, Henry, and Palmer, C. E.: Dental caries in American Indian children. Pub. Health Bull. #239. Washington, U. S. Govt. Printing Office, 1937.

(3) Klein, Henry, Palmer, C. E., and Kramer, M: Studies on dental caries. II. The use of the normal probability curve for ex- pressing the age distribution of eruption of the permanent teeth. Growth, 1937, 1, 385-394.

(4) Palmer, C. E., Klein, Henry, and Kramer, M.: Studies on dental caries. III. A method of determining posteruptive tooth age. Growth, 1938, 2, 149-159.

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KLEIN AND PAfiER: SEX DIFFERENCES IN CARIES

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Article Contentsp. 207p. 208p. 209p. 210p. 211p. 212p. 213p. 214p. 215p. 216

Issue Table of ContentsChild Development, Vol. 12, No. 2, Jun., 1941Some Sex Differences Observed in a Group of Nursery School Children [pp. 75 - 79]Factors Associated with Crying in Young Children in the Nursery School and the Home [pp. 81 - 97]Vowel Elements in the Crying Vocalization of Infants under Ten Days of Age [pp. 99 - 109]The Profile as a Visual Device for Indicating Central Tendencies in Speech Data [pp. 111 - 120]The Influence of Social Factors upon the Persistence of Satiation in Pre-School Children [pp. 121 - 129]The Measurement of Parent Behavior [pp. 131 - 166]The Berkeley Growth Study [pp. 167 - 173]A Comparison of Routine Hospital Records of Birth Stature with Measurements of Birth Stature Obtained for Longitudinal Research [pp. 175 - 181]Further Results on the Trend of Weight in White School Children [pp. 183 - 205]Studies on Dental Caries XI. Sex Differences in the Caries Susceptibility of the Various Morphological Types of Permanent Teeth [pp. 207 - 216]

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