Developmental Enamel Defects (DDE) and Their Association with Oral Health, Preventive Procedures, and Children's Psychosocial Attitudes towards Home Oral Hygiene: A Cross-Sectional Study

Int J Environ Res Public Health. 2020 Jun 5;17(11):4025. doi: 10.3390/ijerph17114025.


Background: Developmental enamel defects (DDE) exert significant effects both on esthetics and occlusal function and prevention should be the general clinical approach to DDE. The purpose of this cross-sectional study was, therefore, to detect, within a pediatric sample, any significant association between DDE and children's psychosocial attitudes towards home oral hygiene, as well as potential associations between primary preventive procedures and DDE.

Methods: 394 schoolchildren (197 males and 197 females, 8.9 ± 1.4 years) underwent an intra-oral examination; they were then interviewed with a brief questionnaire.

Results: 5-6% and 12-14% of participants had, respectively at least one molar and one incisor affected by DDE. In general, no associations were observed in the examined clinical categories (caries and other oral health indices). A strong relationship was found between the presence of molar DDE and children's positive vs. negative psychosocial attitudes towards home oral hygiene.

Conclusions: The probability of finding DDE in our sample of examined children was approximately more than doubled for children with negative psychosocial attitudes towards home oral hygiene, than for children with positive attitudes towards home oral hygiene.

Keywords: behaviors; caries; dental; developmental enamel defects; oral health; psychosocial attitudes and habits.

MeSH terms

  • Attitude
  • Child
  • Cross-Sectional Studies
  • Dental Caries*
  • Dental Enamel / abnormalities*
  • Dichlorodiphenyl Dichloroethylene
  • Female
  • Humans
  • Male
  • Oral Health*
  • Oral Hygiene
  • Prevalence
  • Preventive Health Services


  • Dichlorodiphenyl Dichloroethylene