Aim: The aim of this study was to determine the predictors of proximal decay in the permanent first molar.

Materials And Methods: A cross-sectional study was conducted at the Department of Oral Medicine, Dow Dental College, Dow University of Health Sciences. A total of 171 patients presenting with 227 first molars were included. Calibrated examiners performed a detailed history and examination using a specialized form. The form recorded caries predictors and assigned a caries risk category based on the presence of these predictors. The statistical analysis was performed using the SPSS for windows version 17. A descriptive analysis was used to calculate the mean and proportions. Backward regression was carried out to evaluate the predictor for caries on mesial and distal surfaces at ≤ 0.05.

Results: The included 171 patients presented with a total of 227 decayed first molars and 412 decayed proximal surfaces. The mesial surface was found to be more affected by decay (0.92 ± 0.85). The caries risk profile explains 60%, and caries on the adjacent surface explains 90% of caries occurrence on the mesial surface. In the case of distal surfaces, the predictor which can cause caries significantly was caries risk only. The caries risk profile explains the 3% of caries occurrence on distal surfaces.

Conclusion: Our study identified caries on the adjacent tooth surface and the caries risk profile as significant predictors of future caries risk for the mesial surface of permanent molars.

Clinical Significance: Predictors for mesial and distal surfaces of the permanent first molar may differ. Overall caries risk and status of adjacent teeth must be taken into account to predict future caries occurrence.

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