Approximately 80% of carious lesions in school-age children are on which surface?

• A. Occlusal
• B. Proximal
• C. Buccal
• D. Incisal

Answer: (A)

Pit-and-fissure anatomy on chewing surfaces creates niches that trap plaque and fermentable carbohydrates, making these areas difficult to clean and more prone to demineralization. In school-age children, about 80% of carious lesions occur on the occlusal surfaces of the molars and premolars because of these deep pits and fissures, plus the eruption of the first permanent molars around age six increases the vulnerable chewing surface. Smooth surfaces like buccal or incisal areas are easier to clean and are less likely to harbor plaque in a way that starts decay, and proximal surfaces, while important, are less frequently the initial sites in this age group. So the occlusal surfaces are the most common site for caries in school-age children.