Pierce A, et al. - Researchers conducted this retrospective study to determine the prevalence of developmental defects of enamel (DDE) among American Indian (AI) children and whether DDE were correlated with caries experience and rehabilitative treatment under general anesthesia (GA). Charts of 557 AI children aged 12 to 84 months were reviewed by an Indian Health Service Clinic in Sisseton, SD, USA. Data reported that the overall DDE prevalence was 32.5% (mean equals 0.87 ± 1.59 per child). The presence of DDE was linked to significantly higher mean decayed, extracted and filled (deft) scores, anticipating adverse clinical outcomes. In this cohort of AI children, DDE were prevalent and found to be significantly linked to a higher caries burden and dental rehabilitation under GA. Early detection of DDE in infants and infants along with targeted prevention programs that lead to reducing caries incidence and subsequent treatment under GA.