Should we be concerned about the use of non-fluoride toothpaste? A survey study in two European countries.

BACKGROUND: Toothpastes available in Europe contain a range of fluoride concentrations, with some meeting the recommended level for caries prevention (>1000 ppm fluoride (ppm)) and others containing low or no fluoride. This study evaluated toothpaste fluoride concentrations in Latvia and Lithuania to inform targeted public health strategies in regions with a high prevalence of dental caries. METHODS: This cross-sectional study was conducted from May 2019 to May 2020, using a validated questionnaire in Latvia and Lithuania. Nationally representative samples (1309 families and 5436 members) provided data through a mixed-mode survey (paper and online) on sociodemographic information, toothpaste type, brand, and type. Descriptive statistics and chi-square tests (p < 0.05) were used for analysis. RESULTS: Fifteen percent of families used non-fluoridated toothpaste and 12% used <1000 part per million (ppm) fluoride. In Latvia, 56.8% of preschoolers and 28.7% of schoolchildren used <1000 ppm or non-fluoride toothpaste, whereas in Lithuania, 47.2% of preschoolers and 29.1% of schoolchildren used <1000 ppm or non-fluoride toothpaste; 63% of adolescents and 73% of adults used toothpaste with optimal fluoride content (≥1000 ppm). Of the 228 registered toothpaste types, 62% contained more than 1000 ppm, which is optimal for caries prevention; 29% of Latvian and 24% of Lithuanian families used at least one non-fluoridated toothpaste. CONCLUSION: This study revealed significant gaps in the use of fluoride toothpaste among families in Latvia and Lithuania, especially among children. To effectively prevent dental caries, targeted interventions, and education must promote optimal fluoride toothpaste use, particularly among vulnerable populations.

Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries: a randomised clinical trial.

Knowledge gaps exist regarding optimal silver diammine fluoride (SDF) regimens and the efficacy of new products for arresting dental caries in young children. We evaluated the effectiveness of 38%-SDF (SDI-RivaStar), Tiefenfluorid (TF) comparing with Placebo (P), all in conjunction with behavioural modification (BM), in preventing major complications (endodontic/extractions/pain)-a patient-centred outcome-due to early childhood caries over 12 months in children under 71-months. A six-arm, patient/parent-blinded, superiority, placebo-controlled randomised control trial at the university clinic in Riga, Latvia, from 1/9/20-31/8/22 (Protocol registration ISRCTN17005348). The trial tested six protocols, using three compounds (P/SDF/TF) under two regimes: annual and biannual (P1/P2/TF1/TF2/SDF1/SDF2) for major complications. Secondary outcomes included minor complications and parental satisfaction. All groups received BM. 373/427 randomised children (87.3%) completed the study. SDF2 had a significantly lower rate and risk of major (21.5%, OR = 0.28, 95%CI [0.11, 0.72], p < 0.05) and minor complications (OR = 0.16 (95%CI [0.05, 0.50], p = 0.002). Overall satisfaction was 96% (p > 0.05). SDF biannual application with BM effectively prevented major complications of early childhood caries and was well accepted by children and their parents. Trial registration number: ISRCTN17005348, principal investigator: Ilze Maldupa, registration date: 30/06/2021.Clinical trial registration number: ISRCTN registry: ISRCTN17005348, https://doi.org/10.1186/ISRCTN17005348 , registration date: 30/06/2021.

COVID-19 as an opportunity for minimally-invasive dentistry: a national cross-sectional survey.

BACKGROUND: During the COVID19 pandemic, the Latvian government issued first absolute restrictions (elective treatments prohibited, only emergency care) and later relative restrictions (preference for non-aerosol-generating procedures (AGP) and emergency care) on dental care. This study aims to assess the impact of these restrictions on the decision made by Latvian dentists about caries treatment. METHODS: A Survey-based cross-sectional study was used. A minimum sample size of 174 dentists was estimated for national representativeness (N = 1524). The questionnaire was developed by experts and sent three times via email to Latvian dentists from July to September 2020 and was also delivered in printed form at two national conferences in September and October 2020. Descriptive statistics were calculated. RESULTS: We received 373 completed questionnaires, with a total response rate of 24.5%. Under the recommendation to reduce AGP for the treatment of uncomplicated caries, 10% of the dentists stated that they would stop attending, 54% would only attend emergencies, and 36% would attend as usual. Under prohibition, the percentages are 15%, 74%, and 11%, respectively. Regarding the type of treatment, more than 75% would opt to proceed with selective caries removal for both primary and permanent teeth and 10% for extraction. CONCLUSION: Latvian dentists are willing to treat patients with caries during the pandemic and state that they prefer to use non- or minimally invasive and less aerosol-generating methods for caries treatment.

Caries Prevalence and Severity for 12-Year-Old Children in Latvia.

OBJECTIVES: To study caries prevalence/severity in 12-year-old children in Latvia and potential risk indicators. METHODS: A cross-sectional oral-health national survey of 12-year-old children was conducted in 2016. A nationally representative stratified-cluster probabilistic sample of 2,138 pupils in 92 schools was selected. Children were examined by seven calibrated examiners (kappa inter-examiner, intra-examiner scores of 0.71-0.77, 0.81-0.97, respectively) at school. Enamel-non-cavitated decay (D1), enamel cavitation (D3), dentine cavitation (D5), missing (M) or filled (F) status at the tooth (T)/surface (S) levels were evaluated, and decayed, missing, and filled (DMF) index scores for severity, along with the Significant Caries Index (SiC), were calculated. An associated caries factor questionnaire was completed by participants. RESULTS: The prevalence of caries was 98.5% for D1MFT, 79.7% for D3MFT, and 71.9% for D5MFT. The means (standard deviations) for severity were 9.2 (5.3) for D1MFT, 3.3 (3.0) for D3MFT, and 2.4 (2.4) for D5MFT, and 5.6 (2.1) for the SiC. Indicators associated with a lower risk of caries (D5MFT) were irregular dental visits (prevalence odds ratio POR = 0.45, 95% confidence interval (CI): 0.36, 0.56) and irregular use of mouthwashes (POR = 0.73, 95% CI: 0.60, 0.89). CONCLUSIONS: We found a high caries prevalence and severity in 12 year-old children in Latvia. Although the WHO target for 2010 (D5MFT ≤ 3) is met, the values for caries prevalence (D5MFT > 0 = 71.9%) and severity (D5MFT = 2.5) in 12-year-old Latvian children are higher than the European averages (D5MFT > 0 = 52%, D5MFT = 1.1).