Clinical and Radiographic Progression of Proximal Enamel Caries of Primary Molars Following the Application of Resin Infiltrant vs Tooth Mousse.

Background: Resin infiltration is a technique in which a low-viscosity resin penetrates the proximal carious lesions and stops caries progression. Aim: This study aimed to compare the progression of proximal enamel caries of primary molars following the application of resin infiltrant clinically and radiographically vs Tooth Mousse. Materials and methods: This case-control split-mouth study evaluated 64 proximal surfaces of primary molars in 32 patients. Each patient had one pair of noncavitated proximal caries in two primary molars from different quadrants with radiographic evidence of enamel involvement. The carious lesions in each patient were randomly treated with resin infiltrant and Tooth Mousse. Progression of carious lesions was evaluated clinically and radiographically after 12 months. The two groups were compared by Fisher's exact test. Results: No caries progression was noted in the resin infiltrant group at 12 months, and all 32 surfaces (100%) showed cessation of caries. Four surfaces (12.5%) in the Tooth Mousse group showed caries progression. The two groups were not significantly different in this regard (p = 0.242). Conclusion: Resin infiltrant and Tooth Mousse were both effective in stopping the progression of proximal enamel caries of primary molars. How to cite this article: Baniebrahim G, Seraj B, Ghonche Z, et al. Clinical and Radiographic Progression of Proximal Enamel Caries of Primary Molars Following the Application of Resin Infiltrant vs Tooth Mousse. Int J Clin Pediatr Dent 2024;17(4):385-389.

Anticariogenic Effects of the Dairy Products on Human Saliva: An In Vivo Study.

Aim: The aim of this study was to determine whether the intake of cheese, paneer, and yogurt may help in reversing the acidogenic challenge after the consumption of chocolate at different time intervals. Materials and methods: A total of 120 caries-free children between the ages of 4 and 13 years, with no decayed, missing, and filled teeth (DMFT), were randomly selected from the school. Baseline pH was obtained, and the subjects were asked to eat chocolate. pH was measured again after 10 minutes. Following chocolate exposure, the subjects were then randomly assigned to three groups-cheese, paneer, and yogurt. Salivary pH was measured at intervals of 15, 30, and 60 minutes using the same procedures for all subjects. The data thus obtained were subjected to statistical analysis, which included analysis of variance (ANOVA) test, post hoc tests for multiple comparisons using Tukey's test, and paired t-test. Results: The highest pH value after 15 minutes was seen in cheese (6.43), followed by paneer (6.31) and yogurt (6.30). After 30 minutes, the maximum pH value was seen in the cheese group (6.63), followed by yogurt (6.46) and paneer (6.34). The mean pH value 60 minutes after the consumption of dairy products was highest in paneer (6.53), followed by cheese (6.43) and yogurt (6.37). Conclusion: All the categories were observed in the zone of remineralization. It should be noted that the maximum pH value overall was seen in the cheese group. Clinical significance: Dairy products help maintain salivary pH, which aids in improving enamel health. Hence, dietary dairy recommendations can be incorporated into patient education and caries prevention plans. How to cite this article: Gautam Y, Srivastava M, Verma P, et al. Anticariogenic Effects of the Dairy Products on Human Saliva: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(4):456-460.

Assessment of Interleukin-6 Levels and Lactobacillus casei Counts in Pediatric Stainless Steel and Zirconia Crowns: A Comparative Study.

Background: Pediatric dental crowns play an integral role as they maintain the form and function and prolong the life of the affected tooth. However, placing a crown in the oral cavity creates a new niche for the adhesion of microorganisms that can lead to plaque accumulation, gingival inflammation, and the development of secondary caries, which in the long term might determine the clinical success of the restored tooth. The present study allowed us to assess the changes caused by the full coverage restorations at a clinical, immunological, and microbiological level using enzyme-linked immunosorbent assay (ELISA) and microbial analysis. Materials and methods: The in vivo analysis consisted of a total of 26 children aged 3-10 years. They were divided into two groups, group I (n = 13) children receiving preformed zirconia crowns and group II receiving stainless steel crowns (SSCs). Plaque index (PI) scores, gingival index (GI) scores, and interleukin-6 (IL-6) levels were assessed at baseline and at 45 days of follow-up. The in vitro part of the study consisted of 13 preformed zirconia crowns and 13 SSCs which were immersed in artificial saliva containing strains of Lactobacillus casei which were then processed for their microbial analysis. Results: On mean comparison, preformed zirconia crowns performed superiorly both clinically and immunologically compared to SSCs. Microbial analysis using independent t-test revealed that the colony-forming units (CFU) per milliliter was statistically significantly higher for the SSCs, and the mean difference among the groups was statistically significant (p < 0.01). Conclusion: Preformed zirconia crowns can be a relative replacement for SSCs in primary teeth with the advantage of esthetics and superior periodontal health. How to cite this article: Saharia NP, Malik M, Jhingan P, et al. Assessment of Interleukin-6 Levels and Lactobacillus casei Counts in Pediatric Stainless Steel and Zirconia Crowns: A Comparative Study. Int J Clin Pediatr Dent 2024;17(4):395-403.

Esthetics in Pediatric Dentistry-BioFlx Crowns: Case Series.

Background: The crown is considered the most effective restoration for the management of dental caries. It reproduces the morphology and contour of the damaged coronal portion of the tooth while maintaining its function. The esthetic needs of children and the demands of parents bring advancement in dentistry toward a new era of esthetic crowns. In this era of esthetic crowns, the newly introduced preformed BioFlx crown seems to be an effective esthetic treatment option. Case description: In the present case series, full coverage restoration for the management of carious and pulp therapy-treated primary molars was done by esthetic and flexible BioFlx crown (Kids-e-Dental, LLP, Mumbai, India). Over a 6 months period, the crowns have demonstrated good retention and esthetic results. Conclusion: Dealing with the esthetic needs of children and managing primary molars using BioFlx crowns would be practical and successful. Clinical significance: The treatment described in the case series is a new advancement in pediatric dentistry with promising esthetic alternatives. How to cite this article: Goswami M, Jangra B, Chauhan N, et al. Esthetics in Pediatric Dentistry-BioFlx Crowns: Case Series. Int J Clin Pediatr Dent 2024;17(3):357-361.

Efficacy of Immunoglobulin Y Chewable Tablets on Streptococcus mutans Count in Patients Undergoing Orthodontic Treatment.

Aim: The aim of the study was to determine the efficacy of commercially available immunoglobulin Y (IgY) chewable tablets on Streptococcus mutans (S. mutans) count in patients undergoing orthodontic treatment. Materials and methods: Participants aged between 12 and 19 years who had fixed, nonextraction orthodontic treatment with no carious lesion were included in the study and advised to take IgY chewable tablet for 15 days (one course) and saliva samples were collected from the patients on day 61, 91, and 121 days from the placement of fixed appliance, to assess its ability in reduction of S. mutans count. The collected samples were processed, and S. mutans levels were estimated. The results were tabulated and subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 20, and the repeated measures test was used to compare different groups. Results: Immunoglobulin Y (IgY) chewable tablet was found to be significantly effective in decreasing S. mutans counts in patients undergoing orthodontic treatment during the study period. Conclusion: Oral passive immunotherapy via egg yolk antibody IgY effectively decreased the S. mutans level, which was found to increase during orthodontic fixed appliance treatment. Clinical significance: The IgY chewable tablets can be used as an adjuvant to reduce S. mutans counts and provide basic oral hygiene measures. How to cite this article: Muthukumaran M, Jayaprakash J, Arangannal P, et al. Efficacy of Immunoglobulin Y Chewable Tablets on Streptococcus mutans Count in Patients Undergoing Orthodontic Treatment. Int J Clin Pediatr Dent 2024;17(3):265-269.

Comparative Evaluation of Antibacterial Efficacy and Remineralization Potential of Acidulated Phosphate Fluoride Gel with Herbal Dental Gel Containing Zingiber officinale, Salvadora persica, and Cinnamomum zeylanicum: An In Vitro Study.

Aim: The aim of the study is to evaluate and compare the antibacterial efficacy and remineralization potential of acidulated phosphate fluoride (APF) gel with herbal dental gel containing Zingiber officinale, Salvadora persica, and Cinnamomum zeylanicum. Materials and methods: Ethanolic extracts of Z. officinale, S. persica, and C. zeylanicum were prepared. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of these extracts were determined against Streptococcus mutans and Lactobacillus acidophilus using the resazurin method and agar plate streaking method, respectively. The herbal dental gel was formulated, and its cytotoxicity was evaluated using an 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The antibacterial susceptibility of APF gel and the herbal dental gel was assessed using the agar well diffusion method and time-kill assay. The remineralizing potential was evaluated using a stereomicroscope. Results: Herbal dental gel showed better antibacterial efficacy as depicted by the zone of inhibition of 20 and 21 mm obtained against S. mutans and L. acidophilus, respectively, compared to 11.50 and 16.50 mm zone of inhibition obtained by APF gel. The herbal dental gel also showed better remineralization potential than APF gel after a time interval of 24 and 48 hours, as depicted with a statistically significant p-value of 0.0061 and 0.0219, respectively. In the cytotoxicity test, the fibroblasts showed 100% viability in the presence of both study groups. Conclusion: The results of our study concluded that herbal dental gel is safe and nontoxic, having anticariogenic potential due to its good antibacterial action and remineralization potential as compared to conventional APF gel. How to cite this article: Kohli N, Hugar SM, Hallikerimath S, et al. Comparative Evaluation of Antibacterial Efficacy and Remineralization Potential of Acidulated Phosphate Fluoride Gel with Herbal Dental Gel Containing Zingiber officinale, Salvadora persica, and Cinnamomum zeylanicum: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(3):307-315.

Comparison between Serum and Salivary Albumin and Calcium Levels in Adolescent Age-group with Dental Caries.

Aim: The aim of our pilot study is to analyze the relationship between dental caries and albumin and calcium levels in serum and saliva in adolescent patients with varying caries experience as determined by their caries progression between the age-group of 9 and 19 years. Materials and methods: A total of 20 subjects were selected based on their level of caries progression and divided into four groups of subjects, five in each as follows: group I-enamel caries, group II-dentinal caries, group III-pulpal caries, and group IV-control group. The saliva and serum were collected under standardized conditions from selected patients and analyzed for the presence of albumin and calcium, and then they were correlated to the same level in serum. The statistical analysis was done using the Chi-squared test. Results: According to the present study, there is an increase in the levels of caries with a decrease in the levels of salivary albumin and calcium. Serum albumin and calcium levels were also found to be decreased in caries-prone individuals; hence, a significant correlation between serum and salivary albumin and calcium levels was found. Conclusion: According to a review of the literature, we found an inverse relationship between the levels of albumin and calcium in serum and saliva with dental caries patients. So, it confirms the importance of albumin and calcium levels in inhibiting carrier progression. So it may be used as a biochemical indicator to evaluate the susceptibility of caries. How to cite this article: Vaish S, Gautam K, Agrawal D, et al. Comparison between Serum and Salivary Albumin and Calcium Levels in Adolescent Age-group with Dental Caries. Int J Clin Pediatr Dent 2024;17(3):328-333.

Remineralizing effect of NSF on artificial enamel caries.

INTRODUCTION: Nanotechnology offers new approaches and endless opportunities for remineralizing tooth decay without being toxic or causing allergies. This study aimed to determine the effect of nanosilver fluoride (NSF) on the remineralization potential of enamel caries-like lesions compared to 5% sodium fluoride varnish in permanent teeth. METHODS: Fifteen teeth (molars and premolars) were gathered, cleaned, and polished using a scaler. After sectioning the teeth mesiodistally and removing the roots, the thirty specimens were subjected to a demineralized solution to induce early enamel lesions and then assigned randomly into two equal groups. The test materials were applied, and then all the specimens were subjected to a pH cycling model for 30 days. DIAGNOdent and surface roughness were investigated, and an evaluation of the enamel Ca and P weight% for Ca/P ratio calculation was done using SEM-EDX to analyze the specimens at the end of the study. The data were analyzed using an independent t-test. RESULTS: The mean values for the DIAGNOdent measurements for NSF and NaF at baseline and after demineralization were not significantly different (p > 0.05). After treatment, NaF varnish showed a significantly higher mean DIAGNOdent measurement (11.8 ± 5.80) than NSF (4.7 ± 1.6). The mean surface roughness of the NaF group (1.64 ± 0.39) was much higher than NSF's mean surface roughness (1.07 ± 0.21). Specimens treated with NSF had statistically significant smoother surfaces (p < 0.001). The NSF group had a higher mean Ca/P ratio (2.9 ± 0.35) than NaF (2.2 ± 0.11). This difference was statistically significant (p = 0.012). CONCLUSION: The study reveals that nano silver fluoride is a more effective treatment than sodium fluoride varnish in enhancing teeth's clinical characteristics, particularly in terms of mineral content and surface roughness, suggesting it could be an improved strategy to prevent dental caries and maintain enamel integrity.

Clinical SWIR and CP-OCT imaging of interproximal lesions.

BACKGROUND: Enamel is highly transparent at short wavelength infrared imaging (SWIR) wavelengths allowing the detection of dental decay without the need for ionizing radiation. The purpose of this study was to use SWIR imaging methods including cross polarization optical coherence tomography (CP-OCT), occlusal transillumination (SWIR-OT), proximal transillumination (SWIR-PT), and occlusal reflectance (SWIR-R) to image interproximal lesions in vivo and compare the sensitivity with radiography. METHODS: Participants (n = 30) aged 18-80 each with a radiopositive interproximal lesion scheduled for restoration were enrolled in the study. Studies have shown that the opposing proximal surfaces across the contact will likely also have lesions. SWIR images were acquired of the adjoining teeth at each contact with an interproximal lesion scheduled for restoration. Lesion presence and depth were assessed on each side of the contact for radiography and each SWIR imaging method. Lesions on radiographs and in CP-OCT images were identified by a single examiner while lesions in SWIR images were identified by a contrast threshold via semi-automatic image segmentation. RESULTS: All SWIR imaging methods had significantly higher sensitivity (P < 0.05) than radiographs for the detection of interproximal lesions on the teeth opposite those restored. CP-OCT and SWIR-R imaging methods had significantly higher sensitivity than the other methods. SWIR imaging methods showed significantly higher lesion contrast than radiography. CONCLUSIONS: SWIR imaging methods can be used to detect interproximal lesions on posterior teeth with higher diagnostic performance than radiographs. CP-OCT appears well suited as a potential gold standard for the detection of interproximal lesions and assessment of their severity in vivo.

In vitro assessment of NaF/Chit supramolecular complex: colloidal stability, antibacterial activity and enamel protection against S. mutans biofilm.

OBJECTIVES: This study assessed the effect of NaF/Chit suspensions on enamel and on S. mutans biofilm, simulating application of a mouthrinse. METHODS: The NaF/Chit particle suspensions were prepared at molar ratio [NaF]/Chitmon]≈0.68 at nominal concentrations of 0.2% and 0.05% NaF and characterized by Fourier transform infrared spectroscopy (FTIR), dynamic light scattering and zeta potential. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were measured. The S. mutans biofilm was formed for 7 days on eighty human enamel blocks that were divided into eight groups (n=10/group): i) 0.05% NaF solution; ii) 0.31% Chit solution; iii) NaF/Chit(R=0.68) suspension at 0.05% NaF; iv) 1.0% HAc solution (Control); v) 0.2% NaF solution; vi) 1.25% Chit solution; vii) NaF/Chit(R=0.68) suspension at 0.2% NaF; viii) 0.12% chlorhexidine digluconate. The substances were applied daily for 90s. S. mutans cell counts (CFU/mL) were performed, and the Knoop microhardness (KHN) of enamel samples were measured before and after biofilm formation. The KHN and CFU/mL data were analyzed by repeated measure ANOVA and Tukey's test (α = 0.05). RESULTS: Interactions between NaF and Chit were evidenced in solid state by FTIR spectra. The NaF/Chit complexes showed spontaneous microparticle formation and colloidal stability. The MIC and MBC ranged from 0.65-1.31 mg/mL. The NaF/Chit(R=0.68) suspension at 0.2%NaF Group showed lower CFU/mL values than other groups. The NaF/Chit(R=0.68) suspensions Groups had the highest KHN values after biofilm formation. CONCLUSIONS: The NaF/Chit(R=0.68) complexes exhibited an antibacterial effect against S. mutans biofilm and reduced the enamel hardness loss. CLINICAL SIGNIFICANCE: The NaF/Chit(R=0.68) suspensions showed potential to be used as a mouthrinse for caries prevention.

Childhood obesity in relation to risk of dental caries: a cumulative and dose-response systematic review and meta-analysis.

INTRODUCTION: Earlier studies reported inconsistent findings for the association of childhood obesity with the risk of dental caries. In this systematic review and meta-analysis, we aimed to summarize earlier studies on the association of overweight and obesity with risk of dental caries in children. METHODS: Relevant studies published up to December 2023 were identified through searches in PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using suitable keywords. All observational studies, including cross-sectional or cohort or case-control studies, about the association of each obesity index with risk of dental caries in children which reported odds ratio (OR), hazard ratio (HR), or relative risk (RR) and 95% CIs, were included. Studies involving adults, randomized clinical trials, studies on animals or pregnant women, and studies on other dental disorders were excluded. Risk of bias was assessed using standard methods for observational studies. A total of 22 studies including 40673 participants were included. Studies were pooled using the random-effect model, and results were synthesized with subgroup analyses and assessments of heterogeneity. Limitations included potential publication bias and heterogeneity among study designs. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). RESULTS: Children at the highest category of BMI were 44% more likely to have early childhood caries (ECC) than those at the bottom (OR: 1.44; 95% CI: 1.16 to 1.78). Moreover, combined analysis also showed no significant association between waist circumference (WC) and risk of dental caries in children. However, significant linear and non-linear associations were found between BMI and risk of childhood dental caries. No publication bias was found for the relationship between BMI and the risk of ECC based on visual inspection of a funnel plot and Egger's test. CONCLUSIONS: This study showed a significant direct association between BMI and the risk of dental caries in children. Non-linear analysis showed higher risk of dental caries in children with higher BMI and also among underweight children. Further prospective studies are required to expand current knowledge in this issue. IMPACT STATEMENT: The findings of this study have significant implications for public health and dental care, suggesting association between BMI and the risk of dental caries in children. This comprehensive meta-analysis is among the first to summarize earlier publications on the association of obesity with risk of dental caries in children, highlighting the need for more accurate methods of obesity assessment and further research to understand this relationship better. These findings can help inform public health policies and interventions to reduce the prevalence of childhood obesity and dental caries.

[Dental caries in schools in the city of N'Djamena in Chad: Epidemiological aspects and oral habits in pupils aged from 6 to 12 years]. / Carie dentaire en milieu scolaire dans la ville de N'Djamena au Tchad : aspects épidémiologiques et habitudes bucco-dentaires chez des élèves âgés de 6 à 12 ans.

Background: Dental caries is a global disease that can have disabling effects. In Africa, its prevalence in schools is very variable, due to the great variability of food habits and oral hygiene. This study aimed to assess the prevalence of dental caries, associated factors, and to research oral pathologies associated with that dental decay in one circumscription of the city of N'Djamena. Material and methods: This was a cross-sectional study conducted in 3 schools in the 7th borough of the city of N'Djamena. A total of 360 pupils aged between 6 and 12 years were recruited between October 2021 and September 2022. Each participant underwent to an oral examination which consisted in looking carefully at the pupil's face (cheeks, lips) to note any deformities or possible facial asymmetry, and to check for any sensation of pain in any part of the face. In another hand, the oral examination aimed to look for any decay on all the teeth and determine the category and class of it. Finally, the personal data (age, sex, class, parents' occupations) of each participant and the results of his oral examination were collected into a database and analyzed. Results: A total of 185 pupils had at least one decayed tooth, giving a prevalence rate of 51.4%. Among them, 45% had at least 2 decayed teeth. The school attended and snacking between meals were significantly associated with the presence of caries (p<0.05). Teeth 36 (lower left first molar) and 46 (lower right first molar) were the most often affected by caries (21% and 22% respectively). The mixt DMF index was 0.6 and the overall frequency of decayed teeth was 51.9%. According to Black's classification, class II caries was the most prevalent (48%), while according to Baume's classification, category II was the most prevalent (54%). The time of brushing, the material and the type of product used significantly influenced the appearance of caries (p<0.05). Participants with dental dyschromia had more tooth decay. Conclusion: Caries was prevalent in the targeted schools and represented a real problem for pupils. Implementing an oral health policy based on preventive dentistry by raising awareness among children and their parents would contribute to the proper education of pupils.

Targeting glucosyltransferases to combat dental caries: Current perspectives and future prospects.

The emergence of antimicrobial resistance within bacterial communities poses formidable challenges to existing therapeutic strategies aimed at mitigating biofilm-mediated infections. Recent advancements in this domain have spurred the development of targeted antimicrobial agents, designed to selectively eradicate the primary etiological agents while preserving the beneficial microbial diversity of the oral cavity. Targeting glucosyltransferases (GTFs), which play crucial roles in dental biofilm formation, offers a precise strategy to inhibit extracellular polysaccharide synthesis without compromising oral microbiota. This review article delves into the intricate mechanisms underlying dental caries, with a specific focus on the role of GTFs, enzymes produced by S. mutans. It further provides an overview of current research on GTF inhibitors, exploring their mechanisms of action, efficacy, and potential applications in clinical practice. Furthermore, it discusses the challenges and opportunities in the development of novel GTF inhibitors, emphasizing the need for innovative approaches to combat biofilm-mediated oral diseases effectively.

The association between dental caries and serum crp in the us adult population: evidence from NHANES 2015-2018.

BACKGROUND: Dental caries remains one of the most prevalent diseases worldwide, affecting 29.4% of the global population. Despite numerous efforts to diagnose, predict, and prevent dental caries, the incidence continues to rise. Salivary biomarkers provide a non-invasive means for early detection of various oral conditions. C-reactive protein (CRP) is a key marker, elevated in both oral and general inflammatory conditions such as diabetes, periodontitis and oral squamous cell carcinoma. Considering the emerging connection between oral and systemic health, it is worth exploring the various factors associated with this widespread disease. This study investigates the association between CRP levels and dental caries in the United States population, utilizing data from the National Health and Nutrition Examination Survey (NHANES). METHODS: The study analyzed data from the 2015-2018 NHANES cycles, focusing on a nationally representative sample of individuals aged 30 years and above. Weighted multivariable negative binomial and logistic regression analyses were employed to explore the relationship between dental caries and CRP levels, adjusting for age, gender, race, education level, diabetes status, and gum disease. RESULTS: The results of the negative binomial regression analysis demonstrated a positive association between higher CRP levels and an increased mean number of dental caries (Adjusted Mean Ratio [AMR] = 1.7; 95% CI: 1.3 - 2; P: < 0.001). The logistic regression analysis showed that individuals with higher CRP levels have a 50% increase in the odds of developing dental caries (AOR: 1.5, CI: 1.2 - 1.9; P: < 0.01). CONCLUSION: The results of this cross-sectional study of the U.S. population highlight the positive association between high CRP levels and increased dental caries. These findings contribute to the growing body of evidence supporting the integration of oral and systemic health care. Further research is necessary to deepen our understanding of the mechanistic relationship between CRP levels and dental caries.

Development of Root Caries Associated With the Use of Sugar-Free Nicotine Lozenges: A Long-Term Case Report.

The authors present a case concerning an adult male patient who developed multiple sites of root caries adjacent to the area where he habitually held a sugar-free nicotine lozenge that contained mannitol and maltodextrin. The root caries occurred despite the patient's excellent oral hygiene, exemplary dietary habits, and clinically normal salivary flow. Between 1999 and 2008, he had only required two restorations to repair carious lesions. This patient had a 20+-year habit of using smokeless tobacco before switching to a cessation aid nicotine lozenge in May of 2008. A full-mouth series of radiographs taken in November 2009 revealed carious lesions on virtually every posterior tooth. The nicotine lozenge's principal ingredients were mannitol (75.7%) and maltodextrin. According to the United States' current Food and Drug Administration (FDA) guidelines, manufacturers can advertise these lozenges as sugar-free. Thus, it is assumed by the public that these types of products are incapable of "causing a cavity." However, this case report presents evidence suggesting that frequent use of sugar-free nicotine lozenges may be associated with dental caries.

Cross-sectional survey and analysis of factors influencing the prevalence of dental caries among older individuals aged 65-74 in Guangdong Province in 2021.

BACKGROUND: The prevalence of oral diseases is subject to change over time. In 2021, Guangdong Province conducted its fourth survey assessing the oral health status of individuals aged 65-74. MATERIALS AND METHODS: Evaluation criteria and potential influencing factors were identified. A sample of residents aged 65-74 from 13 designated monitoring sites in Guangdong Province was randomly selected for the study. Spearman correlation analysis was employed to investigate the clinical correlation between influencing factors and evaluation criteria. Negative binomial and zero-inflated negative binomial regression models were utilized to examine the factors influencing caries prevalence. In contrast, logistic regression was employed to identify the risk factors for caries occurrence. A p-value of ≤0.05 was considered statistically significant. RESULTS: The prevalence of caries rate of crowns, roots, and teeth were 76.36%, 52.25%, and 79.2%, respectively. Individuals with periodontal pockets exhibited a significantly higher risk of root caries. The presence of dental calculus significantly exacerbated the occurrence of crown, root, and dental caries, and increased the risk of crown and dental caries. Consuming sweet foods once or more a week notably increased the average root decayed score (D of roots), the prevalence rate of root caries, and the D score of the Decayed, Missing, and Filled teeth [DMFT] index in individuals already afflicted with this condition. Similarly, the consumption of sweetened drinks significantly elevated the risk of crown and root caries, exacerbating overall caries progression. Frequencies of manual toothbrush and toothpick cleaning showed a negative correlation with average tooth missing score (MT). In contrast, the frequency of manual/electric toothbrush and toothpick cleaning was negatively correlated with the DMFT index. Engaging in dental diagnosis and treatment behaviors significantly increased the number of filled crowns (F), MT, and DMFT scores while reducing the prevalence of dental caries. CONCLUSIONS: In Guangdong Province, caries prevalence among older individuals aged 65-74 remains substantial. Relevant professionals and institutions must provide comprehensive guidance and assistance to the older population, emphasizing the importance of reducing the consumption of sweets and sweetened beverages, adopting correct tooth brushing techniques and frequency (at least twice daily), timely treatment of periodontal diseases, conducting regular epidemiological caries surveys, and addressing economic barriers to accessing caries diagnosis and treatment services.

Caries lesions progression in adults: A prospective 2-year cohort study.

OBJECTIVE: Dental caries is one of the most prevalent chronic non-communicable diseases worldwide. There is a lack of evidence, especially in adult populations, documenting caries disease progression considering lesion severity, activity and tooth surface-level characteristics. The study aimed to investigate the extent to which primary active caries lesions in adults affect caries lesions progression compared with inactive caries lesions over a 2-year follow-up period, considering their severity, surface and tooth type. METHODS: A prospective study data set from a cohort of workers in a factory in Belarus were used. Participants aged 18-64 years with 20 or more natural teeth were included in the study. The participants were clinically examined twice within an interval of 2 years and completed a self-reported questionnaire. One calibrated examiner evaluated caries lesions using the International Caries Detection and Assessment System (ICDAS) and the Nyvad system. The primary outcome was caries lesions' progression. The lesion was classified as 'progressed' if it turned to a more advanced severity stage, was restored or missing/extracted due to caries. A multilevel Poisson regression was used to estimate the association between baseline caries lesions' characteristics and caries lesion progression. RESULTS: Out of 495 participants, 322 people completed clinical examinations at baseline and 2 years later, with an attrition rate of 35%. The prevalence of active DS1-6 and DS5-6 lesions at the baseline was 83.8% and 64.8%, respectively. In 2 years, 24% of active non-cavitated and 31% of active micro-cavitated/shadowed caries lesions progressed, while 15% of inactive caries lesions, non- or micro-cavitated/shadowed, progressed. The adjusted rate ratio (RR) for ICDAS3 + 4 caries lesions progression was 1.41 (CI 95% 1.16, 1.70) than ICDAS1 + 2 lesions. The RR for ICDAS1 + 2, active and ICDAS3 + 4, active lesions was 1.78 (CI 95%, 1.40, 2.27) and 1.97 (CI 95%, 1.53, 2.55), respectively than ICDAS1 + 2, inactive lesions. The RR for caries lesions progression on proximal surfaces and on pits and fissures was 1.57 (CI 95%, 1.30, 1.89) and 1.37 (CI 95%, 1.11, 1.67), respectively than smooth surface lesions. CONCLUSION: In caries active adults over 2 years, most non- and micro-cavitated/shadowed active and inactive caries lesions did not progress. Among caries lesions that showed progression, more severe lesions were more likely to progress than less severe lesions; active lesions were more likely to progress than inactive lesions. Pit and fissure caries lesions and proximal lesions were more likely to progress than smooth surface lesions.

Preventing proximal enamel caries in neighboring tooth with glass ionomer cement restoration and silver diamine fluoride pretreatment.

OBJECTIVE: To investigate caries preventive effects of 38% silver diamine fluoride (SDF) pretreatment on neighboring tooth proximal to glass ionomer cement (GIC), including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations in an in vitro model. METHODS: HUMAN TOOTH BLOCKS WERE RESTORED WITH: : SDF+CGIC (Group 1), CGIC (Group 2), SDF+RMGIC (Group 3) or RMGIC (Group 4). Enamel specimen simulating proximal surface of neighboring tooth was placed in proximity to the restorations. The specimen underwent cariogenic challenge with cross-kingdom biofilm of Streptococcus mutans, Lacticaseibacillus casei and Candida albicans. After cariogenic challenge, the biofilm's growth kinetics, viability, and morphology were evaluated by propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. The enamel lesion depth, surface morphology and crystal characteristics were determined by micro-computed tomography (micro-CT), SEM and X-ray diffraction (XRD), respectively. RESULTS: PMA-qPCR demonstrated lower microbial growth in Group 1 and 3 compared with Group 2 and 4 (p<0.05). CLSM showed the dead-to-live ratio in Groups 1-4 were 1.15±0.12, 0.53±0.13, 1.10±0.24 and 0.63±0.10, respectively (Group 1,3>2,4, p<0.05). SEM revealed Groups 1 and 3 had scattered biofilm whereas Group 2 and 4 had confluent biofilm. Micro-CT showed the enamel lesion depths (µm) were 98±9, 126±7, 103±6 and 128±7 for Group 1 to 4, respectively (Group 1,3<2,4, p<0.05). SEM revealed oriented and ordered enamel prismatic patterns in Group 1 and 3, not in Group 2 and 4. XRD showed the reflections of hydroxyapatite in Groups 1 and 3 were sharper than Groups 2 and 4. CONCLUSION: SDF pretreatment enhances the preventive effect of GIC on proximal enamel surface on neighboring tooth through inhibiting cariogenic biofilm, reducing enamel demineralization and promoting enamel remineralization. CLINICAL SIGNIFICANCE: SDF pretreatment of GIC restorations can help prevent caries on neighboring teeth, particular for patients with high caries risk.

ARE PIT AND FISSURE SEALANTS EFFECTIVE IN PREVENTING AND ARRESTING OCCLUSAL CARIES IN PRIMARY AND PERMANENT TEETH? AN OVERVIEW OF SYSTEMATIC REVIEWS.

OBJECTIVES: To compile the evidence from systematic reviews (SRs) about the use of sealants for preventing and arresting pit and fissure occlusal caries in primary and permanent teeth. MATERIALS AND METHODS: A search was performed in six databases and gray literature up to May 2023. Systematic reviews (SRs) that included randomized trials (RCTs) and nonrandomized clinical trials (n-RCTs) aiming to answer the PICO-based focused question "are pit and fissure sealants (I) more effective than other interventions, control or no treatment (C) in preventing and arresting occlusal caries (O) in primary and permanent teeth (P)?", were included. The methodological quality was assessed using the AMSTAR-2. The overlap between reviews was calculated (corrected covered, CCA). RESULTS: Among the 25 included SRs, 18 underwent meta-analysis. Eighteen SRs considered sealing enamel caries lesions, one considered sealing dentine caries, and six considered both. Seventeen SRs were devoted to preventive sealing (RCT only, n = 12; RCT and n-RCT, n = 5), while eight were devoted to prevention and arrest of dental caries (RCT only, n = 5; RCT and n-RCT, n = 3). Nine SRs showed positive results for the primary dentition, and the most frequent periods of follow-up were at least 6 (n = 5) and 12 months (n = 4). According to our meta-analysis, a significant association between resin-based sealants (RBS) and dental caries prevention was detected at 6 months (n = 1) and over longer follow-up periods (n = 4), and the DMFT and dmft indices decreased (n = 2). RBS was better than fluoride varnish at preventing dentine caries (n = 1). A lower caries incidence rate was observed in the resin-modified glass ionomer group at 6 months (n = 1). Overall, the sealants were superior (n = 11), similar (n = 21), or inferior (n = 1) to the other treatments. The AMSTAR-2 scores for studies on preventive sealing were critically low (n = 8), low (n = 6), moderate (n = 1) and high (n = 2) for studies on preventive sealing and critically low (n = 5), low (n = 2) and high (n = 1) for studies on the prevention and arrest of caries lesions. The overlap was low (CCA = 3%). CONCLUSION: This overview suggests that pit and fissure sealants are not inferior to other interventions in preventing and arresting dental caries lesions in primary and permanent teeth.

PREVENTING CARIES AFTER RADIOTHERAPY TO THE HEAD AND NECK REGION - A SYSTEMATIC REVIEW.

OBJECTIVES: Radiotherapy to the head and neck region (HN) bears the risk of a rampant development of caries, making intensified prevention necessary. Aim of this systematic review was to summarize the evidence on the efficacy of caries preventive measures in these patients. METHODS: Clinical studies investigating caries in patients with radiotherapy in the HN with at least 1 caries preventive intervention compared to any control were included. Reports in languages other than English or German were excluded. Records were identified on PubMed, Web of Science, Google Scholar, and Cochrane Library mid-January 2024. Risk of bias was assessed with RoB2. Results were summarized. Planned meta-analyses could not be performed, because of heterogenous data. RESULTS: Five studies were included, with a total of 355 participants. They were irradiated with up to 70 Gy and received different caries preventive interventions, including sodium fluoride or stannous fluoride gels, remineralizing solutions, an "Intraoral Fluoride Release System" and sucrose restricted diet. Caries score increased between 0.48 DMF-S and 9.2 DF-S per year. Largest differences in caries increments were measured between groups with insufficient and with rigorous fluoride application. CONCLUSIONS: The main limitations were compromised randomization, heterogeneity of patients and small sample sizes. Clinical studies on caries prevention after radiotherapy to the HN are lacking and the existing ones bear extensive limitations. However, the large effect size and broad consensus suggest the use of fluoride to be indispensable in preventing caries in these patients. The study was funded by the Medical Center - University of Freiburg and was not registered.