Evaluating the Success of Preformed Resin Bonded Composite Strip Crowns for the Primary Central Incisor in Restoring Carious Primary Canine Teeth: A Retrospective Analysis.

Background Restoration of primary canine teeth in pediatric dentistry requires a balance of functional, biological, and esthetic factors. Stainless steel crowns, while effective for posterior restorations, often have patient acceptance issues due to esthetic limitations. Resin-bonded composite strip crowns have gained traction for anterior restorations due to their superior esthetic qualities and repairability. However, their long-term performance in primary canines characterized by unique morphological and functional demands has not been thoroughly evaluated. This study investigates the efficacy of resin-bonded incisor strip crowns in primary canines over three years, assessing their functional durability, biological integrity, and esthetic performance to provide a comprehensive evaluation of their long-term success in this application. Methods This retrospective observational study, conducted from September 2023 to December 2023 at the Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India, received ethical approval from the Institutional Human Ethical Committee (IHEC/SDC/PEDO-2103/23/131). Dental records from January 2020 to December 2020 were reviewed by two investigators to identify children aged six years or younger who had undergone pulpectomy in primary canine teeth and were restored with resin-bonded incisor strip crowns. Exclusions included records with missing contact details or post-treatment radiographs. The purpose was to ensure a three-year review period when contacting patients in 2023. Eligible parents were contacted by phone, informed about the study, and invited for a review. Informed consent was obtained in person. Children with exfoliated primary canines and those whose parents did not sign the consent form were excluded. The restored crowns were evaluated using World Dental Federation (FDI) criteria across functional, biological, and esthetic domains by two calibrated examiners. Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States), with categorical variables expressed as n (%), inter-examiner reliability assessed by Cohen's kappa, and chi-square test used for goodness of fit, setting significance at 95%. Results Of the 92 primary canines restored with resin-bonded incisor strip crowns, 60 children were evaluated. The retention rate at the three-year follow-up was 50 (83.3%). Functional evaluation revealed that 48 (80%) of crowns maintained surface texture, 42 (70%) preserved form and contour, and 52 (86.6%) demonstrated acceptable occlusion and wear. Biologically, 55 (91.7%) of the crowns had no secondary caries, and 56 (93.4%) had no dental hard tissue defects at the margin. Esthetically, 48 (80%) of crowns retained surface texture, 46 (76.6%) had a satisfactory color match, and 45 (71.6%) exhibited minimal marginal staining. Statistical analysis confirmed significant results for all functional and esthetic parameters (p < 0.05). Conclusion The technique of placing incisor strip crowns in the place of primary canines can be recommended considering its maintenance of functional, biological, and esthetic properties.

Comparative Evaluation of Total Antioxidant Capacity and pH of Saliva in Children with and without Early Childhood Caries.

BACKGROUND: Early childhood caries (ECC), a type of tooth decay that affects preschool children, is a complex chronic disease resulting from an imbalance of multiple risk factors and protective factors of tooth decay, over time. The antioxidant system in saliva is one of its defense mechanisms against disease agents. The pH of saliva also affects the integrity of the oral cavity, hence caries susceptibility. OBJECTIVE: The study assessed and compared the total antioxidant capacity (TAC) and pH of saliva in children with and without ECC. METHODS: Unstimulated whole saliva, using the passive drool method was obtained from children with and without ECC, matched for age and gender. The samples were analyzed for TAC using the phosphomolybdenum assay technique, and pH with a hand-held digital pH meter. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 21. Association between categorical variables was determined using Chi-square, while analysis of variance (ANOVA) was used to compare the means. The level of significance (p-value) was set at 5% (0.05). RESULTS: A total of 68 children were examined (34 with ECC and 34 without ECC). The mean TAC in the ECC group was (0.53± 0.2) which was higher than the mean TAC of (0.36± 0.1) in the group without ECC. The mean pH (6.17±0.5) in the ECC group was lower than the mean pH (6.74± 0.5) in the caries-free group. The difference was statistically significant, p value<0.001. CONCLUSION: The saliva samples of children with ECC contained higher mean TAC and lower pH values compared to those without, who had lower mean TAC and higher pH values. This suggests a relationship between antioxidant production and cariogenesis. There was a statistically significant positive correlation between TAC and the pH of saliva in children with ECC.

CONTEXTE: La carie de la petite enfance (CPE), un type de carie dentaire qui touche les enfants d'âge préscolaire, est une maladie chronique complexe résultant d'un déséquilibre de multiples facteurs de risque et de facteurs de protection contre la carie dentaire, au fil du temps. Le système antioxydant de la salive est l'un de ses moyens de défense. mécanismes contre les agents pathogènes. Le pH de la salive affecte également l'intégrité de la cavité buccale, d'où la susceptibilité aux caries. OBJECTIF: L'étude a évalué et comparé la capacité antioxydante totale (TAC) et le pH de la salive chez les enfants avec et sans CPE. METHODES: Salive entière non stimulée, en utilisant le La méthode de la bave passive a été obtenue auprès d'enfants avec et sans CPE, appariés en fonction de l'âge et du sexe. Les échantillons ont été analysés pour le TAC à l'aide de la technique de dosage du phosphomolybdène et le pH avec un pH-mètre numérique portatif. Les données ont été analysées á i'aide du paquet statistique pour les sciences sociales (SPSS) version 21. L'association entre les variables catégorielles a été déterminée à l'aide du chi carré, tandis qu'une analyse de variance (ANOVA) a été utilisée pour comparer les moyennes. Le niveau de signification (valeur p) a été fixé à 5 % (0,05). RESULTATS: Un total de 68 enfants ont été examinés. (34 avec ECC et 34 sans ECC). Le TAC moyen dans le groupe ECC était de (0,53 ± 0,2), ce qui était supérieur au TAC moyen de (0,36 ± 0,1) dans le groupe sans ECC. Le pH moyen (6,17 ± 0,5) dans le groupe ECC était inférieur au pH moyen (6,74 ± 0,5) dans le groupe sans carie. La différence était statistiquement significative, valeur p <0,001. CONCLUSION: Les échantillons de salive des enfants atteints de CPE contenaient un TAC moyen plus élevé et des valeurs de pH plus faibles par rapport à ceux sans TAC, qui avaient un TAC moyen plus faible et des valeurs de pH plus élevées. Ceci suggère une relation entre la production d'antioxydants et la cariogenèse. Il existait une corrélation positive statistiquement significative entre le TAC et le pH de la salive chez les enfants atteints de CPE. MOTS CLES: Carie de la petite enfance (CPE), Salive, pH, Capacité antioxydante totale (TAC).

An interdisciplinary intervention program to prevent early childhood caries in the Dominican Republic.

Objective: The principal aim of this randomized clinical trial (RCT) was to test the effectiveness in the prevention of Early Childhood Caries (ECC) through an educational intervention program with the use of a printed guide for pediatricians and parents both designed by pediatric dentists. Materials and methods: After ethical approval, the first step was to design the educational guides, which were based on the information obtained from a focus group with pediatricians (n = 3), phone interviews with mothers to toddlers' (n = 7), and the best evidence available about children's oral health. For the RCT, 309 parents with their 10-12 months old children were randomly allocated to either the intervention or the control group. Parents in the intervention group received oral health education from the pediatricians supported by the printed guides. Parents in both groups received an oral health kit with a toothbrush and toothpaste at the first visit as well as at each 6-month follow-up visit. After 18 months the children were evaluated using ICDAS criteria. Results: At baseline, data were available from 309 children (49.8% girls). The mean age of the children was of 10.8 months (SD = 0.8) and 69.3% had not had their teeth brushed with toothpaste. After 18 months, a total of 28 (22%) children in the intervention group and 44 (24%) in the control group were clinically examined. Regarding the number of tooth surfaces with caries lesions, the children in the intervention group had a mean of 6.50 (SD = 6.58) surfaces, while the children in the control group had a mean of 5.43 (SD = 4.74) surfaces with caries lesions. This difference was not significant (p = 0.460). Conclusion: The RCT showed no effectiveness in caries-progression control. Despite this result, this study managed to identify barriers that do not allow pediatricians from offering parents adequate oral health recommendations. With this learning, it is possible to work on collaborative programs with pediatricians that over time likely will increase dental health by controlling for ECC.

A mixed methods approach to obtaining health care provider feedback for the development of a Canadian pediatric dental caries risk assessment tool for children <6 years.

Introduction: Early childhood caries (ECC) is a chronic but preventable disease affecting young children worldwide. Many young children face access to care barriers to early preventive dental visits for a variety of reasons, which can increase their risk for ECC. Non-dental primary health care providers are well positioned to assist in assessing a child's risk for ECC by performing caries risk assessment (CRA). The purpose of this project was to report on primary health care provider and stakeholder feedback in order to refine a drafted CRA tool for Canadian children <6 years of age intended for use by non-dental primary health care providers. Methods: In this mixed methods project, we conducted six focus groups with primarily non-dental primary health care providers followed by a short paper-based survey to quantify preferences and feedback. Data were thematically and descriptively analyzed. Results: Participants' feedback on the drafted CRA tool included the need for it to be relatively quick to complete, easy and practical to score, easy to implement into practitioners' clinic schedules, and to include anticipatory guidance information to share with parents and caregivers. All participants (100%) welcomed a CRA tool. Many (85.4%) liked a layout that could be added to tools they already utilize. Most (73.2%) wanted the tool to be in colour, and many (90.2%) wanted the tool to include pictures. Conclusion: Non-dental primary health care providers informed the final development and layout of the newly released Canadian CRA tool. Their feedback resulted in a user-friendly CRA tool with provider-patient dynamics and preferences.

Role of mutans streptococci, acid tolerant bacteria and oral Candida species in predicting the onset of early childhood caries.

Aim: Early childhood caries is the most common chronic infectious disease in children in the United States. This study, which is part of a larger, longitudinal study exploring oral microbiological components of caries development in children, reports on the impact of total mutans streptococci (MS), total acid tolerant bacteria and Candida species on the development of dental caries in a subset of these children. Of particular interest was the relationship between caries development and co-colonization of mutans streptococci and Candida species. Methods: Children between the ages of 12 and 47 months displaying no evidence of dental caries were recruited for a longitudinal study (n = 130). Twelve age- and gender-matched pairs were selected. In each pair, one child developed caries during the study, and one did not. Whole mouth plaque samples were collected by swab at baseline and every 6 months thereafter for a duration of 18 months and spiral plated for microbial counts (CFU/ml). Cut-offs based on percent of total cultivable flora were designated for all microbial measures. A scoring system designated the Plaque Microbial Index (PMI) was developed for use in statistical analyses to assess potential predictive factors for caries risk assessment. Results: Children who developed caries were significantly more likely to harbor higher percentages of acid tolerant bacteria (p = 0.003), MS (p < 0.001) and have Candida species present (p < 0.001) at ≥1 visit leading up to caries onset. Mean PMI scores derived from the aforementioned microbial measures, were higher for caries active children than caries free children (p = 0.000147). Co-colonization of MS and Candida species was significantly associated with caries development (p < 0.001) and detection of both at the same visit had a 100% positive predictive value and 60% negative predictive value for caries development. Conclusion: In children who developed caries, there was a statistically significant association with the percent of total flora that was acid tolerant, the percent of MS, the presence of Candida and co-colonization of MS and Candida species. Combining these microbial measures into PMI scores further delineated children who developed caries from those who remained caries-free. These microbiological measures show potential as predictive factors and risk assessment tools for caries development.

Candida albicans CHK1 gene regulates its cross-kingdom interactions with Streptococcus mutans to promote caries.

The cross-kingdom interactions between Candida albicans and Streptococcus mutans have played important roles in early childhood caries (ECC). However, the key pathways of C. albicans promoting the cariogenicity of S. mutans are still unclear. Here, we found that C. albicans CHK1 gene was highly upregulated in their dual-species biofilms. C. albicans chk1Δ/Δ significantly reduced the synergistical growth promotion, biofilm formation, and exopolysaccharides (EPS) production of S. mutans, the key cariogenic agent, compared to C. albicans wild type (WT) and CHK1 complementary strains. C. albicans WT upregulated the expressions of S. mutans EPS biosynthesis genes gtfB, gtfC, and gtfD, and their regulatory genes vicR and vicK, but chk1Δ/Δ had no effects. Both C. albicans WT and chk1Δ/Δ failed to promote the biofilm formation and EPS production of S. mutans ΔvicK and antisense-vicR strains, indicating that C. albicans CHK1 upregulated S. mutans vicR and vicK to increase the EPS biosynthesis gene expression, then enhanced the EPS production and biofilm formation to promote the cariogenicity. In rat caries model, the coinfection with chk1Δ/Δ and S. mutans decreased the colonization of S. mutans and developed less caries especially the severe caries compared to that from the combinations of S. mutans with C. albicans WT, indicating the essential role of C. albicans CHK1 gene in the development of dental caries. Our study for the first time demonstrated the key roles of C. albicans CHK1 gene in dental caries and suggested that it may be a practical target to reduce or treat ECC. KEY POINTS: • C. albicans CHK1 gene is important for its interaction with S. mutans. • CHK1 regulates S. mutans two-component system to promote its cariogenicity. • CHK1 gene regulates the cariogenicity of S. mutans in rat dental caries.

Prevalence and Risk Factors for ECC Among Preschool Children from India along with the Need of its Own CRA Tool- A Systematic Review.

Introduction: Caries in the deciduous dentition of children under six years of age is termed as early childhood caries (ECC). ECC is prevalent among Indian children and identifying modifiable risk factors is important for prevention. This systematic review was undertaken to describe the burden of ECC in India, its prevalence, associated risk factors along with its repercussions on childhood health. Materials and Methods: A search was conducted for published Indian studies on ECC through electronic databases and complemented with hand search. The protocol for the present systematic review was registered at PROSPERO (Ref No.CRD42022306234)Care was taken to include studies which could represent all parts of India- Central, North, South, East and West. Included papers were reviewed for prevalence of ECC and reported risk factors. Results: Overall 37 studies on ECC in India were identified relating to prevalence, 11 reported risk factors and two reported on the association between severe ECC and nutritional health and well-being. The prevalence of ECC in India in these studies varied from16% to 92.2%. This systematic review revealed that ECC is prevalent among Indian children and highlights the need of preventive intervention and early risk assessment by its own caries risk assessment (CRA) tool. Occurrence seems to be firmly connected with age, snacking frequency, feeding and oral hygiene habits and with social determinants of health including parental education level, low socioeconomic status and number of siblings.

Early Childhood Caries in Preschool Children of Ambala District: A Cross-sectional Study.

Introduction: With increased focus on preventive and promotive interventions in recent years, initial noncavitated carious lesions have drawn attention of healthcare planners as a relevant dental health indicator. Aim and objectives: The aim of the present study was to assess the prevalence and clinical sequelae of early childhood caries in District Ambala, Haryana. Materials and method: The present cross-sectional study was conducted among 1,474 children aged 36-71 months old from randomly selected anganwadi centers or preschools. Clinical examination was carried out by single trained calibrated principal investigator and data was recorded on self-structured recording format. The caries assessment was made using International Caries Detection and Assessment system-II [ICDAS -II] and Pulpal Involvement, Ulceration, Fistula and Abscess [pufa/PUFA] Index, respectively. Later decayed, missing, and filled teeth [dmft] values were deduced from ICDAS codes to compare with known indices. Results: The prevalence of ECC was found to be 65.5 % [ICDAS code other than 0] and 38.2% [dmft < 0]. Prevalence of clinical sequelae [pufa < 0] was found to be 16.5%. There was increase in prevalence of dental caries [ICDAS code other than 0] with increasing age, and difference was statistically significant. Conclusion: The high prevalence of dental caries in this younger age-group suggests the need to curate strategies for prevention of early childhood caries and oral health promotion that include supportive and practical advice for parents and caregivers of preschool and anganwadi children. Clinical significance: Traditionally, dental caries are detected at cavitation stage however last 20 years have seen the shift to detection of noncavitated lesions that have slow rate of progression and it is the right time for controlling the severity of the lesion. The present study also highlights the need for the non-surgical management of noncavitated lesions. How to cite this article: Early Childhood Caries in Preschool Children of Ambala District: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(S-2):S191-S196.

Evaluation of a caries prevention programme for preschool children in Switzerland: is the target group being reached?

BACKGROUND: With the goal of reducing the prevalence of early childhood caries, the city of Zurich, Switzerland, started a specific prevention programme in 2010. All 2-year-olds are invited to a free dental check-up at a local public dental health service before the first legally mandated yearly dental check-up for school children between 4 and 5 years of age (at kindergarten). However, for the success of this prevention programme, it is of particular importance that children at high risk of caries are reached. The objective of our study was to assess the effectiveness of the prevention programme in (1) reaching the children who needed it the most and (2) improving subsequent oral health. METHODS: This retrospective cohort study included all children born between July 1, 2013 and July 15, 2014 who had lived in Zurich between the ages of 23 and 36 months. Socio-economic data were extracted from official school records, and dental health data from public dental clinic records. Binomial and quasi-binomial generalised linear models were used to identify the socio-economic factors associated with toddler check-up attendance and to assess the associations between attendance and caries experience (dmft [Formula: see text] 1) as well as degree of treatment (proportion m+f out of dmft) at the kindergarten check-up, adjusting for socio-economic factors. RESULTS: From a total of 4376 children, 2360 (54%) attended the toddler check-up (mean age 2.4 years) and 3452 (79%) had a dental examination at kindergarten (mean age 5.3 years). Non-Swiss origin of the primary caretaker, presence of older siblings, low amount of savings and allocation to certain public dental clinics were associated with a lower odds of attendance. Factors associated with a higher odds of caries experience were similar to those associated with a lower odds of attendance at the toddler check-up, but additionally included low income. Attendance at the toddler check-up was non-significantly associated with a lower odds of caries experience at kindergarten (adjusted OR 0.84, 95% CI from 0.70 to 1.01), but was significantly associated with a higher degree of treatment at this stage (adjusted OR 2.41, 95% CI from 1.79 to 3.24). CONCLUSIONS: Our study suggests that children with a high caries risk are less likely to attend the toddler check-up. Greater effort should be put into reaching these children.

Salivary cystatin S levels in children with early childhood caries in comparison with caries-free children; statistical analysis and machine learning.

BACKGROUND: Early childhood caries is the most common infectious disease in childhood, with a high prevalence in developing countries. The assessment of the variables that influence early childhood caries as well as its pathophysiology leads to improved control of this disease. Cystatin S, as one of the salivary proteins, has an essential role in pellicle formation, tooth re-mineralization, and protection. The present study aims to assess salivary cystatin S levels and demographic data in early childhood caries in comparison with caries-free ones using statistical analysis and machine learning methods. METHODS: A cross-sectional, case-control study was undertaken on 20 cases of early childhood caries and 20 caries-free children as a control. Unstimulated whole saliva samples were collected by suction. Cystatin S concentrations in samples were determined using human cystatin S ELISA kit. The checklist was collected from participants about demographic characteristics, oral health status, and dietary habits by interviewing parents. Regression and receiver operating characteristic (ROC) curve analysis were done to evaluate the potential role of cystatin S salivary level and demographic using statistical analysis and machine learning. RESULTS: The mean value of salivary cystatin S concentration in the early childhood caries group was 191.55 ± 81.90 (ng/ml) and in the caries-free group was 370.06 ± 128.87 (ng/ml). T-test analysis showed a statistically significant difference between early childhood caries and caries-free groups in salivary cystatin S levels (p = 0.032). Investigation of the area under the curve (AUC) and accuracy of the ROC curve revealed that the logistic regression model based on salivary cystatin S levels and birth weight had the most and acceptable potential for discriminating of early childhood caries from caries-free controls. Furthermore, using salivary cystatin S levels enhanced the capability of machine learning methods to differentiate early childhood caries from caries-free controls. CONCLUSION: Salivary cystatin S levels in caries-free children were higher than the children with early childhood caries. Results of the present study suggest that considering clinical examination, demographic and socioeconomic factors, along with the salivary cystatin S levels, could be usefull for early diagnosis ofearly childhood caries in high-risk children; furthermore, cystatin S is a protective factor against dental caries.

Socio-Economic Status May Associate Different Risk(s) with Early Childhood Caries (ECC) That Can Cause the Development of Psychomotor Deficiency in Preschool Children Aged 3-6 Years Old: The Results of Preliminary Analysis from a Cohort Study.

BACKGROUND: We have recently shown that there is a positive correlation between severe caries and developing psychomotor deficiency in preschool children. To fully re-assess such a relationship, we embarked on a 3-year longitudinal follow-up study of kindergarteners, where we aimed to: (i) confirm whether early childhood caries is causally related to the development of psychomotor deficiency as proposed, and (ii) address any significant role or contribution of socio-economic status associated with caries-psychomotor interactions in the preschooler family cohorts studied, over time. METHODS: A longitudinal study was designed where the total sum of 159 kindergarteners aged 3-6 from the central and southern regions of Taiwan were randomly selected and recruited for clinical examination of caries, together with questionnaires for personal, demographic and dietary information, socio-economic status, and the children's psychomotor development scales which were collected and analyzed over time. Student's t test, chi-squared test, correlation coefficients, and multiple linear regression analysis with R2 determinants were employed to assess any attributable differences (of 0~1) between SES vs. psychomotor manifests and caries measured among all variables computed. RESULTS: The results of our preliminary analyses show that: (i) there was likely a causal relationship between caries activities and aspects of general development scale via the Chinese Child Development Inventory over time (4.01 ± 3.47 vs. 5.88 ± 2.58, respectively) in the 3-6-year-old preschoolers, and (ii) there was significantly more attributable influence (via higher R-squared values) from SES and psychomotor manifests than that of caries and the Chinese Child Development Inventory counterparts, as detected over time. CONCLUSION: Collectively, the resulting analyses support our previous findings and confirm that there is likely a causal relationship between severe caries and psychomotor deficiency in growing preschoolers; the resulting analyses revealed that such causally related interactions may be attributably explainable by a content-reliant association via socio-economic status analyzed in the kindergartener family cohorts studied. Thus, the socio-economic status or its constituents/factors will have a much broader influence not only associated with developing early childhood caries (a biologic trait), but also for psychomotor deficiency (a social trait) in vulnerable children at risk.

A Formative Assessment of Social Determinants of Health Related to Early Childhood Caries in Two American Indian Communities.

In the United States, children from diverse ethnic groups and those with low socioeconomic status are at a significantly increased risk for early childhood caries. Despite the efforts focused on decreasing early childhood caries in American Indian (AI) populations, these children have the highest incidence of dental caries of any ethnic group, with four times the cases of untreated dental caries compared to white children. This qualitative formative assessment was conducted in two AI communities. Semi-structured interviews (n = 57) were conducted with caregivers and providers to understand the social and community contexts in which oral health behaviors and practices occur from the perspective of the caregivers, oral health care providers, and social service providers in the communities. The analysis was informed by the social determinants of health framework. The key social determinants of pediatric oral health relevant to our study communities included limited access to: oral health promoting nutritious foods, transportation for oral health appointments, and pediatric specialty care. This formative assessment provided locally and contextually relevant information to shape the development of an oral health clinical trial intervention to address early childhood caries in these two communities.

Replication of GWAS significant loci in a sub-Saharan African Cohort with early childhood caries: a pilot study.

BACKGROUND: Early childhood caries (ECC) is a rapidly progressing form of dental infection and a significant public health problem, especially among socially and economically disadvantaged populations. This study aimed to assess the risk factors for ECC among a cohort of Sub-Saharan African children and to determine the role of genetics in the etiology of ECC. METHODS: A sample of 691 children (338 with ECC, 353 without ECC, age < 6 years) was recruited from schools in Lagos, Nigeria. Socio-demographic, dental services utilization and infant dietary data were obtained with interviewer-administered questionnaire. Oral examination was conducted using the WHO oral health diagnostic criteria. Saliva samples were collected from the children for genetic analysis. Single nucleotide polymorphisms were selected from previous study for genotyping. Genetic association analyses to investigate the role of genetics in the etiology of ECC was done. Bivariate comparisons and Multivariate logistic regression analyses were conducted to assess associations between ECC and predictor variables, p < 0.05. RESULTS: Of the 338 children with ECC, 64 (18.9%) had Severe-Early Childhood Caries (S-ECC). Children aged 48-59 months comprised the highest proportion of subjects with ECC (165; 48.8%) and S-ECC (24; 37.5%) while female subjects had higher dt (3.13 ± 2.56) and dmft values 3.27 ± 2.64. ECC was significantly more prevalent among children who were breastfed at night ≥ 12 months (OR 3.30; CI 0.39, 4.75), those with no previous dental visit (OR 1.71; CI 0.24, 2.77), those who used sweetened pacifiers (OR 1.85; CI 0.91, 3.79) and those who daily consumed sugar-sweetened drinks/snacks (OR 1.35; CI 0.09, 18.51). A suggestive increased risk for ECC (OR 1.26, p = 0. 0.0397) was observed for the genetic variant rs11239282 on chromosome 10. We also observed a suggestive reduced risk for ECC (OR 0.80, p = 0.03) for the rs131777 on chromosome 22. None of the genetic variants were significant after correction for multiple testing (Bonferroni p value p = 0.004). CONCLUSIONS: Prolonged night-time breastfeeding, poor utilization of dental services and daily consumption of sugar were risk factors for ECC. Larger sample size is needed to confirm the results of the genetic analysis and to conduct genome wide studies in order to discover new risk loci for ECC.

Association of parental-reported vitamin D supplementation with dental caries of 3-year-old children in Poland: a cross-sectional study.

OBJECTIVE: The study aimed to assess the association between parental-reported vitamin D supplementation and caries in a national sample of 3-year-olds in Poland. MATERIALS AND METHODS: A total of 1900 children, representing all provinces of Poland, were invited. The questionnaires concerned vitamin D supplementation, socio-demographics, and oral health behaviours. Based on dental examination, caries scores (dmft/dmfs), prevalence of early childhood caries (ECC) and severe ECC (S-ECC) were calculated. The Spearman's correlation, linear regression and logistic regression were used to assess the association between various factors and caries (p < 0.05). RESULTS: A total of 1638 children were tested. Of this number, 99.1% infants were supplemented with vitamin D. Supplementation had been continued seasonally in 55.2% children. ECC/S-ECC prevalence were significantly lower in children receiving vitamin D (ECC 38.3% vs. 44.7%, OR = 0.77; S-ECC 20.5% vs. 27.1%, OR = 0.69; p < 0.05). Mean dmft/dmfs were lower in those with supplementation (1.54 ± 2.72 vs. 2.24 ± 3.55; 2.40 ± 5.56 vs. 3.72 ± 7.56, respectively; p < 0.001). After controlling for confounding factors, supplementation was not significantly associated with caries; only dt/ds were still associated. Maternal education, sweetened beverages before bedtime, bottle use were significantly associated with S-ECC. CONCLUSIONS: Lower caries prevalence was observed in those with vitamin D supplementation. The association between parental-reported vitamin D and ECC/S-ECC was not significant in Polish children. Decayed teeth and supplementation were still associated. Dietary habits can modify the association with caries. CLINICAL RELEVANCE: There may be an association between vitamin D supplementation and lower caries in children. Parents should supplement their children during periods of significant growth and development.

Salivary Microbiome Variation in Early Childhood Caries of Children 3-6 Years of Age and Its Association With Iron Deficiency Anemia and Extrinsic Black Stain.

ECC is a common clinical manifestation of the oral cavity in childhood and Iron deficiency-anemia (IDA) is a high-risk factor but extrinsic black stain on the tooth surface is a protective factor for caries. There is limited information about oral microecological change in early children who suffer from ECC with IDA and extrinsic black stain (BS). This study enrolled 136 children aged 3-6 years. Dental caries and teeth BS were examined. Saliva was collected for 16S rRNA gene and fingertip blood were for Hemoglobin test. There are 93 ECC including 13 with IDA (IDA ECC) and 80 without IDA (NIDA ECC) and 43 caries free (CF) including 17 with BS (BSCF) and 26 without BS (NBS CF). Statistical analysis of microbiota data showed differences of the oral flora in different groups. The oral flora of the IDA ECC group had a high diversity, while the BSCF group had a low diversity. The bacterial genera Bacillus, Moraxella, and Rhodococcus were enriched in the IDA ECC while Neisseria was enriched in the NIDA ECC. Neisseria only exhibited high abundance in the BSCF, and the remaining genera exhibited high abundance in the NBSCF. Interestingly, the BSCF had the same trend as the NIDA ECC, and the opposite trend was observed with IDA ECC. We established random forest classifier using these biomarkers to predict disease outcomes. The random forest classifier achieved the best accuracy in predicting the outcome of caries, anemia and black stain using seven, one and eight biomarkers, respectively; and the accuracies of the classifiers were 93.35%, 94.62% and 95.23%, respectively. Our selected biomarkers can achieve good prediction, suggesting their potential clinical implications.

The Burden of Early Childhood Caries in Children under 5 Years Old in the European Union and Associated Risk Factors: An Ecological Study.

The associations among early childhood caries (ECC), socioeconomic status, and sugar consumption are of the utmost importance, due to their potential policy implications. The purpose of this study was to identify trends in ECC burden in children under 5 years old among European Union (EU) member states over time and to evaluate the relationship with its risk factors. Global Burden of Disease 2019 data were analyzed to estimate the burden of ECC over time, specifically incidence, prevalence, and years lived with disability (YLDs) for children under 5 years old. Four ecological variables with a potential effect on YLDs for ECC were used to investigate the association between 2014 and 2017. The YLDs rate was consistently higher among Eastern EU countries over time. Univariate models showed a positive significant association between at-risk-of-poverty rate and YLDs rate, while GDP per capita and urbanization were inversely associated with YLDs rate. In the multivariate analysis, sugar consumption, GDP per capita and urbanization showed significant association with YLDs rate. After stratification by region, association remained significant only in the Eastern EU countries between GDP, urbanization, and YLDs rate, while sugar consumption and at-risk-of-poverty rate had no significant impact on YLDs rates. This study found increasing ECC burden in the EU. The complexity of the problem indicates the need for innovative and personalized policy approaches to tackle the disease.

Oral Health-related Quality of Life of Children with Early Childhood Caries before and after Receiving Complete Oral Rehabilitation under General Anesthesia.

Introduction: Early childhood caries (ECC) significantly affects the quality of life of children due to recurrent pain, infection, and other associated problems. Aim and objective: To assess the change in oral health-related quality of life of children aged <5 years undergoing complete oral rehabilitation under general anesthesia. Materials and methods: A total of 50 healthy children affected with ECC were enrolled for the present study. Oral health-related quality of life (OHRQoL) of every child was assessed by interviewing the mothers using a prevalidated Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire one day prior to the treatment appointment and comparing the scores with those at 1 and 3 months post-treatment to evaluate the changes in the OHRQoL, if any and assess the stability of the changes. Results: The results revealed a statistically significant reduction in Ouality of Life (QoL) scores of all the domains and total ECOHIS scores between baseline and 1 month, and baseline and 3 months. Conclusion: The oral health-related quality of life showed a significant improvement after complete oral rehabilitation under general anesthesia and the improvement persisted beyond the immediate post-treatment period. How to cite this article: Raghu R, Gauba K, Goyal A, et al. Oral Health-related Quality of Life of Children with Early Childhood Caries before and after Receiving Complete Oral Rehabilitation under General Anesthesia. Int J Clin Pediatr Dent 2021;14(S-2):S117-S123.

Differences in Sweet Taste Perception and Its Association with the Streptococcus mutans Cariogenic Profile in Preschool Children with Caries.

The aim of the study was to verify the hypothesis about differences in sweet taste perception in the group of preschool children with and without caries, and to determine its relationship with cariogenic microbiota and the frequency of sweets consumption in children. The study group included of 63 children aged 2-6 years: 32 with caries and 31 without caries. The study consisted of collecting questionnaire data and assessment of dental status using the decayed, missing, filled in primary teeth index (dmft) and the International Caries Detection and Assessment System (ICDAS II). The evaluation of sweet taste perception was carried out using a specific method that simultaneously assessed the level of taste preferences and the sensitivity threshold for a given taste. The microbiological analysis consisted of the assessment of the quantitative and qualitative compositions of the oral microbiota of the examined children. The sweet taste perception of children with caries was characterized by a lower susceptibility to sucrose (the preferred sucrose solution concentration was >4 g/L) compared to children without caries (in the range ≤ 4 g/L, p = 0.0015, chi-square test). A similar relationship was also observed for frequent snacking between meals (p = 0.0038, chi-square test). The analysis of studied variables showed the existence of a strong positive correlation between the perception of sweet taste and the occurrence and intensity of the cariogenic process (p = 0.007 for dmft; and p = 0.012 for ICDAS II), as well as the frequency of consuming sweets (p ≤ 0.001 for frequent and repeated consumption of sweets during the day, Spearman test) in children with caries. Additionally, children with an elevated sucrose taste threshold were more than 10-times more likely to develop S. mutans presence (OR = 10.21; 95% CI 3.11-33.44). The results of this study suggest the future use of taste preferences in children as a diagnostic tool for the early detection of increased susceptibility to caries through microbial dysbiosis towards specific species of microorganisms.

Dental Caries in Children Under Five Years of Age in Mongolia.

During the Japan International Cooperation Agency (JICA) partnership program in Mongolia, six times between October 2017 and October 2019, education for caries prevention, a questionnaire of daily oral health behavior, and an oral examination for parents and children aged 0-5 years old were done. The target parent population were middle socio-economic class families. In total, there were 2223 participants. The caries prevalence measured in October 2017, January, April, and October 2018, and April and October 2019, was 78.0% (95% CI: 74.2-81.4); 79.4% (73.7-84.4); 80.8% (76.2-84.9); 76.4% (70.1-82.0); 89.3% (85.3-92.6); and 82.6% (79.3-85.6), respectively. Compared to October 2017, in October 2019, the deft of three years old was significantly decreased (p < 0.01) and that of four years old was also decreased (p = 0.085). For the prevention of early childhood caries (ECC), daily oral health behaviors are important. In 2019, compared with the percentage of 0-5 years old in 2017, the frequency of tooth cleaning per day, parents cleaning after children, and parents watching during children's tooth cleaning were significantly increased (p < 0.01). Unfortunately, the frequency of sugary-snack intake per day showed an increased tendency (p < 0.05). The baby teeth decayed, extracted and filled (deft) index at three and/or four years old in October 2019 was correlated with the childrens' background characteristics, such as parent educational attainment, frequency of sweets intake, frequency of daily tooth cleaning, and parental cleaning of children's teeth. The effects of the JICA program were recognized.