Influence of maternal attitudes and parenting style on children`s dental caries experience.

OBJECTIVE: To evaluate the effect parental attitudes have on the dental caries experience of children. METHODS: The cross-sectional observational study was conducted at Yeditepe University, Istanbul, Turkey, from March to September 2019, and comprised mothers of children who came to the Department of Paediatric Dentistry for treatment of children. Multi-variable poisson regression model was run to predict prevalence of dental caries. Mothers' attitudes in family were measured using the parental attitude research instrument scores. Data was analysed using Stata 15. RESULTS: There were 258 mothers of as many children aged 6-15 years. Among the children, 150(58%) were boys and 108(42%) were girls. 'Rejection of traditional housewife role' and 'level of discipline' had a statistically negative correlation (p<0.05), while 'level of marital conflict' had a statistically positive correlation with the prevalence of caries. CONCLUSIONS: Healthy family environment and empowering parental style had a positive effect on the oral health of children.

Human permanent tooth sizes are associated with genes encoding oestrogen receptors.

OBJECTIVE: To evaluate if genetic polymorphisms in the oestrogen receptor 1 (ESR1) and oestrogen receptor 2 (ESR2) genes encoded for oestrogen receptors alpha (ERα) and beta (ERß) are involved in permanent tooth size. DESIGN: Cross-sectional study. SETTING: Orthodontic Clinic at School of Dentistry of Ribeirão Preto, University of São Paulo. PARTICIPANTS: A total of 108 orthodontic patients. MATERIALS AND METHODS: Pre-treatment orthodontic records were evaluated. Dental casts were used to determine the maximum crown measurements of fully erupted permanent teeth in the mesiodistal dimensions. Second and third molars were not included in the analysis. Genomic DNA samples were used for the genotyping of four genetic polymorphisms: ESR1 (rs9340799 and rs2234693) and ESR2 (rs1256049 and rs4986938). The associations between tooth size and sex were evaluated using t test. The associations between tooth size and genotype were analysed with linear regression and adjusted by sex at an alpha of P⩽0.05. RESULTS: Female patients presented smaller tooth size than male patients. A statistically significant difference was observed in almost all teeth (P<0.05). The genetic polymorphisms in rs9340799, rs2234693, rs1256049 and rs4986938 were associated with some tooth sizes in both the maxilla and mandible (P<0.05). CONCLUSION: This study provides evidence that genetic polymorphisms in ESR1 and ESR2 could be associated with tooth size in permanent teeth.

Single nucleotide polymorphism rs4284505 in microRNA17 and risk of dental fluorosis.

OBJECTIVES: The aim of this study is to evaluate the association between the single nucleotide polymorphism (SNP) rs4284505 within the gene that codifies microRNA17 (miRNA17) and dental fluorosis (DF) in a group of children. METHODS: Children living in a city with fluoridation of public water supplies were included. DF was assessed in erupted permanent teeth by Dean's modified index. The miR-SNP rs4284505 was selected in miRNA17 and genotyping was carried out by real-time PCR. Genotype and allelic distributions between DF and control, and between DF phenotypes (mild, moderate and severe) and control were analysed. RESULTS: Among a total of 527 children enrolled for the study, 383 were DF free and 144 presented DF. In the dominant model analysis (AA + AG vs. GG) the miR-SNP rs4284505 was associated with moderate DF, with carriers of the GG genotype having an increased risk of more than two times for DF (p = 0.031; Odds Ratio = 2.26, Confidence Interval 95%= 1.04-4.73). Allelic distribution showed borderline statistical significance for moderate DF with the carriers of G allele having an increased risk for DF (p = .050; Odds Ratio = 1.75, Confidence Interval 95%= 1.00-3.12). CONCLUSION: The miR-SNP rs4284505 in miRNA17 was associated with an increased risk of DF.

Awareness and Experience regarding Child Abuse and Neglect Among Dentists in Turkey.

Objectives: This study assessed the level of knowledge, attitudes, and awareness of child abuse and neglect (CAN) among dentists. Study design: The sample, consisted of 20,298 Turkish Dental Association (TDA) members, which comprise about two thirds of all dentists, specialists, academics and dental PhD students in Turkey. Among the 20,298 emails sent, 1,020 responses were obtained Descriptive analysis was performed and correlations were tested using the Chi-square and Fischer's Exact tests. A p value of <0.05 was considered statistically significant. Results: Of the participating dentists, 32.7% were able to identify cases of CAN cases, while 17.1% had suspected cases of child abuse and only 1% of them, reported these, to the authorities. The most frequently cited reasons for hesitation to report CAN cases were lack of adequate history (45%), lack of knowledge about the healthcare worker's role in reporting CAN (18.3%), and considerations of the possible consequences against the child (18.8%). Only 11.6% of the participants had received undergraduate level training on the topic of CAN; The majority (86.5%) expressed the need for further education on this issue, and, also, 84.3% believed that it should be a part of postgraduate education. Conclusions: Improvements in CAN education and continuing education courses are necessary to equip dentistry professionals with adequate knowledge about the physical and behavioral indicators of possible abuse, the current legislation regarding mandated reporting and the procedures for reporting suspected cases.

Fine-Mapping of Xq25.1-27.2 Shows Association of Early Childhood Caries with Genetic Variants Depending on Dietary Habits, Protecting Children Who Drink Milk before Going to Bed.

Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of unequal contributions of risk factors and protective factors that influence the disease. The aim of this study was to assess if the X chromosome region previously linked to caries was associated with ECC. Two hundred and fifty-nine unrelated children with no chronic illnesses from 2 to 5 years of age who had no systemic fluoride consumption were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire, and caries experience data were collected by clinical examination. Twenty-three markers in ten genes were studied. Genotyping of the selected polymorphisms was carried out by real-time polymerase chain reaction. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries free. The markers in Xq25.1-27.2 were associated with ECC when children were using milk bottle for longer times (p = 0.01) and had more snacks over the course of a day (p = 0.05). Conversely, the markers in the X chromosome studied here were protective for ECC (p = 0.008) in children consuming milk before going to sleep. The genes located in the X chromosome possibly contribute to ECC and have an impact on ECC depending on the dietary habits.

RANKL is associated with persistent primary teeth and delayed permanent tooth emergence.

BACKGROUND: Tooth eruption is a process that is not fully understood. AIM: To evaluate whether genetic polymorphisms for RANK/RANKL/OPG are associated with delayed tooth emergence. To evaluate whether the relative expression of this genes is associated with persistent primary teeth. DESIGN: To evaluate whether genetic polymorphisms for RANK/RANKL/OPG could be involved in delayed tooth emergence, saliva samples from 160 children, aged 6-13 years old, were analysed. To test if there is correlation between gene expression of RANK/RANKL/OPG in children with delayed tooth emergence and persistent primary teeth, periapical tissue from 15 children with persistent primary teeth and from 15 control subjects were collected for qPCR analysis. RESULTS: Fifty-six children with delayed tooth emergence (35%) had at least one permanent tooth with delayed emergence. The T allele in RANKL (rs9594738) increased the risk of delayed tooth emergence (P = 0.02; OR = 1.71, 95%CI 1.09-2.75). The relative gene expression for RANKL and the ratio RANKL/OPG in children with delayed tooth emergence and persistent primary teeth were lower compared to controls (P = 0.02 and P = 0.005, respectively). CONCLUSIONS: Data suggest that the polymorphism rs9594738 in RANKL is associated with delayed permanent tooth emergence. Moreover, reduced relative gene expression of RANKL in periapical tissue is associated with persistent primary teeth.

The Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate on Molar-Incisor Hypomineralisation: A Pilot Study.

PURPOSE: To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) application on noncarious MIH (molar-incisor hypomineralisation) lesions using a DIAGNOdent device (KaVo), which measures laser fluorescence within the mineral structure of the tooth. MATERIALS AND METHODS: A total of 461 subjects age 7-12 (mean ±â€¯SD was 9.9 ±â€¯1.6) years were examined. Fifty- four children were diagnosed with MIH and divided into 2 groups. A total of 38 teeth met the inclusion criteria and were included in the study. Group 1 subjects (n = 15) used a paste containing 10% CPP-ACP, and group 2 subjects (n = 23) used a paste containing 10% CPP-ACP with 0.2% NaF (CPP-ACFP) for one month. RESULTS: After the application of the pastes for one month, significant decreases were found in the mean DIAGNOdent readings for both groups (CPP-ACP p = 0.0015 and CPP-ACFP p = 0.0001). However, the percentage decreases in both groups were not significantly different from each other (60.4% and 45.5% in CPP-ACP and CPP-ACFP groups, respectively). CONCLUSION: This pilot study shows that using CPP-ACP and CPP-ACFP had a positive effect in reducing hypomineralisation on enamel surfaces of MIH-diagnosed teeth for a one month period. It is important to diagnose molar-incisor hypomineralisation at an early stage to prevent excessive caries develeopment. Therefore, further clinical studies are necessary on the long-term application of these kinds of nanocomplexes.

Early childhood caries is associated with genetic variants in enamel formation and immune response genes.

Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of an imbalance of risk factors and protective factors that influence the disease. The aim of this study was to assess genetic and environmental factors that may contribute to ECC. Two hundred and fifty-nine unrelated children were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire, and caries experience data were collected by clinical examination. Twenty-three markers in 10 genes were studied. Genotyping of the selected polymorphisms was carried out by real-time PCR. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries free. The genotype TT in ALOX15 (rs7217186) was a risk factor for ECC, whereas the genotypes GG in ENAM (rs1264848), AG and GG in KLK4 (rs198968), CT in LTF (rs4547741), and GG in TUFT1 (rs3790506) were protective for EEC. In conclusion, environmental factors and gene interactions can act as protective or risk factors for ECC. These factors together contribute to the presence and severity of the disease.

Aquaporin 5 Interacts with Fluoride and Possibly Protects against Caries.

Aquaporins (AQP) are water channel proteins and the genes coding for AQP2, AQP5, and AQP6 are clustered in 12q13. Since AQP5 is expressed in serous acinar cells of salivary glands, we investigated its involvement in caries. DNA samples from 1,383 individuals from six groups were studied. Genotypes of eight single nucleotide polymorphisms covering the aquaporin locus were tested for association with caries experience. Interaction with genes involved in enamel formation was tested. The association between enamel microhardness at baseline, after creation of artificial caries lesion, and after exposure to fluoride and the genetic markers in AQP5 was tested. Finally, AQP5 expression in human whole saliva, after exposure to fluoride in a mammary gland cell line, which is known to express AQP5, and in Wistar rats was also verified. Nominal associations were found between caries experience and markers in the AQP5 locus. Since these associations suggested that AQP5 may be inhibited by levels of fluoride in the drinking water that cause fluorosis, we showed that fluoride levels above optimal levels change AQP5 expression in humans, cell lines, and rats. We have shown that AQP5 is involved in the pathogenesis of caries and likely interacts with fluoride.