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

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

Artificial intelligence chatbots and large language models in dental education: Worldwide survey of educators.

INTRODUCTION: Interest is growing in the potential of artificial intelligence (AI) chatbots and large language models like OpenAI's ChatGPT and Google's Gemini, particularly in dental education. To explore dental educators' perceptions of AI chatbots and large language models, specifically their potential benefits and challenges for dental education. MATERIALS AND METHODS: A global cross-sectional survey was conducted in May-June 2023 using a 31-item online-questionnaire to assess dental educators' perceptions of AI chatbots like ChatGPT and their influence on dental education. Dental educators, representing diverse backgrounds, were asked about their use of AI, its perceived impact, barriers to using chatbots, and the future role of AI in this field. RESULTS: 428 dental educators (survey views = 1516; response rate = 28%) with a median [25/75th percentiles] age of 45 [37, 56] and 16 [8, 25] years of experience participated, with the majority from the Americas (54%), followed by Europe (26%) and Asia (10%). Thirty-one percent of respondents already use AI tools, with 64% recognising their potential in dental education. Perception of AI's potential impact on dental education varied by region, with Africa (4[4-5]), Asia (4[4-5]), and the Americas (4[3-5]) perceiving more potential than Europe (3[3-4]). Educators stated that AI chatbots could enhance knowledge acquisition (74.3%), research (68.5%), and clinical decision-making (63.6%) but expressed concern about AI's potential to reduce human interaction (53.9%). Dental educators' chief concerns centred around the absence of clear guidelines and training for using AI chatbots. CONCLUSION: A positive yet cautious view towards AI chatbot integration in dental curricula is prevalent, underscoring the need for clear implementation guidelines.

Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China.

Background: Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments. Methods: We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific. Results: Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries. Conclusions: The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.

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

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

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

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

The global prevalence of early childhood caries: A systematic review with meta-analysis using the WHO diagnostic criteria.

AIM: To estimate the global prevalence of early childhood caries using the WHO criteria. DESIGN: Systematic review of studies published from 1960 to 2019. DATA SOURCES: PubMed, Google Scholar, SciELO, and LILACS. Eligibility criteria were articles using: dmft-WHO diagnostic criteria with calibrated examiners, probability sampling, and sample sizes. STUDY SELECTION: Two reviewers searched, screened, and extracted information from the selected articles. All pooled analyses were based on random-effects models. The protocol is available on PROSPERO 2014 registration code CRD42014009578. RESULTS: From 472 reports, 214 used WHO criteria and 125 fit the inclusion criteria. Sixty-four reports of 67 countries (published 1992-2019) had adequate data to be summarised in the meta-analysis. They covered 29 countries/59018 children. Global random-effects pooled prevalence was (percentage[95% CI]) 48[43, 53]. The prevalence by continent was Africa: 30[19, 45]; Americas: 48 [42, 54]; Asia: 52[43, 61]; Europe: 43[24, 66]; and Oceania: 82[73, 89]. Differences across countries explain 21.2% of the observed variance. CONCLUSIONS: Early childhood caries is a global health problem, affecting almost half of preschool children. Results are reported from 29 of 195 countries. ECC prevalence varied widely, and there was more variance attributable to between-country differences rather than continent or change over time.

Transcultural adaptation and reliability of the Spanish version of a questionnaire about oral hygiene advice given by dentists in Chile / Adaptación transcultural y confiabilidad del cuestionario en español de recomendaciones acerca de higiene oral entregadas por dentistas en Chile

To adapt and evaluate validity and reliability of the Spanish version of a questionnaire about oral hygiene advice given by dentists in Chile Materials and methods: A validation study was conducted according to recommendations of COSMIN. The original questionnaire was adapted from English into Spanish using translation, back translation, expert review and pilot test sample by 56 dentists. The instrument consisted of 3 sections: recommendations for oral hygiene, relevance given to delivery of oral hygiene instruction and training and experience in delivering oral hygiene recommendations. It was reapplied in 5 of them a week later. Reliability was measured with internal consistency (Cronbach’s alpha), test-retest reliability (Cohen’s kappa and weighted kappa) and measurement error (limits of agreement, LdA). Content validity was evaluated by experts and construct validity by using convergent validity(Pearson correlation). Results: A good level of internal consistency that applies to 5 items (Cronbach’s alpha = 0.73) was obtained. For items on a nominal scale, Cohen Kappa coefficient was 0.80 (95 percent CI=0.64 to 0.95) and for ordinal items weighted kappa coefficient (linear weighting) was 0.76 (95 percent CI=0.65 to 0.88). The difference between the scores calculated for the measurements was 1 standard deviation 2.35. Ninety five percent of the differences were between -5.7 to 3.7 (+/-4.7 LoA = 1) and the variance of the total score was 29- 41. A good level of convergent validity (Pearson correlation=0.63) was obtained. Conclusion: The final questionnaire is valid and reliable to be applied to Chilean dentists with a profile like those included in this study in order to identify and quantify the oral hygiene instruction they provide to patients. Future studies should assess validity and reliability of this adaptation for other Spanish-speaking countries...

Adaptar y evaluar validez-confiabilidad del cuestionario en español acerca de las recomendaciones de higiene oral entregada por dentistas en Chile. Método: Estudio de validación realizado según recomendaciones COSMIN. El cuestionario original en inglés se adaptó al español mediante traducción, retrotraducción, revisión de expertos y prueba piloto en muestra de 56 dentistas. El instrumento constaba de 3 secciones: recomendaciones de higiene oral, relevancia dada a la entrega de recomendaciones de higiene oral y entrenamiento y experiencia en la entrega de recomendaciones de higiene oral. Se volvió a aplicar en 5 de ellos una semana después. Se midió confiabilidad mediante consistencia interna (alfa de Cronbach), test-retest (kappa de Cohen y kappa ponderado) y medición del error (límites del acuerdo, LdA). Se evaluó la validez de contenido por expertos y la validez de constructo mediante validez convergente (correlación de Pearson). Resultados: Se obtuvo un buen nivel de consistencia interna que aplica para 5 ítems (alfa de Cronbach=0.73). Para los ítems nominales el coeficiente de kappa de Cohen fue 0.80(95 por ciento IC=0.64- 0.95) y para los ordinales el coeficiente de kappa ponderado (ponderación-lineal) fue 0.76 (95 por ciento IC=0.65-0.88). La diferencia calculada para los puntajes entre mediciones fue 1, desviación estándar 2.35. El 95 por ciento de las diferencias estaban entre -5.7 hasta 3.7 (LdA=1+/-4.7) y la varianza del total de los puntajes fue de 29-41. Se obtuvo un buen nivel de validez convergente (correlación de Pearson=0.63). Conclusión: La versión final obtenida del cuestionario es válida y confiable para ser utilizada en dentistas chilenos con un perfil similar a los incluidos en este estudio para identificar y cuantificar las recomendaciones de higiene oral que entregan a los pacientes. Futuros estudios deberán evaluar la validez y confiabilidad de esta adaptación otros países de habla hispana...

Smoking and attitudes towards it and its cessation among dental students in Latvia.

BACKGROUND: The prevalence of smoking is higher in Latvia than in most EU countries. This study aimed to determine the level of knowledge of dental students in Latvia about the effects of smoking on oral health and their attitudes toward smoking and its cessation. METHODS: A cross-sectional survey among all the dental students in Latvia was conducted in 2011. Students at the Riga Stradins University were asked to participate in this anonymous, voluntary survey. The questionnaire included items concerned with the students' own smoking habits, their knowledge of smoking as an addiction and its health effects and their attitudes towards its prevention and cessation in a dental setting. The response rate was 87% (173/200). The Chi-square test and logistic regression were used for the statistical analyses. RESULTS: About one quarter of the students (24%) were daily or occasional smokers and almost half of the male students (46%) had smoked at least 100-times in their lifetime. The students revealed a lack of knowledge about the addictive nature of smoking, in that about half of the students did not consider smoking physically or socially addictive. About one fifth (21.4%) didn't consider environmental tobacco smoke (ETS) harmful to one's health. Although the students' awareness of smoking improved during their studies, the most significant factor related to their knowledge was their own smoking history (OR=2.7; p=0.021). CONCLUSIONS: Smoking was frequent among undergraduate dental students and they lacked knowledge of its addictiveness. More emphasis ought to be placed on education with regard to smoking and on cessation services.

Evidence based toothpaste classification, according to certain characteristics of their chemical composition.

Toothpastes are daily oral care products, the chemical composition of which is constantly changing due to manufacturer's competition. It becomes more and more difficult for dentists to recommend the best toothpaste and for patients to choose one. The objective of this paper was to draw out recommendations based on the best evidence available and to propose a new classification of toothpastes. Publications were searched in PubMed database (published between 1991-2011, limited to English language articles in dental journals). Recommendations for toothpaste choice and usage were developed from the best evidence available.

Comparative analysis of CRT Buffer, GC saliva check buffer tests and laboratory titration to evaluate saliva buffering capacity.

OBJECTIVE. The purpose of this study is to evaluate the ability of two commercial strip tests and laboratory titration to detect saliva buffer capacity. MATERIALS AND METHODS. Sixty-four patients were examined. Stimulated saliva was collected and buffer capacity was determined with two different chair-side strip tests in addition to immediate transportation to the laboratory to check the buffering ability by titrating with 0.005 M HCl and measuring pH by digital pH/Ion meter, used as a gold standart. The correlation were analyzed using the Spearman Rank Correlation Test, Cohen's Kappa coefficient and Pearson's Correlation test, p < 0.01. Sensitivity and specificity were used to measure precision of these tests. RESULTS. The response rate was 80%. High buffer capacity was found in 23.4% of cases, medium in 62.5%, and low in 14.1%. The Spearman Rank Correlation coefficient between the titration method and CRT Buffer test was 0.685 and the GC Saliva Check Buffer was 0.837. The Kappa coefficient for the CRT Buffer test was 0.508, while the coefficient for the GC Saliva Check Buffer was 0.752. The Pearson Correlation for the GC Saliva Check was 0.675. The difference is found in the buffer capacity at initial pH and at pH value 3. CONCLUSIONS. Both colorimetric tests correlate with the acid titration method in laboratory and are usable for saliva buffer capacity detection in dental offices. Buffer capacity detected in laboratory at different pH values can provide more information regarding caries risk.