Association between asthma and enamel defects in primary and young permanent teeth - A systematic review.

Childhood respiratory diseases, such as asthma, are important public health problems worldwide and could be associated with tooth enamel defects. This study aimed to verify the relationship between asthma and enamel defects in teeth, to answer the following question: "Could asthma in children be significantly associated with enamel defects in deciduous dentition and young permanent teeth?." PUBMED-MEDLINE, EMBASE, LILACS, and COCHRANE databases were systematically searched and assessed articles (2000-2021) were cautiously scored according to a predetermined criterion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were considered. Twenty-two articles were critically appraised and used as a basis for conclusions. The relationship between asthma and enamel defects was confirmed in the majority of appraised papers, one with a high level of evidence, nine with a moderate level, and four with a low level. Out of the eight manuscripts investigating the influence of asthma medication on enamel defects, only three (one with high, one moderate, and another with a low level of evidence) suggested an association. It can be concluded that asthma is closely connected with enamel defects in young permanent teeth. However, as most of the papers appraised were of cross-sectional or case-control design, further well-designed clinical investigations with a prospective design are welcome to reinforce our findings.

Salivary Microbiological and Gingival Health Status Evaluation of Adolescents With Overweight and Obesity: A Cluster Analysis.

Given the high prevalence of obesity in children and adolescents, the investigation of early markers is of clinical importance to better manage this condition. Thus, the aim was to evaluate the cross-sectional relationship between salivary microbiota, gingival health status, and excess weight in adolescents. A total of 248 students (14-17 y; 119 girls) were included, free of caries lesions and periodontal pockets. Physical examination included measures of height, weight, and body fat percentage (%BF). Oral examination was performed to gather information on dental (DMFT index) and gingival health status. Unstimulated saliva was submitted to qPCR reactions to quantify Streptococcus mutans, Porphyromonas gingivalis, Bifidobacteria, and Streptococcus pneumoniae percentages and the NFKappaB expression. Two-way ANOVA was applied considering group (normal-weight/overweight/obesity) and sex factors, in addition to cluster analysis. Group effect was significant for %S. mutans (partial eta2 = 0.20; p < 0.001) and %Bifidobacteria (partial eta2 = 0.19; p < 0.001), with overweight and obesity groups showing the highest levels compared to normal-weight ones, with no significant sex effect. There was no difference in the frequency of gingivitis, P. gingivalis, and S. pneumoniae percentages or NFKappaB expression between groups. Cluster analysis generated three clusters according to body fat accumulation: "Higher %BF," "Moderate %BF," and "Lower %BF." "Higher %BF" cluster was characterized by higher body fat percentage and higher salivary %Bifidobacteria, while cluster "Lower %BF" was characterized by lower body fat percentage and lower frequency of gingivitis ("Moderate %BF" cluster was the contrast). According to nutritional status, a difference in salivary S. mutans and Bifidobacteria percentages was found, with overweight or obesity adolescents showing the highest percentages than normal-weight ones. Besides, a positive relationship between body fat accumulation and Bifidobacteria count was observed, indicating a possible interaction between oral bacteria communities and weight gain.

Activity of Carbonic Anhydrase VI is Higher in Dental Biofilm of Children with Caries.

This study investigated pH, activity and concentration of carbonic anhydrase VI (CA VI) in dental biofilm of caries and caries-free children of 7-9 years old. Seventy-four children were selected and divided into two groups. The caries diagnosis was performed according to the WHO criteria, including the early caries lesion. After biofilm collection and pH determination, CA VI concentration and activity were determined by ELISA and Zimography respectively. The data were submitted to a Mann-Whitney test and to Pearson and Spearman correlation analyses. Means and standard deviations of dental caries for the caries group were of 3.162 ± 1.385. The biofilm pH was significantly higher in the caries-free group. The CA VI activity was significantly higher in biofilm of children with caries. The CA VI concentration was significantly higher in biofilm of caries-free children. In caries-free children, there was a moderate negative correlation between CA VI activity and concentration in dental biofilm as well as between pH and CA VI activity. A negative correlation between biofilm pH and CA VI concentration was found in the caries group. In conclusion, CA VI was shown to be more active in the biofilm of school children with caries in order to contribute to neutralization of biofilm acid.

Relationship among α amylase and carbonic anhydrase VI in saliva, visible biofilm, and early childhood caries: a longitudinal study.

AIM: This longitudinal study investigated the relationship among early childhood caries (ECC), α amylase, carbonic anhydrase VI (CA VI), and the presence of visible biofilm, besides detecting if these variables could predict risk for ECC. DESIGN: One hundred children were divided into two groups: caries group (n = 45) and caries-free group (n = 55). Visible biofilm on maxillary incisors was recorded, followed by caries diagnosis in preschoolers at baseline and at follow-up. Saliva samples were collected, and activities of CA VI and α amylase were determined. Data normality was assessed by Shapiro-Wilk test and then Mann-Whitney, Spearman correlation, and chi-square tests followed by multiple logistic regression analysis (α = 0.05, 95% confidence interval). RESULTS: CA VI activity was significantly higher in saliva of children with caries (P ≤ 0.05), and α amylase activity was significantly higher in saliva of caries-free children (P < 0.0001). Children with α amylase activity in saliva lower than 122.8 U/mL (OR = 3.33 P = 0.042) and visible biofilm on maxillary incisors (OR = 3.6 P = 0.009) were more likely to develop ECC than caries-free children. A negative correlation between caries and α amylase activity was found (P = 0.0008). CONCLUSIONS: The presence of visible biofilm and low salivary activity of α amylase may be considered risk predictors for ECC.

CO2 laser irradiation enhances CaF2 formation and inhibits lesion progression on demineralized dental enamel-in vitro study.

This study evaluated if Carbon dioxide (CO2) (λ 10.6 µm) laser irradiation combined with acidulated phosphate fluoride gel application (APF gel) enhances "CaF2" uptake by demineralized enamel specimens (DES) and inhibits enamel lesion progression. Thus, two studies were conducted and DES were subjected to APF gel combined or not with CO2 laser irradiation (11.3 or 20.0 J/cm(2), 0.4 or 0.7 W) performed before, during, or after APF gel application. In study 1, 165 DES were allocated to 11 groups. Fluoride as "CaF2 like material" formed on enamel was determined in 100 DES (n = 10/group), and the surface morphologies of 50 specimens were evaluated by scanning electron microscopy (SEM) before and after "CaF2" extraction. In study 2, 165 DES (11 groups, n = 15), subjected to the same treatments as in study 1, were further subjected to a pH-cycling model to simulate a high cariogenic challenge. The progression of demineralization in DES was evaluated by cross-sectional microhardness and polarized light microscopy analyses. Laser at 11.3 J/cm(2) applied during APF gel application increased "CaF2" uptake on enamel surface. Laser irradiation and APF gel alone arrested the lesion progression compared with the control (p < 0.05). Areas of melting, fusion, and cracks were observed. CO2 laser irradiation, combined with a single APF application enhanced "CaF2" uptake on enamel surface and a synergistic effect was found. However, regarding the inhibition of caries lesion progression, no synergistic effect could be demonstrated. In conclusion, the results have shown that irradiation with specific laser parameters significantly enhanced CaF2 uptake by demineralized enamel and inhibited lesion progression.

Assessment of cavitated and active non-cavitated caries lesions in 3- to 4-year-old preschool children: a field study.

BACKGROUND: The prevalence of early childhood caries (ECC) is high in developing countries; thus, sensitive methods for the early diagnosis of ECC are of prime importance to implement the appropriate preventive measures. AIM: To investigate the effects of the addition of early caries lesions (ECL) into WHO threshold caries detection methods on the prevalence of caries in primary teeth and the epidemiological profile of the studied population. DESIGN: In total, 351 3- to 4-year-old preschoolers participated in this cross-sectional study. Clinical exams were conducted by one calibrated examiner using WHO and WHO + ECL criteria. During the exams, a mirror, a ball-ended probe, gauze, and an artificial light were used. The data were analysed by Wilcoxon and Mc-Nemar's tests (α=0.05). RESULTS: Good intra-examiner Kappa values at tooth/surface levels were obtained for WHO and WHO+ECL criteria (0.93/0.87 and 0.75/0.78, respectively). The dmfs scores were significantly higher (P<0.05) when WHO+ECL criteria were used. ECLs were the predominant caries lesions in the majority of teeth. CONCLUSIONS: The results strongly suggest that the WHO+ECL diagnosis method could be used to identify ECL in young children under field conditions, increasing the prevalence and classification of caries activity and providing valuable information for the early establishment of preventive measures.

A importância da prática de alimentação, higiene bucal e fatores sócio-econômicos na prevalência da cárie precoce da infância em pré-escolares de Itatiba-SP / The importance of feeding practices, oral hygiene and socioeconomic factors in the early childhood caries prevalence in preschool children from Itatiba-SP

Objetivo: Verificar se a dieta, incluindo hábitos de aleitamento, a higiene bucal e os fatores sócio-econômicos podem ser considerados indicadores de risco para a cárie precoce da infância (CPI) em pré-escolares de Itatiba-SP. Material e método: A amostra foi constituída por 288 crianças, de 3 a 4 anos, que freqüentavam pré-escolas públicas do município de Itatiba-SP. Uma cirurgiã-dentista calibrada (Kappa=0,78) realizou exame físico para a determinação da presença de biofilme dentário e do índice de cárie. Para a avaliação da dieta foi empregado um diário alimentar, enquanto hábitos de aleitamento, higiene bucal, etnia, renda familiar e escolaridade materna foram avaliados por um questionário. Os dados foram analisados pelo teste qui-quadrado/exato de Fisher, seguido de regressão logística múltipla (alfa=0,05) expressa por razão de chances (odds ratio -OR). Resultados: A ingestão de açúcar na forma sólida 3 ou mais vezes ao dia (OR=4,5), a amamentação não exclusiva no peito por 12 meses ou mais (OR=2,0), a presença de biofilme dentário nos incisivos superiores (OR=3,1) e o fato de levar lanche para consumir na escola (OR=2,1), além da merenda, apresentaram associação significativa com a CPI (<0,05). Já os fatores etnia, escolaridade, renda familiar e freqüência de higiene bucal não se mostraram estatisticamente significativos (p>0,05). Conclusão: Os resultados sugerem que a exposição frequente aos açúcares na forma sólida, a presença de biofilme dentário e o fato de levar lanche para escola, principalmente os cariogênicos, são indicadores de risco expressivos para a cárie precoce da infância na população estudada.

Purpose: This study aimed to verify if the cariogenic diet, including nursing habits, the oral hygiene and the socioeconomic factors could be considered risk indicators for early childhood caries (ECC) in preschool children from Itatiba-SP. Methods: The sample was composed of 288 children, 3 to 4 years old, who attended public preschools from Itatiba-SP. Clinical examinations were conducted by one calibrated dentist (Kappa=0.78) for biofilm presence and caries index determination. For the diet evaluation, a diet chart was used, whereas the nursing habits, oral hygiene, ethnicity, family income and mothers´ level of education were evaluated by a questionnaire. Data were analyzed by chi-square/fisher´s exact test and multiple logistic regression (alfa=0.05) expressed by odds ratios (OR). Results: Sugar consumption in the solid form three or more times a day (OR=4.5), non-exclusive breast-feeding for 12 months or more (OR=2.0), presence of biofilm on the maxillary incisors (OR=3.1) and intake of snacks or drinks at school (OR=2.1), in addition to school meals were significantly associated with ECC (p<0.05). Besides, the factors ethnicity, level of education, family income and oral hygiene frequency did not show statistical significance (p>0.05). Conclusion: The results suggest that frequent exposure to solid sugar, biofilm presence and snacks as complement to school meals, particularly the cariogenic ones, are expressive risk indicators for early childhood caries in the population studied.