A systematic review of caries risk in children <6 years of age.

BACKGROUND: For caries risk assessment (CRA) tools for young children to be evidence-based, it is important to systematically review the literature to identify factors associated with the onset of early childhood caries (ECC). AIM: This updated systematic review aimed to identify current evidence on caries risk in young children. DESIGN: A comprehensive and systematic literature search of relevant databases was conducted to update a previous systematic review and identify risk factors associated with ECC. Potential risk factors were identified based on strength of association using odds ratios, hazard ratios, relative risk, etc. GRADE was used for rating quality evidence through consensus. RESULTS: Twenty-two studies met inclusion criteria for the search from mid-2017 to 2021. Twenty-five publications from the prior systematic review, from 1997 to mid-2017, were also included. Several socioeconomic, behavioral, and clinical variables were identified as ECC risk factors. Factors included the following: age, socioeconomic status, frequency of and supervised toothbrushing, fluoride exposure, breast- and bottle-feeding, feeding habits, absence of a dental home, past caries experience, active non-cavitated lesions, visible plaque, enamel defects, and microbiome. CONCLUSION: This study provides updated evidence of risk factors for ECC that could be included in CRA tools.

An investigation of data from the first year of the interim Canada Dental Benefit for children <12 years of age.

Introduction: In 2022, the federal government announced a commitment of $5.3B to provide dental care for the uninsured, beginning with children <12 years of age. Now referred to as the Interim Canada Dental Benefit (CDB), the program targets those <12 years of age from families with annual incomes <$90,000 without private dental insurance. The purpose of this study was to review federal data from the Government of Canada on public uptake and applications made to the Canada Revenue Agency (CRA) during the first year of the Interim CDB. Methods: Data for the first year of the Interim CDB (up to June 30, 2023) were accessed from the Government of Canada Open Data Portal through Open Government Licence-Canada. Rates of children receiving the Interim CDB per 1,000 were calculated by dividing the number of beneficiaries by the total number of children 0-11 years by province or territory, available from Statistics Canada for the year 2021. Results: During the first year of the program, a total of 204,270 applications were approved, which were made by 188,510 unique applicants for 321,000 children <12 years of age. Over $197M was distributed by the CRA. Overall, the national rate for receiving the Interim CDB was 67.8/1,000 children. Ontario (82.5/1,000), Manitoba (77.1/1,000), Nova Scotia (73.4/1,000), and Saskatchewan (72.3%), all had rates of children with the Interim CDB above the national rate. Conclusions: Data from the first year of the Interim CDB suggests that this federal funding is increasing access to care for children <12 years by addressing the affordability of dental care. Governments and the oral health professions need to address other dimensions of access to care including accessibility, availability, accommodation, awareness, and acceptability of oral health care.

Advances in novel therapeutic approaches for periodontal diseases.

Periodontal diseases are pathological processes resulting from infections and inflammation affecting the periodontium or the tissue surrounding and supporting the teeth. Pathogenic bacteria living in complex biofilms initiate and perpetuate this disease in susceptible hosts. In some cases, broad-spectrum antibiotic therapy has been a treatment of choice to control bacterial infection. However, increasing antibiotic resistance among periodontal pathogens has become a significant challenge when treating periodontal diseases. Thanks to the improved understanding of the pathogenesis of periodontal disease, which involves the host immune response, and the importance of the human microbiome, the primary goal of periodontal therapy has shifted, in recent years, to the restoration of homeostasis in oral microbiota and its harmonious balance with the host periodontal tissues. This shift in therapeutic goals and the drug resistance challenge call for alternative approaches to antibiotic therapy that indiscriminately eliminate harmful or beneficial bacteria. In this review, we summarize the recent advancement of alternative methods and new compounds that offer promising potential for the treatment and prevention of periodontal disease. Agents that target biofilm formation, bacterial quorum-sensing systems and other virulence factors have been reviewed. New and exciting microbiome approaches, such as oral microbiota replacement therapy and probiotic therapy for periodontal disease, are also discussed.

Two Component Regulatory Systems and Antibiotic Resistance in Gram-Negative Pathogens.

Gram-negative pathogens such as Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa are the leading cause of nosocomial infections throughout the world. One commonality shared among these pathogens is their ubiquitous presence, robust host-colonization and most importantly, resistance to antibiotics. A significant number of two-component systems (TCSs) exist in these pathogens, which are involved in regulation of gene expression in response to environmental signals such as antibiotic exposure. While the development of antimicrobial resistance is a complex phenomenon, it has been shown that TCSs are involved in sensing antibiotics and regulating genes associated with antibiotic resistance. In this review, we aim to interpret current knowledge about the signaling mechanisms of TCSs in these three pathogenic bacteria. We further attempt to answer questions about the role of TCSs in antimicrobial resistance. We will also briefly discuss how specific two-component systems present in K. pneumoniae, A. baumannii, and P. aeruginosa may serve as potential therapeutic targets.