DENTAL CARIES INTENSITY IN CHILDREN WITH DISTURBANCES IN TOOTH FORMATION, SURVIVED AFTER THE CHORNOBYL NPP ACCIDENT. / INTENSYVNIST' KARIIeSU U DITEI Z PORUShENNIaMY FORMUVANNIa ZUBIV, POSTRAZhDALYKh VNASLIDOK AVARIÏ NA ChORNOBYL'S'KII AES.

OBJECTIVE: assessment of dental caries intensity in children with disturbances in tooth formation living in radiologically contaminated territories as a result of the Chornobyl NPP accident. MATERIALS AND METHODS: Children aged 6-14 years old (n = 1470) suffering from disturbances in tooth formation(DTF) with the residents of radiologically contaminated territories (n = 528) among them were enrolled in the study.The DTF subtypes were assayed, namely the systemic enamel hypoplasia (SEH) and molar incisor hypomineralisation(MIH). Personal radiation history was recorded. Intensity of caries and caries of surfaces in the mixed (i.e. transitional) occlusion (df+DMF, dfs+DMFS coefficients) and permanent occlusion (DMF, DMFS coefficients) was identified. RESULTS: Caries intensity in the exposed children suffering DTF with mixed and permanent dental occlusion was sig-nificantly higher vs. either in children exposed to ionizing radiation with no DTF or in the control group (р < 0.001,р < 0.001 and р < 0.05, р < 0.001 correspondingly). The highest caries intensity of the permanent teeth was revealedin the residents of contaminated territories suffering SEH (6.95 ± 2.3) vs. cases of MIH (5.68 ± 1.97) as a result ofnonsymmetrical teeth involvement. CONCLUSIONS: The highest values of df+DMF, dfs+DMFS coefficients were diagnosed in children with a mixed dentalocclusion aged 6-14 years old living on territories contaminated as a result of the ChNPP accident as compared tothe not exposed subjects and control group (7.2 ± 2.07 and 8.98 ± 2.4, р < 0.001). A very high intensity of cariesand surface caries of permanent teeth (DMF = 6.79 ± 2.34, DMFS = 8.69 ± 2.75, р < 0.001) was established in children exposed to ionizing radiation and suffering DTF. Such a high intensity may be due to the impact of a set of negative factors including the ionizing radiation in low doses and peculiarities of economic component of social sta-tus of study subjects, namely the unbalanced diet. In case of permanent occlusion the intensity of caries and cariesof tooth of in children survived after the ChNPP accident and suffering SEH was significantly (р < 0.05) higher compared to the persons suffering MIH.

MRSA infection of masticatory spaces in a paediatric patient.

Diagnosis of source of maxillofacial infection in paediatric patients can be challenging due to difficulty in eliciting a proper history and multiple potential sources of infection. Identification and removal of the nidus of infection with decompression and institution of antibiotic therapy as per the culture-sensitivity report form the mainstay treatment of the infection. Deviation from it may result in persistence or even progression of infection, resulting in significant morbidity and mortality. In the past decade, the incidence of community-acquired methicillin-resistant Staphylococcus aureus infection in the oral cavity has seen an upward trend. This has further led to an increase in complexity in the diagnosis of maxillofacial infections. In this case, the authors want to bring to light the challenges faced in managing a paediatric patient with persistent fascial space infection even after removal of the offending tooth, which signifies the importance of managing the infection by the time-tested protocol.

Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues.

The macroscopic and microscopic anatomy of the oral cavity is complex and unique in the human body. Soft-tissue structures are in close interaction with mineralized bone, but also dentine, cementum and enamel of our teeth. These are exposed to intense mechanical and chemical stress as well as to dense microbiologic colonization. Teeth are susceptible to damage, most commonly to caries, where microorganisms from the oral cavity degrade the mineralized tissues of enamel and dentine and invade the soft connective tissue at the core, the dental pulp. However, the pulp is well-equipped to sense and fend off bacteria and their products and mounts various and intricate defense mechanisms. The front rank is formed by a layer of odontoblasts, which line the pulp chamber towards the dentine. These highly specialized cells not only form mineralized tissue but exert important functions as barrier cells. They recognize pathogens early in the process, secrete antibacterial compounds and neutralize bacterial toxins, initiate the immune response and alert other key players of the host defense. As bacteria get closer to the pulp, additional cell types of the pulp, including fibroblasts, stem and immune cells, but also vascular and neuronal networks, contribute with a variety of distinct defense mechanisms, and inflammatory response mechanisms are critical for tissue homeostasis. Still, without therapeutic intervention, a deep carious lesion may lead to tissue necrosis, which allows bacteria to populate the root canal system and invade the periradicular bone via the apical foramen at the root tip. The periodontal tissues and alveolar bone react to the insult with an inflammatory response, most commonly by the formation of an apical granuloma. Healing can occur after pathogen removal, which is achieved by disinfection and obturation of the pulp space by root canal treatment. This review highlights the various mechanisms of pathogen recognition and defense of dental pulp cells and periradicular tissues, explains the different cell types involved in the immune response and discusses the mechanisms of healing and repair, pointing out the close links between inflammation and regeneration as well as between inflammation and potential malignant transformation.

Impacts of sleep on the characteristics of dental biofilm.

Dental biofilm present on the tooth surface is associated with oral diseases, such as dental caries and periodontal disease. Because bacterial numbers rapidly increase in saliva during sleep, oral care before sleeping is recommended for the prevention of chronic oral diseases. However, temporal circadian changes in the quantity and quality of dental biofilms are poorly understood. This study aimed to investigate the impacts of sleeping on dental biofilm amounts and compositions by using an in situ model. The use of this in situ model enabled us to investigate dental biofilm formed in the oral cavity and to perform a quantitative analysis. Subjects began wearing oral splints in the morning or before sleeping, and biofilm samples were collected at 8, 16, and 24 h after the subjects began wearing oral splints; these samples were then used in various experiments. No significant changes in the numbers of biofilm-forming bacteria were caused by sleep. However, the relative abundances of genera related to periodontitis (i.e., Fusobacterium and Prevotella) increased after awakening. In conclusion, the numbers of biofilm-forming bacteria were not affected by sleep, and the abundances of obligate anaerobes increased after sleep. This research may aid in defining efficacious preventive oral care.

Dental considerations in a paediatric patient with Diamond-Blackfan anaemia.

Diamond-Blackfan anaemia (DBA) is a rare genetic disorder characterised by a decrease in the production of red blood cells due to bone marrow malfunction. The estimation of disease occurrence is approximately 1 in 100 000-2 00 000 live births. This paper presents the case of a 7-year-old male child diagnosed with DBA at the age of 4 months. The diagnosis was established with haematological findings, bone marrow biopsy and molecular testing. The case was managed successfully for dental symptoms without any complication.

The influence of malocclusion, sucking habits and dental caries in the masticatory function of preschool children.

The aim of this study was to evaluate the association of malocclusion, nutritive and non-nutritive sucking habits and dental caries in the masticatory function of preschool children. A cross-sectional study was conducted with a sample of 384 children aged 3-5 years. A single examiner calibrated for oral clinical examinations performed all the evaluations (kappa > 0.82). Presence of malocclusion was recorded using Foster and Hamilton criteria. The number of masticatory units and of posterior teeth cavitated by dental caries was also recorded. The parents answered a questionnaire in the form of an interview, addressing questions about the child's nutritive and non-nutritive sucking habits. The masticatory function was evaluated using Optocal test material, and was based on the median particle size in the masticatory performance, on the swallowing threshold, and on the number of masticatory cycles during the swallowing threshold. Data analysis involved simple and multiple linear regression analyses, and the confidence level adopted was 95%. The sample consisted of 206 children in the malocclusion group and 178 in the non-malocclusion group. In the multiple regression analysis, the masticatory performance was associated with age (p = 0.025), bottle feeding (p = 0.004), presence of malocclusion (p = 0.048) and number of cavitated posterior teeth (p = 0.030). The swallowing threshold was associated with age (p = 0.025), bottle feeding (p = 0.001) and posterior malocclusion (p = 0.017). The number of masticatory cycles during the swallowing threshold was associated with the number of cavitated posterior teeth (p = 0.001). In conclusion, posterior malocclusion, bottle feeding and dental caries may interfere in the masticatory function of preschool children.

Assessment of the impact of toothache, untreated caries and its consequences on the quality of life among poor Brazilian children / Avaliação do impacto da dor de dente, da cárie não tratada e suas consequências na qualidade de vida de crianças brasileiras

Purpose: to evaluate the impact of dental pain and the consequences of untreated dental caries on the quality of life in children of low social-economic status aged from 8 to 10 years old. Materials and Methods: in this cross-sectional study, 230 children were submitted to a clinical examination in which the caries-pufa ratio was measured, afterward, they answered to two questionnaires: one about their quality of life (CPQ8-10) and the other about dental pain. Data were statistically analyzed through Chi-square, Mann-Whitney or Kruskal-Wallis tests to evaluate the association between the variables with impact on children's OHRQoL. To establish the existence of risk factors among variables and impact on OHRQoL a Poisson Regression model was applied. Results: dental caries (p = 0.003; PR 2.39; 95% CI 1.04­1.56), severity of untreated caries (p = 0.008; PR 2.86; 95% CI 1.13­2.00), toothache (p < 0.001; PR 2.31; 95% CI 1.64­3.27) and PUFA + pufa index (p < 0.023; PR 2.68; 95% CI 1.10­1.87) were associated with and were a predictor factor for impact on overall OHRQoL. All of these variables also had an effect over the social welfare subscale (p ≤ 0.001), whereas caries presence was also statistically linked with the emotional wellbeing subscale (p = 0.008) and dental pain with all four subscales (p ≤ 0.001). Conclusion: untreated dental caries' clinical consequences and dental pain exerted a negative influence on the quality of life of schoolchildren analyzed.(AU)

Objetivo: avaliar o impacto da dor de dente e das consequências da cárie não tratada na qualidade de vida de crianças entre 8 e 10 anos com baixos indicadores socioeconômicos. Métodos: neste estudo transversal, 230 crianças escolares foram submetidas a um exame clínico, no qual foram avaliados seus CPO/ceo (Dentes cariados, perdidos e obturados) e PUFA/pufa (Envolvimento pulpar, ulceração, fístula e abscesso). Em um segundo momento, elas responderam a dois questionários: um sobre a qualidade de vida (CPQ8-10) e outro sobre odontalgia. Os dados foram analisados estatisticamente por meio dos testes de Chi-quadrado, Mann-Whitney ou Kruskal-Wallis, para avaliar a associação entre as variáveis e o impacto na qualidade de vida relacionada à saúde oral (QdVRSO) da criança. Para estabelecer a existência de fatores de risco para impacto na QdVRSO entre as variáveis, um modelo de regressão de Poisson foi aplicado. Resultados: a presença de cárie (p = 0,003; RP 2,39; 95% IC 1,04-1,56), a severidade da cárie não tratada (p = 0,008; RP 2,86; 95% IC 1,13-2,00), dor de dente (p < 0,001; RP 2,31; 95% IC 1,64-3,27) e PUFA/pufa (p < 0,023; RP 2,68; 95% IC 1,10- 1,87) foram associados com impacto na QdVRSO, assim como também foram fatores preditores para o impacto na qualidade de vida relacionada à saúde oral. Todas as então citadas variáveis também exerceram efeito sobre a subescala do bem-estar social (p ≤ 0,001), enquanto a presença de cárie esteve estatisticamente conectada com a subescala do bem-estar emocional (p = 0,008) e a dor dentária com todas as subescalas da QdVRSO (p ≤ 0,001). Conclusão: as consequências clínicas da cárie não tratada e a dor dentária exercem uma influência negativa na qualidade de vida das crianças analisadas.(AU)

Carious Lesion Severity Induces Higher Antioxidant System Activity and Consequently Reduces Oxidative Damage in Children's Saliva.

Oxidative stress biomarkers can be found at detectable concentrations in saliva. These salivary biomarkers reflect specific oxidation pathways associated with caries and periodontitis. Our study evaluated the influence of dental caries severity (assessed using the ICCMS™ criteria) on the levels of oxidative stress biomarkers in saliva from children. Unstimulated saliva samples were collected from patients (from one to three years old) in a day care center in Birigui, SP, Brazil, two hours after fasting. Children were divided into four groups (n = 30/group), according to caries severity: caries free (group A), early carious lesions (group B), moderate carious lesions (group C), and advanced carious lesions (group D). The following salivary biomarkers were determined: total proteins (TP), measured by the Lowry method; oxidative damage, measured by the TBARS method; total antioxidant capacity (TAC); superoxide dismutase (SOD) enzymatic antioxidant activity; and uric acid (UA) non-enzymatic antioxidant activity. Data were analyzed by ANOVA, followed by the Student-Newman-Keuls test, Pearson and Spearman correlation coefficients, and multivariable linear regression (p < 0.05). TP, TAC, SOD enzymatic antioxidant activity, and UA non-enzymatic antioxidant activity increased with caries severity, consequently reducing salivary oxidative damage. It was concluded that higher caries severity increases salivary antioxidant system activity, with consequent reduction in salivary oxidative damage.

Early childhood feeding practices and dental caries among Australian preschoolers.

BACKGROUND: Recent reviews have proposed a causal relationship between prolonged breastfeeding and early childhood caries (ECC), but the evidence to date is inconsistent, with few cohort studies and limited investigation of key confounders. OBJECTIVE: This study aimed to investigate the relationship between dietary practices and early childhood caries in a birth cohort of Australian preschoolers. METHODS: Participants underwent a standardized dental examination at 2-3 y of age to determine the prevalence of ECC (based on the presence of decayed, missing, or filled tooth surfaces). Breastfeeding practices were reported at 3, 6, 12, and 24 mo of age. Intakes of free sugars were assessed at 1 and 2 y of age. Multivariable regression models generated prevalence ratios (PR) for the association between ECC and breastfeeding duration, and between ECC and sleep feeding practices at 1 y, controlling for sociodemographic factors and free sugars intake. RESULTS: There was no independent association between breastfeeding beyond 1 y of age and ECC (PR 1.42, 95% CI: 0.85, 2.38), or between breastfeeding to sleep and ECC (PR 1.12, 95% CI: 0.67, 1.88), although the direction of effect was suggestive of an association. The only factors independently associated with ECC were high free sugars intakes (PR 1.97, 95% CI: 1.13, 3.44), and greater socioeconomic disadvantage (PR 2.15, 95% CI: 1.08, 4.28). Most participants who were breastfed at 1 y of age had ceased by 18 mo or 2 y. CONCLUSIONS: Breastfeeding practices were not associated with ECC. Given the wide-ranging benefits of breastfeeding, and the low prevalence of sustained breastfeeding in this study and Australia in general, recommendations to limit breastfeeding are unwarranted, and breastfeeding should be promoted in line with global and national recommendations. To reduce the prevalence of early childhood caries, improved efforts are needed to limit foods high in free sugars.

The influence of malocclusion, sucking habits and dental caries in the masticatory function of preschool children

Abstract The aim of this study was to evaluate the association of malocclusion, nutritive and non-nutritive sucking habits and dental caries in the masticatory function of preschool children. A cross-sectional study was conducted with a sample of 384 children aged 3-5 years. A single examiner calibrated for oral clinical examinations performed all the evaluations (kappa > 0.82). Presence of malocclusion was recorded using Foster and Hamilton criteria. The number of masticatory units and of posterior teeth cavitated by dental caries was also recorded. The parents answered a questionnaire in the form of an interview, addressing questions about the child's nutritive and non-nutritive sucking habits. The masticatory function was evaluated using Optocal test material, and was based on the median particle size in the masticatory performance, on the swallowing threshold, and on the number of masticatory cycles during the swallowing threshold. Data analysis involved simple and multiple linear regression analyses, and the confidence level adopted was 95%. The sample consisted of 206 children in the malocclusion group and 178 in the non-malocclusion group. In the multiple regression analysis, the masticatory performance was associated with age (p = 0.025), bottle feeding (p = 0.004), presence of malocclusion (p = 0.048) and number of cavitated posterior teeth (p = 0.030). The swallowing threshold was associated with age (p = 0.025), bottle feeding (p = 0.001) and posterior malocclusion (p = 0.017). The number of masticatory cycles during the swallowing threshold was associated with the number of cavitated posterior teeth (p = 0.001). In conclusion, posterior malocclusion, bottle feeding and dental caries may interfere in the masticatory function of preschool children.

Tooth loss in adults: factors associated with the position and number of lost teeth.

OBJECTIVE: To evaluate the factors associated with tooth loss in adults from the position and number of teeth lost in the dental arches. METHODS: This is a cross-sectional, population-based study with adults participating in the epidemiological survey of oral health of São Paulo in 2015. The outcome of the study was tooth loss, assessed by the proposed classification, namely: I) lost up to 12 back teeth; II) lost up to 12 teeth (including front teeth); and III) lost more than 12 teeth. A four-block analysis was conducted, supported by a conceptual theoretical model adapted for tooth loss. For the multinomial logistic regression, "individuals who did not lose teeth due to caries or periodontal disease" was used as reference (p < 0.05). RESULTS: Of 6,051 adults evaluated, 25.3% (n = 1,530) were classified in category I, 32.7% (n = 1,977) in II, 9.4% (n = 568) in III, and 1.9% (n = 117) were edentulous. Lower income and schooling, the perception of need for treatment and the last appointment motivated by routine, pain or extraction were associated with tooth loss, regardless of the classification. The negative evaluation of the dental service was associated with individuals who lost up to 12 teeth, both front and back. The presence of women and periodontal pocket were associated with tooth loss of up to 12 teeth, including front, and more than 12 teeth. Caries were associated with adults who lost up to 12 teeth, including front teeth. CONCLUSION: The proposed classification allowed the identification of differences between the associated factors. Thus, the need to consider such classification in future studies is evident.

Stable isotope and dental caries data reveal abrupt changes in subsistence economy in ancient China in response to global climate change.

Prior to the introduction of wheat and barley from Central Asia during the Neolithic period, northern Chinese agricultural groups subsisted heavily on millet. Despite being the focus of many decades of intensive interest and research, the exact route(s), date(s), and mechanisms of the spread and adoption of wheat and barley into the existing well-established millet-based diet in northern China are still debated. As the majority of the important introduced crops are C3 plants, while the indigenous millet is C4, archaeologists can effectively identify the consumption of any introduced crops using stable carbon isotope analysis. Here we examine published stable isotope and dental caries data of human skeletal remains from 77 archaeological sites across northern and northwestern China. These sites date between 9000 to 1750 BP, encompassing the period from the beginning of agriculture to wheat's emergence as a staple crop in northern China. The aim of this study is to evaluate the implications of the spread and adoption of these crops in ancient China. Detailed analysis of human bone collagen δ13C values reveals an almost concurrent shift from a C4-based to a mixed C3/ C4- based subsistence economy across all regions at around 4500-4000 BP. This coincided with a global climatic event, Holocene Event 3 at 4200 BP, suggesting that the sudden change in subsistence economy across northern and northwestern China was likely related to climate change. Moreover, the substantially increased prevalence of dental caries from pre-to post-4000 BP indicates an increase in the consumption of cariogenic cereals during the later period. The results from this study have significant implications for understanding how the adoption of a staple crop can be indicative of large-scale environmental and socio-political changes in a region.

Sialometry and concentration of phosphate and calcium in stimulated whole saliva and gingival crevicular fluid and its association with dental caries in schoolchildren / Asociación de sialometría, fosfato y calcio en saliva total bajo estímulo y en líquido crevicular gingival con caries dental en escolares

Introduction: The remineralizing properties of saliva contribute to maintain the physical and chemical integrity of the mineral structure of teeth, which protects it from the installation and evolution of dental caries. Objective: To relate sialometry, buffering capacity, calcium and phosphate concentration in whole stimulated saliva, and in gingival crevicular fluid with school children caries severity and activity. Materials and methods: We selected 36 schoolchildren aged 6 years: 18 with caries (International Caries Detection and Assessment System, ICDAS>1 group) and 18 without caries (ICDAS=0 group). The severity and activity of dental caries were diagnosed in the primary dentition: in the occlusal surface of molars and in the vestibular of the anterior teeth by ICDAS-II. Results: Caries in occlusal surface were more severe than in vestibular surface. The concentration of calcium in saliva and phosphate in healthy teeth gingival crevicular fluid were higher in the ICDAS>1 group. The concentration of calcium in gingival crevicular fluid was higher in the ICDAS=0 group than in the decayed teeth of the ICDAS>1 group. We found a statistically significant association between the frequency of active caries andthe concentration of phosphate in gingival crevicular fluid of teeth with caries, as well as between the severity of caries with buffering capacity and the concentration of phosphate in the gingival crevicular fluid of teeth with caries. Conclusion: We found an association between dental caries with buffering capacity and buccal calcium and phosphate.

Introducción. La capacidad de la saliva para la remineralización contribuye a mantener la integridad fisicoquímica de la estructura mineral de los dientes, lo cual los protege de la aparición y evolución de la caries dentaria. Objetivo. Establecer la relación de la sialometría, la capacidad amortiguadora, la concentración de calcio y fosfato en la saliva total estimulada y en el líquido crevicular gingival, con la gravedad y la actividad de las caries en escolares. Materiales y métodos. Se seleccionaron 36 escolares de 6 años, 18 con caries (International Caries Detection and Assessment System, ICDAS, código 2 o mayor) y 18 sin caries (ICDAS, código 0). En la dentición primaria, se evaluaron la gravedad y la actividad de la caries dentaria en la superficie de oclusión de los molares y en la vestibular de los dientes anteriores, y se codificaron mediante el ICDAS-II. Resultados. Se evidenció una mayor gravedad de las caries en la superficie de oclusión que en la vestibular. Las concentraciones de calcio en la saliva y de fosfato en el líquido crevicular gingival de los dientes sanos, fueron mayores en el grupo con un código ICDAS de 2 o mayor. La concentración de calcio en el líquido crevicular gingival fue mayor en el grupo con código ICDAS 0 que en los dientes cariados del grupo con código ICDAS de 2 o mayor. Se encontró una asociación estadísticamente significativa entre la frecuencia de caries activas y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, como también entre la gravedad de las caries y la capacidad amortiguadora, por una parte, y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, por la otra. Conclusión. Se evidenció una asociación entre la caries dental, la capacidad amortiguadora y la química bucal del calcio y el fosfato.

Prospective cohort of adult oral health in Piracicaba, SP, Brazil.

OBJECTIVE: To describe the methodological aspects of a Prospective Cohort Study of adult oral health in Piracicaba, Brazil. RESULTS: This Prospective Cohort Study evaluated adults (20-64 years old) between the years of 2011 and 2015, in Piracicaba, São Paulo, Brazil. The main objective was to evaluate the risk factors for tooth loss in adults. Data were collected at households and selected via probabilistic sampling, through clinical examination of caries, considering as variables the decayed, missing and filled permanent teeth index, need for caries treatment, periodontal disease (Community Periodontal Index and Periodontal Attachment Loss), use and need for dental prosthesis, and presence of visible biofilm. A questionnaire about demographic, socioeconomic and health habits, use of dental services, self-perceived quality of life (Oral Health Impact Profile-14) and health literacy (14-item Health Literacy Scale) was also employed. In 2011, 248 adults participated, and in 2015, 143 (follow-up rate = 57.7%). Despite the follow-up sample loss, most sociodemographic characteristics remained in the participant sample: for example, women (72.0%) (p = 0.534), family income between R$545,00 and R$1090,00 (63.9%) (p = 0.920), above 11 years of education (53.1%) (p = 0.200) and belonging to middle class (67.1%) (p = 0.909).

Tobacco use and caries increment in young adults: a prospective observational study.

OBJECTIVE: Tobacco use has a negative influence on general and oral health but data concerning caries are mainly derived from epidemiological and cross-sectional studies. The aim of this study was to investigate smoking and use of smokeless tobacco (Swedish snus) as determinants of dental caries increment in young adults over 3 years. The baseline cohort consisted of 1295 19-year-olds registered at eight Public Dental Clinics representing socioeconomic strata. After 3 years, 982 of the patients could be reexamined (drop-out rate 24.2%). Caries was scored as decayed and filled surfaces according the WHO criteria and the individual caries increment was recorded by counting the number of surfaces that changed from "sound" to "decayed/filled" over the study period. Information on habitual tobacco use (smoking, snuffing) was collected from a structured questionnaire at baseline. RESULTS: The baseline prevalence of smoking and use of Swedish snus was 22.3% and 6.3% respectively. Smoking, but not snuffing, displayed a statistically significant relationship with caries increment over 3 years. For smoking, the relative risk was 1.5 (95% CI 1.2-1.7) and the number needed to harm 6.8 (95% CI 4.5-14.2). Thus, habitual smoking is a risk factor for caries in young adults and the findings reinforce arguments that dental health professionals should incorporate anti-smoking activities in their preventive strategies.

The concept of exposure when selecting comparison groups for determining individual susceptibility to addiction to cigarette smoking.

Smoking is a leading cause of preventable death. The effect of tobacco is even more contundent in people with mental illness and, in general, cigarette smoking addiction is influenced by genetic factors. The opioid system is involved in the mesolimbic reward system, which is of great importance in addictive behaviors, such as smoking and is influenced by genes such as the OPRM1. The aim of this study was to evaluate if selecting a comparison group that include light smokers versus people that never smoked impacts the results of genetic association studies. In addition, to evaluate the genetic association in different groups of smokers by analyzing independent covariates such as mental illness and clinical dental data. All subjects were participants of the Dental Registry and DNA Repository project. Genotyping was carried out using TaqMan chemistry for two markers in OPRM1 (rs553202 and rs7755635). Logistic regression analyses were performed as implemented in PLINK. The established value for alpha was 5%, and the Hardy-Weinberg equilibrium was evaluated by the chi-square test with one degree of freedom for each marker. 1,897 patients were included, which were allocated to eight distinct groups, according to the frequency and quantity of cigarettes smoked and mental illness status. There was no significant association between the two markers in OPRM1 and smoking. When mental illness and dental clinical data (tooth loss, dental caries, and periodontitis) were used as covariates, there were associations between heavy smoking and OPRM1, when non-smokers were used as comparison. We did not have diet or microbiome data to consider for these dental analyses and suggest that these kinds of data should be always incorporated in the future. Significant results were found only when the covariables mental illness and oral clinical data were added to the analysis.

Oral Health Knowledge and Behavior among Adults in the United Arab Emirates.

Background: The prevalence of periodontal diseases is increasing in the United Arab Emirates (UAE) despite a worldwide decline in the prevalence of dental caries among children and adolescents. The aims of this study were to determine the levels of oral health knowledge and health-related behavior in adult UAE residents, and the relationship between these variables and oral health. Methods: A descriptive cross-sectional survey with nonprobability sampling was used in this study. A sample of 630 adults residing in the UAE completed an oral health survey to assess their oral health knowledge and behavior. Mean oral health knowledge and behavior scores were calculated and correlated with population demographic and behavioral variables. Results: Participants were found to have an acceptable oral health knowledge score (OHKS) of 10.50 (2.36) where 62 % of participants answered the questions correctly. Results showed that age, gender, nationality, smoking, and physical activity were significantly associated with the knowledge score. However, only gender, nationality, and smoking predicted oral health knowledge scores after further regression analysis. On the other hand, the mean oral health behavior score (OHBS) for all participants was 8.91 (2.29); 98% of all participants practiced at least an acceptable level of oral behavior and 53% practiced a good to perfect level. Age, gender, educational level, employment status, insurance status, marital status, nationality, smoking, and physical activity showed significant statistical association with the score of behaviors related to oral health. Only gender, number of diabetes sessions attended, and health information sources used remained significant after further regression analysis. Conclusion: Further efforts are required to spread awareness about oral health and encourage the UAE population to develop healthy oral habits. Such programs will decrease the occurrence and burden of many chronic oral diseases especially periodontal diseases.

Asociación de sialometría, fosfato y calcio en saliva total bajo estímulo y en líquido crevicular gingival con caries dental en escolares / Sialometry and concentration of phosphate and calcium in stimulated whole saliva and gingival crevicular fluid and its association with dental caries in schoolchildren

Resumen Introducción. La capacidad de la saliva para la remineralización contribuye a mantener la integridad fisicoquímica de la estructura mineral de los dientes, lo cual los protege de la aparición y evolución de la caries dentaria. Objetivo. Establecer la relación de la sialometría, la capacidad amortiguadora, la concentración de calcio y fosfato en la saliva total estimulada y en el líquido crevicular gingival, con la gravedad y la actividad de las caries en escolares. Materiales y métodos. Se seleccionaron 36 escolares de 6 años, 18 con caries (International Caries Detection and Assessment System, ICDAS, código 2 o mayor) y 18 sin caries (ICDAS, código 0). En la dentición primaria, se evaluaron la gravedad y la actividad de la caries dentaria en la superficie de oclusión de los molares y en la vestibular de los dientes anteriores, y se codificaron mediante el ICDAS-II. Resultados. Se evidenció una mayor gravedad de las caries en la superficie de oclusión que en la vestibular. Las concentraciones de calcio en la saliva y de fosfato en el líquido crevicular gingival de los dientes sanos, fueron mayores en el grupo con un código ICDAS de 2 o mayor. La concentración de calcio en el líquido crevicular gingival fue mayor en el grupo con código ICDAS 0 que en los dientes cariados del grupo con código ICDAS de 2 o mayor. Se encontró una asociación estadísticamente significativa entre la frecuencia de caries activas y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, como también entre la gravedad de las caries y la capacidad amortiguadora, por una parte, y la concentración de fosfato en el líquido crevicular gingival de los dientes afectados, por la otra. Conclusión. Se evidenció una asociación entre la caries dental, la capacidad amortiguadora y la química bucal del calcio y el fosfato.

Abstract Introduction: The remineralizing properties of saliva contribute to maintain the physical and chemical integrity of the mineral structure of teeth, which protects it from the installation and evolution of dental caries. Objective: To relate sialometry, buffering capacity, calcium and phosphate concentration in whole stimulated saliva, and in gingival crevicular fluid with school children caries severity and activity. Materials and methods: We selected 36 schoolchildren aged 6 years: 18 with caries (International Caries Detection and Assessment System, ICDAS>1 group) and 18 without caries (ICDAS=0 group). The severity and activity of dental caries were diagnosed in the primary dentition: in the occlusal surface of molars and in the vestibular of the anterior teeth by ICDAS-II. Results: Caries in occlusal surface were more severe than in vestibular surface. The concentration of calcium in saliva and phosphate in healthy teeth gingival crevicular fluid were higher in the ICDAS>1 group. The concentration of calcium in gingival crevicular fluid was higher in the ICDAS=0 group than in the decayed teeth of the ICDAS>1 group. We found a statistically significant association between the frequency of active caries andthe concentration of phosphate in gingival crevicular fluid of teeth with caries, as well as between the severity of caries with buffering capacity and the concentration of phosphate in the gingival crevicular fluid of teeth with caries. Conclusion: We found an association between dental caries with buffering capacity and buccal calcium and phosphate.

Relationship between Molar Incisor Hypomineralization (MIH) severity and cavitated carious lesions in schoolchildren.

The aim of this study was to identify the relationship between Molar Incisor Hypomineralization (MIH) severity and cavitated carious lesions in schoolchildren. This crosssectional study included 506 schoolchildren selected from public schools. The prevalence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry criteria (EAPD), while the prevalence and severity of caries was evaluated by applying the ICDAS (International Caries Detection and Assessment System). The prevalence of MIH was 42.4%, with a severity of 21.7% mild, 7.7% moderate, and 13.0% severe. Prevalence was 61.6% for incipient lesions and 34.0% for cavitated lesions. The prevalence of ICDAS II ≥4 lesions was higher in schoolchildren with MIH than in those without MIH (55.8% vs. 44.2%, p<0.001). In the multinomial model, children with MIH in the moderate/ severe category were more likely (OR=3.28; CI95% 1.01 - 10.6, p<0.048) to present cavitated lesions. The presence of MIH at mild levels was not associated with cavitated carious lesions. A high prevalence of MIH was observed. Moderate and severe levels of MIH were associated with cavitated carious lesions. To prevent dental caries, it is important to identify MIH in children, particularly in the moderate and severe categories.

El objetivo de este estudio fue identificar la asociación entre la severidad de la Hipomineralización IncisivoMolar (HIM) y las lesiones cavitadas de caries en escolares. Estudio transversal que incluyó a 506 escolares seleccionados de escuelas públicas. La prevalencia y la severidad de HIM se evaluó utilizando los criterios de la European Academy of Pediatric Dentistry (EAPD), mientras que la prevalencia y severidad de caries se evaluó mediante los criterios del ICDAS (International Caries Detection and Assessment System). La prevalencia de HIM fue del 42.4%, por severidad: 21.7% leve; 7.7% moderado y 13.0% severo. La prevalencia de lesiones incipientes fue de 61.6% y 34.0% para lesiones cavitadas de caries. La prevalencia de ICDAS II ≥4 lesiones fue mayor en escolares con HIM que en aquellos sin HIM (55.8% vs 44.2%, p<0.001). En el modelo multinomial, los niños con HIM en la categoría moderada / severa tienen mayor probabilidad (RM = 3.28; IC95% 1.0110.6, p<0.048) de presentar lesiones cavitadas de caries. La presencia de HIM en niveles leves no se asoció con la presencia de lesiones cavitadas de caries. Se observó una alta prevalencia de HIM. Los niveles moderados y severos de HIM se asociaron con lesiones cavitadas de caries. Para prevenir la caries dental, es importante identificar la HIM en los niños, particularmente en las categorías moderada y severa.

Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: the Brazilian Osteoporosis Study (BRAZOS)

Abstract Introduction: Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures. Methods: Individuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men and women ≥40 years old. The research was conducted through in-home interviews administered by a trained team. Nutrition Database System for Research (NDSR) software was used to analyze data on the intake of nutrients, which were employed to calculate the DII using Statistical Analysis Software (SAS®) and Statistical Package for the Social Sciences (SPSS®) to assess its association with low-impact fractures. Results: A total of 2269 subjects had their DII score calculated using information from 24-h recall data. Males had lower DII than females (DII = 1.12 ± 1.04 vs DII = 1.24 ± 0.99, p = 0.012). Women taking statins had lower DII (DII = 0.65 ±1.14 vs DII + 1.26 ± 0.98, p = 0.002), indicating a greater potential for diet-related anti-inflammatory effects. Conclusion: Our findings suggest that women might have a pro-inflammatory diet pattern compared to men. However, we did not find any association between DII scores and low-impact fractures.