Dental caries in children and vitamin D deficiency: a narrative review

Introduction of fruit juice and sugar-sweetened beverages before 6 months of age and early childhood caries at 3.5 years: the ELFE cohort study

The aim of this study was to investigate the relationships between the introduction of fruit juice or sugar-sweetened beverages (SSBs) before the age of 6 months and the presence of early childhood caries (ECC) at 3.5 years of age. The study is based on data from the population-based nationwide prospective cohort study ELFE (French Longitudinal Study of Children). Children were recruited at birth in 2011 in France. Detailed data on the children's diets, as well as socio-economic characteristics and dental caries at 3.5 years, were prospectively collected through online questionnaires and telephone interviews of the parents. The primary outcome was the presence of ECC reported by the parents at 3.5 years. The main exposure was the introduction of fruit juice or SSBs before the age of 6 months into the child's diet. Among the 10,921 children included, 1955 (19.5%) were exposed to fruit juice or SSBs before 6 months of age and 229 (3.0%) had ECC; 53 (4.7%) of exposed children and 176 (2.5%) of those not exposed had ECC at 3.5 years of age. Based on multivariable analysis, introduction of fruit juice or SSBs before 6 months of age was associated with ECC at 3.5 years (adjusted OR = 1.5, 95% CI [1.1, 2.2]).

CONCLUSION

This study indicates that early introduction of fruit juice or SBBs is associated with an increased risk of developing ECC, highlighting the need for early prevention by childhood professionals and nationwide prevention campaigns.

WHAT IS KNOWN

• Consumption of SSBs is a well-known risk factor for dental caries in children, yet fruit juices still culturally maintain a healthy image. • Limited data on ECC risk factors in children under 4 years have been published.

WHAT IS NEW

• The very early introduction of fruit juices or SSBs into a child's diet is later associated with ECC at 3.5 years. • This study is the first to investigate complementary feeding in relation to ECC before the age of 4 using a nationwide population-based design.

[Vitamin D role in oral cavity diseases]

The purpose of this scientific article is to analyze the scientific literature aimed at identifying the relationship between vitamin D levels in the body and diseases of the oral organs, in order to determine the potential impact of vitamin D deficiency on their development. Special attention is paid to the development of recommendations for maintaining optimal vitamin D levels for various population groups in order to strengthen both general health and prevent diseases of the oral cavity.

Erosive tooth wear, dental decay, and periodontal health in obese and normal weight children and adolescents

AIM

This study aimed to compare the oral health status between normal weight (NW) and obese weight (OW) children/adolescents.

METHODS

Eighty-two participants aged 6-16 years were included in this cross-sectional study. The children/adolescents were classified according to the body mass index (BMI): NW (n = 41) and OW (n = 41). Caries experience was assessed by the International Caries Detection and Assessment System (ICDAS-II), decay, missing, filling teeth (dmft) for the primary teeth and (DMFT) for the permanent teeth, erosive tooth wear using Basic Erosive Wear Examination (BEWE), Plaque Index (PI) and Gingival Index (GI), probing depth (PD). Also, the relationship between procalcitonin (PCT), C-reactive protein (CRP), parathyroid hormone (PTH), and 25(OH)D blood biochemistry and oral health was evaluated in obese children/adolescents.

RESULTS

Evaluation was made of a sum of 82 children/adolescents, comprising 43 females and 39 males, with a median age of 14 years in the obese group and 13 years in the NW group. Significant differences were determined between patients with NW and those who were obese, particularly in BMI, family income level, and tooth brushing habits. The results of the study indicate that individuals with obesity tend to exhibit significantly higher scores for PI, and GI as compared to those with NW (p < .05) CONCLUSION: Oral hygiene in children with systemic diseases should be treated with a multidisciplinary approach and under regular control by a pediatrician and pediatric dentist, as it may also affect the medical health of the children/adolescents.

Activity and levels of TNF-α, IL-6 and IL-8 in saliva of children and young adults with dental caries: a systematic review and meta-analysis

BACKGROUND

Cytokines play an important role in the immunopathogenesis of dental caries. A systematic review and meta-analysis was carried out with the following three objectives: 1)To deepen and discuss through a comprehensive analysis of the literature the effects of dental caries on the activity and levels of TNF-α, IL-6 and IL-8 in saliva of children and young adults, 2)To compare the levels of this cytokines in saliva of the exposure group (moderate-severe dental caries) with the control group (caries-free or mild dental caries), and 3)To determine whether the levels of these cytokines could be used as a complementary clinical diagnostic tool to assess the severity of dental caries.

METHODS

The protocol followed PRISMA and Cochrane guidelines and was registered in the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/MF74V . A digital search was performed in PubMed/MEDLINE, Cochrane, Scopus, and Google Schoolar databases from February 15th, 2012, to January 13th, 2024. The methodological validity of the selected studies was assessed using Joanna Briggs Institute (JBI) tool. A meta-analysis was performed using a random-effects model to evaluate the association between dental caries/health, and the concentration of TNF-α, IL-6 and IL-8.

RESULTS

The search strategy provided a total of 126 articles, of which 15 investigations met the inclusion criteria. The total number of patients studied was 1,148, of which 743 represented the case/exposure group, and 405 represented the control group. The age of the patients ranged from 3 to 25 years. IL-6 was the most prevalent cytokine in the saliva of children and young adults with active dental caries. The meta-analysis revealed that there are significant differences between the levels of IL-6 and TNF-α in saliva of children with active dental caries compared to their control groups.

CONCLUSIONS

The findings suggest that IL-6 and TNF-α levels may have potential as complementary biomarkers for assessing dental caries severity. However, further research is needed to validate these findings in larger and more diverse populations before clinical application.

The Potential Systemic Role of Diet in Dental Caries Development and Arrest: A Narrative Review

Current conceptualizations of dental caries etiology center primarily on the local role of sugar, starch, or other fermentable carbohydrates on tooth enamel demineralization-a well-established and empirically supported mechanism. However, in addition to this mechanism, studies dating back to the early 1900s point to an important systemic role of diet and nutrition, particularly from pasture-raised animal-source foods (ASF), in dental caries etiology and arrest. Findings from animal and human studies suggest that adherence to a diet high in calcium, phosphorus, fat-soluble vitamins A and D, and antioxidant vitamin C, as well as low in phytates, may contribute to arrest and reversal of dental caries, particularly among children. Furthermore, findings from observational and experimental studies of humans across the life-course suggest that fat-soluble vitamins A, D, and K2 may interact to protect against dental caries progression, even within a diet that regularly contains sugar. While these historic studies have not been revisited in decades, we emphasize the need for them to be reinvestigated and contextualized in the 21st century. Specifically, methodologically rigorous studies are needed to reinvestigate whether historical knowledge of systemic impacts of nutrition on dental health can help to inform current conceptualizations of dental caries etiology, prevention, and arrest.

Seasonal Variations in 25-Hydroxyvitamin D Levels among Pediatric Patients Attending the Healthcare Centre

Vitamin D plays an essential role in maintaining bone density, building the immune system, and regulating cell growth alongside other key biological functions. Limited data are available about the seasonal variation in vitamin D levels in the pediatric population in Saudi Arabia. This study aimed to investigate the seasonal influence on the pediatric circulating levels of 25(OH)D. A total of 1790 pediatric outpatients who visited the University healthcare centre were included in this study. Overall, there was a noticeably high prevalence (69%) of both combined 25(OH)D deficiency and insufficiency. The highest mean serum concentration of 25(OH)D was recorded in summer (29 ng/mL) and autumn (27 ng/mL). The deficient and insufficient categories were predominant, accounting for 33% and 36%, respectively. Comparable patterns were recorded during autumn, winter, and spring. Interestingly, the 25(OH)D level was significantly associated with the four seasons (p = 0.001), with females having a higher prevalence of 25(OH)D deficiency in the spring and summer than males. Furthermore, only in autumn and winter, we found a significant association between gender and 25(OH)D status (p < 0.001 for both). Another association between nationality and the circulating levels 25(OH)D was found during autumn and winter (p < 0.001 and p = 0.01), respectively. In all seasons, age had a negative impact on serum (OH)D levels. However, this relationship was statistically significant (p < 0.05) only in summer, autumn, and winter. Gender was a significant predictor, with 25(OH)D levels in autumn and winter and an odds ratio of 1.67 in autumn and 2 in winter, indicating that being men had a positive influence on circulating 25(OH)D levels. There were highly significant differences in 25(OH)D concentrations among different age categories. The Saudi population experiences low levels of vitamin D, particularly in autumn and winter periods. This study showed that seasonality, age category, nationality, and gender influence vitamin D status, suggesting the need for tailored intervention and monitoring of 25(OH)D status to reach adequate levels of vitamin D. Healthcare practitioners and policymakers may consider the interplay between age, nationality, gender, and seasonal variations when addressing vitamin D status and a targeted supplementation approach for high-risk groups that may develop health issues.

Platelet-rich fibrin in dentistry

OBJECTIVES

To review the progress of Platelet Rich Fibrin (PRF) as a biomaterial in dentistry and to highlight its promising application as a safe and biocompatible autologous platelet concentrate. Publications were searched in GeenMedical, X-mol, GoogleScholar, and PubMed from October 2024 with no language restrictions. The literature was searched for relevant databases and journals on the use of PRFs in dentistry up to October 2024, and the inclusion criteria included randomized controlled trials, clinical trials, case series, and systematic reviews.

CONCLUSION

PRF is a second-generation platelet concentrate that is sourced from oneself, has fewer adverse effects, and is simple and safe to prepare. These materials include growth factors and fibrin scaffolds, which are extensively utilized in regenerative medicine. By outlining PRF, we found that good results can be achieved when PRF is used to treat these conditions.

CLINICAL SIGNIFICANCE

The application of PRF in dentistry is widespread, particularly in periodontal soft and hard tissue regeneration, oral lichen planus, and pulpal regeneration. This article reviews the background, classification, and preparation methods of PRFs, along with their dental applications. We anticipate further research on various PRF derivatives in the future, which will significantly improve the utilization of PRF in oral applications and offer fresh insights for diagnosing and treating oral diseases.