Clinical management and prevention of dental caries in athletes: A four-year randomized controlled clinical trial

Diagnostic accuracy, available treatment, and diagnostic methods of dental caries in practice: a meta-analysis

Background

Diagnosis of dental caries and identification of patients with dental caries is the biggest challenge in dentistry. For this diagnostic accuracy, several methods are studied. The present study attempts to re-study the published data in the last 50 years, between 1960 and 2020.

Main body

Based on designed keywords, we made a thorough search of 4 different databases and found 3887 articles after removing the duplicate. The included database was PubMed, Ovid, Web of Science, and Cochrane library. On keen screening of the articles, we included 19 articles in the review. All the articles were analyzed based on the Cochrane risk assessment method. Maximum studies of up to 80% of caries management are based on children from 1 to 10 years of age. About 47% of articles were found based on reported use of drugs against dental caries, whereas 52.6% of articles were based on the behavioral and socio-demographic study of the mother and caretakers. We found that attentive parents and caretakers of the children can help in reducing the prevention of caries. Frese et al. (Sci Rep. 8(1):16991, 2018. 10.1038/s41598-018-34777-x), Liu et al. (PLoS ONE 8(11):e78723, 2013. 10.1371/journal.pone.0078723), and Innes et al. J Dent Res 99(1):36–43, 2020. 10.1177/0022034519888882) were the studied articles with high quality and low bias risk. These methods were based on the use of stannous fluoride for dental caries, the study of the effect of smoking on older adults, by checking the anxiety level of the participants.

Short conclusions

Tooth decay is a common condition in the general population and affects mostly children. The method with high accuracy and low risk can be recommended for routine treatment.

The Current Strategies in Controlling Oral Diseases by Herbal and Chemical Materials

Dental plaque is a biofilm composed of complex microbial communities. It is the main cause of major dental diseases such as caries and periodontal diseases. In a healthy state, there is a delicate balance between the dental biofilm and host tissues. Nevertheless, due to the oral cavity changes, this biofilm can become pathogenic. The pathogenic biofilm shifts the balance from demineralization-remineralization to demineralization and results in dental caries. Dentists should consider caries as a result of biological processes of dental plaque and seek treatments for the etiologic factors, not merely look for the treatment of the outcome caused by biofilm, i.e., dental caries. Caries prevention strategies can be classified into three groups based on the role and responsibility of the individuals doing them: (1) community-based strategy, (2) dental professionals-based strategy, and (3) individual-based strategy. The community-based methods include fluoridation of water, salt, and milk. The dental professionals-based methods include professional tooth cleaning and use of varnish, fluoride gel and foam, fissure sealant, and antimicrobial agents. The individual-based (self-care) methods include the use of fluoride toothpaste, fluoride supplements, fluoride mouthwashes, fluoride gels, chlorhexidine gels and mouthwashes, slow-release fluoride devices, oral hygiene, diet control, and noncariogenic sweeteners such as xylitol. This study aimed to study the research in the recent five years (2015–2020) to identify the characteristics of dental biofilm and its role in dental caries and explore the employed approaches to prevent the related infections.

Long-Term Use of Oral Hygiene Products Containing Stannous and Fluoride Ions: Effect on Viable Salivary Bacteria

The aim of this randomized, controlled clinical trial was to isolate and identify viable microorganisms in the saliva of study participants that continuously used a stannous and fluoride ion (F/Sn)-containing toothpaste and mouth rinse over a period of three years in comparison to a control group that used stannous ion free preparations (noF/Sn) over the same time period. Each group (F/Sn and noF/Sn) included 16 participants that used the respective oral hygiene products over a 36-month period. Stimulated saliva samples were collected at baseline (T0) and after 36 months (T1) from all participants for microbiological examination. The microbial composition of the samples was analyzed using culture technique, matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, and 16S rDNA Polymerase Chain Reaction (PCR). There were only minor differences between both groups when comparing the absolute values of viable microbiota and bacterial composition. The treatment with F/Sn led to a slight decrease in disease-associated and a slight increase in health-associated bacteria. It was shown that the use of stannous ions had no negative effects on physiological oral microbiota even after prolonged use. In fact, a stabilizing effect of the oral hygiene products containing stannous ions on the health-associated oral microbiota could be expected.

Stannous Fluoride Effects on Enamel: A Systematic Review

In recent years there has been a lot of talk about toothpastes with a particular chemical compound: stannous fluoride (SnF2). Its presence is currently still highly controversial, as the latter could have negative health effects. The different companies that produce toothpastes express its dosage in ppm. The purpose of this systematic literature review is to analyze all randomized clinical trials in the literature over the last 10 years and to draw clear results on the function of stannous fluoride, for this purpose the authors performed a Mann-Whitney U Test.

MATERIALS

The first analysis of the literature produced a number greater than 800 results, subsequently applying the inclusion and exclusion criteria, and following a manual analysis of the results, 26 manuscripts have been obtained.

RESULTS

From the results analyzed in this review, it could be shown that stannous fluoride does not present important contraindications, if not those commonly reported for fluorine. A meta-analysis on enamel loss has been conducted, it shows that SnF2 products provide better results with a p < 0.05 value.

CONCLUSION

This compound could have significant effects in favor of erosion and recalcification of the enamel, on the biofilm formation, gingival inflammation, and in addition, it could be an important aid in the removal of tooth stains and halitosis.

Prevalence and risk indicators of non-carious cervical lesions in male footballers

Background

Non-carious cervical lesions (NCCLs) have shown a significant incidence and prevalence and have been increasingly associated with people’s lifestyles and youths. This cross-sectional study aimed to determine the prevalence of NCCLs in footballers and to address potential risk indicators.

Methods

Fourty-three male semi-professional footballers with an average of 27 years old completed a questionnaire and were subjected to intraoral examination in terms of cervical tooth wear, morphological characteristics of NCCLs, tooth sensitivity, occlusal/incisal wear, and malocclusion classification. Also, laboratory assays were performed to determine salivary parameters: flow rate, pH, buffer capacity, level of Ca (calcium), Na (sodium), and K (potassium) ions, and level of cortisol. The data obtained from the questionnaire and intraoral examinations were subjected to Chi-square and Poisson regression models while the data obtained from the laboratory assays were analyzed by using analysis of variance (p <  0.05).

Results

The prevalence of NCCLs was 39.5%. The participants presented predominantly initial lesions with signs of mechanical stress. The daily training time was found as a significant risk indicator (p = 0.028). The multivariate analysis showed a significant difference in the variables daily training time (p = 0.023), lemon water intake while fasting (p = 0.002), toothpaste type (p = 0.004), tooth sensitivity (p = 0.006); previous orthodontic treatment (p = 0.003), and occlusion type (p = 0.008). All participants presented normal salivary parameters and levels of cortisol.

Conclusion

The prevalence of NCCLs among footballers was remarkable. The premolars were the most affected teeth and presented symptoms/signs of initial lesions. The daily training time was a dominant risk indicator of NCCLs development. Footballers presented adequate salivary parameters and cortisol levels.

Influence of the long-term use of oral hygiene products containing stannous ions on the salivary microbiome - a randomized controlled trial

Oral hygiene products containing tin are suitable to prevent erosive tooth wear, yet effects on the oral microbiota are not known yet. Therefore, this study determined the salivary microbiome of 16 participants using products with stannous ions for three years (TG) compared with a control group (CG) to assess their influence on the microbiota. Participants were included in a randomized controlled clinical trial (RCT) with biannual visits. Illumina Miseq sequencing revealed as most abundant genera: Streptococcus (TG 14.3%; CG 13.0%), Veillonella (TG 11.3%; CG 10.9%), Prevotella (TG 7.0%; CG 9.8%), Haemophilus (TG 6.6%; CG 7.2%), Porphyromonas (TG 5.9%, CG 5.1%), Leptotrichia (TG 5.8%; CG 4.9%), Actinomyces (TG 4.0%; CG 4.6%) and Neisseria (TG 5.4%; CG 4.2%). Beta-Diversity was not significantly different between groups at both time points, although significant differences between groups were found for certain taxa after three years. The genus Prevotella was found in higher abundance in CG whereas Neisseria and Granulicatella, health-associated taxa, were found more abundantly in TG. Salivary microbiota after three years reflected a composition associated with oral health, hence continual use as a preventive measure for dental erosion can be considered safe and benefitting oral health for patients with a high risk of erosion.