Risk factors for dental caries in Latin American and Caribbean countries

Dental caries in anterior teeth of babies can predict the occurrence of severe dental caries in posterior teeth: a 3-year cohort study

OBJECTIVE

To evaluate whether the presence of dental caries in the primary anterior teeth of 1- and 2-year-old babies can predict the occurrence of severe dental caries in the primary posterior teeth of these children after a 3-year follow-up.

METHODOLOGY

This cohort study was carried out with 99 children and their guardians who were assessed at the beginning of the study and reassessed after 3 years. Severe caries in posterior tooth at the 3-year follow-up is the dependent variable. Caries in anterior tooth at baseline is the main independent variable. Other independent variables are family income, mother's education, oral hygiene, night oral hygiene, sucrose consumption, and history of toothache. Descriptive analysis, chi-square test, and Poisson regression were performed.

RESULTS

The incidence of severe caries in posterior tooth was 3.33 times higher in children with caries in anterior tooth at baseline (95% CI 2.06-5.37). Children who belonged to lower-income families both at baseline and at follow-up (RR: 2.75; 95% CI 1.40-5.39), who did not perform night-time oral hygiene at baseline (RR: 1.76; 95% CI 1.10-2.80) and who had a frequency of sucrose consumption equal to or greater than twice a day, both at baseline and at follow-up (RR: 4.07; 95% CI 2.03-8.19) had a higher risk of developing severe dental caries in posterior deciduous teeth.

CONCLUSION

Children with dental caries in primary anterior teeth when they were babies have a higher incidence of severe caries in posterior teeth.

Prevalence and clinical risk factors of dental caries in Syrian children: a cross-sectional study

This study aimed to estimate dental caries' prevalence and potential risk factors among schoolchildren aged 8-12 in Damascus, Syria. The study was cross-sectional and conducted between February 2023 and April 2024, the target population was 1,052 children selected using multi-stage cluster sampling. Dental caries were determined using the DMFT/dmft index, while additional information on sociodemographic status, and attitude towards oral hygiene practices, were collected via a structured questionnaire. Data analyses were conducted using the Statistical Package for Social Sciences (SPSS). The overall prevalence of dental caries was 90.8%. Males had a slightly higher prevalence (91.9%) than girls (89.8%). Children aged [10-12] years showed the highest caries prevalence (91.7%). The mean DMFT/dmft score was 2.07 ± 1.91/3.74 ± 2.25, respectively. Caries prevalence was significantly associated with the type of school attended, family size, socioeconomic status, and parental education. Additionally, the frequency of tooth brushing, dental flossing, and irregular dental visits were significantly linked to higher caries incidence. It was found that caries experience remains high in the children in Damascus, with many associated factors including their sociodemographic factors and oral behaviors. We confirm that visiting the dentist regularly, using dental floss, and brushing regularly decreased the prevalence of dental caries among children.

Influence of Behavioral and Sociodemographic Factors on Dental Caries in Mexican Children

BACKGROUND

In Mexico, tooth decay is common among children and is on the rise. A strong relationship exists between behavioral, socioeconomic, demographic, and biological factors and the severity and development of dental caries.

OBJECTIVE

The present study analyzed the risk factors contributing to dental caries in a Mexican pediatric population.

MATERIALS AND METHODS

This study employed a cross-sectional design. One hundred fifty-one children were evaluated after providing their assent and the informed consent of their legal guardians. The study subjects recruited underwent dental assessments, dietary habits, and physical activity examinations.

RESULTS

Only 36 children were classified as overweight or obese, while 121 children had a high quality of life related to oral health. Most of the children showed deficient eating and physical activity habits. Additionally, nearly half displayed severe dental carie lesions. The occurrence of caries was linked to both age and tooth brushing habits. The median of teeth with initial caries lesions was higher among female children. Furthermore, parental education was associated with the presence of fluorosis and the frequency of tooth brushing.

CONCLUSION

Our study revealed deficient eating habits and a high prevalence of dental caries among children aged 6-12. Additionally, parents and guardians demonstrated insufficient knowledge about general oral health issues, the risk factors for caries, and their potential consequences, which means a need for both preventive and corrective treatments. This highlights the need for strategies focused on improving oral health care and prevention.

Prevention of White Spot Lesions Induced by Fixed Orthodontic Therapy: A Literature Review

Objectives: This study aims to review the scientific literature on the prevention of white spot lesions (WSLs) associated with fixed orthodontic treatment. WSLs result from enamel demineralization and pose aesthetic and functional challenges. The study evaluates the effectiveness of various preventive interventions to reduce the risk of WSLs during orthodontic care. Methods: A comprehensive literature search was conducted using MeSH terms such as "white spot", "fixed orthodontic treatment", "CPP-ACP", "topical fluoride", and "demineralized lesion", combined with the Boolean operator 'AND'. Databases searched included PubMed, EMBASE, Scopus, and OpenGrey, focusing on studies published between January 2014 and September 2024. The inclusion criteria required studies to evaluate interventions aimed at reducing WSL risk in patients undergoing fixed orthodontic treatment. A total of 41 articles were screened, with 17 selected based on relevance and methodological rigor. Results: The review identified several effective strategies for preventing WSLs. Topical fluoride applications, particularly high-concentration varnishes, significantly reduced WSL prevalence, with some studies favoring fluoride varnish over other interventions. CPP-ACP and CPP-ACPF formulations demonstrated potential for remineralizing demineralized enamel, especially when combined with fluoride toothpaste. High-fluoride toothpaste and acidulated phosphate fluoride mouthwash were effective in reducing lesion incidence, emphasizing the importance of patient compliance in daily oral hygiene routines. Professional interventions, such as fluoride varnish applications, showed enhanced outcomes when re-applied periodically. Conclusions: Preventing WSLs during orthodontic treatment is crucial for ensuring the aesthetic and functional success of therapy. Strategies combining fluoride-based interventions with casein phosphopeptide formulations offer significant benefits. However, patient education and adherence to recommended oral hygiene practices remain critical. Further research is needed to compare the long-term effectiveness of these interventions and to explore new technologies for WSL prevention.

Atraumatic restorative treatment induces transient changes in salivary total protein and redox biomarkers in children with caries: A non-randomized clinical study

AIM

This study aimed to evaluate if dental atraumatic restorative treatment (ART) impacts salivary total protein and redox biomarkers in children with caries.

METHODS

The study included 30 children (aged 4 to 6 years) with caries on posterior deciduous teeth, classified by ICCMS, attending a basic education school. Participants were divided into enamel (n = 15) and dentin (n = 15) lesion groups. Unstimulated saliva samples were collected before (B), immediately after (A), and seven days after (A7) ART. Analyses included total protein concentration, lipid peroxidation (TBARS), total antioxidant capacity (TAC), and uric acid (UA). The results obtained at different time points (B, A, A7) were compared between children with caries and between those with enamel or dentin lesions using a paired repeated-measures ANOVA, followed by Tukey's post-hoc test (p < 0.05).

RESULTS

ART caused significant decreases in total protein concentration (p = 0.0146), which rebounded by the 7th day. TBARS levels increased (p = 0.0215) immediately after ART and remained unchanged until the 7th day. TAC (p = 0.0032) and UA (p = 0.0006) levels decreased in the saliva of children 7 days after ART. These changes were significant only in children with dentin lesions, not enamel lesions.

CONCLUSION

ART temporarily alters salivary protein levels and redox biomarkers in children with caries, returning to baseline after 7 days. These findings highlight the importance of complementing restorative treatments with dietary advice and oral hygiene to ensure comprehensive caries management.

Effects of D-Tagatose on Cariogenic Risk: A Systematic Review of Randomized Clinical Trials

Dental caries remains a prevalent chronic disease driven by dysbiosis in the oral biofilm, with Streptococcus mutans playing a central role in its pathogenesis.

OBJECTIVE

This study aimed to assess the effect of D-tagatose on cariogenic risk by analyzing randomized clinical trials (RCTs).

METHODS

A systematic literature review was conducted targeting RCTs published up to 2024 in eight databases and two gray literature sources. The search strategy utilized Medical Subject Headings (MeSHs) and relevant keywords combined via Boolean operators using the query "Tagatose OR D-tagatose AND Dental Caries". Eligible studies must evaluate the impact of D-tagatose on cariogenic risk, as indicated by reductions in colony-forming units (CFUs) and improvements in salivary pH levels in treatment groups.

RESULTS

From 1139 retrieved records, three studies met the inclusion criteria. These studies consistently demonstrated significant reductions in CFU counts and improvements in salivary pH levels in groups treated with D-tagatose compared to controls using other non-caloric sweeteners or placebos (p < 0.01). However, the quality of the evidence was heterogeneous, with certain methodological concerns.

CONCLUSIONS

Although the findings suggest potential benefits of D-tagatose in reducing cariogenic risk, limitations such as small sample sizes and variability in study methodologies warrant caution. Further robust investigations are needed to substantiate these promising results and support the integration of D-tagatose into oral care formulations aimed at reducing cariogenic risk.

Association of socio-demographic characteristics, comorbidities, lifestyle habits, and saliva parameters with dental caries in adults with obesity

OBJECTIVE

To describe the oral health status of patients with obesity and to explore the socio-demographic characteristics, comorbidities, lifestyle habits (tobacco, alcohol, sweet/acidic diet), and saliva parameters most associated with the dental caries experience.  Material and methods: We conducted a cross-sectional analysis of 204 patients' data with obesity attending a therapeutic education programme. Caries experience (number of decayed, missing, and filled teeth [DMFT]), periodontal status, oral hygiene, occlusal tooth wear, masticatory inefficiency, and saliva parameters were recorded.

RESULTS

Mean DMFT was 12 ± 7 and was independently associated with age (mean 47 ± 14 years; for 1 standard deviation (SD) increase: β = 0.22, 95% confidence interval [CI] = 0.16-0.29), female sex (72%; β = 3.76, 95% CI = 1.65-5.87), brushing <2 times/day (35%; β = 2.86, 95% CI = 0.81-4.90), salivary buffering capacity (low [46%] vs. normal [40%]: β = 2.02, 95% CI = 0.08-3.95; very low [10%] vs. normal: β = 3.34, 95% CI = 0.31-6.37), and salivary consistency (bubbly [30%] vs. clear [57%]: β = 2.45, 95% CI = 0.52-4.38).

CONCLUSIONS

Improving patients' competencies for oral care, such as teeth brushing twice daily, is necessary to limit the burden of dental caries in individuals with obesity. Acting on salivary composition may also be of interest, and further studies are required to explore the underlying mechanisms.

Socioeconomic inequalities in early childhood caries: evidence from vulnerable populations in Colombia

The Colombian Chapter of the Alliance-for-a-Cavity-Free-Future (Col-ACFF) has been conducting a health promotion and caries prevention program among young children in four vulnerable Colombian municipalities (baseline data from 2012-2014). This study aimed to quantify socioeconomic inequalities in early childhood caries (ECC) and examine the potential role of daily fluoride-toothpaste use, previous-year dental-care visit, and nutrition/diet-related aspects. The study sample included 1344 children aged 1-5 years. Inequalities in the age-standardized prevalence rates of and mean number of tooth surfaces affected by moderate/extensive (dME) and initial (dIME) caries (defined using the ICDAS-merged-epi criteria) by household income and level of education were examined using the relative index of inequality (RII) and the slope index of inequality (SII). Approximately one-third of the children included in this study exhibited dME, while 84% exhibited dIME. The majority of outcomes exhibited social gradients, and significant relative (RII) and absolute (SII) inequalities in ECC were observed. The SII estimate indicated an absolute difference of 12.4% in the prevalence of moderate/extensive carious lesions among children living in households with the lowest compared to the highest education levels [SII: 12.4; 95% confidence interval (CI): 2.7-22.1]. These children were also 6.7 times more likely to exhibit dIME compared to those living in households with higher levels of education (SII:6.73 95% CI: 4.18-9.29). Daily use of fluoride toothpastes, dental care visits in the previous year, and nutrition/diet-related factors played a limited role in ECC inequalities. In conclusion, significant ECC inequalities were observed in these vulnerable populations, highlighting the importance of upstream and downstream interventions that raise awareness among stakeholders and improve community- and individual-based practices to address this.

Dental Caries in Children and Its Relationship with Parenting Styles: A Systematic Review

BACKGROUND

It can be affirmed that the parenting style of parents has an impact on the health-related behaviors of their children; the environment that parents create for their children can have an impact on both their habits and their oral health, and on the incidence of dental caries in children. The purpose of this study was to analyze the association between parenting style and childhood dental caries.

METHODS

Two researchers independently searched the English literature published up to May 2024 in four databases (PubMed, Web of Science, Scopus y Cochrane Library). The risk of bias was evaluated using the Modified Newcastle-Ottawa Quality Assessment Scale (NOS). This study is registered on PROSPERO (CRD42024573447).

RESULTS

Of the 130 studies identified, nine of them, with a total of 4250 participants, met our inclusion criteria. The evidence on the relationship between parenting styles and dental caries is varied. Of the studies reviewed, three showed a significant association between both factors, while four found no correlation, and two reported no significant differences in relation to parenting styles and the occurrence of dental caries.

CONCLUSIONS

This discrepancy emphasizes the need for further research. Parenting styles impact child dental behavior on a global level, highlighting the relevance of recognizing these approaches in a dental context, given that parents have a fundamental role in guiding their children's behaviors.

Caries experience and social insertion in schoolchildren from an urban population in the ecuadorian highlands: a descriptive study

Objective

To analyze the relationship between caries experience and social insertion in 12-year-old schoolchildren from an urban population in the Ecuadorian highlands. Materials and.

Methods

A cross-sectional descriptive design was conducted in 2023 with 12-year-old students in the Bellavista parish, Cuenca, Ecuador. Caries experience was measured using the severity levels of the WHO (World Health Organization) DMFT index. At the same time, social insertion was determined through the INSOC (Social Insertion) survey. The total population included 458 data points for the caries experience evaluation phase and 422 for the social insertion phase. Pearson's chi-square and Mann-Whitney U tests were applied.

Results

A percentage of 60.7% of schoolchildren had current caries. Regarding caries experience, 43.7% showed a shallow level, and 11,8% a very high level. Regarding sex, no statistically significant difference was found when comparing DMFT levels (X2, p=0.393). Regarding social insertion, schoolchildren came from the working-class and sub-salaried employee strata with 27.5% and 20.9%, respectively. No significant association was found between caries experience and social insertion in this population (X2 p=0.459). The social insertion stratum with the highest frequency of high DMFT levels was that of the children of migrants, with 27.27%.

Conclusion

No significant association was found between caries experience and social insertion.

Integrating oral and social factors in individual caries risk assessments in preschool children-a registry-based study

PURPOSE

To investigate the predictive ability of individual Caries Risk Assessments (CRA) regarding oral factors supplemented with social factors in relation to caries outcome in preschool children. Furthermore, to assess various models of CRA with oral and social factors included, aiming to identify the most suitable models for different age groups.

METHODS

The design is a retrospective registry-based cohort study. Children visiting the dentists at ages 3 and 6 years were included. Data on oral and social factors were obtained from dental records, the Swedish Quality register for caries and periodontitis (SKaPa), and Statistics Sweden (SCB). Various models of CRA were designed, combining oral and social factors. Models were analyzed with univariable associations using simple logistic regression, and the results were presented as odds ratios (ORs). In addition, models were analyzed with area under the receiver operating characteristic (ROC) curve (AUC). Pairwise comparisons were conducted by DeLong's test, with p < 0.05 considered significant.

RESULT

Oral factors were the most significant for caries outcome (OR 9.6), followed by social factors: foreign background (OR 4.6), low income (OR 2.83), low education of the mother (OR 2.77), single-parent family (OR 2.11), and having ≥ 3 siblings (OR 1.71), (p < 0.01). The predictive ability of CRA improved when models combining oral and social factors were used, compaired to CRA based solely on oral factors (p < 0.05). An increase of up to 15% was seen when CRA was conducted closer to the outcome.

CONCLUSION

Models for Caries Risk Assessment including oral and social factors increase the predictive ability. Caries Risk Assessment has limited durability.

Parental Knowledge, Attitudes, and Practices Regarding Early Childhood Caries in Bihor, Romania: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Early childhood caries (ECC) is a significant global health issue, particularly affecting deciduous teeth in young children. ECC is prevalent in Romania, where nearly half of children experience dental caries. This study aimed to assess the influence of gender, age, and living environment on parents' knowledge, attitudes, and practices (KAP) regarding ECC in Bihor County, Romania, using a KAP-type questionnaire.

METHODS

A cross-sectional study was conducted between March and September 2024, utilizing an online KAP questionnaire distributed via social networks. The sample comprised 419 parents of children under six years old. Respondents provided socio-demographic data and answered questions regarding their knowledge, attitudes, and practices concerning ECC prevention, treatment, and oral health. Statistical analysis was conducted using Chi-square tests to assess associations between demographic factors and parental KAP. A p-value of less than 0.05 was considered statistically significant.

RESULTS

Of the 419 respondents, 83.1% were female, and 62.5% were between the ages of 31 and 40. Significant gender-based differences were found in knowledge about pain from caries (93.7% of female participants vs. 81.7% of male participants, p = 0.004) and the importance of brushing twice daily (93.7% of female respondents vs. 80.3% of male respondents, p = 0.010). Younger parents (aged 18-30) were more likely to affirm the effectiveness of fluoride (65.4%) compared to those aged 31-40 (53.1%, p = 0.02). Urban parents were more likely to correctly identify the timing of tooth eruption (59.1% vs. 52.6% of rural parents, p = 0.021).

CONCLUSIONS

The study highlights gender, age, and urban-rural disparities in parental knowledge and attitudes towards ECC. These findings underscore the need for targeted educational interventions to improve oral health outcomes and reduce ECC prevalence in the Bihor region. Tailored public health strategies addressing demographic factors could enhance preventive oral health behaviors and reduce the healthcare burden associated with untreated dental caries.

Dental caries prevalence and caries-associated risk factors of students aged 12-15 in Xide County of Liangshan Prefecture, China: a cross-sectional study

OBJECTIVE

About 2 billion people have caries in permanent teeth, and 514 million children have caries in primary teeth worldwide. Regional disparities in caries prevalence are evident in various areas of China. A comprehensive understanding of the status of dental caries and its associated risk factors is essential for developing effective dental health policies in economically disadvantaged regions. Thus, this study aims to examine the prevalence of dental caries and its risk factors among students aged 12-15 in Xide County, a remote mountainous area in China.

DESIGN

In this cross-sectional study, dental health surveys were conducted using self-administered questionnaires and the Decayed-Missing-Filled Tooth (DMFT) Index. An oral clinical examination was carried out by the criteria and guidelines set forth by WHO.

SETTING

Xide County, Liangshan prefecture, China in 2022.

PARTICIPANTS

558 students aged 12-15 years completed the survey.

RESULTS

The study conducted in Xide County found a dental caries prevalence of 42.5% among 12-15 year-old students, with a mean DMFT of 1.50 (SD=2.25). Multivariable logistic regression analysis identified several significant risk factors for dental caries (p<0.05), including starting brushing after the age of six (OR 0.34, 95% CI 0.17 to 0.65), brushing teeth less than once a day (OR 9.24, 95% CI 5.53 to 15.33) and consuming carbonated drinks more than once a day (OR 0.28, 95% CI 0.14 to 0.53). Additionally, the use of fluoride (OR 0.61, 95% CI 0.43 to 0.85) and awareness of its protective effect on teeth (OR 0.75, 95% CI 0.59 to 0.98) were found to be associated with a lower risk of dental caries (p<0.05).

CONCLUSION

The prevalence of dental caries among students aged 12-15 in Xide County was identified as a significant public oral health concern. The oral health behaviours of students were found to be influenced by factors at the family and community levels.

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.

Potential interaction of sugar intake and tobacco exposure on dental caries in adults-A cross-sectional study from the National Health and Nutrition Examination Survey

Background/purpose

We suspected that there might be an interaction between sugar intake and tobacco exposure on the risk of dental caries. The study aimed to investigate the associations of sugar intake or tobacco exposure with the risk of dental caries.

Materials and methods

This cross-sectional study obtained data of 18804 participants from National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Weighted univariable and multivariable logistic regression models were applied to explore the associations of total sugar intake or tobacco exposure with the risk of dental caries. The relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI) evaluated the interaction between total sugar intake and tobacco exposure on the risk of dental caries. The effect size of odds ratio (OR), and 95% confidence interval (CI) was inputted.

Results

The OR of dental caries in adults with cotinine >10 ng/mL was 1.59 (95%CI: 1.38-1.82). The increased risk of dental caries was found in people with total sugar >19.5%E compared to those with total sugar ≤19.5%E (OR = 1.55, 95%CI: 1.34-1.78). Compared to people with cotinine ≤10 ng/mL and total sugar ≤19.5%E, adults with cotinine >10 ng/mL and total sugar >19.5%E were correlated with elevated risk of dental caries (OR = 2.76, 95%CI: 2.29-3.33). The interaction indicators RERI was 0.980 (95%CI: 0.413-1.547), API was 0.355 (95%CI: 0.192-0.517), and SI was 2.250 (95%CI: 1.344-3.767).

Conclusion

There might be interaction between sugar intake and tobacco exposure on the occurrence of dental caries in adults.

The use of mouthwash containing trimetaphosphate as an adjunct therapy to fluoridated toothpaste reduces enamel demineralization

INTRODUCTION

The decline in dental caries has been attributed to the widespread use of fluoride (F). Two forms of presentation are fluoridated toothpaste (FT) and mouthwash (MW), widely used by the population.

MATERIALS AND METHODS

This study aimed to evaluate in vitro the effects of combining FT and MW, whether supplemented with sodium trimetaphosphate (TMP) or not, on dental enamel demineralization. Bovine enamel blocks (n = 60) were selected based on initial surface hardness (SHi) and divided into 5 experimental groups (n = 12 each): I) Placebo Toothpaste (without F/TMP); II) 1100 ppm F Toothpaste (FT); III) 1100F associated with a MW at 100 ppm F (FT + MW 100F); IV) 1100F associated with a MW at 225 ppm F (FT + MW 250F); and V) 1100F associated with a MW at 100 ppm F supplemented with 0.4 % TMP (FT + MW 100F-TMP). The blocks were treated twice a day, undergoing 5 pH cycles over 7 days. Thus, the percentage change in surface hardness (%SH), integrated subsurface hardness loss (ΔKHN), and the concentration of F, phosphorus (P), and calcium (Ca) in the enamel were determined. The data were submitted to ANOVA and Student-Newman-Keuls test (p < 0.001).

RESULTS

The 1100F group was statistically inferior to the groups associated with MW for %SH, ΔKHN, and the concentration of P and Ca in the enamel (p < 0.001). Blocks treated with FT + MW 225F and FT + MW 100F-TMP showed significantly lower %SH compared to the other groups (p < 0.001). The FT + MW 100F - TMP group exhibited the lowest depth mineral loss (ΔKHN), and higher concentration de P in enamel (p < 0.001).

CONCLUSION

The adjunct use of MW with FT produces a greater protective effect in inhibiting enamel demineralization, and the supplementation of TMP to the MW with 100F provides a superior effect compared to MW with 225F.

CLINICAL SIGNIFICANCE

This combination of treatments could be regarded as one of several alternative fluoride supplements for subjects at elevated risk of caries.

Association of Papacarie Duo® and low-level laser in antimicrobial photodynamic therapy (aPDT)

Dental caries is a multifactorial, non-communicable disease. Effective treatment options for minimally invasive removal of carious tissue include Papacarie Duo® gel and antimicrobial photodynamic therapy (aPDT). aPDT involves a combination of a light source and photosensitizer. Given that Papacarie Duo® contains a percentage of blue dye, this study aims to explore the antimicrobial potential of Papacarie Duo® when associated with a light source against Streptococcus mutans strains. The chosen light source was a low-power diode laser (λ = 660 nm, E = 3 J, P = 100 mW, t = 30 s). To assess antimicrobial capacity, planktonic suspensions of Streptococcus mutans were plated on Brain Heart Infusion Agar (BHI) to observe the formation of inhibition halos. The studied groups included methylene blue (0.005%), Papacarie Duo®, distilled water (negative control), 2% chlorhexidine (positive control), Papacarie Duo® + laser, and methylene blue (0.005%) + laser. Following distribution onto plates, each group was incubated at 37 °C for 48 h under microaerophilic conditions. Inhibition halos were subsequently measured using a digital caliper. The results showed that chlorhexidine had the greatest antimicrobial effect followed by the group of irradiated methylene blue and irradiated Papacarie Duo®. All experimental groups demonstrated antimicrobial potential, excluding the negative control group. The study concludes that Papacarie Duo® exhibits antimicrobial properties when associated with a low-power diode laser.

Experience, Prevalence, and Severity of Dental Caries in Mexican Preschool and School-Aged Children

Objective Dental caries in Mexico continues to be a public health problem, indicated by it is high prevalence and incidence in children. This disease is associated with pain in preschool and school children, with large-scale consequences for the individual, society, and health systems. The objective of the present study was to determine the experience (mean of caries indices), prevalence, and severity of caries in children 2-12 years of age who sought dental care at a dental school in Mexico. Material and methods A cross-sectional study was carried out on 826 clinical records of patients ages 2-12 years. The dependent variable was caries, in terms of experience (mean primary teeth (dmft) and permanent teeth (DMFT) indices), prevalence (dmft and DMFT greater than 0), and severity (cutoffs of caries indices at various levels). The independent variables were age and sex. The data were analyzed in Stata 14 (StataCorp LLC, College Station, Texas). Results The average age was 7.2±2.3; 52.4% were boys. In the primary dentition, the caries experience (mean dmft) was 3.01±3.30, the prevalence of caries was 65.8%, and the severity dmft>3=37.3% and dmft>6=15.6%. In the permanent dentition, the caries experience (mean DMFT) was 0.99±1.88, the prevalence of caries was 31.5%, and the severity DMFT>3=12.5% ​​and DMFT>6=1.6%. The percentage of caries-free children in both dentitions was 26.1% (n=216/826). The experience, prevalence, and severity of caries were statistically different by age (p<0.001). Only in the severity of dmft>3 were differences observed across sex (p<0.05). Among children with mixed dentition, primary teeth were more affected than permanent teeth (2.46±2.87 vs 0.88±1.61; p<0.0001). Conclusions About seven out of 10 children were affected by cavities in either or both dentitions. It was observed that age was positively associated with dental caries, equally affecting girls and boys. In this sample, the primary dentition was impacted more than the permanent dentition. Despite being preventable, dental caries continues to be a health problem in children.

Core Cariology Curriculum Framework in Spanish for Latin American dental schools: development and consensus

The aim of this study was to develop and achieve consensus on a cariology teaching framework for dental schools in Latin American Spanish-speaking countries. The Delphi process, with a ≥8 0% pre-defined participants' agreement, included three phases and a Coordinating Group. During the Preparation phase three panels of experts were selected and invited to participate: a) Regional academic/professional Dental Associations (Associations-Panel): n = 12; b) Regional Dental Schools (Dental-Schools-Panel): existing dental schools (n = 263) from the 19 Spanish-speaking regional countries; c) International academic/professional associations Peer Experts (Peer-Panel): n = 4. Based on consensus documents from Europe, Colombia, the Caribbean, USA, Chile and Spain, and updated scientific evidence, the Coordinating Group developed a baseline framework proposal of domains, main competencies (MC) and specific competencies (SC). The Consultation-Agreement and Consensus phases included three rounds of questionnaires with a step-wise sharing of the MC updated version of the consensus framework with the Dental-Schools-Panel and including SC with the Associations-Panel. Diverse communication strategies were used ( e.g ., independent google-form questionnaires and workshops). Consensus was reached after an on-site Associations-Panel workshop and secret voting, followed by an online meeting with the Peers-Panel. A total of 127 academic/professional institutions participated (Associations-Panel: 11, 91.6%; Dental-Schools-Panel: 112, 42.6%, all countries; Peers-Panel: 4, 100%). The baseline Cariology teaching framework of 5 domains, 10 MC and 92 SC underwent modifications after agreements for a final consensus framework consisting of 5 domains, 10 MC and 85 SC. A Core Cariology curriculum framework in Spanish for Latin American Dental Schools was successfully developed and agreed upon with regional dental academic and professional institutions.

No genetic causal association between dental caries and Alzheimer's disease: a bidirectional two-sample Mendelian randomization analysis

Background

An increasing number of observational studies have suggested an association between dental caries and Alzheimer's disease (AD). The association between dental caries and Alzheimer's disease may be mediated by confounders or reverse causality. In this study, we conducted bidirectional two-sample Mendelian randomization (MR) to estimate the bidirectional causality between dental caries and AD.

Materials and Methods

Genome-wide association study (GWAS) summary statistics of dental caries were extracted from a published meta-analysis which included a total of 487,823 participants. GWAS datasets of AD and AD onset age were obtained from the FinnGen bank. A bidirectional two-sample analysis was performed to explore the causality between dental caries and AD.

Results

For the dental caries-AD causality estimation, there was no significant association between dental caries and AD, neither with the AD GWASs from the FinnGen database (OR: 1.041, p = 0.874) nor with those from the International Genomics of Alzheimer's Project (OR: 1.162, p = 0.409). In addition, the genetic susceptibility to dental caries was not related to the onset age of AD. No causality existed between dental caries and early-onset AD (OR: 0.515, p = 0.302) or late-onset AD (OR: 1.329, p = 0.347). For the AD-dental caries relationship, no causality was detected by the IVW method (OR: 1.000, p = 0.717). Findings from other MR methods were consistent. The pleiotropy test and sensitivity analysis confirmed the validity of these MR results.

Conclusions

In this bidirectional MR study, robust evidence to support a bidirectional causal effect between dental caries and AD from the GWAS results within large-scale European-descent populations was absent. Having dental caries would not alter the onset age of AD.

Assessing Adherence to Provider's Recommendations in Caries Risk Assessment and Management: A Retrospective Data Review

AIM

To evaluate the distribution of caries risk category of patients at a dental institution and determine adherence to providers' recommendations.

MATERIALS AND METHODS

A cross-sectional retrospective review of 1,235 patients records that included data collection on demographics, the sum of the number of decayed, missing due to caries, and filled teeth in the permanent teeth (DMFT), presence of frequent snacking, stimulated salivary flow rate, stimulated saliva pH, saliva buffering capacity, biofilm activity, caries risk category, anti-caries prescription accept/decline, and change in the caries risk category. Statistical analysis was carried out through Pearson's Chi-squared test and linear model ANOVA with a significance level of 0.05.

RESULTS

Pearson's Chi-squared test showed a statistically significant difference in frequency by risk category (p < 0.001) indicating that patients were skewed toward high and extreme caries risk. Linear model ANOVA showed that higher risk categories were associated with lower salivary flow rates (p = 0.010) and higher biofilm activity (p < 0.001). About, 1 out of 3 patients were reported to have frequent snacking (N = 391, 32%). Frequent snacking patients were more likely to present with higher caries risk assessment (p < 0.001), younger age (p < 0.001), and female (p < 0.001). Despite recommendations from the dental student provider, only 27% accepted the anti-cavity prescriptions while 61% declined the recommendation.

CONCLUSION

Distribution of caries risk category is not evenly distributed, but rather skewed toward high and extreme caries risk levels. Despite the identified risks, there is low adherence to the recommendations provided by healthcare providers. The results underscore the necessity for targeted interventions and initiatives aimed at fostering behavioral changes to enhance oral health outcomes.

CLINICAL SIGNIFICANCE

There is a high need for targeted interventions and initiatives that promote behavioral changes to enhance oral health outcomes.

Evaluation of the clinical impact and In Vitro antibacterial activities of two bioactive restoratives against S. mutans ATCC 25175 in class II carious restorations

Background

Streptococcus mutans is a Gram-positive opportunistic bacterial pathogen and that causes dental caries and then restorative treatment remains the best clinical practice approach to repair and prevent dental caries.

Aims

This study compared the antimicrobial performance of resin modified glass ionomer cement (RM-GIC) and ACTIVA restoratives by evaluating the S. mutans count, pH levels, and plaque index (PI) scores before and on the 7^th day of restoration, and then determined the antimicrobial activities against S. mutans ATCC 25175 in both restoratives in vitro.

Materials and Methods

Seventy-eight eligible Saudi female participants, with class II carious lesions, were randomly distributed into RM-GIC and ACTIVA restorative groups. We evaluated the S. mutans count by the serial dilution technique and salivary pH by using a portable pH meter. The PI scores were determined by Silness-Löe method and the antibacterial activity by the agar well diffusion method. Statistical analysis of normality distribution was performed with the Kolmogorov-Smirnov and the difference between groups was an analysis by paired t-test. In addition, the independent sample was compared with the independent samples t-test.

Results

Both groups reduced the S. mutans count, pH acidity, and PI scores, and this reduction was statistically significant on the 7^th day of restoration (P < 0.05), preference for ACTIVA. The in vitro antibacterial activity against S. mutans ATCC 25175 showed a non-significant difference between both bioactive restorative materials (P < 0.05).

Conclusion

The novel application of ACTIVA restorative material is a promising option for patients at risk of caries.

Associations between Maternal Education and Child Nutrition and Oral Health in an Indigenous Population in Ecuador

The global nutrition transition has increased the prevalence of childhood dental caries. Greater understanding is needed of the impact of social determinants—including maternal education—on child oral health. This is a cross-sectional analysis of a convenience sample of families of 458 indigenous Ecuadorian children aged 6 months through 6 years from 2011−2013. Data was collected by mother interviews and child dental and anthropometric examinations. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between years of maternal education and maternal-child oral health practices and child oral health outcomes. Each additional year of maternal education was significantly (p < 0.05) associated with some healthier practices including greater likelihood of mothers and children drinking milk daily (OR 1.20; 95% CI 1.08, 1.34); and less healthy practices including greater likelihood of bottle-feeding children with sugary liquids (OR 1.14; 95% CI 1.06, 1.22) and to older age, giving children sweets daily, calming children with a bottle or sweets, and less likelihood of helping brush their children’s teeth (OR 0.93; 95% CI 0.88, 0.98). Each year of maternal education had a small but statistically non-significant influence on increasing the odds of children being among those who are cavity-free (OR 1.03; 95% CI 0.92, 1.16). Interventions to improve health outcomes should focus not just on maternal education but also address social and commercial determinants of health through nutrition and oral health education, as well as policies to reduce sugar and ensure universal access to oral health care.

Development and Physicochemical Characterization of Eugenia brejoensis Essential Oil-Doped Dental Adhesives with Antimicrobial Action towards Streptococcus mutans

Dental caries is a multifactorial, biofilm-dependent infectious disease that develops when detrimental changes occur in the oral cavity microenvironment. The antimicrobial and antivirulence properties of the essential oil obtained from the leaves of Eugenia brejoensis Mazine (EBEO) have been reported against Gram-positive and Gram-negative bacteria. Herein, the antimicrobial action of EBEO towards Streptococcus mutans is reported, along with the development and characterization of dental adhesives doped with. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of EBEO were determined against S. mutans, while its toxicity was analyze using Tenebrio molitor larvae. EBEO (MIC and 10×MIC) was incorporated into the Ambar Advanced Polymerization System® (Ambar APS), a two-step total-etch adhesive system (FGM Dental Group), and the antibiofilm action was evaluated. The reflective strength, modulus of elasticity, degree of conversion, and maximum rate of polymerization of each adhesive were also determined. The MIC and MBC values of EBEO against S. mutans were 62.5 µg/mL. The tested concentrations of EBEO were non-toxic to T. molitor larvae. The formation of S. mutans biofilms was significantly inhibited by EBEO and EBEO-coated resin discs (p < 0.05). Importantly, EBEO incorporation did not affect the mechanical and physicochemical properties in relation to oil-free adhesive version. EBEO showed strong antibacterial and antibiofilm activity against S. mutans, no toxicity effect against T. molitor larvae, and did not jeopardize the physical-chemical properties tested.

Caries risk assessment using different Cariogram models. A comparative study about concordance in different populations—Adults and children

This methodological survey aimed to verify whether there is concordance among several Cariogram different risk models at different thresholds, comparing both children and adult populations and how each risk/protective factor weight on the overall caries risk profile. Three groups’ data (two in children and one in adults) were obtained from previous studies, while a fourth, in young adults, was ad hoc enrolled. Different caries risk levels were assessed: a) three risk categories with two different thresholds as: “low risk”  =  61–100% or 81–100% chance to avoid caries, “moderate risk”  =  41–60% or 21–80% and “high risk”  =  0–40% or 0–20%, named model 1 and 2; b) four risk categories with two different thresholds as: “low risk”  =  61–100% or 76–100%, “moderate/low risk” = 41–60% or 51–75%; “moderate/high risk” = 21–40% or 26–50% and “high risk” = 0–20% or 0–25%, model 3 and 4; c) five risk categories as: “very low risk”  =  81–100%; “low risk”  =  61–80% “moderate risk” = 41–60%; “high risk” = 21–40% and “very high risk” = 0–20%, model 5. Concordance of the different Cariogram risk categories among the four groups was calculated using Cohen’s kappa. The weight of the association between all Cariogram models toward the Cariogram risk variables was evaluated by ordinal logistic regression models. Considering Cariogram model 1 and 2, Cohen’s Kappa values ranged from 0.40 (SE = 0.07) for the young adult group to 0.71 (SE = 0.05) for the adult one. Cohen’s Kappa values ranged from 0.14 (SE = 0.03 p<0.01) for the adult group to 0.62 (SE = 0.02) for the two groups of children in models 3 and 4. Statistically significant associations were found for all Cariogram risk variables excepting Fluoride program in models 4 and 5 and the overall risk on children’s samples. Caries experience showed a quite variable weight in the different models in both adult groups. In the regression analyses, adult groups’ convergence was not always achievable since variations in associations between caries risk and different risk variables were narrower compared to other samples. Significant differences in caries risk stratification using different thresholds stands out from data analysis; consequently, risk assessments need to be carefully considered due to the risk of misleadingly choosing preventive and research actions.

Added Sugar and Oral Health: A Position Paper of the Brazilian Academy of Dentistry

Excessive sugar consumption is the main cause of dental caries. Dental caries is highly prevalent and negatively impacts the quality of life at all stages. Furthermore, sugar consumption is associated with other noncommunicable conditions and diseases, such as obesity, diabetes, and cardiovascular diseases. The aim of this paper is to propose recommendations at the individual and population levels for health professionals, families, educators, stakeholders, and public officials to reduce the burden of dental caries and other noncommunicable diseases that are caused by the excessive sugar intake. A systematic search was performed in PubMed and Cochrane databases to investigate the effectiveness of strategies and policies aiming to reduce sugar consumption as well as the impact of different patterns of sugar consumption on the occurrence of dental caries. Reference list of the identified papers and practice guidelines were manually reviewed as well. Based on the best evidence available, the Brazilian Academy of Dentistry recommends not to offer sugars to children younger than 2 years of age, and to limit total sugar consumption to &lt;25 g per day after 2 years of age. Furthermore, families should be informed to limit sugar exposure, sugar-free areas should be available, content of food labels and advertisement should be regulated, taxation of products with sugar should be introduced, and reformulation of foods and drinks to reduce concentrations of sugars should be considered.

New Method of Avoiding Underestimation of Caries Incidence and Its Association with Possible Risk Factors in Japanese University Students: A Prospective Cohort Study

The objective of this three-year prospective cohort study was to investigate the association between a new definition of an increase in dental caries and risk factors in Japanese young adults. Data of Okayama University students who volunteered to undergo oral examinations and answer questionnaires in 2015 and 2018 were analyzed. The status of filled teeth and the status of occlusal/proximal surfaces of filled or decayed teeth were recorded. An increase in dental caries was defined as a change in the status of filled teeth and/or an increase in dental caries of occlusal and proximal surfaces. A total of 393 participants (18.2 ± 0.8 years) were analyzed. First and second molars showed a high prevalence of dental caries. Of the participants, 144 (36.6%) showed an increase in dental caries. In all the participants and in the females, the decayed, missing, and filled teeth (DMFT) score and history of orthodontic treatment at baseline were significantly associated with an increase in dental caries (p < 0.05) in logistic regression analyses. In the males, the DMFT score and the daily frequency of snacking (≥2) at baseline were significantly associated with an increase in dental caries (p = 0.04). The DMFT score and history of orthodontic treatment at baseline can be risk factors for an increase in dental caries using the new definition in young adults.