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Effectiveness of various methods of educating children and adolescents for the maintenance of oral health: A systematic review of randomized controlled trials.

School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children. This systematic review (SR) aimed to assess the effectiveness of different methods of oral health education in children and adolescents. Systematic search was conducted in PubMed, Cochrane, Web of Science, LILACS, Scopus, and EMBASE on January 29, 2023. Review included only randomized controlled trials (RCTs), and their risk of bias (ROB) was assessed by Cochrane RoB-2. Data were extracted and analyzed by expert group. The GRADE approach was used to assess the quality of evidence for each outcome. Every step was conducted in duplicate, and disagreements were resolved by consulting the third reviewer. The SR included 10 RCTs with majority showing a high ROB. They included 12 methods with the commonest being the use of leaflets/flash cards. Most interventions were effective in improving oral hygiene, gingival health, and knowledge except conventional teaching methods, lecture by using PowerPoint by dentists, and e-learning interventions. The grade of evidence in the majority of outcomes was found to be low or very low. Interventions using the interactive methods such as games, motivational-experiential learning, and audiovisual methods were found to be more effective than controls and other interventions. Variabilities in study methods and outcome variables must be addressed in the future.

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In vitro caries-preventive effect of a mineralization-promoting peptide combined with fluoride gel on sound primary teeth.

Mineralization-promoting peptide-3 (MPP3) is a new biomimetic remineralization agent. To assess the remineralization efficiency of MPP3, either alone or in combination with fluoride gel. The samples were divided into four groups: control, 1.23% fluoride gel, 10% MPP3 gel, and 1.23% fluoride gel + 10% MPP3. Following the application of remineralization agents (4 min), the samples remained in a pH-cycling model (37°C, 4 weeks). Microhardness, microcomputed tomography (micro-CT), polarized light microscopy (PLM), and field emission scanning electron microscopy (FE-SEM) analysis were conducted. RM-ANOVA, one-way ANOVA, and intraclass correlation coefficient (ICC) were used for statistical analysis, and a significance level of p < .05 was employed. Mineralization-promoting peptide 3 and fluoride gel + MPP3 increased the microhardness of the enamel compared with initial values in each group (p < .05). Mineralization-promoting peptide 3 successfully maintained the mineral density of enamel, although the cariogenic pH-cycling and PLM results indicated that the lesion depth (μm) was significantly lower in the fluoride gel + MPP3 group (27.0336 ± 12.53650) than in the control group (37.3907 ± 12.76002, p < .05). The combined use of MPP3 with fluoride gel enhanced the caries-protective and mineralization-promoting effects of fluoride. Mineralization-promoting peptide 3 may be a potential agent that can be employed to improve the physical properties of enamel.

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Dental caries and associated factors in 7-, 12- and 15-year-old schoolchildren in the canton of Basel-Landschaft, Switzerland: Changes in caries experience from 1992 to 2021.

Epidemiological surveys in schoolchildren are used to assess the current status of oral health. To investigate the changes in caries experience among schoolchildren in the canton of Basel-Landschaft, Switzerland, over a period of three decades. Secondary objectives were to evaluate the impact of various personal and demographic factors such as age group, place of residence or dental hygiene awareness on caries prevalence as well as the history of orthodontic treatment in the year 2021. A random sampling of school classes from first, sixth and ninth grades, that is schoolchildren aged 7, 12 and 15 years, was performed. Children's dmft and DMFT scores were determined according to the WHO methodology while information on oral hygiene habits and dental prophylaxis awareness was collected by means of a questionnaire directed to the legal guardians of the children. Individual logistic regressions were performed to identify possible influencing factors for caries. A total of 1357 schoolchildren could be included in the study. In the year 2021, the youngest age group had an average of 0.68 primary teeth that needed treatment, whereas the 12- and 15-year-olds each had approximately 0.3 permanent teeth requiring treatment. While these numbers remained constant over the examination period of three decades, most of the other caries indices improved. Younger children (p = .001) and children with a migrant background (p < .001) were found to be risk groups. Orthodontic treatment was more frequent in females, schoolchildren of Swiss nationality and children attending higher secondary schools at ninth grade. This study demonstrated that even in a country with a low prevalence of caries experience, untreated carious lesions remain a problem as their prevalence remained unchanged over the examination period of three decades.

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The Turkish version of Caries Impacts and Experiences Questionnaire for Children: Translation, reliability, and validity.

Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) has been developed to assess the oral health-related quality of life (OHRQoL) associated with caries. This study aimed to evaluate the validity and reliability of the CARIES-QC in the Turkish-speaking population following its translation and adaptation into Turkish (CARIES-QC/T). Two hundred and fifty children between the ages of 5 and 16 years who have active dental caries were included in the study and answered the Turkish-translated and cross-culturally adapted final version of CARIES-QC/T. Test-retest reliability and internal consistency were used to examine the reliability of the CARIES-QC/T. Factor structure of CARIES-QC/T was analyzed using exploratory factor analysis (EFA), and convergent validity was determined. Cronbach's alpha and McDonald's ômega values were 0.907 and 0.908, respectively. For the CARIES-QC/T scale, the intraclass correlation coefficient (ICC) value was 0.933, and polychoric correlations ranged from 0.390 to 0.794. The convergent validity of the items revealed a statistically significant correlation with the global question (rs  = 0.821, p < .001). The EFA results of CARIES-QC/T suggested a one-factor solution and explained 59.7% of the total variance. The findings provided supporting evidence that the CARIES-QC/T could be used as a tool for measuring OHRQoL in healthy Turkish-speaking children aged 5-16 years with active caries.

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Referral from well-child care clinics to dental clinics leads to earlier initiation of preventive dental visits: A quasi-experimental study.

An ealy first preventive dental visit for children is recommended no later than twelve months. However, still many children have their first dentsl visit relatively late. To evaluate whether active or passive referral by a well-child care (WCC) physician of babies for a first preventive dental visit leads to earlier initiation of dental care. From WCC clinics in two Dutch regions, 629 parents of babies participated. Parents received an active referral from a WCC physician for a dental visit for their babies (n = 204) or received care as usual (CAU) (n = 136) in one region and a passive referral (n = 143) or CAU (n = 146) in the other region. Active referral involved parents receiving a scheduled appointment at the dental practice, and passive referral involved parents making an appointment themselves. During the WCC visit, parents completed a baseline questionnaire. At age 2.5 years, parents received a follow-up questionnaire about dental attendance. Of the active referral intervention group, 59.3% had their first preventive dental visit in their first year compared with 3.7% in the CAU group (p < .001); for the passive referral group, 46.9% compared with 9.6% (p < .001). Referral of babies by WCC for their first preventive dental visit leads to earlier initiation of dental care. An active referral had a larger effect than passive referral.

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Effect of photobiomodulation on the efficacy of anesthesia in maxillary permanent molar teeth with molar incisor hypomineralization: A randomized clinical trial.

Difficulty in anesthetizing teeth that have been diagnosed with molar incisor hypomineralization (MIH) is a frequently reported clinical problem. The effects of low-level laser application (photobiomodulation) on the efficacy of anesthesia during the dental treatment of patients with MIH have not yet been studied. To assess the effects of photobiomodulation therapy (PBMT) on the efficacy of anesthesia in maxillary permanent molar teeth with MIH. This prospective, parallel-arm control, randomized, triple-blind clinical trial included children aged 7-12 years. Maxillary permanent first molar teeth with MIH that required pulpotomy treatment were included. Seventy participants were randomly divided into two groups: experimental (with PBMT) and control (placebo). In the experimental group, before the administration of local infiltration anesthesia, PBMT (diode laser: 940 nm; continuous mode; 0.5 W; 78 J/cm2 ) was applied to the oral mucosa for 60 s each. In the control group, the laser probe was channeled toward the mucosa but was not activated. Pain scores were evaluated during the access cavity preparation of the pulpotomy treatment (when using the dentin cutting handpiece and while entering into the pulp) using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Additional anesthesia requirements were assessed in both groups. The data obtained were analyzed for statistical significance (p < .05). The chi-squared test was used to determine the effect of PBMT on categorical outcomes. The no-pain scores of the experimental group were higher than those of the control group (29% vs. 20%). Moderate-to-high pain was more frequent in the control group than in the experimental group (43% vs. 20%). While 31% of the experimental group required supplemental anesthesia, 49% of the control group required supplemental anesthesia during pulpotomy of the tooth with MIH. No statistical difference, however, was found between the two groups in terms of pain scores and the need for supplemental anesthesia (p = .235, p = .143). Anesthesia with and without PBMT caused no difference in pain during the treatment of maxillary molar teeth with MIH.

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Caregiver-reported dental manifestations in individuals with genetic neurodevelopmental disorders.

Children with neurodevelopmental disorders (NDDs) often have poor oral health and dental abnormalities. An increasing number of genes have been associated with neurodevelopmental conditions affecting the oral cavity, but the specific dental features associated with many genes remain unknown. To report the types and frequencies of dental manifestations in children with neurodevelopmental conditions of known genetic cause. A 30-question survey assesing ectodermal and dental features was administered through Simons Searchlight, with which formed a recontactable cohort of individuals with genetic NDDs often associated with autism spectrum disorder (ASD). Data were collected from a largely paediatric population with 620 affected individuals across 39 genetic conditions and 145 unaffected siblings without NDDs for comparison. Drooling, difficulty accessing dental care, late primary teeth eruption, abnormal primary and permanent teeth formation, misshapen nails, and hair loss were more frequent in individuals with NDDs. Additionally, we evidenced an association between three new pathogenic gene variant/oral manifestation pairs: CSNK2A1/unusual primary teeth, DYRK1A/late primary teeth eruption, and PPP2R5D/sialorrhea. Our results demonstrate that genetic NDDs caused by mutations in CSNK2A1, DYRK1A, and PP2R5D are associated with unique dental manifestations, and knowledge of these features can be helpful to personalize dental care.

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