Caries Activity Research Articles

Successful dental treatment using case for carpule as a distraction technique during local anesthesia: a case report

Dental anxiety is described as a feeling of apprehension followed by some fear that something might happen during dental treatment, and most of the time it is also accompanied by fear. During pediatric dental care, dental anxiety is common and can be controlled through behavioral management of the child, using traditional techniques such as “tell-show-do”, cards, videos, music, imitation, voice control and distraction. Objective: To report a clinical case of a child with Down’s Syndrome and a negative history of previous dental treatment, in which behavioral management was successfuly carried out with the distraction technique, using a case in the carpule syringe. Case report: The guardian of a child 7-year[1]old male patient with Down’s Syndrome and a negative history of previous dental treatment sought for dental treatmant. During the interview, the guardian reported the child’s negative experience due to the drastic use of restraint measures. The clinical examination revealed the presence of biofilm, active caries and an indication for extractions. As the child was resistant to treatment, behavioral management sessions were carried out. Due to the various needs for more invasive procedures, preparation for anesthesia was carried out. For this stage, an alligator-type visual distraction device was used, which acts as a cover for the carpule syringe. After correct management, the child was more receptive to treatment, which was carried out without the need for drastic physical restraint measures. Conclusion: The use of the case to camouflage the carpule proved to be effective as a behavioral management technique in improving the child’s behavior, reducing fear and decreasing anxiety.

Caries Activity Tests and Associated Factors among 3-5-Year-Old Preschool Children in Zhao County, Hebei Province, China.

This study aimed to investigate the caries activity (CA) and its caries status in children aged 3-5 years in Zhao County, Hebei province, China and to explore the related factors. Cariostat caries activity test and oral examination were performed on children aged 3-5 years old in Zhao county, Hebei province by a stratified sampling. A questionnaire survey was used to analyze the CA-related factors and the receiver operating characteristic curve (ROC) was to evaluate the diagnostic value of Cariostat caries activity test in children with early childhood caries (ECC). The caries status among preschool children in Zhao county of Hebei province was serious. The higher the mean dmft of children, the greater the CA value. Mother's educational level and children's diet and lifestyle habits were closely related to CA. The Cariostat caries activity test has good efficacy in diagnosing ECC with high sensitivity and specificity.

DIFFERENCES KNOWLEDGE IN EARLY CHILDHOOD CARIES (ECC) PREVENTION AMONG PRIMIPAROUS AND MULTIPAROUS BREASTFEEDING MOTHERS

Early Childhood Caries is a common dental health issue among children. According to the Basic Health Research of Lampung Province in 2018, the prevalence of active dental caries ranged from 19.6% to 20.67%. Multiparous breastfeeding mothers (> 1 child) tend to have more experience and are likely to possess better knowledge regarding oral health compared to primiparous mothers (1 child). The aim of this study is to analyze the differences in knowledge about Early Childhood Caries prevention between primiparous and multiparous breastfeeding mothers at the Maternal and Child Health Clinic of Satelit Public Health Center Bandar Lampung City. This study is a quantitative cross-sectional study with comparative analytical testing using the Mann-Whitney test. A sample of 100 participants was selected through quota sampling. The participants were interviewed using a questionnaire consisting of 8 questions. The results showed that the average knowledge score for primiparous breastfeeding mothers was 4.09±1.176, while for multiparous breastfeeding mothers, it was 4.79±1.160. Bivariate analysis showed a significant difference p=0.019 in knowledge about Early Childhood Caries prevention between multiparous and primiparous breastfeeding mothers. This study indicates a significant difference in Early Childhood Caries prevention knowledge, with multiparous breastfeeding mothers having greater knowledge compared to primiparous breastfeeding mothers.

Phenotypic Identification of Streptococcus mutans and Attendant Bacteria From Dentin Caries and Necrotic Pulp, and Its Correlation with Caries Activities Tests

Abstract Background: Dental caries is a worldwide disease, which can affect all ages and sexes. The dominant bacteria and the first colonizer in dental plaque are Streptococcus mutans due to its adhesion to the hard surface, metabolizing of sugar, and forming tooth cavity if not treated will reach the root pulp, producing necrotic pulp. Objectives: The current study was designed to detect S. mutans and attendant bacteria in the oral cavity of patients with two types of caries (dentin caries and necrotic pulp), and its relation with MDFT score and Alban test. Materials and Methods: Two samples were collected from every 150 patients including one from dentin caries and the other from necrotic pulp, who have attended the Dental Teaching Hospital at the University of Mosul, in Mosul, Iraq with ages ranging between 6 and 76 years, and both sexes, from the beginning of March 2022 to the end of October 2022. Results: VITEK 2 compact system used to identify of S. mutans at a high number of 39 (32.5%) in dentin caries while Enterococcus faecalis gave a high number of 43 (35.8%) in necrotic pulp in addition to other different bacterial species were identified as Streptococcus sanguinis, Streptococcus gordonii, Streptococcus anginosus, Lactococcus acidophilus, Staphylococcus aureus, Actinomycus spp., Staphylococcus hominis, Enterococcus faecium, Lactococcus lactis, Lactococcus garvieae, Lactococcus raffinolactis, Kocuria rosea, Pediococcus acidilactici, Pediococcus pentosaceus, and the fungal Candida albicans. The sex had no significant correlation with other factors, while age had a significant effect at P < 0.05 level and pH of saliva had a significant effect at P < 0.01 with DMFT and lactobacillus count. The DMFT had a significant effect at P < 0.01 level with pH of saliva and count of S. mutans and Lactobacillus count at P < 0.05. Conclusions: The current study concluded that the cariogenic bacteria S. mutans was the most prevalent in dentin caries (carious lesion), and E. faecalis was the most prevalent in necrotic pulp by using VITEK 2 compact system, and the caries activities tests show pH of saliva had a significant effect with DMFT and lactobacilli colonies count and Streptococci colonies count.

Rinse aid with bischofite: prevention of caries and gingivitis in adolescents

The frequency of using liquid complementary hygiene products has been increasing significantly in recent years. This trend is typical not only for adults, but also for children. The ease of use of rinses, foams, suspensions largely contributes to the growth of their popularity. As substances having a complex effect, researchers have long been interested in mineral complexes, among which calciumand magnesium-containing compounds are of particular importance [2, 3]. Such natural minerals as carnalite, kieserite, and bischofite are of particular interest. The effectiveness of the anti-carious, anti-plaque and anti-inflammatory effects of preventive drugs was evaluated: irrigator liquid + mouthwash WATERDENT Anti-caries and baby foam for the oral cavity WATERDENT Happy Smile during the rehabilitation period in children with permanent bite. Materials and methods. An open comparative study of the effectiveness of the use of liquid for the irrigator + mouthwash WATERDENT «Anticaries» and baby foam for the oral cavity WATERDENT Happy Smile was conducted. To assess the effectiveness of the hygiene products used, the following clinical indicators were selected: the caries intensity index (KPI), the Green – Vermillion simplified index (IG-U), the PMA index and the Mulleman – Cowell index. Clinical parameters were determined before and after the use of the compared hygiene products in groups after 1 month. During the study, laboratory saliva parameters were monitored: saliva pH, total protein, determination of saliva Ca and Md. 3 groups of participants were recruited from among those who applied for help at the UMMU dental clinic. All volunteers were somatically healthy children aged 12–18 years with different caries activity and catarrhal gingivitis, randomly distributed by gender and age. Statistical data processing was carried out in Microsoft Excel and Statist programs. Results. The evaluation of clinical tests in the groups showed a significant change in the indices of PMA and Grinn – Vermilion (р ≤0,05) in patients of the main group and a statistically significant improvement in the index of Grinn – Vermilion (р ≤ 0,05) in patients using foam (comparison group), while in the control group there were no dynamics of statistically significant changes in clinical indicators. An increase in the level of calcium in saliva in patients who used Irrigator Liquid + mouthwash WATERDENT Anti-caries from 2.30 to 2.95 characterizes the high mineralizing potential of bischofite, which is part of its composition, and its karyoprophylactic property. An assessment of laboratory data in the main and comparison groups at the beginning of the experiment and after 1 month showed a significant change in total protein values from 2.94 to 2.26 and 2.72 to 2.09 g/l, respectively, for these groups (p <0.05), which shows the positive effect of these products on hygiene, on changes in saliva properties and karyoprophylactic potential. Conclusions. Clinical and laboratory studies of the use of Liquid for irrigator + rinse WATERDENT Anti-caries and baby Foam for the oral cavity Waterdent Happy Smile confirm the claimed consumer properties of these products: anti-carious, anti-plaque and anti-inflammatory effects and can be recommended in comprehensive individual hygienic oral care for children.

Diet Quality and Physical Activity and Their Association with BMI and Dental Caries Among High School Adolescents: A Cross-Sectional Study.

Objectives: The aim of this study was to assess diet quality and its association with obesity and dental caries. It also assessed adolescents' physical activity (PA) level and its relationship with obesity. Methods: This cross-sectional study examined 300 high school adolescents. Body mass indices (BMI) were calculated after taking participants' heights and weights. Caries activity was recorded as decayed, missed, and filled scores (DMFT). Diet quality was assessed using the KIDMED questionnaire, and four additional questions were added to assess junk food consumption. PA was assessed using PAQ-A. KIDMED, junk food, and PA scores were calculated. Statistical analyses included Kruskal-Wallis and Wilcoxon Rank Sum tests for group comparisons. A Generalized Linear Model (GLM) was utilized to assess predictors of BMI percentile. Results: The KIDMED score was 3.0 ± 2.5, with 57.7% of participants classified as having very poor diet quality and 39% categorized as needing improvement. The majority of the participants had low PA levels (81.3%), with only 18% reporting moderate PA. No associations were observed between KIDMED scores, junk food consumption with BMI percentile, DMFT, or number of decayed teeth. Children with "very poor" KIDMED scores had a BMI percentile of 58.7 ± 33.9, while those with "needs improvement" and "optimal" diets had percentiles of 60.0 ± 30.0 and 65.1 ± 35.7, respectively. Higher PA levels were associated with better diet quality (p-value <0.001). The regression analysis, controlling for age, sex, DMFT, KIDMED, junk food consumption, and PA score did not identify any predictors of BMI percentile. Conclusions: Participants consumed poor quality diets and engaged in minimal PA. No associations could be concluded between diet and PA with either BMI or dental caries. Further research is needed to better understand these relationships.

The prevalence of dental caries in children with iron deficiency anemia in the Karaganda Region

Aim of the study. To assess the prevalence of caries in children with iron deficiency anemia.Materials and methods. A study was conducted on 1500 children and adolescents in 3 areas of the Karaganda region, of which 54% suffer from IDA. Study examined children and adolescents aged 3 to 17 years, who were classified into three age categories: preschool children (3-6 years), primary school age (7-11 years), and high school age (12-17 years). The analysis was aimed at identifying the connection between iron deficiency anemia and the prevalence of caries among children and adolescents in the Karaganda region. To achieve this goal, statistical methods were applied, including correlation analysis and analysis of variance, considering age groups and regional characteristics.Results and discussion. All study participants examined showed a direct connection between the degree of iron deficiency anemia (IDA) and the prevalence of caries, amounting to 67.98%, which is a significant correlation. This effect is especially noticeable among children aged 7 to 11 years. It was also found that with an increase in the severity of iron deficiency anemia, an increase in the number of cases of decompensated caries is observed.Conclusions. Children and adolescents with iron deficiency anemia (IDA) exhibit higher rates of caries activity. In severe iron deficiency anemia, there is a high prevalence of caries, which indicates a significant impact of iron deficiency on dental health. Such figures indicate the importance of timely diagnosis and treatment of iron deficiency anemia to improve overall health and prevent possible complications in the form of oral diseases, including caries.

Asynchronous teledentistry program in two long-term care facilities: Iowa's virtual dental home pilot project.

Older adults living in long-term care facilities (LTCFs) often have poor oral health and difficulty accessing dental services. The aim was to implement a virtual dental home (VDH) program for residents in two LTCFs utilizing asynchronous teledentistry techniques and mobile dental equipment. This pilot project was a 6-month longitudinal cohort study in two LTCFs. Dental hygienists and dentists from a local community health care center utilized asynchronous teledentistry to provide diagnostic and preventive dental services onsite and to establish a dental home for additional comprehensive care services. Data were collected, including resident's demographics, oral health status, and dental services received. Descriptive data analyses, Wilcoxon signed rank, and McNemar tests were conducted. Thirty-four residents completed in-person baseline oral exams and 16 residents completed the recall exams. Ninety-two percent (n=23) of dentate residents (n=25) had untreated caries and 64% (n=16) of dentate residents had at least one sextant of severe gingival inflammation. The median number of teeth with active untreated caries (p=.01) significantly decreased and arrested caries (p=.02) significantly increased from baseline. Iowa's VDH pilot project was successful in establishing a dental home using asynchronous teledentistry for residents in two LTCFs and providing resident access to preventive and disease control dental services.

Validity assessment of a third-generation light-induced fluorescence device in detecting proximal and occlusal caries lesions: A cross-sectional study

ObjectivesThe objective of this study was to evaluate the efficacy of a quantitative light-induced fluorescence (QLF) device (QrayCam Pro, AIOBIO, Seoul, Republic of Korea) in detecting and differentiating the severity of posterior proximal and occlusal primary caries. Materials and methodsThe study included a total of 120 teeth in 60 patients (of both genders, aged between 21 and 38 years) between January and March 2024, one carious tooth and one sound tooth were selected at random in each patient. All occlusal surfaces were evaluated in accordance with the International Caries Detection and Assessment System (ICDAS) Nyvad Criteria, using the visual tactile method. The ICDAS employs a scoring system ranging from 0 to 6, while the Nyvad Criteria employs a similar scoring system. Addionally, the depth of the proximal lesions was scored (0–6) using bite-wing radiography. The quantitative values representing the maximum loss of fluorescence (∆Fmax) and the maximum change in the ratio of red and green fluorescence (∆Rmax) were obtained using the Q-ray Clinical software v 1.45. To assess the validity, the sensitivity, specificity, and area under the receiver operating characteristics curve (AUROC) were calculated. Spearman correlation coefficient was used to investigate the correlation between the findings of the traditional and QLF examination methods. ResultsThe AUROC values for both ∆Fmax and ∆Rmax were found to be excellent. The sensitivity of QrayCam Pro was found to be 84–88.6%, while the specificity was 100%. The correlation analysis demonstrated a strong correlation between scores obtained from the traditional examination and the QLF values. ConclusionsBased on the findings of this study, QrayCam Pro exhibits potential as a valuable additional tool for not only detecting caries but also for assessing their severity and activity. Clinical relevanceThis study revealed that QrayCam Pro might be suggested as a precise tool for enhancing caries detection and assessment compared to traditional methods. By providing quantitative data on caries severity and activity, it enables more informed treatment decisions, potentially optimizing outcomes for patients.

Tactile sensation in relation to roughness and reflection of active initial lesions in primary (deciduous) and permanent dentition in vitro

ObjectivesThis study evaluated whether a relationship exist between tactile sensation, roughness and reflection intensity in active enamel lesions of primary (deciduous) and permanent dentition. MethodsFreshly extracted teeth of the primary (n=29) and permanent (n=60) dentition of patients who underwent serial extractions under general anesthesia due to multiple deep caries lesions showing active lesions (International Caries Detection and Assessment System scores of 2) were selected. The mean linear (Ra), area-related (Sa), volume-related (Vmc) roughness and vertical reflection intensity (VRI) of sound (S) and carious (C) areas were determined by using a 3D-laser-scanning-microscope and a multi-sensor microscope with two different chromatic-confocal optics. Furthermore, two blinded examiners evaluated the roughness by tactile examination using three different explorers (S23H,405CP11, S3C). ResultsMean differences (95%CI) between S and C for teeth of the primary dentition were: Ra:-1.9(-2.3;-0.4)µm, Sa:-31.8(-1.8;0.0)µm, Vmc:-1.8(-1.6;-0.0)ml/m2, VRI:29(20;43) and for teeth of the permanent dentition: Ra:-4.0(-2.5;-1.0)µm, Sa:-4.8(-3.0;-1.1)µm, Vmc:-4.6(-3.4;-0.5)ml/m2, VRI:34(19;44) differing significantly between S and C (p<0.05,Wilcoxon test). No significant difference was observed between 1st and 2nd dentition (p>0.05, Kruskal-Wallis test) as well as commercial and experimental optic (p>0.05). The highest positive predictive value (PPV) was achieved by examiner 1 with explorer S3C (1st dentition 67%;2nd dentition 100%;pooled dentition 88%)), while examiner 2 revealed the highest PPV with explorer S23H (89%;86%;88%). ConclusionDifferences in roughness and reflectance between sound and caries-active enamel surfaces could be evaluated in both primary and permanent dentition. These differences could also be reliably detected using three different explorers with good validity. However, the most predictive explorer seems to differ between examiners. Clinical SignificanceIn both primary (deciduous) and permanent dentition active caries lesions exhibit significantly higher roughness and lower vertical reflection intensity compared with sound enamel. These differences are detectable by blind tactile examination and objective methods such as 3D-laser-scanning or multi-sensor microscopy, highlighting their utility in caries diagnosis in both dentitions.

Quantitative assessment of early caries lesion activity using novel dye-enhanced fluorescence imaging

ObjectivesThis study aimed to evaluate the validity of the dye-enhanced quantitative light-induced fluorescence (DEQLF) method for assessing early enamel caries activity. MethodsSeventy extracted human teeth with early enamel caries on smooth surfaces were included. Two dentists evaluated the caries activity using the Nyvad system followed by the DEQLF method. The teeth were hydrated with distilled water for 60 s, dehydrated with compressed air for 10 s, and stained with 100 μM fluorescein sodium solution for 10 s. White and fluorescent images were captured using a QLF-D 2+ Billuminator. The change in fluorescence (ΔΔG) was calculated using image analysis software. Independent-sample t-tests were performed to evaluate the difference in ΔΔG between active and inactive lesions for both DEQLF and conventional quantitative light-induced fluorescence (QLF) methods. Receiver operating characteristic (ROC) curve analysis was used to assess the validity of ΔΔG for distinguishing lesion activity using the area under the ROC curve (AUROC). ResultsAmong the 70 caries lesions, 33 were active and 37 were inactive. Using the DEQLF method, the ΔΔG for active lesions (3.8 ± 5.6) was significantly higher than that for inactive lesions (1.0 ± 2.5) (P < 0.05). With the conventional QLF method, there was no significant difference in ΔΔG between active (-1.1 ± 1.7) and inactive (-1.3 ± 1.7) lesions. DEQLF-derived ΔΔG demonstrated an AUROC of 0.72, a sensitivity of 0.67, and a specificity of 0.76. ConclusionsApplying the DEQLF method to human teeth enabled the quantitative assessment of lesion activity based on dye penetration. DEQLF-derived ΔΔG values showed significant differences based on lesion activity status and demonstrated high validity in distinguishing lesion activity. Clinical significanceClinicians can use the DEQLF method, which involves applying a fluorescent dye for 10 s prior to conventional QLF, to objectively quantify and distinguish the activity status of early enamel caries, potentially replacing the traditional reliance on subjective visual assessments.

Study on the association between malnutrition, early childhood caries and caries activity among children aged 3–5 years

BackgroundThis study aims to investigate the association between malnutrition and early childhood caries (ECC) and caries activity among children aged 3–5 years, in order to provide a theoretical basis for preventing and blocking ECC and improving malnutrition.MethodsChildren aged 3–5 years from six kindergartens in Zhao Xian, China were enrolled in this study. The decayed, missing, filled teeth (dmft) of all children were examined and recorded. The Cariostat method was used to detect dental caries activity, collect anthropometric data and measure haemoglobin concentration. Parents were asked to complete a questionnaire on the general characteristics and oral health behaviour of the participants. The “Growth Standards for Chinese Children Under 7 Years Old” was used to assess the nutritional status of all participating children. Wilcoxon rank sum test and multivariate logistic regression analysis were used to analyse and evaluate the relationship between ECC, caries activity and malnutrition.ResultsA total of 635 children who met the criteria were included in this study. After adjusting for confounding factors, logistic regression showed that the risk of ECC was significantly increased in underweight children compared with normal children (OR = 5.43, P < 0. 05); compared with normal children, the risk of ECC decreased in overweight and obese children (OR = 0.31, P < 0.001); underweight children had higher caries severity than normal weight children, and the difference was statistically significant (OR = 2.69, P < 0. 05); stunted children had higher caries severity than normal weight children and the difference was statistically significant (OR = 2.28, P < 0.05); underweight was positively associated with caries activity and the association was statistically significant (OR = 2.33, P < 0. 05); stunting was positively associated with caries activity and the association was statistically significant (OR = 2.1, P < 0.05); overweight and obesity were negatively associated with caries activity and the association was statistically significant (OR = 0.61, P < 0.05).ConclusionsThe risk of ECC among children aged 3–5 years was positively associated with undernutrition and negatively associated with overnutrition. The severity of ECC among children aged 3–5 years was positively associated with undernutrition. The caries activity among children aged 3–5 years was positively associated with undernutrition and negatively associated with overnutrition.

The level of dental fear and anxiety is higher in children with both severe Molar-Incisor Hypomineralisation and active dental caries lesions compared to children without these conditions

PurposeTo assess levels of dental fear and anxiety (DFA) in children with and without Molar-Incisor Hypomineralisation (MIH) and dental caries lesions.MethodsIn this cross-sectional observational study, 159 children between 8 and 12 years of age were included. For the evaluation of DFA, children responded to the validated version of the Children’s Fear Survey Schedule-Dental Subscale. MIH was assessed using the MIH Index. To evaluate the activity of dental caries lesions and dental caries experience, the Nyvad criterion and the dmft/DMFT index were used, respectively. Dental hypersensitivity was evaluated using air stimulation and a Visual Analogue Scale. The association between MIH and dental caries with DFA was assessed using the generalised linear model with Poisson family, identity link function and robust variance estimation. The significance level was set at 5%.ResultsThe mean DFA score was 28.3 (SD = 13.4) with scores ranging from 15 to 64. Amongst children presenting both MIH and dental caries, the perception of DFA was notably higher compared to those with either MIH or dental caries alone. The activity of caries lesion in patients with MIH also influenced DFA levels (diff: 18.6; 95% CI: 12.0–25.2; p < 0.001). Dental caries experience in the primary dentition also demonstrated statistical significance concerning DFA (95% CI: 0.8–13.3; p value = 0.027).ConclusionChildren with MIH exhibit higher levels of DFA than children without MIH. The experience of dental caries and the activity of caries lesions significantly influence the perception of DFA in children with MIH.

Caries lesions progression in adults: A prospective 2-year cohort study.

Dental caries is one of the most prevalent chronic non-communicable diseases worldwide. There is a lack of evidence, especially in adult populations, documenting caries disease progression considering lesion severity, activity and tooth surface-level characteristics. The study aimed to investigate the extent to which primary active caries lesions in adults affect caries lesions progression compared with inactive caries lesions over a 2-year follow-up period, considering their severity, surface and tooth type. A prospective study data set from a cohort of workers in a factory in Belarus were used. Participants aged 18-64 years with 20 or more natural teeth were included in the study. The participants were clinically examined twice within an interval of 2 years and completed a self-reported questionnaire. One calibrated examiner evaluated caries lesions using the International Caries Detection and Assessment System (ICDAS) and the Nyvad system. The primary outcome was caries lesions' progression. The lesion was classified as 'progressed' if it turned to a more advanced severity stage, was restored or missing/extracted due to caries. A multilevel Poisson regression was used to estimate the association between baseline caries lesions' characteristics and caries lesion progression. Out of 495 participants, 322 people completed clinical examinations at baseline and 2 years later, with an attrition rate of 35%. The prevalence of active DS1-6 and DS5-6 lesions at the baseline was 83.8% and 64.8%, respectively. In 2 years, 24% of active non-cavitated and 31% of active micro-cavitated/shadowed caries lesions progressed, while 15% of inactive caries lesions, non- or micro-cavitated/shadowed, progressed. The adjusted rate ratio (RR) for ICDAS3 + 4 caries lesions progression was 1.41 (CI 95% 1.16, 1.70) than ICDAS1 + 2 lesions. The RR for ICDAS1 + 2, active and ICDAS3 + 4, active lesions was 1.78 (CI 95%, 1.40, 2.27) and 1.97 (CI 95%, 1.53, 2.55), respectively than ICDAS1 + 2, inactive lesions. The RR for caries lesions progression on proximal surfaces and on pits and fissures was 1.57 (CI 95%, 1.30, 1.89) and 1.37 (CI 95%, 1.11, 1.67), respectively than smooth surface lesions. In caries active adults over 2 years, most non- and micro-cavitated/shadowed active and inactive caries lesions did not progress. Among caries lesions that showed progression, more severe lesions were more likely to progress than less severe lesions; active lesions were more likely to progress than inactive lesions. Pit and fissure caries lesions and proximal lesions were more likely to progress than smooth surface lesions.

A randomised clinical trial to arrest caries using silver diamine fluoride therapy with two postoperative instructions

ObjectiveThe objective of this study is to investigate the beneficial effect of not rinsing for 30 min in arresting early childhood caries after SDF therapy. MethodsThis randomised clinical trial recruited 3- to 4-year-old kindergarten children with active (soft) dentine caries. A questionnaire was sent to the parents to collect children's demographic data and oral health-related behaviours. A dentist conducted an oral examination and measured the caries experience using dmft index and oral hygiene using visible plaque index. After 38 % SDF therapy, the children were randomly allocated into two groups. Children in group A were instructed to rinse with water immediately, whereas children in group B were asked to refrain from rinsing, drinking, or eating for 30 min. After six months, the same examiner determined the lesion activity (active/arrest) of the SDF-treated carious tooth surface. Generalized Estimating Equations was used to compare the proportion of caries arrest (caries-arrest rate) between the two groups. ResultsThis study recruited 298 children with 1,158 decayed tooth surfaces receiving SDF therapy at baseline and evaluated 275 (92 %) children with 1,069 (92 %) SDF-treated tooth-surface at the six-month examination. The demographic background, oral hygiene and caries status of two groups were comparable at baseline (p > 0.05). The caries-arrest rate for group A and group B were 65 % (337/519) and 61 % (338/550), respectively (p = 0.28). ConclusionThis randomised clinical trial found not rinsing for 30 min after SDF therapy is not better than immediate rinsing in arresting early childhood caries. Clinical significanceTopical SDF application leaves an unpleasant taste in the mouth, which may affect the acceptance or even rejection of SDF therapy among young children. This study provides clinicians with information to make their decision on postoperative instruction after SDF therapy.

Relationship of dietary nutrients with early childhood caries and caries activity among children aged 3–5 years—a cross-sectional study

BackgroundEarly childhood caries (ECC) is a challenge for pediatric dentists all over the world, and dietary factor is an important factor affecting the occurrence of ECC. Currently, there is limited research on the impact of dietary nutrient intake from Chinese diets on ECC. The purpose of this study is to explore the correlation of dietary nutrients intake with ECC and caries activity (CA) among children aged 3–5 years, and to provide dietary guidance to slow down the occurrence and development of ECC.MethodsA cross-sectional study was conducted in 2022. A total of 155 children were divided into three groups: caries-free group, ECC group and Severe early childhood caries (SECC) group according to the caries statues. And according to the caries activity test (CAT) value, they were also divided into three group: low CA group (L-CA), middle CA group (M-CA) and high CA group (H-CA). The 24-hour dietary intake information was collected by mobile phone application (APP). The intake of children’s daily dietary nutrients were calculated referring to “China Food Composition Tables”.ResultsIn this study, 17, 39,and 99 children were diagnosed with caries-free, ECC, and SECC. There were 33, 36, and 86 children diagnosed with L-CA, M-CA, and H-CA. The risk of ECC was increased with the intake of cholesterol(OR = 1.005) and magnesium (OR = 1.026) and decreased with the intake of iron (OR = 0.770). The risk of SECC was increased with the intake of cholesterol (OR = 1.003). The risk of high CA was increased with the intake of cholesterol (OR = 1.002). The combined application of dietary total calories, carbohydrate, cholesterol, sodium, magnesium and selenium in the diagnosis of ECC had an area under ROC curve of 0.741.ConclusionsThe increased dietary cholesterol intake may be a common risk factor for ECC and high CA in children aged 3–5. The combined application of dietary intake of total calories, carbohydrate, cholesterol, sodium, magnesium and selenium has a higher predictive value for the occurrence of ECC.

EVALUATING THE EFFICACY OF 38% SDF VS 5% NAF VS APF GEL IN ARRESTING DENTAL CARIES AND REDUCING BACTERIAL ACTIVITY: AN IN-VIVO STUDY

Background: The study was formulated to compare the efficacy of 38% SDF as a caries arresting agent as well as antibacterial and antiplaque agent in vivo with 5% sodium fluoride varnish (NaF) and 1.23% acidulated phosphate fluoride (APF) gel. Study Design: Total of 74 children aged 6-9 years (boys = 34, girls = 40) who had active caries with dmfs/DMFS score equal to or more than 1 were included in the study for a period of 12 months. Children were divided into three different groups-Group 1: 38%SDF Group 2: 5% fluoride varnish and Group 3: 1.23% APF gel. Fluoride application was done at baseline, 6th month and 12th month. Saliva collection was done at baseline, after 72 hrs, 6th month and12thmonth.Tryptone-yeastcysteine-sucrose-bacitracin agar (TYCSB) was used inoculate salivary Streptococcus mutans and incubated at 37°C for 72 hrs.The colony characteristics were studied and number of colony forming units of Streptococcus mutans (CFU/ml) of saliva were counted using digital colony counter.All subjects were evaluated for caries arrest status and plaque score (Silness&amp;Loe index)at 6th and 12thmonthas well as Streptococcus mutans counts in saliva at 72 h, 6th and 12thmonth. Results: Significant reduction was found in caries arrest status plaque score as well as S. mutans counts in Group 1 as compared with Groups 2 and 3. Conclusion: In vivo application of SDF is effective in controlling progression of caries, decreases plaque score and S. mutans counts in saliva as compared to fluoride varnish and APF gel.

Effects of personalized oral hygiene management on oral health status of pregnant women.

The Cariostat caries activity test (CAT) was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral health status of pregnant women. To investigate whether personalized oral hygiene management enhances the oral health status of pregnant women. A total of 114 pregnant women who were examined at Dalian Women's and Children's Medical Center were divided into four groups: High-risk experimental group (n = 29; CAT score ≥ 2; received personalized oral hygiene management training), low-risk experimental group (n = 29; CAT score ≤ 1; received oral health education), high-risk control group (n = 28; CAT score ≥ 2), and low-risk control group (n = 28; CAT score ≤ 1). No hygiene intervention was provided to control groups. CAT scores at different times were compared using independent samples t-test and least significant difference t-test. No significant difference in baseline CAT scores was observed between the experimental and control groups, either in the high-risk or low-risk groups. CAT scores were reduced significantly after 3 (1.74 ± 0.47 vs 2.50 ± 0.38, P < 0.0001) and 6 months (0.53 ± 0.50 vs 2.45 ± 0.42, P < 0.0001) of personalized oral hygiene management intervention but not after oral health education alone (0.43 ± 0.39 vs 0.46 ± 0.33, P > 0.05 and 0.45 ± 0.36 vs 0.57 ± 0.32, P > 0.05, respectively). Within groups, the decrease in CAT scores was significant (2.43 ± 0.44 vs 1.74 ± 0.47 vs 0.53 ± 0.50, P < 0.0001) for only the high-risk experimental group. Personalized oral hygiene management is effective in improving the oral health of pregnant women and can improve pregnancy outcomes and the oral health of the general population.

Effectiveness of Fluoride Varnishes for White Spot Lesion Prevention and Remineralization during Orthodontic Treatment: A Randomized Controlled Trial.

This study investigated the effectiveness of titanium tetrafluoride (TiF4) varnish compared to sodium fluoride (NaF) varnish for preventing and remineralizing white spot lesions (WSLs) in individuals undergoing orthodontic treatment. This randomized, placebo-controlled, and double-blinded study was conducted with sixty-five adolescents who were selected based on caries activity and then randomized into three parallel groups: G1 (placebo varnish), G2 (5%-NaF varnish) and G3 (4%-TiF4 varnish). Volunteers received varnish application weekly for the first 4 weeks, after 6 (T1) and 12 (T2) months. The measured outcomes included: prevention of new WSLs, and reversal/progression of WSLs, assessed by Nyvad and ICDAS indices, as well as quantitative light-induced fluorescence (QLF). Chi-square, ANOVA, and Kruskall-Wallis tests were applied. The level of significance was set at 0.05, and post hoc Bonferroni test for p values were performed to correct for multiple comparisons. 1,274 teeth were included; 70.5% were Nyvad 0, and 29.5% were Nyvad 1, with no differences between the groups at baseline (T0). Regarding ICDAS, 70.5% were ICDAS 0, 21.6% were ICDAS 1, and 7.9% were ICDAS 2. G1 showed an increasing prevalence of WSLs at T1 and maintained stable at T2; G2 exhibited a decline at T2, while G3 experienced a decrease at T1 and T2 (p &lt; 0.01). Incidence of WSLs at T2 was 10.2% (G1), 5.6% (G2) and 1.4% (G3). The percentage of teeth initially scored as Nyvad 0 that progressed to Nyvad 1 was 13%, 6.8%, and 1% for G1, G2, and G3, respectively. Conversely, the percentage of teeth initially scored as Nyvad 1 that regressed to Nyvad 0 or Nyvad 2 (T0-T2) was 14%, 49.3%, and 74.4%, respectively (p &lt; 0.001). As for ICDAS index, regression was observed in 6.5%, 17.8% and 24%, while progression was observed in 14.9%, 7.7% and 0.9% for G1, G2 and G3, respectively (p &lt; 0.001). Significant differences among the 3 groups for integrated fluorescence loss (mean±SD, G1: -14.28±9.47, G2: -11.10±11.49 and G3: -6.77±11.00) were found at T2 (p &lt; 0.01). Both varnishes demonstrated the ability to prevent and remineralize WSLs. However, TiF4 varnish exhibited the most effective control over WSLs during the 12-month orthodontic treatment.

Analyzing the Salivary Antioxidant Capacity in Children before and after Dental Caries Restoration: A Comparative Scientific Investigation

Aim: The purpose of this study is to examine the total antioxidant capacity (TAC) as a biomarker to investigate oxidative stress in different pathological conditions. The primary goal is to compare the TAC levels in saliva before and after the restoration of carious teeth. Additionally, the study aims to explore potential differences in TAC between genders with the intention of establishing a possible link between salivary TAC and dental caries. Materials and Methods: In this research, we employed a random selection process to assemble two cohorts: Group I, comprising 27 male individuals, and Group II, encompassing 27 females, all falling within the age bracket of 7 to 10 years. Saliva samples were procured from each participant both thirty days prior to and subsequent to the restorative dental intervention. To gauge the levels of total antioxidant capacity (TAC), we employed Cayman’s antioxidant assay kit and quantified the outcomes employing a nanodrop instrument. Results: The obtained data was subjected to statistical analysis using SPSS version 18.0. The paired t-test was used to compare the TAC levels before and after the restorative procedure within each group (Group I and Group II). The results revealed that after restoration, both Group I and Group II showed a significant increase in TAC levels compared to before restoration (P = 0.000). Additionally, the Student t-test was employed to compare the TAC levels between Group I (males) and Group II (females). Interestingly, the study observed that the TAC of saliva was significantly higher in males compared to females, both before and after the restoration of carious teeth. Conclusion: Our research demonstrated reduced TAC levels in areas affected by dental caries, and these levels exhibited a significant rise following the restoration of all carious teeth. Consequently, it can be deduced that the evaluation of caries activity and the effectiveness of its treatment can be facilitated through the assessment of salivary factors, which holds promise for applications in preventive dentistry. Clinical Significance: TAC can be employed as a biomarker and a therapeutic target because a reduced TAC level before restoration is a sign of infection.