Caries Assessment Research Articles

The effectiveness of integrating role play into case-based learning in dental education: enhancing critical thinking and teamwork skills

BackgroundModern dental education necessitates dynamic methodologies to foster critical thinking and teamwork skills, which might include case-based learning (CBL) and role play (RP).ObjectivesTo evaluate the impact of the combined CBL and RP (CBL-RP) approaches on critical thinking and teamwork skills among dental students by comparing pre- and post-RP evaluation scores.MethodsThis pre-post intervention study was conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. The study involved all 193 third-year dental students, who were organized into groups of 7–9 members to participate in four CBL sessions. Each CBL session consisted of a detailed case scenario, a pre-RP presentation preparation, a CBL-RP session facilitated by a trained instructor, and a post-RP presentation. Case scenarios included demographic data, chief complaints, medical and dental histories, social history, clinical images, radiographs, caries assessment, periodontal charts, and questions targeting specific intended learning outcomes and social factors impacting oral health. Students’ performances were evaluated pre- and post-RP using a standardized rubric focused on critical thinking and teamwork, with outcomes assessed through individual and collective scores. Outcomes were analysed using paired samples t-tests and repeated measures ANOVA.ResultsThe study revealed significant improvements in total scores, combining critical thinking and teamwork, from pre- to post-RP evaluations across four sessions. Mean scores consistently increased post-RP (P < 0.001 for all sessions). Session scores, calculated as the averages of pre- and post-RP evaluations, showed a progressive increase from session 1 to session 4, indicating significant overall improvement (F = 16.8, P < 0.001). Pairwise comparisons identified session 4 as having significantly higher scores than the earlier sessions. Both teamwork and critical thinking scores showed significant increases from pre- to post-RP evaluations in each session (P < 0.001), with an upward trend in mean scores across sessions.ConclusionThis interventional study demonstrates the effectiveness of integrating RP into CBL sessions in enhancing critical thinking and teamwork skills among dental students. This integration supports the efficacy of active learning and integrated educational strategies in engaging students and enhancing clinical learning outcomes.

A REVIEW OF CONTEMPORARY METHODS FOR CARIES RISK ASSESSMENT

Introduction. Modern dentistry offers various risk assessment tools, such as CAMBRA, Cariogram, and the ADA Risk Assessment Tool. These tools help dentists create personalized treatment plans. However, their effectiveness is still debated. Materials and Methods. An electronic search was conducted using the Cochrane Library, PubMed, and Scopus databases without any regional or temporal restrictions. The following keywords were used: CAMBRA, Cariogram, ADA Risk Assessment Tool, caries risk assessment, ECAT. This comprehensive search strategy ensured a broad and unbiased collection of relevant studies. Results. Quantitative methods include CAMBRA (Caries Management by Risk Assessment), Cariogram, the ADA Risk Assessment Tool, OHIS (Oral Health Impact Profile), and ECAT (Early Childhood Caries Assessment Tool). Qualitative methods, on the other hand, rely on clinical examination, saliva analysis, and genetic testing. Discussion. The key similarities among the aforementioned methods are evident. First, all of these methods employ a comprehensive approach, considering multiple factors that contribute to caries risk, such as oral hygiene, diet, dental history, saliva composition, fluoride exposure, and other relevant risk factors. Second, each method supports an individualized approach, allowing for the development of personalized treatment and prevention plans based on the patient's specific risk profile. Finally, all of these methods are designed to identify patients at high risk for caries, facilitating early intervention and preventive measures. Conclusion. Contemporary quantitative methods for assessing caries risk, such as CAMBRA, the ADA Risk Assessment Tool, Cariogram, and ECAT, prove to be effective in evaluating individual risks for tooth decay. Each method has its strengths and limitations, and the optimal choice for a particular dental practice may depend on factors like the dentist’s preferences, available resources, and patient demographics.

Oral Health of 7- to 9-Year-Old Children Born Prematurely-A Case-Control Observational Study with Randomized Case Selection.

Background: Along with the long-term sequelae of preterm birth for general health, oral health is potentially influenced by prematurity due to developmental and behavioral peculiarities. Objectives: This study aimed to compare oral health parameters in the mixed dentition of prematurely and full-term born children. Methods: Dental caries, developmental defects of enamel (DDE), and gingival inflammation were assessed in 7-to-9-year-old children (n = 38) born preterm (PT) compared to a matched control group born full-term (FT) in Germany. Dental caries was recorded using the International Caries Detection and Assessment System (ICDAS II) and DMFT/dmft-criteria. DDE was scored with modified DDE-Index and periodontal health by Periodontal Screening Index (PSI). Statistical analysis included McNemar's test and Poisson regression. The significance level was p ≤ 0.05. Results: Caries prevalence was 47.4% in PT and 57.9% in FT. In the primary dentition, FT children were significantly more affected than PT children (1.6 dmft vs. 2.7 dmft; p = 0.035). PT children with extremely low birthweight (ELBW) had the highest caries experience (3.2 dmft; 1.0 DMFT). Prevalence of DDE in primary teeth was significantly higher in PT (55.3%) than in FT children (28.9%; p = 0.008). PSI was 3.8 in PT and 3.3 in FT children, but significantly higher in PT children with ELBW (7.4; p = 0.125). Conclusions: PT children are at higher risk for DDE in primary teeth and compromised periodontal health than FT children. Children with ELBW are most susceptible for dental caries and gingivitis.

Multiancestry Genome-Wide Association Study of Early Childhood Caries.

Early childhood caries (ECC) is the most common noncommunicable childhood disease-an important health problem with known environmental and social/behavioral influences lacking consensus genetic risk loci. To address this knowledge gap, we conducted a genome-wide association study of ECC in a multiancestry population of U.S. preschool-age children (N = 6,103) ages 3 to 5 y participating in a community-based epidemiologic study of early childhood oral health. Calibrated examiners used International Caries Detection and Assessment System criteria to measure ECC; the primary trait was the number of primary tooth surfaces with caries experience (i.e., dmfs index). We estimated heritability and concordance rates and conducted genome-wide association analyses to estimate overall genetic effects as well as stratified by sex, household water fluoride, and dietary sugar and leveraged combined gene/gene-environment effects using 2-degree-of-freedom joint tests. Common genetic variants explained 24% of ECC phenotypic variance among unrelated individuals, while concordance rates were 0.64 (95% confidence interval [CI] = 0.42-0.79) among monozygotic twins and 0.44 (95% CI = 0.34-0.53) among first-degree relatives. Across all analyses, we identified 21 novel nonoverlapping genome-wide significant loci (P < 5 × 10-8) and 1 genome-wide significant gene (TAAR6) associated with ECC. The taste receptor activity gene set, with known roles in chemosensing, bacterial recognition, and innate immunity in the oral cavity, was strongly associated with ECC. While no locus remained significant after studywise multiple-testing correction, 3 loci were nominally significant (P < 0.05) and directionally consistent in external cohorts of 285,248 adults (rs1442369, DLGAP1 and rs74606067, RP11-856F16.2) and 18,994 children (rs71327750, SLC41A3). Meanwhile, the strongest marker known to be associated with adult caries (rs1122171, tagging the long noncoding RNA PITX1-AS1) was nominally significant (P = 0.01) and directionally consistent with ECC in our study. Taken together, the results of this study add to the genomics knowledge base for early childhood caries, offer several plausible candidates for future mechanistic studies, and underscore the importance of accounting for sex and pertinent environmental exposures in genetic investigations.

Near-infrared light transillumination (NIR-LT) vs clinical-visual inspection/FOTI to detect interproximal caries lesions in vivo.

To evaluate the ability of near-infrared light transillumination (NIR-LT) to detect interproximal enamel and dentinal caries lesions compared to clinical-visual inspection aided by fiber-optic transillumination (FOTI). From 170 Finnish adolescents aged 15 to 17 years, 5,294 interproximal surfaces of premolars and molars were examined first clinical-visually aided by FOTI (VI&#43;FOTI) using the International Caries Detection and Assessment System (ICDAS) classification. Subsequently, the surfaces were examined using NIR-LT. The extent of lesions was determined using the modified NIR-LT classification based on the Söchtig criteria. For the analyses, data on maxillary and mandibular premolars and molars were combined. Distributions of lesions were presented as frequencies. Differences between VI&#43;FOTI and NIR-LT at the tooth and tooth surface levels were analyzed by chi-square and Fisher exact tests. Sensitivity and specificity of the NIR-LT method to detect any lesion was performed using VI&#43;FOTI as the gold standard. By VI&#43;FOTI, 92.4% surfaces were classified as sound and by NIR-LT, 88.2%. Enamel caries lesions were found on 7.0% of the surfaces by VI&#43;FOTI and on 11.6% by NIR-LT. Nearly double the number of enamel lesions were identified by NIR-LT for all examined teeth groups, except for mandibular molars where this was 1.3-fold. In 66% of the surfaces, the differences between NIR-LT and VI&#43;FOTI findings were statistically significant (P .001). The sensitivity for all teeth of NIR-LT was 48.4% and the specificity was 91.1%. Radiation-free NIR-LT method shows considerable potential as a supplementary method for early detection of caries lesions among low-caries prevalence adolescents.

Training protocol and calibration of the International Caries Detection and Assessment System in a school-based clinical trial of elementary school-age children.

This paper demonstrates International Caries Detection and Assessment System (ICDAS) training procedures and inter/intra-examiner reliability for lesion severity, activity, and filling criteria in an elementary school setting. ICDAS training was conducted in December 2021 prior to a school-based cluster-randomized controlled trial. A total of 59 children (6-8 years old) in grades 1-2 from one school in Houston, Texas were recruited. Two licensed dentists received a 5-day training from an ICDAS trainer at the participating school. Thirty-eight children were evaluated at least once by each dental trainee, and 18 had repeat examinations. The ICDAS criteria were used to classify dental caries lesion severity (0-6), lesion activity (active/inactive), and filling material (0-9) of all visually available primary and permanent tooth surfaces. Inter and intra-examiner reliability between each dental trainee and the "gold standard" trainer was evaluated using Kappa statistics. For lesion severity, the examination indicated an inter-rater weighted Kappa of 0.77 (95% CI 0.71-0.82) and 0.82 (95% CI 0.77-0.87) for each trainee examiner compared to the gold standard examiner. The Kappas increased slightly from the first to second examinations (lesion-weighted Kappa: 0.76 to 0.84 and 0.82 to 0.84). The intra-rater reliability indicated excellent reliability for lesion and filling (0.83 to 0.94) and moderate for activity (0.58). ICDAS training/calibration were essential to ensure accuracy and reliability of dental caries measurements. The study demonstrated that ICDAS training of dentists with no prior criteria experience is feasible in a community setting and can lead to high reliability and repeatability.

Phone-Based Parental Support Program for Caries Prevention in Children: A Randomized Controlled Trial.

Children referred for comprehensive dental care under general anesthesia, due to severe early childhood caries, have a high risk of continued caries progression in posttreatment years. To assess the effect of a phone-delivered, motivational interviewing-based parental support program on caries recurrence and oral health habits in preschool children treated under general anesthesia for severe early childhood caries. The prospective design of this 2-arm randomized clinical trial (allocation ratio 1:1; blinded outcome assessment) comprised 151 patients from pediatric dental departments in the Stockholm region of Sweden. Inclusion criteria were healthy children aged <6 y with early childhood caries who were scheduled for treatment under general anesthesia. Control group parents received standard advice on toothbrushing and sugar reduction. Intervention group parents received planned phone counseling with an oral health coach every other week for 1 y, based on motivational interviewing principles, offered in Arabic, English, Polish, Turkish, and Swedish. The primary outcome was caries progression 1 and 2 y postsurgery, assessed using the International Caries Detection and Assessment System. Secondary outcomes were parent-reported daily toothbrushing and dietary habits. Sixty-five percent of the control group and 77% of the intervention group experienced caries relapse on at least 1 new surface after 1 y (nonsignificant). At the 2-y follow-up, relapse rates were 53% (control group) and 71% (intervention group; P < 0.05) compared with baseline. The intervention group was significantly less likely to engage in adverse oral health behaviors such as snacking on sweets (intervention group, 10%; control group 33%) and sweet drinks (intervention group 9%; control group, 29%) after 1 y. No group differences in daily fluoride toothpaste brushing occurred. The motivational interviewing-based parental support program improved dietary habits but showed no effect on caries recurrence in children treated under general anesthesia for early childhood caries.ClinicalTrials.gov NCT02487043. The findings of this study can assist clinicians, public health leaders, and researchers in tailoring preventative behavior-focused programs for early childhood caries. These results may improve the understanding of how behavioral interventions that involve parents of young children affect caries prevention, highlighting approaches that are less likely to be effective and guiding future efforts toward more promising strategies for high-risk populations.

Photoactivated rose bengal-doped TiO2 nanoparticles modified fifth-generation adhesive on the survival rate of Streptococcus mutants and mechanical properties of tooth-colored restorative material to carious dentin.

Assessment of the antimicrobial, micro tensile bond strength (μTBS), and degree of conversion (DC) of fifth-generation adhesive modified using photoactivated 0.5% rose bengal (RB) and photoactivated RB-doped titanium dioxide nanoparticles (TiO2NPs) in different concentrations (2% and 5%) as compared with the unmodified adhesive bonded to the carious affected dentin (CAD). Forty mandibular molars with caries progression up to the middle third of the dentin, as per the International Caries Detection and Assessment System (ICDAS) score of 4 and 5 were included. Specimens were divided into four groups based on etch and rinse adhesive (ERA) modification group 1: unmodified ERA, group 2: photoactivated 0.5% RB photosensitizer (PS) modified ERA, group 3: photoactivated RB-doped 2 wt% TiO2NPs adhesive, group 4: photoactivated RB-doped 5 wt% TiO2NPs adhesive. Followed by adhesive and composite restoration on the CAD surface. All the specimens were thermocycled and an assessment of μTBS and failure pattern analysis was performed. The antibacterial potency of RB and RB-doped TiO2NPs (2% and 5%) followed by their activation using visible light against Streptococcus mutans (S.mutans) were tested. The survival rate of S.mutans was assessed using the Kruskal-Wallis test. The analysis of μTBS involved the use of ANOVA, followed by a post-hoc Tukey honestly significant difference (HSD) multiple comparisons test. Group 1 (Unmodified ERA) (0.52 ± 0.31 CFU/mL) treated samples unveiled the highest means of bacterial survival and lowest μTBS (11.32 ± 0.63 MPa). Nevertheless, group 4: photoactivated RB-doped 5 wt% TiO2NPs adhesive displayed the lowest outcomes of S.mutans survival (0.11 ± 0.02 CFU/mL) and highest bond strength (18.76 ± 1.45 MPa). The photoactivated RB-doped 2 wt% TiO2NPs in adhesive demonstrated promising enhancements in both μTBS and antibacterial efficacy against S.mutans. However, it is noteworthy that this modification led to a decrease in the DC of the adhesive. RESEARCH HIGHLIGHTS: Unmodified ERA-treated samples unveiled the highest bacterial survival and the lowest μTBS. Photoactivated RB-doped 5 wt% TiO2NPs adhesive displayed the lowest S.mutans survival rate and highest bond strength. DC decreased with an increase in concentration of TiO2.

A Randomized Controlled Trial Evaluating the Clinical Performance of Bioactive Restorative Material and Resin-modified Glass Ionomer Cement in Carious Primary Molar Restorations.

To evaluate the clinical performance (marginal discoloration, surface texture, and retention) of bioactive restorative material (ACTIVA) and resin-modified glass ionomer cement (RMGIC) in carious primary molar restorations at 6 and 12-month intervals. The split-mouth randomized controlled trial comprised 31 children aged 5-8 years having contralateral matched pair of carious primary molars with an International Caries Detection and Assessment System (ICDAS) II score 5. Sixty-two teeth were randomly allocated into two groups: group I-ACTIVA (n = 31) and group II-RMGIC (n = 31). After caries excavation, the teeth were restored with the respective materials and evaluated the marginal discoloration, surface texture, and retention after 6 and 12 months using modified USPHS (United States Public Health Service) criteria under the dental operating microscope. Mann-Whitney "U" test was used for intragroup comparison and the Wilcoxon signed-rank test for intergroup comparison. A statistically significant difference was found in the surface texture of ACTIVA and RMGIC restorations at both 6-month (p = 0.002) and 12-month (p = 0.001) intervals, whereas the difference in the marginal discoloration and retention were not significant at both 6-month (p = 0.267 and 0.161, respectively) and 12-month intervals (p = 0.339 and 0.064, respectively). The surface texture of ACTIVA is found to be superior to RMGIC, whereas marginal discoloration and retention are similar to RMGIC at both 6 and 12-month intervals. ACTIVA bioactive restorative material and RMGIC both enhance tooth remineralization with improved adhesion and fluoride release properties, making them valuable choices in various clinical scenarios. Bhavana K, Uloopi K, Vinay C, et al. A Randomized Controlled Trial Evaluating the Clinical Performance of Bioactive Restorative Material and Resin-modified Glass Ionomer Cement in Carious Primary Molar Restorations. Int J Clin Pediatr Dent 2024;17(10):1109-1113.

Use of artificial intelligence to detect dental caries on intraoral photos.

Dental caries is one of the most common diseases globally and affects children and adults living in poverty who have limited access to dental care the most. Left unexamined and untreated in the early stages, treatments for late-stage and severe caries are costly and unaffordable for socioeconomically disadvantaged families. If detected early, caries can be reversed to avoid more severe outcomes and a tremendous financial burden on the dental care system. Building upon a dataset of 50,179 intraoral tooth photos taken by various modalities, including smartphones and intraoral cameras, this study developed a multi-stage deep learning-based pipeline of AI algorithms that localize individual teeth and classify each tooth into several classes of caries. This study initially assigned International Caries Detection and Assessment System (ICDAS) scores to each tooth and subsequently grouped caries into two levels: Level-1 for white spots (ICDAS 1 and 2) and level-2 for cavitated lesions (ICDAS 3-6). The system's performance was assessed across a broad spectrum of anterior andposterior teeth photographs. For anterior teeth, 89.78% sensitivity and 91.67% specificity for level-1 (white spots) and 97.06% sensitivity and 99.79% specificity for level-2 (cavitated lesions) were achieved, respectively. For the more challenging posterior teeth due to the higher variability in the location of white spots, 90.25% sensitivity and 86.96% specificity for level-1 and 95.8% sensitivity and 94.12% specificity for level-2 were achieved, respectively. The performance of the developed AI algorithms shows potential as a cost-effective tool for early caries detection in non-clinical settings.

Combination of Silver Diamine Fluoride and Hall Technique for Caries Management in Primary Molars: A Randomized Controlled Trial.

Combination of different noninvasive caries arresting approaches may improve the effectiveness and success rate of individual procedures for caries management. The purpose of this study was to evaluate clinical and radiographic success rate of a combination of 38% silver diamine fluoride (SDF) application and Hall technique (HT) for the management of dentinal caries in primary molars and compare it with conventional stainless steel crown (SSC) restoration. Children aged 4-8 years, having carious primary molars with the International Caries Detection and Assessment System (ICDAS) score of 5 or 6, were randomly assigned to treatment group A or B. Treatment group A (n = 25) received 38% SDF application and Hall crown, while group B (n = 25) received conventional SSC restoration. Follow-up was done at 1 month, 3, 6, 12, 24, and 30 months intervals. There was one case of major failure in group A (93.5% successful) while no case of major failure in group B (100% successful) and the difference was not statistically significant (p > 0.05). For minor failure (loss of SSC), the success rate was 91.3% in group B and 84.2% in group A, wherein the difference was not statistically significant (p > 0.05). Conservative management of dentinal carious lesions with SDF and HT showed a similar success rate as compared to conventional operative procedures. This protocol can help reduce the clinical chair time and the need for deep sedation/general anesthesia in young children suffering from deep carious lesions with reversible pulpitis. CTRI/2020/07/026877, Clinical Trial Registry-India. Mittal M, Chopra R, Kumar A, et al. Combination of Silver Diamine Fluoride and Hall Technique for Caries Management in Primary Molars: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(10):1114-1120.

Analysis of the intensity of carious infection of teeth in children permanently living in conditions of a pollated ecosystem.

Aim: Assessment of dental caries and its impact on the level of dental health of children aged 15-18 years of Upper Tysa region, who constantly live in conditions of combined negative effects of factors of natural and technological genesis. Materials and Methods: During the dental examination, the incidence of dental caries in 360 children aged 15-18 years from various biogeochemical zones of the cross-border region of the Upper Tysa region was studied and assessed using the International Caries Detection and Assessment System - ICDAS II (International Caries Detection and Assessment System). Results: It was found that the use of physiologically suboptimal drinking water from decentralized water resources is among the environmental determinants of the state of dental health of children in the Upper Potyssia. In lowland children in Hungary and Slovakia, caries was observed more often on the chewing surfaces than on the proximal ones (46/42; 64/54), and in Ukraine and Romania, on the contrary, the prevalence of the carious process was observed on the proximal surfaces (71/98; 70/ 94). This may be related to longer exposure to factors. In conclusion, the analysis of the ICDAS II indicator among children of the cross-border region of the Upper Tysa region indicates certain features that underlie the state of dental health in different regions, including climate-geographic zones and special biogeochemical provinces. Conclusions: The obtained data can be used both to forecast the dynamics of dental morbidity in children living in these regions, and to develop differentiated tactics of treatment and preventive measures.

Assessment of Refractive Errors, Dental Caries, and Scoliosis in School Children Aged 6-14 Years: A Study in Durrës Schools

This study aims to assess the prevalence of refractive errors, dental caries, and scoliosis in children aged 6-14 years across several primary and secondary schools in the city of Durrës. The sample includes 370 students from "Vincenc Prendushi", "Nënë Tereza", "Vasil Ziu", "Abedin Dino", and "Bajram Curri" schools. Each school was selected randomly. From each school we have selected different classes and students for further evaluation. Each student underwent a clinical examination to evaluate vision, oral health, and postural status. Refractive errors were assessed using Snellen chart table placed in 6 meters. Dental caries was evaluated through clinical inspection of the teeth, using the DMFT index (Decayed, Missing, and Filled Teeth). Scoliosis was diagnosed through physical examination and the Adams forward bend test, done in physiotherapy lab of Aleksander Moisiu University. The results provide insight into the risk factors and the need for early interventions to improve the overall health of children in this age group. Out of the 370 students, 28% (104 students) were found to have refractive errors, with myopia being the most common condition, affecting 17% (63 students), followed by hyperopia in 9% (33 students), and astigmatism in 2% (8 students). A total of 42% (155 students) exhibited signs of dental caries, with an average DMFT score of 2.8, indicating a moderate level of oral health concerns. Additionally, 12% (45 students) were diagnosed with scoliosis, with mild curvature observed in 8% (30 students) and moderate to severe curvature in 4% (15 students). These findings suggest a significant need for vision correction, oral health education, and orthopedic monitoring in the student population. Early detection and preventive measures in schools are crucial to addressing these health issues effectively and ensuring the well-being of children during their developmental years.

Importance of the application of the International Caries Detection and Assessment System (ICDAS) in modern dentistry

Importance of the application of the International Caries Detection and Assessment System (ICDAS) in modern dentistry

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.

Problematic screen exposure and oral health in preschool children: a comparison study

ObjectivesRecent studies have highlighted the association between problematic screen exposure (PSE) in preschool children and various health issues. This study aims to determine the relationship between PSE and oral/dental health as well as parafunctional oral habits in this population.MethodsHealthy children aged 3 to 6 years who visited the pediatric dentistry outpatient clinic were included in the study. PSE was evaluated using the parent-reported ‘Seven-in-Seven-Screen-Exposure Questionnaire’. An intraoral examination was conducted to record the number of decated, missing, and filled teeth, along with scores from the International Caries Detection and Assessment System II (ICDAS II), as well as dental plaque and gingival indices.ResultsA total of 210 mother–child pairs were included in the study, comprising 70 pairs with PSE and 140 pairs without PSE. The sociodemographic characteristics, frequency of daily tooth brushing behaviors, use of children's toothpaste, and regular dental examinations were statistically evaluated between the PSE and non-PSE group (p > 0.05). Additionally, there was no statistically significant difference between the groups in terms of having abnormal oral habits (p > 0.05). In the PSE group, the median scores for gingival and plaque index were significantly higher (p = 0.011 and p = 0.006, respectively). The median number of decayed teeth was significantly higher in the PSE group (p = 0.039).ConclusionsTurkish preschool children with PSE were found to have a significantly higher likelihood of experiencing poor oral health. Consequently, it is essential to conduct oral health examinations for Turkish preschool children exhibiting PSE. The study may have clinical implications for the evaluation of preschool children with problematic media use within dental practice.

The Correlation Between Odontogenic Infection and Total Spectrum of Dental Caries with Oral Health Related Quality of Life in Children with Intellectual Disabilities.

: Children with Intellectual Disabilities (ID) have a higher rate of untreated caries and often progress to caries with pulpal involvement or odontogenic infections. This can be assessed using the Caries Assessment Spectrum and Treatment (CAST) index and the Pulp Ulcer Fistula Abscess (PUFA) index. Dental problems often have an impact on quality of life, so Oral Health-Related Quality of Life (OHRQoL) assessment is needed for ID children. To identify and analyze the correlation between odontogenic infection, the total spectrum of caries, and OHRQoL in ID children. : The subjects of the research were 70 ID children who attended Special Needs Schools (SNS) Type D of the Foundation for the Development of Disabled Children (FDDC). This research uses an analytical survey using questionnaires and interviews to assess OHRQoL. The sampling technique, namely Total Sampling, obtained 43 ID child subjects who met the inclusion criteria. The data were tested statistically using the Spearman Correlation non-parametric test and the t-test. : The average value of odontogenic infection in the population was 1.79, including in the poor category, and the total spectrum of dental caries was 51.16%, including severe morbidity. Multivariate analysis showed a significant correlation between odontogenic infection, total spectrum of caries, and OHRQoL; odontogenic infection with total dental caries spectrum was significantly associated with each p-value = 0.0000, while the correlation between OHRQoL and both odontogenic infection and total caries spectrum had p-values > 0.05, respectively, so it is considered not significant. : Odontogenic infection in ID children is a poor category. The total spectrum of dental caries in ID children mostly includes severe morbidity. There is a correlation between odontogenic infections, the total spectrum of dental caries, and OHRQoL, as well as between odontogenic infections and the total spectrum of dental caries.

Assessment of Severity and Pattern of Early Childhood Caries Using ICDAS II Criteria: A Descriptive Cross-sectional Study

Introduction: Early childhood caries is highly prevalent worldwide. The International Caries Detection and Assessment System incorporates both the non-cavitated and cavitated carious lesions with acceptable reliability. The objective of the present study was to assess the severity and pattern of early childhood caries among children visiting outpatient department of a dental college in Nepal. The study also aimed to compare the severity and pattern based on individual tooth type. Methods: A cross-sectional study was conducted among children of age group 24-71 months in primary dentition stage. The International Caries Detection and Assessment System II criteria was used to detect dental caries, and its severity and pattern. The ethical approval was taken from the institutional ethical committee (IRC Ref. No.: 1, 36, 2079/2080 IRC PDCH 2022 21).Results: The dental cries in children of age group 48-60 months was 1338 (33.46%) and dentinal caries (Code 5) was observed in 112 (8.37%). Multi-surface caries was 644 (16.15%), and occlusal surface caries was 481 (12.06%). Among the study population, 227 (5.69%) of the teeth assessed were associated with restoration and sealants. Enamel caries among the maxillary second molars (55/65) (Code 3) was in 94 (23.5%), and the dentinal caries (Code 5) in maxillary central incisors (51/61)was in 90 (22.78%). Conclusions: Majority of the children enrolled in the study had multiple cavitated and non-cavitated carious teeth involving different surfaces. Severity and pattern of caries also varied among individual tooth type.

Arresting Active Carious Lesions Using Minimal Intervention Dentistry among a Group of Preschool Children: A Randomized Controlled Clinical Trial.

This clinical trial investigated the effectiveness of three minimal intervention dentistry protocols in arresting dentin caries in primary molars of preschool children. Treatment time, anxiety in children, adverse events, and parents' esthetic perception were all assessed. One hundred thirty-five 3-5-year-old children with active dentin caries lesions on the occlusal surface of primary molars were randomly allocated to the control group receiving atraumatic restorative treatment (ART) and two test groups receiving 38% silver diamine fluoride (SDF) or ultraconservative treatment (UCT). The existence and activity of caries were assessed using the International Caries Detection and Assessment System II (ICDAS II) criteria. Children were followed up at 3, 6, and 12 months. The time required to perform the treatments was recorded, and a facial image scale (FIS) was applied to assess anxiety. Questions posed to caregivers were used to investigate adverse events and esthetic assessment. After a year, the overall success rates of UCT, SDF, and ART were 61.6, 87.2, and 84.6%, respectively, with a statistically significant difference (p < 0.05). The time required to treat with SDF was significantly lower than that needed for ART and UCT (p < 0.01). Anxiety levels were significantly lower in the SDF group (p = 0.003). There was no difference in the percentage of adverse events and parental esthetic perception (p = 0.604). After 3 months, the arrest rates of ART, SDF, and UCT were similar. However, after 1 year, the arrest rate of UCT was significantly lower. Silver diamine fluoride takes significantly less chair time and has success rates comparable to ART. Ultraconservative treatment has a short-term successful application. It was confirmed that there were no variations in adverse events between SDF, ART, and UCT. NCT05314660. Hamza BE, Attia NM, Abdellatif AM, et al. Arresting Active Carious Lesions Using Minimal Intervention Dentistry among a Group of Preschool Children: A Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent 2024;17(9):1018-1024.

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.