Caries Control Research Articles

Public measures to reduce the consumption of added sugars and their impact on the occurrence of oral diseases: an integrative literature review

The consumption of added sugars has increased globally, influencing the high prevalence of chronic non-communicable diseases (NCDs), including oral diseases such as tooth decay and periodontitis, highlighting the need for effective public policies to control the consumption of sugary products. This work aimed to identify whether external public interventions to reduce the consumption of sugary products impact the occurrence of chronic oral diseases, being an integrative literature review. The electronic search was carried out in the SciELO, Cochrane and PubMed databases, using the English descriptors “sugar sweetened drink”, “sugar, public health” and “oral health” and their Portuguese counterparts. The application of taxes on sugary products, especially drinks, was the most investigated public measure, showing a positive effect on caries control. However, more studies are needed to draw concrete conclusions about its effectiveness in preventing and controlling periodontitis. Although taxation is effective for cavities, public policies that facilitate access to a healthy diet for the vulnerable population

Serum vitamin D level and female teenage caries experience: a cross-sectional study in Iran

Aims: This study aimed to assess Serum Vitamin D level and female teenage caries experience. Methods: This study evaluated 330 healthy female Iranian students between 13 to 19 years residing in Rey city. A questionnaire collected their demographic information. They underwent clinical dental examination to determine the number of decayed (D), missing (M) and filled (F) teeth (DMFT index). The nutritional status was evaluated using the food frequency questionnaire(FFQ) by assessing the consumption of cariostatic, cariogenic, remineralizing, sticky foods and carbohydrates. The serum samples were collected to measure the serum vitamin D level using high-performance liquid chromatography(HPLC). Data were analyzed by multiple logistic regression and independent samples t-test. Results: The mean DMFT was 5.34±3.94. Of all, 69.3% had severe vitamin D deficiency, 20.3% had moderate vitamin D deficiency and 10.4% had normal level of vitamin D. Cariostatic agents consumption had a significant inverse correlation with DMFT (P=0.006). An increase in serum level of vitamin D by more than 10.27 ng/mL was associated with a reduction in prevalence of dental caries by 22%. Increased consumption of cariostatic agents by more than 89.30 g/day decreased the prevalence of dental caries by 32%. No significant association was noted between the prevalence of dental caries and level of parent’s education, consanguinity of parents, level of income, place of residence, frequency of tooth brushing, dental flossing, and dental visits (P>0.05). Conclusions: While the serum vitamin D level had no significant effect on DMFT, the nutritional regimen seemed to play a more important role in caries control.

A Tele-detection and referral pAthways model for early childhood cariEs control- a protocol for a randomized factorial study: the TRACE study

BackgroundEarly childhood caries (ECC) is one of the most common childhood diseases affecting the primary teeth of children younger than 6 years of age. ECC progression can be reversed in the early stages although these lesions often go undetected. New approaches are needed to detect oral diseases at an early stage when they can be better controlled. The aim of the study is to assess the effectiveness of ECC tele-detection methods combined with referral pathways with and without user fee removal in controlling ECC.MethodsA randomized factorial trial will be used to compare two tele-dentistry detection methods for ECC (intraoral camera and smartphone camera) and two referral pathways (user fee removal versus conventional care). The study will recruit children younger than 6 years of age in marginalized communities in Alexandria, Egypt. The primary outcome is the percentage of teeth receiving indicated care, while the secondary outcomes are the oral health-related quality of life, acceptance of teledentistry by dentists, procedure time, and child cooperation. Two-way analysis of variance will be used to assess the effect of the two factors as between group variables on the outcomes after 6 and 12 months. The interaction between detection methods and referral pathways will also be assessed, and the effect of confounders will be controlled in a multivariable linear regression model.DiscussionThe findings of this study have the potential to inform clinical practice and oral healthcare policies for ECC management. Successful tele-detection and referral pathways could be integrated into oral healthcare systems, leading to improved oral health outcomes for children.Trial registrationThe trial has been registered on ClinicalTrials.gov in August 2023 (initial release) ID: NCT06019884.

Effects of Nitrate and Nitrite on Plaque pH Decrease and Nitrite-Producing and -Degrading Activities of Plaque in vitro.

The purpose of this study was to investigate the effects of nitrate and nitrite on the pH-lowering activity of human plaque, the nitrite-producing and -degrading activities of human plaque, and their correlation. Nitrate and nitrite were added to human plaque suspensions collected from the buccal aspect of maxillary molars of patients visiting a general dental clinic, and changes in pH were measured with and without glucose addition. Nitrite-producing and -degrading activities were evaluated by adding nitrate and nitrite to the plaque suspension and measuring the increase and decrease in nitrite with Griess reagent, respectively. The addition of nitrate inhibited both endogenous and glucose-induced plaque pH-lowering. The addition of glucose enhanced the production of nitrite from nitrate by about 3.3-fold. The addition of nitrite also inhibited endogenous plaque pH-lowering, but the addition of glucose promoted nitrite degradation by only about 1.1-fold. Nitrite-producing activity was positively correlated with age, but not with nitrite-degrading activity. This study revealed that nitrite was produced from nitrate and inhibited the pH-lowering activity of human plaque, which may contribute to caries control. Both nitrite-producing and -degrading activities occurred in human plaque, but no correlation was found between them. Furthermore, nitrite production was enhanced by glucose metabolism, which may function as a self-regulatory mechanism (resilience) to prevent excessive acidification by glucose metabolism.

School-based caries prevention using silver diamine fluoride: A pragmatic randomized trial in low-income rural children.

Dental caries is the world's most prevalent noncommunicable disease, disproportionately affecting children from low-income families and rural geographic areas. The CariedAway 3.0 study was a cluster-randomized pragmatic non-inferiority trial comparing silver diamine fluoride (SDF) to sealants and atraumatic restorations (ART) for the prevention and control of dental caries. All participants also received fluoride varnish. Analysis consisted of mixed-effects logistic regression for caries prevalence and weighted least squares and mixed-effects negative binomial regression for caries incidence. A non-inferiority margin of 10% for the difference between groups was used. Dental caries was defined as an ICDAS score of four or greater. A total of 3345 children were enrolled across 35 schools; however there was a large proportion of children who were noncompliant and received external dental care over the course of the trial. In adjusted analyses of compliant participants (n=1083; 543 in the SDF group and 540 in the sealant and ART group), there was no difference in the weighted risk difference between treatment groups (B=0.003, 95% CI = -0.0001, 0.0008). The odds of caries prevalence was elevated in the SDF group in longitudinal analyses (OR = 1.35, 95% CI = 0.86, 2.11) but was not significant and was below the non-inferiority margin. There were no significant differences between groups for caries incidence in adjusted models (IRR = 1.19, 95% CI = 0.81, 1.74). Results for intent to treat analyses were similar to that of per-protocol. In this school-based clinical trial, the prevalence of dental caries in children treated with SDF and fluoride varnish was non-inferior compared to those treated with sealants, ART, and fluoride varnish, although the overall risk was slightly higher. Unfortunately, a high rate of dropout and participant noncompliance was observed, likely due to the impacts of COVID-19 on study procedures. As a result, observed effects may be unreliable beyond the short-term. NCT03448107.

Silver modified atraumatic restorative treatment: a paradigm shift in dental caries management.

Silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) are treatment modalities that are minimally invasive and used for the prevention and control of dental caries. The amalgamation of these two techniques has led to the development of silver modified atraumatic restorative treatment (SMART). In this approach the carious lesion is restored with glass-ionomer cement (GIC) after SDF application. SMART effectively arrests caries without removing additional tooth structure, making it a promising option for caries management in children who lack cooperative ability.This article reviews the literature on SMART, the evidence regarding its applications in dental practice, its advantages, drawbacks, the scope for research, and clinical use.

Fissure Sealants or Fluoride Varnish? A Randomized Pragmatic Split-Mouth Trial

This study aimed to compare the clinical effectiveness of resin-based fissure sealants (FS) and fluoride varnish (FV) in children at high caries risk. A practice-based split-mouth randomized clinical trial was conducted at 9 Public Dental Service (PDS) clinics in Norway. In total, 409 children age 6 to 10 y at high caries risk (d3mft > 0) meeting inclusion criteria were recruited by dentists and dental hygienists during routine examination. Eligibility criteria were 2 fully erupted first permanent molars (FPMs) in the same jaw, with sound occlusal surfaces or with initial caries. Participation was voluntary, caregivers and eligible children were informed about the study, and written parental consent was obtained. FS and FV were randomly applied on contralateral FPMs in the same jaw, with each participant serving as their own control. FS was applied at baseline and thereafter maintained according to clinicians’ conventional procedures, whereas FV was applied at baseline, 6 mo, and 12 mo. The study outcome was success, with no need for invasive treatment (caries control), while failure was defined as dentin carious lesion or restoration. Two-level mixed-effects logistic regression analysis was used to compare FS and FV groups. Of 409 recruited children, 369 (90%) children/tooth pairs were examined after 36 mo. Intention-to-treat analysis showed 94.1% adjusted predicted probability (aPP) of success (95% confidence interval [CI] 91.7 to 96.4) in the FS group and 89.6% aPP (95% CI 86.5 to 92.7) in the FV group. In the adjusted analysis, the FV group had a lower OR for success compared with the FS group (OR 0.54, 95% CI 0.24 to 0.87). In the population studied, the clinical effectiveness of FS was statistically significantly higher compared with FV but below the estimated minimal clinically important difference of 10%.

Antibacterial Effect of Mouth Rinsing with a Solution Containing 1.6% Syzygium aromaticum Extract against Streptococcus mutans: An In vivo Randomized Controlled Trial

Background and Objective: Clove (Syzygium aromaticum) extract has antimicrobial and antioxidant potential. The objective was to assess and compare the salivary Streptococcus mutans counts on Mitis Salivarius Bacterium agar plates after 1 h of mouth rinsing with 30 mL solutions containing S. aromaticum and 0.2% chlorhexidine among 18–30-year-old adults in a clinical setting. Methodology: Sixteen participants fulfilling the eligibility criteria were randomized into two groups. Group A: rinsed with 0.16% S. aromaticum extract mouth rinse and Group B: rinsed with 0.2% chlorhexidine mouthwash. Saliva samples of the participants were collected before and 1 h after mouth rinsing with 30 mL of interventional mouth rinse, for S. mutans count analysis. IBM SPSS Statistics for Windows version 20 (IBM Corp., Armonk, N.Y., USA) was used for statistical analysis. The significance level was fixed at P < 0.05. Intra and Intergroup comparison of microbial counts was done using the Wilcoxon signed–rank test and Mann–Whitney U-test, respectively. Results: The results of the study showed that there was a significant reduction in salivary S. mutans counts in both the groups postmouth rinsing with interventional solutions (P < 0.05). However, the intergroup comparison revealed that, in the chlorhexidine group, there was significantly more reduction in salivary S. mutans counts compared to S. aromaticum mouth rinsing group (P = 0.02). Conclusion: There was a reduction in salivary S. mutans counts after mouth rinsing with a solution containing S. aromaticum. Hence, clove mouth rinse could be an effective aid for the prevention and control of dental caries since it is safe and culturally acceptable.

Control of Dental Caries in Children and Adolescents Using Fluoride: An Overview of Community-Level Fluoridation Methods.

The maintenance of oral health is a crucial aspect of general well-being; however, a significant proportion of the worldwide population experiences a range of oral diseases. Dental caries is a highly prevalent non-communicable disease globally, especially in children and adolescents. Fluoride is involved in the control of dental caries, primarily by decreasing the critical pH for dental hard tissue dissolution and decreasing enamel solubility. Due to the substantial data supporting the efficacy of fluoride in controlling dental caries, many community-level fluoridation initiatives have been devised and executed as global public health preventive interventions. These initiatives encompass the fluoridation of water, salt, and milk. Water fluoridation is considered safe and effective when fluoride levels are maintained within the recommended range (0.6 to 1.1 mg/L). Salt fluoridation has a cariostatic potential similar to that of water fluoridation, and a fluoride concentration of 250 micrograms per gram in salt is not associated with an increased risk of developing dental fluorosis. However, there is currently an effort to reduce the consumption of table salt in order to mitigate the harmful effects of excessive salt consumption. It has been hypothesized that fluoride food supplementation, such as fluoridated milk, is associated with a decrease in caries experience in permanent teeth; however, the effect is not clear in primary teeth. Public-level fluoride interventions are more cost-effective than the operative care of caries lesions and limit the burden of care. The administration of fluorides should be conducted using safe methods, limiting ingestion, and adhering to the guidelines set by international and national health agencies in each country. This is particularly important when considering children with developing dentitions. Fluoride is an important tool in the control of dental caries, but it is crucial to combine it with good oral hygiene, a healthy diet, and regular visits to a dental professional to maintain long-term oral health.

Brazilian primary dental care in a universal health system: Challenges for training and practice

ObjectivesTo report the challenges for training and practice for the Brazilian primary dental care in a universal health system. MethodsHealth, education and protection rights against poverty are guaranteed by the 1988 Brazilian Constitution and public health in Brazil is provided by the Unified Health System (SUS), one of the largest public health systems in the world. According to SUS, every Brazilian citizen has the right to free primary oral health care as secondary and tertiary care, offering a unique opportunity to integrate oral care within general health care. ResultsThe Brazilian undergraduate Dental curriculum was updated in 2021 aiming to graduate general practitioners with a major in comprehensive health care in primary health care, integrated with public and general health. This curriculum update requires at least 20% of the academic hours to be exercised outside the university walls (extramural or community work), preferably within the SUS. ConclusionsConsidering the World Health Organization (WHO) agenda, Brazil needs to advance the innovative oral health workforce, the integration of oral health into primary care, the population access to essential dental medicines and optimal fluorides for caries control. Clinical significanceIt is necessary political action and the engagement of multiple stakeholders, mainly from the health and education sectors, to improve primary health care

Comparison between the ion-specific electrode and SPADNS methods for analysis of fluoride concentration in the water supply

The maintenance of adequate fluoride (F) concentration in the public water supply is fundamental for ensuring that the community use of F can reach the maximum benefit for caries control and minimum risk for dental fluorosis. Thus, surveillance systems must use accurate and valid analytical methods to determine F concentration and, according to the literature, give preference to the ion-specific electrode (F- ISE) analysis. Aim: The objective of this study was to compare the accuracy of the ISE and SPADNS methods in the determination of the F concentration in the same water sample. Methods: Duplicate water samples were taken from 30 sampling sites in the municipality of Maringá, state of Paraná, monthly for 12 months, totaling 276 samples. An aliquot was analyzed by the FOP-UNICAMP Oral Biochemistry laboratory, using the F- ISE method, and the other one, by the SANEPAR laboratory in Maringá/PR, using the SPADNS method. Descriptive analysis and Pearson’s correlation test were applied, with a significant level of p<0.05. Results: Results were expressed as ppm F (mg F/L), and a very strong positive correlation (r= 0.91; p<0.001) was detected between the two methods of analysis. Conclusion: Our findings suggest that the determination of f luoride concentration in water can be made with accuracy by the SPADNS method, a standardized analysis protocol.

Bioprospecting and Exploration of Phytochemicals as Quorum Sensing Inhibitors against Cariogenic Dental Biofilm

Dental caries is a polymicrobial infection affecting the dental hard tissues. Excessive carbohydrate intake leads to the accumulation of acid-producing and acid-resistant microorganisms in the oral region. It is a biofilm-dependent oral infection with cariogenic pathogens and the most prevalent disease globally. The prevention and control of caries play a vital role in global health management. Periodontal diseases and subgingival plaque etiology are due to the combined action of bacterial invasion and immune reaction, resulting in the devastation of periodontal tissues, culminating in tooth loss. The compact micro colony inhabiting the dental surfaces attaches with secreted polymer, forming a biofilm. Bacterial biofilm impervious to various drugs and chemicals poses a significant challenge in therapeutic scenarios of medical and odonatological infections. The quorum-sensing signaling mechanism in bacteria controls the metabolic and physiologic properties involved in bacterial existence, pathogenesis, and virulence. Hence, studies monitoring the molecular mechanism of quorum sensing and their restricted social interactions will be highly beneficial in the treatment regimen of the modern era. Natural bioactive compounds can be exploited for their medicinal value in combating oro-dental infections. Phytochemicals are promising candidates that could provide novel strategies for fighting infections. The current review highlights the mechanism of quorum sensing, plant products’ effect in controlling quorum sensing, and biofilm-induced dental infections like Periodontitis.

Comparison of the Antibacterial Efficacy of Bamboo Shoot Ethanol Extract With Chlorhexidine Mouth Rinse Against Salivary Streptococcus mutans and Lactobacillus acidophilus: An Ex Vivo Study.

Background Dental caries is the most prevalent polymicrobial oral infectious disease tormenting individuals' healthy lifestyles and presents a significant public health problem. The objective of this study was to evaluate and compare the antibacterial properties of different concentrations of bamboo shoot ethanol extract with chlorhexidine mouth rinse on isolates of salivary Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus). Materials and methods Non-stimulated salivary samples from 30 young adults were treated ex vivo with bamboo shoot ethanolic extract at concentrations of 30 µg/ml, 40 µg/ml, 50 µg/ml, and 60 µg/ml. The colony-forming units were quantified by measuring the number of viable bacterial cells. Inhibition zones were evaluated using the agar diffusion method. One-way ANOVA and post-hoc test were used to analyze the significant difference between variables using SPSS version 22.0 (IBM Corp., Armonk, NY). Results The mean zone of inhibition with bamboo shoot ethanolic extract against salivary S. mutans (23.00 ± 0.816) and L. acidophilus (22.00 ± 0.816) total counts was closest to the control chlorhexidine (S. mutans =22.00 ± 0.876 and L. acidophilus =21.10 ± 0.876). A greater activity against S. mutans and L. acidophilus is seen in the zone of inhibition of the 60 µg/ml experimental concentration of bamboo shoot ethanolic extract, with a significant difference in the disc diffusion assay. Conclusion The treatment with bamboo shoot extract was equivalent effective in the mentioned bacterial species. Clinical relevance It can be assured that preventive measures like mouth rinse and dentifrices compromising bamboo shoots, a potential dental biomaterial, would be optimistic agents for caries control, including the cariostatic effect.

Talon Cusp from Southern Region of Saudi Arabia: Report of Two Cases with Mini Review

Talon cusp is an uncommon dental anomaly characterized by the presence of an accessory cusp-like structure projecting from the cingulum area of an anterior teeth. This anomaly generally poses problems for the patient in terms of esthetics, caries control and occlusal accommodation. This cases report with mini-review presents a brief classification of talon cusp, summary of published case report worldwide, and a unique occurrence of maxillary talon cusp in a 23-year female and 9-year male patient. The clinical and radiographic findings, along with the management of this rare dental anomaly are discussed.

Research interest on dental sealant in dentistry based on the 100 most cited articles: bibliometric analysis.

The aim of this study was to identify and analyze the characteristics of the 100 most cited articles about dental sealants (DS) in dentistry. In September 2023, a search was performed in the Web of Science Core Collection (WoS-CC) database. The following information was extracted from each article: number and density of citations, year of publication, authorship, journal, impact factor, keywords, study design, theme, continent, country, and institution. The citations of the WoS-CC were compared with those of the Scopus and Google Scholar databases. The VOSviewer software was used to generate collaborative networks. The number of citations ranged from 33 to 205. The articles were published between 1961 and 2016. Buonocore MG (7%) was the most prominent author among the most cited. The Journal of the American Dental Association was the most frequent journal (25%) and Journal of Dental Research (7.6) had the highest impact factor. Most studies had interventional (41%) and laboratory (31%) designs, mainly addressing DS effectiveness in the prevention and control of dental caries (86%). There was a predominance of publications from North America (46%) and the USA was the country with the highest number of articles (44%). The most frequent institutions were the Centers for Disease Control and Prevention (USA) and the University of Rochester (USA) (6% each). "Retention" was the most frequent keyword. In conclusion, the 100 most cited articles were mostly interventional and laboratory studies, addressing the retention and efficacy of DS. Most of the articles were concentrated in North America and Europe, demonstrating a little collaboration from other continents.

Estimation of fluoride release and recharge potential among Zirconomer, GC Gold Label Hybrid, Ketac Molar, and Tetric Prime: An in vitro study

Abstract Background: The preventive role of fluoride in caries control is mainly due to the formation of fluorapatite crystals which are more resistant to acid attack. Glass ionomer cement (GIC), its newer modifications, and certain composites in which fluoride has been incorporated show fluoride release. Aim: This research aims to compare the initial fluoride liberated, the fluoride liberated after recharge, and the mean percentage reduction of modified varieties of GICs along with fluoride-releasing composites. Materials and Methods: Forty specimen blocks of the materials to be tested were divided into 5 groups (n = 8), namely Group 1: Zirconomer (SHOFU), Group 2: GC GOLD Label Hybrid (GC), Group 3: Tetric Prime (Ivoclar), Group 4: Ketac Molar (3M), and Group 5: TE-Econom Plus (Ivoclar). The initial fluoride liberated was measured on the 1st day, after 1 week, and after a fortnight, using a benchtop analyzer and total ionic strength adjustment buffer III analyzer. Then, fluoride application was done with fluoridated dentifrice using the hand brush method, and the samples were rechecked for fluoride release at similar time intervals, i.e. 1, 7, and 15 days. Results: Zirconomer showed significantly higher initial fluoride release. The minimum mass of fluoride was released by TE-Econom. A similar pattern was observed for fluoride liberation after recharge, with Zirconomer showing maximum re-release of fluoride and TE Econom showing maximum reduction in fluoride release after 15 days. Conclusion: Zirconomer exhibited high initial fluoride liberation and fluoride liberation after recharge following topical fluoride application. GC Gold Label Hybrid and Ketac Molar showed the least percentage reduction in the biweekly fluoride liberation which was remarkably lower than Zirconomer. Fluoride-releasing composites showed the least amount of initial fluoride liberation and fluoride liberation after recharge.

The Effect of Enzymatic Treatment with Mutanase, Beta-Glucanase, and DNase on a Saliva-Derived Biofilm Model

Introduction: The dental biofilm matrix is an important determinant of virulence for caries development and comprises a variety of extracellular polymeric substances that contribute to biofilm stability. Enzymes that break down matrix components may be a promising approach to caries control, and in light of the compositional complexity of the dental biofilm matrix, treatment with multiple enzymes may enhance the reduction of biofilm formation compared to single enzyme therapy. The present study investigated the effect of the three matrix-degrading enzymes mutanase, beta-glucanase, and DNase, applied separately or in combinations, on biofilm prevention and removal in a saliva-derived in vitro-grown model. Methods: Biofilms were treated during growth to assess biofilm prevention or after 24 h of growth to assess biofilm removal by the enzymes. Biofilms were quantified by crystal violet staining and impedance-based real-time cell analysis, and the biofilm structure was visualized by confocal microscopy and staining of extracellular DNA (eDNA) and polysaccharides. Results: The in vitro model was dominated by Streptococcus spp., as determined by 16S rRNA gene amplicon sequencing. All tested enzymes and combinations had a significant effect on biofilm prevention, with reductions of >90% for mutanase and all combinations including mutanase. Combined application of DNase and beta-glucanase resulted in an additive effect (81.0% ± 1.3% SD vs. 36.9% ± 21.9% SD and 48.2% ± 14.9% SD). For biofilm removal, significant reductions of up to 73.2% ± 5.5% SD were achieved for combinations including mutanase, whereas treatment with DNase had no effect. Glucans, but not eDNA decreased in abundance upon treatment with all three enzymes. Conclusion: Multi-enzyme treatment is a promising approach to dental biofilm control that needs to be validated in more diverse biofilms.

Epigallocatechin gallate-immobilized antimicrobial resin with rechargeable fluorinated synergistic composite for enhanced caries control

ObjectivesGiven the global prevalence of dental caries, impacting 2.5 billion individuals, the development of sophisticated prevention filling materials is crucial. Streptococcus mutans, the principal caries-causing strain, produces acids that demineralize teeth and initiate dental caries. To address this issue, we aimed to develop a synergistic resin-based composite for enhancing caries control. MethodsThe synergistic resin composite incorporates fluorinated kaolinite and silanized Al2O3 nanoparticle fillers into an epigallocatechin gallate (EGCG) immobilized urethane-modified epoxy acrylate (U-EA) resin matrix, referred to the as-prepared resin composite. The EGCG-modified TPGDA/U-EA network was synthesized by preparing methacrylate-functionalized isocyanate (HI), reacting it with EGCG to form HI-EGCG, and then incorporating HI-EGCG into the TPGDA/U-EA matrix. The lamellar space within the kaolinite layer was expanded through the intercalation of acrylamide into kaolinite, enhancing its capability to adsorb and release fluoride ions (F–). The layered structure of acrylamide/ kaolinite in the U-EA resin composite acts as a F– reservoir. ResultsThe physico-mechanical properties of the as-prepared resin composites are comparable to those of commercial products, exhibiting lower polymerization shrinkage, substantial F– release and recharge and favorable diametral tensile strength. The immobilized EGCG in the composite exhibits potent antimicrobial properties, effectively reducing the biofilm biomass. Furthermore, the synergistic effect of EGCG and fluorinated kaolinite efficiently counteracts acid-induced hydroxyapatite dissolution, thereby suppressing demineralization and promoting enamel remineralization. SignificanceOur innovative EGCG and fluoride synergistic composite provides enhanced antimicrobial properties, durable anti-demineralization, and tooth remineralization effects, positioning it as a promising solution for effective caries control and long-term dental maintenance.

Microenvironment-Driven Fenton Nanoreactor Enabled by Metal-Phenolic Encapsulation of Calcium Peroxide for Effective Control of Dental Caries.

Caries are one of the most common oral diseases caused by pathogenic bacterial infections, which are widespread and persistently harmful to human health. Using nanoparticles to invade biofilms and produce reactive oxygen species (ROS) in situ is a promising strategy for killing bacteria and disrupting the structure of biofilms. In this work, a biofilm-targeting Fenton nanoreactor is reported that can generate ROS responsive to the cariogenic microenvironment. The nanoreactor is constructed by metal-phenolic encapsulation of calcium peroxide (CaO2) followed by modification with a biofilm targeting ligand dextran. Within the cariogenic biofilm, the Fenton nanoreactor is activated by an acidic microenvironment to be decomposed into H2O2 and iron ions, triggering a Fenton-like reaction to generate ROS that can eliminate the biofilm by breaking down extracellular polymeric substances(EPS)and killing cariogenic bacteria. Meanwhile, the depletion of excess protons in biofilm leads to a reversal of the cariogenic microenvironment. The Fenton nanoreactor can effectively inhibit the biofilm formation of Streptococcus mutans on ex vivo human teeth and is effective in preventing caries meanwhile maintaining the oral microbial diversity in rat caries infection model. This work provides a novel and efficient modality for acid microenvironment-driven ROS therapy.

Multiomics analysis reveals the genetic and metabolic characteristics associated with the low prevalence of dental caries

ABSTRACT Background Despite poor oral hygiene, the Baiku Yao (BKY) ethnic group in China presents a low prevalence of dental caries, which may be related to genetic susceptibility. Due to strict intra-ethnic marriage rule, this ethnic has an advantage in studying the interaction between genetic factors and other regulatory factors related to dental caries. Methods Peripheral blood from a caries-free adult male was used for whole genome sequencing, and the BKY assembled genome was compared to the Han Chinese genome. Oral saliva samples were collected from 51 subjects for metabolomic and metagenomic analysis. Multiomics data were integrated for combined analysis using bioinformatics approaches. Results Comparative genomic analysis revealed the presence of structural variations in several genes associated with dental caries. Metabolomic and metagenomic sequencing demonstrated the caries-free group had significantly higher concentration of antimicrobials and higher abundance of core oral health-related microbiota. The functional analysis indicated that cationic antimicrobial peptide resistance and the lipopolysaccharide biosynthesis pathway were enriched in the caries-free group. Conclusions Our study provided new insights into the specific regulatory mechanisms that contribute to the low prevalence of dental caries in the specific population and may provide new evidence for the genetic diagnosis and control of dental caries.