Caries in primary teeth and caries in permanent teeth: association and effect modifiers.

To re-examine Japan's long-term decline in permanent-tooth caries among 12-year-olds and assess its implications for population-level caries prevention beyond historically dominant systemic fluoride-centered prevention frameworks. Ecological analysis of national surveillance data. We assembled long-term nationwide data from Japan on caries experience in 12-year-olds. Data were derived from standardized school dental examinations with high coverage and low temporal variability. Trends were examined descriptively and interpreted in relation to historically established systemic fluoride-caries prevention frameworks, including population fluoride exposure and long-term changes in sugar availability. Japan experienced a near-continuous decline in caries among 12-year-olds over approximately 40 years, reaching a national mean DMFT of 0.53 in 2023-well below levels historically reported in populations exposed to systemic fluoride through community water fluoridation. This decline occurred without community water fluoridation and largely before the approval of high-fluoride toothpaste in 2017 and its recommendation for school-aged children in 2023. Although sugar availability declined early, caries levels continued to fall long after sugar intake stabilized. Japan represents a rare natural social experiment demonstrating that sustained population-level caries reduction can occur through cumulative non-systemic fluoride pathways. These findings suggest fluoride-centered frameworks alone may not fully explain long-term population trends and support a broader multicausal approach to caries prevention. They may inform population-level oral health strategies in settings where reliance on systemic fluoride alone may be insufficient.

Evidence on the relationship between rheumatoid arthritis (RA) and oral health remains inconsistent. In this cross-sectional study, the authors compared oral health-related quality of life (OHRQoL), caries experience, salivary function, periodontal status, and risk of developing caries in adults with RA and systemically healthy control participants. Sixty-seven adults with RA (confirmed diagnosis for ≥ 2 years) and 64 age- and sex-comparable healthy control participants underwent comprehensive oral examinations including decayed, missing, and filled teeth and decayed, missing, and filled surfaces indexes, initial caries assessment, root caries evaluation, and Community Periodontal Index scoring. Unstimulated and stimulated salivary flow rates, pH, and buffering capacity were measured. Cariogram software, Version 1.3 (Malmö University) was used for caries risk profiling. Participants completed validated OHRQoL questionnaires. Patients with RA had significantly reduced salivary flow (both, P < .001), higher buffering capacity (P = .034), and greater caries experience (decayed, missing, and filled teeth index: P = .035; missing teeth: P = .002). Results of a cariogram revealed lower caries-free probability in patients with RA (33% vs 52%). Periodontal findings were comparable (P = .075). OHRQoL was better in patients with RA (median, 5 vs 7; P = .047). RA is associated with salivary hypofunction and increased risk of developing caries. Although patients with RA reported better OHRQoL, objective clinical assessments revealed elevated risk of developing caries, underscoring the need for comprehensive preventive strategies tailored to this population. Dental care professionals should implement regular caries risk assessments, salivary function monitoring, high-fluoride regimens, and oral hygiene protocols adapted to functional limitations for patients with RA to prevent progressive caries and tooth loss.

Dental caries remains one of the most prevalent oral health problems among school-age children, particularly in the 10–14-year age group. Knowledge of dental caries is a key predisposing factor that can influence oral health behaviors, such as toothbrushing practices and dietary habits, which in turn affect caries experience. This study aimed to analyze the relationship between knowledge of dental caries and caries experience among children aged 10–12 years at SDN 12 Payakumbuh City. This analytical study employed a cross-sectional design involving 40 students selected through total sampling. Data were collected using a structured questionnaire to assess knowledge and clinical examination using the DMF-T index to measure caries experience. Data were analyzed using univariate and bivariate methods, with the chi-square test applied to determine the association between variables. The results showed that 37.5% of respondents had good knowledge, 55% had moderate knowledge, and 7.5% had poor knowledge. Regarding caries experience, 67.5% of respondents were categorized as having poor caries status (DMF-T &gt; 1), while 32.5% were categorized as good (DMF-T ? 1). Statistical analysis revealed a significant relationship between knowledge and caries experience (p &lt; 0.05). Children with better knowledge tended to demonstrate lower caries experience, likely through more favorable oral health behaviors. In conclusion, knowledge of dental caries is significantly associated with children’s caries experience, mediated by oral health behaviors. Strengthening oral health education programs is essential to promote preventive behaviors and reduce the burden of dental caries among school-age children. Early treatment, such as restorative care, is also recommended to prevent further complications.

Background/Objectives: Unhealthy dietary behaviors and suboptimal oral hygiene practices remain common among Italian children, potentially affecting both nutritional and oral health. Dental caries, a preventable yet highly prevalent condition in pediatric populations, has a multifactorial etiology in which lifestyle factors play a key role. This study aimed to assess the prevalence of dental caries, dietary habits, and oral hygiene behaviors in school-aged children in Lombardy, and to identify factors associated with prevalent caries status. Methods: A cross-sectional study was conducted on 307 schoolchildren aged 9–10 years from ten schools in Northern Italy. Oral health status was evaluated through the plaque index and the DMFT/dmft index during school-based dental examinations. Dietary habits, lifestyle, and oral hygiene practices were collected through structured questionnaires. A mixed-effects logistic regression model was developed to explore potential associations between variables and prevalent caries status. Results: The dietary patterns, weight status, oral hygiene behaviors, and oral health conditions were generally consistent with the national data. Higher plaque index, skipping breakfast, consuming mid-morning snacks, and parental reports of previous caries experiences were retained in the final model. Internal validation suggested reasonable discriminatory ability overall, whereas calibration shows heterogeneity across schools. Conclusions: The findings highlight suboptimal dietary and oral hygiene behaviors among Lombardy schoolchildren and confirm their association with dental caries. Lifestyle-related factors, particularly oral hygiene practices and eating patterns, showed a relevant association with prevalent caries status in the analyzed sample. These results underscore the need for targeted preventive strategies integrating nutritional education and oral health promotion in pediatric populations.

Introduction: Thalassemia is a hereditary hemoglobin disorder requiring frequent blood transfusions, often leading to systemic complications that may influence oral health. The DMFT/deft index is a standard tool for assessing dental caries experience in children. The aim of the study is to investigate the association between thalassemia and dental caries burden in pediatric patients. Materials and Methods: A comparative cross-sectional study was conducted among 120 children, aged 6–12 years, divided into two groups: Group I: Control Group, Group II: Children diagnosed with thalassemia. Dental examination was performed and DMFT/deft scores were recorded. The data was collected and analysed statistically. Results: The mean DMFT/deft score was significantly higher in thalassemic children compared to healthy controls (p &lt; 0.05). A positive correlation was observed between serum ferritin levels and increased DMFT/deft scores. Factors such as duration of disease, frequent hospital visits and frequency of iron chelation therapy may have contributed to higher caries prevalence. Conclusion: Children with thalassemia exhibit higher DMFT/deft scores compared to healthy children, indicating poor oral health status. Early dental intervention and preventive strategies should be integrated into the comprehensive care of thalassemic patients.

Community water fluoridation is widely recognised as an effective and equitable population-level strategy for preventing dental caries. However, its relevance has been questioned in recent international debates, particularly in settings with widespread access to other fluoride sources. This study examined the association between municipal community water fluoridation coverage and dental caries outcomes among 5-year-old children residing in 313 Brazilian municipalities. This cross-sectional study used individual-level data from the Brazilian National Oral Health Survey (SB Brasil 2023) and municipal-level data on community water fluoridation coverage from the Water Quality Surveillance Information System (Sisagua). The analytical sample comprised 6128 5-year-old children. Caries experience was assessed using the dmft index, and untreated caries were measured as the number of decayed primary teeth. Multilevel negative binomial regression models with random intercepts for municipality were fitted, incorporating rescaled sampling weights and adjusting for sex, race/ethnicity, maternal education, and household income. The findings revealed that higher municipal community water fluoridation coverage was associated with lower caries experience. In fully adjusted models, each unit increase in fluoridation coverage (0-1) was associated with a reduction in mean dmft (RR = 0.74; 95% CI: 0.63-0.86) and untreated caries (RR = 0.73; 95% CI: 0.64-0.84). Persistent socioeconomic and racial inequalities were observed, with higher caries levels among Black, Mixed-race, and Indigenous children. In conclusion, community water fluoridation remains an effective and equitable public health intervention for preventing early childhood caries in Brazil, particularly in contexts of social inequality and heterogeneous municipal implementation.

Longitudinal evidence on individual-level changes in caries experience across the life course in Germany is lacking. Therefore, one objective of the 6th German Oral Health Study (DMS • 6) was to reexamine participants of the Fifth German Oral Health Study (DMS V) after 9 years, to assess changes in the caries burden during the life course. The caries experience, including decayed, missing, filled teeth (DMFT), and root caries, was assessed at baseline (2014) and follow-up (2023) in three age groups of the DMS • 6 cohort. The sample comprised 371 adolescents (20-year-olds at follow-up), 342 adults (43- to 52-year-olds at follow-up), and 350 seniors (73- to 82-year-olds at follow-up). Mean changes in caries experience and participant-level caries incidence and progression were calculated. Mean DMFT increased from 0.4 to 1.8 in adolescents, from 10.7 to 11.8 in adults, and from 16.1 to 18.5 in seniors. Furthermore, the proportion of caries-free adolescents reduced from 81.7% to 47.7%. The cumulative caries incidence in adolescents who were caries-free at baseline was 43.2%. Cumulative caries progression (at least one additional DMF tooth) was observed in 54.1%, 58.4%, and 77.0% of adolescents, adults, and seniors, respectively. Regarding the tooth surface level, 98.3%, 91.1%, and 77.5% of tooth surfaces remained sound throughout the observation period in adolescents, adults, and seniors, respectively. The prevalence of root caries markedly increased from 11.1% to 30.7% in adults and from 32.9% to 61.1% in seniors. This 9-year longitudinal study demonstrated caries increments during the life course in all three age groups. Adolescents predominantly presented with newly filled teeth, adults showed increased numbers of filled and missing teeth, and seniors primarily presented with a larger number of extracted teeth. Individuals with early caries experience exhibited greater increments. The pronounced increase in root caries among adults and seniors highlights the need to intensify targeted root-surface-focused prevention alongside ongoing primary prevention for high-risk groups. (Quintessence Int 2026;57(Suppl):S14-S22; doi: 10.3290/j.qi.b6955475).

To investigate tooth anomalies, caries status, and gingival health in individuals with different types of cleft lip and palate (CLP). Radiographic and photographic records of 116 patients with CLP were retrospectively examined. Standardized forms were completed in three age-based subgroups (3-5 years, 6-12 years, ≥13 years) and three cleft type groups (right UCLP, left UCLP, BCLP). The DMFT index in permanent teeth, dmft in deciduous teeth, tooth anomalies, and gingival health were recorded. Prevalence of decay and anomalies in the cleft region was evaluated. Kruskal-Wallis and chi-squared tests were used. A significance level of p 0.05 was considered statistically significant. The mean DMFT value was 3.96 ± 3.12, and the mean dmft value was 1.18 ± 2.59. In the anterior region, no filled permanent teeth were found in 109 individuals, no supernumerary teeth in 105, and no teeth with shape abnormalities in 97. Healthy gums were observed in 48 patients. The relationship between cleft type and maxillary anterior decay showed statistically significant differences (p 0.05), and DMFT values also differed statistically significantly among cleft groups (p = 0.001). Patients not only exhibit poor overall oral hygiene but also a higher prevalence of decay in the cleft region. Adoption of a multidisciplinary approach and collaboration with other healthcare professionals can further enhance overall health and quality of life for these individuals. This is among the first studies in Turkey to simultaneously evaluate anomalies, caries, and gingival health in CLP patients with an a priori power analysis. These findings underline the importance of early, targeted preventive dental strategies in individuals with cleft lip and palate, particularly in the cleft region where caries and dental anomalies are more prevalent. An integrated evaluation of dental anomalies, caries experience, and gingival health may support more effective preventive dentistry and improved long-term oral health outcomes in this high-risk population.

This cross-sectional study aims to investigate the association between socioeconomic and behavioural factors and dental caries among primary schoolchildren in Riyadh, Saudi Arabia. A total of 202 first-grade primary school students (mean age 6.2 years; 111 (55%) female) from public schools in Riyadh, Saudi Arabia, participated in the study. Socioeconomic and behavioural data were collected using the World Health Organization (WHO) oral health questionnaire completed by parents, while dental caries, measured using the decayed-missing-filledteeth (dmft) index, was assessed through clinical examination following WHO criteria. Ethical approvals were obtained from King Saud University (Institutional Review Board (IRB) No. 24/1240) and King's College London (LRS/DP-23/24-40999). Logistic regression was used to assess the association between parents' education and dental caries, adjusting for age, gender, dental visits in the last year, routine dental visits, oral hygiene, and sugar consumption. The overall caries prevalence (dmft > 0) was 85.2% (172/202), with a mean dmft score of 5.43 (SE = 0.31). The percentage of children with untreated caries in deciduous teeth was 83.7% (169/202), with a mean of 4.96 (SE = 0.281). In the logistic regression, higher maternal education was negatively associated with caries experience (odds ratio (OR): 0.26, 95% confidence interval (CI): 0.07-0.99). A dental visit within the last year was positively associated with caries experience (OR: 3.46, 95% CI: 1.25-9.64). In contrast, routine dental visits for check-ups were negatively associated with caries experience (OR: 0.27, 95% CI: 0.08-0.90). Maternal education and consistent routine dental check-ups emerged as significant protective factors against dental caries. Emphasising preventive dental care and parental education may reduce the burden of caries among Saudi children.

Self-reported smoking during pregnancy is subject to measurement error, bringing into question previously reported associations with offspring caries experience. We evaluated whether a previously identified prenatal smoking-associated DNA methylation (DNAm) signature, and separately gestational smoking indexed through self-report and plasma cotinine, was associated with offspring caries. The Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort (n = 577 mother-child dyads, recruited from June 2009-September 2010) ascertained gestational smoking exposure (by questionnaires and plasma cotinine), DNAm (using umbilical cord tissue), and child dental caries (by clinical examinations at age 3 y). We used zero-inflated Poisson regression to evaluate whether a weighted smoking-associated DNAm risk score (wMRSDNAm) was associated with the count of tooth surface caries, adjusted for maternal age, education, ethnicity, breastfeeding, preterm status, child sex, and toothbrushing frequency. Of the women, 53% were never smokers and 3% were heavy smokers; children had a mean (standard deviation) of 2.47 (5.20) decayed, missing, and filled surfaces. The mean wMRSDNAm for the 16 CpGs included was -0.21 (0.02), with an interquartile range of 0.02. Each additional IQR of wMRSDNAm was associated with a 20% higher adjusted caries experience risk, relative risk (RR) (95% confidence interval [CI]) = 1.20 (1.10, 1.31), and a lower adjusted odds of excess zeros, odds ratio (95% CI) = 0.91 (0.70, 1.17). Children of mothers who smoked during gestation (based on self-report/cotinine) also had higher adjusted caries experience risk: relative risk (RR) (95% CI) = 1.31 (1.11, 1.55) and RR (95% CI) = 1.12 (0.81, 1.54) for light and heavy smoking, respectively. These findings corroborate a link between prenatal smoking and offspring caries and provide novel information of a positive association between maternal smoking-associated DNAm risk scores and greater offspring caries experience. While replication in independent studies is warranted as these results are based on CpGs derived from umbilical cord DNA, these findings point to a need for greater smoking cessation support.

Children experiencing dental neglect are often exposed to persistent pain that diminishes quality of life and adversely affects overall developmental progress. Failure to prevent or treat caries occurring in early childhood in a timely manner may lead to dental neglect and contribute to the development of carious lesions in the permanent dentition later in life. The aim of this study was to examine the relationship between DMFT, DMFS, and PUFA values of Permanent first molars (PFMs) and the level of dental neglect in children aged 7–10 years and to contribute to the existing body of knowledge in this field. This study is a cross-sectional study involving 234 children aged 7–10 and their parents. The four permanent first molars that had erupted in the children’s mouths were examined, and their DMFT, DMFS, and PUFA values ​​for these teeth were recorded. Parents then completed the Dental Neglect Scale (DNS), and the data were recorded. Data analysis were performed using IBM SPSS Statistics version 27. The relationships between DMFS, DMFT, and PUFA scores of PFMs and DNS scores were analyzed using Spearman’s correlation analysis. The mean DMFT, DMFS, PUFA, and DNS scores for the PFMs were 2.41 ± 1.54, 4.13 ± 3.34, 0.34 ± 0.71, and 15.94 ± 3.59, respectively. No significant correlation was found between DNS scores and DMFT-PFM (rho = 0.106; p > 0.05) or DMFS-PFM (rho = 0.097; p > 0.05) scores. However, a weak positive and statistically significant correlation was observed between DNS scores and PUFA-PFM scores (rho = 0.174; p = 0.008). Parental dental neglect appears to be more strongly associated with the advanced consequences of untreated caries in PFMs rather than with early caries experience. These findings emphasize the importance of early parental awareness and preventive care.

Tooth brushing is an important yet often neglected behavior that affects the oral health of preschool children. Maternal supervision of tooth brushing plays a crucial role in establishing healthy practices. This study aimed to assess the association between maternal attitude toward child tooth brushing and child's oral health status among preschoolers in Hyderabad, Telangana, India. A cross-sectional study was carried out among 384 children aged 3-5years attending preschools in Hyderabad. Maternal attitude was assessed using the 18-item attitude scale of Parenting and Child Tooth Brushing Assessment Questionnaire (PACTA) on a 5-point Likert scale (score ranges from 18 to 90, where a greater score indicates a better attitude). Dentition status of children was recorded according to World Health Organization (WHO) criteria. Statistical tests included chi-square, Mann-Whitney U, and Kruskal-Wallis tests. Multivariate logistic regression analysis was performed with maternal attitude domains as independent variables using SPSS software version 24.0. A p value ≤ 0.05 was considered statistically significant.Please confirm if all the authors names are presented accurately and in the correct sequence. Kindly check and confirm whether the names of all authors has been processed correctly and amend if necessary.corrections have been marked RESULTS: The overall mean maternal PACTA score was 63.22 ± 9.89. The prevalence of dental caries was 34.1%. Higher mean decayed (d) component and overall mean dmf scores were observed among children of mothers with poor Lack of Concern domain (p-0.05; p-0.05), poor Emotional Reaction (p-0.04; p-0.03) and poor overall PACTA (p-0.01; p-0.01) scores. Poor maternal attitude toward child tooth brushing was significantly associated with caries experience among preschool children.

Dental caries remains a global challenge, with high prevalence among five-year-old children and regional inequalities. The aim of this study is to identify factors associated with protection from dental caries in five-year-old children, using Salutogenic Theory as a reference. Secondary data were analyzed from the Minas Gerais Oral Health Survey. Five-year-old children (n = 1193) were examined. Parents or guardians answered a questionnaire addressing individual variables and the use of dental services. Dependent variables were the absence of caries activity (ACA) and absence of caries experience (ACE), which were extracted from the decayed-missing-filled primary teeth (dmft) index. Logistic regression analysis was used to estimate odds ratios with 95% confidence intervals for each block of variables on the hierarchical levels. The Complex Samples module of the SPSS 19.0 program was used. Five hundred ninety-five children (50.5%) in the overall sample were caries-free. In the final model, white skin color, monthly family income greater than R$1500, having more than six material goods, and not visiting a dentist in the previous year were associated with ACA and ACE. Factors related to socioeconomic conditions were associated with protection from dental caries in early childhood, supporting equity-based public policies to increase the number of children not affected by caries.

Background: A single gene mutation causes beta-thalassemia, an autosomal recessive disorder. It's hemolytic anemia that needs constant blood transfusions for life. In children and adolescents with thalassemia major, no clear concepts are found concerning the association between beta-thalassemia and growth retardation is a common side effect. Saliva contains a variety of biochemists, which may affect the severity of dental caries. Aim: This research aimed to evaluate the link between β -thalassemia major, dental caries and growth impairment in relation to some salivary constituents. Materials and Method: As part of an investigation at the Basra/Iraqi Thalassemia Center, 40 thalassemic children aged 10 to 12 were compared to 40 healthy controls in terms of dental caries (who were the same age and gender as the study group). Anthropometric measurements were used to assess their physical development. A sample of unstimulated whole saliva was taken from each child to determine salivary calcium, phosphorus, and alkaline phosphatase enzyme concentrations. Result: For both the primary and permanent dentition, dental caries experience (dmft/DMFT) was higher among β-thalassemic children, with a statistically significant difference. A higher percentage of thalassemic youngsters were found to be underweight. Although salivary constituents like calcium, phosphorus, and alkaline phosphatase enzyme were higher in the control group than in the study group, there was no statistically significant difference between the two groups. Conclusion: Dental caries and growth impairment were associated with beta-thalassemia major.

Purpose: To investigate the association between pregnant women receiving oral health guidance from health care professionals and their children visiting a dentist before 12 months of age. Methods: Data were drawn from multiple follow-ups of the 2015 Pelotas Birth Cohort. The main outcome was whether the child had a dental visit in the first year of life, either for preventive care or treatment of dental problems. The primary exposure was the mother's receipt of oral health guidance from a health care professional during pregnancy. Potential confounders included socioeconomic and demographic characteristics, maternal experience of dental caries, and dental visits during pregnancy. Multinomial logistic regression was used for the analysis, comprising 3,938 mother-child dyads. Results: Children whose mothers received oral health guidance during pregnancy had a 60% higher prevalence of preventive dental visits compared to those whose mothers did not receive such guidance (prevalence ratio=1.60; 95% confidence interval [CI]=1.19 to 2.15). Conclusion: This study found that professional oral health guidance provided to mothers during pregnancy was positively associated with a higher likelihood of their children receiving preventive dental care during the first year of life.

Background/Aim: Dental caries is a multifactorial disease influenced by dietary habits, lifestyle factors, and host biochemical processes. Oxidative stress and advanced glycation end products (AGEs) have been implicated in oral and systemic pathophysiology, but their combined association with caries experience remains unclear. This study aimed to evaluate the relationships between caries indices, diet, smoking, oxidative stress markers, and AGEs in adults. Materials and Methods: A cross-sectional study was conducted on adults enrolled in the SALIVAGES project (2018-2020). Dental status was assessed using the DMFT index. Dietary habits and smoking status were recorded using a validated questionnaire. Oxidative stress parameters (TAC, TOS, OSI, NO, MDA, total thiols) and AGEs (FruLys, MG-H1, CML, CEL, Pyr, Arg, Lys) were quantified in saliva and plasma. Associations were analyzed using correlation tests and multivariable regression models (α = 0.05). Results: The mean DMFT was 21.89 ± 7.13, with missing teeth predominating. Caries experience was significantly associated with oxidative stress, AGEs, diet, and lifestyle. Higher decay scores were associated with increased NO and total thiols and reduced antioxidant capacity. Several salivary AGE-related biomarkers (FruLys, MG-H1, CML, and CEL) were negatively associated with the decay index. Sugary beverages, refined carbohydrates, pastries, and donuts were strongly positively associated with the decay index, whereas wholemeal bread showed an inverse association with caries indices. Smoking was independently associated with higher decay and DMFT values, corresponding to an approximately three-unit higher DMFT score. Conclusions: Caries experience in adults is associated with dietary, lifestyle, and biochemical factors. Sugar intake and smoking showed the strongest associations with caries indices, while oxidative stress parameters and selected salivary AGE-related biomarkers showed weaker but significant inverse associations with decay. These findings support preventive strategies targeting diet quality, smoking cessation, and redox balance to reduce oral disease burden.

Molar incisor hypomineralisation (MIH) is a prevalent developmental enamel defect and has been associated with increased caries experience. To determine caries experience and prevalence, and their relationship with the presence of MIH in schoolchildren from Pachuca, Mexico. A cross-sectional study including 714 randomly selected participants aged 6 to 13years. Clinical examination was undertaken and carious lesions and MIH were classified according to ICDAS II and EAPD MIH-criteria, respectively. Questionnaires collected sociodemographic, socioeconomic, and health information. Mean age was 8.8 ± 1.8years; mean caries experience for cavitated lesions (ICDAS 5-6) was 2.1 ± 2.5 in primary dentition and 0.2 ± 0.7 in permanent dentition, resulting in a combined mean (dmft + DMFT) of 2.2 ± 2.6. Caries prevalence (ICDAS ≥ 2) was 78% in primary and 46.7% in permanent teeth. Eighty-eight children (12.3%) had MIH, of whom 54 (61.4%) had cavitated lesions (ICDAS 5-6) in permanent teeth, higher than in children without MIH (7%) (p = 0.0001). Mean caries experience (ICDAS 5-6) was significantly greater in the MIH group (1.25 ± 1.34) compared to the non-MIH group (0.10 ± 0.45; p = 0.0001). Variables statistically significantly associated with caries prevalence and experience included the child's age, oral hygiene, MIH presence and soy extract ingestion; and parental perception of the child's general appearance. Several variables, including MIH, child age, oral hygiene and soy extract ingestion, and parental perception of their child's general appearance, were associated with higher caries prevalence and experience.

To determine the extent that parenting styles and oral health behaviours mediate the relationship between socioeconomic circumstances (SEC) and childhood dental caries experience: pre-/post-national roll-out in 2011 of Childsmile, the child oral health improvement programme for Scotland. A longitudinal design linked 2798 participants from Birth Cohort-1 (following from age 10 months in 2005/06 to age 5 years in 2009/10) and 3015 from Birth Cohort-2 (following from age 10 months in 2011 to age 5 years in 2015) of the Growing Up in Scotland study with caries experience at age five from the National Dental Inspection Programme. Two Structural Equation Models (Birth Cohort-1 and 2) tested an a priori framework to explain the social gradient (SEC: Income Poverty, Area-based Deprivation, Household Education, Household Employment) in caries experience, considering proximal behaviours (toothbrushing, cariogenic diet, regular dental attendance) before introducing validated parenting styles (Parental Responsiveness/Demandingness). Models for both the pre-/post-Childsmile cohorts illustrated similar pathways. Dental attendance and parenting had no direct effect on caries experience. Responsiveness partially mediated the SEC-toothbrushing relationship, while demandingness partially mediated the SEC-diet relationship. Cariogenic diet directly increased caries experience prevalence (β = 0.33/0.24), while increased toothbrushing persistently decreased caries (β = -0.18/-0.13). Total mediated effect of SEC decreased from 58.8% to 39.1%, with the largest relative decrease being directly via toothbrushing (9.5%/4.0%). The effect mediated through parenting pathways remained minimal (4.8%/3.5%). Pathways between SEC and childhood caries were unchanged after Childsmile roll-out, with minimal effects from parenting styles. The diminishing SEC effects via toothbrushing may be positively attributed to Childsmile interventions. The persistent unexplained effect of SEC on caries experience highlights the need for equity-focused structural approaches that address broader socioeconomic inequalities.

Evidence suggests that a low copy number (CN) (2-3) of the α-amylase 1 gene (AMY1) may reduce the risk of dental caries, although findings remain inconsistent. Variations observed between studies could potentially be explained by the modulation of third factors, such as obesity, which may amplify the cariogenic potential of high AMY1 CN. This cross-sectional study explored the relationship between AMY1 gene CN variation (CNV) and dental caries experience, assessed with the Decayed and Filled Surfaces (DFS) index in young adults, and whether this association varied by obesity status. A total of 597 participants (52.4% female, aged 26-29 years) from the Norwegian Fit Futures 3 study (2021-2022) were included. Salivary AMY1 CN was measured using droplet digital polymerase chain reaction. Obesity was defined as BMI ≥30 kg/m2. We analysed AMY1 CN as both continuous and categorical variables (2-3 [17%], 4-6 [53%], and 7-14 [30%] CN) using logistic regression. Although AMY1 CN alone was not associated with DFS, its interaction with obesity was significant (p = 0.036). Among obese individuals, a one-unit increase in AMY1 CN raised the probability of DFS ≥9 by 4.7 percentage points, with no association observed in non-obese individuals. In obese participants (n = 103), sex-adjusted odds ratios (ORs) for DFS ≥9 were as follows: OR 1.25 (95% CI: 1.02-1.53) per unit increase in AMY1 CN; OR 3.47 (95% CI: 1.23-9.79) for 4-6 versus 2-3 CN, and OR 4.48 (95% CI: 1.35-14.89) for 7-14 versus 2-3 CN. This study found that AMY1 gene CN alone was not directly associated with dental caries in young adults. However, obesity was identified as an effect modifier in the relationship between salivary AMY1 CNV and dental caries experience. Specifically, dental caries experience was higher in obese individuals with above-average AMY1 CN. These findings highlight the complex interplay between genetic, metabolic, and behavioural factors in dental caries development. Further research is needed to confirm these results and to explore the underlying mechanisms of this interaction.