Caries-free Children Research Articles

Oral biofilm composition and phenotype in caries-active and caries-free children.

During development of dental caries, oral biofilms undergo changes in microbial composition and phenotypical traits. The aim of this study was to compare the acid tolerance (AT) of plaque from two groups of children: one with severe caries (CA) and one with no caries experience (CF) and to correlate this to the microbial composition and metabolic profile of the biofilms. Dental plaque samples from 20 children (2-5 years) in each group were studied. The AT was analyzed by viability assessment after exposure to an acid challenge (pH 3.5), using LIVE/DEAD® BacLight™ stain and confocal microscopy. Levels of acid tolerance (AT) were evaluated using a scoring system ranging from 1 (no/low AT), to 5 (high/all AT). Metabolic profiles were investigated following a 20 mM glucose pulse for one hour through Nuclear Magnetic Resonance (NMR). Microbial composition was characterized by 16S rRNA Illumina sequencing. The mean AT score of the CA group (4.1) was significantly higher than that of the CF group (2.6, p < 0.05). When comparing the end-products of glucose metabolism detected after a glucose-pulse, the CA samples showed a significantly higher lactate to acetate, lactate to formate, lactate to succinate and lactate to ethanol ratio than the CF samples (p < 0.05). The bacterial characterization of the samples revealed 25 species significantly more abundant in the CA samples, including species of Streptococcus, Prevotella, Leptotrichia and Veillonella (p < 0.05). Our results show that AT in pooled plaque from the oral cavity of children with severe caries is increased compared to that in healthy subjects and that this can be related to differences in the metabolic activity and microbial composition of the biofilms. Thus, the overall phenotype of dental plaque appears to be a promising indicator of the caries status of individuals. However, longitudinal studies investigating how the AT changes over time in relation to caries development are needed before plaque AT could be considered as a prediction method for the development of dental caries.

Role of Salivary Protease Enzymatic Activity in Saliva of Children with and without Early Childhood Caries: A Randomized Clinical Trial.

Early childhood caries (ECC) is one of the most prevalent diseases in children worldwide. Early childhood caries is driven by a dysbiotic state of oral microorganisms, mainly caused by a sugar-rich diet. Additionally, poor oral hygiene or insufficient dental plaque removal leads to the rapid progression of ECC. Early childhood caries leads not only to dental destruction and pain in children but also affects the quality of life of the caregivers.Additionally, upon neutrophil activation at inflammatory locations, these proteases are externalized in an active state, aiding in the control of inflammatory and immunological responses. Any enzyme that catalyzes proteolysis reactions is known as a protease. Proteases are produced by human glands or derived from microbes in the oral cavity. Additionally, the oropharyngeal mucosae and crevicular fluids are sources of protease. This study is aimed at the estimation and correlation of salivary protease enzymatic activity in the saliva of children with and without ECC. A total of 50 children were included in the study, which was divided into two groups: group I (caries-active) and group II (caries-free)-each consisting of 25 children. Unstimulated saliva samples were collected and subjected to a spectrophotometer for analysis. Salivary protease levels were estimated and correlated between caries-active and caries-free children. The correlation between caries score and salivary protease activity was statistically significant with a moderate correlation. The comparison of mean salivary protease activity between caries-active and caries-free groups was statistically significant. However, the comparison of salivary protease activity based on different age-groups was not statistically significant, whereas gender and caries scores in group A were statistically significant. In conclusion, there is a substantial correlation between salivary protease enzyme levels and the severity of dental caries, and an increase in salivary protease enzyme levels is linked to a considerable rise in caries severity. As a result, prevention may be possible with early detection. Thimmegowda U, Kuri PN, Dhamnekar P. Role of Salivary Protease Enzymatic Activity in Saliva of Children with and without Early Childhood Caries: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(8):877-880.

Ethnicity-based analysis of supragingival plaque composition and dental health behaviours in healthy subjects without caries

ObjectiveThe primary objective of this study was to scrutinise the disparities in the diversity, structure, and function of the oral microbiome among caries-free children from the Zhuang and Han ethnic groups with a focus on the influence of ethnically distinct oral health behaviours on the composition of the oral microbiota. MethodsA questionnaire survey was conducted to assess oral health behaviours and dental plaque samples were collected from 96 Zhuang and Han children aged 4–5 years living in Guangxi, southern China for high-throughput sequencing. PCR amplification was performed for sequencing of the V4 region of the 16S rDNA gene, and second-generation sequencing was performed using the Illumina MiSeq platform to compare and analyse the diversity, structure and function of the microbiota. ResultsSingle-factor analysis revealed significant differences between the Zhuang and Han ethnic groups regarding juice consumption, the frequency of consuming sugar-sweetened food or beverages before bedtime, the age that individuals started toothbrushing, the frequency of toothbrushing and the frequency of parental assistance with toothbrushing (p < 0.001). The dominant phyla were Proteobacteria, Firmicutes, etc., and the dominant genera included Streptococcus and Neisseria. The dental plaques of the caries-free Zhuang and Han ethnic groups had similar core microbiomes, with no significant differences in the diversity and structure of the microbiota and no significant differences in the abundance of the dominant genera. In addition, no significant difference in metabolic function was observed between the Zhuang and Han ethnic groups. ConclusionThe core oral microbiota was consistent in caries-free Zhuang and Han children. Despite differences in dietary habits and oral hygiene behaviours between the Zhuang and Han ethnic groups, with a high frequency of sugary food intake but better oral health behaviours in the Zhuang group, there were no significant differences in the diversity, structure and function of the oral microbiota of caries-free children in the Zhuang and Han ethnic groups.

Evaluation of Oral Health Status and Treatment Needs of Children with Congenital and Acquired Heart Disease.

Objective: To evaluate the oral health status and treatment needs of children with congenital and acquired heart disease. Methods: This descriptive study included 301 children aged 5-14 from June 2022 to June 2023. Heart conditions were classified by congenital/acquired status and severity. The children's sociodemographic characteristics, medical and dental history, tooth brushing habits, and non-nutritional habits (bruxism, nail-biting, thumb-sucking, etc.) were evaluated. Oral health assessments including caries, oral hygiene, enamel defects, and dental treatment needs-related indices were recorded. Results: The mean age was 8.95 ± 2.91 years, and 271 (90%) of the children had congenital heart disease. The children with moderate and severe heart disease had significantly higher decayed/missing/filled surfaces (dmfs) (p = 0.038) and pulp exposure (p = 0.015) compared to the children with mild heart disease. According to the International Caries Detection and Assessment System II (ICDAS II) index, which included initial caries lesions, there were no caries-free children and 75.7% had extensive caries. The mean plaque index and gingival index were found to be 1.18 ± 0.38 and 0.69 ± 0.53, respectively. Enamel defects were observed in 15.9%. The Treatment Needs Index (TNI) was 85.8% for the primary teeth and 88.9% for the permanent teeth. The Care Index (CI) was 12.4% for the primary teeth and 10.8% for the permanent teeth. Conclusions: Children with congenital and acquired heart disease exhibit a high prevalence of untreated dental caries, gingivitis, and plaque accumulation, with a high need for dental treatments. Dentists should prioritize addressing these issues to prevent the risk of infective endocarditis (IE) and improve oral health outcomes in this population.

The Prevalence of Candida albicans and Malassezia globosa in Preschool Children with Severe Early Childhood Caries: A Case-Control Study.

Background: This cross-sectional study aimed to identify the prevalence of Candida albicans and Malassezia globosa in children with severe early childhood caries and caries-free children in Hong Kong. Methods: This study first recruited a total of 80 children aged between 48 and 72 months old, 40 children with severe early childhood caries, and 40 caries-free children. The children were then further divided into four groups, with 20 children in each group: Group 1: Severe early childhood caries-C. albicans, Group 2: Severe early childhood caries-M. globosa, Group 3: Caries-free-C. albicans and Group 4: Caries-free-M. globosa. Saliva, plaque, and caries lesion samples were collected from participants with severe early childhood caries, while only saliva and plaque samples were collected from caries-free participants. Caries status of the primary molars was assessed using WHO's decayed, missing, and filled tooth index, and the severity of cavitated lesions was determined based on International Caries Diagnosis and Assessment System criteria as caries code 5 or 6. The samples were analyzed using an Internal Transcribed Space and Quantitative Real-Time Polymerase Chain Reaction. Results:C. albicans was more prevalent in saliva and plaque samples of severe early childhood caries than in the caries-free group. Proportion of C. albicans in both saliva and plaque samples differed significantly between severe early childhood caries and caries-free groups (p < 0.05). Within the severe early childhood caries group, the proportion of children with C. albicans varied between 6 and 46%. No significant difference in M. globosa load was found between plaque samples of the severe early childhood caries and caries-free groups (p = 0.159). Conversely, no significant difference in M. globosa load was observed between saliva samples of severe early childhood caries and caries-free groups (p = 0.051). Conclusions: This study demonstrated a strong association between C. albicans and severe early childhood caries. M. globosa was detected in both the caries-free and severe early childhood caries groups, albeit at low levels.

Fungi and bacteria occupy distinct spatial niches within carious dentin.

The role of bacteria in the etiology of dental caries is long established, while the role of fungi has only recently gained more attention. The microbial invasion of dentin in advanced caries especially merits additional research. We evaluated the fungal and bacterial community composition and spatial distribution within carious dentin. Amplicon 16S rRNA gene sequencing together with quantitative PCR was used to profile bacterial and fungal species in caries-free children (n = 43) and 4 stages of caries progression from children with severe early childhood caries (n = 32). Additionally, healthy (n = 10) and carious (n = 10) primary teeth were decalcified, sectioned, and stained with Grocott's methenamine silver, periodic acid Schiff (PAS) and calcofluor white (CW) for fungi. Immunolocalization was also performed using antibodies against fungal β-D-glucan, gram-positive bacterial lipoteichoic acid, gram-negative endotoxin, Streptococcus mutans, and Candida albicans. We also performed field emission scanning electron microscopy (FESEM) to visualize fungi and bacteria within carious dentinal tubules. Bacterial communities observed included a high abundance of S. mutans and the Veillonella parvula group, as expected. There was a higher ratio of fungi to bacteria in dentin-involved lesions compared to less severe lesions with frequent preponderance of C. albicans, C. dubliniensis, and in one case C. tropicalis. Grocott's silver, PAS, CW and immunohistochemistry (IHC) demonstrated the presence of fungi within carious dentinal tubules. Multiplex IHC revealed that fungi, gram-negative, and gram-positive bacteria primarily occupied separate dentinal tubules, with rare instances of colocalization. Similar findings were observed with multiplex immunofluorescence using anti-S. mutans and anti-C. albicans antibodies. Electron microscopy showed monomorphic bacterial and fungal biofilms within distinct dentin tubules. We demonstrate a previously unrecognized phenomenon in which fungi and bacteria occupy distinct spatial niches within carious dentin and seldom co-colonize. The potential significance of this phenomenon in caries progression warrants further exploration.

Quantitative Analysis of Bifidobacterium and Scardovia wiggsiae in Dental Plaque from Children in Northern Thailand and Their Association with Caries Factors

Abstract Objectives The aim of this study were to measurably detect Bifidobacterium and Scardovia wiggsiae in plaque from severe early childhood caries (S-ECC) and caries-free children and to analyze the interrelation between these bacteria and clinical caries presentation and caries-related factors assessed by questionnaire. Materials and Methods One-hundred forty supra gingiva plaque samples from children aged between 2 and 5 years were used in this study. There were 70 children in each group. Recorded plaque index, modified gingival index, and decay, missing, and filled tooth (dmft) scores. Parents' attitudes, child's oral hygiene, and diet were assessed by questionnaire. DNA was extracted from plaque samples and quantitative real-time polymerase chain reaction using fluorescent dye was performed. Results Plaque (p &lt; 0.001) and modified gingival indices (p &lt; 0.001) in the S-ECC group were higher than in the caries-free group. Prevalence of Bifidobacterium (p = 0.004) and S. wiggsiae (p &lt; 0.001) in the S-ECC group was higher than in the caries-free group. The numbers of total bacteria (p = 0.003), Bifidobacterium (p &lt; 0.001), and proportion of Bifidobacterium to total bacteria (p &lt; 0.001) were higher in the S-ECC group. Detections of both bacteria, Bifidobacterium + S. wiggsiae (p &lt; 0.001), were higher in the S-ECC group than in the caries-free group. In the S-ECC group, dmft scores (p &lt; 0.001; p = 0.024) and the modified gingiva index (p = 0.004; p = 0.002) were higher in the presence of Bifidobacterium and S. wiggsiae, respectively. In the S-ECC group, the dmft scores (p = 0.005) and modified gingiva index (p = 0.004) were higher in the presence of both Bifidobacterium + S. wiggsiae. There were positive correlations between the Bifidobacterium level (p = 0.003), the proportion of Bifidobacterium to total bacteria (p = 0.017), and S-ECC. The level of Bifidobacterium (p &lt; 0.001) and ratio of Bifidobacterium to total bacteria (p &lt; 0.001) were correlated with the dmft score and modified gingival index in the S-ECC group. From the questionnaire, S-ECC were associated with major caregiver (p = 0.002), parent education levels (p = 0.02), prolonged bottle-feeding (&gt;18 months) (p = 0.015), night-time feeding (p &lt; 0.001), eating cariogenic snacks (p = 0.019), and frequency of dental visits (p = 0.003). Conclusions Levels of total bacteria, Bifidobacterium, S. wiggsiae and plaque, and the modified gingival indices were higher in the S-ECC group. Factors associated with S-ECC included the major caregiver, parent education levels, feeding patterns, cariogenic snacks consumption, and frequency of dental visits.

Estimation and Correlation of Alkaline Phosphatase Enzymatic Activity in Saliva with and without Early Childhood Caries in South Indian Children: A Randomized Clinical Trial.

Early childhood caries (ECC) is a major common problem seen in children and is the most prevalent chronic disease that leads to discomfort, pain, and poor quality of life, affecting the health of children. Alkaline phosphatase (ALP) is a nonspecific phosphomonoesterase that functions through a phosphoery 1 intermediate to produce free inorganic phosphate. It has different isoenzymes produced by different cell types such as polymorphonuclear leukocytes, osteoblasts, macrophages, and fibroblasts within alveolar bone and/or salivary glands. Various studies show that higher ALP activity is related to periodontal disease and dental caries. This study aims to estimate and correlate salivary Alkaline Phosphatase enzyme activity in the saliva of children with and without ECC. A total of 50 children were included in the study, divided into two groups-caries-active and caries-free, each consisting of 25 participants. Unstimulated saliva samples were collected and subjected to a spectrophotometer for analysis. ALP enzyme activity levels were estimated and correlated between caries-active and caries-free children. The correlation between caries score and ALP activity was statistically significant, with a moderate correlation. The comparison of mean ALP activity between caries-active and caries-free groups was statistically significant. However, the comparison of ALP based on different age-groups and gender was not statistically significant. There was a statistically significant correlation between caries scores and the caries-active group. In conclusion, there is a substantial correlation between ALP enzyme levels and the severity of dental caries. An increase in ALP enzyme level is linked to a considerable rise in caries severity. Therefore, prevention may be possible with early detection. Thimmegowda U, Kuri PN. Estimation and Correlation of Alkaline Phosphatase Enzymatic Activity in Saliva with and without Early Childhood Caries in South Indian Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(5):528-531.

Comparative Assessment of Total Antioxidant Capacity of Unstimulated Saliva Which Can Reflect the Oxidative Stress between Autism Children and Normal Children

ABSTRACT Aim: To assess the level of total antioxidant capacity (TAC) in the unstimulated saliva of autism children and normal children. Methods: A total of 60 children participated in the study (autism children—30; normal children—30) in the age-group of 7–14 years, at a Special Needs Children’s Home in Salem district. Both groups were further subdivided into subgroups of 15 children each (caries-free and caries-active). All children were given instructions regarding saliva sample collection, and unstimulated saliva samples were collected in sterile cryovials and transported to the laboratory at 4°C, where the TAC of saliva was evaluated using the spectrophotometric assay. Results: TAC of autism children was comparable to that of normal children due to personal care and improved diet. TAC was increased in caries-active children when compared to caries-free children in both groups. When comparing the mean values of TAC in caries-active and caries-free children of both groups, it was not statistically significant. So, from the above results, it can be assumed that the diet, age, and caries activity have a definitive influence on the TAC level of saliva. Conclusion: Personal hygiene, diet, age, and caries activity have a definitive influence on the level of TAC in saliva.

Anticariogenic Effects of the Dairy Products on Human Saliva: An In Vivo Study.

The aim of this study was to determine whether the intake of cheese, paneer, and yogurt may help in reversing the acidogenic challenge after the consumption of chocolate at different time intervals. A total of 120 caries-free children between the ages of 4 and 13 years, with no decayed, missing, and filled teeth (DMFT), were randomly selected from the school. Baseline pH was obtained, and the subjects were asked to eat chocolate. pH was measured again after 10 minutes. Following chocolate exposure, the subjects were then randomly assigned to three groups-cheese, paneer, and yogurt. Salivary pH was measured at intervals of 15, 30, and 60 minutes using the same procedures for all subjects. The data thus obtained were subjected to statistical analysis, which included analysis of variance (ANOVA) test, post hoc tests for multiple comparisons using Tukey's test, and paired t-test. The highest pH value after 15 minutes was seen in cheese (6.43), followed by paneer (6.31) and yogurt (6.30). After 30 minutes, the maximum pH value was seen in the cheese group (6.63), followed by yogurt (6.46) and paneer (6.34). The mean pH value 60 minutes after the consumption of dairy products was highest in paneer (6.53), followed by cheese (6.43) and yogurt (6.37). All the categories were observed in the zone of remineralization. It should be noted that the maximum pH value overall was seen in the cheese group. Dairy products help maintain salivary pH, which aids in improving enamel health. Hence, dietary dairy recommendations can be incorporated into patient education and caries prevention plans. Gautam Y, Srivastava M, Verma P, et al. Anticariogenic Effects of the Dairy Products on Human Saliva: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(4):456-460.

Effect of vitamin D on salivary cathelicidin in kindergarten children with dental caries

Background: Dental caries is a heterogeneous microbial infection affecting the mineralized dental tissues and characterized by a gradual demineralization process. Vitamin D aids in the immunological response to oral infections, and its insufficiency can impact the patient’s general and dental health. Small cationic peptides known as cathelicidins are essential for developing innate immune systems. This study aimed to investigate the impact of vitamin D on the innate immune response by assessing the levels of cathelicidin in children with tooth decay. Subjects and Methods: This study included 60 children aged 4-5 years, with 30 children having caries and 30 without caries. Oral examinations were conducted and scored using the dmfs index. Saliva samples were collected from all subjects, and ELISA was employed to determine vitamin D and cathelicidin levels. Results: The current findings revealed that salivary levels of cathelicidin and vitamin D were significantly lower (P &lt; 0.01) in children affected by caries than caries-free children. The results also showed a significant decrease (P &lt; 0.01) in cathelicidin levels compared to the vitamin D sufficient group. Conclusions: The study concludes that children with caries and vitamin D deficiency exhibit low levels of cathelicidin. The observed link between vitamin D deficiency and caries suggests that vitamin D contributes to the synthesis of cathelicidin.

Comparison of Salivary Flow Rate, pH, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children.

Early childhood caries (ECC) is the most common chronic disease of childhood in many developing countries, which is associated with local, systemic, psychological, and social consequences. Multiple variables are shown to be associated with an increased risk of ECC. The knowledge regarding the role of saliva in the pathophysiological process of ECC still remains controversial and unexplored. Scanty studies focused on probing the role of salivary flow rate, pH, buffering capacity, and secretory immunoglobulin A (sIgA) in unstimulated whole saliva of children with ECC and children without ECC. To assess the salivary flow rate, pH, buffering capacity, and sIgA levels in children with ECC and caries-free children and to evaluate their role in caries risk assessment.Materials and Methods: The study was carried out among 64 children aged between 24 and 71 months. Clinical examinations were carried out according to the criteria by the World Health Organization, and carious status was recorded. Subjects were categorized as group I with ECC (dmfs-Decayed, Missing or Filled Surfaces (Deciduous dentition) of ≥5), and group II included children without ECC (dmfs = 0). Unstimulated whole salivary samples were collected in a sterile vial and stored at -70°C by draining. Estimations of salivary flow rate, pH, buffering capacity, and sIgA levels were done. Digital pH meters were used for the estimation of pH and buffering capacity. A human IgA enzyme-linked immunosorbent assay (ELISA) kit was used to estimate sIgA levels. Statistical software IBM Statistical Package for the Social Sciences (SPSS) statistics 20.0 (IBM Corporation, Armonk, New York, United States of America) was used to analyze the data. The mean salivary flow rate decreased in group I children with ECC (0.15 ± 0.05) when compared to group II children without ECC (0.67 ± 0.14), which was statistically significant. In caries active children, no statistically significant correlation was found between salivary flow rate and the dmfs scores [r-value (-0.247)] and p-value (0.147). The mean level of salivary pH is decreased in group I children with ECC (4.65 ± 0.4) when compared to group II children without ECC (7.28 ± 0.18). In the caries active group, the levels of salivary pH decrease as the dmfs scores increase, and this correlation is found to be statistically significant (r-value of 0.547 and p-value of 0.002). The mean level of buffering capacity is decreased for caries-active children (5.45 ± 0.49) when compared to caries-free children (8.94 ± 0.42). In caries active children, as the dmfs scores increase, the salivary buffering capacity decreases, and this correlation is found to be not statistically significant (r-value of -0.334 and p-value of 0.161). The mean levels of sIgA in group I children with ECC were higher (10.61 ± 0.90) than that in group II children without ECC (6.11 ± 1.22). In the caries-active group, the salivary sIgA levels were comparatively higher than in the caries-free children. As the dmfs scores increase, the level of the sIgA increases in caries-active children, and this correlation is noted to be highly statistically significant (r-value of 0.769 and p-value 0.008). Children with ECC showed decreased salivary flow rate, pH, buffering capacity, and increased sIgA levels, while children without ECC showed increased salivary flow rate, pH, buffering capacity, and decreased sIgA levels. The salivary parameters, such as salivary flow rate and buffering capacity, showed no correlation with the dmfs score, while salivary pH and sIgA levels have a positive correlation in caries-active children. Sivakumar A, Narayanan R. Comparison of Salivary Flow Rate, Ph, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children. Int J Clin Pediatr Dent 2024;17(3):334-340.

Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research.

Early childhood caries (ECC) remains one of the most prevalent diseases mutilating the primary dentition. It is a multifactorial disease that severely affects the quality of life of affected children. One of the risk indicators reported in the literature is the presence of viable mutans streptococci (MS) and protective factors such as salivary immunoglobulin A (SIgA). Hence, it is important to identify such risks and protective factors associated with ECC using simple yet reliable methods supported by advanced technology and a fully automated platform to improve the results. A retrospective analysis was done on 40 children who were divided into two groups: group I (experimental) and group II (control). Group I comprised 30 healthy children who were further divided into three subgroups of 10 children each. Group IA with decayed, missing, filled teeth/decayed, extracted, filled teeth (dmft/deft) = 1-2, group IB with dmft/deft = 3-4, group IC with dmft/deft ≥5, and group II, comprising 10 healthy children having no caries by using World Health Organization (WHO) 2013 Oral Health Survey criteria. Unstimulated saliva was collected by drooling saliva into a sterile container. The samples were transported to the central research laboratory for SIgA by the immunoturbidimetry method by a fully automated Abbott Architect c system. The data obtained was subjected to statistical analysis. On comparison of SIgA in between varying severities of dental caries and caries-free children between age-group of 3 and 6 years, it was found to be below the grand median 0.20 mg/mL for subgroups IA and control group II. A significant negative statistical correlation (r = -0.948) was present between the SIgA and varying severities of ECC and the control group. The low dmft/deft group was found to be relatively closer to the caries-free groups as their mean dmft was 1.50, standard deviation (SD) ± 0.53. A slight change in dmft/deft score and SIgA could be used as a potential biomarker for assessing the severity of ECC in children between age-group of 3 and 6 years. Sharma V, Bagchi A, Dutta B, et al. Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research. Int J Clin Pediatr Dent 2024;17(3):316-320.

Proportion of Streptococcus mutans, Streptococcus sanguinis, and Candida albicans in Early Childhood Caries: Evaluation by qPCR

Background Early childhood caries (ECC) is one of the most common diseases in children. It is associated with oral microbiome dysbiosis, characterized by a reduced beneficial oral microbiome and an increased pathogenic oral microbiome. Objective This study aims to detect and quantify S. mutans, S. sanguinis, and C. albicans in dental plaque samples from caries-free and ECC groups of children using the quantitative polymerase chain reaction (qPCR). Materials and Methods Supragingival plaque samples were collected from 30 children aged 2 to 5 divided into three groups: 15 caries-free children, 7 ECC, and 8 S-ECC. The abundance of microorganisms was determined by qPCR. The obtained data were analyzed using one-way ANOVA (post hoc Bonferroni) and the Pearson and Spearman correlation tests. Results The S-ECC group had a higher proportion of S. mutans and C. albicans. The proportion of S. sanguinis was higher in the ECC and had a positive correlation (P &lt; 0.05) with S. mutans in this same group. Conclusion The proportion of S. mutans, S. sanguinis, and C. albicans differed between the caries-free, ECC, and S-ECC groups, and they correlated with each other in the occurrence of ECC.

Caries prevalence and water fluoridation in Israel: a cross-sectional study.

To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5,000 individuals was fluoridated. In 2014, CWF in Israel stopped. Data on 12-year-old children from all areas in Israel from the national cross-sectional epidemiological survey conducted in 2011 to 2012 were stratified by city water fluoridation and by city and school socioeconomic status. Two dependent variables were defined: (1) DMFT index of caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov classification of fluorosis. Data from 2,181 12-year-olds were analyzed. The average DMFT was 1.17 ± 1.72, and 49% were caries-free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs 0.98 in fluoridated cities) and there were more caries-free children in fluoridated cities (56.4% vs 40.6% in nonfluoridated). DMFT was higher in cities with lower socioeconomic status than high socioeconomic status (1.29 vs 1.05, respectively, P < .001) and there were fewer caries-free children in low socioeconomic status cities (44.5% vs 53.0% in high socioeconomic status cities, P < .0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in the Thylstrup-Fejerskov index), had questionable to mild fluorosis (9.3%). CWF is a cheap, simple method of dental health protection that reaches all socioeconomic levels, and cessation of water fluoridation reduced the health of Israel's children. Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

Changes of Salivary Concentration of IL-6 and TNF-Α in Early Childhood Caries

Background: Early childhood caries is a biofilm-dependent, critical, widespread health problem in both developing and industrialized countries. The interleukin-6 (IL-6) has several roles in the body's response to inflammation and tissue damage. TNF-α is a pleiotropic cytokine that acts as a pro-inflammatory cytokine. Aim of Study: The purpose of this research was to assess the salivary concentrations of TNF-α and IL-6 in children with dental caries and study the correlation between cytokines and DMFs index. Materials and Methods: Eighty children aged four and five took part in the study. Forty children with ECC served as the research group, whereas 40 caries-free children of the same age and gender served as the control group. Clinical parameters were assessed after an oral examination and measurement. All participants had saliva samples obtained. IL-6 and TNF-α concentrations in saliva were estimated using an ELISA test. Results: The current study found a significant elevation (P&lt;0.05) in mean levels of TNF-α and IL-6 among children with ECC in comparison to caries free children. Moreover, there is significant positive correlation between IL-6 and TNF-α levels in caries children. Conclusion: Based on these results, it seems likely that elevated levels of TNF-α and IL-6 are involved in ECC.

The Association Between Vitamin D and Early Childhood Caries: A Systematic Review and Meta-Analysis.

Previous surveys have reported that children with vitamin D deficiency were likely to suffer from early childhood caries (ECC). The aim of this systematic review and meta-analysis was to determine 1. whether the status of vitamin D is intrinsically related to the occurrence of ECC and 2. the optimal level of vitamin D for the prevention of ECC. The database of PubMed, Web of Science, Cochrane, Embase and Google scholar were searched for targeted literature. The eligibility criteria were observational studies in which children with ECC were compared to children without ECC in terms of their vitamin D status. Applying the Newcastle-Ottawa tool, study selection, data extraction, and risk of bias assessment were performed by 2 reviewers independently. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.4 software. 501 articles were retrieved from the electronic databases; 11 studies were finally included in systematic review, 10 studies of which were submitted to meta-analysis. The 25(OH)D levels in the ECC group were statistically significantly lower compared with that in the caries-free group (WMD = -13.96, 95% CI: [-19.88,-8.03], p < 0.001), especially in regard to the association between S-ECC and vitamin D (WMD = -18.64, 95% CI: [-20.06,-17.22], p < 0.001). The subgroup analyses in terms of geographical region demonstrated that children with a level of 25(OH)D of 50-75 nmol/l were more likely to have ECC than those with over 75 nmol/l (OR = 1.42, 95% CI: [1.26,1.60], p < 0.001), with data from Asia and Europe combined for analysis Conclusions: The level of vitamin D was lower in children with ECC than in caries-free children, and the correlation between S-ECC and vitamin D was even stronger. The optimal 25(OH)D level for preventing occurrence and development of ECC was ≥ 75 nmol/l. Thus, clinicians should view the development of early caries also from a systemic perspective.

Comparison the salivary streptococcus mutans levels between caries-active and caries-free children from Birjand, Iran: A case-control study

ObjectiveDental plaque bacteria, including Streptococcus mutans (SM), play a role in the pathogenesis of the dental caries. There are conflicting results regarding the association of salivary SM level and dental caries susceptibility. Our aim was to compare salivary SM levels in colony-forming units (CFU) between children with active caries and caries-free children in Birjand, Iran. MethodsThis case-control study included 61 six-year-old children referred to health centers in Birjand city, Iran, in 2022. The children were divided into two groups: case (dmft/DMFT>0 with active caries) (including 31 children) and control (dmft/DMFT = 0 [caries-free]) (including 30 children). Demographic information and dental history were recorded. Oral examinations were also performed by the dentist. Unstimulated saliva samples were collected from children. The number of salivary SM colonies was determined using the microbial culture and confirmed using the polymerase chain reaction (PCR). The data were analyzed using Chi-square and T-tests at a significance level of p < 0.05. ResultsThe mean number of SM colonies was 126.24 ± 92.78 CFU/ml and 92.38 ± 75.34 CFU/ml in case and control groups, respectively. No significant difference was found in salivary SM levels between case and control groups (P = 0.125). No significant association was observed between caries experience with gender (P = 0.363), type of school (public/private) (P = 0.296), receiving oral health education (P = 0.072) and frequency of tooth brushing (P = 0.935). The mean gingival index (P = 0.001) and plaque index (P = 0.025) in case group were significantly higher than control group. ConclusionThere is no significant difference in salivary SM levels between caries-active and caries-free children in Birjandi children.

Experience, Prevalence, and Severity of Dental Caries in Mexican Preschool and School-Aged Children.

Objective Dental caries in Mexico continues to be a public health problem, indicated by it is high prevalence and incidence in children. This disease is associated with pain in preschool and school children, with large-scale consequences for the individual, society, and health systems. The objective of the present study was to determine the experience (mean of caries indices), prevalence, and severity of caries in children 2-12 years of age who sought dental care at a dental school in Mexico. Material and methods A cross-sectional study was carried out on 826 clinical records of patients ages 2-12 years. The dependent variable was caries, in terms of experience (mean primary teeth (dmft) and permanent teeth (DMFT) indices), prevalence (dmft and DMFT greater than 0), and severity (cutoffs of caries indices at various levels). The independent variables were age and sex. The data were analyzed in Stata 14 (StataCorp LLC, College Station, Texas). Results The average age was 7.2±2.3; 52.4% were boys. In the primary dentition, the caries experience (mean dmft) was 3.01±3.30, the prevalence of caries was 65.8%, and the severity dmft>3=37.3% and dmft>6=15.6%. In the permanent dentition, the caries experience (mean DMFT) was 0.99±1.88, the prevalence of caries was 31.5%, and the severity DMFT>3=12.5% ​​and DMFT>6=1.6%. The percentage of caries-free children in both dentitions was 26.1% (n=216/826). The experience, prevalence, and severity of caries were statistically different by age (p<0.001). Only in the severity of dmft>3 were differences observed across sex (p<0.05). Among children with mixed dentition, primary teeth were more affected than permanent teeth (2.46±2.87 vs 0.88±1.61; p<0.0001). Conclusions About seven out of 10 children were affected by cavities in either or both dentitions. It was observed that age was positively associated with dental caries, equally affecting girls and boys. In this sample, the primary dentition was impacted more than the permanent dentition. Despite being preventable, dental caries continues to be a health problem in children.

Caries prevalence and water fluoridation in Israel: a cross-sectionalstudy.

To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5000 individuals was fluoridated. In 2014 CWF in Israel stopped. Data on 12-year-old children from all areas in Israel from the national crosssectional epidemiological survey conducted in 2011-2012 were stratified by city water fluoridation and by city and school socio-economic status (SES). Two dependent variables were defined: (1) DMFT index -caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov (TF) classification of fluorosis. Data from 2181, 12-year-olds was analyzed. the average DMFT was 1.17+1.72 and 49% were caries free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs. 0.98 in fluoridated cities) and there were more caries free children 56.4% in fluoridated cities vs. 40.6% in non-fluoridated. DMFT was higher in cities with lower SES than high SES (1.29 vs. 1.05 respectively, p<0.001) and there were less caries free children in low SES (44.5% vs. 53% in high SES cities, p<0.0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in TF index), had questionable to mild fluorosis (9.3%). CWF is a cheap, simple method of dental health protection that reaches all socio-economic levels and cessation of water fluoridation reduced the health of Israel's children. Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.