Caries-free Research Articles

Polymerase chain reaction-based identification of various serotypes of Streptococcus mutans in adults with and without dental caries.

Dental caries is a multistep process which initiates the development of plaque' defined as a structured biofilm containing microbial communities. Teeth provide unique surfaces for bacterial colonization. Serotypes of Streptococcus mutans implicate the development of dental caries. The aim of the study was to determine the prevalence and association of serotypes of S. mutans in groups with and without dental caries. One hundred and fifty adults aged between 18 and 35 years were included in the study. Supragingival plaque samples were collected, followed by deoxyribonucleic acid extraction. Polymerase chain reaction was performed to identify S. mutans and its serotypes. Proportions of S. mutans and its serotypes were correlated with caries-active (CA) and caries-free (CF) groups. CA group showed 66.7% positivity for S. mutans and CF group showed only 42.7% of positivity. Serotype C showed a higher proportion followed by E' F, and K in the CA group, whereas in the CF group, higher proportion was observed with K followed by C' E, and F. 70.8% cases showed single serotype in the CA group and 83.3% in CF group. Multiple serotypes were seen in 29.2% in the CA group and 16.7% in the CF group. The study clearly established variation in proportions of S. mutans and its serotypes between CA and CF groups. Positive correlation was observed in the CA group for S. mutans and its serotypes.

Association of Dental Caries in Primary Teeth With HLA Class II Gene Among Syrian Children.

Background and objectives Numerous studies have shown that there is evidence that genetic factors contribute in different ways to the occurrence of caries lesions, and the multiple differences in the human leucocytes antigen (HLA) gene patterns play an important role in the body's immune response. Therefore, this study aimed to evaluate the association between some HLA class II alleles (HLA-DR4, HLA-DQ2, HLA-DQ4) and early childhood caries (ECC) occurrence in Syrian children. Materials and methods The study included 80 children aged three to six, divided into two groups: Group 1 (n = 40) being severe early childhood caries (S-ECC) children (deft ≥ 10) and Group 2 (n = 40) being free caries children (deft = 0). The genomic DNAs were extracted and collected by taking a buccal swab using a sterile metal strip and were amplified by polymerase chain reaction-single specific primer (PCR-SSP) and then HLA-typing was performed for all alleles. Results There were no statistically significant differences in the frequency of occurrence of S-ECC, HLA-DR4, and HLA-DQ2 alleles (p = 0.626, 0.256 respectively), while the incidence of S-ECC was associated with the DQ4 allele (p = 0.012). Conclusion HLA class II molecules may play a crucial role in predisposing to ECC, since positive HLA-DQ4 may enhance the chance of developing ECC. However, no association were found between (HLA-DR4 and HLA-DQ2) and ECC.

Association between Candida albicans and childhood dental caries in Japanese children

IntroductionThe possible association between Candida carriage in children and childhood caries has not been elucidated in the Japanese population. This study aimed to investigate the prevalence, maternal relatedness, and genotypic distribution of Candida albicans in this population. Materials and methodsWe collected dental plaque samples from 55 mother-child pairs in the Caries group and 25 pairs in the caries-free (CF) group to analyze microbial data (carriage and viable counts), focusing on Streptococcus mutans and C. albicans. Clinically isolated 118 Candida strains were further evaluated using arbitrarily primed polymerase chain reaction. ResultsA higher C. albicans carriage rate was observed in the Caries pairs (25.5 % in children, 47.3 % in mothers) than in CF pairs (0 % in children, 24.0 % in mothers). The viable counts of S. mutans were significantly higher in the Caries group than in the CF group (p < 0.05). In addition, S. mutans counts positively correlated with C. albicans counts in the dental plaque of caries-affected children (r = 0.549). Almost all Candida-positive children (92.9 %) were diagnosed with severe early childhood caries, and 79.7 % of Candida isolates from the mother-child pairs were similar at the strain level. C. albicans genotype A was the most predominant (70.6 %) strain, followed by genotype D (17.6 %) in dental plaques from children in the Caries group. ConclusionsThe presence of C. albicans is a risk factor for childhood caries in a Japanese population. Our findings provide new insights into maternal-child oral health instructions based on microbial factors associated with dental caries.

Comparison of oral cavity protein abundance among caries-free and caries-affected individuals-a systematic review and meta-analysis.

Some salivary proteins seem to be differently abundant among caries-free (CF) and caries-affected (CA) individuals, but previous results are contradictory precluding that definitive conclusion be drawn. A pooled analysis of the available evidence may provide more robust data on identifying oral cavity protein patterns among CF and CA individuals. This systematic review and meta-analysis (PROSPERO CRD42021269079) aimed to compare the oral cavity protein abundance among caries-free and caries-affected individuals. This study was conducted following PRISMA guidelines. PubMed, Embase, and Web of Science databases were systematically assessed (up to February 2023) to retrieve clinical studies written in English, German, or in Latin-based languages that compared the oral cavity protein abundance among CF and CA individuals. Data extraction and methodological quality assessment (NIH guidelines) were independently performed by two investigators. Qualitative synthesis was performed from all included studies and meta-analysis was performed using a random-effects model with inverse variance for studies that reported the concentration of proteins or enzymatic activity. Standardized mean difference (SMD) with respective 95% confidence interval (CI) were calculated for each outcome. A total of 90 studies (two cohort and 88 cross-sectional designs) of more than 6,000 participants were selected for data extraction, being the quality of evidence graded as "fair" for most of them. The oral cavity of CF individuals presented lower total protein concentration [SMD = 0.37 (95% CI: 0.07-0.68; 18 studies)], lower total antioxidant capacity [SMD = 1.29 (95% CI: 0.74-1.85); 17 studies], and lower carbonic anhydrase activity [SMD = 0.83 (95% CI: 0.58-1.09); three studies], whereas CA individuals presented lower carbonic anhydrase concentration [SMD = -0.66 (95% CI: -1.00 to -0.32); three studies], urease [SMD = -0.95 (IC 95%: -1.72 to -0.17); four studies], and arginine deiminase system [SMD = -2.07 (95% CI: -3.53 to -0.62); three studies] activities. Antimicrobial peptides, secretory immunoglobulin-A concentrations and alpha-amylase activity were similar among individuals. Differences on oral cavity protein abundance were observed among CF and CA individuals. These data indicate some protein patterns for the oral health and dental caries conditions. Even when statistically significant, some of the results were not very consistent. Cohort studies need to be conducted to validate these results.

Salivary elemental signature of dental caries: a systematic review and meta-analysis of ionomics studies.

Trace- and macro-chemical elements are crucial for cellular physiological functioning, and their alterations in biological fluids might be associated with an underlying pathological state. Hence, this study aimed to examine and summarize the published literature concerning the application of salivary ionomics for caries diagnosis. An extensive search of studies was conducted using PubMed, EMBASE, Web of Science, and Scopus, without any language and year restriction for answering the following PECO question: "In subjects (i.e., children, adolescents, or adults) with good systematic health, are there any variations in the salivary concentrations of trace- or macro-elements between caries-free (CF) individuals and caries-active (CA) subjects?" A modified version of the QUADOMICS tool was used to assess the quality of the included studies. The Review Manager Version 5.4.1. was used for data analyses. The analysis of salivary chemical elements that significantly differed between CF and CA subjects was also performed. Thirty-four studies were included, involving 2299 CA and 1669 CF subjects, having an age range from 3 to 64years in over 16 countries. The meta-analysis revealed a statistically significant difference (p < 0.05) in the salivary levels of calcium, phosphorus, chloride, magnesium, potassium, sodium, and zinc between CA and CF subjects, suggesting higher levels of calcium, phosphorus, potassium, and sodium in CF subjects while higher levels of chloride, magnesium, and zinc in CA patients. Half of the included studies (17/34) were considered high quality, while the remaining half were considered medium quality. Only zinc and chloride ions were found to be higher significantly and consistent in CF and CA subjects, respectively. Conflicting outcomes were observed for all other salivary chemical elements including aluminum, bromine, calcium, copper, fluoride, iron, potassium, magnesium, manganese, sodium, ammonia, nitrite, nitrate, phosphorus, lead, selenium, and sulfate ions.

Risk Indicators for Noncavitated and Cavitated Carious Lesions in Preschool Children

ObjectiveThe aim of this study was to evaluate the risk indicators associated with noncavitated and cavitated lesions in preschool children. MethodsThe cross-sectional study included 3- to 4-year-old healthy children (N = 741) recruited in a randomised controlled clinical trial. After obtaining written informed consent, parents completed a questionnaire about their child's sociodemographic background and oral health–related behaviours and parents' oral health–related knowledge and attitude. Caries and plaque were evaluated using International Caries Detection and Assessment System-II and Visible Plaque Index (VPI), respectively. Children were grouped according to their oral health status as being caries-free (CF), having only noncavitated lesions (NC), or having cavitated lesions (CL). The least absolute shrinkage and selection operator (LASSO) sparse multinomial regression was used to study the variables using 1 standard error above the minimum criterion set at P < .05. ResultsThe prevalence of children with NC and CL was 29.1% and 49.4%, respectively, with a prevalence of early childhood caries being 78.5%. The proportion of children who brushed twice or more than twice a day was highest in CF (71.7%), followed by NC (58.3%), and was least in CL (57.7%). A higher percentage of CL children (56.2%) had twice or more than twice the frequency of between-meal snacking than CF (41.7%) and NC (41.1%) (P < .001) children. The variables included with non-zero coefficients in the model were mean parental oral health knowledge, attitude score, and children's mean VPI score, and all were significant for CL; however, in NC, only VPI score was found to be significant. ConclusionsPoor oral hygiene is the risk indicator associated with the presence of NC in preschool children, whilst poor oral hygiene and poor parental oral health knowledge and attitude are associated with the presence of cavitated lesions.

Identification and Correlation of Streptococcus mutans and Streptococcus sanguinis in Caries-active and Caries-free Children: A PCR Study.

Dental caries is currently considered an ecological imbalance within the oral biofilm leading to the dissolution of the tooth's hard tissues. It has been traditionally thought that two species belonging to the Streptococci group, Streptococcus mutans (SM) and Streptococcus sanguinis (SS), are the etiologically responsible for the onset of dental decay. The present in vivo study was conducted on 40 children with caries-active (CA) and caries-free (CF). They were allocated into two groups, group I (CA) = 20 and group II (CF) = 20. The whole saliva was collected into the vials with buffer solution and was stored in cold storage. Polymerase chain reaction (PCR) was done to identify and correlate SM and SS in CA and CF children. Comparison of mean SM level between CA and CF groups showed a statistically significant result at p = 0.001. Spearman's correlation between caries score and SM showed a strong correlation of 0.77 between caries score and SM, which was statistically significant at p = 0.001. Similarly, SS and caries scores showed a weak correlation of 0.22. Simple linear regression analysis to SM and caries score showed a significant increase of 4.74 units for 1 score increase in caries score, which is statistically significant. The presence of SM levels in children with caries is significant, whereas, in CF children, SS levels are present in increased levels. A strong correlation was seen between caries scores and SM. The simple linear regression analysis predicts a statistically significant increase by 4.74 units per increase of 1 score of caries at p < 0.001. As caries increase, SM count increases, but SS count decreases; as SS count increases, there is a reduction in SM counts. Thimmegowda U, Belagatta V, Chikkanarasaiah N, et al. Identification and Correlation of Streptococcus mutans and Streptococcus sanguinis in Caries-active and Caries-free Children: A PCR Study. Int J Clin Pediatr Dent 2023;16(1):9-15.

Saliva proteomic profile of early childhood caries and caries-free children

Objective Saliva plays an important antimicrobial role and it is related to the pathogenesis of early childhood caries (ECC). The aim of this study was to compare the proteomic profile of unstimulated saliva of children aged 3–5 years who had ECC and caries-free (CF) children. Materials and methods After the saliva collection from 20 children (ECC: n = 10; CF: n = 10), the samples were processed for proteomic analysis on a mass spectrometer. Results 1638 proteins were identified, of which 355 were present in both groups. A total of 579 proteins were exclusively identified in the CF group and included Leucine-rich alpha-2-glycoprotein, Protein S100-A5, Protein S100-A8 and Mucin-2. Moreover, 704 proteins were exclusively identified in the ECC group, including Enamelin. The differential expression analysis revealed that 112 proteins were up-regulated in the CF group. Among these proteins, we highlighted Hemoglobin subunit gamma-1 (343-fold increase), gamma-2 (336-fold increase) and alpha (40-fold increase). Conclusions The proteomic profile of the saliva varied substantially between the groups. Hemoglobin subunit gamma-1, gamma-2 and alpha may play a protective role in children with ECC. These proteins should be evaluated in future studies, because they may be possible good candidates to be included in anti-caries dental products.

Dental caries experience and its relationship to demographic factors in 2- to 6-year-old children in Fars-Iran in 2018.

Among oral conditions, tooth decay is the most common chronic childhood disease. Children's dental caries are influenced by several factors, among which diet is one of the most highlighted ones. The present study was conducted to examine the decayed, missing and filled teeth in primary dentition (dmft) and caries-free (CF) indexes as well as the impact of nutrition and demographic factors on oral health of 2- to 6-year-old children in Fars Province. A cross-sectional study was conducted on children aged 2-6 years old to evaluate dmft and CF indices according to the latest WHO standards as well as their demographic characteristics in 2018. A questionnaire was used for data collection. A total of 2220 children were recruited. The mean dmft was 1.37 ± 2.69. The components of the dmft score included decay (1.23 ± 2.6), missing (0.03 ± 0.11) and filling (0.11 ± 0.7) in primary dentition, and the prevalence of caries-free children was 66.5%. The results showed that dmft had a significant positive relationship with breastfeeding termination time, maternal education level and maternal age. Birth weight, consumption of iron, vitamin A and D supplements, age at onset of complementary feeding and maternal occupation had no significant relationship with dmft. The tooth decay index of 2- to 6-year-old children in Fars Province is very different from WHO global standards. Therefore, educating mothers about the duration of breastfeeding is important to achieve standard values for the dental caries index.

Comparative real-time PCR quantification of cytomegalovirus in severe early childhood caries and caries-free children

The present study was undertaken to evaluate cytomegalovirus (CMV) load in carious lesions in children with severe early childhood caries (S-ECC) and compare it with caries-free (CF), healthy children, by quantitative real-time polymerase chain reaction (PCR). Dental plaque samples were collected from 57 subjects including S-ECC (n = 33) and CF (n = 24) patients. The two groups were matched in terms of age, gender, and socioeconomic status. After deoxyribonucleic acid (DNA) extraction, SYBR Green real-time PCR was used to quantify CMV DNA. The CMV DNA was detected in seven patients in theS-ECC group. The mean of decayed, missing, and filled tooth surfaces (dmfs) was 11.90 ± 5.95 in the S-ECC group. There was no significant difference in gender between the two groups. There was a significant relationship between CMV positivity in children and theS-ECC group (p = 0.043). Results of this study suggest a relationship between the presence of CMV in the oral cavity and S-ECC. We can design clinical trials to confirm these results and improve children's dental care.

Proteomic study of plaque fluid in high caries and caries free children.

BACKGROUND: The occurrence and development of caries is a complex process affected by multiple factor.OBJECTIVE: The present study was envisaged to evaluate the plaque fluid in caries free children and children with high caries, in order to establish a data set of bacterial secretion proteomics. A non-labeled quantitative technique based on two-dimensional liquid chromatography-series mass spectroscopy was employed to detect plaque fluid. Based on the proteomics data, the database search, data processing and pathway analysis illuminated the function of these proteins, and clarified the role of plaque microecology in caries occurrence and development.METHODS: The study enrolled 8 caries free (CF) children, whose decayed-missed-filled surface of teeth is 0 (dmfs 0), and caries sensitive (CS) children, whose decayed-missed-filled surface of teeth is 10(dmfs 10) (3 5 years old) for the smooth tooth plaque and the plaque in the high caries group. The plaque protein was extracted using the unlabeled quantitative technique like liquid chromatography-series mass spectrometry, using DeCyder MS Differential Analysis Software (version 1.0, GE Healthcare) that detected and compared the spectra, and quantified the full scanning before series mass spectroscopy. After obtaining all peptides with quantitative information, significantly differential polypeptide molecules were obtained ( 0.05), and a metabolic pathway analysis was performed.RESULTS: We identified 1,804 peptides with quantitative information, including 39 in CF, 30 in CS, and 1,735 similarly expressing peptides. After statistical analysis, 603 statistically different expression peptide data sets were obtained, including 202 high-expressed peptides in Group CF, 33 greater than 1.5 fold peptides, 401 high-expressed in Group CS and 199 greater than 1.5 fold peptide (173 nonredundant proteins).CONCLUSION: Our study obtained the largest known dataset of the bacterial secretion protein in children with high caries, and screened the data set of high caries state. 603 peptides were statistically rich in 101 pathways, including glycolysis pyruvate acid metabolism, tricarboxylic acid cycle, pentyl phosphate pathway, fructose mannose metabolism, starch and sucrose metabolism, and ABC transporters.

The Association of Early Childhood Caries with Salivary Antimicrobial Peptide LL37 and Mutans Streptococci.

This study aims to determine the relation of salivary LL37 level and mutans streptococci levels in early childhood caries (ECC). A case-control study was performed in children ≤71 months old. Unstimulated whole saliva was collected and the level of salivary LL37 was measured using an enzyme-linked immunosorbent assay kit. The mutans streptococci oral bacteria were isolated from saliva and identified using a modified SB-20 culture medium (SB-20M). Data were analyzed using descriptive statistics, bivariate, and Spearman's rank correlation analysis. The was a variability of salivary LL37 level among the children and the level was significantly associated with age and races. The median (IQR) value of salivary LL37 in caries-free (CF) children was significantly higher 393.50 (580.55) ng/mL compared to 172.50 (234.65) ng/mL in the ECC group. The ECC children exhibited a significantly higher count of S. mutans and S. sobrinus compared to the CF children. An inverse weak correlation between salivary LL37 and dmft was also observed. The low salivary LL37 level and higher S. mutans and S. sobrinus count in ECC supported the protective role of salivary LL37 against dental caries. Further studies are required to explore the definite relation between salivary LL37 levels and dental caries.

Mutans Streptococci and Lactobacilli: Colonization Patterns and Genotypic Characterization of Cariogenic Bacterial Species in American Indian Children

Aim: The purpose of this study was to investigate the presence of Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus species in an American Indian population displaying a high incidence of severe early childhood caries (S-ECC) and to explore the genotypic diversity and fidelity of transmission of S. sobrinus in this population.Methods: We report here on the microbial profiles of 71 children compiled from birth to 36 months of age and initial exploration of genotypic diversity in a subset of 40 mother/child dyads. Whole mouth plaque samples were collected from mother/child dyads in a Northern Plains American Indian cohort. Mutans streptococci (MS) and Lactobacillus counts were recorded and presence/absence of S. mutans, S. sobrinus, and Lactobacillus was noted for each child. S. sobrinus was isolated and genotyped via arbitrarily primed-polymerase chain reaction (AP-PCR).Results: The children in this study were divided into caries active (CA) and caries free (CF) groups. S. mutans, S. sobrinus, and Lactobacillus species were detected more frequently in CA groups. Distribution of MS and Lactobacillus counts was significantly different between the two groups, as was the distribution of three species colonization profiles. Twelve S. sobrinus genotypes were detected in the subset of mother/child dyads. Individual participants displayed a range of 0–3 distinct genotypes while mother/child pairs displayed a range of 1–5 genotypes. Eighty-three percent of children shared at least one genotype with his/her mother.Conclusion: Caries active children in this population display different microbial profiles than the caries free children in this cohort. A small number of S. sobrinus genotypes appear to be very common in this population. A high rate of vertical transmission of S. sobrinus from mother to child is seen in these mother/child dyads.

Salivary Malondialdehyde Level as a Lipid Peroxidation Marker in Early Childhood Caries

Background: Early childhood caries (ECC) is an aggressive and multifactorial form of dental caries in children, in which the biomarkers of oxidative stress may increase. Objectives: This study aimed to compare the salivary malondialdehyde (MDA) levels in children with early childhood caries (ECC) and caries-free (CF) children. Methods: To this end, 42 ECC children and 42 CF children, aged 4 - 6 years, were randomly selected from the kindergartens of four socio-economically different districts of Isfahan. An unstimulated saliva sample was obtained from children fasting during the past night using the spitting method. In the laboratory, the MDA levels were evaluated spectrophotometrically. An independent-samples t-test was used to examine the differences between the two groups. Results: The mean salivary MDA level was significantly higher in the ECC group than in the CF group (P = 0.01), and there was no significant relationship between salivary MDA and gender (P = 0.44 in the ECC group, P = 0.30 in the CF group). Moreover, no significant relationship was noticed between MDA with decayed, missing, filled teeth (dmft). Conclusions: The findings documented a relationship between ECC and MDA as one of the products of oxidative stress reactions. Accordingly, the MDA level of saliva can be a critical indicator in determining the status of caries in children.

Functionally Active Microbiome in Supragingival Biofilms in Health and Caries

The oral microbiome is unique at inter and intra-individual levels at various sites due to physical and biological factors. This study aimed to compare the bacterial composition of supragingival biofilms collected from enamel sites with different caries activity, from active and inactive-caries subjects, and from caries-free (CF) subjects. Twenty-two individuals (aged between 13 and 76 years old; med = 23.5 years old) were allocated into 3 groups: caries-active (CA) (n = 10), caries-inactive (CI) (n = 6), and CF (n = 6). From the CA group, 3 sites were sampled: CA (active non-cavitated lesion), CI (inactive non-cavitated lesion), and sound enamel surface (S). From the subjects of the CI group, biofilm from a CI lesion was collected (INCL), while for the CF subjects, a pool of biofilm from sound enamel surfaces was sampled. The total RNA was extracted, and cDNA libraries were prepared and paired-end sequenced (Illumina HiSeq 3,000). Final dental biofilm samples analysed from CA was 16 (ANCL-CA = 6, INCL-CA = 4, S-CA = 6); from CI, 3 (INCL-CI = 3); and from CF, 6 (S-CF = 6) (some samples were lost by insufficient genetic material). Read sequences were processed and analysed using the Metagenomics RAST server. High-quality sequences (3,542,190) were clustered into operational taxonomic units (97% identity; SILVA SSU), representing 915 genera belonging to 29 phyla (higher abundant: Actinobacteria, Firmicutes, Bacteroidetes, and Fusobacteria). The presence of a core microbiome was observed (123 shared genera). The alpha diversity analysis showed less bacterial diversity in disease (S-CA) compared to health (S-CF). The dominant genera included Actinomyces, Corynebacterium, Capnocytophaga, Leptotrichia, Veillonella, Prevotella, Streptococcus, Eubacterium, and Neisseria. Veillonella and Leptotrichia were related with disease and Prevotella with health. Corynebacterium, Capnocytophaga, and Actinomyces clustered together presenting high abundance in health and disease. The Metric Multidimensional Scaling Ordination analysis shows that sites from active subjects (ANCL-CA, INCL-CA, and S-CA) are closer to each other than either INCL-CI subjects or S-CF subjects. In conclusion, supragingival bacterial communities presented intra-individual similarities, but inter-individual diversity and difference in bacterial composition reveal that the subject’s caries activity status matters more than sites.

Bacterial Composition and Metabolomics of Dental Plaque From Adolescents.

Supragingival dental plaque samples were collected from 40 Swedish adolescents, including 20 with caries lesions (CAR) and 20 caries-free (CF). Fresh plaque samples were subjected to an ex vivo acid tolerance (AT) test where the proportion of bacteria resistant to an acid shock was evaluated through confocal microscopy and live/dead staining, and the metabolites produced were quantified by 1H Nuclear Magnetic Resonance (1H NMR). In addition, DNA was extracted and the 16S rRNA gene was sequenced by Illumina sequencing, in order to characterize bacterial composition in the same samples. There were no significant differences in AT scores between CAR and CF individuals. However, 7 out of the 10 individuals with highest AT scores belonged to the CAR group. Regarding bacterial composition, Abiotrophia, Prevotella and Veillonella were found at significantly higher levels in CAR individuals (p=0.0085, 0.026 and 0.04 respectively) and Rothia and Corynebacterium at significantly higher levels in CF individuals (p=0.026 and 0.003). The caries pathogen Streptococcus mutans was found at low frequencies and was absent in 60% of CAR individuals. Random-forest predictive models indicate that at least 4 bacterial species or 9 genera are needed to distinguish CAR from CF adolescents. The metabolomic profile obtained by NMR showed a significant clustering of organic acids with specific bacteria in CAR and/or high AT individuals, being Scardovia wiggsiae the species with strongest associations. A significant clustering of ethanol and isopropanol with health-associated bacteria such as Rothia or Corynebacterium was also found. Accordingly, several relationships involving these compounds like the Ethanol : Lactate or Succinate : Lactate ratios were significantly associated to acid tolerance and could be of predictive value for caries risk. We therefore propose that future caries risk studies would benefit from considering not only the use of multiple organisms as potential microbial biomarkers, but also their functional adaptation and metabolic output.

Early Childhood Caries Experience Associated with Upper Respiratory Infection in US Children: Findings from a Retrospective Cohort Study.

Both Early Childhood Caries (ECC) and Upper Respiratory Infection (URI) are infectious diseases. The oral cavity is considered a potential reservoir of respiratory pathogens due to the anatomical proximity between the oral cavity and respiratory system, which implies a potential association between ECC and URI. Hence, this study aimed to evaluate the association between ECC experience and URI incidence in preschool children. This retrospective cohort study collected data via electronic health records. The exposure was ECC before 3 years of age. The dependent variable was the incidence of URI between 4-6 years of age. To analyze the factors associated with the time-to-event of URI, we used log-rank tests and Cox regression models to compare the survival of URI between the ECC and Caries-Free (CF) groups, adjusting factors including demographic-socioeconomic characteristics and medical conditions. To analyze factors associated with the number of URI episodes, we used negative binomial regression models adjusting for factors mentioned above. A total of 497 US preschool children were included, with 117 ECC and 380 CF children. More children with ECC (58.1%) developed URI than the CF group (47.6%) during the follow-up period (4-6 years of age) (p=0.04). The ECC children were at 1.6 times higher risk to develop URI than the CF children even after accounting for other URI risk factors (Hazard Ratio 1.57 (1.13, 2.10), p=0.007). Our study suggests a potential association between ECC and URI, with an inference that early life ECC experience could be used as a predictor for developing URI in preschool age. The causal relationship between ECC and URI incidence in young children needs to be investigated through future studies.

Spanish Curriculum in Cariology for undergraduate dental students: Proceedings and consensus.

Cariology is today a broad-based discipline and in the Spanish university teaching field, all this knowledge is not unified in a curriculum. Therefore, the aim was to develop a consensus text based on the European Core Curriculum, updated, and adapted to the characteristics of the Spanish university environment. A Spanish Cariology Curriculum Group (SCCG) was set up with members of the Spanish Society of Epidemiology and Oral Public Health (SESPO), Spanish Society of Conservative and Aesthetic Dentistry (SEOC) and Spanish Society of Paediatric Dentistry (SEOP) and university experts to adapt the European Core Curriculum in Cariology for undergraduate dental students (ECCC) for Spain. The work was carried out online during 2018 and 2019, and also face-to-face meetings took place to obtain a draft curriculum open for discussion that was presented to all the Spanish universities. The final modifications to the document were specified in a Consensus Conference of Spanish universities offering a Degree in Dentistry that took place in Madrid on 19November 2019. Thirty-eight university experts, under SCCG supervision, participated in the elaboration of the new framework document. A total of 16 universities, from 23 invited, reached a consensus as to the contents of the Spanish Curriculum in Cariology for undergraduate dental students. This new Curriculum emphasises learning outcomes, uses a consensus-based terminology pertaining to caries and other hard-tissue conditions, and introduces a new domain of competence in Domain III of ECCC. This new Cariology Curriculum is the result of a very broad-based consensus of university experts in Spain and lays the foundation for the implementation of an integrated teaching of Cariology in Spain in adherence to Alliance for a Caries Free Future (ACFF) objectives.

Firmicutes Levels in the Mouth Reflect the Gut Condition With Respect to Obesity and Early Childhood Caries.

The present cross-sectional study investigated whether Firmicutes (F) and Bacteroidetes (B) levels in the mouth reflected the gut condition in obesity and early childhood caries (ECC). Eighty preschoolers (3-5 years) were equally assigned into four groups: 1. obese + ECC, 2. obese + caries-free (CF), 3. eutrophic + ECC, and 4. eutrophic + CF. Nutritional status and ECC were assessed based on the WHO criteria. Dental biofilm and fecal samples were collected for F and B quantification using RT-PCR analysis. Data were evaluated using three-way-ANOVA and Pearson’s correlation (α = 0.05). Regardless of the anatomical location effect (p = 0.22), there were higher values for F in the obese children + ECC compared with those in obese + caries-free (CF) in both mouth and gut (p < 0.05). The correlation for F at these sites was negative in obese children + ECC (r = −0.48; p = 0.03) and positive in obese children + CF (r=0.50; p = 0.03). Bacteroidetes were influenced by ECC (p = 0.03) and the anatomical location (p = 0.00), and the levels tended to be higher in the mouth of the obese children + ECC (p = 0.04). The F/B ratio was higher in the gut and was affected by the anatomical location (p = 0.00). This preliminary study suggested that modulated by ECC, counts of oral Firmicutes reflected corresponding condition in the gut of obese preschoolers. In addition, we first evidenced that the Firmicutes phylum behave differently according to the nutritional status and caries experience and that supragingival biofilm and gut could share levels of similarity.

The Correlation of Knowledge of Dental Health with Prevalence of Free Permanent First Molar Dental Caries in Islamic Boarding School

Background: Children aged between 6-12 years or school-age children are groups who are susceptible to oral diseases, especially caries, permanent first molar because they still have self-defeating habits in oral health. In addition, this erupted tooth does not replace any primary teeth and is located behind. Purpose: The knowledge of the correlation between students’ knowledge of cariogenic food and the low prevalence of free caries for permanent first molars in students of Secondary School of DARUL HIKMAH Al Hidayah Islamic Boarding School in Surabaya. Method: Type the research conducted was sectional analytic research. The sampling technique in this study was simple random sampling. Based on the simple random sampling technique, the target of this study was 102 students aged 12 years. Data collection method used observation. Data analysis techniques used the Pearson test. Results: there was a correlation between students’ knowledge of cariogenic food and the low prevalence of the number of caries-free in permanent first molars in students of Secondary School of DARUL HIKMAH Al Hidayah Islamic Boarding School in Surabaya. Conclusion: The prevalence of caries-free number of permanent first molars in Secondary School of DARUL HIKMAH Al Hidayah Islamic Boarding School Surabaya in the low category.