Enamel Caries Research Articles

Non-invasive Treatment of Demineralized Enamel by Eggshell Powder, Bioactive Glass, and Casein: Comparative Study

Introduction: Non-invasive treatment protocol of demineralized enamel lesions as more conservative procedure by different remineralizing agents would bring a major approach in the clinical management of these enamel defects. Aim: The present study was aimed to investigates in-situ remineralization of the demineralized enamel surface, by treatment with different remineralizing agents and stored in an artificial saliva with neutral pH, at 37 °C for 21 days. Materials and Method: We investigated the morphology, and chemical composition of the demineralized and remineralized enamel surface, which treated with Chicken Eggshell powder solution (CESPS), Bioactive Glass (BAG), and Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) as remineralizing agent twice daily and stored in artificial saliva for 21 days. The surface morphology, as well as the chemical composition of the remineralized enamel samples were studied by scanning electron microscopy (SEM) coupled with energy dispersive X-ray (EDX) spectrometry. Results: CESPS resulted in the higher and significant remineralization results when comparing with BAG alone or in combination with it as well as it showed significant effect when compared with CPP-ACP. Conclusion: CESPS, BAG, and CPP-ACP can use as non-invasive treatment of early carious enamel lesions.

Near-infrared transillumination with high dynamic range imaging for occlusal caries detection in vitro.

The aim of this study was to assess near-infrared transillumination with high dynamic range imaging (NIRT-HDRI) for occlusal caries detection in vitro and to compare it with visual inspection using the International Caries Detection and Assessment System II (ICDAS) and digital bitewing radiography (BWR). Sixty-one extracted permanent molars with sound or occlusal carious surfaces without severe cavitation were visually assembled. Two examiners assessed twice these surfaces independently using ICDAS, BWR and NIRT-HDRI. The latter was performed with a prototype consisting of two laser sources (780nm), a CCD sensor and subsequent processing with image analysis software. Thresholds for carious surfaces, enamel and dentin lesions were defined for all methods. Micro-computed tomography served as the reference standard. Linear weighted Kappa analysis of the methods versus the reference at the threshold carious surface, enamel and dentin lesion revealed 0.59/0.08/0.12 for ICDAS, 0.37/- 0.06/0.58 for BWR and 0.33/- 0.01/0.51 for NIRT-HDRI. Sensitivity values at the three thresholds were 0.85/0.78/0.13 for ICDAS, 0.59/0.00/0.69 for BWR and 0.98/0.33/0.78 for NIRT. Specificity values at the three thresholds were 0.70/0.40/1.00 for ICDAS, 0.9./0.96/0.90 for BWR and 0.30/0.65/0.72 for NIRT-HDRI. Reliability analysis revealed substantial agreement for BWR and NIRT and almost perfect agreement for ICDAS. NIRT exhibited a strong ability to identify occlusal dental decay in general; however, it revealed a tendency towards overestimation. Its strength was the detection of dentin caries lesions compared with ICDAS and BWR. NIRT-HDRI seems to be a suitable method to detect hidden dentin caries as a supplement to visual examination.

Laser induced fluorescence with 2-D Hilbert transform edge detection algorithm and 3D fluorescence images for white spot early recognition.

There is a must for non-invasive caries detection method to supplement traditional visual assessment by the clinician before lesion progression reaches a stage requiring invasive therapy. In this paper, the nature of tissue response to light interaction has been used for early diagnosis, using laser induced fluorescence spectroscopy. Human tooth sample was illuminated with He-Ne laser sources (633nm) with energy 5mW. The reflected and emitted spectra of investigated samples were collected using hyperspectral camera to develop multispectral images. The variation of reflected and emitted energy as function in wavelength was employed to generate characteristic spectrum of each tooth tissue. Human teeth caries lesion releases their excess energy by emitting fluorescence light producing chemical footprint signature for each tooth elements and caries state. This non-invasive, non-contact, and non-ionizing hyperspectral imaging system was employed to diagnose and classify different caries types and stages. Reconstructed 3D fluorescence images offered discrimination between enamel and dentin caries at 633nm illumination spectral line; white spot lesion was clearly detected and recognized at far visible and infrared wavelength ranges. This study reports on customized optical imaging system that can offer high sensitivity, high resolution. Optimum stimulating wavelength for early caries detection was reported to be 633nm. This novel approach can offer a full map of caries degree status.

Effect of Different Formulations and Application Methods of Coral Calcium on its Remineralization Ability on Carious Enamel

BACKGROUND: Coral calcium is a new biomimetic product and dietary supplement which consists mainly of alkaline calcium carbonate.
 AIM: The aim of the current study is to compare the remineralization effect of coral calcium in different formulations and application methods.
 METHODS: A total of 35 extracted molars was collected, examined, and sectioned to obtain 70 sound enamel discs, all specimens were examined for calcium mineral content using energy dispersive analysis of X-rays (EDAX) coupled with scanning electron microscope. Hydroxyapatite (HA) nanoparticles were synthesized through wet chemical precipitation approach and characterized by transmission electron microscopy (TEM) and Fourier transform infrared (FT-IR) analysis. Teeth specimens were subjected to demineralization, and mineral content was measured, specimens were divided into ten groups according to the remineralizing agent used, where Groups 1–3 used 10, 20, and 30 weight % (wt.%) coral calcium gel, respectively, Groups 4–6 used 10, 20, and 30 wt.% coral calcium and nanohydroxyapatite mix gel, and Groups 7–9 used 10, 20, and 30 wt.% coral calcium with argon laser activation and Group 10 (control group) without a remineralizing agent. All groups were re-examined by EDAX after remineralization.
 RESULTS: The TEM and FT-IR analysis confirmed the formation of rod shape HA in nanoparticles size range. All groups showed a statistically significant decrease in calcium level after demineralization, all groups showed a statistically significant increase in calcium content after remineralization except for the control group. Moreover, Groups 2 and 8 showed the highest increase in calcium level after remineralization.
 CONCLUSION: Coral calcium showed a significant remineralizing effect on carious enamel (demineralization) with an optimum concentration of 20 wt.%.

Tuftelin-derived peptide facilitates remineralization of initial enamel caries in vitro.

With the gradual discovery of functional domains in natural proteins, several biologically inspired peptides have been designed for use as biomaterials for hard tissue regeneration and repair. In this study, we designed a tuftelin-derived peptide (TDP) and tested its effects on hydroxyapatite crystallization and remineralization of initial enamel carious lesions in vitro. Using circular dichroism spectroscopy, we found that TDP contained 36.1% β-sheets and β-turns, which could be influenced by calcium ions. We verified the ability of TDP to crystallize hydroxyapatite using transmission electron microscopy and its ability to bind to the enamel surface and hydroxyapatite using confocal laser scanning microscopy and Langmuir adsorption isotherms (K = 881.56, N = 1.41 × 10-5 ). Artificial enamel lesions were generated on human enamel blocks and subjected to a 12-day pH cycling model and were treated with 25 μM TDP, 1 g/L sodium fluoride (NaF), or deionized water. We analyzed the results of remineralization by surface microhardness testing, polarized light microscopy, and transverse microradiography. The TDP group showed significantly higher surface microhardness recovery (49.21 ± 1.66%), shallower lesions (34.89 ± 4.05 μm), and less mineral loss (871.33 ± 81.49 vol%·μm) after pH cycling than the deionized water group (p < .05). There were no significant differences between the TDP and NaF groups. Our experiment indicated that TDP could regulate hydroxyapatite crystallization and promote remineralization of enamel caries in vitro.

Biomimetic chitosan against bioinspired nanohydroxyapatite for repairing enamel surfaces

In this study, chitosan was employed as a novel biomimetic mineralization model to repair damaged enamel to compare its performance with that of bioinspired zinc-doped nanohydroxyapatite. Fifty human premolar tooth slices were prepared, and artificial caries lesions were induced to produce demineralized enamel surfaces. The etched slices were randomly divided into two groups: a chitosan-hydrogel-treated group and a zinc-doped nanohydroxyapatite-treated group. In vitro assessment using energy-dispersive X-ray analysis, X-ray diffraction analysis and scanning electron microscopy was conducted at the baseline, demineralization and remineralization stages. Baseline results were matched with those for normal enamel; a marked reduction in the calcium (Ca)/phosphorus (P) ratio to 1·12 and the lack of the characteristic hydroxyapatite diffraction peaks were detected for demineralized enamel. The remineralization stage revealed evident recovery of the mineral contents (the calcium/phosphorus ratio was 1·61 for the chitosan-treated group and 1·58 for the bioinspired-nanohydroxyapatite-treated one), with apparent distinctive X-ray diffraction patterns of hydroxyapatite in both groups. Scanning electron microscopic analysis showed the absence of etched enamel porosity, with the formation of a newly formed rod-like apatite layer, similar to natural enamel, which extended over the treated enamel surfaces of both groups. Chitosan hydrogel is recommended as a biomimetic mineralization smart system for repairing demineralized carious enamel.

Monitoring enamel caries on resin-treated occlusal surfaces using quantitative light-induced fluorescence: an in vitro study.

The aim of this study is to evaluate the ability of quantitative light-induced fluorescence (QLF) to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. Sixty extracted permanent teeth had one occlusal site selected and were categorized according to the International Caries Detection and Assessment System (ICDAS) criteria. The teeth were divided into three groups (n = 20): ICDAS 1, ICDAS 2, and ICDAS 3. The teeth were assessed by a trained examiner using QLF in two phases: (A) before and (B) after treatment with resin infiltrant. The caries lesions were evaluated using the following QLF parameters: area (mm2); ΔF, fluorescence loss (%); and ΔQ, fluorescence loss integrated over the lesion area (%*mm2). The resin infiltrant (Icon™) was applied on the occlusal surface following the manufacturer's recommendations. The teeth were then sectioned and prepared for polarized light microscopy analysis. The penetration of resin infiltrant was measured with ImageJ. The groups showed a statistically significant difference in all QLF parameters before and after caries infiltration, with the reduction of fluorescence values posttreatment (p < 0.05). Infiltrant penetration was observed in all groups, with a statistical difference between all groups (p < 0.05). The reduction in QLF parameters after resin infiltration suggests that QLF is able to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant.

Saliva proteomics from children with caries at different severity stages.

To perform a comparative analysis of saliva protein profile of patients with early childhood caries at different levels of severity and caries-free individuals. Stimulated saliva samples were collected from 126 children (2-6years old), classified according to the ICDAS II, and divided into 3 groups (n=42): caries-free (CF), enamel caries (EC), and dentine caries (DC). Samples were digested and analyzed by nanoUPLC coupled with a mass spectrometry. Data analyses were conducted with Progenesis QI for Proteomics Software v2.0. Gene Ontology (GO) terms and protein-protein interaction analysis were obtained. A total of 306 proteins (≈6 peptides) were identified. Among them, 122 were differentially expressed in comparisons among children with different caries status. Out of the 122 proteins, the proteins E2AK4 and SH3L2 were exclusively present in groups CF and EC, respectively, and 8 proteins (HAUS4, CAH1, IL36A, IL36G, AIMP1, KLHL8, KLH13, and SAA1) were considered caries-related proteins when compared to caries-free children; they were up-regulated proteins in the caries groups (EC and DC). The identification of exclusive proteins for caries-free or carious-related conditions may help in understanding the mechanisms of caries and predicting risk as well as advancing in caries control or anti-caries approaches.

Diagnostic Performance of ICDAS II, FluoreCam and Ultrasound for Flat Surface Caries with Different Depths

The use of ultrasound for the diagnosis of natural caries lesions with different depths on flat surfaces of permanent molar teeth was studied. A total of 200 freshly extracted permanent molar teeth with natural caries lesions were included. After evaluation with International Caries and Detection Assessment System II (ICDAS II), mineral loss and lesions in the teeth were detected with a fluorescence device, FluoreCam and lesion depths were measured using ultrasound. The teeth were sectioned and examined histologically using a microscope. The intraclass correlation coefficient was 0.97 for the ultrasound system, 0.65 for the ICDAS II classification and 0.59 for FluoreCam (p < 0.001 for all). With an increase in ICDAS II scores, mean ultrasound values, FluoreCam-Size and microscope measurements increased numerically, while FluoreCam-Intensity and FluoreCam-Impact measurements inversely decreased (p < 0.001). There was a high level of agreement between histologic diagnosis and ultrasound. Ultrasound and FluoreCam can be used to detect enamel caries on flat surfaces.

Anti-caries effect of resin infiltrant modified by quaternary ammonium monomers

ObjectivesResin infiltrant is used in early enamel caries. However, commercial resin infiltrant lacks persistent antibacterial activity. Dimethylaminododecyl methacrylate (DMADDM) was added to resin infiltrant to give it sustainable antibacterial properties and inhibit demineralization. MethodsAfter the application of resin infiltrant to bovine enamel, cytotoxicity, surface roughness, and aesthetics were assessed. A multi-species biofilm was incubated on the enamel disk before and one month after microbial-aging. After a 48-h anaerobic incubation, biomass accumulation, metabolic activity, and lactic acid were analyzed using a crystal violet assay, an MTT (3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, and a lactic acid assay. Biofilm structure and composition were determined by live/dead staining, exopolysaccharide (EPS) staining, scanning electron microscopy (SEM), and quantitative polymerase chain reaction (qPCR). The depth and content of demineralization were tested by transverse microradiography (TMR). ResultsIncorporating DMADDM did not increase the cytotoxicity or change the physical properties when the mass fraction of the DMADDM was 2.5–10 %. The modification decreased the amount of bacterial biofilm, metabolic activity, lactic acid production, EPS, and the proportion of Streptococcus mutans in the biofilms. It also provided anti-demineralization effects. The surface roughness and antibacterial ability were not changed after one month of microbial-aging. ConclusionThe incorporation of DMADDM improved the antibacterial and anti-demineralization effects of the material. It demonstrated a sustained antibacterial effect. Clinical significanceThe antibacterial modification might be a potential choice for future clinical applications to inhibit early enamel caries.

PH-responsive calcium and phosphate-ion releasing antibacterial sealants on carious enamel lesions in vitro

ObjectiveNanoparticles of amorphous calcium phosphate (NACP) have shown beneficial effects of a robust release of calcium and phosphate ions at low pH. Here we examined the effect of NACP combined into antibacterial/rechargeable sealant formulations on the mineral content of artificial carious enamel during pH-cycling mimicking intraoral conditions. Materials and MethodsNACP and a quaternary ammonium methacrylate (DMAHDM) were synthesized. Three resin sealants were formulated: "base formulation" (without NACP and DMAHDM, used as control); "NACP on the base formulation" (with 20 wt.% NACP); "NACP on the antibacterial formulation" (with 20 wt.% NACP and 5 wt.% DMAHDM). Standardized enamel windows on sealed non-carious human molars were demineralized and randomly divided into four groups: three groups of teeth sealed with the experimental materials and one group of teeth without sealant application used as negative control. The teeth were exposed to pH cycling regime. The changes in the mineral content of enamel were assessed by quantitative surface hardness loss in percentage (%SHL) and qualitative analyses via scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM-EDX) and polarized light microscopy (PLM). ResultsThe contact with NACP-containing formulations provoked significant lower %SHL on sealed enamel (p < 0.05) in comparison to control groups. This outcome was supported by the results of SEM-EDX, in which the enamel presented higher percentages of calcium and phosphate than control groups. PLM showed less enamel superficial demineralization around the sealants containing NACP. ConclusionNACP incorporated into an antibacterial sealant protected the enamel against demineralization. pH-responsive calcium and phosphate-ion releasing sealants with antimicrobial and rechargeable properties may be a reliable complementary approach for caries management. Clinical significanceDental caries is the most common childhood disease. Enamel demineralization represents the initial stage of carious lesion formation and may lead to invasive dental procedures. We explored the role of amorphous calcium phosphate (NACP) in a newly-developed antibacterial and rechargeable dental sealant formulation as a preventive approach.

Prevalence of Dental Caries and Dental Defects of Enamel in Children Aged 3 to 5 Years-Old from Salvador- BA, Brazil, 2018

Prevalence of Dental Caries and Dental Defects of Enamel in Children Aged 3 to 5 Years-Old from Salvador- BA, Brazil, 2018

Clinical performance of clinical-visual examination, digital bitewing radiography, laser fluorescence, and near-infrared light transillumination for detection of non-cavitated proximal enamel and dentin caries.

The aim of this study was to compare the clinical performance of clinical-visual examination using the International Caries Detection and Assessment System (ICDAS) II, digital bitewing radiography, near-infrared light transillumination (NIR-LT), and laser fluorescence (LF) for the detection of non-cavitated proximal enamel and dentin caries. The study included 335 patients, aged 12-18years, with no cavities in the posterior teeth. Clinical-visual inspections of 335 non-cavitated proximal caries were performed by two examiners. For enamel caries, clinical validation included a combination of clinical-visual and digital bitewing radiography assessments. For dentin caries, the clinical validation was opening the cavity. The accuracy rate, sensitivity, specificity, predictive values, and areas under receiver operating characteristic curves were determined. The agreement between the examiners' measurements was calculated using the kappa coefficient. The sensitivity, specificity, and accuracy of the methods were compared using the McNemar test. The significance level was set at p < 0.05. Digital bitewing radiography had the highest sensitivity (0.96) and accuracy (0.96), and LF had the lowest sensitivity (0.38) and accuracy (0.39). After separation of the lesions into enamel and dentin caries, clinical-visual examination had the highest sensitivity (0.98) and accuracy (0.98) for enamel caries, while digital bitewing radiography had the highest sensitivity (0.97) and accuracy (0.97) for dentin caries. The NIR-LT method had a higher sensitivity for enamel caries (0.86). Each method also differed significantly from the others (p < 0.001). Digital bitewing radiography gave the best prediction of proximal enamel and dentin caries. NIR-LT showed good potential for detection of proximal caries.

Do enamel and dentine caries at 5 years of age predict caries development in newly erupted teeth? A prospective longitudinal study

Objective: To explore caries development in children from 5 to 12 years of age, and to study whether enamel caries and dentine caries at 5 years of age could predict caries prevalence at 12 years of age, controlled for child characteristics.Methods: The study included 3282 children examined at 5 and 12 years of age. Data were collected by clinical examination and questionnaire. Enamel and dentine caries were registered at surface level. Data were tested by t-test and analysed by bi- and multivariate logistic regression. The study was ethically approved.Results: In 5-year-olds, 15% of the children had dentine caries experience and 21% had enamel caries. In 12-year-olds, 32% had dentine caries experience and 47% had enamel caries. Children with dentine caries experience at 5 years of age had at 12 years of age developed more surfaces with enamel caries (mean 2.8, SD 4.2) and dentine caries experience (mean 1.8, SD 2.5) than other children (p < .05). Dentine caries experience at 12 years of age was associated with having only enamel caries (OR 1.6, CI 1.2–2.0) and dentine caries experience (OR 3.2, CI 2.6–3.9) at 5 years of age. Family status and parental education were related to caries development.Conclusion: Children with caries in primary teeth continued to be caries risk children during the mixed dentition period. In addition to dentine caries experience, enamel caries in primary teeth was a predictor for caries development in young permanent teeth and may be used to improve the caries risk assessment.

High contrast dental imaging using a random fiber laser in backscattering configuration

In this work, a backscattering imaging method based on near infrared random fiber laser is shown to provide a high contrast optical image between carious and sound enamel. The obtained contrast is 0.70, which is more than 8 times higher than the contrast obtained from radiographic imaging. Caries and cracks in enamel could clearly be identified against healthy enamel using the optical system. The near infrared wavelength, high spectral density and low coherence of random fiber laser contribute to its deep penetration, high brightness and low speckle contrast, using the method in a backscattering configuration opens potential clinical use.

Remineralization of enamel caries by an amelogenin-derived peptide and fluoride in vitro.

Dental caries is one of the most common oral diseases in the world. This study was tantamount to investigate the combinatory effects of an amelogenin-derived peptide (called QP5) and fluoride on the remineralization of artificial enamel caries. The peptide QP5 was synthesized and characterized, and the binding capability of the peptide on hydroxyapatite (HA) and demineralized tooth enamel surface was analysed. Then, the mineralization function of the peptide and fluoride was studied through the spontaneous mineralization testing and remineralization on enamel caries in vitro. First, the novel peptide QP5 could bind on the hydroxyapatite and demineralized tooth enamel surfaces. Second, QP5 can transitorily stabilize the formation of amorphous calcium phosphate and direct the transformation into hydroxyapatite crystals alone and in combination with fluoride. In addition, compared to blocks treated by peptide QP5 alone or fluoride, the sample blocks showed significantly higher surface microhardness, lower mineral loss and shallower lesion depth after treatment with a combination of QP5 and fluoride at high or low concentrations. The peptide QP5 could control the crystallization of hydroxyapatite, and combinatory application of peptide QP5 and fluoride had a potential synergistic effect on the remineralization of enamel caries.

Deep penetration fluoridation for caries prevention and treatment: the use of Tiefenfluorid® junior in children. Case reports

The use of fluoride, a healthy diet and good dental care habits are the pillars of the fight against caries. At a time when the anti-fluoride movement is on the increase and raises doubts even amongst the dentists and dental hygienists, the dental environment should be based on the credible scientific evidence regarding the effectiveness and safety of therapy in their clinical management. The article presents the clinical cases in which the agent for deep penetration fluoridation Tiefenfluorid® junior (Humanchemie, German) was used in the treatment and prevention of carious lesions in children. The visual-tactile method was used for detecting caries lesions. The International Caries Detection and Assessment System – ICDAS II was used for classifying dental caries. Carious lesions activity were assessed using visual-tactile method at control visits every 3 months within 12 months. Fluoride is effective in the treatment of initial caries in enamel, and the agent based on silver and fluorine SDF (Silver Diamine Fluoride) effectively inhibits tooth decay in the dentin. The disadvantage of SDF is the black color of the teeth. In contrast to common fluoride compounds, the solution with fluoride Tiefenfluorid® junior (Humanchemie, German) becomes non-toxic due to the reaction with the second application solution with calcium hydroxide. Furthermore, the process takes place deep in the funnels of the dental enamel, not on the tooth surface. The deep penetration fluoridation can be used for the caries prophylaxis, including the mineral fissure sealing, as well as for the treatment of initial caries lesions. In the treatment of initial caries in small children, it is an alternative to the silver nitrate impregnation and for the fluoride varnishes.

Prenatal Substance Use Disorders and Dental Caries in Children

Substance use is common in women of reproductive age, but limited data exist on the dental health of their children, including risk of caries. We conducted a longitudinal cohort study of 790,758 infants born between 2006 and 2016 in Quebec, Canada. We identified women with substance use disorders before or during pregnancy. The main outcome measure was hospitalization for dental caries in offspring up to 12 y after birth. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for the association of maternal substance use with pediatric dental caries, adjusted for potential confounders. Children exposed to maternal substance use had a higher incidence of hospitalization for dental caries than unexposed children (105.2 vs. 27.0 per 10,000 person-years). Maternal substance use was associated with 1.96 times the risk of childhood dental caries (95% CI, 1.80–2.14), including a greater risk of caries of enamel, dentin, or cementum (HR, 2.00; 95% CI, 1.82–2.19) and dental pulp (HR, 2.36; 95% CI, 2.07–2.70), relative to no substance use. Associations were elevated for alcohol (HR, 2.31; 95% CI, 2.03–2.64) but were also present for cocaine, cannabis, opioids, and other substances. Substance use during pregnancy was more strongly associated with dental caries hospitalization than prepregnancy substance use. Associations were stronger in early childhood. Maternal substance use is associated with the future risk of dental caries hospitalization in children. Targeting substance use early in the lives of women may contribute to dental caries prevention in offspring.

Oral Health Practices And Status Of 12-Year-Old Pupils In The Western Region Of Cameroon

Dental caries, though common, presents with considerable variation in occurrence between countries, regions within countries, areas within regions, and among social and ethnic groups. The aim of this study was to describe the oral health status and practices of primary school children in the western region of Cameroon.&#x0D; This was a comparative descriptive cross sectional study took place in April to October 2018 in primary schools located in three localities (Urban, semi urban and rural) of the West region of Cameroon using a multistage random (cluster) sampling technique.&#x0D; There were a predominance of female pupils 265(54.9 %) than males 218 (45.1 %) and 411 (85.1 %) of the pupils had toothbrushes with the majority from urban areas 142 (94.7%). The frequency of brushing was higher in urban than the semi-urban and rural areas and 212 (50.5) of them brushed teeth once a day and nearly half 184 (43.8) twice daily. More than half 238 (56.7) of the children brush before breakfast wake up less than half brush 176 (42%) brush after supper. Two third 280(66.8%) of the children brush their teeth with toothbrush and without toothpaste 54(39.4%) was higher in rural areas. Wood ash 7 (5.1%), soap 4(2.9%) and chewing sticks 3(2, 2%) were most frequently used for brushing in rural areas. The majority 395 (82 %) of the children had plaque, 73(15.1 %) presented with dental mal positions, 341 (70.6 %) with bleeding gums and 223 (46.2 %) had calculus which was predominant in lower incisors. The prevalence of dental caries in the entire population was 28.1%.The majority of pupils 346 (71.6 %) were caries free and 01 (0.2 %) had a missing tooth due to decay. None of the children presented with filled teeth. The mean DMFT was higher in the rural (0.39) as compared to the semi urban (0.18) and the urban (0.09) respectively. The mean DMFT index of the entire population was 0.28 while 135(27.9%) of the pupils presented with enamel caries which was predominant in the first permanent molar, 19 (47.2%) presented with deep caries mostly in the second deciduous molars and 8 (22.5%) presented with enamel caries on the second deciduous molars. Dental trauma 12 (2.5%) was mostly found in the upper central incisors. More than a third 61(36.1%) of the pupils who presented with gingivitis were from rural areas,43(25,4%) from semi urban, and 40(26.7%) from urban areas. Almost all the children who lived in semi-urban 157(92.9%) and in urban areas 150 (78.7%) consumed cariogenic diets. A third of the children who ate in-between meals lived in urban areas149 (34.2%) while 123 (72.8%) of the children in semi-urban areas were conscious of their oral hygiene, and 61 (37.2%) of the children’s food are controlled by the parents. Only 37 (7.7 %) of the children have done have ever been to a dentist.&#x0D; The prevalence of dental caries, periodontal diseases and other orofacial lesions in the western region of Cameroon was low. Dental caries was found to be higher in rural and urban areas.&#x0D; Collaboration between the ministries of health and basic education is necessary as a measure to institute oral health education in primary schools. This will go a long way to reduce inequalities in oral health by improving in the oral practices.

Comparison of resin infiltration and microabrasion in the treatment of enamel caries

The study compared the efficacy and stability of resin infiltration and microabrasion therapeutic effect in patients with enamel caries. Materials and methods. The study included 80 patients with caries in white or pigmented spot stage on the vestibular surface of the anterior teeth. 40 patients underwent microabrasion, 40 — resin infiltration. Patients were evaluated initially, after oral hygiene, after the procedure, and 1 year later, the intensity of dental caries according to the patient hygiene performance index (PHP), gingival sulcus bleeding index (SBI), community periodontal index (CPI) and hyperesthesia level. Results. In both groups the effect was evaluated in 2 subgroups: 1) with high caries resistance and non-increased tooth sensitivity; 2) with high and medium caries resistance and increased tooth sensitivity. After microabrasion, the greatest changes were observed for hyperesthesia in patients with increased tooth sensitivity (p<0.0001 compared with the baseline and the infiltration group). PHP and CPI measures improved significantly in both microabrasion and infiltration groups. After the procedure microabrasion effectiveness was 75%, caries infiltration — 50%. After a year, relapse was recorded in 5 (12.5%) patients in the microabrasion group and in 28 (70%) people in the infiltration group (p<0.0001). Conclusions. Enamel resistance and tooth sensitivity should be considered while choosing treatment method for enamel caries. For patients with high enamel resistance and lack of dentin hyperesthesia, microabrasion is appropriate followed by remineralizing therapy. For teeth with moderate enamel resistance and dentin hyperesthesia, the combined method is recommended: resin infiltration with remineralizing therapy, followed by enamel microabrasion.