Carious Teeth Research Articles

Association between distal decay in second molar and impacted mandibular third molars: a retrospective study

Lower third molars are the most common impacted teeth encountered in clinical practice. There are various pathologies associated with the impacted tooth such as root resorption, distal caries of the adjacent tooth, cyst formation, periapical radiolucency and osteitis. One of the biggest dilemma faced by clinicians is the prophylactic extraction of the impacted third molar as it can lead to potential pathological complications.

Primary Dentition Caries Patterns as Predictors of Permanent Dentition Caries: A Prospective Cohort Study

The aims of this study were to estimate the risk of caries in the permanent teeth at 12 years of age and to describe the diagnostic accuracy of caries patterns in the primary dentition at age 4 years to predict caries at age 12 years. A prospective cohort study followed children from birth to age 12 years in the city of São Leopoldo, Brazil. Sociodemographic variables were collected at birth, and dental caries was measured at 4 and 12 years of age (n = 204). At 4 years, children were classified according to the presence of caries (cavitated and non-cavitated lesions), number of lesions, affected segment (anterior or posterior), and affected surface (occlusal, smooth, or proximal). Prediction of permanent dentition caries occurrence (DMFT ≥1) (primary outcome) involved Poisson regression with robust variance and standard diagnostic accuracy measures. The prevalences of caries at age 4 years (including non-cavitated lesions) and 12 years were 61.8% and 42.2%, respectively. All caries patterns in the primary dentition were associated with caries in the permanent dentition. In multivariable analysis, the strongest associations were carious lesions on the primary posterior teeth (RR 2.2; 95% CI 1.5–3.2) and occlusal surfaces (RR 2.1; 95% CI 1.4–3.0). Among patterns evaluated, the presence of any tooth with caries (cavitated or non-cavitated) had the highest sensitivity (73%), but any tooth with cavitated decay had the highest accuracy (67%). In conclusion, any dental caries experience in early childhood is strongly predictive of dental caries experience in early adolescence. Primary dentition carious lesions on the posterior teeth or occlusal surfaces and the presence of cavitated lesions were stronger predictors.

Differential analysis of the dentin soluble proteomic

ObjectivesTo perform a differential analysis of the dentin soluble proteomic and assess the effects of tissue health state and protocol for protein extraction. We hypothesized the dentin soluble proteomic varies according to the tissue physiopathological state (intact vs. caries-affected) and protocol used to extract its proteins. MethodsDentin from freshly extracted non-carious and carious teeth were randomly assigned for protein extraction using either guanidine-HCl/ethylenediaminetetraacetic acid (EDTA) or acetic acid. Protein extracts from intact and caries-affected dentin were processed and digested with trypsin for shotgun label-free proteomic analysis (nLC-ESI-MS/MS). Peptides identification was performed on a nanoACQUITY UPLC-Xevo Q-Tof MS system. Peptides identified with scores of confidence greater than 95% were included in the quantitative statistical analysis embedded in the PLGS software. Differences between experimental conditions were calculated using Student test-t with significance pre-set at α=0.05. ResultsA total of 158 human proteins were identified. Approximately one-sixth of proteins (24/158) were present in at least two different extracts. Conversely, the greatest number of proteins (134/158) was identified uniquely in only one of the extracts. Overall, a larger number of soluble proteins was retrieved from caries-affected than intact dentin (86/158). Likewise, a greater number of proteins was extracted by the guanidine-HCl/EDTA (106/158) in comparison to acetic acid protocol. Several proteins detected in dentin extracts, mainly those from caries-affected teeth, are biological and/or metabolically involved with tissue turnover/remodeling. ConclusionThe identity/abundance of soluble proteins retrieved from and remained in dentin noticeably depend on this tissue physiopathological state and protocol used to remove its minerals. Clinical significanceThe present findings brought new insight into the proteomic phenotype of human dentin and may provide targets for the development of novel caries disease-prevention therapies.

Photonics-based treatments: Mechanisms and applications in oral infectious diseases.

Infectious diseases remain a serious global challenge threatening human health. Oral infectious diseases, a major neglected global problem, not only affect people's lifestyles but also have an intimate association with systemic diseases. Antibiotic therapy is a common treatment. However, the emergence of new resistance problems hindered and enhanced the complication of the treatment. Currently, antimicrobial photodynamic therapy (aPDT) has long been the topic of intense interest due to the advantage of being minimally invasive, low toxicity, and high selectivity. aPDT is also becoming increasingly popular and applied in treating oral diseases such as tooth caries, pulpitis, periodontal diseases, peri-implantitis, and oral candidiasis. Photothermal therapy (PTT), another phototherapy, also plays an important role in resisting resistant bacterial and biofilm infections. In this mini-review, we summarize the latest advances in photonics-based treatments of oral infectious diseases. The whole review is divided into three main parts. The first part focuses on photonics-based antibacterial strategies and mechanisms. The second part presents applications for photonics-based treatments of oral infectious diseases. The last part discusses present problems in current materials and future perspectives.

Novel antibacterial and apatite forming restorative composite resin incorporated with hydrated calcium silicate

BackgroundWhite Portland cement is a calcium silicate material. It exhibits antibacterial properties and is biocompatible. In addition, calcium silicate-based materials are known to release calcium ions and form apatite. The purpose of this study was to develop a novel bioactive restorative resin composite with antibacterial and apatite forming properties to prevent tooth caries at the interface of teeth and restorative materials, by incorporation of hydrated calcium silicate (hCS) derived from white Portland cement.MethodsTo prepare the experimental composite resins, a 30 wt% light-curable resin matrix and 70 wt% filler, which was mixed with hCS and silanized glass powder were prepared in following concentrations: 0, 17.5, 35.0, and 52.5 wt% hCS filler. The depth of cure, flexural strength, water sorption, solubility, and antibacterial effect were tested. After immersion in artificial saliva solution for 15, 30, 60, and 90 days, ion concentration by ICP-MS and apatite formation using SEM-EDS, Raman spectroscopy and XRD from experimental specimens were analyzed.ResultsAll experimental groups showed clinically acceptable depths of cure and flexural strength for the use as the restorative composite resin. Water sorption, solubility, released Ca and Si ions increased with the addition of hCS to the experimental composite resin. Experimental groups containing hCS showed greater antibacterial effects compared with the 0 wt% hCS filler group (p < 0.05). The 52.5 wt% hCS filler group produced precipitates mainly composed of Ca and P detected as hydroxyapatite after immersion in artificial saliva solution for 30, 60, and 90 days.ConclusionsThis results show that composite resins containing hCS filler is effective in antibacterial effects. hCS has also apatite formation ability for reducing gap size of microleakage by accumulating hydroxyapatite precipitates at the restoration-tooth interface. Therefore, novel composite resin containing hCS is promising bioactive resin because of its clinically acceptable physiochemical properties, antibacterial properties, and self-sealing potential for prevention of microleakage for longer usage of restorations.

Prevalence Of Dental Caries Among Primary School Students In Madurai City, Tamilnadu, India

Aim: Dental caries is an important public health issue,influenced by various socio–demographic factors. The occurrence of carious teeth in school children is very much of concern as it will restrict their daily activities at the schools and homes instigating reductant loss of study, work and play hours.Therefore, the present study was aimed to determine the prevalence of dental caries amongprimary and middle school going childrenin Madurai city. Materials &amp; Methods: For this study, an overall of 40 Corporation schools were randomly selected from the Madurai city. About 3380 children aged between 6-10 years were selected from these schools.Assessment of dental caries prevalence was performed using WHO Basic Oral Health Surveys – Oral Health Assessment Form for the Children (2013). Each child was examined in their respective school by dental surgeons. Result: Out of the 3380 school children that wereexamined, 1475 were boys and 1905 were girls.43% school children had dental caries.Prevalence of dental caries was highest among the10-year-old school students (22.70%) and the lowest in 6- year-olds (17.62%). The dominance of dental caries was higher in girls (55.21%) than boys (44.78). Conclusion: The overall prevalence of dental carieswas 43% and it was higher in 10years old when compared to other age groups.Increased prevalence suggeststhat furtherfollow ups and likewise improving the awareness among teachers, parents and students are necessary too.Also, immediate oral health promotion strategies such as an increase in school dental health programmes are recommended.

Patients Perception of Quality of life Post Endodontic Therapy and Rehabilitation- A cross sectional study

Background- Dental caries is one of the most prevalent diseases of humans. Its sequalae are pain, swelling and eventually loss of tooth, if not treated in time, leading to improper mastication, digestion and hence, poor nutrition which affects one’s systemic health. One of the treatment modalities for carious tooth infecting the pulp is root canal therapy. It includes removal of all the carious tooth structure, shaping, cleaning, and disinfecting the root canals, obturating it and rehabilitating it with a suitable restoration. Patients have a varied perception about root canal therapy due to fear of pain, number of appointments and duration of the treatment procedure. Many a times patients also insist for extraction of an otherwise restorable tooth to get an implant. Thus, the aim of this study was to assess the patient’s perception of Quality of Life Post endodontic therapy and rehabilitation. Materials and Methods: In this Cross-sectional study, a questionnaire was designed comprising of 21 questions, and was filled by the adult patients who underwent root canal therapy in the past. Results: Majority of patients got their treatment done because of the chief complaint of a painful tooth, some had the chief complaint of a fractured tooth, swelling and discharge. 66.5% patients said that their treatment was completed in 2-3 appointments of 45mins-1 hour; 56.2% of patients said that the root canal therapy was not painful, and 90.1% of the patients have healthy and satisfactory condition of the root canal treated tooth. Conclusion: Almost all the patients who filled the questionnaire said that there is a significant improvement in their quality of life after the root canal therapy and rehabilitation, also 94% of patients said that they would recommend getting a root canal therapy instead of extraction. Key Words: Root canal therapy, Pain, Extraction Quality of life.

Clinical Performance of Diagnostic Methods in Third Molar Teeth with Early Occlusal Caries.

The aim of this study was to compare the diagnostic performance of clinical visual examination (ICDAS II), digital periapical radiography (PR), near infrared light transillumination (NIR-LT), and laser fluorescence (LF) to microcomputed tomography (Micro-CT) which is the reference standard for the detection of non-cavitated occlusal enamel and dentin caries in third molar teeth. Potential participants were consecutively recruited. In this prospective study, 101 third molars of 101 patients were examined; the molars had non-cavitated occlusal caries which required extraction. ICDAS II, PR, NIR-LT and LF examinations were carried out by two blinded examiners. Reference standard was determined by micro-CT imaging seven days after extraction. Accuracy rate, sensitivity, specificity, predictive values and areas under receiver operating characteristic (ROC) curves (Az) were statistically analyzed. Nonparametric variables were subjected to the Kruskal-Wallis Test. Significance level was set as p &lt; 0.05. NIR-LT had the highest sensitivity (99.67-99.67%) and accuracy (78.22-77.23%) for the determination of occlusal enamel caries according to examiners 1 and 2, respectively. LF method had the highest sensitivity (70.83-54.17%) and accuracy (66.34-59.41%) for determining occlusal dentin caries according to examiners 1 and 2, respectively. The ROC curve (Az) value ranged between 0.524 and 0.726 for the different methods tested. Most effective methods for the diagnosis of occlusal enamel and dentin caries were determined to be NIR-LT and LF pen methods, respectively. The present prospective clinical study showed that NIR-LT and LF-Pen were a reliable modality for the detection of occlusal enamel and dentin caries without ionizing radiation.

Continuing Challenges and Current Issues of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia: Case Report

Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy, accounting for nearly 75% of all newly diagnosed leukemias and 25% of all malignancies in childhood. The Philadelphia chromosome-positive Ph+ is a rare subtype of ALL, considered one of its poorest subgroups, and accounts for 3-5% of pediatric ALL. Dentists should acquire some background information about leukemia and its oral manifestations for better dental care. Commonly reported oral manifestations include regional lymphadenopathy, mucous membrane petechiae and ecchymoses, gingival bleeding, gingival hypertrophy, pallor, and non-specific ulcerations. In this case report, we aim to raise awareness among dentists and discuss the orthodontic management of a pediatric patient with Ph+ ALL. The patient was cleared by her treating physician, and treatment was done in the dental chair. Treatment included restorations of all carious teeth, reinforcement of oral hygiene, a series of removable appliances to correct the anterior cross-bite, and in-office bleaching.

Pathway of Effects of Socioeconomic Status on Rural Left-behind Children to Receive Oral Health Services: A Structural Equation Modeling.

In a rural area with a high proportion of left-behind children (LBC), we aimed to identify the pathway of influence of socioeconomic status (SES) on LBCs to receive oral health services after individualized advice. Between September and October 2020, in a rural area of Yunnan, a survey of 238 LBC and 210 non-left-behind children (NLBC) showed that 91.9% and 94.2% had primary teeth caries, respectively. Their caregivers were advised on (1) dental care: bringing the children to seek professional dental care; and (2) self-care: supervising the children's oral health behaviors. Two to three months later, the children and their caregivers were visited to assess the compliance with these items of advice. Structural equation modeling (SEM) was used to handle the association between SES and compliance with the advice. A heatmap was used to visualize the data of reasons for seeking dental care or not. A total of 183 (87.1%) NLBCs and 206 (86.6%) LBCs were given the above advice; 32.9% of caregivers complied with dental care advice without a statistical difference between the LBC and NLBC group; 69.9% of caregivers of NLBCs complied with self-care advice, statistically more than those LBCs (59.2%). The education of caregivers was significantly associated with compliance with both advice items in univariate analysis. SES had a direct effect on the children being left behind and the level of oral health knowledge and awareness of the caregivers. Being left behind did not have an independent effect on receiving oral health services for children. "Dental disease was not severe" and "having no pain" were the main reasons for not seeking dental care. There was no clear grouping of participants with different background information based on the reasons given for seeking or not seeking dental care. Our study pointed to the importance of SES level. Being left behind alone may not be a risk factor for missing oral health services among rural children.

Radiographic Assessment of Permanent First Molars Among Adults in Riyadh: A Retrospective Study.

Introduction The first permanent molars (FPMs) are the first permanent teeth to emerge in the oral cavity, which have an important role in dentition, dental development, and occlusion. FPMs are the most susceptible teeth to caries due to early eruption. There are many adverse consequences related to losing FPMs. Many of the previous studies focused on younger age groups. To the best of our knowledge, there needs to be more newly updated data reported in the literature regarding the status of FPMs in adults in Saudi Arabia. The study aimed to assess the status of permanent first molars among adults in a sample of patients in Riyadh. Methods A cross-sectional retrospective study was conducted from the records of patients in the Dental University Hospital, College of Dentistry, King Saud University (KSU), after obtaining ethical approval. Panoramic images of 810 patients ages 18 and above who were seen at KSU, College of Dentistry, were examined to assess the status of FPMs. A panoramic examination was undertaken for various dental reasons in the time between the years 2017 and 2022.Patients were divided into three age groups: 18-30, 31-50, and >50 years. Data werecollected in a particular form and analyzed. The prevalence of missing teeth, as well as restored and carious teeth, were recorded. In addition, further information regarding the type of restoration was recorded. Correlations of the findings regarding age, gender, side, and jaw were determined for all cases and were performed using the chi-square test. P-values less than 0.05 were considered statistically significant. Results A total of 810 patients' panoramic radiographs were studied. Panoramic male study subjects were 382 (47.2%), and females were 427 (52.8%). Three-hundred thirty-nine (339; 41.9%) of them were of less than 30 years of age, 327 (40.4%) were in the age group of 31-50 years, and the remaining 144 (17.8%) were above 50 years of age. The prevalence of missing first molar teeth was 145 (17.9%) for teeth 16, 147 (18.1%) for teeth 26, 207 (25.5%) for teeth 36, and 188 (23.2%) for teeth 46. No statistically significant association was found between the age groups and genderand the first molar missing teeth (p=0.848 & p=0.159). Nineteen point thirteen percent (19.13%) of patients had only one missing FPM, 12.3%of patients had two, and 6.29% of them had three missing FPM teeth. Five point fifty-five percent (5.55%) of patients had four missing FPMs. A total of 56.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (14.8%), and the left mandibular quadrant showed a slightly higher rate of missing FPM (25.55%). Statistically, a significant association was seen between the number of missing FPM among different age groups, p-value <0.0001. The most restored, carious, and replaced tooth was the mandibular left molar, and tooth-colorrestoration was the most commonly used restoration. Conclusion A high prevalence rate of missing first permanent molars (FPMs) was found in this study population. This calls for more awareness and preventive measures to preserve such significant teeth, thereforereducing the need for complex procedures. Further prospective studies on a larger population are needed to comprehensively evaluate the status of FPMs.

CLINICAL FEATURES OF THE CARIES COURSE OF TEMPORARY TEETH IN CHILDREN.

The aim: Assess the incidence of caries of temporary teeth in children using the indices drxfm, SIC, ICDAS. Materials and methods: A survey of 255 children 3 and 6 years old was conducted and 2 research groups were formed. We determined the prevalence, intensity of caries by the expanded formula drxfm, SIC-index and ICDAS II 1-6, as well as determined the Green-Vermilion hygienic index. Results: The high prevalence of caries of permanent teeth according to WHO criteria was revealed. The average value of ICDAS II 1-6 at the age of 3 years is 1.91 « 0.24 teeth, p <0.05. In 6-year-olds, this index was 3.78 « 0.32 teeth, p <0.05. In 3-year-old children, the average value of SIC was 2.64 « 0.09 teeth, which probably differed from that of 6-year-old children - 6.82 « 0.12 teeth. Regarding the Green-Vermilion index, unsatisfactory oral hygiene was found in children aged 3 and 6 years. Conclusions: Thus, the obtained high rates of prevalence and intensity of caries determine the special importance of caries prevention measures and indicate the need to find new approaches in the fight for dental health of children.

Oral microbiome characteristics in children with and without early childhood caries.

Early childhood caries (ECC) negatively affects children's growth due to its close relation to an imbalance of the oral microbiota. This study aimed to evaluate the distribution of the oral microbiota in children with ECC and healthy individuals. The oral microbiota of 20 children with dental caries from both carious teeth (CC cohort) and healthy teeth (CH cohort), and the oral microbiota of 20 healthy control children (HH cohort) were subjected to 16S rDNA sequencing. The results revealed significant differences between the microbial structure of the CC and CH cohorts of every child with ECC. The most common microbes were Streptococcus, Neisseria, Leptotrichia, Lautropia and Haemophilus. Specifically, the CC cohort contained Lactobacillus, Veillonella, and Prevotella 7, the CH cohort contained Actinomyces, Bifidobacterium and Abiotrophia, and the HH cohort mainly contained Neisseria, Leptotrichia, Porphyromonas and Gemella. Lastly, we established a random forest model consisting of 10 genera (Prevotella 7, Actinobacillus, etc.) which demonstrated promising clinical diagnostic ability (area under the curve (AUC) = 89.8%). These findings indicate that oral microbiota can potentially be used as therapeutic targets or diagnostic markers for the early prediction and prevention of caries in children.

Impact of Oral Health on Rheumatoid Arthritis

This is a narrative review describing how oral infections and diseases associate with rheumatoid arthritis. From the voluminous oral microbiom, bacteria can get access to circulation through inflamed periodontal tissue, oral mucosa, and carious teeth. This results in upregulation of a number of chemokines and cytokines that often cause chronic, subclinical systemic inflammation with consequent organ pathology. The periodontal pathogen Porphyromonas gingivalis was observed to cause citrullination of proteins that play a role in the development of arthritis by generating of specific autoantibodies such as anti-citrullinated peptide antibody. These migrate and form immune complexes at the synovial membrane of joints. In general, patients with rheumatoid arthritis should have a healthy mouth. Dry mouth is a symptom seen among many patients with rheumatic diseases, also rheumatoid arthritis. Because saliva is one of the principal defense factors of the mouth, hyposalivation renders the patient liable to oral diseases. Consequently, the patients must drink enough daily and use saliva substitutes when necessary, and, above all, maintain good oral hygiene daily. In rheumatoid arthritis, manual dexterity may be impaired, however, causing cleaning the teeth difficult. Hence, patients with rheumatic diseases like rheumatoid arthritis need counseling and individual oral health care instructions by oral health care professionals for implementation at home. An electric toothbrush should be recommended. Regular oral health examinations by dentists are needed more often than among the healthy.

Evaluation of Antimicrobial Effects of Trona and Alum on Dental Caries Isolates

Trona and alum are chemical substances found abundantly in nature. Dental caries, usually of bacterial origin, is a chronic disease in which microorganisms metabolize sugars from the diet and produce acid which can demineralize enamel, dentine, cementum and inorganic portion of tooth, followed by destruction of organic portions, leading to cavity formation. This research work was aimed at evaluating the antimicrobial effects of trona and alum on microorganisms isolated from dental caries. It was carried out at Microbiology laboratory unit of Nnamdi Azikiwe University, Awka, Nigeria. Eighty-five dental swab specimens were aseptically and properly collected from patients with carious tooth using sterile swab sticks. Microorganisms were isolated and identified using standard macroscopic, microscopic, biochemical and molecular testing methods. The isolates were Streptococcus mutans, Staphylococcus aureus, Bacillus cereus, Lactobacillus spp and Candida albicans. Antimicrobial sensitivity test of trona and alum on the isolates was carried out using the agar-well diffusion method. The results revealed that these isolates were susceptible to the natural compounds as zones of inhibition were observed at different concentrations. Alum showed the highest zone of inhibition of 25mm against Lactobacillus sp. at 200mg while trona showed inhibition of 17mm against Bacillus cereus at 200mg. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the compounds were also determined. The MIC and MBC of alum against the isolates ranges between 50mg/ml to 12.5mg/ml; while trona recorded 200mg/ml against all the isolates. The findings provide the scientific basis for use of alum and trona as antimicrobial agents; thus the need for their production at industrial level.

Comparison of Effectiveness of Two Silver Compounds in Arresting Caries in Outreach Programs in Karnataka

Context: Silver compounds have been used clinically in dentistry and have effectively arrested dental caries. However, their potential use in community outreach programs has not been explored. Aims: This study aims to investigate the effectiveness of two silver compounds, silver diamine fluoride (SDF) and silver nitrate (SN), in arresting caries in deciduous teeth when used in outreach programs. Settings and Design: This is a randomized trial with a split mouth design done in three primary schools in Dharwad city. Subjects and Methods: This study was conducted among 174 teeth in 58 subjects between the ages of 4 years and 6 years. Pairs of carious teeth in each subject were randomized into two groups: Group A and Group B. Teeth in Group A were treated with 38% SDF and teeth in Group B were treated with 25% SN. These teeth were examined for the arrest of caries after treatment, at the end of 3 months and 6 months. Statistical Analysis: Descriptive statistics were used to analyze the demographic characteristics and percentages of arrested and active carious lesions. Chi-square test was done to compare the proportion of arrested teeth within and between the groups. Results: All the teeth showed arrest of caries immediately after treatment in both the groups which significantly reduced after 6 months. The result also showed that there was no significant difference in the reduction of arrested carious teeth between the two groups. Conclusions: Both SDF and SN can be used in outreach programs with comparable effectiveness in arresting dental caries.

Does Tooth Brushing Prevent Dental Caries among Children? A Systematic Review and Meta-analysis

Introduction: Dental caries is the most widespread noncommunicable disease, which needs immediate attention. Globally, it has been estimated that around 60%–90% of school children are affected with dental caries. These carious teeth can be prevented by simple, cost-effective interventions at the individual and community levels. Various studies reported the role of oral hygiene practices particularly the frequency of brushing of teeth in improving oral health status with varying success. Hence, this meta-analysis was undertaken to determine the effect of oral hygiene practices particularly the frequency of brushing in preventing dental caries in children. Methods: The PubMed, Cochrane, Google Scholar, and Scopus databases were searched from January 1, 2000 to October 31, 2022. Hand-searching was performed for relevant journals. Reference articles including children from 3 to 5 years old were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Newcastle–Ottawa scale for cross-sectional studies. Articles were further analyzed using Open Meta-Analyst. Results: The studies included in qualitative synthesis were 27 and 7 were included in meta-analysis. The pooled prevalence of dental caries among children who brushed once a day and twice a day was 48.7% and 36.6%, respectively. The odds of having dental caries in children who brushed their teeth oncea day was found 1.58 times higher than in those who brushed their teeth twice a day. The absolute reduction in dental caries was 11.3% among those who brushed their teeth twice a day than those who did it once a day (95% confidence interval: 3.2%–19.5%, I 2 = 79.59%, P &lt; 0.001). Conclusion: Brushing twice a day after 3 years of birth can lead to the prevention of dental caries at the individual and community level. Hence, tooth brushing twice a day can act as major preventive program and one should teach the children when they are young and provided supervised tooth brushing to prevent dental caries.

Oral Health Complaints in Pregnant Women Visiting a Tertiary Care Hospital in Mumbai, India: A Retrospective Observational Study

Introduction: Pregnancy results in a lot of changes within the oral cavity, and recent reports have suggested an association between dental issues and poor pregnancy outcomes. Although many studies indicate that dental procedures can be carried out safely on pregnant patients to alleviate pain and promote better oral health, dental health is not given importance in pregnancy mainly due to fear and misconceptions that dental care can adversely affect the foetus. Aim: To summarise the dental presenting complaints and clinical examination findings of pregnant women and to evaluate the proportion of those compliant with the respective dental treatment services recommended by the dentist. Materials and Methods: It was a retrospective observational study analysing data pertaining to all pregnant patients who reported to the Department of Dentistry at Seth G.S. Medical College and King Edward Memorial Hospital in Maharashtra, India between December 2017 and September 2018. There was no formal sample size estimation, and all eligible patients’ data available in the department registry, which was maintained as part of routine clinical care, were analysed. A structured Case Record Form (CRF) was used to collect demographic and clinical data from these registers, and descriptive statistics were used to summarise the data. Results: The mean±Standard Deviation (SD) age of study sample was 27.69±4.584 years. A total of 81 patients’ data were included for the analysis. The most common presenting complaint and examination finding were pain and dental caries, respectively. The most common treatment plan suggested and performed was medication, followed by extraction. The number of patients who followed up was 37 (45.67%). Conclusion: Pain and carious tooth were the most common presenting complaint and examination finding, respectively. The proportion of patients who came for follow-up was not adequate, warranting enhanced awareness activities to reduce stigma over dental care during pregnancy.

Prospektivna opservaciona kohortna studija oralnog zdravlja osoba sa invaliditetom

Introduction: People with disabilities represent a vulnerable category of the population in terms of oral health due to the inability to adequately maintain oral hygiene. The aim of our work is to analyze the status of oral health expressed by an adequate indicator in the population of people with disabilities who come to the national special rehabilitation hospital in Serbia for prosthetic rehabilitation. Material and methods: The study was performed as a prospective observational cohort study that included 51 subjects who had at least one limb amputated and who were hospitalized for prosthetic rehabilitation after limb amputation. After the examination of the oral cavity, the Decayed, Missing and Filled Teeth (DMFT) index was determined, which represents the sum of the total number of carious, filled and extracted teeth. Results: Patients had an average DMFT index of 22 (median) with an interquartile range of 17 to 27. The high value of the DMFT index was most heavily influenced by the number of extracted teeth. The median number of extracted teeth was 16 (interquartile range: 10 - 25). There were significantly less carious teeth, 2 (0 - 3), while there were the least teeth with dental fillings, 0 (0 - 2). Conclusion: High values of the DMFT index in the patients with disabilities indicate the need for the oral health improvements in this vulnerable population.

Estimation of fluoride ion concentration in urine after application of silver diamine fluoride in patients with severe early childhood caries.

Despite the University of California San Francisco, the American Academy of Pediatric Dentistry (AAPD), and the Food and Drug Administration having approved the use of silver diamine fluoride (SDF) in arresting dentinal caries, literature available on its systemic absorption is limited. This study aimed to assess any systemic absorption of fluoride ion following the topical application of SDF in young children. Children aged between 3 and 6 years who were diagnosed with severe early childhood caries and required rehabilitation were recruited for the study. Before the onset of treatment for the arrest and control of caries, a baseline urine sample as a control was collected from the patient. In accordance with the manufacturer's instructions and AAPD guidelines, SDF was topically applied on a minimum of five carious teeth, following which additional urine samples were collected after 2 h and after 24 h, respectively, of application of SDF. The urine samples were stored at -20°C, and the estimation of fluoride ion concentrations in urine was then ascertained using a fluoride ion selective electrode. The results revealed that the fluoride concentration in urine before application of SDF was 0.66 mg/L ± 0.25 mg/L, and following 2 h of application, it was 1.13 mg/L ± 0.23. However, 24 h postapplication, the urinary fluoride concentration was reduced to 0.63 mg/L ± 0.20, which is close to the baseline value of the control sample. There was no significant systemic absorption of fluoride following the application of SDF, and it could be adopted as an effective and safe agent in the armamentarium for managing caries in young children.