Automated detection of tooth loss using tooth numbering segmentation in 3D intraoral scans from a population-based sample with artificial intelligence.

Oral diseases are prevalent among people with HIV (PWH) receiving antiretroviral therapy (ART), yet longitudinal data on oral health outcomes and oral health-related quality of life (OHQoL) in this group are limited. This study investigates the longitudinal associations among demographic, clinical, and behavioral factors and oral health outcomes, as well as their impact on OHQoL in PWH on ART. In this two-year prospective observational study, 227 PWH on ART participated in five visits at 6-month intervals. We collected data on demographics; socioeconomic status; HIV history; ART; lifestyle risk factors such as tobacco, alcohol and recreational drug use; saliva flow rate; dental caries (DMFT and MT indices) and periodontal disease (clinical attach loss-CAL, Bleeding on probing-BOP and pocket depth-PD); OHQoL based on NHANES Oral Health Survey; and xerostomia-related quality of life. We used the generalized estimating equations version of linear regression to quantify associations among these factors. DMFT (β = 1.05; p < 0.001) and MT (β = 0.89; p = 0.006) significantly increased with increasing age, among Blacks (DMFT: β = 3.25, p = 0.002; MT: β = 3.60, p = 0.003), and with increasing duration of HIV (p = 0.014). Higher salivary flow rate was associated with lower DMFT (p = 0.002) and MT (p < 0.001) scores, whereas bictegravir treatment was associated with increased DMFT (p = 0.046). Longer HIV duration correlated with decreased clinical attachment loss (p = 0.005), bleeding on probing (BOP; p = 0.036) and pocket depth (0.003). Bictegravir use was also correlated with decreased CAL (p = 0.019) and BOP% (p = 0.035). Hispanics showed reduced BOP (p = 0.010) when compared with non-Hispanics. Higher DMFT scores were associated with decreased OHQoL (p = 0.003). Adult PWH on ART have a high risk of dental caries and tooth loss, with hyposalivation/xerostomia contributing to lower OHQoL. While periodontal outcomes appeared favorable among individuals with longer HIV duration, aging, smoking, and specific ART exposures influenced oral health trajectories.These findings emphasize the importance of integrating oral health care into HIV treatment models and highlights the importance of addressing salivary dysfunction and caries risk in aging populations with HIV.

Dental caries remains one of the most prevalent chronic diseases among children globally. This study aimed to determine the current prevalence of dental caries and identify key factors associated with caries among 12-year-old children in Shanghai based on a theory-informed analytical framework, to inform targeted prevention strategies. A school-based cross-sectional survey was conducted in 2024. A total of 2570 children aged 12 years were selected from 16 districts of Shanghai using a multi-stage, stratified, cluster sampling method. Data were collected through oral clinical examinations performed by calibrated dentists using WHO criteria and a structured questionnaire covering socio-demographics, dietary habits, oral hygiene behaviors, knowledge, attitudes, and dental service utilization. Caries experience was assessed using the DMFT index. Univariate analyses (Chi-square test, Mann-Whitney U test, Kruskal-Wallis H test) were conducted. For multivariable analysis, covariate sets were determined using a directed acyclic graph, and modified Poisson regression with robust variance was employed to estimate prevalence ratios. Cross-tabulation and the Chi-square test were used to analyze the distribution differences in the intake frequency of five major cariogenic foods between genders. The overall caries prevalence was 19.65%, with a mean DMFT of 0.41 ± 1.04. Multivariable analysis using modified Poisson regression revealed that lower paternal education level (prevalence ratio [PR] = 1.344, P = 0.012), female sex (PR = 1.524), suburban residence (PR = 1.238), and higher frequency of dessert and candy intake were significantly associated with increased caries. Compared with children consuming desserts ≤ 1 time/week, those consuming desserts ≥ 1 time/day had a higher caries prevalence (PR = 1.391, P = 0.003), with a dose-response gradient observed across intake categories. A similar pattern was found for candies (≥ 1 time/day vs. ≤1 time/week: PR = 1.458, P = 0.001). Brushing time and brushing specific surfaces were not significantly associated with caries. Children without fissure sealants had a lower caries prevalence than those with sealants (PR = 0.749, P = 0.001). Higher oral health knowledge was paradoxically associated with higher caries prevalence (PR = 0.735, P = 0.027). Girls had higher intake of solid sweets, while boys consumed more sugary beverages. The caries prevalence among 12-year-old children in Shanghai is relatively low, yet significant differences exist by sex, region, and socioeconomic factors. Dietary behaviors-particularly frequent dessert and candy intake-were the primary modifiable factors. The inverse association between fissure sealants and caries likely reflects indication bias. The paradoxical knowledge-caries association suggests reverse causality. Bridging the knowledge-behavior gap remains a priority for prevention.

Chronic stress and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis may influence oral health, yet evidence linking long-term glucocorticoid exposure to dental caries in adolescents remains limited. Hair cortisol and cortisone provide integrated biomarkers of chronic HPA-axis activity, and their ratio reflects glucocorticoid metabolic balance and 11β-hydroxysteroid dehydrogenase activity, which may be influenced by chronic stress-related physiological dysregulation. The objective was to examine the association between hair cortisol, cortisone, and their ratio with dental caries prevalence and severity in adolescents. This secondary cross-sectional analysis included 550 adolescents aged 14-15 years from the Kazakhstan Adolescent Health Study. Dental caries was assessed using the DMFT index. Hair glucocorticoid concentrations were measured by liquid chromatography-mass spectrometry, log-transformed, and the cortisol-to-cortisone ratio (CCR) was standardized (z-score). Multivariable logistic regression estimated odds ratios across hierarchical models adjusting for sociodemographic, socioeconomic, and behavioral factors, with school region as a fixed effect and robust standard errors. Zero-inflated negative binomial (ZINB) models examined associations with caries count. Among 550 participants, 84% had DMFT ≥ 1. Although unadjusted analyses did not show significant differences in CCR by caries status (p = 0.079), higher standardized CCR was associated with increased odds of dental caries after multivariable adjustment (OR = 1.40, 95% CI: 1.04-1.89 per SD increase). Results were consistent across sensitivity analyses, including Firth's penalized logistic regression (OR = 1.36, 95% CI: 1.01-1.85). In ZINB analyses, CCR was not significantly associated with caries count. Individual glucocorticoids showed weaker, less consistent associations than their ratio. In this cross-sectional sample, higher CCR was associated with greater odds of dental caries after adjustment for measured covariates. Although elevated CCR may reflect physiological dysregulation associated with chronic stress, it should not be interpreted as a direct measure of stress. These findings are exploratory, require cautious interpretation given the cross-sectional design and absence of a significant unadjusted association, and need confirmation in longitudinal studies.

To analyze municipal inequalities in the prevalence of caries-free children among 2-, 4-, and 6-year-old children treated in the eastern sector of Santiago, Chile, during 2024, and to evaluate the presence of social inequalities according to municipal socioeconomic position. An ecological study based on monthly statistical records (REM) from the Chilean Ministry of Health. Data from 6,951 children aged 2, 4, and 6 years who entered dental care at primary health care centers in the eastern sector were analyzed. The prevalence of caries-free children was estimated as the proportion of children with a dmft index of 0, by municipality and age group. Territorial inequalities were assessed using absolute and relative differences, and the relative variation index. The social gradient was analyzed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII), considering the Social Priority Index as the socioeconomic position variable. A statistical significance level of p&lt;0.05 was used. The analyses were performed using Stata 19.5. The overall prevalence of children with no caries experience was 62.9%. By age, prevalence was 87.6% at 2 years, 49.6% at 4 years, and 50.3% at 6 years. The absolute differences between communes reached 25.3 percentage points at 2 years and exceeded 50 percentage points at 4 and 6 years. The relative difference indicated that the commune with the highest prevalence had approximately twice the prevalence of the commune with the lowest (PR=2.02). Inequalities were more pronounced at older ages. No statistically significant socioeconomic gradient was observed according to SII and RII. The prevalence of children without caries experience decreases with age, and territorial gaps widen in later stages. The absence of a statistically significant social gradient should be interpreted with caution, considering the limitations of the study design and the context analyzed.

The relationship between food security with diet quality and dental caries experience among Aboriginal and Torres Strait Islander children.

Background: The prevalence of oral diseases in Vietnam has remained high in recent years, especially dental caries and gingivitis. Conventional dental education in schools is ineffective in maintaining good behavior. Evidence regarding motivational aspects of oral health education in primary school students is limited. Therefore, this study will evaluate the effectiveness of dental education interventions based on content that enhances motivation. Methods: A non-randomized two-cluster controlled before-after study was conducted in two primary schools in Hanoi, Vietnam, in 2024. Third-grade students were interviewed using a motivational questionnaire (DIM-S), then we examined the indicators OHI-S, DMFT (permanent teeth) and dmft (primary teeth) at the initial time (T1) and after 12 months (T2). Kim Lien School received a motivation-based education approach with content built upon the DIM-S guidelines; Khuong Thuong School received a traditional dental education approach. Results: At time point T1, extrinsic motivation predominated (86.41% in the control group; 95.95% in the intervention group). Mean motivation increased by 0.95 points in the intervention group (from 15.03 ± 1.56 to 15.98 ± 1.41; p < 0.001) compared with 0.17 points in the control group (p = 0.329); The difference is statistically significant (p < 0.001). The proportion of students with extrinsic motivation decreased by 8.91% in the intervention group (p < 0.001) but increased by 5.83% in the control group (p = 0.238); p = 0.003 when testing for differences between groups. The OHI-S index decreased in the intervention group (-0.31; p < 0.001) and increased in the control group (+0.14; p = 0.048); p < 0.001 when testing for differences in changes between the control and intervention groups. The DMFT index for permanent teeth increased in both groups, with no statistically significant difference (p = 0.178); the DMFT index for deciduous teeth decreased in both groups, with no statistically significant difference (p = 0.353). Conclusions: Motivation-based school dental education was associated with improved oral-care motivation and oral hygiene and with an increased percentage of students with intrinsic motivation after 12 months. However, maintaining student motivation still requires a combination of preventive measures to reduce oral disease incidence and longer follow-up.

The aim of this study was to evaluate and compare the effects of resin infiltration (RI), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), fluoride varnish (FV), and fluoride toothpaste on white spot lesions (WSLs) over a 24-month period. This study was a 24-month prospective, randomized, double-blind, multicenter clinical trial. Stratified randomization by center was employed, and patients were randomized using allocation sequences, with allocation concealment achieved via sequentially numbered, opaque, sealed envelopes. Seventy-nine participants who had finished orthodontic treatment were randomly assigned to be treated with RI, CPP-ACP, FV or fluoride toothpaste and were recalled every 6 months. The subjects in the RI group who received the RI treatment at baseline and had their teeth coated with fluoride toothpaste every six months starting from the second visit. In addition, all the participants used the provided fluoride toothpaste to brush their teeth twice daily for routine oral hygiene. The DMFT index was recorded at baseline and at each visit. Intraoral images were captured, and the changes in the WSLs area were assessed by ImageJ software. In this study, we enrolled 20 participants in the FV group, CPP-ACP group, and RI group and 19 participants in the fluoride toothpaste group. Ultimately, 14, 17, 12, and 14 participants in each group completed the final follow-up, respectively. After 24 months, there were no significant differences in the mean DMFT index between the groups. All four treatments effectively reduced the WSLs over time. After 24 months, the rate of change in WSLs area in the RI group (-56.66 ± 20.70, 95%CI: -62.23, -51.09) was significantly lower than those in the FV group (-42.01 ± 18.12, 95%CI: -46.28, -37.75), the CPP-ACP group (-45.27 ± 18.13, 95%CI: -49.83, -40.70) and the fluoride toothpaste group (-35.19 ± 25.79, 95%CI: -40.99, -29.38). Besides, the rate of change in WSLs in the CPP-ACP group was significantly lower than that in the fluoride toothpaste group. During the 24-month period, the combined use of RI, FV, CPP-ACP with fluoride toothpaste and fluoride toothpaste alone were effective in treating WSLs. RI management achieved the best and most stable effect in terms of reducing WSLs after 24 months. In addition, after 24 months, CPP-ACP management was better than fluoride toothpaste management alone for reducing WSLs. Chinese Clinical Trials Register, TRN: ChiCTR2000032516, Registration date: 1 May 2020.

To analyze factors associated with tooth loss in 12-year-old adolescents, data were collected from 615 adolescents attending public schools in the five most densely populated cities in the state of Mato Grosso do Sul, Brazil. Tooth loss was assessed using the M component of the DMFT index. Information was also obtained on access to fluoridated water, consumption of unhealthy foods, and sedentary behaviour. Guided by the social determinants of health framework, multilevel logistic regression analyses were conducted to test associations. The prevalence of tooth loss among adolescents was 5%. In the adjusted models, sedentary behaviour was significantly associated with tooth loss [odds ratio (OR) = 1.77; 95% CI: 1.28-2.45], while access to fluoridated water was a protective factor [OR = 0.40; 95% CI: 0.16-0.99]. Household income below the poverty line and moderate to high consumption of unhealthy foods showed higher odds of tooth loss, but the confidence intervals included the null value in the adjusted model. Sedentary behaviour was significantly associated with tooth loss in 12-year-old adolescents, whereas access to fluoridated water was protective. Sedentary behaviour should be interpreted as a marker of broader lifestyle and social vulnerabilities rather than as a direct causal factor.

Background: Dental caries in children has been explored not only as a local oral condition but also in relation to potential systemic inflammatory changes. This study evaluated systemic inflammatory biomarkers and hematologic indices in children with dental caries and examined their association with caries severity, as assessed by the DMFT index. Methods: In this exploratory cross-sectional sibling-controlled study, 114 participants were included: 75 children with dental caries and 39 unaffected siblings serving as controls. All participants underwent blood testing, including inflammatory biomarkers (TNF-α, NGAL) and hematologic indices (NLR, LMR, PLR, IIC, MCVL, SII, SIRI, AISI). Group comparisons were performed using parametric or nonparametric tests, depending on data distribution. Correlation analyses were conducted within the caries group. Age- and sex-adjusted univariate and multivariable linear regression models were used to identify predictors of DMFT, and logistic regression was applied to evaluate associations with high caries burden (DMFT ≥ 6). Results: Children with caries showed higher NGAL, PLR, and MCVL, and lower LMR than controls, while IIC showed a non-significant upward trend. Correlation analysis revealed strong associations among several inflammatory indices, largely reflecting shared computational components. DMFT showed a modest positive correlation with LMR, whereas associations with classical inflammatory biomarkers such as TNF-α and NGAL were weak or absent. In age- and sex-adjusted models, several markers showed borderline associations with DMFT, but none remained independently significant in multivariable analyses. Age was the strongest predictor of DMFT, while sex showed no significant effect. Logistic regression for high DMFT confirmed age as the only significant determinant. Conclusions: In this exploratory pediatric cohort, children with dental caries showed differences in selected systemic inflammatory and hematologic biomarkers compared with unaffected siblings. However, most biomarkers showed only limited independent associations with caries severity after adjustment, with age emerging as the primary determinant of DMFT. These findings suggest that systemic inflammatory markers have limited independent explanatory value for caries severity and should be interpreted as exploratory rather than clinically definitive.

Objectives: The impact of dental and oral health conditions on the oral health state and oral health-related quality of life (OHRQL) in geriatric in-hospital (GIH) patients requires clarification. For this reason, this exploratory and hypothesis-generating study aimed to examine the associations between intra-oral risk factors (IRFs), masticatory functions (MFs), and treatment satisfaction (TS) in this context. Methods: This retrospective cohort study enrolled a total of 81 patients requiring immediate prosthetic treatment (IPT) by consultant dentists at Sana Hospital, Coburg, Germany. The evaluation focused on oral and dental state and MFs such as a modified DMFT and Eichner Index (EI), as well as on IRFs such as inflammation, mucogingival junction insufficiency (MGJI), severe bone crest atrophy (SBCA), and oral pain. The outcomes were measured after IPT using MF improvement (MFI) as the primary outcome and TS as the secondary outcome. Results: The outcomes (p < 0.05) were evaluated using objective measures such as the calculations of the EI, the EI modifications and the modified DMFT index. The results were associated, respectively, with the different IRFs and with specific SBCA. A total of 85% of GIH patients suffered from severe bone crest atrophy (SBCA), which showed a significant association with MF measured using EI after IPT (p = 0.001). MFI after IPT was associated with the EI before IPT (p < 0.000). The achieved MFI was finally associated with the untreated sample (all patients, p < 0.000) and with the presence or absence of the following IRFs at baseline: inflammation (p < 0.003), absence of oral pain (p < 0.000), presence of SBCA (p < 0.000), and absence of MFI (p < 0.000). A total of 78% of GIH patients confirmed treatment satisfaction (TS) after IPT, which was significantly and strongly associated with SBCA (p < 0.003). Conclusions: Oral health was primarily impaired by SBCA and can be measured by the analysis of EI and DMFT associations, which provided MFI and TS as outcomes for OHRQL.

Timing of the first dentist and early or late eruption of teeth may be important indicators of susceptibility to caries. A common misconception among the general population is that late-erupting teeth are less susceptible to dental caries, whereas early-erupting teeth are more susceptible to decay. This study aimed to examine the relationship between the first dental visit age (FDVA), dental age (DA), and caries experience in children. A retrospective observational study was conducted using clinical records and orthopantomograms of children in the early mixed dentition period at a university hospital for the routine dental examination needs. FDVA was obtained from patient records, and DA was assessed on orthopantomograms using the Willems method based on the developmental stages of seven mandibular left permanent teeth. Caries status was evaluated radiographically using the Decayed, Missing, and Filled Teeth (DMFT)/decayed, missing, and filled teeth (dmft) indices. Statistical analyses included paired t -tests, one-way analysis of variance, and Pearson correlation tests. Totally, orthopantomograms of 1989 children were examined. The mean FDVA was 7.11 years. Children with lower FDVA had significantly higher dmft scores ( P = 0.0001). The mean DA (8.64 years) was significantly higher than the mean chronological age (CA) (7.93 years) ( P = 0.0001). Children whose DA exceeded their CA had significantly higher DMFT scores ( P = 0.0001), although this association was not observed for dmft. DA higher than CA is associated with an increased risk of caries, particularly in the permanent dentition. Children with an earlier FDVA exhibited higher dmft values, possibly because those with more existing caries were brought to the dentist earlier.

HighlightsPublic health relevance—How does this work relate to a public health issue?This study addresses an important gap in public health research by including a substantial sample of children capable of providing self-reported data, which is uncommon for this age group.Additionally, a large proportion of participants had never accessed dental care, highlighting barriers to oral health services and the vulnerability of this population.Public health significance—Why is this work of significance to public health?Dental fear and anxiety are highly prevalent across populations and are influenced by multiple factors. This study underscores the importance of adopting an individualised approach when assessing children, particularly by considering psychosocial determinants such as maternal depression.Furthermore, it focuses on a population with unmet oral health needs, reinforcing its relevance to public health interventions.Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?The findings provide important evidence to inform policymakers, particularly in the Municipality of Carmópolis de Minas and similar settings, about the need to prioritise children’s oral health. The high prevalence of dental caries and the dependence on public health services highlight the urgent need for targeted preventive and care strategies.For researchers, this study offers an innovative methodological contribution by incorporating children’s self-reports of dental fear and anxiety along with structural equation modelling. This approach enables the simultaneous assessment of multiple associated factors, providing a more comprehensive understanding of the determinants of dental fear and anxiety.Dental fear and anxiety (DFA) are common among children, and their occurrence needs to be assessed in population-based studies. This study aimed to evaluate a structural model for the association of DFA in children with individual and family-related factors. A representative cross-sectional study was conducted in Carmópolis de Minas, Brazil, with 272 children aged 4–6 years. Children’s DFA was self-reported using the Children’s Fear Survey Scale—Dental Subscale, and caregivers' DFA using the Dental Fear Survey. Caregivers provided sociodemographic information on the family and children’s health. Two calibrated dentists examined the children for dental caries using the DMFT index. Structural equation modelling was performed. Dental caries showed a direct association with greater DFA in children (β = 0.145; p = 0.036). Toothache showed an indirect association with children’s DFA through the variable “dental visit”, as children with toothache had visited the dentist more recently (β = 0.401; p < 0.001), and a more recent dental visit was associated with DFA (β = −0.158; p = 0.037). Maternal depression was associated with greater caregiver DFA (β = 0.124; p = 0.006), but no association was found between children’s DFA and caregiver’s DFA (p > 0.05). Children with caries-related toothache who visited the dentist within six months before data collection—and more recently—had higher DFA.

The causes of exostoses, such as mandibular/maxillary torus, include bruxism, occlusal force, genetics, and environmental factors. This study investigated the correlation between mandibular/maxillary torus and periodontitis. A total of 478 patients over 20 years of age who visited the general dental clinic from 2001 to 2014 were enrolled in the study. Clinical data, including periodontal probing depth, bleeding on probing, and DMFT index, were evaluated. The general condition of the patients, including back pain, shoulder stiffness, and history of smoking, was evaluated via medical interviews. Logistic regression analysis was performed to assess the association between mandibular/maxillary torus and patient characteristics. Apart from sex, no statistically significant differences were observed between the torus and the other patient characteristics. In addition, no significant association was found between the presence of a torus and the number of teeth with a probing depth of > 6 mm. These findings suggest that the mandibular/maxillary torus does not contribute to periodontitis. Additional longitudinal studies are warranted to elucidate the complex interplay between genetic predisposition, environmental factors, and mechanical stress in the development of the torus and its potential impact on periodontal health.

Background : Globally, people with disabilities account for more than 1 billion individuals or 15% of the population. In Indonesia, the 2018 Susenas data reports that 14.2% (30.38 million) of the population lives with disabilities. Children with Down syndrome exhibit distinct orofacial characteristics, including a higher prevalence of periodontal disease, malocclusion, delayed tooth eruption, mouth breathing habits, and congenital dental anomalies such as hypodontia and microdontia. Purpose : This literature review aims to analyze the role of parents in maintaining oral health and supporting oral hygiene practices in children with Down syndrome. Methods : A literature search was conducted using databases (PubMed and Scopus) following PRISMA-ScR guidelines, with inclusion criteria limited to articles published within the last 10 years. Results : The review indicates that children with Down syndrome have a high prevalence of periodontal disease, malocclusion, and poor oral hygiene status (OHI-S), mainly due to functional limitations. Although the DMF-T index tends to be lower compared to other disabilities, oral health problems remain significant. Parents play a crucial role in assisting daily oral hygiene practices, ensuring access to dental care, and supporting preventive behaviors. However, limited parental knowledge and awareness, along with restricted access to dental services, contribute to suboptimal oral health outcomes. Conclusion : Parental involvement is essential in maintaining oral health in children with Down syndrome, particularly in overcoming functional limitations. However, inadequate knowledge and limited access to preventive and promotive oral health services hinder optimal care. Strengthening parental education and improving access to dental health services are necessary to enhance oral health outcomes in this population.

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

To assess the association between apical periodontitis (AP) and subclinical symptoms of anxiety, depression and disordered eating. A total of 120 individuals were included in this case-control study. Sixty subjects were assigned to case (AP+) and 60 to control group (AP-). The periapical and dental status were assessed using radiographic images (OPT, periapical radiographs) and dental examination. The DMFT index (decayed, missing and filled teeth) and the periapical index (PAI) scores were recorded. All subjects were interviewed to compile medical history data, anxiety (Hamilton A), depression (Hamilton D) and eating disorder (EAT-26) questionnaires. Inferential and both simple and multiple logistic regression analyses were performed. Significant associations were observed between AP and higher scores on HAM-A, HAM-D and EAT-26. The regression model showed that higher PAI scores were significantly associated with increased odds of anxiety, depression and disordered eating. A PAI score of 3 showed increased odds of anxiety (OR = 5.57, p = 0.004) and depression (OR = 3.65, p = 0.025). A PAI score of 4 showed even greater odds for anxiety (OR = 8.68, p = 0.001), depression (OR = 14.07, p = 0.001) and disordered eating (OR = 3.98, p = 0.032). Participants with more than one periapical lesion were 3.56 times more likely to report higher levels of anxiety (p = 0.007), 3.59 times more likely to experience elevated depression (p = 0.018) and 3.08 times more likely to exhibit disordered eating behaviours (p = 0.028). Additionally, higher DMFT scores were associated with an increased likelihood of higher HAM-A scores (OR = 1.18, p = 0.001). The study results show a statistically significant higher prevalence of mood disorders and mental health-related conditions including anxiety, depression and eating disorders in patients with AP. Longitudinal studies are needed to determine the nature of the observed association. ClinicalTrials.gov identifier: NCT06589076.

This study aimed to evaluate the impact of preterm birth on oral and dental health by employing various indexes and to investigate its impact on the prevalence of Early Childhood Caries (ECC) in relation to sociodemographic and dietary risk factors. The study included 257 children (131 girls and 126 boys) aged 32 to 76 months who attended to the Department of Pediatric Dentistry at Alanya Alaaddin Keykubat University, Faculty of Dentistry. Infants delivered at 36 weeks of gestation or before were classified as the "Preterm" group, whilst those born at 37 weeks or after were classified as the "Full-term" group. Sociodemographic, prenatal, and postnatal data, which may serve as possible risk factors for ECC, were recorded. Oral and dental health data were assessed utilizing the International Caries Detection and Assessment System (ICDAS II), dmft index, gingival index (GI), and plaque index (PI). The acquired data were subjected to statistical analysis. The prevalence of ECC was 65.4% in full-term children and 65.3% in preterm children. No statistically significant difference was found between preterm and full-term children regarding the mean dmft value, ICDAS II classification, PI, GI, or the presence of ECC (p > 0.05). Logistic regression analysis showed that ECC was significantly associated with infrequent tooth brushing (adjusted OR = 0.469, 95% Cl = 0.225-0.981, p = 0.044), frequent sugary snack consumption (adjusted OR = 0.247, 95% Cl = 0.111-0.548, p = 0.001) and the use of sweetened pacifiers (adjusted OR = 0.141, 95% Cl = 0.022-0.909, p = 0.039). The absence of maternal caries was identified as a protective factor against ECC (adjusted OR = 0.558, 95% Cl = 0.326-0.954, p = 0.033). In addition, oral and dental health outcomes were influenced by a range of sociodemographic, maternal, and behavioral factors, including parental education level, maternal antibiotic use during pregnancy, breastfeeding status, and overall oral hygiene and dietary practices. The data indicate that ECC is multifactorial and may be influenced by environmental, dietary, and individual factors, despite the absence of an association between ECC and preterm birth.

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

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