High Caries Activity Research Articles

Cost-effectiveness of silver diamine fluoride depends on caries activity: A decision analytic model.

The study sought to assess the cost-effectiveness of silver diamine fluoride (SDF) relative to sodium fluoride varnish (NaF), and direct restorations placed chairside or under general anaesthesia (GA), accounting for caries activity. An analytical decision tree model was developed with clinical data from multiple centres to evaluate the four treatment options among all children aged 1 to 6 years in Singapore (N=231,880) over a 12-month time horizon. Base-case scenarios consisted of children with low- (1 carious tooth) and high- (7 carious teeth) caries activity. Incremental cost-effectiveness ratios (ICER) and net monetary benefits (NMB) were tabulated with the outcomes set to be the control of active caries and avoidance of tooth extractions. Deterministic and probabilistic sensitivity analyses were conducted. Overall, SDF was less effective than direct restorations placed chairside but was less costly. For children with low-caries activity, the ICER for SDF was $9 per caries-controlled tooth, and $68 per extraction avoided. For children with high-caries activity, the ICERs were $267 and $1 909 respectively. At a willingness-to-pay threshold of $30, the NMB was negative (favours restorations) for caries control in children with low-caries activity and positive (favours SDF) for all other situations. In the low-caries activity group, SDF had a 41.5% probability of being cost-effective for caries control and 49.2% probability of being cost-effective for the avoidance of extraction. The corresponding probabilities for the high-caries activity group were 99.8% and 100%. The NMB of SDF increases proportionally with caries activity, suggesting utilisation of SDF should depend on caries activity. Results were most sensitive to changes in relative cost, and effectiveness of SDF/direct restorations. SDF was cost-effective in most situations except for caries control in children with low-caries activity. Direct restorations were more effective and should be considered in low-caries activity children.

Relationship of dietary nutrients with early childhood caries and caries activity among children aged 3–5 years—a cross-sectional study

BackgroundEarly childhood caries (ECC) is a challenge for pediatric dentists all over the world, and dietary factor is an important factor affecting the occurrence of ECC. Currently, there is limited research on the impact of dietary nutrient intake from Chinese diets on ECC. The purpose of this study is to explore the correlation of dietary nutrients intake with ECC and caries activity (CA) among children aged 3–5 years, and to provide dietary guidance to slow down the occurrence and development of ECC.MethodsA cross-sectional study was conducted in 2022. A total of 155 children were divided into three groups: caries-free group, ECC group and Severe early childhood caries (SECC) group according to the caries statues. And according to the caries activity test (CAT) value, they were also divided into three group: low CA group (L-CA), middle CA group (M-CA) and high CA group (H-CA). The 24-hour dietary intake information was collected by mobile phone application (APP). The intake of children’s daily dietary nutrients were calculated referring to “China Food Composition Tables”.ResultsIn this study, 17, 39,and 99 children were diagnosed with caries-free, ECC, and SECC. There were 33, 36, and 86 children diagnosed with L-CA, M-CA, and H-CA. The risk of ECC was increased with the intake of cholesterol(OR = 1.005) and magnesium (OR = 1.026) and decreased with the intake of iron (OR = 0.770). The risk of SECC was increased with the intake of cholesterol (OR = 1.003). The risk of high CA was increased with the intake of cholesterol (OR = 1.002). The combined application of dietary total calories, carbohydrate, cholesterol, sodium, magnesium and selenium in the diagnosis of ECC had an area under ROC curve of 0.741.ConclusionsThe increased dietary cholesterol intake may be a common risk factor for ECC and high CA in children aged 3–5. The combined application of dietary intake of total calories, carbohydrate, cholesterol, sodium, magnesium and selenium has a higher predictive value for the occurrence of ECC.

Clinical characteristics and caries risk assessment of tobacco heating systems smokers, cigarette smokers and non-smokers: a cross-sectional study.

The study compared clinical characteristics and caries risk assessments between tobacco heating system (THS) smokers, cigarette smokers and non-smokers. General data, data regarding fluoridation, smoking and dietary habits was obtained through a questionnaire. Caries experience was assessed by the DMFT index; the amount of biofilm by the Full mouth plaque score index; the amount of salivation by the quantum of stimulated salivation test; salivary pH with pH indicator strips and salivary number of S.mutans and Lactobacilli by cultivation on agar plates. The Cariogram method was used to assess caries risk. No differences between the groups was detected regarding education level, average daily number of meals, fluoridation programs, systemic diseases, and caries experience. The groups significantly differed in the amount of salivary S.mutans and Lactobacilli (p < 0.001), accumulated biofilm (p = 0.034), salivation quantum (p < 0.001), and saliva pH (p = 0.009). Exposure to tobacco smoke and heated tobacco aerosol increased the accumulation of biofilm and decreased salivary pH. Smoking increased S. mutans, while THS consumption decreased salivation and Lactobacilli the most. The Cariogram analysis found no differences in chances of avoiding new caries lesions between the groups, but a significant difference in developing caries lesions due to dietary habits was detected (p < 0.001) with non-smokers having higher risk than smokers, but not than THS consumers. THS and cigarette smoking were related to clinical characteristics that affect caries activity even though the caries risk assessment revealed no significant difference in the chances of avoiding new caries lesions between the groups. THS and cigarette smokers could have higher caries activity than non-smokers. The clinical study protocol has been registered on ClinicalTrials.gov under the ID number: NCT06314100.

ANTIBACTERIAL ACTIVITY TEST OF CUCUMBER PEEL EXTRACT (Cucumis sativus L.) AGAINST Streptococcus mutans BACTERIA

Background: Dental caries is a process of tooth demineralization caused by acids produced from food metabolism in bacteria. One of the main etiological factors of dental caries is the microorganisms known as Streptococcus mutans bacteria. S. mutans is one of the components of human dental plaque that is associated with sucrose diet and high caries activity. Cucumber peel extract (Cucumis sativus L.) is known to have an antibacterial activity due to the presence of secondary metabolites such as flavonoids, steroids, alkaloids, saponins and phenols found in cucumber peel. Purpose: This study aimed to determine the antibacterial activity at the lowest concentration of cucumber peel extract (Cucumis sativus L.) against Streptococcus mutans bacteria. Method: This study employed the disc diffusion method with a post-test only control group design. Streptococcus mutans bacteria were cultured on Mueller Hinton Agar media, and cucumber peel extract (Cucumis sativus L.) was applied as the antibacterial agent at concentrations of 0.01 g/ml, 0.05 g/ml, 0.1 g/ml, 0.2 g/ml, 0.4 g/ml and 0.5 g/ml with seven repetitions. Results: The results of the study showed that cucumber peel extract (Cucumis sativus L.) formed inhibition zones around the paper discs against the growth of Streptococcus mutans bacteria at concentrations of 0.4 g/ml and 0.5 g/ml. Conclusion: The concentrations of 0,4 g/ml and 0,5 g/ml are the lowest concentrations of cucumber peel extract (Cucumis sativus L.) that can inhibit the growth of Streptococcus mutans bacteria. Keywords : Antibacterial, Cucumber peel, Dental Caries, Streptococcus mutans

Silver release from dentine treated with combinations of silver diamine fluoride, potassium iodide and etching

For individuals with very high to extremely high caries activity and poor control of daily oral hygiene, a simple treatment for arresting their caries activity is necessary. Silver Diamine Fluoride (SDF) has become increasingly common for this purpose due to its efficacy and ease of application. To avoid or reduce tooth discoloration after SDF treatment potassium iodide (KI) may be applied. However, the release of silver from SDF-treated tooth surfaces may be of concern. Thus, the aim of the present study was to quantify the amount of silver leached in both a short- and long-term perspective. In this in vitro experiment we measured the cumulative release of silver from SDF-treated dentin surfaces with and without imminent application of KI, and with and without phosphoric acid etching as pre-treatment, after 24 h and weekly for four weeks. The release of silver was highest after 24 h for all treatment groups, with a significant drop after this point. When etching was not used, the use of KI did not affect the release of silver. However, when etching was used, there was a significantly lower silver release when KI was also used compared to when KI was not used. This effect was largest for the first two weeks, after which the difference was smaller as all groups released low amounts of silver.

Correlation between caries activity and salivary microbiota in preschool children.

Early childhood caries (ECC) is the most common chronic infectious oral disease in preschool children worldwide. It is closely related to the caries activity (CA) of children. However, the distribution characteristics of oral saliva microbiomes in children with different CA are largely underexplored. The aim of this study was to investigate the microbial community in saliva of preschool children with different CA and caries status, and to analyze the difference of microbial community in saliva of children with different CA and its correlation with ECC. Subjects were divided into 3 groups based on the Cariostat caries activity test: Group H, high CA (n=30); Group M, medium CA (n = 30); Group L, low CA (n=30). Questionnaire survey was used to explore the related influencing factors of CA. According to the caries status (on the basis of decayed mising filled teeth), these subjects were divided into caries-free group (dmft=0, n=19), caries-low group (0 < dmft ≤ 4, n=27) and caries-high group (dmft > 4, n=44). Microbial profiles of oral saliva were analyzed using 16S rRNA gene sequencing. There were significant differences in the microbial structure (P < 0.05). Scardovia and Selenomonas were the biomarkers of both H group and high caries group. The genus Abiotrophia and Lautropia were the biomarkers of both the L group and the low caries group, while the Lactobacillus and Arthrospira spp. were significantly enriched in the M group. The area under the ROC curve of the combined application of dmft score, age, frequency of sugary beverage intake, and the genus Scardovia, Selenomonas, and Campylobacter in screening children with high CA was 0.842. Moreover, function prediction using the MetaCyc database showed that there were significant differences in 11 metabolic pathways of salivary microbiota among different CA groups. Certain bacteria genera in saliva such as Scardovia and Selenomonas may be helpful in screening children with high CA.

Oral health problems and dental service utilization in children with hearing impairment: a narrative review

Children with hearing disability face challenges on accessing healthcare services caused by their lack of ability to express their oral health problems and affect their oral health status. This narrative review aims to explore oral health status in hearing impaired children and discuss in detail about dental service utilization in children with hearing impairment. Many studies assessed oral health status of children with hearing impairment. A comprehensive retrieval of the English literature from 2012 to 2022 was done in PubMed, ScienceDirect and ProQuest. Oral health assessments including dental caries, gingival problems and periodontal condition. Healthcare seeking behavior of the parents of hearing-impaired children is reflected by dental service utilization. Hearing impaired children have a high prevalence of caries, high caries activity and poor gingival condition compared to their counterparts. There are unmet dental treatment needs due to their dependence on parents or caregiver on decision making. Proper oral health educational method for hearing impaired children and their parents or caregiver is needed to improve oral health status and dental service utilization.

Taste perception in children with different caries activity

PurposeThe aim of the study was to investigate whether caries-active and caries-free children differ in terms of their taste perception for sweet, sour, salty and bitter.MethodsThe study group consisted of 100 children aged 5–10 years: 50 caries-free children and 50 children with at least four untreated carious lesions. Taste perception was analysed using two test systems. First, filter paper strips impregnated with four taste qualities (sweet, sour, salty, and bitter) at four defined intensities were used (“taste strips”). Then a tasting spray in suprathreshold concentration of the respective taste was applied. The children were asked to name the perceived taste. The parents answered a questionnaire about the children’s dietary habits.ResultsThe children with high caries activity scored lower on average on the taste strips than the caries-free participants. For the taste sprays, the perception of the taste quality “bitter” was significantly worse in the children with caries than in caries-free children (Mann–Whitney U test p < 0.05).ConclusionThe results of this study suggest that taste preferences in children are associated with increased susceptibility to tooth decay.

Dietary intake and meal patterns among young adults with high caries activity: a cross-sectional study

BackgroundDental caries is a multifactorial disease that is highly dependent on diet, where a lower consumption and intake frequency of sugar would be favorable. The aims were (i) to examine dietary intake and meal patterns, more specifically sugar intake and foods high in sugar, among young adults with high caries activity, and (ii) to investigate the association between dietary and meal patterns consumption, and level of caries activity.MethodsThis study presents baseline data from an ongoing randomized controlled trial. A total of 50 young adults (aged 23.0 ± 3.0 years) with ≥ 2 decayed tooth surfaces were included. Dietary intake was captured with a 59-item food frequency questionnaire (FFQ) and a three-day food diary. Adherence to dietary guidelines was analyzed by comparing the dietary intake to the Nordic Nutritional Recommendations (NNR) 2012 and by using the Healthy Dietary Adherence score (HDAS). Participants were categorized into two groups: (i) the Caries group with 2–4 decayed surfaces, and (ii) the High caries group with ≥ 5 decayed surfaces.ResultsThe High caries group reported a statistically significantly higher snack and total meal intake compared to the Caries group, as well as a sugar intake exceeding the Nordic nutritional recommendations. The majority of the participants reported a high intake frequency (> 2.5/day) of sweet foods and drinks and less than one intake of fruit and vegetables, respectively, per day. Similar results were found when analyzing adherence by using the HDAS, where the lowest adherence according to dietary guidelines was shown for the food groups of sugar, whole meal products, and fruit and vegetables.ConclusionThe results indicated a high intake of sugar and low intake of fruit, vegetables, and fiber in high caries-active individuals.

Development and Assessment of Bioactive Coatings for the Prevention of Recurrent Caries Around Resin Composite Restorations.

To develop hydrophilic resin-based surface coatings containing bioactive agents (proanthocyanidins from Vitis vinifera and calcium silicate) and assess their protective role at the dentin and enamel margins of cervical restorations against demineralization under simulated conditions of high and low caries activity. Suboptimal resin composite restorations were placed on cervical cavity preparations on buccal and lingual surfaces of thirty-two molars after a contamination protocol. Groups were divided according to the resin-based coatings (n=8): resin without bioactive (C), resin containing 2% enriched Vitis Vinifera (VVE), and resin coat containing 10% calcium silicate (CaSi). The control group did not receive a resin (NC). To simulate a hydrolyticenzymatic degradation, specimens were subjected to 2-month storage followed by incubation in esterase at 37°C for 8 days. Afterwards, recurrent caries was induced using a pH-proteolytic model on half of the specimens to simulate high caries activity, and the other half remained in simulated body fluid (SBF). Measurements of cross-section microhardness (KHN) and infiltration with rhodamine-B assessed the micropermeability (MP), the extent of demineralization (ED), and the demineralization area (DA). Data were analyzed using analysis of variance (ANOVA) and post-hoc tests (α=0.05). VVE and CaSi presented higher cross-sectional KHN values for enamel and dentin (p<0.001). The bioactive coatings resulted in lower MP, ED, and DA compared to NC (p<0.005) in enamel and dentin. CaSi coating preserved the enamel from demineralization (p=0.160). The application of bioactive coatings represents a potential strategy to protect the enamel-dentin margins of resin restorations.

ОЦЕНКА ВЛИЯНИЯ ЛЕЧЕБНО-ПРОФИЛАКТИЧЕСКИХ ЗУБНЫХ ПАСТ НА СОЗРЕВАНИЕ ЭМАЛИ В АСПЕКТЕ ВОЗРАСТА И СТЕПЕНИ АКТИВНОСТИ КАРИЕСА У ШКОЛЬНИКОВ 6–7, 12, 15 ЛЕТ

It is possible to increase the effectiveness of preventive dental measures by a differentiated approach to the use of toothpastes [3]. The most intensive incorporation of calcium and fluorides into the composition of the hard tissues of teeth occurs during their formation and mineralization [4, 5]. At the end of the growth and mineralization of the teeth, the enamel and dentin of the teeth become less permeable to fluoride, but the need for them does not disappear. Also, a number of authors note that the need for ions with different caries activity may differ. The purpose of our study was to study the effectiveness of the use of toothpastes in 6–7, 12, 15-year-old schoolchildren with various caries activity. We examined 532 children, attending organized children's groups in Yekaterinburg. By a randomization procedure based on the method of random numbers, children were divided into groups according to the type of paste used: calcium-containing, fluorine-containing, combined use of calcium and fluorine-containing pastes, paste based on organosilicon glycerohydrogel. The toothpastes effectiveness was assessed by the change in enamel resistance by functional methods: electrometry and Enamel Resistance Test. The annual increase in caries was taken into account. It was found that calcium-containing toothpastes are most effective in the first month of use, then the effect of their use weakens. Fluoride toothpastes lead to a persistent but slow increase in enamel resistance. The combined use of calcium and fluoride toothpastes gives a quick and lasting effect. A paste based on organosilicon glycerohydrogel gives a persistent decrease in enamel electrometry, with the best results in the group of schoolchildren with high caries activity.

In situ evaluation of 200 ppm fluoride toothpaste content trimetaphosphate, xylitol and erythritol on enamel demineralization and dental biofilm

ObjectiveTo evaluate the effect of low-fluoride (F−) toothpaste and sodium trimetaphosphate (TMP) associated with xylitol and erythritol (XE) on enamel demineralization and biofilm composition. MethodsThis crossover double-blind in situ study consisted of five phases (seven days each), in which 14 volunteers wore oral appliances containing four enamel bovine blocks. The cariogenic challenge was performed by exposure to a 30% sucrose solution (6x/day). The toothpaste treatments (3x/day) were as follows: placebo (no F−/TMP/XE); 200 ppm F− (NaF) (200F); 1,100 ppm F− (1100F); 16% Xylitol and 4% Erythritol (XE); and 200 ppm F−, 0.2% TMP, 16% xylitol, and 4% erythritol (200F-TMP-XE). Percentage of surface hardness loss (%SH) and integrated loss of subsurface hardness (ΔKHN), and calcium (Ca2+), phosphate (PO43−), and F− on enamel and biofilm were determined; as well as insoluble extracellular polysaccharide (EPS). ResultsXE and 1100F groups showed no significant difference for %SH and ΔKHN values (p = 0.220 and p = 0.886), and the 200F-TMP-XE group had the lowest mineral loss (p < 0.001). Ca2+ and PO43− in the enamel showed the highest values (p < 0.001) for the 200F-TMP-XE group. Higher values of F− in the enamel and biofilm were observed for the 1100F group (p < 0.001). There was no difference for Ca2+ (p = 1.00) and EPS (p =0.918) values between XE and 200-TMP-XE groups in the biofilm, but their values were higher and lower than the 1100F (p = 0.002 and p = 0.029), respectively. Conclusions200F-TMP-XE promoted a greater protective effect against enamel demineralization and significantly affected the composition of biofilm formed in situ compared to 1100F toothpaste. Clinical SignificanceLow-F− toothpaste containing TMP and polyols can be considered an effective and safe measure to improve the oral health of individuals, especially patients with high caries activity.

Oral health status and microbial load of Streptococcus mutans in children with Cerebral palsy in a tertiary care hospital in Delhi.

Cerebral palsy (CP) is a childhood debilitating condition which impairs the physical and mental ability of an individual to maintain oral health. The objective of the present study was assessment of dental neglect and burden of treatment needs of children affected with CP as compared to normal children in a tertiary care hospital in Delhi. A sample size of 104 children of age group of 6-14 years was selected, in which 52 children of CP (case group) and 52 normal school children (control group) were recruited. Children from both groups were examined, and calculation of drug master files (DMFS), defs, oral hygiene index (OHI), and gingival index was done. The presence of trauma and malocclusion was assessed. Present caries activity was assessed by the level of Streptococcus mutans present in saliva in both groups. Treatment needs were then assessed based on intraoral findings. Data were analyzed by SPSS 20.0 software. Student's t-test and nonparametric statistical tests such as Chi-square test and Mann-Whitney test were used as per the nature of variables studied for statistical analysis with the level of significance denoted at P < 0.05. The mean DMFS, gingival index, OHI, and treatment needs were observed to be higher in the CP group. Increased S. mutans levels were observed in saliva of CP patients. Defs score, trauma, and malocclusion were not statistically significantly higher in CP group as compared to the control group. Cerebral palsy group had a poor oral and gingival health, a higher DMFT and burden of treatment needs and an increased risk of further caries progression due to high caries activity indicated by increased level of salivary Streptococcus mutans than the control group.

Manejo odontológico de paciente con Deficit de Factor XII: Reporte de un caso

El Servicio de Medicina Transfusional del Centro Hospitalario Pereira Rossell es el centro de referencia nacional en el área materno infantil. En el marco del convenio MSPFacultad de Odontología de la UDELAR, se atienden en este Servicio pacientes con diversas coagulopatías. El déficit de factor XII es una patología de baja prevalencia (1-1000000) y no existe evidencia científica que respalde protocolos clínicos de atención a nivel odontológico. Se presenta el caso clínico del paciente NT, portador de esta patología, de alto riesgo con alta actividad de caries, en dentición mixta, a quien se le realizó tratamiento odontológico integral con apoyo del equipo multidisciplinario que trabaja en el Servicio de Hemoterapia del CHPR.

Overview of the Total Bacteria and Number of Streptococcus mutans in the Saliva of Children with High Caries Activity

Introduction: Microorganisms play a crucial role in the early stage of caries. Streptococcus mutans produces lactic acid, which enhances the risk of caries. Polymerase chain reaction (PCR) is a molecular biology technique used in the amplification and replication of DNA. PCR exhibits high specificity and a rapid detection time, as well as differentiation between microorganisms. Based on a previous study, there is a significant correlation between S. mutans in saliva and the prevalence of caries. Objectives: To provide an overview of the total bacteria and number of S. mutans in the saliva of children aged between 5 and 10 years at the Department of Pediatric, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia. Methods: Saliva sample from children (n = 28, aged 5-10 years old) was collected from healthy children. 2-3 mL of a saliva samples were collected and cultured by using TYS media for total bacterial count. The number of S. mutans in the saliva of these children was counted by real-time PCR methods by using a fluorescence chemical compound green SYBR using 16S rRNA gene specific primers for S. mutans. Results: The average number of total bacterial colony count in saliva was 9.965 ± 2.078 log10 CFU/mL, and the average number of S. mutans in the saliva of children was 8.303 ± 2.351 log10 CFU/mL. Conclusion: The number of S. mutans in the saliva of children in Department of Pediatric, Faculty of Dentistry, Trisakti University was categorized is in the high-risk.

Stomatološko liječenje u općoj anesteziji u sustavu jednodnevne kirurgije

ObjectiveTo analyze data on full-mouth rehabilitation under general anesthesia (GA) performed at the University Clinical Hospital Zagreb with emphasis on patient characteristics, type of procedure and postoperative complications.Materials and methodsRetrospective chart review of 100 patients treated under GA at the Dental clinic’s day care surgery. Patient’s demographic (sex, age) and clinical data (diagnosis, GA technique, intubation type, procedure duration, number of carious teeth, presence of visible calculus, number of sealed teeth, fillings, extractions and endodontic treatments, discharge time, postoperative complications) were registered.ResultsEighty patients were treated under GA because of noncompliance due to different reasons and twenty patients because of either their poor physical condition or extensive dental procedure. Median DMFT per patient was 9(0-21). Eighty nine patients underwent full-mouth dental restoration and 11 patients underwent other types of procedures. Ninety-six patients were safely discharged the same day. Four patients experienced postoperative complications and three of them were hospitalized for another 24-48 hours for postoperative follow-up.ConclusionPatients with physical and/or intellectual disabilities have higher caries activity and increased dental treatment needs compared to the general population. Dental treatment under GA in day care service is a safe and effective way of providing dental care for noncompliant patients.

A threshold gap size for in situ secondary caries lesion development

ObjectivesThis study investigated the influence of very small gaps in secondary caries (SC) development and additionally linked the threshold gap size with the caries activity level from volunteers. MethodsFor 21 days, 15 volunteers wore a modified occlusal splint loaded with dentin-composite samples restored with different interfaces: bonded (B = samples restored with complete adhesive procedure), no-bonded (NB = restored with composite resin without adhesive procedure), and 30, 60 and 90 μm (no adhesive procedure and with intentional gap). The splint was dipped in a 20% sucrose solution (10 min) 8 x per day. Samples were imaged with transversal wavelength independent microradiography (T-WIM) and lesion depth and mineral loss were calculated. Average wall lesion depth from each volunteer was determined and according to the values the volunteers were grouped as high, mid and low caries activity levels. ResultsNo wall lesion formation was observed in B and NB groups. In general, intentional gaps led to SC lesion depth progression independent of caries activity level of volunteers. No substantial wall lesions were found for two volunteers. A trend for deeper lesion in larger gaps was observed for the high activity group. ConclusionVery small gaps around or wider than 30 μm develop SC independent of the caries activity level of the patient and SC wall lesion progression seemed to be related to individual factors even in this standardized in situ model. SignificanceIndependently of caries activity level of the patient, the threshold gap size for secondary caries wall lesion seems to be 30 μm at most.

Rationale for caries prevention in young adults based on caries resistance rates

The aim of the study was to evaluate the effectiveness of caries prevention in young adults with different caries resistance rates. Sixty-seven patients aged 18-20 with low (n=32) and high (n=35) dmft were enrolled in the study. Caries prevention efficacy was assessed by laboratory tests: enamel resistance test (ERT), clinical enamel remineralization speed test (CERST), estimation of calcium and inorganic phosphorus in oral fluid. Patients with high caries activity in addition to conventional prevention program received prophylaxis procedure with Clinpro White Varnish (3M ESPE). ERT and CERST were significantly higher in high dmft (>13) subgroup. Statistically significant difference in ERT and CERST was observed between subgroups at 3 and 6 months evaluation after prevention program.

Correlation between Caries Related Microorganisms in the Dental Plaque and Saliva with Dental Caries Level in the Upper and Lower Jaws in 5 - 9 Years Old Children in Baghdad City

Background: The oral cavity is considered as a complex ecological niche, its complex microbial community is reflected to it. Streptococcus mutans has been implicated as one of the major etiological factor of dental caries. Tooth surfaces colonized with Streptococcus mutans are at a higher risk for developing caries, while lactobacilli are considered as the secondary invaders, not initiators of the carious lesion. The main purpose of this study was to correlate the dental caries (for primary and permanent teeth) in the upper jaw with the streptococcus mutans and lactobacilli count in the dental plaque and saliva, also to correlate the dental caries (for primary and permanent teeth) in the lower jaw with the streptococcus mutans and lactobacilli count in the saliva. Materials and methods: Forty seven children aged 5-9 years old were selected for this study. Dental caries recording was carried out by the dmfs index (decayed, missed, filled surfaces for primary teeth) to inspect the primary teeth and DMFS index (decayed, missed, filled surfaces for permanent teeth) to inspect the permanent teeth, by using the dental mirror and explorer. Collection of salivary samples was performed in the morning between (10-11) a.m. at least one hour after breakfast, then normal saline was added to have tenfold dilutions, for the purpose of full colony counting of the caries related microorganisms (streptococcus mutans and lactobacilli), then inoculation was done in the special selective media (for the streptococcus mutans is Mitis-Salivarius-Bacitracin agar, and for the lactobacilli is Rogosa agar). Counting of the colonies of the bacteria were estimated by the aid of dissection microscope Results: The highest level of dmfs means was found in primary upper teeth, it was 17.6383 ± 10.10 while for the permanent teeth the mean of DS and DMFS was highest in the lower teeth, it was 0.7391 ± 1. Pearson correlation was used to show the correlation between the ds and dmfs of upper and lower primary teeth with the level of streptococcus mutans in saliva (sm. Sal) and lactobacillus in saliva ,there was a significant correlation between the ds and dmfs for upper primary teeth at level 0.01 (2-tailed), and there was negative correlation between dsl and level of streptococcus mutans in saliva (sm. Sal) also there was negative correlation between dmfs for upper and lower primary teeth with level of streptococcus mutans in saliva, also the correlation between lactobacillus level in plaque with streptococcus level in plaque was negative, while for upper permanent teeth the correlation was negative with both type of bacteria level in plaque with the DSU and DMFSU Conclusion: The caries activity was more prominent in upper teeth than lower teeth, levels of streptococcus mutans were not associated with high caries activity, which emphasizes and consistent with the fact that the dental caries is a multifactorial disease, related to many factors.

Dental Care for an adolescent with chromosome pentasomy: rare case report with a two year follow-up

Pentasomy of the x chromosome is a rare syndrome of unknown incidence and there are few reports in the scientific literature, especially in terms of dental care for patients with this syndrome. The aim of this study was to report the dental care given to an adolescent with pentasomy of the X chromosome. The patient presented a cleft palate, impacted teeth, malocclusion, high caries activity, gingivitis and multiple tooth loss due to caries. Despite the difficulties of carrying out the dental work due to involuntary movements and the initial lack of collaboration from the patient the overall dental care was completed on an outpatient basis. The therapeutic success of the treatment was strongly supported by the significant cooperation and relationship that grew up along the period of the treatment, as well as the desire to have the treatment done by both the patient and her parents.