High Caries Risk Research Articles

Assessing the Relationship Between COVID-19 and Dental Decay Risk in Youth: A Retrospective Analysis.

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted public health globally, with particular attention on the effects on children, adolescents, and young adults. This study aimed to investigate the potential relationship between COVID-19 and caries risk in this age group. A retrospective chart review was conducted on 120 patients between the ages of six and 25 years who received dental treatment at a university-affiliated dental clinic between January 2020 and December 2021. Demographic and medical data were collected, and dental examinations were performed to record the number of decayed, missing, and filled teeth (DMFT) and decayed, missing, and filled surfaces (DMFS). Data were analyzed using descriptive statistics, chi-square test or Fisher's exact test, student's t-test or Mann-Whitney U test, and multivariate regression analysis. Of the 120 patients, 40 were COVID-19-positive, and 32 of those patients were at high caries risk. Of the 80 patients who were COVID-19 negative, 48 were at high caries risk. There was a statistically significant association between COVID-19 exposure and caries risk. Participants who tested positive for COVID-19 had 1.8 times higher odds of dental caries than those who tested negative. However, no significant association was found between caries risk and age, gender, or previous dental history. The findings suggest that COVID-19 may be a risk factor for caries in children, adolescents, and young adults. Dental professionals should consider COVID-19 exposure as a potential risk factor when assessing caries risk in this age group. Further research is needed to better understand the mechanism underlying this association.

Fissure Sealants or Fluoride Varnish? A Randomized Pragmatic Split-Mouth Trial

This study aimed to compare the clinical effectiveness of resin-based fissure sealants (FS) and fluoride varnish (FV) in children at high caries risk. A practice-based split-mouth randomized clinical trial was conducted at 9 Public Dental Service (PDS) clinics in Norway. In total, 409 children age 6 to 10 y at high caries risk (d3mft > 0) meeting inclusion criteria were recruited by dentists and dental hygienists during routine examination. Eligibility criteria were 2 fully erupted first permanent molars (FPMs) in the same jaw, with sound occlusal surfaces or with initial caries. Participation was voluntary, caregivers and eligible children were informed about the study, and written parental consent was obtained. FS and FV were randomly applied on contralateral FPMs in the same jaw, with each participant serving as their own control. FS was applied at baseline and thereafter maintained according to clinicians’ conventional procedures, whereas FV was applied at baseline, 6 mo, and 12 mo. The study outcome was success, with no need for invasive treatment (caries control), while failure was defined as dentin carious lesion or restoration. Two-level mixed-effects logistic regression analysis was used to compare FS and FV groups. Of 409 recruited children, 369 (90%) children/tooth pairs were examined after 36 mo. Intention-to-treat analysis showed 94.1% adjusted predicted probability (aPP) of success (95% confidence interval [CI] 91.7 to 96.4) in the FS group and 89.6% aPP (95% CI 86.5 to 92.7) in the FV group. In the adjusted analysis, the FV group had a lower OR for success compared with the FS group (OR 0.54, 95% CI 0.24 to 0.87). In the population studied, the clinical effectiveness of FS was statistically significantly higher compared with FV but below the estimated minimal clinically important difference of 10%.

Development of Oral Healthcare Plan for Children with Congenital Anomalies

Background: Children having birth defects denote a high-risk group for oral diseases compared to their healthy counterpart. Untreated dental caries significantly accounts for the oral disease burden of children with birth defects. A preventive oral health and restorative dental care package with close follow up could offer much benefit for such children and this poster provides some baseline information in this regard.Objective: To describe an oral health care package offered to high caries risk children with birth defects at a multi-specialty, tertiary care, and premier public dental hospital setting in Sri Lanka.Methods: A Sample of 79 children with birth defects who visited the Preventive Oral Health Unit of the National Dental Hospital (Teaching) Sri Lanka from 1st January 2017 to 29th April 2019 were included in the present analysis, by extracting data from unit’s data base. The level of corporation of a child for oral health care was assessed by child’s compliance with mouth examination and provision of simple dental treatment in a child-friendly dental setting.Results: Children with birth defects aged (mean ± SD) [6.02 ± 3.17-years], carried a high burden of untreated dental caries. The mean number (±SD) of non-cavitated decayed teeth was 2.65± 3.62, cavitated decayed teeth was 2.97±2.97 and pulp exposed teeth was 3.59 ±3.60 respectively. Children were offered a preventive oral health care package comprised of customized behavioural management, oral hygiene instructions and dietary counselling (for parental care givers), professional fluoride applications, simple restorations of carious teeth, fissure sealant applications for permanent molar teeth, referral for pulp therapy for pulp exposed symptomatic teeth under general anaesthesia to Restorative Unit B with follow up of care. 50.6% of children deemed cooperative and 8.9% were partially cooperative to receive oral health care provided by the Preventive Oral Health Unit.Conclusion: This baseline information must be utilized for effective planning of oral healthcare for children with birth defects.

Enhanced anti-biofilm and anti-caries potential of arginine combined with calcium glycerophosphate and fluoride

ObjectiveThe aim of this work was to evaluate the antibiofilm and anticaries properties of the association of arginine (Arg) with calcium glycerophosphate (CaGP) and fluoride (F). MethodsAn active attachment, polymicrobial biofilm model obtained from saliva and bovine teeth discs were used. After the initial biofilm growth period, the enamel discs were transferred to culture medium. The treatment solutions were added to the culture media to achieve the desired final concentration. The following groups were used: negative control (Control); F (110 ppm F); CaGP (0.05 %); Arg (0.8 %) and their associations (F + CaGP; Arg + F; Arg + CaGP; Arg +F + CaGP). The following analyses were carried out: bacterial viability (total bacteria, aciduric bacteria and mutans streptococci), pH assessment of the spent culture medium, dry weight quantification, evaluation of surface hardness loss (%SH) and subsurface mineral content. Normality and homoscedasticity were tested (Shapiro-Wilk and Levene's test) and the following tests were applied: two-way ANOVA (acidogenicity), Kruskall-Wallis (microbial viability) and one way ANOVA (dry weight, %SH, mineral content). ResultsThe association Arg + F + CaGP resulted in the lowest surface hardness loss in tooth enamel (-10.9 ± 2.3 %; p < 0.05). Arg +F + CaGP exhibited highest values of subsurface mineral content (10.1 ± 2.9 gHAP/cm3) in comparison to Control and F (p < 0.05). In comparison to Control and F, Arg +F + CaGP promoted the highest reduction in aciduric bacteria and mutans streptococci (5.7 ± 0.4; 4.4 ± 0.5 logCFU/mL, p < 0.05). ConclusionsThe Arg-F-Ca association demonstrated to be the most effective combination in protecting the loss of surface hardness and subsurface mineral content, in addition to controlling important virulence factors of the cariogenic biofilm. Clinical significanceOur findings provide evidence that the Arg-F-Ca association showed an additive effect, particularly concerning protection against enamel demineralization. The combination of these compounds may be a strategy for patients at high risk of caries.

Laser fluorescence assessment of dental caries arrest with two silver fluoride agents in patients with special needs– a preliminary report

PurposeWhile silver diamine fluoride has been used extensively for caries arrest and desensitising, silver fluoride (AgF) at neutral pH may also have value as a minimally invasive dental caries treatment. This study explored the effectiveness of two AgF products (AgF/KI and AgF/SnF2) when used in adult patients with special needs (SN) who had high caries risk and salivary gland hypofunction.MethodsThis split-mouth clinical study, over two appointments 3-months apart, compared the impact of a single application of AgF/KI (Riva Star Aqua, SDI) and AgF/SnF2 (Creighton Dental CSDS, Whiteley) on matched carious lesions in the same arch, by clinical visual-tactile (cVT) assessment of caries status and laser fluorescence (LF, DIAGNOdent) evaluation of bacterial load in the lesions, using repeated measures analysis.ResultsTwelve participants were recruited in the study. A total of 56 teeth (28 pairs) were included. Both AgF products gave a significant decrease in caries activity as measured by cVT (P < 0.0001) and LF (P = 0.0027). There were no statistically significant differences between the two AgF treatments, with response rates for improvements in active lesions of 92% in the AgF/KI arm, and 96% in the AgF/SnF2 arm. There was no effect of tooth type, lesion type, arch type, plaque metabolism and plaque area at the site level on outcomes, nor was there a clustering effect of sites in a patient level analysis. Overall, LF was superior to cVT for detecting lesions that still progressed despite treatment (P = 0.0027).ConclusionA single application of AgF/KI or AgF/SnF2 has high predictability (over 90%) for achieving arrest in active caries lesions in adult patients with SN and high caries risk. Clinical assessment should use visual-tactile examination combined with LF readings to detect lesions that are still progressing and that require additional treatments. Future studies should compare these AgF modalities with SDF and explore factors such as time between applications and the need for repeated applications.Trial registrationThe study was registered with the Australian Clinical Trials Registry (ACTRN12621001139864p) on 23/08/2021.

Identifying Risk Factors for Dental Emergency Visits in the US Army.

The purpose of this study is to examine the relationship between subjects' oral health characteristics and the incidence of a dental emergency over 1 year. The Corporate Dental System (CDS) generated a limited data set for service members assigned for dental care at Fort Liberty, North Carolina. Data extracted included demographics and oral health characteristics (dental readiness classification, caries risk, periodontal screening and recording values (PSR), and tobacco use). Subjects were grouped based on the presence of a dental emergency visit code in the past year. A total of 20,210 individuals were included in the sample; 8.5% of individuals sought emergency dental care during the period. Kruskal-Wallis tests found significant differences (P < 0.05) in dental emergencies between age groups, sex, rank, dental readiness classification, and caries risk. Younger age, female soldiers, and low caries risk had the most significant increase in dental emergencies. There was no significant difference in dental emergencies between PSR or tobacco usage groups. This study supports a relationship between demographics, oral health characteristics, and dental emergencies. Age may be related to service members entering the military with untreated or managed dental needs, notably around the age of third molar eruption. Sex differences may be related to willingness or preference to utilize non-emergency dental care visits. The inverse relationship between caries risk and dental emergencies could be due to identification and management of high caries risk patients. This project highlights the need for further study and increasingly discrete measurement of oral health care characteristics and coding for etiologies of dental emergencies.

Fluoride varnish applications provided in general dental practice for children of primary school age in three areas of the UK.

Introduction Dental guidelines recommend professional application of fluoride varnish (FV) at least twice a year for children from the age of three.Methods NHS dental claims data were reviewed for children born in 2009 for the five-year period 2015-2019 and who attended the dentist in one of three geographical areas, labelled as Bristol, Birmingham and Cardiff. Data for 14,566 children were included in the study.Results Only 3.5% of children had been provided with ten or more FV applications at the dentist in the five-year period. Children in the Cardiff region fared less well for fluoride applications than their Bristol and Birmingham counterparts, including children that were seemingly at high risk of caries for part of the time period reviewed. For all three regions, the mean number of FV applications increased with an increase in the number of fillings provided.Conclusion Awareness of the apparent lack of FV application in the dental surgery may provide an opportunity to improve child dental health.

Tooth Brushing Learning Methods: Differential or Conventional? – A Randomized Controlled Clinical Trial

Introduction: Proper tooth brushing is a complicated process for children. Therefore, the aim of this study was to investigate the effect of differential learning to improve tooth brushing in children. Methods: In this prospective, controlled, single-blinded, randomized clinical trial, 58 children between 3 and 8 years of age (mean: 5.7 ± 1.5 years; 29 female) were randomly assigned to test or control group through the child’s self-drawing of an unlabeled envelope from a box. All children received oral hygiene instructions and information in these sealed envelopes and were asked to follow the corresponding instructions at home for 28 days. Children in the test group received instructions with exercises using the differential learning method, whereas the children in the control group received the usual tooth brushing instructions. Results: At baseline and planned follow-ups after 4 and 12 weeks, plaque and gingival indices (QHI, PBI) were recorded in both groups by 2 calibrated and blinded investigators. At baseline, there were no significant differences between the test and control groups regarding plaque and gingival indices (QHI: 4.1 ± 0.5 vs. 4.1 ± 0.4; p = 0.7; PBI: 0.6 ± 0.3 vs. 0.6 ± 0.3; p = 0.7). At the 1st and 2nd follow-up, both groups showed improved oral health indices, but there was an overall better improvement in the test group. While the difference in gingival indices was statistically significant in the 1st recall (PBI/test: 0.1 ± 0.2 vs. control: 0.3 ± 0.2; p < 0.001), the difference in plaque indices was not (QHI/test: 2.1 ± 0.9; control: 2.6 ± 0.9; p = 0.07). At the 2nd recall (mean week = 19.5 weeks), the test group showed statistically significant and clinically relevant better oral health indices than the control group (2nd recall, QHI/test: 2.1 ± 0.9 vs. control: 3.2 ± 1; p < 0.001; PBI/test: 0.1 ± 0.2 vs. control: 0.5 ± 0.2; p < 0.001). Conclusion: In conclusion, differential learning leads to oral hygiene improvement in children with high caries risk and initially poor oral hygiene, which was superior to the conventional learning method through repetition in the medium term.

Dental caries management by risk assessment among children

Dental caries is the highest-frequency oral disease. The purpose of this study is to assess the risk of developing dental caries for groups of children aged three to six in the city of Varna, Bulgaria, taking into account clinical risk factors. The population of this study included 300 children aged 3 to 6 years. Hence, as many 30 children for the experimental and 30 children for the control groups were included in the study with saliva tests. After that, standardized means of decayed, filled surfaces (DFS) index was estimated. The teeth of the children in the experimental group were covered for three months with Clinpro™ White Varnish. The Research Ethics Committee at the MU-Varna University approved the study. We applied the Greene and Vermillion oral hygiene index. Biostatistics was conducted with a specialized package for statistical analyzes was used StatSoft, STATISTICA manual (Software system for data analysis STATISTICA 10.0, 2010. The results in our study show the strong influence of carbohydrate nutrition and poor oral hygiene on the development and progression of the caries process. The results of the study of the frequency of caries lesions on surfaces show a value of 6.35±0.65. Caries lesions on 1 and 2 surfaces predominate (23.75%). Almost 100% of the children in the control group had Streptococcus mutans and a high risk of caries. From the risk assessment results obtained for each child patient, individual prevention programs are prepared for children.

Are GIC sealants as effective as composite sealants in caries prevention?

Fissure sealants (FS) are micro-invasive procedures that have proved to be effective in caries prevention in caries-free, first permanent molars. Within high-caries risk individuals, fissure sealants arrest the caries process in early caries lesions stages. Composite resin (CR) sealants have been recognized as the gold standard FS material; however, new evidence has emerged in relation to GIC sealants in their applicability and longevity. This review provides evidence-based information supporting the effectiveness of GIC sealants in caries prevention in comparison to CR sealants, by assessing their properties, methodology and utility in healthy and anomaly-affected teeth. CPD/Clinical Relevance: This article will inform clinicians about the effectiveness of GIC sealants and CR sealants in caries prevention.

Abstract TMP77: Oral Health as a Risk Factor for Spontaneous Intracerebral Hemorrhage: A Mendelian Randomization Analysis

Background: Poor oral health is a highly prevalent and modifiable risk factor that is associated with higher risk of cardiovascular disease, including ischemic stroke. However, the relationship between oral health and spontaneous intracerebral hemorrhage (ICH) has not been studied. We tested the hypothesis that genetically-determined poor oral health increases the risk of ICH. Methods: We conducted a two-sample Mendelian Randomization (MR) study using summary statistics from the largest genome-wide associations studies of oral health and ICH conducted to date. As genetic instruments (e.g., genetic risk variants for oral health), we identified 105 independent single nucleotide polymorphisms known to be associated with higher risk of caries, dentures and missing teeth at genome wide levels (p&lt;5x10 -8 ). The primary analysis employed summary statistics-based MR to assess the relationship between poor oral health and risk of ICH in any brain location. Secondary analyses evaluated deep and lobar ICH separately. Results: The primary analysis using the inverse variance-weighted MR method showed that genetically-increased risk of poor oral health was associated with a higher risk of ICH (OR 2.34, [1.08-5.06], p=0.029). Secondary analyses indicated a more potent association with deep ICH (OR 3.20 [1.34-7.6], p=0.008), whereas the link with lobar ICH was not statistically significant (OR 1.32 [0.53-3.27], p=0.543). Sensitivity analyses detected no horizontal pleiotropy in our findings (MR-PRESSO global test p-values &gt;0.05). Conclusion: Genetically-determined poor oral health is associated with an increased risk of ICH, particularly in the case of deep ICH. Because gene-disease associations are less prone to confounding, our results suggest that this association is causal. However, further analyses are needed to validate these results and identify the mediating mechanisms. Because oral health is an easily modifiable process, it may be a promising target for very early interventions focused on mitigating the risk of hemorrhagic stroke.

Dental implications of childhood obesity and prevention and management methods in dental office

Childhood obesity is a common chronic disease in childhood, and its prevalence and socioeconomic costs have increased worldwide over the past 40 years. The World Health Organization has designated obesity as a global epidemic, emphasizing the need for its treatment and management. The impacts of childhood obesity on dentistry include a higher risk of dental caries, advanced dental development, as well as psychological changes (anxiety, depression, attention deficit hyperactiv-ity disorder) and physical changes (increased complications, changes in drug metabolism) that should be considered when implementing preventive strategies, orthodontic treatment, behavior management and sedative procedures. Dentists should regularly check child’s body mass index and diet for every child visiting dental office. Parental obesity, consumption of sugar-sweetened beverages, poor dietary habits, and lack of exercise can be a risk factors for obesity in normal/overweight child. Diet counseling should be provided to high-risk children and their parents. Preventing childhood obesity is crucial, and the key point in treating childhood obesity is behavior modification therapy, which focuses on regulating daily eatinghabits and physical activity. Dentists should recognize the seriousness of childhood obesity and participate in the prevention and management of the obesity epidemic, thus enhancing oral and systemic health

Correlation of The Gluten-Free Diet and Caries in Children with Attention Deficit Hyperactivity Disorder (ADHD)

Background: ADHD children exhibit a higher risk of dental caries due to dietary factors, irregular eating patterns, and challenges in maintaining proper oral hygiene. A gluten-free diet is one dietary intervention that has gained attention in managing ADHD symptoms. Purpose: Investigates the potential relationship between gluten-free diets and caries in children with ADHD. Reviews: Several studies suggest that children with ADHD on a gluten-free diet may have a lower risk of dental caries due to reduced carbohydrates. Improved dietary habits and enhanced oral hygiene may contribute. However, the impact varies based on diet, oral care, and genetics. The availability of gluten-free products with added sugars poses a potential risk to dental health, emphasizing the importance of considering overall dietary patterns. Conclusion: The increased adoption of gluten-free diets can reducing the risk of dental caries in children with ADHD, but further research is needed to validate the potential relationship between that.

Determination of Fluoride Content of Selected Brands of Bottled Water Sold in Lafia Town using Two Different Methods

Fluoride is a well known compound for preventing dental caries, and its major root of ingestion is potable water. In this research, fluoride concentration in five brands of bottled-water samples sold in Lafia city (A, B, C, D and E) was investigated. Five different batches of each brand were analyzed. Samples were determined via potentiometric, and photometric methods. The mean concentration of fluoride within the investigated samples, were of the range 0.30 – 0.44 mg/L which were below WHO recommended limit, except sample B (0.53 mg/L) which was within the recommended limit. In the photometric method, the concentrations of the samples were within the range of 0.51 – 0.88 mg/L which were within WHO recommended limit. The outcome of this research suggests that within areas where there is elevated content of fluoride in water, bottled-water should be consumed instead of tap water because the former minimizes the danger of fluorosis. However, people who majorly drink bottled-water maybe at higher risk of dental caries; and need to take fluoride supplements. In this study, concentration of fluoride determined by photometric method was significantly higher than that of ISE method (P&lt;0.05). Hence, photometric method was more sensitive than the ISE method.

Silver diamine fluoride – ‘The silver bullet’ in pediatric dentistry: An overview of past, present and prospects

Various fluoride-containing topical agents like sodium fluoride, acidulated phosphate fluoride, Silver fluoride, and Silver diamine fluoride (SDF) have also been developed to prevent and intercept dental caries, particularly in children. SDF in 38% concentration for preventing and arresting dental caries in children. SDF is applied exclusively to carious lesions, both cavitated and non-cavitated, forming a protective layer on demineralized enamel and dentin. This layer enhances resistance to acid dissolution and enzymatic digestion of collagen, promoting mineralization and the formation of hydroxyapatite and fluorapatite SDF is a versatile treatment option for caries management, offering benefits in various clinical scenarios, including difficult access cases, high caries risk patients, and prevention of pit and fissure caries. The present article discusses the utility of SDF in dentistry, with an emphasis on pediatric dentistry

In vitro remineralization of adjacent interproximal enamel carious lesions in primary molars using a bioactive bulk-fill composite

BackgroundSurface remineralization is recommended for the management of active non-cavitated interproximal carious lesions in primary teeth. According to the American Academy of Pediatric Dentistry, a recently recognized category of materials called bioactive restorative materials can be used for remineralization. This study aimed to evaluate the release of fluoride (F), calcium (Ca) and phosphate (P) ions from Predicta® Bioactive Bulk-fill composite compared with EQUIA Forte® and Filtek™ Z350 and to determine the remineralization effect of these 3 restorative materials on adjacent initial interproximal enamel carious lesions.MethodsThe release of F, Ca and P ions from 3 groups ((n = 10/group) (Group 1- Predicta®, Group 2- EQUIA Forte® and Group 3- Filtek™ Z350)) was determined at 1st, 4th, 7th and 14th days. After creating artificial carious lesions, human enamel samples were randomly assigned into 3 groups (n = 13/group) which were placed in contact with occluso-proximal restorative materials and exposed to a 14-day pH cycling period. Surface microhardness was determined using a Knoop microhardness assay at baseline, after artificial carious lesions formation and after pH cycling. The difference in the percentage of surface microhardness recovery (%SMHR) among groups was compared. Mineral deposition was analyzed with energy-dispersive x-ray spectroscopy (EDS) and the enamel surface morphology was evaluated with scanning electron microscopy (SEM). Kruskal-Wallis’s test with Dunn’s post hoc test and one-way ANOVA with Tukey’s post hoc test were used for data analysis.ResultsEQUIA Forte® released the highest cumulative amount of F and P ions, followed by Predicta® and Filtek™ Z350. Predicta® released higher amount of Ca ions than EQUIA Forte® and Filtek™ Z350. Predicta® demonstrated the highest %SMHR, followed by EQUIA Forte® and Filtek™ Z350. There was a significant difference in the %SMHR between Predicta® and Filtek™ Z350 (p < 0.05). However, EQUIA Forte® demonstrated the highest fluoride content, followed by Predicta® and Filtek™ Z350. The SEM images of EQUIA Forte® and Predicta® revealed the greater mineral deposition.ConclusionPredicta® demonstrated a marked increase in surface microhardness and fluoride content of adjacent initial interproximal enamel carious lesions in primary molars compared with Filtek™ Z350. Predicta® is an alternative restorative material to remineralize adjacent initial interproximal enamel carious lesions in primary molars, especially in high-risk caries patients.

Association between dietary fiber to carbohydrate ratio and risk of dental caries in diabetic patients: an analysis of the National Health and Nutrition Examination Survey 2015-2020.

People with diabetes mellitus have a higher risk of dental caries than the general population. Diet is one of the most important factors affecting the risk of dental caries. This study aimed to evaluate the effect of dietary fiber to carbohydrate ratio (FCR) on the risk of dental caries in diabetic patients. Data of this cross-sectional study were extracted from the 2015-2020 cycle of the National Health and Nutrition Examination Survey (NHANES) database. FCR levels were divided into two categories based on the median (0.13). The outcomes were untreated dental caries and dental caries experience. The associations of FCR with untreated dental caries and dental caries experience were assessed using multivariable logistic regression analysis and reported as odds ratio (OR) and 95% confidence interval (CI). Stratified analyses were performed according to age (<65 and ≥ 65 years), gender (female and male), hypertension (yes and no), and the ratio of family income to poverty (PIR, <1 and ≥ 1). A total of 2,412 patients diagnosed with diabetes were included, of whom 728 (30.18%) had untreated dental caries and 2,104 (87.23%) had dental caries experience. Patients with FCR ≥0.13 were correlated with lower odds of untreated dental caries (OR = 0.72, 95%CI: 0.52-0.99) and dental caries experience (OR = 0.63, 95%CI: 0.42-0.93) compared to patients with FCR <0.13. Stratified analyses demonstrated that patients with FCR ≥0.13 were found to be related to lower odds of untreated dental caries in those aged <65 years (OR = 0.64, 95%CI: 0.42-0.97), female (OR = 0.57, 95%CI: 0.35-0.93), with hypertension (OR = 0.66, 95%CI: 0.45-0.96), and PIR ≥1 (OR = 0.64, 95%CI: 0.42-0.99). Similar results to untreated dental caries were observed in the analysis of dental caries experience (p < 0.05). High levels of FCR may be associated with a lower risk of dental caries in patients with diabetes. Increasing the proportion of dietary fiber intake among diabetic patients may help prevent the occurrence of dental caries.

Prevalence of salivary microbial load and lactic acid presence in diabetic and non-diabetic individuals with different dental caries stages.

This study aims to correlate caries-causing microorganism load, lactic acid estimation, and blood groups to high caries risk in diabetic and non-diabetic individuals and low caries risk in healthy individuals. This study includes 30 participants divided into 3 groups: Group A, High-risk caries diabetic individuals; Group B, High-risk caries non-diabetic individuals; and Group C, Low-risk caries individuals. The medical condition, oral hygiene, and caries risk assessment (American Dental Association classification and International Caries Detection and Assessment System scoring) were documented. Each individual's 3 mL of saliva was analyzed for microbial load and lactic acid as follows: Part I: 2 mL for microbial quantity estimation using nutrient agar and blood agar medium, biochemical investigation, and carbohydrate fermentation tests; Part II: 0.5 mL for lactic acid estimation using spectrophotometric analysis. Among the selected individuals, blood group correlation was assessed. The χ2 test, Kruskal-Wallis test, and post hoc analysis were done using Dunn's test (p < 0.05). Group A had the highest microbial load and lactic acid concentration, followed by Groups B and C. The predominant bacteria were Lactobacilli (63.00 ± 15.49) and Streptococcus mutans (76.00 ± 13.90) in saliva. Blood Group B is prevalent in diabetic and non-diabetic high-risk caries patients but statistically insignificant. Diabetic individuals are more susceptible to dental caries due to high microbial loads and increased lactic acid production. These factors also lower the executing tendency of neutrophils, which accelerates microbial accumulation and increases the risk of caries in diabetic individuals.

Efeitos de dentifrícios contendo carvão ativado no esmalte dental: uma revisão da literatura

ABSTRACT The increased demand for white teeth has intensified the commercialization of new bleaching products, particularly those that can be accessed easily, do not require the direct supervision of a dentist, and are affordable. Among these new products, several dentifrices publicized as bleaching products have been developed, most recent of them being the activated charcoal toothpaste, which entered the market promising to whiten teeth. While it is portrayed as a healthy and ecological product, there is a paucity of scientific evidence supporting its alleged benefits. Therefore, this literature review aimed to evaluate activated charcoal containing oral hygiene products on their bleaching ability and effects on enamel. After analyzing several in vitro studies on the subject, it can be concluded that these products do not have a bleaching effect per se, but act by removing the extrinsic pigments from the teeth. However, most of the products containing activated charcoal could have abrasive effects on the surface of the enamel. Therefore, it is suggested caution about the indication of these dentifrices, especially for individuals predisposed to dental wear, such as gingival recession, reduced salivary flow, and high risk of caries or dental erosion.

Comparison of the physical properties of glass ionomer modified with silver phosphate/hydroxyapatite or titanium dioxide nanoparticles: in vitro study.

Glass ionomer cements (GICs) are the common materials employed in pediatric dentistry because of their specific applications in class I restorations and atraumatic restoration treatments (ART) of deciduous teeth in populations at high risk of caries. Studies show a limited clinical durability of these materials. Attempts have thus been made to incorporate nanoparticles (NPs) into the glass ionomer for improving resistance and make it like the tooth structure. An in vitro experimental study was conducted using the required samples dimensions and prepared based on the test being carried out on the three groups with or without the modification of light-cured glass ionomer. Samples were grouped as follows: control group (G1_C), 2% silver phosphate/hydroxyapatite NPs group (G2_SPH), and 2% titanium dioxide NPs group (G3_TiO2). The physical tests regarding flexural strength (n = 10 per group), solubility (n = 10 per group), and radiopacity (n = 3 per group) were performed. The data were analyzed by Shapiro Wilks test, and one-way analysis of variance (one-way ANOVA), and multiple comparisons by post hoc Tukey's test. The p-value of < 0.05 was considered significant. No statistically significant difference was observed between the control group (G1_C) and (G2_SPH) (p = 0.704) in the flexural strength test, however differences were found between G2_SPH and G3_TiO2 groups, ANOVA (p = 0.006); post hoc Tukey's test (p = 0.014). Pertaining to the solubility, G2_SPH obtained the lowest among the three groups, ANOVA (p = 0.010); post hoc Tukey's test (p = 0.009). The three study groups obtained an adequate radiopacity of >1 mm Al, respectively. The resin-modified glass ionomer cement (RMGIC) was further modified with 2% silver phosphate/hydroxyapatite NPs to improve the physical properties such as enhancing the solubility and sorption without compromising the flexural strength and radiopacity behavior of modified RMGIC. The incorporation of 2% titanium dioxide NPs did not improve the properties studied.