High Caries Research Articles

Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational Cross-Sectional Study With Meta-Analysis.

This web-based survey, conducted across multiple countries, sought to explore the factors that impact the decision-making of clinicians when it comes to managing defective direct restorations. A survey consisting of 14 questions was sent out to dentists in 21 countries through various online platforms. The survey consisted of two sections. The first contained five questions about demographic information, while the second involved eight clinical scenarios. In the second part, participants were tasked with deciding whether to repair or replace defective composite and amalgam restorations. Three thousand six hundred eighty dental practitioners completed the survey. For composite restorations, repair was preferred in scenarios like partial loss or fracture (RR:0.72; 95% CI: 0.58, 0.89; p = 0.002), whereas replacement was favored for secondary caries (RR:2.43; 95% CI: 1.87, 3.16; p < 0.001) and open/defective margins (RR:3.93; 95% CI: 2.68, 5.76;p < 0.001). Amalgam restorations were mostly replaced across all scenarios. The main factors influencing decision-making were caries risk, restoration size, and patient oral hygiene. Substantial heterogeneity was observed across countries. This study underscores the complexity of the decision-making process and the need for evidence-based guidelines to inform clinicians' decisions regarding restoration management. Patient-level factors predominantly influence decision-making, emphasizing the need for individualized approaches. The study reveals that the material type in the original restoration is a critical determinant, with composite restorations being repaired in specific scenarios, while amalgam restorations are consistently replaced across different countries. Key patient and tooth-level factors, such as high caries risk, poor oral hygiene, and restoration size, significantly impact clinicians' decisions, often favoring replacement over repair. These findings underscore the necessity for evidence-based guidelines to assist clinicians in making informed choices, ultimately enhancing the quality of patient care.

Cariogenic potential of the Streptococcus mutans Cid/Lrg system: an in vivo animal case study.

In our prior study using a dual-species (Streptococcus mutans/Streptococcus gordonii) competitive mouse caries model to investigate the contribution of S. mutans LrgAB to in vivo fitness, S. mutans wild-type and ΔlrgAB mutants consistently outnumbered S. gordonii and had high caries scores, even though the ΔlrgAB mutant is highly sensitive to oxidative stress. To determine whether the highly cariogenic sucrose diet used in the previous study masked the contribution of LrgAB to competitive fitness of S. mutans against S. gordonii, we recapitulated our previous mouse caries experiment with a modification in which 4% sucrose drinking water was replaced with sterile water, hypothesized to decrease the frequency of exposure of mice to sucrose, a determinant in the cariogenicity of S. mutans. Given that both S. mutans ΔlrgAB and ΔcidB mutants are sensitive to oxidative stress and share similar transcriptional profiles, these strains, as well as wild-type UA159, were tested in this modified dual-species mouse caries model. When comparing between groups the colonization within molar dental biofilms of S. mutans strains, ΔlrgAB mutant was at a level similar to the wild type, whereas S. mutans ΔcidB was modestly lower than both wild-type and S. mutans ΔlrgAB. The severity of total sulcal caries in both the ∆cidB and ∆lrgAB mutant infections was significantly lower than that of wild type. These results demonstrate that the Cid/Lrg system aids in S. mutans fitness against S. gordonii and caries potential in vivo, a phenotype likely masked in our previous study by more frequent exposure to sucrose.IMPORTANCEThe development of a mature biofilm on the tooth surface is the central event in the pathogenesis of dental caries, which primarily requires that cariogenic organisms withstand the limited resources or environmental fluctuations experienced in the oral cavity. The sensitive and heterogeneous response of the cid and lrg operons to complex external signals has been hypothesized to trigger differentiation of the Streptococcus mutans biofilm community into distinct functional subpopulations to promote survival and persistence of the S. mutans community when challenged by an unfavorable environment. The study described herein enlightens our understanding of how Cid/Lrg contributes to S. mutans pathogenic potential in vivo (caries development), warranting further research regarding the adaptive role of Cid/Lrg system in human oral biofilms toward the development of anti-caries strategies directed at the Cid/Lrg system.

Optimizing Treatment for Severe-Early Childhood Caries: The Role of Groper’s Appliance

Severe-Early Childhood Caries (S-ECC), often leading to serious health issues if left untreated, possesses a great restorative challenge to the pediatric dentist. This case report discusses a comprehensive management of S-ECC in a 5-year-old female patient with high dental caries risk. The patient presented with multiple carious lesions, root stumps, and fenestrated roots, necessitating a staged intervention. Treatment involved restorations with glass ionomer cement, pulpectomy followed by omega loop post build-up on anterior tooth and stainless-steel crowns on posterior teeth. Additionally, extractions were performed and Groper’s appliance was inserted for esthetic rehabilitation and space maintenance on maxillary anterior and posterior regions, respectively. Following completion of the planned treatment, overall risk assessment measured low. This case report emphasizes the importance of rehabilitative interventions in S-ECC, showcasing Groper's appliance as a viable and effective treatment option.

Buonocore Memorial Lecture 2023: Longevity of Dental Restorations or Longevity of Teeth: What Matters?

This paper aims to raise a discussion from the perspective of maintaining long-term oral health, posing a critical question: What holds greater significance for maintaining oral health, the longevity of restorations or teeth? This question explores the aspects that truly matter in ensuring sustained oral health throughout an individual's life. Restoration longevity is well-researched, and evidence shows several risk factors influencing longevity. The dentist's decision-making factor may be of utmost importance, and further studies are needed to investigate its relevance. The critical risk factors for restoration longevity are active pathology (high caries risk), less prominent parafunction, and extensive defects such as endodontic treatment. However, tooth longevity and the main risk factors for tooth loss are not well-researched. The evidence shows dental caries, and its sequelae, are the principal reasons for tooth loss. Patient-related risk factors, especially those associated with lifestyle and health choices, play a major role in the longevity of restorations and, more importantly, tooth longevity. To provide personalized dental care with maximum patient benefit, clinicians should identify and record potential risk factors, promoting a healthy lifestyle to ensure tooth and dentition longevity. Moreover, the evidence suggests that decision-making frameworks based on minimal intervention principles offer the best standard for clinical practice, promoting a longstanding healthy oral environment.

Salivary Physicochemical Parameters in Relation to Dental Caries and Adiposity Status.

The objective of this study was to investigate the correlations between salivary physicochemical parameters, adiposity, and caries indices in Hong Kong adolescents. A total of 921 adolescents aged 12-15 years from four randomly selected local secondary schools were invited to participate in this cross-sectional study. Dental examinations including the number of decayed, missing, and filled teeth (DMFT), salivary physicochemical parameters, and anthropometric measurements were performed. The Mann-Whitney U test was used to examine the differences in salivary parameters and adiposity indices between participants with different levels of caries experience. Correlations between adiposity indices, salivary parameters, and caries indices were examined using Spearman's correlation coefficients. The participation rate was 83.6%. After exclusion, data from 695 adolescents were analysed. Adolescents with high caries experience (DMFT ≥ Significant Caries Index [SiC Index]) had significantly higher weight-to-height ratio (W/H) and waist circumference (WC) z-scores and lower unstimulated and stimulated salivary flow rates and buffering capacity than those with DMFT < SiC Index. Except for body mass index z-score, the other adiposity indices were negatively correlated with at least one salivary physicochemical parameter (stimulated salivary flow rate or salivary buffering capacity) (rs ranged from -0.078 to -0.132). After adjusting for age and sex, decreased stimulated salivary flow rate was associated with higher body fat percentages, WC, and waist-to-height ratio z-scores, whereas low salivary buffering capacity was associated with higher W/H and WC z-scores. There is a potential link between adiposity indices and certain salivary physicochemical parameters that are implicated in the aetiology of dental caries.

Assessment of overall caries risk and mode of birth delivery in infants and children with and without ECC: a cross-sectional study.

The study assessed the caries risk in infants and children with and without early childhood caries (ECC) using American Academy of Pediatric Dentistry Caries Risk Assessment Tool (AAPD CRAT) and identified the association between caries risk and mode of birth delivery. This cross-sectional study included 96infants and childrenwith all maxillary and mandibular primary anterior teeth and at least two primary molars erupted clinically in the oral cavity. The details on the mode of birth delivery were noted in a preformed template along with the demographic details, followed by caries risk assessment (CRA) to assess the caries risk of an individual. The outcome assessment for overall caries risk was performed for the ECC and non-ECC group and compared against the mode of birth delivery. Descriptive statistics were performed for all the study variables (gender, overall caries risk, mode of birth delivery, and term of delivery). The Chi-square test was used to compare the categorical variables between the two groups (ECC and non-ECC groups). The high caries risk category contributed to 52.1% and 68.8% in the ECC and non-ECC groups, respectively. The prevalence of vaginal mode of delivery was 41.7% and 52.1% in the ECC and non-ECC groups, respectively. Caries risk increases with increasing age and the non-ECC group shows more risk (68.8%) than the ECC group. In comparison with the variables against the groups (ECC and non-ECC), Chi-square test revealed that only the term of delivery (p value = 0.035) and overall caries risk (p = 0.045) showed statistically significant difference. The proportion of high caries risk subjects was significantly more in the non-ECC groups. Children delivered by the C-section mode showed high caries risk (66.7%) when compared with the vaginal mode of delivery (53.3%). A validated CRAT for predicting caries risk is required.

Associations between risk factors, including approximal contact types and dental caries in children from low-income families. Pilot study.

The present cross-sectional study was conducted to evaluate various caries risk factors in children from low socio-economic groups and to assess if children with broad contacts between one or more primary molars (type I and S) should be categorized as at high caries risk. Clinical examinations were performed on 107, 3- to 10-year-old children from low socio-economic settings. Contact types along with other caries risk factors (insurance, diet, plaque, and fluoride use, and diet habits) were analyzed for effect on presence of caries lesions (prevalence) and caries experience (decayed, missing, filled teeth). 78% of the study population had dental caries lesions, with an average dmft of 5.6. Of the 277 evaluated contacts, 88% were categorized as broad contacts. Multivariate analyses failed to validate that broad contacts were a predictor of dental caries lesions. However, the analysis showed an association of insurance status, plaque index with dmft. In conclusion, the present study could not implicate broad contacts as a factor that increased caries risk in the studied population; however, it validates the importance of insurance status, plaque index, as well as diet frequency as predictors of dental caries lesions.

Preventing proximal enamel caries in neighboring tooth with glass ionomer cement restoration and silver diamine fluoride pretreatment

ObjectiveTo investigate caries preventive effects of 38 % silver diamine fluoride (SDF) pretreatment on neighboring tooth proximal to glass ionomer cement (GIC), including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations in an in vitro model. Methods: Human tooth blocks were restored withSDF+CGIC (Group 1), CGIC (Group 2), SDF+RMGIC (Group 3) or RMGIC (Group 4). Enamel specimen simulating proximal surface of neighboring tooth was placed in proximity to the restorations. The specimen underwent cariogenic challenge with cross-kingdom biofilm of Streptococcus mutans, Lacticaseibacillus casei and Candida albicans. After cariogenic challenge, the biofilm's growth kinetics, viability, and morphology were evaluated by propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. The enamel lesion depth, surface morphology and crystal characteristics were determined by micro-computed tomography (micro-CT), SEM and X-ray diffraction (XRD), respectively. ResultsPMA-qPCR demonstrated lower microbial growth in Group 1 and 3 compared with Group 2 and 4 (p < 0.05). CLSM showed the dead−to-live ratio in Groups 1–4 were 1.15±0.12, 0.53±0.13, 1.10±0.24 and 0.63±0.10, respectively (Group 1,3 > 2,4, p < 0.05). SEM revealed Groups 1 and 3 had scattered biofilm whereas Group 2 and 4 had confluent biofilm. Micro-CT showed the enamel lesion depths (µm) were 98±9, 126±7, 103±6 and 128±7 for Group 1 to 4, respectively (Group 1,3 < 2,4, p < 0.05). SEM revealed oriented and ordered enamel prismatic patterns in Group 1 and 3, not in Group 2 and 4. XRD showed the reflections of hydroxyapatite in Groups 1 and 3 were sharper than Groups 2 and 4. ConclusionSDF pretreatment enhances the preventive effect of GIC on proximal enamel surface on neighboring tooth through inhibiting cariogenic biofilm, reducing enamel demineralization and promoting enamel remineralization. Clinical significanceSDF pretreatment of GIC restorations can help prevent caries on neighboring teeth, particular for patients with high caries risk.

Assessment of dental hard tissues and periodontium in children with hemophilia

Relevance. Children suffering from hemophilia primarily receive dental care when they present with acute tooth pain or exacerbation of an existing condition. Due to the rarity (orphan nature) of hereditary coagulopathies, dentists often lack the experience and knowledge to utilize modern methods of prevention and treatment for this patient category. Additionally, the lack of regular dental check-ups for children with hemophilia often leads to a high level of oral morbidity and a need for specific treatments, as indicated by literature data.Materials and methods. The primary methods used to assess oral health in children with hemophilia included detailed questioning, detection of carious lesions in dental hard tissues, assessment of oral hygiene, and the condition of periodontal tissues.Results. Among pediatric patients with hemophilia, poor oral hygiene was associated with a high prevalence of carious lesions (100%) and very high caries intensity values (8.8, ranging from 7 to 11). Additionally, there was a relatively high prevalence of gingival inflammation, accompanied by pronounced gingival bleeding. A direct correlation was identified between the level of oral hygiene and the degree of gingival bleeding in children aged 6-17 years with hemophilia. The deterioration of dental indicators corresponded to the severity of hemophilia, the primary disease in these children.Conclusion. The study demonstrated that pediatric patients with hemophilia, particularly those with moderate to severe forms, had significantly worse indicators of oral hygiene, dental hard tissues, and gingival health compared to generally healthy children. The results indicate the necessity for dental monitoring and rehabilitation for children with hemophilia to detect and effectively treat oral diseases at early stages.

Unmasking caries risk: a multi-regional study in Saudi Arabia

BackgroundDental caries are common and troublesome and may affect individuals’ health conditions. It is crucial to comprehend the caries experience for prevention, management, and enhancing oral health. Techniques such as CAMBRA can help assess an individual’s risk factors for caries lesions. This study aims to assess the caries risk in five distinct regions of Saudi Arabia, utilizing the CAMBRA methodology.MethodsThis multiregional cross-sectional study was conducted at university dental clinics across the five regions of Saudi Arabia, using a Caries Management by Risk Assessment (CAMBRA) tool. This study used binary logistic regression analysis, the Pearson Chi-square test, and descriptive analysis as statistical methods.ResultsA total of 551 respondents participated in the study, with 59.7% being male and 40.3% being female. The age group with the highest proportion was 20–29, making up 31.6% of the participants. All participants exhibited at least one caries lesion (100%), with white spots (66.4%) and enamel lesions (56.1%) being the most prevalent. The moderate-risk category encompassed the largest proportion of participants, accounting for 60% of the total. High caries risk had a significant association with age group (P < 0.001), education (P < 0.001), profession (P < 0.001), and socio-economic status (P < 0.001). Furthermore, only age and socio-economic status showed a significant relationship with high caries risk in the multiple logistic regression.ConclusionThe CAMBRA tool indicates a high prevalence of moderate risk across the five regions of Saudi Arabia, identifying age and socio-economic status as significant predictors of caries risk.

Remineralization efficiency of three different agents on artificially produced enamel lesions: A micro-CT study.

This study aimed to assess the remineralization efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), silver diamine fluoride/potassium iodide (SDF/KI), and sodium fluoride with functionalized tricalcium phosphate (NaF/fTCP) on artificial early enamel lesion using laser fluorescence and micro-CT analysis. On extracted impacted third molars, artificial enamel lesions were prepared. Twenty-eight specimens were randomly assigned to four groups (n = 7 per group): a control group (artificial saliva), CPP-ACP (GC Tooth Mousse), SDF/KI (Riva Star), and NaF/fTCP (Clinpro White varnish). Following the manufacturer's instructions, the remineralization agents were applied to demineralized surfaces. Laser fluorescence and micro-CT were used to evaluate the remineralization efficacy of the agents and analyzes were performed during four stages: before demineralization, after demineralization, 1st day of remineralization and 30th day of remineralization. Shapiro-Wilk test, repeated measures two-way ANOVA, and Spearman correlation tests were used for statistical analysis. A significant level of p < 0.05 was established. SDF/KI significantly reduced the lesion area and lesion volume on the demineralized enamel surface after 30 days of remineralization. In the T3 period, SDF/KI increased the mineral density statistically significantly compared to the T1 period. The laser fluorescence values for all three remineralizing agents exhibited a linear decrease. A significant correlation between the fluorescence values and the mineral density was found (p = 0.01). All three investigated agents were showed positive remineralization efficacy on artificial enamel lesion. However, SDF/KI, containing silver diamine fluoride and potassium iodide exhibited superior than other agents in promoting remineralization. Although all three remineralization agents showed positive remineralization efficacy on artificial enamel lesions, SDF had higher remineralization performance over the other two agents. SDF has potential to prevent progression of demineralization in treating children with high caries risk in the long-term.

The Effects of MMP3 (rs679620) and VDR (rs731236) Gene Polymorphisms on Dental Caries: A Pilot Study.

Caries formation is a process affected by various factors. Studies have shown that genetic factors also play a role in caries formation. The aim of our study is to examine the effects of matrix metalloproteinase (MMP)3 (rs679620) and vitamin D receptor (VDR) (rs731236) gene polymorphisms on caries formation. Following routine oral examinations in individuals aged between 20 and 44 years, the diagnosis was made according to the decayed, missing, and filled teeth (DMFT) index, and experimental group was defined as "high caries risk" (DMFT ≥ 14, n = 28), and the control group as "no caries" (DMFT = 0, n = 28). Plaque index and bleeding on probing were measured from participants with a detailed anamnesis. Periodontally healthy individuals with less than 10% bleeding on probing were included in the study (n = 56). After DNA isolation from blood samples taken from the participants, the genotyping of MMP3 (rs679620) and VDR (rs731236) gene polymorphisms were determined using the real-time polymerase chain reaction technique. Data were analyzed with IBM SPSS V23.0. Data distribution was evaluated with Kolmogorov-Smirnov's test. Pearson's chi-square test was used to compare categorical data according to groups. The results were evaluated using a significance level of p < 0.05. Regarding MMP3 and VDR gene polymorphisms, there was a statistically significant difference between the groups in terms of MMP3 (rs679620) (p < 0.001). There was no statistically significant difference between the VDR (rs731236) genotype distributions of the groups (p = 0.659). Within the limits of this study, MMP3 rs679620 gene polymorphism may have an effect on caries formation.

Evaluation of change in knowledge, attitude, and practice of medical students towards early childhood oral health following educational intervention

Medical health professionals have the opportunity to influence the oral health of children, as they are the first health professionals to come in contact with expectant mothers and parents of infants and toddlers. Aim: To evaluate and compare undergraduate medical students’ knowledge, attitude, and practice about early childhood oral health care before and after educational intervention. Methods: A cohort study was conducted among undergraduate medical students during their course. The baseline knowledge and attitude of 80 medical students were evaluated using a validated questionnaire (Phase I). Following, they completed 8 hours of educational intervention and their change in the knowledge and attitude was reassessed (Phase II). The intervention continued through web-based learning till they reached their residency. The students’ knowledge, attitude, and practice were again reassessed at the end of their residency (Phase III). Results: Knowledge: There was a significant increase in the knowledge about the term gum pads, from 70% in Phase I to 90% in Phase III. Only 30% of medical students knew that the oral cavity of a newborn was devoid of microorganisms during Phase I, but this knowledge improved to 86% in Phase III. Almost 58 to 90% of the medical students had a basic knowledge of the influence of high caries on mothers, the importance and benefit of antenatal counselling, and the effect of poor maternal health. In Phase I, although 92% were aware of the multifactorial pattern of dental caries, only 42% and 53% knew the causative organism and transmissibility of it from mother to child, respectively. Around 77% and 62% agreed that antenatal counselling and counselling on feeding and weaning, respectively, will prevent ECC. Attitude: The attitude towards treating primary teeth was less (66%) in Phase I, subsequently increasing to 100% at the end of Phase III. Practice: Following Phase III, most of them (88%) examined the child’s oral cavity during routine medical checkups in the Knee-to-Knee position (93%) and counted the number of teeth present (91%), and they were able to identify the dental carious teeth (88%). Conclusion: The medical curriculum should include a module on early childhood oral health.

Evaluation of Caries Risk Using Cariogram Among Orthodontic Patients Before and During Treatment: A Comparative Study.

Objective The primary objective was to examine the Cariogram parameters among orthodontic patients with fixed appliances and evaluate the impact of preventive measures on mitigating the risk of dental caries during orthodontic therapy. Materials and methods Patients visiting the representative orthodontic clinics across 14 districts of Kerala participated in the comparative cross-sectional study from January 2023 to January 2024. The sampling method employed in this study was convenience quota sampling, where study subjects were allocated from each of the low, moderate, and high caries risk profiles until the sample size reached the minimal requirement within each group. The baseline Cariogram scores were used to divide the consented participants into two distinct groups. The intervention group was provided with preventive initiatives, including toothpaste comprising 1,450 ppm fluoride, 0.2% NaF mouthwash, pre-cut strands of SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, as well as videos, pamphlets, and brochures that promoted oral health habits. In contrast, the control group received normal oral health education solely through the use of pamphlets and brochures. After six months, the Cariogram elements were re-evaluated for individuals in both groups. The independent sample t-test and paired t-test were applied to evaluate statistically significant differences between and within the two groups, respectively, using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, US). The distribution of patients based on their caries risk profiles was compared between groups at the commencement of the study and six months later using the Chi-square test. Results While the intervention group had 20 males and 22 females, the control group consisted of 21 males and 21 females. The average age in the intervention and control groups was 20.7±3.56 years and 21.2±3.12 years, respectively. Between the two groups, age (t=-0.68; p=0.50) and gender differences (λ2=0.05; p=0.83) were statistically insignificant. The percentage mean of the "Chance to avoid caries" associated with the intervention group increased significantly from 46.15±0.96 to 57.88±1.91, (p<0.001). On the other hand, the chance to avoid caries in the control group at the commencement of the treatment and six months later was found to be statistically insignificant. A statistically highly significant differences for all the Cariogram parameters were found when contrasted between the groups after six months of orthodontic treatment. The distribution of caries risk categorization between the control and intervention groups after six months of orthodontic treatment was found to be statistically significant (λ2=20.16;p<0.0001). Further, a statistically significant difference was observed during the pre-treatment phase and six months later in the intervention group (λ2=13.02; p=0.001). Conclusion The study findings reveal that it would be prudent to utilize 0.2% sodium fluoride mouth rinse, SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, along with toothpaste containing 1450 ppm fluoride daily, to mitigate the risk of dental cavities during orthodontic treatment, in comparison to the control group.

Effect of Matcha Tea Versus Green Tea on Salivary pH and Flow Rate in High Caries Risk Patients: A Randomized Controlled Trial.

Effect of Matcha Tea Versus Green Tea on Salivary pH and Flow Rate in High Caries Risk Patients: A Randomized Controlled Trial.

TLR2 and TLR4 Polymorphisms Are Not Associated with Dental Caries in Polish Children.

The aim of the present study was to analyze the association of the TLR2 (Toll-like receptor 2 gene) 2258G>A (rs5743708), TLR4 (Toll-like receptor 4 gene) 896A>G (rs4986790), and TLR4 1196C>T (rs4986791) polymorphisms with dental caries in Polish children. The participants, 261 15-year-old children, were divided into two groups: 82 cases (i.e., children with DMFT (Decayed, Missing, and Filled Teeth) index >5, having either moderate or high caries experience, assigned as the "higher" caries experience group) and 179 controls (i.e., children with DMFT ≤ 5, having either low or very low caries experience, assigned as the "lower" caries experience group). Genomic DNA was isolated from buccal swabs, and genotyping was determined by means of real-time PCR (polymerase chain reaction). There were no significant differences in the genotype or allele distributions in all tested SNPs (single nucleotide polymorphisms) between children with "higher" caries experience and those with "lower" caries experience. TLR4 haplotype frequencies did not differ significantly between cases and controls. In an additional analysis with another case definition applied (subjects with DMFT ≥ 1 were assigned as "cases", whereas children with DMFT = 0 were assigned as "controls"), no significant differences in the TLR2 and TLR4 genotype, allele frequencies, and TLR4 haplotype frequencies were found between the case and the control groups. The results of the present study broaden our knowledge on the potential genetic factors that might affect caries risk and suggest that TLR2 rs5743708 and TLR4 rs4986790 and rs4986791 SNPs are not associated with dental caries susceptibility in Polish children.

The association between smoking and smokeless tobacco use with dental caries among Pakistani patients

BackgroundTobacco use is widely recognised as a significant risk factor for oral cancer and periodontal diseases. However, the relationship between various types of tobacco use and dental caries has been inconsistent. This study aimed to determine the association between smoking and smokeless tobacco and dental caries among patients in a tertiary care hospital in Quetta, Pakistan.MethodsThis cross-sectional study was conducted from November 2020 to March 2021 among patients in a tertiary care hospital in Quetta, Pakistan. Oral examinations and interviews were performed according to the WHO Oral Health Survey basic methods (5th edition) to determine dental caries status, tobacco use, and oral health behaviours. The odds ratio and binary logistic regression were analysed to assess the association between the types (smoking tobacco, smokeless tobacco, and use of both types), duration, and frequency of tobacco use and high caries level (DMFT ≥ 5).ResultsFour hundred participants aged 18–65 were included, and 67.8% were tobacco users. Use of both smoking and smokeless tobacco (aOR = 14.7, 95%CI = 1.87–115.96, p = 0.011), smokeless tobacco only (aOR = 5.90, 95%CI = 1.89–18.37, p = 0.002), and smoking only (aOR = 2.18, 95%CI = 1.23–3.88, p = 0.008) were associated with significantly increased risk of high caries. Using tobacco for longer periods and more frequently daily also significantly increases the risk of high caries.ConclusionSmoking and smokeless tobacco are significantly associated with high dental caries after adjusting for other factors. Due to the high severity of dental caries and the high prevalence of tobacco use among Pakistani patients in this study, it is highly recommended to strengthen policies aimed at reducing tobacco usage, including smokeless forms.

Portable Saliva Sensor Based on Dual Recognition Elements for Detection of Caries Pathogenic Bacteria.

Dental caries is one of the most common diseases affecting more than 2 billion people's health worldwide. In a clinical setting, it is challenging to predict and proactively guard against dental cavities prior to receiving a confirmed diagnosis. Streptococcus mutans (S. mutans) in saliva has been recognized as the main causative bacterial agent that causes dental caries. High sensitivity, good selectivity, and a wide detection range are incredibly important factors to affect S. mutans detection in practical applications. In this study, we present a portable saliva biosensor designed for the early detection of S. mutans with the potential to predict the occurrence of dental cavities. The biosensor was fabricated using a S. mutans-specific DNA aptamer and S. mutans-imprinted polymers. Methylene blue was utilized as a redox probe in the sensor to generate current signals for analysis. When S. mutans enters complementarily S. mutans cavities, it blocks electron transfer between methylene blue and the electrode, resulting in decreases in the reduction current signal. The signal variations are associated with S. mutans concentrations that are useful for quantitative analysis. The linear detection range of S. mutans is 102-109 cfu mL-1, which covers the critical concentration of high caries risk. The biosensor exhibited excellent selectivity toward S. mutans in the presence of other common oral bacteria. The biosensor's wide detection range, excellent selectivity, and low limit of detection (2.6 cfu mL-1) are attributed to the synergistic effect of aptamer and S. mutans-imprinted polymers. The sensor demonstrates the potential to prevent dental caries.

Prevalence of dental carries and its association with breastfeeding duration among young children in Addis Ababa, Ethiopia

BackgroundBreastfeeding is a crucial feeding practices that significantly contributes to the healthy development of children. However, the effect of breastfeeding duration on caries risk is unclear, as different studies have found different results. This study aims to assess the prevalence of dental caries and its association with breastfeeding duration among young children aged 12–36 months in selected health facilities of Addis Ababa, Ethiopia.MethodsA cross-sectional study among 380 children aged 12–36 months from 11 health centers in Addis Ababa was conducted. Questionnaires and dental examinations were used to collect data. Dental caries was measured by the deft (decayed–extracted–filled teeth) index. Binary logistic regression was used to assess the association between dental caries and duration of breastfeeding, after adjusting for the confounders.ResultsThe prevalence of dental caries was 53.4% (95% CI: 48.3, 58.5%), with 13.7% having high caries and 39.7% having low caries. Breastfeeding duration was not significantly associated with dental carries, after adjusting for confounders. However, sugar intake, older age, mothers’ unemployment, and not being in marital union are risk factors for dental caries development.ConclusionsPromotion of healthy diet, especially limiting intake of sugar and sweets, and integration of oral health into primary health care programs are recommended. Further research using longitudinal design or meta-analysis is recommended to establish more concise evidence on the association between breastfeeding duration and dental caries.

Validation of an improved questionnaire assessing the social cognitive constructs of the Health Action Process Approach among parents regarding brushing their children's teeth.

The Health Action Process Approach (HAPA) describes social cognitive constructs related to behaviour change. A validated questionnaire is needed to measure these constructs in paediatric dentistry. The aim of this study was to improve an existing HAPA-based questionnaire for parents regarding brushing their children's teeth and to assess its validity and reliability in a population of parents of high caries risk children. Parents of high caries risk children of 3-10 years filled out the adjusted HAPA-based questionnaire. Mokken scale analysis, graded response model analyses, factor analyses and reliability analyses were performed according to the protocol of Dima. Discriminant validity was assessed by comparing the mean scores of the HAPA constructs between two groups of participants, based on different levels of caries experience, brushing frequency and education level of the mother. The Mokken scale analysis and factor analyses indicated a multidimensional eight factor scale. The graded response model did not fit our data. The subscale action control could be identified as a two-factor subscale. Reliability indices from the Dima protocol varied, for instance Cronbach alpha ranged from 0.73 to 0.96. The constructs coping self-efficacy, action planning and action control discriminated between brushing frequencies. The adjusted HAPA-based questionnaire is an improved, valid and reliable instrument that could be used to evaluate HAPA-based interventions to improve children's oral health.