Initiation Of Caries Research Articles

Caries preventive therapy

Caries preventive therapy includes fluoride in various forms, behavioral management, non-fluoride chemical therapy, dietary modification, education, risk assessment and an understanding of the individual patient’s reasons for caries initiation or progression. Currently available caries preventive therapeutic options are described.

Salivary and Serum Antioxidant and Oxidative Stress Markers in Dental Caries

Dental caries is the most common, chronic, noncommunicable, preventable oral disease worldwide. Oxidation may play an important role in dental caries initiation and progression. Antioxidants in body fluids protect cells. The aim of this study was to evaluate salivary and serum total antioxidant capacity (TAC) and malondialdehyde (MDA) levels in dental caries. A total of 118 healthy caries-free and caries-active male and female students participated. Caries was detected clinically. Unstimulated whole-saliva samples and blood samples were obtained. Sialochemical analysis was carried out by spectrophotometric assay. Data were analyzed with the Student t test using STATA 11. Salivary and serum TAC levels in the case and control groups did not show any significant differences. Mean salivary MDA levels in the case and control groups were 0.71 ± 0.1 and 0.35 ± 0.06 nmol/mL, respectively. The results showed significantly higher levels of salivary and serum MDA in the case group compared to the healthy control group. The oxidative stress marker was significantly higher in the caries group compared to the healthy control group. Antioxidants were not significantly different between the two groups. MDA can be produced by dental caries, resulting in a decrease in antioxidant levels, causing disease progression. Further studies are necessary to determine whether MDA is the cause or effect of the disease.

Difference in virulence and composition of a cariogenic biofilm according to substratum direction

The aim of this study was to investigate the difference in composition and virulence of Streptococcus mutans biofilms according to substratum direction. S. mutans biofilms (46-h-old) were formed on three different saliva-coated hydroxyapatite (sHA) disc direction groups: downward (discs placed in the direction of gravity), vertical (discs placed parallel to gravity direction), and upward (discs placed opposite to gravity). The 46-h-old biofilms on sHA discs in the upward direction showed the highest biofilm accumulation, colony forming unit (CFU) count, and extracellular polysaccharide (EPS) amount, followed by those in the vertical and downward directions. In the confocal laser scanning microscopy (CLSM) study, the biofilms in the upward direction also showed the highest bacterial count (live or dead cells) and EPS biovolume. Scanning electron microscopy (SEM) analysis confirmed the microbiological and biochemical results. In addition, biofilm density and acid production were higher in the upward direction than those in the other directions. Our findings suggest that substratum direction, which might be related to gravity, strongly influences the formation and virulence of cariogenic biofilms and subsequent initiation of dental caries. Collectively, the differences in the formation and virulence of cariogenic biofilms are related to the direction of tooth surface (occlusal surfaces of mandibular teeth > proximal surfaces > occlusal surfaces of maxillary teeth).

Pathophysiology of Dental Caries.

Carious lesion dynamics are dependent predominantly on the availability of fermentable sugars, other environmental conditions, bacteria, and host factors. Our current understanding of the microorganisms involved in the initiation and progression of caries is still rather incomplete. The most relevant acidogenic-aciduric bacterial species known to date are Streptococcus mutans, bifidobacteria, and lactobacilli. Whereas mutans streptococci are initiators, bifidobacteria and lactobacilli are more enhancers for progression. Boosters for microbial activity are specific environmental conditions, such as the presence of fermentable dietary sugars and the absence of oxygen. Based on these conditions, the necrotic and/or contaminated zone fulfils all criteria for disease progression and has to be removed. For those deep lesions where the pulp vitality is not affected, a selective removal of the contaminated leathery dentine should take place as this approach lowers the risk of regrowth of the few embedded microbial cells here. In repelling the microbial attack and repairing damage, the host has developed several ingenious strategies. A major resistance to carious lesion progression is mounted by the dentine-pulp tissues. The signalling molecules and growth factors released upon dentine demineralisation upregulate the odontoblast activity and act as sensor cells. After carious stimulation, odontoblasts initiate an inflammatory reaction by producing chemokines and synthesise a protective tertiary dentine. After the destruction of these cells, the pulp still has a high capacity to synthesise this tertiary dentine thanks to the presence of adult stem cells within the pulp. Also, in addition to the systemic regulation, the pulp which is located within inextensible the confines of the dentine walls has a well-developed local regulation of its inflammation, regeneration, and vascularisation. This local regulation is due to the activity of different pulp cell types, mainly the fibroblasts, which secrete soluble molecules that regulate all these processes.

Comparative evaluation of antibacterial effect of three commercially available herbal products against Streptococcus mutans: An In vitro Study

Background: In recent years, the researches concerning the use of herbal products have been vastly analyzed to decrease the disease burden caused by dental caries. It has been found that certain phytochemicals present in the plants have certain inhibitory effect toward Streptococcus mutans which is currently the main causative organism for dental caries initiation. Hence, in the present study, certain commercial herbal products have been tested for their antibacterial effect. Aim: This study aims to compare the antibacterial action of three commercially available herbal products against S. mutans. Material and Methods: An in vitro study was conducted with commercially available herbal products. They were Aloe Barbadensis Miller (Aloe vera), Ocimum tenuiflorum (Thulasi), and Stevia rebaudiana (Stevia). The antimicrobial effectiveness (zone of inhibition) of herbal products was determined using agar well diffusion method. Pure strains of S. mutans MTCC 890 were procured from culture collection center, Imtech, Chandigarh. The culture was grown in Brain Heart Infusion Agar, and around 20 ml each was poured into sterile petri plates. Chlorhexidine (CHX) was taken as positive control, and distilled water was taken as negative control. Statistical analysis was done using SPSS version 17 software. Results: All herbal products were found to be having variable antimicrobial activity against S. mutans. The mean zone of inhibition after 24 h incubation measured for Stevia, Thulasi, and A. vera was 22.33 mm, 11 mm, and 0 mm, respectively. The mean zone of inhibition of positive control CHX was found to be 13.6 mm. Conclusion: The antibacterial effect shown by Stevia was superior when compared with CHX and Thulasi. The Thulasi have more inhibitory effect than A. vera, and A. vera fails to show any zone of inhibition against S. mutans when compared with other herbal products. Thus, Stevia product can be strongly recommended as a caries preventing agent after sufficient clinical trials by future research.

Comparing the Effectiveness of Probiotic, Green Tea, and Chlorhexidine- and Fluoride-containing Dentifrices on Oral Microbial Flora: A Double-blind, Randomized Clinical Trial.

Introduction:Oral cavity harbors wide variety of microorganisms; these are considered crucial for the dental caries initiation and progression. Plaque-induced caries is a local disease; therefore, dentifrices are the most ideal vehicle for the daily delivery of antibacterial agents. In recent years, alternatives to fluorides such as green tea, probiotic, and chlorhexidine (CHX) toothpastes have been proposed to possess antiplaque and anticariogenic properties.Aim:To compare the effectiveness of probiotic, green tea, and CHX- and fluoride-containing dentifrices on oral microbial flora.Materials and Methods:A double-blinded, parallel group, randomized controlled clinical trial was conducted among healthy adults. Fifty-two individuals were randomly allocated to four groups (n = 13): Group I – green tea dentifrice, Group II – fluoridated dentifrice, Group III – CHX dentifrice, and Group IV – probiotic dentifrice. Plaque and saliva samples were evaluated for Streptococcus mutans and Lactobacillus at baseline and 15th and 30th days of follow-up. Paired t-test and one-way ANOVA were used to compare the mean differences of plaque and salivary S. mutans counts at two and three time periods. Wilcoxon signed-rank and Kruskal–Wallis tests were used to compare the mean Lactobacillus count in plaque and saliva samples at two and three time periods, respectively.Results:The mean S. mutans and Lactobacillus counts in plaque and saliva samples were significantly reduced by all the treatment groups at the 30th day of follow-up. However, Group III showed the highest reduction and was found to be statistically significant (P < 0.05).Conclusion:All the four groups exhibited antimicrobial activity by bringing about a significant reduction in the mean S. mutans and Lactobacillus colony counts at the 30th day of follow-up. Among all the preventive modalities, Group III (CHX dentifrice) showed better results compared to other groups.

The relationship between dental caries and carbohydrates intake among preschool-aged children in rural and urban areas

Introduction: The prevalence of dental caries among children has increased in the past decades. Dental caries has a multifactorial aetiology, including host (saliva and teeth), microbiology (plaque), substrate (diet), and time. The role of fermentable carbohydrates intake as a risk factor in the initiation and progression of dental caries. The purpose of this study was to determine the relationship between dental caries and carbohydrates intake among preschool-aged children in rural and urban areas of the city of Cimahi, Indonesia. Methods: The method used was an analytical cross-sectional study with pathfinder survey based on the WHO basic methods of oral health surveys. The data were collected through intraoral examination, and nutritional status measurement was done by using food frequency questionnaire. Statistical analysis used was the chi-square test. Results: From the study towards 100 preschool children resulted the prevalence of dental caries in rural and urban area respectively was 96 and 92%. The average value of deft index in urban area was 8.46 (95% CI:7.00-9.91) and was 7.98 (95% CI:6.50-9.45) in rural area. The average value of sucrose intake frequency in urban area was 237.14 (95% CI:204.95-269.32), whilst in rural area was 177.54 (95% CI:155.66-199.41). Conclusion: There was a relationship between dental caries and carbohydrates intake among preschool-aged children in the rural and urban area of the city of Cimahi, Indonesia.

Evaluation of exposure to fluoride in child population of North Argentina.

Fluoride is an important element for humans. It inhibits initiation and progression of dental caries and stimulates bone formation. However, excessive intake may lead to the appearance of dental and/or skeletal fluorosis and a decrease in intellectual coefficient in child populations. This study evaluates exposure to fluoride in the child population of Chaco province (Argentina) by analysis of drinking water, food and its bioaccessible fraction (quantity of fluoride solubilised by gastrointestinal digestion and available for intestinal absorption) and urine as a biomarker of internal dose. The concentration of fluoride in drinking water varied between 0.050 and 4.6mgL-1, and 80% of the samples exceeded the WHO drinking-water guideline value (1.5mgL-1). Fluoride concentrations in food ranged between 0.80 and 3.0mgkg-1 fresh weight (fw), being lower in bioaccessible fraction (0.43-1.9mgkg-1, fw). On the basis of the consumption data declared for the young child population, fluoride intake varies between 4.1 and 6.5mgday-1, greater than the level recommended for this age group. Moreover, in some cases, concentrations of fluoride found in urine (0.62-8.9mgL-1) exceeded those reported in areas with declared fluorosis. All data obtained show the worrying situation of child population in this area of Argentina.

Microbiomes of Site-Specific Dental Plaques from Children with Different Caries Status.

The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMINGS) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMINGS, and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different (P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis, which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans, Scardovia wiggsiae, Parascardovia denticolens, and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression.

Effects of Arginine on Streptococcus mutans Growth, Virulence Gene Expression, and Stress Tolerance.

Streptococcus mutans is a common constituent of oral biofilms and a primary etiologic agent of human dental caries. The bacteria associated with dental caries have potent abilities to produce organic acids from dietary carbohydrates and to grow and metabolize in acidic conditions. By contrast, many commensal bacteria produce ammonia through the arginine deiminase system (ADS), which moderates the pH of oral biofilms. Arginine metabolism by the ADS is a significant deterrent to the initiation and progression of dental caries. In this study, we observed how exogenously provided l-arginine affects the growth, the virulence properties, and the tolerance of environmental stresses of S. mutans Supplementation with 1.5% arginine (final concentration) had an inhibitory effect on the growth of S. mutans in complex and chemically defined media, particularly when cells were exposed to acid or oxidative stress. The genes encoding virulence factors required for attachment/accumulation (gtfB and spaP), bacteriocins (nlmA, nlmB, nlmD, and cipB), and the sigma factor required for competence development (comX) were downregulated during growth with 1.5% arginine. Deep sequencing of RNA (RNA-Seq) comparing the transcriptomes of S. mutans growing in chemically defined media with and without 1.5% arginine revealed differential expression of genes encoding ATP-binding cassette transporters, metal transporters, and constituents required for survival, metabolism, and biofilm formation. Therefore, the mechanisms of action by which arginine inhibits dental caries include direct adverse effects on multiple virulence-related properties of the most common human dental caries pathogen.IMPORTANCE Metabolism of the amino acid arginine by the arginine deiminase system (ADS) of certain oral bacteria raises the pH of dental plaque and provides a selective advantage to health-associated bacteria, thereby protecting the host from dental caries (cavities). Here, we examine the effects of arginine on the cavity-causing bacterium Streptococcus mutans We find that arginine negatively impacts the growth, the pathogenic potential, and the tolerance of environmental stresses in a way that is likely to compromise the ability of S. mutans to cause disease. Using genetic and genomic techniques, multiple mechanisms by which arginine exerts its influence on virulence-related properties of S. mutans are discovered. This report demonstrates that a primary mechanism of action by which arginine inhibits the initiation and progression of dental caries may be by reducing the pathogenic potential of S. mutans.

The oral bacterial microbiome of occlusal surfaces in children and its association with diet and caries.

Dental caries is the most prevalent disease in humans globally. Efforts to control it have been invigorated by an increasing knowledge of the oral microbiome composition. This study aimed to evaluate the bacterial diversity in occlusal biofilms and its relationship with clinical surface diagnosis and dietary habits. Anamneses were recorded from thirteen 12-year-old children. Biofilm samples collected from occlusal surfaces of 46 permanent second molars were analyzed by 16S rRNA amplicon sequencing combined with the BLASTN-based search algorithm for species identification. The overall mean decayed, missing and filled surfaces modified index [DMFSm Index, including active white spot lesions (AWSL)] value was 8.77±7.47. Biofilm communities were highly polymicrobial collectively, representing 10 bacterial phyla, 25 classes, 29 orders, 58 families, 107 genera, 723 species. Streptococcus sp_Oral_Taxon_065, Corynebacterium matruchotii, Actinomyces viscosus, Actinomyces sp_Oral_Taxon_175, Actinomyces sp_Oral_Taxon_178, Actinomyces sp_Oral_Taxon_877, Prevotella nigrescens, Dialister micraerophilus, Eubacterium_XI G 1 infirmum were more abundant among surfaces with AWSL, and Streptococcus gordonii, Streptococcus sp._Oral_Taxon_058, Enterobacter sp._str._638 Streptococcus australis, Yersinia mollaretii, Enterobacter cloacae, Streptococcus sp._Oral_Taxon_71, Streptococcus sp._Oral_Taxon_F11, Centipeda sp._Oral_Taxon_D18 were more abundant among sound surfaces. Streptococcus mutans was detected on all surfaces in all patients, while Streptococcus sobrinus was detected only in three patients (mean relative abundances 7.1% and 0.6%, respectively). Neither species differentiated healthy from diseased sites. Diets of nine of the subjects were scored as high in fermentable carbohydrates (≧2X/day between meals). A direct association between relative abundances of bacteria and carbohydrate consumption was observed among 18 species. High consumption of fermentable carbohydrates and sound surfaces were associated with a reduction in bacterial diversity. PCoA plots displayed differences in bacterial community profiles between sound and diseased surfaces. Our study showed that, in addition to mutans streptococci, other species may be associated with the initiation of dental caries on occlusal surfaces, and that biofilm diversity of tooth surfaces is influenced by carbohydrate consumption and a surface’s health status.

Dental caries.

Dental caries is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues. Caries can occur throughout life, both in primary and permanent dentitions, and can damage the tooth crown and, in later life, exposed root surfaces. The balance between pathological and protective factors influences the initiation and progression of caries. This interplay between factors underpins the classification of individuals and groups into caries risk categories, allowing an increasingly tailored approach to care. Dental caries is an unevenly distributed, preventable disease with considerable economic and quality-of-life burdens. The daily use of fluoride toothpaste is seen as the main reason for the overall decline of caries worldwide over recent decades. This Primer aims to provide a global overview of caries, acknowledging the historical era dominated by restoration of tooth decay by surgical means, but focuses on current, progressive and more holistic long-term, patient-centred, tooth-preserving preventive care.

Management of Cavitated Root Caries Lesions: Minimum Intervention and Alternatives.

The prevalence of root caries among the elderly is increasing. The lesion shape can vary considerably from a broad shallow saucer-shape to a deeper defined cavity. The variety of shapes poses a series of complications when considering restorative management. This is accompanied with a paucity of clinical evidence on treatment techniques and clinical outcomes. The current philosophy centered on conservative management of root caries will most likely provide patients with the greatest chance of maintaining their teeth. When a lesion can be effectively cleaned in conjunction with a high fluoride content toothpaste and other remineralizing agents, this should be the treatment of choice. For lesions that are cavitated and cannot be effectively cleaned, the initial management should be to apply remineralizing agents for a period to "harden" lesion margins thus potentially reducing the prepared cavity and restoration size, as well as providing a better-defined tooth-restoration margin for finishing. Material selection is either a glass ionomer cement (conventional or resin-modified) or resin-based material. Frequently, the restoration site is easily contaminated; hence, glass ionomer cement is an ideal material. However, for saliva-deficient patients, resin composite or a combination of resin composite and resin-modified glass ionomer adhesive allows for a highly polished, easily cleansable restoration surface that may reduce the potential for further caries initiation. The current evidence base for the restoration of root caries is poor.

Biodegradation of Resin-Dentin Bonds: a Clinical Problem?

Biodegradation of the resin-dentin interfaces has been a focus of research over the last decade. Most studies show that degradation of both the collagen and the adhesive take place within short periods of time after bonding, and claim that such loss of structure at the interface opens opportunity for secondary caries initiation and progression thus leading to failure of the restoration. Open margins are further compromised by thermo-mechanical loading and enzymes produced by local bacteria. While marginal gaps appear to be unavoidable, it is remarkable that resin composite restorations can deliver successful clinical service for many years provided preventive and conservative measures to reduce the caries-risk of the patient are applied along with the restorative treatment. This review will look into the evidence from laboratory studies that investigated degradation of bonds and the consequences leading to clinical failure and balance that against the results of clinical trials that evidence the factors associated with the durability and clinical success of resin composite restorations.

Functional Relationship between Sucrose and a Cariogenic Biofilm Formation.

Sucrose is an important dietary factor in cariogenic biofilm formation and subsequent initiation of dental caries. This study investigated the functional relationships between sucrose concentration and Streptococcus mutans adherence and biofilm formation. Changes in morphological characteristics of the biofilms with increasing sucrose concentration were also evaluated. S. mutans biofilms were formed on saliva-coated hydroxyapatite discs in culture medium containing 0, 0.05, 0.1, 0.5, 1, 2, 5, 10, 20, or 40% (w/v) sucrose. The adherence (in 4-hour biofilms) and biofilm composition (in 46-hour biofilms) of the biofilms were analyzed using microbiological, biochemical, laser scanning confocal fluorescence microscopic, and scanning electron microscopic methods. To determine the relationships, 2nd order polynomial curve fitting was performed. In this study, the influence of sucrose on bacterial adhesion, biofilm composition (dry weight, bacterial counts, and water-insoluble extracellular polysaccharide (EPS) content), and acidogenicity followed a 2nd order polynomial curve with concentration dependence, and the maximum effective concentrations (MECs) of sucrose ranged from 0.45 to 2.4%. The bacterial and EPS bio-volume and thickness in the biofilms also gradually increased and then decreased as sucrose concentration increased. Furthermore, the size and shape of the micro-colonies of the biofilms depended on the sucrose concentration. Around the MECs, the micro-colonies were bigger and more homogeneous than those at 0 and 40%, and were surrounded by enough EPSs to support their structure. These results suggest that the relationship between sucrose concentration and cariogenic biofilm formation in the oral cavity could be described by a functional relationship.

EAPD interim seminar and workshop in Brussels May 9 2015 : Non-invasive caries treatment.

AimThis was to collect information for the 9th European Academy of Paediatric Dentistry Interim Seminar and Workshops to discuss the state of art on non-invasive caries therapy to be used if possible to formulate clinical guidelines by European experts in paediatric dentistryMethodsBased on systematic reviews and additional papers were assessed for methods to prevent caries initiation and caries progression both in the state of pre-cavitation and cavitation without invasive technologies.ResultsThe use of fluoridated water, careful diligent daily use of fluoride toothpaste, fluoride varnishes, pit and fissure sealants and leak-proof restorative materials without excavation of caries are evidence based for caries prevention and for non-invasive treatment of pre-cavitated and cavitated caries. Other technologies are far less evidenced based and would not logically fit in guidelines for the non-invasive treatment of caries. Recent studies on cavitated lesions in the primary dentition demonstrate that thorough oral hygiene practices may arrest progression. This strategy depends heavily on the strategies in the dental surgery to change behaviour of children. An important aspect is for advice to be tailored at recall intervals to ensure compliance and to timely detect unnecessary and unwanted progression of the lesions.ConclusionNon-invasive therapies have been proven to be effective for caries prevention and the management of pre-cavitated caries lesions. Non-invasive therapies can also be effective to arrest cavitated lesions but the success depends greatly on behavioural changes of patients to brush the lesions.

Assessment of Streptococcus mutans in healthy versus gingivitis and chronic periodontitis: A clinico-microbiological study.

Background:Dental caries and periodontal disease are most common oral diseases. Streptococcus mutans are considered to be the major pathogens in initiation of dental caries. Evidence shows that periodontal disease and caries share a number of contributory factors. Thus in view of these findings it would be worthwhile to examine whether Streptococcus mutans persist within the saliva and subgingival environment of the periodontitis patients and to determine whether there is any association between Streptococcus mutans colonization, pH of saliva and sub-gingival plaque pH in periodontal diseases before therapy.Methods:The study comprises of 75 subjects aged between 20-70 years, reporting to department of Periodontology, KLEs Institute of Dental Sciences, Bangalore. Subjects were divided into 3 groups of 25 each. Group 1 – Healthy controls, Group 2 – Gingivitis Group, 3 – Chronic periodontitis. Unstimulated saliva was collected in sterile container and immediately pH was evaluated. Subgingival plaque samples were collected from four deepest periodontal pockets in chronic periodontitis and from first molars in healthy subjects using 4 sterile paper points. In gingivitis subjects samples were collected from areas showing maximum signs of inflammation. All paper points and saliva samples were cultured on mitis salivarius agar culture media with bacitracin for quantification of the Streptococcus mutans colonies.Results:Increased colonization of Streptococcus mutans was seen in chronic periodontitis subjects both in saliva and sub-gingival plaque samples. There was also a positive correlation seen with the periodontal parameters.Conclusion:More severe forms of periodontal disease may create different ecological niches for the proliferation of Streptococcus mutans.

Evaluation of chemokines in gingival crevicular fluid in children with dental caries and stainless steel crowns: A clinico-biochemical study.

The study was conducted to detect the presence of macrophage inflammatory protein-1α (MIP-1α) and MIP-1β and estimate their levels in gingival crevicular fluid (GCF) in children with dental caries and stainless steel crowns. A total of 80 children with primary dentition were selected and categorized into four groups with twenty in each group; Group 1 - healthy subjects, Group 2 - dental caries, Group 3 - dental caries involving the pulp, and Group 4 - stainless steel crowns. GCF samples were collected by an extra-crevicular method with microcapillary pipettes. The GCF samples were quantified by ELISA and the levels of MIP-1α and MIP-1β were determined. MIP-1α and MIP-1β were detected in all the samples. Highest mean concentration in GCF was obtained for Group 3 followed by Groups 2 and 4 while the lowest concentration was seen in Group 1. This suggests that MIP-1α and MIP-1β levels in GCF increased proportionately with the inflammation. GCF serves as a noninvasive diagnostic fluid to measure biomarkers released during dental caries initiation and progression. MIP-1α and MIP-1β chemokines can be considered as novel biomarkers, in biological mechanism underlying the pathogenesis and inflammation in children with dental caries and stainless steel crowns.

Demystifying Apples in Health and Dentistry

Demystifying Apples in Health and Dentistry Apples are frequently associated with chewing and teeth. Anecdotal folklore ascribes magical powers to apples. Besides growing fresh fruit harvests for consumption, universally apple industries include ciders, fruit juices, dried fruits jellies and confection products. Large varieties of apples exist worldwide, but apple consumption does not prevent or cure tooth decay. Apples contain fermentable carbohydrates that overwhelm any protective plaque-biofilm removal apple fibre may impart after rigorous chewing. Malic acid in apple decalcifies enamel and allows for initiation of caries. Apples may be a good source of fibre and nutrients, but apples are not a benevolent detergent health chew.

IMPROVEMENT OF ORAL HYGIENE STATUS IN CHILDREN INFLUENCED BY MOTIVATION PROGRAMS

Background: Providing and maintaining proper oral hygiene is related with the control of initiation and progression of dental caries and periodontal diseases. Objective: To accentuate on the application and effectiveness of standardized motivational program for oral hygiene in children with assessment of OHI-S GreenVermillion. Methods: The study includes 200 children from 3 to 6 years of age. Comparison and evaluation of effectiveness of toothpastes with different fluoride concentrations regarding proper hygiene status in children. Application of OHI-S by Green-Vermillion. Examined children are divided into two groups. The first group consists of 100 children divided into two subgroups. The subgroup of children aged from 3 to 5 years washed their teeth with toothpaste containing 500 ppm F. The subgroup of children at the age of 6 used toothpaste containing 1000 ppm F. Concerning the second, control group of 100 children no specific motivation activities were provided. Results: Among children being influenced by standardized motivation program combined with application of toothpaste with 500 ppm F, 45% show better oral hygiene level. Among children influenced by standardized motivation program and toothpaste of 1000 ppm F, 20% of them are with improved oral hygiene status. Reduction of the OHI-S values in children from 3 to 5 years is established from 1.92 to 1.16. In children at the age of 6 OHI-S is reduced from 1.67 to 1.14. Conclusion: 1. All children improve their oral hygiene status after a period of training and motivation. 2. In children at high decay risk standardized motivation program should be combined with additional prophylactic approaches.