Low Caries Rate Research Articles

Investigation of the presence of Non-carious cervical lesions (NCCLs) in ancient adult skulls: analyzing data from prehistoric and historical samples through a systematic review and meta-analysis

ObjectivesHistorically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient populations, lower caries rates are discovered, attributed in part to dietary factors. These populations consumed abrasive foods, leading to occlusal wear and reduced non-axial occlusal forces, potentially influencing Non-Carious Cervical Lesions (NCCLs). Although some attribute NCCLs to abfraction, the mechanism remains debated. This systematic review aims to evaluate the presence of NCCLs in ancient populations, shedding light on the factors contributing to their occurrence.Materials and MethodsThe present systematic review was registered on PROSPERO, and the manuscript was prepared following PRISMA guidelines.ResultsAfter the literature search and article screening, data from 6 studies were included in the meta-analysis, with only 2 reporting NCCLs in ancient skulls, encopassing 17 subjects in 805 examined skulls, suggesting their presence even before the widespread use of toothbrushes. This finding indicates a potential etiopathogenic mechanism linked to abfraction, but the cause is complex and involves abrasive and erosive factors closely tied to dietary habits.ConclusionsIn summary, NCCLs were present in ancient populations, albeit with a much lower prevalence. Their occurrence cannot be solely attributed to wear mechanisms but must be connected to abrasive factors related to diet or practices with religious and cultural significance, such as the use of labrets. Clinical relevance: Th the knowledge of NCCLs presence in acient sculls is crucial today for better understand the associated risk factors. In this context, the analysis of ancient skulls allows us to discern the role that tooth brushing and diet played in the formation of NCCLs, over the past century.

One step polishing to compare the mean surface roughness of nanohybrid and microhybrid composite resins

Objectives: This study's goal was to compare the mean surface roughness of nano hybrid and micro hybrid composites using a one-step polishing method. This comparison was made based on the idea that a material with reduced surface roughness will exhibit superior perishability, aesthetics, surface & optical properties, which means less wear, less staining, low plaque, and low caries rate. Methodology: This comparative study was carried out in April 2023 at the Ayub Medical College in Abbottabad, Pakistan, with a sample size of 100 (50 in each group), determined by the WHO calculator. Using a mechanical stainless steel template, 120 composite resin specimens mounted on acrylic blocks with dimensions of 2 mm x 3 mm x 3 mm were created. Results: 100 samples, separated into two groups, were used in this study. According to descriptive statistics, mean surface roughness and standard deviations for Nano hybrid composite in Group A were recorded as 0.076+0.025 and for Micro hybrid composite in Group B, they were 0.001+0.036. Conclusion: After polishing with a one-step procedure, there is a noticeable difference between the surface roughness of nano hybrid and micro hybrid composite resins, indicating that the former has higher polish ability than the latter.

Differential Unmet Needs and Experience of Restorative Dental Care in Trajectories of Dental Caries Experience: A Birth Cohort Study

Dental caries is a chronic and cumulative disease but little has been reported on the continuity of the disease and its treatment through life. Group-based multi-trajectory modeling was used to identify developmental trajectories of untreated carious tooth surfaces (DS), restored tooth surfaces (FS), and teeth extracted due to caries (MT) from ages 9 to 45 years in a New Zealand longitudinal birth cohort, the Dunedin Multidisciplinary Health and Development Study (n = 975). Associations between early-life risk factors and trajectory group membership were examined by specifying the probability of group membership according to a multinomial logit model. Six trajectory groups were identified and labeled: “low caries rate”; “moderate caries rate, maintained”; “moderate caries rate, unmaintained”; “high caries rate, restored”; “high caries rate, tooth loss”; and “high caries rate, untreated caries”. The two moderate-caries-rate groups differed in count of FS. The three high-caries-rate groups differed in the relative proportion of accumulated DS, FS, and MT. Early childhood risk factors associated with less favorable trajectories included higher dmfs scores at age 5, lack of exposure to community water fluoridation during the first 5 years of life, lower childhood IQ, and low childhood socioeconomic status. Parent self-ratings of their own or their child’s oral health as “poor” were associated with less favorable caries experience trajectories. Children who had clinical signs of dental caries together with a parent rating of child’s oral health as poor were more likely to follow a less favorable caries trajectory. Higher deciduous dentition caries experience at age 5 years was associated with less favorable caries trajectories, as were children whose parents gave “poor” ratings of their own or their child’s oral health. These findings highlight the considerable intergenerational continuity in dental caries experience from early childhood to midlife. Subjective measures of child oral health are informative and might aid as predictors of adult caries experience in cases where childhood dental clinical data were not available.

Association of salivary physicochemical characteristics and peptide levels with dental caries in children.

The purpose of this investigation was to evaluate the association of physicochemical properties and antimicrobial peptide levels of saliva with caries activity in children. The required volume of unstimulated saliva was collected from 41 children aged 3-12 years with no systemic diseases. Caries activity was calculated using DMFS and dmfs records for each participating child. Collected saliva samples were then examined for their flow rate, pH, and buffering capacity. The concentration of three peptides was assessed including LL-37, human neutrophil peptide (HNP) 1-3, and human beta-defensin (HBD)-3 through an enzyme-linked immunosorbent assay. The correlation between caries activity score (CAS) and salivary variables was looked using the linear regression and Spearman's correlation method. The comparison of CAS means between high- and low-value groups of salivary items was performed using independent sample t-test while the association of CAS and salivary parameters in categorical scale was tested by Chi-square test. No statistically significant differences were found between the CAS means at low and high categories of each salivary physicochemical parameter and those of antimicrobial peptides. There was a negative correlation between HNP1-3 and CAS and also between HBD-3 and CAS, but these results were not statistically meaningful. High HNP1-3 concentration was noted in 67% of the low caries rate group and 29% of the high caries rate group, with a statistically significant difference between the low and high caries rate groups (P = 0.019). Salivary inherent factors are not dominant determinants in caries activity. The current results may suggest that α-defensins (HNP1-3) have a protective role against dental caries.

Healthy and cariogenic foods consumption and dental caries: A preschool‐based cross‐sectional study

To evaluate the association of the consumption of healthy and cariogenic foods with the prevalence of untreated dental caries among preschool children. A cross-sectional study was conducted with 427 5-year-old preschoolers. Caries was evaluated through a clinical examination using dmft index. Parents/guardians answered a questionnaire addressing socioeconomic status, eating frequency, and oral hygiene habits. The prevalence of untreated caries was 51%. The multiple models demonstrated a seven percent increase in the prevalence of untreated caries with each additional daily contact with cariogenic foods, whereas a four percent reduction in this prevalence rate was found for each additional contact with healthy foods. When the number of daily contacts with cariogenic and healthy foods was incorporated into the same model, the former reached only borderline statistical significance (p=0.05), whereas the latter maintained an association with lower caries rates (p=0.01). A dietary assessment based solely on the frequency of the consumption of cariogenic foods may not be sufficient to understand the occurrence of dental caries in preschool children. It is necessary a more comprehensive evaluation of the dietary pattern, once a healthy diet can present an association with lower prevalence of caries even among preschool children who consume cariogenic foods.

Income as a Protective Factor for Dental Caries among Indigenous People from Central Brazil.

The objective of this paper was to evaluate the association between eligibility for a conditional cash transfer program, based on household income, and dental caries in 12-year-old children from three Indigenous ethnic groups living in Mato Grosso do Sul state, Central Brazil. A population-based cross-sectional study was performed in three ethnic groups: Kaiwoá, Guarani, and Terena. The study population was drawn by stratified sampling according to each ethnic group with a probability proportional to the village size. The number of untreated decayed permanent teeth as a count variable was the outcome measure. Ethnic group and eligibility for the conditional cash transfer program showed significant association with untreated caries. Children from Guarani and Terena presented respectively two-fold and 2.8-fold higher caries rate (p<.001) compared with Kaiwoá in the adjusted model, while children from no eligible cash transfer program households had a 40% lower caries rate (p=.034).

Oral hygiene behaviors and caries experience in Northwest PRECEDENT patients.

To investigate the association between oral hygiene behaviors (toothbrushing, water rinsing after brushing, interproximal cleaning, and adjunctive use of fluoride products) and recent caries (past 24months) in a random sample of patients in Northwest PRECEDENT practices. Practitioner-members of Northwest PRECEDENT, a dental practice-based research network, conducted a longitudinal study on caries risk assessment. At baseline, patients completed a questionnaire on oral self-care, snacking, health, and socio-demographics. A dental examination recorded readily visible heavy plaque and decayed, missing, and filled teeth; chart review captured new caries and treatments in the previous 24months. Bivariate and multiple generalized estimating equations (GEE) log-linear regression models stratified by age-groups were used to relate oral hygiene behaviors to the primary outcome of mean dental caries in the past 24months on data from 1400 patients in 63 practices. The primary exposure of interest was fluoride toothbrushing frequency. Fluoride toothbrushing once per day or twice or more per day by patients 9-17 was significantly associated with a 50% lower mean caries rate compared with fluoride toothbrushing less than once per day, after adjustment for covariates [rate ratios (RR)=0.5; 95% confidence intervals (CI)=0.3-0.8]. After adjustment, for patients 18-64, fluoride toothbrushing two or more times per day was significantly associated with a 40% lower recent mean caries rate (RR=0.6; 95% CI=0.4-0.9); in patients 65+, twice a day or more fluoride toothbrushing was not associated with lower caries rates (RR=1.1; 95% CI=0.7-1.8). Of the other oral hygiene variables, after adjustment, patients 18-64 who rinsed with water after brushing had a 40% lower mean caries rate compared with no rinsing (RR=0.6; 95% CI=0.4-0.9) and the presence of readily visible heavy plaque was significantly associated with an increase in the mean caries rate for patients 18-64 (RR=1.6; 95% CI=1.2-2.2) and 65+ (RR=2.5; 95% CI=1.8-3.5). In the present study, the frequency of fluoride toothbrushing and the presence of readily visible heavy plaque were the factors most strongly associated with mean caries rate. In young patients with permanent dentition, the daily application of fluoride toothpaste appears more important than emphasis on thorough plaque removal. While for adults, the protective effect of twice daily fluoride toothbrushing disappears with advancing age and the presence of readily visible heavy plaque becomes increasingly associated with caries risk.

Child, neglect and oral health

BackgroundDespite advancements in oral health policies, dental caries still a problem. The lack of parents/caregiver’s care regarding child’s oral health, which characterizes neglect, may lead to a high prevalence of caries. Therefore, the objective of this study was to analyze the relation between dental caries and neglect in five year-old children.MethodsQuantitative study performed in two different moments. First, the children underwent oral examinations and physical inspection. Then, a semi-structured interview was performed with parents of children with high and low caries rate.ResultsIn all, 149 physical inspections and oral exams were performed. The number of decayed, missing and filled teeth – dmf-t was 2.75 (SD 2.83); 16 children had extremely high values (dmf-t ≥7), 85 intermediate values (1 ≤ dmf-t ≥ 6) and 48 extremely low (dmf-t = 0). Nearly all caregivers were female (96.7%; n = 29), mostly mothers (93.3%; n = 28). Associations were found between caries experience and reason of the last consultation (p = 0.011), decayed teeth and child’s oral health perception (p = 0.001). There was a trend towards a significant association between general health and decayed teeth (p = 0.079), general hygiene and caries experience (p = 0.083), and caries experience and number of times the child brushes the teeth (p = 0.086).ConclusionThere’s a relation between caries experience and children’s oral health perception by caregivers, as well as between caries experience and children’s access to dental care. There is a trend towards association between caries experience and risk factors suggestive of neglect.

Dental management of a patient with progressive familial intrahepatic cholestasis

Progressive familial intrahepatic cholestasis refers to a heterogenous group of autosomal recessive disorders in which children develop severe intrahepatic cholestasis progressing to biliary cirrhosis and chronic liver failure, usually during the first decade of life. The clinical features include jaundice, hepatomegaly, splenomegaly, growth retardation and severe pruritus. The laboratory tests demonstrate elevated bilirubin, bile acids and liver function enzymes. The only curative treatment of progressive familial intrahepatic cholestasis is liver transplantation.This article presents the medical and dental history along with a comprehensive dental management and prognosis of a 6years old male patient with progressive familial intrahepatic cholestasis type I and liver cirrhosis 5years post living related liver transplant in Riyadh, Saudi Arabia. The patient demonstrated improved oral hygiene performance during the course of treatment, and continued to demonstrate a low caries rate up to 7months following treatment. Based upon the apparent success of the preventive programme, the patient was judged to have a very good prognosis.

Comments on Soltysiak's paper: “Comment: Low dental caries rate in Neandertals: The result of diet or the oral flora compositions?”

A low frequency of dental caries in Neandertal population is still puzzling. Many authors stress that the lower frequency of dental caries was related to a meat diet. However, a recent publication in HOMO – Journal Comparative Human Biology presented a new interpretation of dental caries in Neandertals. In this article, Soltysiak supports the thesis that the lower frequency of caries in the Neandertal population from the Near East could not be related to the low-sugar diet, but rather to the absence of cariogenic bacteria species (S. mutans). Although this hypothesis is interesting, I suspect it to be based on several erroneous assumptions, and a misunderstanding of caries as a disease. Although he stressed that the caries lesion is related to many different factors, in his argument he considers one of two alternatives “a low-sugar diet or a lack of cariogenic bacterial species”.

Comment: Low dental caries rate in Neandertals: The result of diet or the oral flora composition?

Dental caries is an infectious disease caused by oral acidophilic bacteria feeding on fermentable sugars, e.g. Streptococcus mutans. The frequency of dental caries in Neandertals was very low. This was usually explained as the result of a low-sugar diet. Recent research, however, revealed some regional differences between European and Near Eastern Neandertals, with the latter consuming considerable amounts of plants including highly cariogenic dates. This discovery, compared with the results of research on genetic diversity of S. mutans, may suggest that this species, and perhaps other most virulent species, were absent in the oral flora of Neandertals.

A review of the oro‐dento‐facial characteristics of hereditary sensory and autonomic neuropathy type III (familial dysautonomia)

The oro-dento-facial features and dysfunction of children with hereditary sensory and autonomic neuropathy type III, known as familial dysautonomia or Riley-Day syndrome, was first described in the scientific literature in 1949. They include dental trauma; dental and soft tissue self-mutilation; normal dental age; normal sequence and timing of eruption and exfoliation of teeth; smaller tooth size; different and disproportional tooth components; normal alveolar bone height; small jaws, mild crowding, and malocclusions. These persons have craniofacial morphology that is different from accepted norms but they resemble norms of their ethnic origin. The subjects can have gray, pale, shiny faces with an asymmetric suffering expression; frontal bossing, with eventual hypertelorism and narrow lips; a low-caries rate; drooling, and hypersalivation. They can have changes in salivary composition and content, which influences plaque and calculus and increases the risk of gingival and periodontal diseases. They also have difficulty in controlling oral muscles; a progressive decrease in number of tongue fungiform papillae, accompanied by lack of taste buds; and specific dysgeusia, but a normal sense of smell.

Dental health at the transition from the Late Antique to the early Medieval period on Croatia's eastern Adriatic coast

AbstractDento‐alveolar pathologies: caries, ante mortem tooth loss, abscesses, calculus, alveolar resorption and tooth wear were analysed in two composite skeletal series from Croatia's eastern Adriatic coast (Dalmatia). The first consists of 103 skeletons from seven Late Antique (3rd–6th century AD) sites, the second of 151 skeletons from three Early Medieval (7th–11th centuries AD) sites. As recent bioarhaeological studies (Šlaus,2008) showed a significant increase of disease loads and trauma frequencies in Dalmatia during the Early Medieval period, the aim of this study was to investigate whether dental health was equally adversely affected by the Late Antique/Early Medieval transition. The results of our analyses show that the frequencies of carious lesions, ante mortem tooth loss, abscesses and alveolar resorption increased significantly during the Early Medieval period, as did the degree of heavy occlusal wear on posterior teeth. These data suggest a change in alimentary habits, with a significantly higher dependence on carbohydrates and a greater reliance on hard, fibrous foods requiring vigorous mastication in the Early Medieval diet. The combination of higher calculus and lower caries rates in the Late Antique series similarly suggests more protein in the Late Antique diet and is, therefore, also consistent with the hypothesised change in alimentary habits. In general (the two exceptions are male caries and female alveolar resorption frequencies) lesion frequencies increased uniformly in both sexes suggesting that the deterioration of dental health during the Early Medieval period equally affected males and females. Cumulatively, the collected data suggest that the political, social, economic and religious changes that characterised the Late Antique/Early Medieval transition in Dalmatia resulted in a clear discontinuity, not only from the cultural, but also from the biological point of view with an evident deterioration of oral health during the Early Medieval period. Copyright © 2010 John Wiley & Sons, Ltd.

Caries in Portuguese children with Down syndrome

OBJECTIVES:Oral health in Down syndrome children has some peculiar aspects that must be considered in the follow-up of these patients. This study focuses on characterizing the environmental and host factors associated with dental caries in Portuguese children with and without Down syndrome.METHODS:A sibling-matched, population-based, cross-sectional survey was performed.RESULTS:Down syndrome children presented a significantly greater percentage of children without caries, 78% vs. 58% of non-Down syndrome siblings. This difference in the DMFT index (number of decayed, missing and filled teeth) essentially reflects data obtained from treated teeth, for which 91% of children with Down syndrome had never had a tooth treated vs. 67% of siblings. This result was statistically significant, whereas results for decayed and lost teeth did not differ between Down syndrome children and their unaffected siblings. Additionally, in Down syndrome children, a delayed eruption of the second molar occurs. Down syndrome children and their siblings have similar oral hygiene habits, but a higher percentage of Down syndrome children visit a dentist before the age of three years, in comparison to their siblings. Bruxism was also more common in Down syndrome children compared to their siblings.CONCLUSIONS:Our results show that Portuguese children with Down syndrome have lower caries rates than children without Down syndrome. This reduced prevalence may be associated with the parents' greater concern about oral health care in Down syndrome children, resulting in their taking them sooner to visit a dentist, as well as to a higher bruxism prevalence and delayed tooth eruption.

Relationship between caregiver’s and child’s caries prevalence among disadvantaged African Americans

To assess the relationship between African-American caregivers' and children's caries levels adjusting for sociodemographic factors. A representative sample of 1021 children (0-5 years) and their caregivers were recruited using a stratified two-stage area probability sample of households in Detroit. The response rate was 73.7%. Caries was measured using the International Caries Detection and Assessment System. Caries was defined as D1S/d1s (noncavitated) or D2S/d2s (cavitated lesions) for both caregivers and children. Sociodemographic data included caregivers' employment status, sex, age, income and education. Negative binomial regression techniques were used for the multivariable analyses because of the highly skewed distribution of caries among the children. 48% of the children were male, 39% had employed caregivers, 46% had caregivers with less than a high school education and 44% had family incomes less than $10,000. A total of 47% of the children had at least one noncavitated lesion and 31% had a cavitated lesion. Younger children (ages 0-3 years) had lower caries rates with 24% having one or more noncavitated lesion,18% having a cavitated lesion and 31% with any lesion compared with 78%, 51% and 81%, respectively, among the 4- to 5-year olds. Because of these differences in prevalence in the age groups, subsequent analyses were conducted separately for the two age groups. Multivariable analyses found that the number of cavitated surfaces among the caregivers was significantly related to the number of cavitated and noncavitated lesions among their children for both age groups. The prevalence of children's caries increased with increasing caregivers' caries score when demographic characteristics of caregivers were controlled. Younger children with family incomes of less than $10,000 had a significantly increased risk of higher caries prevalence compared with children in families with incomes greater than or equal to $20,000. Caregivers' caries levels were modestly correlated with children's caries. However, higher caries prevalence among caregivers significantly increased the risk of caries prevalence among their children. Thus, efforts aimed at improving caregiver's oral health could result in reducing caries risk among their children, regardless of whether the mechanism was biologically or behaviorally based. Efforts also should be aimed directly at reducing caries risk among children by increasing fluoride exposure among children and improving access to preventive dental care. Finally, even the poorest of the poor experienced additional health disadvantages associated with income suggesting even small increases in family income raising families could have a significant effect on reducing caries risk among young children.

A 13-year follow-up of a comprehensive program of fissure sealing and resealing in Varkaus, Finland

The objective of the study was to examine the coverage of the sealing program on first permanent molars (FPMs) and second permanent molars (SPMs) and first and second premolars (FSPMs), as well as to monitor the fate of the sealed teeth over time. All patients born in 1977 who had had regular check-ups in the Varkaus Health Center, Finland (n = 166) were included in the 1996 study. Data on the annual state of each tooth had been collected retrospectively since 1983. The coverage for the sealant program was 95%, 92%, and 6% of the FPMs, SPMs, and FSPMs, respectively. Out of the FPMs sealed at age 6 years, 28% were subjected to resealing, 13% developed occlusal, and 15% proximal caries during a 13-year follow-up period. From the SPMs sealed at age 11 years, 24% were subjected to resealing, 4% developed occlusal caries, and less than 2% proximal caries during the 9-year follow-up. None of the sealed FSPMs and only 1% of the non-sealed ones developed occlusal caries during the 9-year period. The mean DMF in the study population (n = 160) at age 12 years was 0.8 (n = 124), compared to a nation-wide mean value of 1.2. A large percentage of the FPMs and SPMs were sealed and then resealed during the study period. Although the study design lacked a control group for comparison, the lower caries rates of this study compared to the results of other studies with only a single application of sealants suggest a major role for resealing.

A dental study comparing age estimations of the human remains from the Swedish warship Vasa

The great Swedish warship Vasa capsized and sank in Stockholm harbour on her maiden voyage in 1628. The ship was raised from the seabed in 1961 and skeletal remains were recovered from at least 25 individuals, with teeth and jaws from 17 of them. The skeletal material was odontologically examined, including dental radiographs. Teeth lost both ante-mortem and post-mortem were recorded and variations in tooth anatomy noted. Acquired changes were recorded including enamel hypoplasia, attrition, dental caries and periodontal recession. Age estimations based on a separate odontological study, osteological changes and tooth attrition had been made in 1989. Ages were estimated additionally by three non-destructive dental methods based on (a) the length of the apical translucent zone, (b) selected measurements both on intact teeth and from ratios on dental radiographs and (c) ratios of the length and width measurements on dental radiographs from selected teeth. Several sources of post-mortem changes had been observed, among them vivianite in 33 teeth from four individuals. The results of the dental examination showed that few teeth had been lost ante-mortem, there was a low caries rate and little loss of periodontal attachments. With few exceptions, there is fairly good agreement between the different methods of estimating age. Age estimates based on dental attrition were, however, significantly different from the other dental methods and age estimates calculated from apical translucency ought to be regarded with scepticism due to post-mortem changes. The chronological ages of the victims will never be known, but age estimates based on all the age-markers available will probably reach a fairly close approximation. Copyright © 1999 John Wiley & Sons, Ltd.

A dental study comparing age estimations of the human remains from the Swedish warshipVasa

The great Swedish warship Vasa capsized and sank in Stockholm harbour on her maiden voyage in 1628. The ship was raised from the seabed in 1961 and skeletal remains were recovered from at least 25 individuals, with teeth and jaws from 17 of them. The skeletal material was odontologically examined, including dental radiographs. Teeth lost both ante-mortem and post-mortem were recorded and variations in tooth anatomy noted. Acquired changes were recorded including enamel hypoplasia, attrition, dental caries and periodontal recession. Age estimations based on a separate odontological study, osteological changes and tooth attrition had been made in 1989. Ages were estimated additionally by three non-destructive dental methods based on (a) the length of the apical translucent zone, (b) selected measurements both on intact teeth and from ratios on dental radiographs and (c) ratios of the length and width measurements on dental radiographs from selected teeth. Several sources of post-mortem changes had been observed, among them vivianite in 33 teeth from four individuals. The results of the dental examination showed that few teeth had been lost ante-mortem, there was a low caries rate and little loss of periodontal attachments. With few exceptions, there is fairly good agreement between the different methods of estimating age. Age estimates based on dental attrition were, however, significantly different from the other dental methods and age estimates calculated from apical translucency ought to be regarded with scepticism due to post-mortem changes. The chronological ages of the victims will never be known, but age estimates based on all the age-markers available will probably reach a fairly close approximation. Copyright © 1999 John Wiley & Sons, Ltd.

Dental and oral findings in patients with familial dysautonomia

Familial dysautonomia is an inherited autosomal recessive disease found almost exclusively in Ashkenazi Jews. It is characterized by selective damage to the sensory, motor, and autonomic peripheral nervous system. The main clinical features include decreased pain sensation, impaired temperature and blood pressure regulation, lack of tearing, absent tendon reflexes, and fungiform papillae on the tongue. The purpose of this study was to explore in depth and to verify the oral and dental status in familial dysautonomia. Twenty-two patients and 44 match-paired healthy persons of Ashkenazi descent were examined. Patients and parents had only little concern for their oral conition. Caries prevalence was lower than normal and plaque accumulation was increased in all patients. Dental trauma was found in 59% of the patients, and 32% showed orodental self-mutilation. Dental age was within normal range, and dental arch measurements implied proportionally small jaws and little crowding. The low caries rate may be related to the known “hypersalivation” in familial dysautonomia and/or a possible change in the salivary composition and content, caused by chronic autonomic denervation.

A 24-month Clinical Study of the Incidence and Progression of Dental Caries in Relation to Consumption of Chewing Gum Containing Xylitol in School Preventive Programs

The effect of chewing gum containing xylitol on the incidence and progression of dental caries was tested in a sample of 274 children, aged eight and nine years, of low socio-economic status and high caries rate. They were divided into two experimental groups (15% and 65% xylitol chewing gum distributed three times a day at school) and one control group (without chewing gum). The three groups were exposed to the same basic preventive program. Children who chewed gum had a significantly lower net progression of decay (progressions-reversals) over a 24-month period than did the controls. Results for the two groups chewing gum were similar. Chewing xylitol gum had a beneficial effect on the caries process for all types of tooth surfaces, and especially for bucco-lingual surfaces. The two experimental groups had a DMF(S) increment of 2.24 surfaces, compared with 6.06 surfaces for the control group. For this indicator, there was no difference between the two experimental groups. Results for the plaque index were in agreement with those of the DMF(S) increment and the net progression of decay.