Low Caries Research Articles

Dental caries and associated factors among Turkish children and adults: Findings from the 3rd National Oral Health Survey.

Information on the current status of oral health and related risk factors is lacking in Turkiye. This study aimed to evaluate dental caries and associated factors among the Turkish population using the findings of the third national oral health survey. This cross-sectional epidemiological survey was carried out between March and September in 2018 including five index ages and age groups (5-, 12-, 15-year-olds, 35-44 and 65-74 age groups). A multistage cluster sampling design was used to obtain a national representative sample of these age groups. Participants were interviewed face-to-face using a structured questionnaire, and oral examinations were performed based on the methods and criteria suggested by the World Health Organization. The adjusted prevalence ratio for dental caries was estimated considering sociodemographic and behavioural characteristics by using log-binomial and robust Poisson regression analysis in R and SAS software. After data cleaning, a total of 11 091 participants remained. The prevalence of dental caries was 76.5% (95% confidence interval: 75.4%-77.7%) and determined to be associated with age, dental visit, and pain or discomfort history during the previous year among the Turkish population. Prevalence was also associated with the mother's education level among 5-, 12- and 15-year-olds. For the 35-44 age group, individuals living in urban areas had lower dental caries than those living in rural areas. For 65-74 age group, none of the factors were significantly associated with dental caries. A high prevalence of dental caries was observed in Turkish children and adults. Therefore, it is necessary to strengthen current preventive oral health programs. Regular disease surveillance should be maintained. National oral health targets should be formulated in accordance with Turkiye's needs, resources and structure.

Sociodemographic, biological, and timing characteristics of dental caries and fluorosis using mixed-type cluster analysis on 12-year-olds in Ho Chi Minh city, 1989–2019

ObjectivesIn 1990, Ho Chi Minh City started Community water fluoridation (CWF) at 0.7 ppm F, and in 2000, it was adjusted to 0.5 ppm F. Here, we analyzed dental caries and fluorosis data in Ho Chi Minh City to explore commonalities associated with CWF among 12-year-old children. MethodsDental caries and fluorosis data were collected in 1989, 2003, 2012, and 2019 (N = 4773). Trained dentists scored dental caries using the WHO detection criteria and fluorosis using Dean's Fluorosis Index. We used these data and the k-prototypes method by the R package to identify clusters of participants with shared clinical and water fluoride levels. ResultsWe used datasets 1 (4773 participants) and 2 (4194 participants, missing fluorosis data in 1989). K-prototypes analysis identified three clusters in each dataset. Cluster 1, with 80 % of the sample at 0.5 ppm F area characterized by low caries and fluorosis scores. Cluster 2 with 60 % of the sample non-fluoridated area had high caries and low fluorosis scores. Cluster 3, with 75 % of the sample in 0.7 ppm area, had low caries but borderline high fluorosis scores. ConclusionIdentifying three clusters based on clinical and environmental scores supports the decision to fluoridate the water to prevent caries (0–0.7 ppm) and the shift from 0.7 to 0.5 ppm to keep the caries preventive effect while reducing the risk of fluorosis. Clinical significanceOur results support the effectiveness of CWF in preventing dental caries and the appropriateness of changing the F concentration to reduce the risk of fluorosis while maintaining its effectiveness.

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

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

Assessment of oral bacteria potentially associated with the mobile microbiome in children with congenital heart disease.

In this case-control study, we aimed to investigate the specific oral pathogens potentially associated with the mobile microbiome in children with congenital heart disease (CHD). Caries, oral hygiene and gingival indices were evaluated in 20 children with CHD and a healthy control group, and venous blood samples and saliva were collected. Using quantitative polymerase chain reaction (qPCR), blood samples were analyzed for the presence of bacterial DNA to determine the mobile microbiome, and saliva samples were analyzed to identify and quantify target microorganisms, including Streptococcus mutans (Sm) and its serotype k (Smk), Fusobacterium. nucleatum (Fn), Porphyromonas gingivalis (Pg), Scardovia wiggsiae (Sw) and Aggregitibacter actinomycetemcomitans (Aa) and its JP2 clone (JP2). The findings were analyzed by Mann Whitney U, chi-square, Fisher's exact and Spearman's Correlation tests. Bacterial DNA was identified in two blood samples. No significant differences were found between the groups regarding the presence and counts of bacteria in saliva. However, the CHD group exhibited significantly lower caries and higher gingival index scores than the control group. The presence of Pg and Aa were significantly associated with higher gingival index scores. Sm and Smk counts were significantly correlated with caries experience. A positive correlation was found between Fn and total bacteria counts. In conclusion, the mobile microbiome, which has been proposed as a potential marker of dysbiosis at distant sites, was very rare in our pediatric population. The counts of target microorganisms which are potentially associated with the mobile microbiome did not differ in children with CHD and healthy children.

The Overview of Correct Toothbrushing and Diet Habit Towards Oral Health Status Using Indonesian Digital Caries Risk Assessment (IDCRA)

Abstract. Dental caries is an infectious disease in oral health and has become a major problem in Indonesia due to a lack of awareness. There are several causes of dental caries, such as consuming sugary snacks and toothbrushing habits which are common in school-aged children. Based on the caries risk assessment survey conducted in Yogyakarta, as many as 76.5% of the children had a high carries risk, 12.9% had a low caries risk, and 10.6% had a moderate caries risk. This research aims to determine the overview and correlation of correct toothbrushing and diet habit on oral health status using the IDCRA application at SD (Elementary School) Muhammadiyah Pepe and SD Muhammadiyah Warungboto Yogyakarta. This research type is descriptive-analytic with a cross-sectional design. The data were collected by subjective and objective intra-oral screening to examine the number of dental caries experiences (DMF-T/def-t) using IDCRA application in elementary school students aged 6-9. The data were then analysed using Spearman correlation by SPSS. The results revealed that students at SD Muhammadiyah Pepe and SD Muhammadiyah Warungboto Yogyakarta had caries with an average of DMF-T/def-t 7,5, meaning each had seven teeth with caries. In addition, most students (74%) consumed sugary snacks 1-3 times daily, while 60,6% needed to brush their teeth correctly. The caries incidence in school-aged children at SD Muhammadiyah Pepe and Warungboto Yogyakarta was classified as very high. This was influenced by their habit of brushing teeth and dietary habits done by the students. So promotive and preventive activities to increase the knowledge and awareness of children and parents need to be carried out regularly.

The Relationship Between Toothbrushing Habits and the Prevalence of Caries and Calculus in School-Age Children Grades 1-6 at Galilea Hosana School Elementary School, Medan Selayang District of North Sumatra, Indonesia

School-aged children constitute a demographic that encounters dental and oral health issues. Poor oral and dental hygiene is associated with the development of caries and calculus. The objective of the study was to establish the relationship between teeth brushing practices and the occurrence of dental caries and calculus in elementary school children from grades 1-6 at Galilea Hosana School, located in the Medan Selayang District of North Sumatra. The research conducted at Galilea Hosana School Elementary School, Medan Selayang District, is a descriptive-analytic study with a cross-sectional design. The research sample consisted of 64 elementary school pupils enrolled at Galilea Hosana School, located in the Medan Selayang District. The students were from grades 1 to 6. The data were gathered through the administration of questionnaires and the physical inspection of the mouth cavity and teeth. The Kruskal-Wallis statistical test was employed to examine the data. The research findings indicated that the mean calculus score for students was 1.40 ± 0.74, which falls within the category of moderate calculus. On the other hand, the average scores for caries DEFT and DMFT among students were 2.02 ± 2.36 and 1.42 ± 2.06, respectively, placing them in the low caries category. Out of the total number of students, 29 (45.3%) had sufficient tooth-brushing habits, while 19 kids (29.7%) had commendable tooth-brushing practices. Only 16 students (25%) had inadequate tooth-brushing habits. The Kruskal-Wallis test revealed a statistically significant association (p≤0.05) between teeth brushing behaviors and the occurrence of caries and calculus in school-age children in grades 1-6 at Galilea Hosana School Elementary School, located in the Medan Selayang District of North Sumatra. The research findings indicate a direct relationship between poor tooth-brushing habits and increased levels of calculus and caries.

Remote assessment of dental records by using intraoral scan-based digital three-dimensional models in an elderly patient population - an exploratory study.

To assess the agreement rates of dental records derived from intraoral scan-based digital three-dimensional models (3DM) and 3DM + panoramic radiographs (3DM+PAN-X) compared to clinical findings. Based on the 3DM/3DM+PAN-X of 50 patients undergoing supportive periodontal therapy (SPT), ten remote raters (inexperienced in using IOS or 3DM) assessed for each site of the dental scheme (32 sites) whether a tooth was missing (M), filled (F), restoration- and caries-free (H), replaced by an implant (I) or decayed (D). Remote records were compared to the clinical reference record of each patient at tooth-level. The clinical records were assessed by an experienced dentist who supplemented the clinical findings with information from available radiographs and the patient records to define the clinical reference record. The agreement-rates for 3DM/3DM+PAN-X at tooth-level are: M: 93%/94%, F: 84%/88%, H: 92%/92%, I: 65%/96%, D: 29%/29%. The overall agreement-rate is 88% for the 3DM-based dental records (14093 of 16000 entries true) and 91% for 3DM+PAN-X (14499 of 16000 entries true). Using 3DM for dental record assessment, posterior teeth had higher odds of correct findings compared to anterior teeth (upper jaw OR=2.34, lower jaw OR=1.27). The remote detection of healthy, missing and filled teeth and implants by raters inexperienced in using IOS or 3DM shows a high agreement-rate with the clinical findings. The additional evaluation of PAN-X increased the agreement-rate significantly for implants. Thus, the remote assessment of dental records using 3DM+PAN-X has a high accuracy when applied in SPT-patients with low caries activity.

Long-term effects of a community-based oral health intervention for young children in the Netherlands: A 5-year follow-up.

The aim of this study was to assess whether referral of parents of 6 months old children by a well-child care (WCC) clinic medical practitioner for an early first dental visit combined with the Non Operative Caries Treatment and Prevention (NOCTP) approach in dental practices was effective to maintain oral health in children. The study was conducted as a quasi-experimental comparative pre-post trial with a baseline measurement before the intervention. In total 1347 children were allocated at the age of 6 months and 306 children (intervention group: n = 166; care as usual (CAU) group: n = 140) underwent an oral examination at 5 years of age and their parents completed a questionnaire. Nonparametric tests and Hurdle models were used to determine differences in caries experience between the intervention and CAU groups. Children in the intervention group had significantly lower caries experience (d1,2,3mfs) than children in the CAU group (Median = 2 vs. 5, r = .15, p < .01). Children in the intervention group had significantly fewer inactive caries lesions compared with children in the CAU group (Median = 2 vs. 3, r = .18, p < .001). No differences were found for dentin caries experience and also no differences for active caries lesions. Referral of parents of newborns for a preventive first dental visit by a WCC medical practitioner combined with NOCTP in dental practices may offer a new opportunity to reduce enamel caries lesions in young children.

Oral microbiota analyses of paediatric Saudi population reveals signatures of dental caries

BackgroundOral microbiome sequencing has revealed key links between microbiome dysfunction and dental caries. However, these efforts have largely focused on Western populations, with few studies on the Middle Eastern communities. The current study aimed to identify the composition and abundance of the oral microbiota in saliva samples of children with different caries levels using machine learning approaches.MethodsOral microbiota composition and abundance were identified in 250 Saudi participants with high dental caries and 150 with low dental caries using 16 S rRNA sequencing on a NextSeq 2000 SP flow cell (Illumina, CA) using 250 bp paired-end reads, and attempted to build a classifier using random forest models to assist in the early detection of caries.ResultsThe ADONIS test results indicate that there was no significant association between sex and Bray-Curtis dissimilarity (p ~ 0.93), but there was a significant association with dental caries status (p ~ 0.001). Using an alpha level of 0.05, five differentially abundant operational taxonomic units (OTUs) were identified between males and females as the main effect along with four differentially abundant OTUs between high and low dental caries. The mean metrics for the optimal hyperparameter combination using the model with only differentially abundant OTUs were: Accuracy (0.701); Matthew’s correlation coefficient (0.0509); AUC (0.517) and F1 score (0.821) while the mean metrics for random forest model using all OTUs were:0.675; 0.054; 0.611 and 0.796 respectively.ConclusionThe assessment of oral microbiota samples in a representative Saudi Arabian population for high and low metrics of dental caries yields signatures of abundances and diversity.

Effect of dietary patterns on dental caries among 12–15 years-old adolescents: a cross-sectional survey

BackgroundSeveral factors can influence the risk of dental caries, among which dietary factors have a significance impact on the occurrence of dental caries. The limitation of current studies is that they only focus on the influence of individual foods on the risk of dental caries. This study use cluster analysis to examine the relationship between dietary patterns and dental caries experience among adolescents aged 12–15.MethodsBased on data from the first oral epidemic survey in Shanxi Province, a cross-sectional study was conducted among 11,351 adolescents aged 12–15 in Shanxi Province through oral examination and questionnaires. The questionnaire included the intake frequency of seven types of food. Descriptive statistics, cluster analysis, and multinomial logistic regression were used to analyze the association between dietary patterns and dental caries experience.ResultsThe prevalence rate of caries was 44.57% and the mean DMFT score was 0.98 ± 1.49 in adolescents aged 12–15 in Shanxi Province. The caries rate was higher in females than males (X2 = 103.59, P < 0.001). Adolescents who grow up in one-child families have a lower caries risk than those who grow up in families with more than one child (OR:0.91; 95%CI:0.84–0.97). The dietary patterns of adolescents aged 12–15 can be divided into eight types, among which refreshments-rich diet (OR:1.47; 95%CI,1.22–1.77) can increase the risk of caries, while the coarse-grains-rich dietery pattern (OR:0.90; 95%CI, 0.79–0.97) has a lower caries risk.ConclusionsSocial determinants of health such as sex, family size and dietary patterns influence the risk of dental caries. Certain dietary patterns could increase or decrease the risk of caries. The government, school canteens and news media should take dietary pattern factors seriously.

A descriptive study on oral hygiene practice and caries increment in children with growth stunting.

Stunting is a condition of malnutrition in children from the womb to the early life stage that causes growth failure in the body and brain. Stunting influences the development and integrity of the oral cavity and increases the risk of developing diseases in the oral cavity, such as dental caries. The growth barriers in stunting children and parental knowledge can affect maintaining oral hygiene. This study aims to determine the description of oral hygiene practice and caries increment in children with growth stunting. This type of research is a quantitative descriptive with a Secondary Data Analysis approach in the form of examination results for the presence or absence of caries through the ICDAS index and the results of the oral hygiene practice questionnaire on 113 children with growth stunting in Sukajadi district, Bandung. Most stunting children (60.2%) experienced increased caries rates classified as low, and 70.8% had poor oral hygiene practices. There were 50 children (44.3%) with poor oral hygiene practice with low caries increment, while 18 children (15.9%) had good oral hygiene practice with low caries increment. Oral hygiene practice is classified as poor, but caries increment is still relatively low in most stunting children in Sukajadi district, Bandung.

Comments on recent community water fluoridation studies

Water fluoridation is a public health measure to reduce levels of dental caries in populations. A report of the recently completed CATFISH study has been published. This was the first UK evaluation of fluoridation introduction for many years; it was carefully designed and executed and is welcomed. The purpose of this article is to highlight the 180-page report of the study and comment on some aspects to aid interpretation of the findings. Significant features were that two cohorts, from birth and from five years, were followed for six years in a fluoridated and a non-fluoridated area, and clinical and cost analyses were reported. Areas of the report which deserve comment are: a) interruption of fluoridation for a year for half the children in the intervention area and its effect; b) clinical results were reported as absolute reduction in caries prevalence, with the preventive fraction for caries severity downplayed; c) the power of the study was diminished by an unexpected lower caries increment; and d) control for differences in diet was not possible. Nevertheless, this major UK study showed clinical and cost benefits of water fluoridation. The risk of cessation of water fluoridation is highlighted in examples of three recently published studies.

The combined effect of pit and fissure sealant application and oral health education on oral health status of children aged 6–9 years: a 12-month follow-up study in Northeast China

BackgroundChildren aged 6–9 years are vulnerable to dental caries due to age-related limitations and a lack of adequate knowledge regarding oral health and hygiene practices. This study aimed to establish a cohort of children aged between 6 and 9 years and conducted a 12-month follow-up to examine the combined effect of pit and fissure sealant (PFS) application and oral health education on their oral health status.MethodsA cohort study with 12-month follow-up was conducted in Liaoning province, China. A multi-stage stratified cluster sampling approach was employed in the study. The enrolled 6- to 9-year-old children were all from the selected primary schools, who had resided in the designated area for at least 6 months. Children who were unable to cooperate with the examiner or without informed consent from their guardians were excluded. Experienced dental professionals examined the oral health status of primary school children aged 6–9 years. All children and their guardians were mandated to complete a questionnaire (qualitative data) at the beginning of the study. In the experiment group, children underwent PFS application and chairside oral health education. Clinical examinations and questionnaire surveys were repeated at the 12-month follow-up. The chi-square test and binary logistic regression were conducted to investigate the potential risk factors associated with dental caries prevalence (dependent variable). Independent variables were items from the questionnaire (such as living place, parents’ education level and children’ birth weight). The significant variables identified in the chi-square tests were subsequently included in the binary logistic regression analysis.ResultsA total of 4,085 children aged 6–9 years were included in the study, with 1805 participants assigned to the experiment group and 2280 to the control group. At baseline, the caries rates of the experimental and control group were 77.95% and 80.35%, respectively without any statistically significant differences. However, at the 12-month follow-up, the caries rate in the experimental group (83.65%) was significantly lower than that in the control group (86.62%) (P < 0.05). The results from the binary logistic regression analysis indicated that parents with a college degree and children in the experimental group exhibited lower caries rates. Conversely, higher caries rates were associated with the consumption of sweet beverages and foods more than once a day and a lack of knowledge regarding the causes of caries (P < 0.05).ConclusionsIn Liaoning, China, children aged 6 to 9 years exhibited a high prevalence of dental caries. Several factors, including the parent’s education level, the frequency of consuming sweet beverages and foods, and the children’s understanding of the cause of caries, significantly affected the caries prevalence rates. The implementation of PFS application and oral health education effectively reduce the caries rate among the surveyed children.

Mouthwashes: Implications for Practice

This is the concluding article in the supplement on the role of mouthwashes in oral care, which summarises the current guidelines across the globe regarding their acceptable adjunctive use for managing caries, gingivitis, and periodontal disease. Based on moderate evidence for clinical effectiveness, most current guidelines suggest fluoride mouthwashes for the management of dental caries, and chlorhexidine for the management of periodontal diseases. However there still appears to be gaps in the literature underpinning these recommendations. Importantly, all evidence supports such mouthwash use "adjunctively," alongside mechanical oral hygiene measures. Other antimicrobial mouthwashes such as essential oils and cetylpyridinium chloride may also be clinically effective against plaque and gingivitis, but there is a current lack of robust evidence of natural mouthwashes to recommend their adjunctive use. The authors of the current review are of the view that mouthwashes may not be of much value in those with good periodontal health or low caries risk. The reasons for this are, the potential i) risks of allergic reactions, ii) dysbiosis of the oral microbiota, iii) emergence of antimicrobial resistance, and iv) deleterious effects on the environment. There is, however, much empirical research needed on mouthwashes, particularly in vivo research derived through clinical trials. Thus, dental practitioners need to keep abreast of the evidence base on the current, and the emerging, over-the-counter mouthwashes, and pay heed to the consensus views emanating from systematic reviews, as well as international guidelines on mouthwashes.

Antibacterial Activity of a Lysin LysP53 against Streptococcus mutans.

Dental caries is a common disease affecting quality of life globally. In the present study, we found that a bacteriophage lysin LysP53 against Acinetobacter baumannii possesses selective activity on Streptococcus mutans, the main etiological agent of dental caries, even in low pH caries microenvironments, whereas only minor LysP53 activity was detected against Streptococcus sanguinis, Streptococcus oralis, and Streptococcus mitis. Testing activity against S. mutans planktonic cells showed that 4 μM LysP53 could kill more than 84% of S. mutans within 1 min in buffer with optimal pHs ranging from 4.0 to 6.5. Daily application of LysP53 on biofilms formed in BHI medium supplemented or not with sucrose could reduce exopolysaccharides, expression of genes related to acid resistance and adhesion, and the number of live bacteria in the biofilms. LysP53 treatment also showed similar effects as 0.12% chlorhexidine in preventing enamel demineralization due to S. mutans biofilms, as well as effective removal of S. mutans colonization of tooth surfaces in mice without observed toxic effects. Because of its selective activity against main cariogenic bacteria and good activity in low pH caries microenvironments, it is advantageous to use LysP53 as an active agent for preventing caries.

The efficacy of combined arginine and probiotics as an add-on to 1450 ppm fluoride toothpaste to prevent and control dental caries in children – A randomized controlled trial

ObjectivesTo determine how daily consumption of a lozenge combining arginine and two probiotic strains affects the Relative Risk Reduction (RRR) in children regarding dental caries transitions and lesion activity at tooth surface level during 10–12 months. MethodsA total of 21,888 tooth surfaces in 288 children were examined. The intervention group (n = 141) received a lozenge containing 2% arginine, Lacticaseibacillus rhamnosus, LGG® (DSM33156), and Lactobacillus paracasei subsp. paracasei, L. CASEI 431® (DSM33451). The placebo group (n = 147) received a placebo lozenge. Both groups received 1,450 ppm F- toothpaste. Primary canines, molars, and first permanent molars were examined clinically (ICDAS0–6) and radiographically (R0–6) at baseline and follow-up. Sealed, filled, and missing surfaces were also included. Caries activity was computed as a sum of each caries lesion's location, color, texture, cavitation, and gingival bleeding. RRRs were computed with cluster effect on surface level. ICH-GCP was followed, including external monitoring. ResultsA total of 19,950 surfaces were analyzed after excluding 1,938 tooth surfaces. No statistically significant differences were found between the groups. The RRRs showed less caries progression (13.6%, p = 0.20), more regression (0.3%, p = 0.44), and fewer active caries lesions (15.3%, p = 0.15) in the intervention group. ConclusionDaily consumption of a lozenge combining arginine and probiotics for 10–12 months given to 5–9-years-old children characterized being with low caries risk demonstrated a marked, though not statistically significant RRR for caries progression, regression, and number of active lesions in the intervention group compared to the placebo-group. ClinicalTrials.gov (NCT03928587). Clinical significanceSince all the RRRs were in favor of the intervention group and the PF of combined arginine and probiotics is high (81.6%) compared to fluoride toothpaste (24.9%) and arginine-fluoride toothpaste alone (19.6%) the combined pre-and probiotics approach may be a future additional tool regarding caries prevention and control.

Short-term use of Lacticaseibacillus rhamnosus SD11 and the oral microbiome: Low caries RCT study.

The objective of the study was to investigate the effect of short-term lozenges containing Lacticaseibacillus rhamnosus SD11 on cariogenic pathogens and on oral microbiota. This double-blind, randomized, controlled trial included 121 subjects and was randomly divided into the control and probiotic group. All subjects were blindly administered to receive the control- or probiotic L. rhamnosus SD11 lozenges every day for 4 weeks and then followed up for another 4 weeks. After probiotic consumption, the probiotic group had significantly lower levels of Streptococcus mutans and significantly higher levels of total lactobacilli at 4 and 8 weeks compared with the baseline. The 16S rRNA sequencing revealed an increase in bacterial diversity and beneficial bacteria in the Firmicutes phylum, Bacilli class, and a reduction in the mutans streptococci group in the probiotic group. The opposite results were found in the control group. This study did not find any caries increment, nor did the subjects have any side effects after product consumption. With the limitation of a short-time study in low caries children, it showed that L. rhamnosus SD11 could increase beneficial bacteria in the Firmicutes phylum and Bacilli class that might support good oral health in children.

KNOWLEDGE AND BEHAVIOR OF BRUSHING TEETH WITH THE EXPERIENCE OF CARIES OF PEDIATRIC PATIENTS AGED 10-14 YEARS

Background: The 2018 Base Health Research results recorded 57.6% of dental and oral problems, caused by a lack of knowledge and behavior of brushing teeth properly and correctly. Children aged 10-14 are children who are vulnerable to dental and oral health problems. This study aims to determine the relationship between knowledge and behavior of brushing teeth with caries experience in pediatric patients aged 10-14 years at the dental polyclinic at Arjawinangun Hospital, Cirebon Regency. Research objective: To analyze the relationship between knowledge and behavor of brushing teeth with caries experience in pediatric patients age 10-14 years old at the dental polyclinic at the Arjawinangun Regional General Hospital. Methodology: The type of research used was quantitative research with a cross-sectional approach to 30 samples based on a purposive sampling technique. Data collection used a questionnaire to measure knowledge and behavior of brushing teeth and the DMF-T index for caries experience. Results: The study showed that 60% of the sample had moderate knowledge, 70% had moderate behavior, and 46.7% had low caries experience. Spearman correlation test results obtained p value = 0.000 meaning that there is a relationship between knowledge and behavior about brushing teeth with caries experience. Conclusion: Knowledge and behavior of brushing teeth are related to dental caries experience.

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 &amp; 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.

Factors associated with oral health status in individuals with Asperger syndrome – A cross-sectional study

Objectives: This study aimed to evaluate oral health and factors that may influence it in individuals with Asperger’s syndrome. Methods: This observational cross-sectional study was divided into two stages: a question- naire and an oral examination, using the decayed-missing-filled index, the gingival index, and the simplified oral hygiene index. Data were analyzed using SPSS® software (version 26.0), considering a significance level of 0.05. After verifying the non-normality with the Kolmogorov-Smirnov test, the Mann-Whitney and Kruskal-Wallis tests were used. Results: The investigation included 23 adults with Asperger syndrome. A decayed-miss- ing-filled index of 2.65(±2.81), a gingival index of 1.06(±0.36) and a simplified oral hygiene index of 2.08(±0.73) were found. Most respondents (60.8%) brushed their teeth twice a day. Individuals with higher brushing frequency and those who recently had an oral appointment had lower calculus deposits (p=0.038 and p=0.021, respectively). Conclusions: The individuals had a low dental caries prevalence, mild gingival inflammation, and a fair oral hygiene status. Although there are factors capable of influencing the oral health of these individuals, good results can be obtained if adequate oral hygiene habits are maintained, namely brushing twice a day.