Predictor Of Caries Risk Research Articles

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

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

Mouthwashes: a review on its efficacy in preventing dental caries

Background: Biofilm plays an important role in the etiology of caries, and can be removed through chemical approach using mouthwash, which has some advantages over the mechanical one. Nowadays, there are a lot of mouthwashes with many active ingredients that have been developed. Aim: To review some mouthwashes’ efficacy in preventing dental caries.Discussion: As recent studies showed that Streptococcus mutans can’t be the sole predictor of caries risk, it is suggested that the mouthwashes are also tested on the other cariogenic bacteria, to better estimate its role in reducing caries risk. It has also been proven that as an adjunctive method, mouthwashes has the ability to decrease oral microbial load and cariogenic plaque, even though the most effective way in controlling caries is still mechanical tooth brushing with fluoride toothpastes. However, long-term clinical studies are still needed to confirm the efficacy of some mouthwashes in caries prevention.Conclusion: Mechanical tooth cleaning using fluoride toothpastes remains the main and most effective way in controlling caries. The use of mouthwash, despite its potential in reducing caries risk, is limited to some people with certain conditions as an alternative method, or as an adjunction to the mechanical tooth cleaning for increasing its efficacy.

Predictors of Caries Risk among Egyptian Children Attending Pediatric Dental Clinics at a University Hospital.

Dental caries is the most prevalent dental disease. The external validity of the available caries risk assessment (CRA) tools is not established, especially among pediatric population. To assess caries risk using the caries management by risk assessment (CAMBRA) protocol among Egyptian children aged 3-12 years and suggest variables that could potentially be used to develop a simpler CRA model. For this cross-sectional study, we recruited 320 children aged 3 to <6 years (Group I) and 320 children aged 6-12 years (Group II). CAMBRA was used to collect data about disease indicators, biological and environmental factors, and protective factors among study participants. Each child was examined clinically to collect data about past caries experiences and to measure plaque scores. The risk of caries was high in 92.5% of Group I and 83.4% of Group II participants. The overall dmft was 5.71 ± 3.18 for Group I and 4.78 ± 2.53 for Group II. In Group I, a significant positive relation was found between the overall mean caries risk score and past caries experience (dmft; r = 0.344, P < 0.001) and mean plaque index (r = 0.463, P < 0.001). In Group II, a significant positive relation was found between the overall mean caries risk score and dmft score (r = 0.511, P < 0.001), S. mutans count (r = 234, P < 0.001), Lactobacilli count (r = 0.316, P < 0.001), and plaque index (r = 0.463, P < 0.001). Participants' age, parents' education, and parents' occupation had a negative significant effect on the overall mean caries risk score. This study suggests predictors that can be used in the development of a new CRA model for children aged 3-12 years.

Salivary sIgA as a predictor of caries risk in stunting children

Background: Stunting has a detrimental influence on the health and development of children and has a number of negative consequences, including an increase in mortality as a result of a loss in bodily immunity, which makes youngsters more susceptible to illness. Additionally, there are impairments in cognitive capacities, as well as learning and productivity in adulthood. Stunting prevalence is relatively high in Indonesia, at 30.8%, compared to the global prevalence of 22.2%. Stunting children tend to have protein energy malnutrition (PEM) condition, which can lead in salivary gland atrophy, decrease sIgA levels, and disrupting the buffering system, cleansing, and antibacterial agents. It is able to increase the risk of dental caries. The purpose of this review is to determine whether salivary sIgA levels can be used to predict the risk of developing caries in stunted children.

Salivary sIgA as a predictor of caries risk in stunting children

Salivary sIgA as a predictor of caries risk in stunting children

Life-conditions and anthropometric variables as risk factors for oral health in children in Ladakh, a cross-sectional survey

BackgroundThe aim of this survey was to evaluate the severity of dental caries among children living in Zanskar Valley (Ladakh, India) and its association with anthropometric and background variables.MethodsThis cross‐sectional survey was conducted on schoolchildren divided into four age groups (< 6, ≥ 6 < 11, ≥ 11 < 14 and > 14 years of age). A total of 1474 schoolchildren (607 males, 41.2%) were examined. Actual caries prevalence (dt/DT) and gingival bleeding were recorded by four calibrated dentists. An ad hoc questionnaire evaluated general health, eating habits, oral hygiene and the self-perception of oral conditions. Height, weight, waist circumference, heart-rate and oxygen-saturation were also collected directly by examiners. Responses to questionnaire items were treated as categorical or ordinal variables. The relationship between children’s caries data, gingival bleeding, gender, Body Mass Index (BMI) following the International Obesity Task Force, waist circumference and questionnaire items was assessed using the Kruskal–Wallis test and Pearson correlation. Conditional ordinal logistic regression was used to analyse associations among caries severity, gender, BMI, waist circumference, oxygen saturation and questionnaire items. A forward stepwise logistic regression procedure was also carried-out to estimate the ORs of gingival bleeding prevalence and the covariates derived from examination or questionnaire.ResultsCaries was almost ubiquitarian with only 10.0% of caries-free children (dt/DT = 0). Caries severity, in both primary and permanent dentitions, was statistically significantly related to gender, waist circumference, BMI, oral hygiene frequency and self-reported chewing problems (p < 0.01 in both dentitions). An increasing relative risk for caries in permanent dentition compared to caries-free subjects was observed in children with a low BMI (RRR = 1.67, 95%CI = 1.54/2.83 for subjects with 1–3 caries lesions and RRR = 1.52, 95%CI = 1.36/1.74 for subjects with > 3 caries lesions); also, children with reduced waist circumference had a higher relative risk to have 1–3 caries lesions (RRR = 2.16, 95%CI = 1.84/2.53) and an even higher risk to have more than 3 caries lesions (RRR = 4.22, 95%CI = 3.33/5.34).ConclusionsA significant impact of untreated caries lesions was observed in Ladakh schoolchildren; low BMI values and reduced waist circumference showed to be the main caries risk predictors. Preventive and intervention programmes should be implemented to improve children's oral health.

Can Salivary Biomarkers Be Used as Predictors of Dental Caries in Young Adolescents?

BackgroundIdentifying caries predictors in the subpopulation at risk is one of the preconditions for developing effective caries prevention measures. The present exploratory study aimed to examine the significance of socio-demographic characteristics, dietary-hygiene habits, salivary pH, and salivary antimicrobial HNP-1, hBD-2, and LL-37 peptides as potential caries risk predictors in children ages 11–13 years.Material/MethodsThis prospective 1-year study enrolled 213 children ages 11–13 years. The subjects underwent a dental examination and their mothers were interviewed. Unstimulated saliva was collected from the subjects to determine its pH value, as well as the salivary levels of HNP-1, hBD-2, and LL-37 peptides in 85 of the subjects. After 12 months, the 1-year caries incidence rate was recorded. Logistic regression analysis was used to estimate the ability of selected variables to predict caries risk.ResultsThe univariable logistic regression analysis determined that the most significant independent caries risk predictors were: sex (female) (OR=2.132, p=0.007), mothers’ education (OR=1.986, p=0.020), salivary pH (OR=0.270, p=0.043), oral hygiene index (OR=1.886, p=0.015), and daily tooth brushing frequency (OR=0.565, p=0.042). The multivariable model showed that sex and oral hygiene-related variables were the most important caries predictors.ConclusionsSalivary HNP-1, hBD-2, and LL-37 peptides were not found to have a significant predictive value. Therefore, socio-demographic and oral hygiene variables remain important caries predictors in early adolescents, suggesting the importance of the mechanical control of biofilm as the key measure for preventing caries. However, there is still a need for effective caries risk biomarkers, and additional research is needed in this area of caries risk prediction.

Quality of Fixed Dental Prostheses and Associated Biological Complications in a Saudi Population

The interrelationships between dental prostheses, abutments, and supporting periodontal tissue are dynamic. Clinical studies assessing the quality and associated complications of fixed dental prostheses (FDPs) in the Saudi population are scarce. The aims of this project were to assess the location and accuracy of marginal adaptation and proximal contact quality of FDPs provided by dentists in the Kingdom of Saudi Arabia and to assess the impact of these factors on the health of the periodontium and caries susceptibility. This retrospective cohort study collected demographic, dental, and social history data from patients with FDPs. Fixed dental prostheses quality was assessed using the United States Public Health Service Criteria, and periodontal health indices were measured. Descriptive and inferential statistics were used for data analysis. Logistic and multiple linear regression analyses were performed to assess predictors of caries risk and periodontal disease, respectively. Sixty-two patients with 62 FDPs were assessed. The mean patient age was 32.45 ± 9.0 (19-61) years with a male-to-female ratio of 3:1. On the assessment, 74.2% had marginal discrepancy, 54.8% had subgingival margins, 22.6% had open or tight proximal contacts, and 8.1% had marginal caries. Well-adapted margins promoted periodontal health, and inadequate proximal contact increased the risk of marginal caries. This study suggests that 26% of FDPs provided by dental practitioners in the Western province, Kingdom of Saudi Arabia, were of high marginal fit and proximal contact quality. Constructing FDPs with high-quality marginal fit and proximal contact promotes periodontal health and reduces caries risk, thereby improving FDP outcome.

Arginine Metabolism in Supragingival Oral Biofilms as a Potential Predictor of Caries Risk.

Ammonia production via the arginine deiminase system (ADS) of oral bacteria can function to reduce the cariogenicity of oral biofilms by neutralizing glycolytic acids that cause tooth demineralization. This cohort study investigated the relationship between ADS activity and bacterial profile changes of supragingival biofilms with caries experience among children over time. A total of 79 children aged 2 to 7 y at baseline were assessed every 6 mo for a period of 18 mo. Children were grouped as caries free (CF), caries active with enamel lesions (CAE), or caries active with dentin lesions (CA). Supragingival plaque samples were collected from caries-free surfaces (PF) and from enamel (PE) and dentin (PD) lesions. Plaque ADS activity was measured by monitoring citrulline production from arginine and compared with ribosomal 16S rRNA-derived taxonomic profiles for the same samples. At baseline, 37% of the children were CF, 34% CAE, and 29% CA. At 18 mo, 26% were CF, 41% CAE, 23% CA, and 10% were caries experienced (new restorations but no caries activity). Throughout the study period, ADS activity was significantly higher in the CF group than the CA group (P < 0.0001), and ADS activity in the PF samples was significantly higher than in the PE and PD samples (P < 0.0001). Distance-based redundancy analysis showed that the bacterial communities could be differentiated when plaque samples are grouped into levels of high and low ADS activity. There is a positive correlation between caries activity and low arginolytic capacity of the supragingival oral biofilms of children and tooth surfaces over time. Measurements of arginine metabolism via ADS may be useful to differentiate the caries risk of individuals and tooth surfaces. Findings from this study support the development of new strategies for caries risk assessment and prevention based on modulation of the virulence of the oral microbiome through arginine metabolism in supragingival biofilms.

Salivary Protein Roles in Oral Health and as Predictors of Caries Risk.

This work describes the current state of research on the potential relationship between protein content in human saliva and dental caries, which remains among the most common oral diseases and causes irreversible damage in the oral cavity. An understanding the whole saliva proteome in the oral cavity could serve as a prerequisite to obtaining insight into the etiology of tooth decay at early stages. To date, however, there is no comprehensive evidence showing that salivary proteins could serve as potential indicators for the early diagnosis of the risk factors causing dental caries. Therefore, proteomics indicates the promising direction of future investigations of such factors, including diagnosis and thus prevention in dental therapy.

Influence of the microbiological component of Cariogram® for evaluating the risk of caries in children

Objective: To compare the risk for caries in children as determined by Cariogram® software (CS; Stockholm, Sweden) with and without its microbiological component and by a form based on Cariogram® (FBC).Methods: Children (n = 28) aged 3–9 years were included. Data were collected clinically and from anamnesis. The salivary levels of Streptococcus mutans (SM) were evaluated. A linear regression model was used to determine which variables were predictive for each type of risk analysis. Caries risk was the dependent variable and the independent variables were caries experience, related disease, plaque amount, diet frequency, salivary levels of SM, fluoride sources and clinical judgment. A paired Student t-test was used for the following comparisons: (a) CS with and without SM; (b) CS without SM and FBC; (c) CS with SM and FBC.Results: The mean dmft/DMFT was 5.56 ± 2.51. There was no difference between the methods (p < .05). Regardless of caries risk, the children presented the same levels of SM (p = .889). Caries experience, plaque amount, diet frequency and fluoride sources were predictors of caries risk in all assessment methods. Clinical judgment was a significant predictor in CS.Conclusions: Caries experience, plaque amount, diet frequency and fluoride sources are valuable predictors of caries risk; microbiological tests are not necessary for evaluating caries risk in children, which can be assessed similarly by CS without SM and FBC.

Caries Risk Assessment in School Children Using Reduced Cariogram Model.

Objective:To estimate the percentage of children with low, moderate and high caries risk; and to determine the predictors of caries risk amongst 11-12 year old Pakistani school children.Methods:Subjects’ caries risk was assessed using the Cariogram programme. The survey was done among school children in Bhakkar district of Punjab, Pakistan. Caries and plaque level were assessed using the DMFT and Sillnes and Loe indices respectively, while diet content and frequency were assessed using a three-day diet diary.Results:A total of 226 children participated in this study, giving a response rate of 75%. Most subjects (39.8%) were in the low risk category with DMFT score of 0. The overall mean DMFT score was 1.49 (±0.63). Linear and multiple regressions were performed to evaluate the predictability of caries risk. Previous experience of dental caries was found to be the most relevant predictor of caries risk (40%).Conclusion:The levels of caries risk amongst Pakistani 11-12 year old school children were generally low. Past caries experience was the most significant factor in predicting future caries lesion in this sample population.

Polymorphisms in sweet taste genes (TAS1R2 and GLUT2), sweet liking, and dental caries prevalence in an adult Italian population.

The aim of the study was to assess the relationship between sweet taste genes and dental caries prevalence in a large sample of adults. In addition, the association between sweet liking and sugar intake with dental caries was investigated. Caries was measured by the decayed, missing, filled teeth (DMFT) index in 647 Caucasian subjects (285 males and 362 females, aged 18-65years), coming from six villages in northeastern Italy. Sweet liking was assessed using a 9-point scale, and the mean of the liking given by each individual to specific sweet food and beverages was used to create a sweet liking score. Simple sugar consumption was estimated by a dietary history interview, considering both added sugars and sugar present naturally in foods. Our study confirmed that polymorphisms in TAS1R2 and GLUT2 genes are related to DMFT index. In particular, GG homozygous individuals for rs3935570 in TAS1R2 gene (p value=0.0117) and GG homozygous individuals for rs1499821 in GLUT2 gene (p value=0.0273) showed higher DMFT levels compared to both heterozygous and homozygous for the alternative allele. Furthermore, while the relationship sugar intake-DMFT did not achieve statistical significance (p value=0.075), a significant association was identified between sweet liking and DMFT (p value=0.004), independent of other variables. Our study showed that sweet taste genetic factors contribute to caries prevalence and highlighted the role of sweet liking as a predictor of caries risk. Therefore, these results may open new perspectives for individual risk identification and implementation of target preventive strategies, such as identifying high-risk patients before caries development.

Does the classification of cerebral palsy influence caries experience in children and adolescents?

AIM: To evaluate the influence of the classification of cerebral palsy CP on the caries experience in children and adolescents, and determine the types of teeth most affected by dental caries. METHODS: A total of 181 individuals with CP, aged 8.30±4.10 years were examined for dental caries diagnosis in primary, mixed and permanent dentitions. The sample consisted of 96 quadriplegic individuals, 56 diplegic, 18 hemiplegic and 11 with choreoathetosis. The groups were compared using Kruskal-Wallis and Chi-square tests. Univariate logistic regression models were used to identify whether age was a predictor of caries risk α=5%. RESULTS: The sample was homogeneous as regards sex and age, among patients with quadriplegia, diplegia, hemiplegia and choreoathetosis. Out of the total sample, 51.4% of the individuals were caries free. The overall mean for the dmft and DMFT indices were 1.70±3.30 and 0.70±1.60, respectively. The mean caries experience in primary, mixed and permanent dentitions did not vary significantly according to the CP classification p>0.05. Child´s age was a predictor for dental caries experience p<0.05. CONCLUSIONS: The CP classification did not influence on caries experience, and the teeth most affected by dental caries were the primary and first permanent molars.

Assessment of caries risk

This paper examines the importance of caries risk assessment, identifies relevant risk factors, including clinical evidence, which has been considered to be the best predictor of caries risk.

Baseline caries prevalence was the most accurate single predictor of caries risk in all age groups

The Cochrane CENTRAL and Medline databases and reference lists of identified were searched. Prospective longitudinal cohorts or randomised controlled trials were included. Study assessment and data extraction were carried out independently by at least two reviewers. The quality of studies was assessed using the QUADAS and AMSTAR tools. The overall quality of evidence was assessed using the GRADE approach. 90 studies were included, seven were of high quality, 35 of moderate quality and the rest poor. The accuracy of multivariate models was higher for pre-school children than for schoolchildren/adolescents. As the models had rarely been tested in independent populations their accuracy is uncertain. The single predictor baseline caries experience had moderate/good accuracy in pre-school children and limited accuracy in schoolchildren/adolescents. In general, the quality of evidence was limited. Multivariate models and baseline caries prevalence performed better in pre-school children than in school-children/adolescents. Baseline caries prevalence was the most accurate single predictor in all age groups. The heterogeneity of populations, models, outcome criteria, measures and reporting hampered the synthesis of results. There is a great need to standardise study design, outcome measures and reporting of data in studies on caries risk assessment. The accuracy of prediction models should be validated in at least one independent population.

Predictors of coronal caries progression in adults: results from the Prevention of Adult Caries Study

This secondary analysis of data from the Prevention of Adult Caries Study (PACS) assesses risk factors for progression of coronal caries. Participants (n = 983) were adults at increased caries risk with at least one cavitated and one noncavitated lesions who were enrolled in a randomized clinical trial to test the effect of a 10% w/v chlorhexidine varnish coating on caries progression. Calibrated examiners scored tooth surfaces using a modified International Caries Detection and Assessment System (ICDAS) classification at baseline and at 7 and 13 months postrandomization. Potential baseline predictors of caries risk were used in adjusted negative binomial regression models to predict net D2FS increment and in linear regression models to predict the rank-normalized net D12FS increment. Mean (SD) D2FS and D12FS increments were and 2.4 (3.1) and 2.1 (6.9), respectively. In multivariate analyses, two or more baseline D2 lesions, consumption of acidic drinks, and increasing age were all significantly associated with increased D2FS and D12FS risk. Daily flossing also was associated with increased D2FS risk. More frequent dental care at baseline was associated with significantly decreased caries risk for both increments. The general concordance of risk factors in the D12FS and D2FS models lends support to the hypothesis that the D1 increment is an intermediate stage in the progression to fully cavitated lesions.

Caries risk assessment in preschool children in Saudi Arabia.

Caries is a prevalent condition in Saudi Arabia. At present, knowledge regarding caries risk factors in Saudi Arabia is limited. The present study aimed to identify characteristic features of Saudi preschoolers at high risk for caries, using the American Academy of Pediatric Dentistry caries risk assessment tool (CAT ) and to report the most significant caries risk predictors. A sample of 407 children aged 4 and 5 years was selected randomly from private and public nursery schools. Their parents answered a questionnaire prepared using the CAT . Each child was examined for the presence of caries and his/her oral hygiene status. According to the CAT , almost all children (89%) were considered to be at high risk. Caries was significantly more prevalent among children attending public than private schools. All CAT variables were significantly related to the presence of caries except general health condition and water fluoridation. Logistic regression analysis showed previous caries experience, enamel demineralisation, and socio-economic status to be the most significant caries risk factors. Most of the Saudi children are considered to be at high risk for caries. Previous caries experience, enamel demineralisation and socioeconomic status are the most significant caries risk predictors. These groups should be targeted for inclusion in caries prevention programmes.

Urease activity as a risk factor for caries development in children during a three-year study period: A survival analysis approach

Recent cross-sectional studies suggest that reduced ability to generate alkali via the urease pathway in dental plaque may be an important caries risk factor, but it has not been assessed prospectively. ObjectiveTo evaluate the effect of plaque and saliva urease activity on the risk for developing new caries over a three-year period in children. MethodsA panel of 80 children, three to six years of age at recruitment, was followed prospectively for three years. Plaque urease activity, saliva urease activity and dental caries were measured every six months. Survival analysis methodology was used to evaluate the effect of urease on caries development during the study period adjusted for gender, age, baseline caries levels, sugar consumption, amount of plaque, and mutans streptococci levels. ResultsThe risk for developing new caries increased in a dose-responsive manner with increasing levels of urease activity in saliva (adjusted HRQ4 vs. Q1: 4.98; 95% CI: 1.33, 18.69) and with decreasing urease activity in plaque (adjusted HRQ4 vs. Q1: 0.29; 95% CI: 0.11, 0.76). Multiple measurements of urease activity were conducted to overcome the variability of urease activity in this study. Baseline caries and mutans streptococci in saliva were also important predictors of caries risk. ConclusionsIncreased urease activity in saliva can be an indicator of increased caries risk in children, whilst increased urease activity in plaque may be associated with reduced caries risk. The reproducibility of urease measurements must be improved before these findings can be further tested and clinically applied.

Is Sugar Consumption Detrimental to Health? A Review of the Evidence 1995—2006

Many countries set quantitative targets for added sugars, justifying this by expressing concern about the likely impact of sugar on weight control, dental health, diet quality, or metabolic syndrome. This review considers whether current intakes of sugar are harmful to health, and analyses recent literature using a systematic approach to collate, rank, and evaluate published studies from 1995–2006. Results from high quality obesity studies did not suggest a positive association between body mass index and sugar intake. Some studies, specifically on sweetened beverages, highlighted a potential concern in relation to obesity risk, although these were limited by important methodological issues. Diet adequacy appeared to be achieved across sugar intakes of 6 to 20% energy, depending on subject age. Studies on metabolic syndrome reported no adverse effects of sugar in the long-term, even at intakes of 40–50% energy. The evidence for colorectal cancer suggested an association with sugar, but this appeared to have been confounded by energy intake and glycemic load. There was no credible evidence linking sugar with attention-deficit, dementia, or depression. Regarding dental caries, combinations of sugar amount/frequency, fluoride exposure, and food adhesiveness were more reliable predictors of caries risk than the amount of sugar alone. Overall, the available evidence did not support a single quantitative sugar guideline covering all health issues.