Role In Prevention Of Caries Research Articles

The Effect of Flossing Techniques on Gum Health and Caries Prevention

Gum health and caries prevention are important aspects in maintaining overall oral health. Flossing technique or the use of dental floss is known as one of the effective methods for cleaning areas between teeth that are not reached by a toothbrush. This study aims to analyze the effect of flossing technique on gum health and caries prevention. This study used an experimental method involving 100 respondents who were divided into two groups, namely the group that routinely flossed and the control group that only relied on a toothbrush. Data were collected through gum health examinations using the gingival index and caries detection through clinical examinations for 3 months. The results showed that the group that routinely flossed experienced a significant decrease in the level of gum inflammation compared to the control group. In addition, the flossing technique was also proven effective in reducing plaque formation between teeth, which is the main factor causing caries. In conclusion, the flossing technique has a positive effect on gum health and can play an important role in caries prevention. Therefore, the use of flossing is recommended as part of an oral hygiene routine to support optimal dental and gum health.

Comparison of Antibacterial Activity of Various Additives to Glass Ionomer Restoration: An In Vitro Study

ABSTRACT Introduction: Glass-ionomer (GIC) cement was introduced in 1972 as a “new filling material of dentistry”. It is bioactive and plays an important role in caries prevention due to its ability to release fluoride into the oral environment and remineralization of dental hard tissues. However, its properties such as moisture sensitivity, wear resistance, and bond strength are not sufficient to inflict the antimicrobial environment. This in vitro study aimed to evaluate the antibacterial property of four different GIC cements against S. mutans and L. acidophilus. Methodology: This study was conducted on 120 disk-shaped samples (30 for antibacterial activity), which were placed in Petri dishes holding Müeller Hinton agar. Bacterial strains were overhauled in the brain heart infusion culture medium, and by utilizing disposable straps on blood agar medium, 100 ml of the strain inoculum was plated out. Through the diffusion method on the solid medium, the antibacterial activity of GIC was determined. Results: The antibacterial activity was the highest for Riva silver and chemifill rock for 24 and 72 hours, respectively. For 48 hours, Equia forte and chemifill rock had the highest antibacterial activity, and there was a significant difference between the groups. Conclusion: Ketac™ molar easymix inhibited the growth of S. mutans and L. acidophilus but had the lowest antibacterial effect compared to other GICs.

Potential role of salivary vitamin D antimicrobial peptide LL-37 and interleukins in severity of dental caries: an exvivo study

IntroductionVitamin D performs various functions as a hormone by promoting calcium absorption but plays a major role in innate immunity,cell differentiation, cell maturation through its genomic effects via vitamin D receptor. The immune response also plays a major role in tooth surface and supporting structure destruction and playing a major factor in high caries formation. The inflammatory cytokines are released has proinflammatory cytokines and stimulate cells in disease process. Therefore, in the present study we have evaluated the association of salivary vitamin D, LL-37, interleukins 6 and 17A in various levels of severity of dental caries.MethodEthical approval was obtained (NU/CEC/2020/0339), 377 individuals reporting to department of conservative dentistry and endodontics, AB Shetty memorial institute of dental sciences were included based on inclusion criteria. The individuals were further divided into caries free(N = 105) and caries active(N = 272) based on their caries prevalence. The salivary were collected and evaluated for vitamin D, LL-37,IL-17A and IL-6.Results were statistically analysed with SPSS vs 22 (IBM Corp, USA). Normally distributed data were expressed as mean ± SD. Skewed data were expressed as median and interquartile range. To compare (mean) outcome measures between the two groups unpaired independent t-test was applied and for values in median IQR, Mann Whitney U test was used. All statistical analysis for P value were two-sided and significance was set to P ≤ 0.05.ResultsThe study showed that, the salivary vitamin D statistically decreased with increasing severity of caries which showed that vitamin D plays an important role in prevention of caries. Antimicrobial peptide LL-37 was higher in caries free group but was not statistically significant, salivary IL-6 level was higher in caries active group but intergroup comparison did not show significant difference. Salivary IL-17A did not show statistically significant between caries active and caries free group.ConclusionThe salivary levels of vitamin D may play a vital role in prevalence of dental caries and its severity which can be a underlying cause in presence of other etiological factors.

Limosilactobacillus reuteri inhibits the acid tolerance response in oral bacteria

Probiotic bacteria show promising results in prevention of the biofilm-mediated disease caries, but the mechanisms are not fully understood. The acid tolerance response (ATR) allows biofilm bacteria to survive and metabolize at low pH resulting from microbial carbohydrate fermentation. We have studied the effect of probiotic strains: Limosilactobacillus reuteri and Lacticaseibacillus rhamnosus on ATR induction in common oral bacteria. Communities of L. reuteri ATCC PTA5289 and Streptoccus gordonii, Streptococcus oralis, Streptococcus mutans or Actinomyces naeslundii in the initial stages of biofilm formation were exposed to pH 5.5 to allow ATR induction, followed by a low pH challenge. Acid tolerance was evaluated as viable cells after staining with LIVE/DEAD®BacLight™. The presence of L. reuteri ATCC PTA5289 caused a significant reduction in acid tolerance in all strains except S. oralis. When S. mutans was used as a model organism to study the effects of additional probiotic strains (L. reuteri SD2112, L. reuteri DSM17938 or L. rhamnosus GG) as well as L. reuteri ATCC PTA5289 supernatant on ATR development, neither the other probiotic strains nor supernatants showed any effect. The presence of L. reuteri ATCC PTA5289 during ATR induction led to down-regulation of three key genes involved in tolerance of acid stress (luxS, brpA and ldh) in Streptococci. These data suggest that live cells of probiotic L. reuteri ATCC PTA5289 can interfere with ATR development in common oral bacteria and specific strains of L. reuteri may thus have a role in caries prevention by inhibiting development of an acid-tolerant biofilm microbiota.

Prevalence of Dental Caries With Salivary Assessment in Six to Twelve Years Old School-Going Children in Shahpura Tehsil, Jaipur.

IntroductionDental caries is a chronic, infectious, and irreversible disease of the calcified tissues of teeth, which demineralises the inorganic portion and destroys the organic substance of the tooth, which often leads to cavitation. Epidemiological studies measuring the prevalence and severity of dental caries have used modified versions of Klein and colleagues’ decayed, missing, and filled (DMF) or Gruebbel’s decayed, extraction indicated, and filled (def) indexes; however, these indexes only capture cavitated lesions. Saliva plays a vital role in caries prevention; significant reduction or deterioration of salivary function can aggravate the development of dental caries. Saliva affects the incidence of dental caries in four ways: as a mechanical cleansing agent that results in less accumulation of plaque, by reducing enamel solubility using calcium, phosphate, and fluoride, by buffering and neutralising the acids produced by cariogenic organisms, or by introducing directly through diet and by antibacterial activity. The study aims to assess the prevalence of dental caries and salivary parameters such as salivary pH, flow, and buffering capacity in six to 12 years old children of a rural tehsil of Jaipur.Materials and methodsThe study was done on a population consisting of 400 school-going children in the age group of six to 12 years. Oral examination was undertaken by a single examiner, who is the study's principal investigator, to avoid inter-examiner variability. Testing of resting saliva was done for evaluation of visual inspection of the level of hydration, saliva consistency, pH measurement, saliva quantity, and buffering capacity.Statistical analysisThe data were analysed using the chi-square test, t-test, and statistical software SPSS version 17.00 (SPSS Inc., Chicago, IL). The chi-square test was used to compare and analyse qualitative data, whereas the unpaired t-test was used to analyse and compare quantitative data. Quantitative data were summarised as mean and standard deviation. A p-value of 0.001 or less was considered for standard significance.ResultsThere was no significant difference in resting salivary flow rate between children with decayed, missing, and filled teeth (DMFT) scores less than 5 and DMFT scores of 5. The mean buffering capacity of stimulated saliva was found to be significantly more among children with DMFT scores less than 5 than children with DMFT scores of 5 or more. The mean pH of resting saliva was found to be significantly higher among children with DMFT scores less than 5 than children with DMFT scores of 5 or more.ConclusionThe prevalence of caries based on age was maximum in mixed dentition and minimum in primary dentition. In contrast, the difference in severity based on age was maximum in permanent dentition. The prevalence of caries was higher in children whose parents were aware of dental health; the difference was more significant in children with primary and mixed dentition. This study showed that salivary parameters such as salivary flow rate, salivary pH, and salivary buffering capacity among school-going children correlated with the prevalence of caries.

Awareness of professional fluoride application and its caries prevention role among women in KSA

ObjectivesConsidering the high caries prevalence among Saudi females, spreading knowledge on caries prevention modalities such as high-concentration professional fluoride (PF) applications could decrease their risk of dental caries. However, little is known about the current level of female awareness on the important caries prevention role of PF applications. Therefore, this study assessed the level of awareness of female adults in the KSA regarding PF application and its role in caries prevention. MethodsAn electronic self-administered anonymous questionnaire was distributed among women in Almadinah Almunawwarah, KSA using social media groups. It consisted of four sections: demographic data, caries experience, knowledge regarding fluoride and caries prevention, and knowledge regarding PF application and caries prevention. For the statistical analyses, simple descriptive statistics as means and frequency distributions were calculated, whereas comparisons were performed using the chi-squared test. ResultsA total of 405 females participated in the study. Participants were mostly married non-working Saudi women aged between 18 and 55 years. The education level of the majority of participants was at least a bachelor's degree. Most of the participants reported a high caries experience indicated by the presence of cavities (69.1%), fillings (87.2%), and missing teeth due to cavities (64.7%). Regarding PF questions, 34.8% knew the role of PF in caries prevention and 35.6% responded correctly to forms of PF. Only 14.5% reported receiving PF, whereas 57.3% did not know the frequency of PF application. A significant relationship was found between a lack of knowledge regarding the role of PF application and the presence of cavities (p = 0.003). Only 30.4% of participants reported receiving advice from their dentists regarding PF application. ConclusionMost female adults in Almadinah Almunawwarah, KSA have limited knowledge of the importance of PF application in caries prevention, which could contribute to their caries experience.

Salivary flow rate, pH, and buffer capacity in the individuals with obesity and overweight; A meta-analysis.

Weight in individuals can affect the saliva structure, which has an essential role in caries prevention. This meta-analysis aimed to compare individuals with obesity (OB)/overweight (OW) and normal weight (NW) in terms of salivary flow rate (SFR), salivary pH (SpH), salivary buffer capacity (SBC). After electronic databases (Web of Science, PubMed, Scopus, Cochrane Library, and Open Grey databases) were screened, studies were selected depending on inclusion criteria. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the risk of bias in individual studies. Mean differences (MD) were used to measure the effect estimates in the comparisons of OB vs NW, OW vs NW, and OB+OW vs NW. Additional analyzes such as subgroup, moderator, sensitivity, and grade were also performed. 24 studies and 2072 participants (SFR: 748 OB, 896 NW, SpH: 137 OB, 166 NW, SBC: 62 OB, 63 NW) were included in the quantitative synthesis. Significantly lower SFR was found in the group with OB compared to NW when saliva was stimulated (MD = -0.21, 95% CI [-0.30, -0.12], P < 0.001), but no significance was obtained when saliva was unstimulated (MD = -0.02, 95% CI [-0.11, 0.06], P = 0.55). No significant difference was found in the group with OB compared to NW in SpH (MD = -0.07, 95% CI [-0.26,0.12], P = 0.48) and SBC (MD = -1.10, 95% CI [-2.29,0.09], P = 0.07). SFR significantly decreases in individuals with OB, notably when saliva is stimulated. Besides, the decrease in SFR is much more prominent in adolescence and adulthood than in childhood. Furthermore, the increase in the severity of OB causes a much greater decrease in SFR. However, regarding SpH and SBC, no significant association exists.

Knowledge, Attitude of Mothers towards Infant Oral Healthcare in Baghdad City/ Al-Karkh

Background: Oral health is a key pointer of overall health, and quality of life, most oral health problems arepreventable. Mothers, significantly impact their infant’s oral health and play a vital role in prevention of dentalcaries among their children.Aim of the Study: To evaluate knowledge, attitude of mothers towards infant oral healthcare in Baghdad city /Al-Karkh.Patients and Methods: A cross-sectional study was conducted among convenient sample of 300 mothers with achild aged less than one year who were attending the primary healthcare centers in Baghdad city/ Al-Karkh. Datawere collected using a self-administered questionnaire composed of questions regarding knowledge, attitudeof mothers toward infant oral healthcare. The data analyzed using Statistical Package for Social Sciences (SPSS)version 25.Results: In this study, 88 (29.3%) of participant mothers had good knowledge, which was significantly higheramong the participant mothers aged ≥ 35 years (42.9%), live in urban areas (40.6%), highly educated (54.1%),employed (45.5%), had ≥ 3 children (41.3%), and mothers whose child aged ≥ 6 months (34.2%).166 (55.3%)ofmothers had good attitudes, which was significantly higher among the participant mothers aged between (30 – 34)years (83.3%), live in the urban areas (69.8), highly educated (91.8%), employed (81.8%,), had ≥3 children (65.1%),and mothers who had child aged ≥6 months (64.9%).Conclusions: Mothers had fair knowledge, good attitude toward infant oral healthcare. Pediatric dentists andany health care professionals like pediatricians and family physicians who care for infant need to be trained todisseminate appropriate infant oral health care information and in the prevention of early childhood caries.

Nanoparticles in caries prevention: A review

Nanotechnology is the branch of engineering that uses molecular machines with precise structures that are less than or equal to 0.1 μm in size. The word nano denotes 10 to the power of minus nine or 1 billionth. Treatment options for dental caries have been extensively studied; among them, the role of nanoparticles is of recent interest. Nanoparticles have shown promising results in the field of caries prevention because of their unique physical, mechanical, and biological characteristics. Nanosized systems have distinctive properties due to their increased surface-to-volume ratio and increased bioavailability toward cells and tissues. Furthermore, improved surface area results in better mechanical interlocking of nanoparticles to the resin matrix. They prevent dental caries by antimicrobial, remineralizing, and anti-inflammatory mechanisms. Although many nanoparticles have been studied for their role in caries prevention, only a few materials which were extensively studied are included in this review.

An in vitro Comparative Evaluation of Fluoride Uptake by Demineralized Enamel Exposed to Four Different Low Fluoride Dentifrices

Background: Topical fluoride application has an important role in caries prevention. The aim of the present study was to evaluate and compare fluoride uptake of tooth enamel after exposure to four commercially available low fluoridated toothpastes. Methods: The present in vitro study was conducted on 60 sound extracted premolar teeth. The teeth were covered with acid-resistance nail polish except at a 5×5 mm area on the buccal and lingual surface of each tooth (for experimental and control group respectively). After demineralization of the window area for 2 days, the teeth were immersed in toothpaste slurry containing: Sodium Fluoride 1000ppm (Group A), Soduim monofluorophosphate 1000ppm (Group B), Soduim monofluorophosphate 500ppm (Group C) and Sodium fluoride 500ppm (Group D). The pH of the dentifrices was measured. The acid biopsy technique and fluoride ion-specific electrode was used for fluoride ion estimation. Results: All of the applied toothpastes significantly increased fluoride content of the enamel compared with the control group (P <0.001). There was a significant difference among the four groups of toothpastes in the mean fluoride uptake and group A showed maximum uptake of fluoride (5.5920 ppm), followed by group B, C and D respectively. According to Pearson correlation analysis, there was not any significant relationship between the pH of the dentifrices and uptake of fluoride. Conclusion: There was a positive correlation between the fluoride concentration of dentifrices and the fluoride uptake on demineralized enamel. The toothpastes containing NaF are more effective than toothpastes containing NaMFP. Moreover, dentifrice pH had no influence on fluoride uptake by enamel.

In Vitro Surface Investigation of Calcium Fluoride-like Precipitation on Human Enamel after Topical Treatment with the Organic Fluoride Nicomethanol Hydrofluoride.

The topical fluoride treatment of teeth can lead to a formation of CaF2-like material, which is considered to play a significant role in caries prevention. Different types of fluoride sources are applied. The aim of this study was to analyse the in vitro fluoridation effect of the lesser known organic fluoride compound nicomethanol hydrofluoride (NH) regarding fluoride accumulation and morphological changes on dental enamel surfaces. Materials and Methods: The fluoridation effect was investigated by scanning electron microscopy (SEM) and energy dispersive x-ray analysis (EDX) after treatment with fluoride solutions at a concentration of 1350 ppm F - and a pH value of 5.5. NH was tested against inorganic sodium fluoride (NaF) as reference. Fluoridation was done on pellicle-free and pellicle-covered enamel. Results: Formation of globular CaF2-like material was observed for both fluoride types. However, NH led to considerably higher calcium fluoride accumulation on the enamel surface as shown by both EDX and SEM. The globule diameters varied between 0.2 and 0.8 µm. Cross-sectional analysis revealed that the globular precipitates lay directly on the enamel surface; only the very surface-near volume was affected. No statistically significant difference of the fluoridation effect was measured with vs without saliva pre-treatment. Conclusion: The experiments showed a 6 times greater F - surface uptake on dental enamel with NH compared to sodium fluoride, thus suggesting an important role of NH during remineralization phases, fostering equilibrium between de- and remineralization.

The impact of salivary lactoperoxidase and histatin-5 on early childhood caries severity in relation to nutritional status

IntroductionEarly childhood caries is a multifactorial disease. Saliva plays an important role in initiation and protection against caries, and its composition is greatly affected by nutritional status. This study was conducted to determine the impact of salivary lactoperoxidase and histatin-5 on the severity of ECC in relation to nutritional status. Materials and methodsThe sample consisted of 120 children aged 5 years, classified into eight groups: mild ECC in underweight children, mild ECC in normalweight children, moderate ECC in underweight children, moderate in ECC normal weight children, severe ECC in underweight children, severe ECC in normalweight, caries-free (control) underweight children and caries-free normalweight children. Each group consisted of 15 children. Stimulated saliva was collected. Salivary lactoperoxidase was analysed using Human LPO/ Lactoperoxidase ELISA Kit (CLIA)-LS-F29892, and salivary histatin-5 was analysed using Human Histatin-5 ELISA Kit MBS705083_48T. ResultsLactoperoxidase and histatin-5 concentrations were significantly higher in caries-free children than in children with ECC, and they were higher in children with mild ECC than in children with moderate ECC or in children with severe ECC. They were significantly higher among children with normal weight than among those who were underweight (p < 0.01). ECC and nutritional status recorded non-significant interactions with both LPO and HST-5 (p > 0.01), but there was significant interaction between these two variables and LPO and HST-5 together (p < 0.01). The Pearson's correlation coefficient test recorded significant negative correlations between ECC severity and both salivary lactoperoxidase and histatin-5 among the eight study groups, whereas significant positive correlations were recorded between BMI values and both salivary lactoperoxidase and histatin-5 among the eight study groups. ConclusionSalivary lactoperoxidase and histatin-5 may be affected by nutritional status, and these two parameters may play an important role in caries prevention at high concentrations. There is interaction between these two parameters and ECC severity and nutrition.

Comparative evaluation of occlusal pits and fissures morphology modification techniques before application of sealants: An In vitro study.

Pits and Fissures are recognized as being highly susceptible to caries. Pit and fissure sealants are one of the best methods of preventing caries as it occludes the fissures and pits from the accumulation of plaque and cariogenic microflora. There are different methods of cleaning and preparing occlusal pits and fissures for preventing caries which helps in alleviating oral health status of paediatric population. The aim of the present study was to evaluate and compare the microleakage of pit and fissure sealants after using five different preparation techniques, namely: A) Conventional technique using pumice prophylaxis, B) enameloplasty with round carbide bur, C) enameloplasty with fissurotomy bur, D) air polisher, and E) air abrasion. The study was conducted on 50 caries-free premolars extracted for orthodontic purpose. These teeth were randomly assigned to five groups, 10 teeth in each for receiving fissure sealant after different surface preparation; thermocycling and sectioning of samples were performed and microleakage was assessed under a stereomicroscope after methylene blue dye immersion. The results of air abrasion groups were significantly superior with "0" microleakage when compared to all other groups followed by round bur, fissurotomy bur, air polisher and pumice prophylaxis. To improve the marginal adaptation of the sealants, minimally invasive methods are the most favoured methods of occlusal preparation. This study promises to show positive results for fissure sealants which are likely to play an important role in caries prevention and techniques that are intended to protect caries susceptible surfaces.

CORRELATION INTERRELATION OF PSYCHOEMOTIONAL STATE OF CHILDRENWITH SOCIO-HYGIENIC FACTORS OF CARIES OCCURRENCE

Questionnaire is one of the possible ways of research in organized children's groups, which allows us to identify socio-hygienic factors of caries occurrence. Proper oral hygiene, awareness of children about this, regular preventive visits to a dentist, knowledge about the possibility of caries prevention play an important role in caries prevention. Lately, a great attention is paid to the psycho-emotional state of adult patients and especially of children due to the impact school strain and the formation of behavioral responses on them.&#x0D; The aim of our research was to study the correlation interrelation between the psycho-emotional state of children from 6 to 16-year-old with the socio-hygienic factors of dental caries occurrence.&#x0D; Dental survey, analysis of the emotional state and interrogation of children and their parents were performed in 295 children from 6 to 16-year-old. Children and their parents were interviewed in order to study the influence of socio-hygienic factors on the possibility of caries occurence. Psycho-emotional state was studied by the following methods: method of definition of school fears, kinetic image of the family, Spielberg's self-esteem scale of personal anxiety level.&#x0D; Definition of school fears has revealed that 13.2% of the surveyed children had signs of general school fear, 15.6% had a fear of social contacts with peers, 10.2% had a fear of social contact with teachers, 17.0% had a fear of self-expression, 10.2% had a fear of knowledge test situations, 38.6% had a fear of not meeting the expectations of others, 14.6% had low physiological resistance to school fears. Anxiety (by Spielberg`s method) was found in 80.3% of surveyed. Only general school fear (rs = 0.17, p &lt;0.005) correlated with the children age. Its frequency increases in 2.6 times after 12 years age.&#x0D; Only 36.1% of children did not experience psychological distress inside of their families. However, tensed relationship inside of families was not determined in 51.4% of children without caries and only in 22.1% of children with caries (pMU &lt;0.001). There are correlation interelationships between caries development and tensed relationships inside of families and general school fear, less pronounced correlation between carious process activity and tension inside of families and general school fear.&#x0D; Children with low physiological resistance to school fears have the least complaints about the condition of tooth hard tissues. However, complaints do not have significant interrelation with caries presence. Children with caries do not have complaints about the presence of carious cavities in teeth, rarely complain on discoloration, misalignment or irregular shape teeth, equaly as children without caries. Children with a fear of knowledge testing are the most likely to complain about the presence of carious cavities.&#x0D; Children who can better resist to school fears are more likely to visit a dentist for a preventive purpose. Children who have a fear of social contact with teachers or fear of unsettled meeting the expectations of others are less likely to seek a preventative meeting with a dentist. Increasing anxiety (according to Spielberg`s method) contributes to preventive treatment. Low physiological resistance to school fears indicates the risk that, even if there is pain in a tooth, children do not seek for a dental support.&#x0D; During the questionnaire of children the dependence of general school fear presence with the age of the child was found, which frequency increases in 2.6 times after 12 years age.&#x0D; There is a correlation interrelationship between the frequency of attendance of a dentist and the presence of a common school fear, ie, greater the fear, less attendences of a dentist. Greater the children`s general school fear is observed, greater the anxiety during the dentist appointment is noted. The results are improved according to work with children and their parents on the regulation of the emotional state of children.

The views and experiences of general dental practitioners (GDP's) in West Yorkshire who used the International Caries Detection and Assessment System (ICDAS) in research.

ObjectiveTo explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries.MethodsThis qualitative study involved one on one interviews with eight GDP’s who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis.ResultsGDP’s indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care.ConclusionThe GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals’ caries management, including appropriate recording of diagnosis and risk assessment.

Series: Caries prevention in historical perspective. Fluoride

Shortly after the Second World War it became known in the Netherlands that fluoride can contribute to the prevention of dental caries. As to how this effect was achieved, opinions differed. Initially, the dominant the view was that fluoride had to be absorbed into the enamel and dentine during tooth formation to make the teeth resistant to caries. Later it was discovered that decalcification of the enamel is inhibited if fluoride is present in the dental plaque. While in the beginning water fluoridation was considered to be the most effective measure to prevent caries, the current position is that tooth brushing with fluoride toothpaste plays the most important role in caries prevention.

Acceptability of Salt Fluoridation in a Rural Latino Community in the United States: An Ethnographic Study.

Compared to other population groups in the United States, caries (tooth decay) is a disproportionately prevalent disease among Latino populations, especially among low-income and rural sub-groups and children under five years of age. Fluoride is a primary preventive for caries. While water fluoridation is a major and effective public health means for delivering fluoride on a mass scale, it does not reach many rural areas or population groups such as Latinos who eschew drinking water from municipal sources. This study examines the acceptability to such groups of salt fluoridation, an alternate means of delivering fluoride long used on a global scale. An ethnographic study in California’s rural Central Valley was performed. Thirty individual interviews and 5 focus groups (N = 61) were conducted in Spanish to investigate low-income Latino migrant caregivers’ experiences, views and understandings of domestic salt, oral health, caries prevention and fluoride. Audio data were transcribed, translated, coded and thematically analyzed. Table salt was readily available and frequently consumed. Both adult and child daily sodium consumption was high. Despite a general feeling that it was good, and present in dentifrices or dietary supplements, most participants had little knowledge about fluoride. Concerns were raised about cardio-vascular and other possibly deleterious effects if an increase in salt consumption occurred because fluoridated salt was viewed as having ‘extra’ benefits. Once informed about fluoride’s safety and role in caries prevention, most participants expressed willingness to use fluoridated salt, especially if it benefitted children. Reassurance about its safety and benefits, and demonstration of its taste, were important aspects of acceptance. Taste was paramount. Participants would not consume more fluoridated salt than their current salt as that would result in unpleasant changes in food flavor and taste. While salt fluoridation is acceptable, the feasibility of producing and distributing fluoridated salt in the United States is, however, complex and challenging.

Casein phosphopeptide-amorphous calcium phosphate and shear bond strength of adhesives to primary teeth enamel.

Background:CPP-ACP (Phosphopeptide-Amorphous Calcium Phosphate) has an important role in caries prevention in pediatric patients. This study was done, because of the great use of CPP-ACP and the need for restoration for teeth treated with CPP-ACP as well as the importance of shear bond strength of adhesives in the success of restorations.Objectives:This study aimed to evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on shear bond strength of dental adhesives to enamel of primary teeth molars.Materials and Methods:This in vitro study was conducted on 180 extracted primary molars. They were randomly divided into 6 groups and each group was divided into 2 subgroups (treated with CPP-ACP and untreated). In subgroups with CPP-ACP, enamel was treated with CPP-ACP paste 1 h/d for 5 days. Types of adhesives that were evaluated in this study were Tetric N-Bond, AdheSE, AdheSE One F, single Bond 2, SE Bond, and Adper Prompt L-Pop. Shear bond strength was tested with a universal testing machine and mode of failure was evaluated under stereomicroscope. Data were analyzed by T test, 2-way analysis of variance (ANOVA), Tukey and Fisher exact test using SPSS18. P < 0.05 was considered as significance level.Results:Shear bond strengths of different adhesive systems to enamel of primary teeth treated and untreated with CPP-ACP showed no significant difference (P > 0.05). Mode of failure in all groups regardless of CPP-ACP administration was mainly adhesive type. Our results indicated that CPP-ACP did not affect shear bond strength of studied adhesives to primary teeth enamel.Conclusions:To have a successful and durable composite restoration, having a high strength bonding is essential. Considering the wide use of CPP-ACP in preventing tooth decay and the role of adhesive shear bond strength (SBS) in success of composite restoration, we conducted the present study to evaluate the effect of CPP-ACP on the SBS of adhesives to primary teeth enamel.

The use of sub-ablative Er:YAG laser irradiation in prevention of dental caries during orthodontic treatment.

This « in-vitro » study had two specific aims: the first, to test using a universal testing machine whether sub-ablative Er:YAG laser irradiation prior to acid etching is effective in orthodontic bracket bonding and secondly using micro-hardness measurements and Scanning Electron Microscopy (SEM) observations to investigate the effectiveness of de-mineralization reduction in enamel treated with sub-ablative Er:YAG laser irradiation followed by fluoride varnish application. One hundred and eighty bovine permanent maxillary incisors were selected for shear bond strength testing and microhardness measurements. Sub-ablative Er:YAG laser irradiation was set at a power density of 2.5 J/cm(2), a frequency of 7 Hz and air/water spray. Brackets were bonded with an auto-curing resin paste. The shear bond strength was measured comparing laser irradiated and non-irradiated enamel surface, followed by SEM observation of the bracket-resin-enamel interface. Microhardness measurements were made on enamel samples before treatment, after samples preparation, and after demineralization. While the adhesion of orthodontic brackets to bovine enamel after sub-ablative Er:YAG laser irradiation and acid etching is comparable to that obtained after conventional acid etching, the effect of laser irradiation associated with topical application of fluoride varnish increases the microhardness of enamel. Sub-ablative Er:YAG laser irradiation before the acid etching doesn't reduce the shear bond whereas when associated with fluoride application it may play a role in caries prevention. Further studies will be necessary to establish the mechanism by which the protective laser activated fluoride effect is achieved.

Knowledge, attitude and practices of rural people about fluorides and fluorosis

Introduction : Fluoride has played a pivotal role in oral health promotion over the past 50 years. The benefits of low levels of exposure are outweighed by adverse effects at high level. The problem of high fluoride concentration in groundwater resources has become one of the most important toxicological and geo-environmental issues in India. A comprehensive understanding of its sources, optimum concentration and adverse effect greatly potentiate the use of fluoride with Aim : Assessing the knowledge, attitude and practices of rural people about fluorides and fluorosis. Materials and methods : Atotal of300 subjects aged 18-30 years were selected by multistage cluster sampling technique. A self administered questionnaire containing 15 close ended questions based on knowledge, attitude and practices regarding fluoride and fluorosis was used for the purpose of collecting data. Results : Majority of people (76%) were aware of the presence of fluoride in drinking water. About (71 %) were of the opinion that fluoride in drinking water has an effect on oral health. Most of them (78%) were not aware of the permissible concentration of fluoride in water and of the presence of fluoride in the tooth paste. A lesser proportion of subjects knew about the role of fluoride role in the prevention of caries. About 68% of the people were of the opinion that the yellow discoloration of the tooth surface causes embarrassment while smiling or speaking. Conclusion : Overall results suggest that knowledge is deficient with respect to optimum concentration of fluoride, its role in prevention of caries and the presence of fluoride in food and tooth paste. Attitude and practices are also unfavourable as far as oral health is considered. There is an urgent need to sensitize the community people regarding precise role of fluoride in oral health.