Treatment Of Early Childhood Caries Research Articles

Parental Knowledge, Attitudes, and Practices Regarding Early Childhood Caries in Bihor, Romania: A Cross-Sectional Study.

Early childhood caries (ECC) is a significant global health issue, particularly affecting deciduous teeth in young children. ECC is prevalent in Romania, where nearly half of children experience dental caries. This study aimed to assess the influence of gender, age, and living environment on parents' knowledge, attitudes, and practices (KAP) regarding ECC in Bihor County, Romania, using a KAP-type questionnaire. A cross-sectional study was conducted between March and September 2024, utilizing an online KAP questionnaire distributed via social networks. The sample comprised 419 parents of children under six years old. Respondents provided socio-demographic data and answered questions regarding their knowledge, attitudes, and practices concerning ECC prevention, treatment, and oral health. Statistical analysis was conducted using Chi-square tests to assess associations between demographic factors and parental KAP. A p-value of less than 0.05 was considered statistically significant. Of the 419 respondents, 83.1% were female, and 62.5% were between the ages of 31 and 40. Significant gender-based differences were found in knowledge about pain from caries (93.7% of female participants vs. 81.7% of male participants, p = 0.004) and the importance of brushing twice daily (93.7% of female respondents vs. 80.3% of male respondents, p = 0.010). Younger parents (aged 18-30) were more likely to affirm the effectiveness of fluoride (65.4%) compared to those aged 31-40 (53.1%, p = 0.02). Urban parents were more likely to correctly identify the timing of tooth eruption (59.1% vs. 52.6% of rural parents, p = 0.021). The study highlights gender, age, and urban-rural disparities in parental knowledge and attitudes towards ECC. These findings underscore the need for targeted educational interventions to improve oral health outcomes and reduce ECC prevalence in the Bihor region. Tailored public health strategies addressing demographic factors could enhance preventive oral health behaviors and reduce the healthcare burden associated with untreated dental caries.

Awareness of Parents toward Preventive Dentistry in North Maharashtra – A Cross-sectional Survey

Background: Oral health is an important component of overall health. In the initial age, primary teeth play an important role in the development of speech, chewing, maintaining space, and guiding the eruption of permanent. Dental caries, malocclusion, early childhood caries (ECC), and trauma are the main diseases of the oral cavity. Aim: Assessment of the awareness regarding preventive dental procedures among parents residing in the North Maharashtra Region. Materials and Methods: The study was a cross-sectional survey consisting of a questionnaire conducted on parents of children in the North Maharashtra Region with a sample size of 220. A structured questionnaire was formulated with 15 questions in English which was translated into the local language (Marathi) for better understanding of parents. The first part of the questionnaire was based on demographic data and the second part consisted of 15 multiple-choice close-ended questions. Questions regarding preventive treatment of dental caries, ECC, topical fluoride, fluoridated toothpaste, pit and fissure sealant, dental habit-breaking appliances, malocclusion, mouthguards, and space maintainers. Questions regarding adverse habits such as thumb-sucking, tongue-thrusting, and nail-biting were also included. Results: About 57.7% of parents visited the dentist after pain. 52.7% of parents were unaware of dental caries and ECC and were not aware that dental caries is a preventable disease. Conclusion: Parental knowledge regarding preventive dental procedures is found to be limited as the utilization of these procedures.

Early childhood caries, family functioning, and common mental disorders in a region of Belo Horizonte, Brazil

Aim: This cross-sectional study aimed to analyze the need for dental treatment in preschool children concerning early childhood caries (ECC), evaluated by the School Health Program (SHP); family functioning; and common mental disorders (CMDs) within families in Belo Horizonte, Minas Gerais, Brazil. Methods: A structured questionnaire was applied to the main caretaker of the 61 children by telephone contact. The questions addressed socioeconomic and demographic data; the Questionnaire of General Family Functioning (GFF) sought to investigate family functioning; and the Self-Reporting Questionnaire (SRQ-20) served to screen for CMDs among the main caretakers. Secondary data were collected from the SHP to survey the need for oral health treatments. The dependent variable was the need for tooth restoration or extraction. The data were analyzed descriptively and by Pearson’s chi-square and Fisher’s exact tests (p < 0.05), using SPSS v.22.0. Results: The median age of the children was 5 years old, and 32.8% required treatment for dental caries. There was no association between the need for tooth restoration or extraction and socioeconomic factors, family relations, and the presence of CMDs in the main caretaker (p > 0.05). However, there was a greater frequency of need for treatment in families with low income (24.6%) and with less social support (family and friends < 1). Children whose family was included in the Family Grant Program (62.3%), the respondent was the mother (57.4%), had completed high school or higher (36.1%), no paid work (42.6%), with a traditional or nuclear family structure (27.8%), and living in a house with good sanitary conditions (63.9%) presented a lower frequency of need for treatment. The GFF and SRQ-20 values among preschool children with and without the need for dental treatment were similar. Conclusion: There was a trend of a higher need for ECC treatment in children from families with lower income and less familiar and social support.

A Comparison of Antimicrobial Efficacy of Silver-based Preventive Restorations (Silver Nitrate, Silver Diamine Fluoride, and Silver Nanoparticles) against Streptococcus mutans Monospecies Biofilm Model.

The ability of the Streptococcus mutans (S. mutans) to form biofilms is not only crucial in the initiation of early childhood caries (ECC) but is also a challenge to its treatment. The current management protocols focus on remineralization and use of antimicrobial formulations which penetrate biofilms, control their formation, and decrease the incidence of caries in children. The paradigm shift toward preventive protocols and increasing antibiotic resistance rekindled the use of silver as a promising antibacterial agent. To gain further insight into the therapeutic potential, aim of the present study was to compare the antibacterial efficacy of silver-based preventive restorations [silver nitrate (AgNO3), silver diamine fluoride (SDF), and silver nanoparticles (AgNPs)] against S. mutans species. Using an ex vivo monospecies biofilm model of S. mutans; the antimicrobial efficacy of three treatment groups (SDF, AgNO3, and AgNPs) was evaluated. There was a significant difference between the negative control and three treatment groups (SDF, AgNO3, and AgNPs). The results showed that the mean diameter of inhibition zones obtained in biofilms treated with AgNPs was 40.3 ± 0.25 mm which was greater than both SDF (37.7 ± 0.18 mm) and AgNO3 (36.26 ± 0.18 mm). The study concluded that the number of viable bacteria was significantly reduced by all three medicaments (p < 0.05). However, AgNPs showed the highest antimicrobial activity in comparison to SDF and AgNO3 against S. mutans biofilm. The present study thus supports that AgNPs are a promising preventive anticaries agent due to their better antibacterial activity in comparison to other silver-based preventive restorations and can be effectively used as an alternative to SDF or AgNO3 for the noninvasive treatment of ECC in the young. Sharma P, Dhawan P, Rajpal SK, et al. A Comparison of Antimicrobial Efficacy of Silver-based Preventive Restorations (Silver Nitrate, Silver Diamine Fluoride, and Silver Nanoparticles) against Streptococcus mutans Monospecies Biofilm Model. Int J Clin Pediatr Dent 2023;16(S-1):S13-S19.

Comparison of Oral Health-Related Quality of Life scores in children treated for early childhood caries under general and local anesthesia: a quasi-experimental study.

The purpose of this study was to compare the changes in oral health-related quality of life (OHRQoL) scores in children treated for Early Childhood Caries (ECC) under general (GA) and local anesthesia (LA). A quasi-experimental study was carried out on 73 children, with 37 in the GA group and 36 in the LA group. The early childhood oral health impact scale (ECOHIS) was used to measure OHRQoL, with the type of anesthesia (LA or GA) serving as the explanatory variable. A Friedman test was used to assess the difference between the LA and GA groups at baseline, one-week, and one-month follow-up points. The results showed a significant difference in the overall mean ECOHIS scores between the LA and GA groups at 1-week (LAmean ± SD = 6.12 ± 1.11, GAmean ± SD = 5.50 ± 0.88; P = 0.01) and 1-month (LAmean ± SD = 5.87 ± 1.12, GAmean ± SD = 4.96 ± 0.99; P < 0.001) follow-up points. Irrespective of the administered anesthesia, a significant (P < 0.001) reduction in the mean score for dental pain was observed at both 1-week (mean ± SD = 1.30 ± 1.16) and 1-month (mean ± SD = 0.81 ± 0.89) timepoints after the treatment, as compared to the baseline assessment (mean ± SD = 2.02 ± 1.02). Early treatment for ECC reduces pain, restore normal activities, and improves the quality of life of affected children. Specifically, GA was found to be more beneficial for both children and parents. However, further studies using more robust study designs and carefully considering related factors are necessary to confirm these findings.

Fluoride prophylaxis - poison or simple way to get rid of early childhood caries (ECC) – review

Introduction: As a prevention, fluoride is used systemically as well as topically in the oral cavity. Thanks to fluoride prophylaxis, one of the most common bacterial disease in the world can be significantly reduced. This disease is dental caries. As such, it constitutes a huge problem in current stomatology, especially the type that affects small children - early childhood caries (ECC). Fluoride has beneficial effects not only in caries prevention but also in arresting and inhibiting the active decay process. Nevertheless, in recent years the use of fluoride is claimed to be controversial due to its toxic properties. Aim: The aim of this study is to summarize the current knowledge on the effect that fluoride has on caries diseases affecting children and the safety of its use based on the available research. Materials and methods: Review of the current literature based on data available in: Pubmed, Ncbi, NIH, AAPD (American Academy of Pediatric Dentistry) and EAPD (European Academy of Pediatric Dentistry) websites using the following phrases: fluoride, fluoride in caries prevention, fluoride in caries, fluoride mechanism, fluoride toxicity, fluoride safety, caries, early childhood caries (ECC). Conclusions: The use of fluoride is debatable, due to its toxic properties when used in excessive doses. The analysis of the studies proved that fluoride concentrations used in dentistry for the prevention and treatment of early childhood caries (ECC) are safe for the children's organism. The benefits resulting from its use in modern dentistry, which should be based on prophylaxis, are indisputable.

Perspective of pediatricians about early childhood caries (ECC) in lumbini province Nepal: A major virulent dental problem

Early childhood caries (ECC) is a significant worldwide oral health problem that needs to be looked after by parents. Some parents do not care about the oral health of their children, and they more frequently visit pediatricians. So, pediatricians are one of the most reliable profession for preventing children’s oral diseases, and promoting awareness. The aim of the study was to know the knowledge and awareness of pediatricians’ about early childhood caries (ECC) in lumbini province, Nepal.A total of 40 pediatricians were selected by using census sampling method and were requested to fill out an objective questionnaire pertaining to individual’s knowledge about ECC, without providing any oral health information taking duration of the study from March 2021 to September 2021.About 23(56.5%) of pediatricians understood the importance of pediatric dentistry. About 34(86.2%) of pediatricians performed oral examination regularly. Around 17% of pediatricians had knowledge of the ECC. Only 14(33.3%) of pediatricians acknowledged the cariogenicity of sugar containing medical syrups.The study shows poor knowledge regarding ECC, oral health, and dental treatment need in children among the surveyed pediatricians although having good knowledge about pediatric speciality and importance of primary dentition. Thus, there is a need to update the Pediatricians on recent recommendations about ECC and its early screening.

Barriers to the Treatment of Early Childhood Caries among General Dentists in and Around Hyderabad, Telangana. A Cross-Sectional Study

Barriers to the Treatment of Early Childhood Caries among General Dentists in and Around Hyderabad, Telangana. A Cross-Sectional Study

Success rate of the treatment of early childhood caries under general anesthesia: A retrospective cohort study in different periods.

The purpose of this study was to evaluate the three-year success rate of the treatment for early childhood caries (ECC) under general anesthesia in different periods (2011 and 2018). Children (<6 years old) who had severe caries and were treated under general anesthesia in 2011 and 2018 were selected and followed up by telephone appointment and clinical examination. Success rate of each treatment was determined and possible factors associated with treatment failure were evaluated. There were 153 patients (with an average age of 48.55 ± 13.37 months) and a total of 2,018 teeth included in the 2011 group. In the 2018 group, there were 273 patients with an average age of 49.01 ± 12.42 months and a total of 3,796 teeth. The success rate in the 2011 group was significantly lower than that in the 2018 group. Teeth with mineral trioxide aggregate (MTA)-capped pulp survived significantly longer than those with calcium hydroxide-capped pulp. The utilization rate of preformed crown restoration was higher than that of resin restoration, and the survival time of dental restorations with preformed crown was prolonged. For posterior teeth, the success rate of indirect pulp capping and pulpotomy was also significantly higher than those without preformed crowns. General anesthesia is a safe and effective behavioral management method for uncooperative children's dental treatment. The use of biocompatible pulp capping materials and preformed crowns improved the success rate of treatment and prolonged the survival time of affected teeth.

Prevalence of Treatment of Early Childhood Caries among Children with Cleft Lip and/or Cleft Palate in Manitoba.

To determine the prevalence of treatment of early childhood caries (ECC) using general anesthesia (GA) in children with cleft lip and/or palate (CL/P). Retrospective chart review of children followed by the Manitoba Cleft Lip and Palate Program (MCLPP) to determine the frequency of treatment for ECC under GA. Children's Hospital, Winnipeg, Canada (a tertiary care centre). Children registered with MCLPP between January 1, 2008- December 31, 2019. The chart review collected data on the following variables: sex, date of birth, postal code, type of cleft, whether child had treatment of ECC using GA, age at the time of GA, and cost of treatment. Association of CL/P with ECC. Overall, 441 children had CL/P. 17% had isolated cleft lip (CL), 46% had isolated cleft palate (CP), and 37% had both cleft lip and palate (CLP). Overall, 24.3% of children with CL/P underwent dental surgery using GA while 14.5% underwent dental surgery to treat ECC between 12-59 months of age. When compared to a reference of Canadian healthy children 12-59 months of age, a child with CL/P was 15 times more likely to require GA to treat ECC. Treatment for caries under GA in children with CL/P is common. In the children with CL/P the rates of GA for treatment of ECC are significantly higher when compared to the general population. Children with CL/P require comprehensive oral health prevention to reduce the risk for caries and the need for treatment under GA.

The Effect of the Treatment of Severe Early Childhood Caries on Growth-Development and Quality of Life.

Untreated early childhood caries (ECC) adversely affect children's quality of life. Our aim was to evaluate the effects of ECC on growth, development, and quality of life. A total of 95 children were divided into three groups: general anesthesia (GA) (n = 31), dental clinic (DC) (n = 31), and control (n = 33). ECOHIS was applied to the parents in the GA and DC groups during a pre-treatment period and also applied in the post-treatment in the first and sixth months. Height, weight, and BMI measurements of the children in the study groups were taken and recorded at the pre-treatment stage and in the post-treatment in the first and sixth months. However, for the control group, these measurements were made just at the baseline and in the sixth month. Upon the treatment of ECC, the total ECOHIS score significantly decreased (p < 0.001) in both groups in the following first month, whereas the scores of the children in the GA group reached a similar level to the DC group at the end of the sixth month. Following treatment, the weight and height of the children with ECC who initially had significantly lower BMI percentiles than the control group (p = 0.008) were observed to increase and, thus, they reached a similar BMI percentile value to the control group in the sixth month. The results of our study revealed that development and growth deficiencies in the children with ECC could be reversed rapidly by dental treatments and, thus, their quality of life would increase. The importance of treating ECC was revealed since treating ECC had positive effects both on the children's growth and development and on the quality of life of the children and their parents.

Patterns of Parental Information Seeking Behavior on Early Childhood Caries: A Qualitative Exploration.

This study aims to explore the information-seeking behavior patterns of parents with children receiving treatment for early childhood caries (ECC). Semistructured in-depth interviews were conducted with 20 parents of children with ECC. A topic guide was developed, focusing on questions relating to (i) the timing of their seeking information on ECC, (ii) the types of EEC information they seek, and (iii) the resources used to seek information. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was performed, whereby the data were coded and categorized into themes and subthemes. Four main themes were identified: the immediacy of seeking information, perceived information need, use of resources, and barriers to seeking information. Parents either sought information immediately after detecting changes to the appearance of their child's teeth, with some being aware of the changes after signs and symptoms developed. The types of information parents usually sought covered the disease, its prevention, and management. Common sources of information were friends, family, the internet, and healthcare professionals. Barriers to seeking information discussed by parents were lack of time as well as insufficiency and inaccuracy of the information they received. This study highlighted the need for comprehensive, tailored early education on ECC for parents using reliable information sources. There is also a need to empower other nondental healthcare professionals to provide oral healthcare education for parents.

RNase III coding genes modulate the cross-kingdom biofilm of Streptococcus mutans and Candida albicans.

Streptococcus mutans constantly coexists with Candida albicans in plaque biofilms of early childhood caries (ECC). The progression of ECC can be influenced by the interactions between S. mutans and C. albicans through exopolysaccharides (EPS). Our previous studies have shown that rnc, the gene encoding ribonuclease III (RNase III), is implicated in the cariogenicity of S. mutans by regulating EPS metabolism. The DCR1 gene in C. albicans encodes the sole functional RNase III and is capable of producing non-coding RNAs. However, whether rnc or DCR1 can regulate the structure or cariogenic virulence of the cross-kingdom biofilm of S. mutans and C. albicans is not yet well understood. By using gene disruption or overexpression assays, this study aims to investigate the roles of rnc and DCR1 in modulating the biological characteristics of dual-species biofilms of S. mutans and C. albicans and to reveal the molecular mechanism of regulation. The morphology, biomass, EPS content, and lactic acid production of the dual-species biofilm were assessed. Quantitative real-time polymerase chain reaction (qRT-PCR) and transcriptomic profiling were performed to unravel the alteration of C. albicans virulence. We found that both rnc and DCR1 could regulate the biological traits of cross-kingdom biofilms. The rnc gene prominently contributed to the formation of dual-species biofilms by positively modulating the extracellular polysaccharide synthesis, leading to increased biomass, biofilm roughness, and acid production. Changes in the microecological system probably impacted the virulence as well as polysaccharide or pyruvate metabolism pathways of C. albicans, which facilitated the assembly of a cariogenic cross-kingdom biofilm and the generation of an augmented acidic milieu. These results may provide an avenue for exploring new targets for the effective prevention and treatment of ECC.

Effect of Dental Treatment on the Body Mass Index of Children Aged 3 - 6 Years Diagnosed with Early Childhood Caries: A Longitudinal Case-Control Study

Background: Dental caries is one of the most common childhood problems, which is associated with other diseases, such as malnutrition. Objectives: This study aimed to investigate the effect of early childhood caries (ECC) treatment on the body mass index (BMI) of children, aged 3 - 6 years. Methods: In this longitudinal case-control study, 96 children, aged 3 - 6 years, were recruited and divided into three groups (n = 32 per group). A questionnaire was completed for each child, and the decayed, missing, and filled teeth (DMFT) index was measured via clinical examination, according to the World Health Organization (WHO) criteria. Anthropometric measurements were performed in each group to assess BMI at baseline and after six months. The first two groups were diagnosed with ECC. For group I, a comprehensive dental treatment was performed under general anesthesia at baseline, while for group II, no treatment was applied during six months. Group III consisted of caries-free children. Data were analyzed using ANOVA, independent t-test, paired t-test, Mann-Whitney U test, and Kruskal-Wallis test (P &lt; 0.05). Results: The mean and standard deviation of the DMFT index were 7.09 ± 2.40, 5.19 ± 1.72, and zero in groups I, II, and III, respectively. The BMI changes after six months were 0.11 ± 0.42, 0.00 ± 0.39, and -0.04 ± 0.64 kg/m2 in groups I, II, and III, respectively. The mean BMI significantly changed in the three groups within six months (P = 0.034). In group I, the BMI changes were significantly greater than the other two groups (P = 0.004). Conclusions: Although a significant negative relationship was found between ECC and BMI, oral hygiene and nutritional behavior were the main confounding variables. Based on the findings, treatment of ECC had a significant positive effect on BMI; therefore, it is important for healthcare professionals to identify and treat children at risk.

Candida albicans and Early Childhood Caries

Early childhood caries (ECC) is a highly prevalent and costly chronic oral infectious disease in preschool children. Candida albicans has been frequently detected in children and has demonstrated cariogenic traits. However, since ECC is a multifactorial infectious disease with many predisposing non-microbial factors, it remains to be elucidated whether the presence and accumulation of C. albicans in ECC is merely a consequence of the adaptation of C. albicans to a cariogenic oral environment, or it plays an active role in the initiation and progression of dental caries. This review aims to summarize the current knowledge on C. albicans and the risk of ECC, with a focus on its synergistic relationship with the cariogenic pathogen Streptococcus mutans. We also highlight recent advances in the development of approaches to disrupt C. albicans-S. mutans cross-kingdom biofilms in ECC prevention and treatment. Longitudinal clinical studies, including interventional clinical trials targeting C. albicans, are necessary to ascertain if C. albicans indeed contributes in a significant manner to the initiation and progression of ECC. In addition, further work is needed to understand the influence of other bacteria and fungi of oral microbiota on C. albicans-S. mutans interactions in ECC.

Lactiplantibacillus Plantarum CCFM8724 Reduces the Amounts of Oral Pathogens and Alters the Oral Microbiota in Children With Dental Caries: a Randomized, Double-Blind, Placebo-Controlled Trial

Objective Early childhood caries (ECC) is closely related to the disorders of oral microbiota. Probiotics antagonize pathogenic bacteria and regulate the composition of the microbiota. We aimed to investigate the effects of Lactiplantibacillus plantarum CCFM8724 on Streptococcus mutans, Candida albicans, and oral microbiota of patients. Methods Children with ECC aged 3‒6 years were randomly divided into probiotic and placebo groups in the double-blind controlled trial. The intervention and washout periods were 28 days and 14 days, respectively. On days 1 and 28, dental plaques were collected. The effects of L. plantarum CCFM8724 on the oral microbiota of patients were investigated by sequencing the V3-V4 region of 16S rDNA. On days 1, 14, 28 and 42, qPCR was used to investigate the effect of L. plantarum CCFM8724 on the amounts of S. mutans and C. albicans in the saliva of children with ECC. Results L. plantarum CCFM8724 significantly reduced the amounts of S. mutans and C. albicans in saliva of children with ECC (p < 0.01). After consumption of L. plantarum CCFM8724, the abundance of Firmicutes, Granulicatella and Gemella increased, whereas the abundance of Proteobacteria, Neisseria, Bifidobacterium and Catonella decreased. Conclusion: Our results emphasize that probiotics could play a beneficial role in the prevention and treatment of ECC in children from an oral microecological perspective.

VALUE-BASED ORAL HEALTH CARE: IMPLEMENTATION LESSONS FROM FOUR CASE STUDIES.

Value-Based Healthcare has gained considerable attention in medicine but relatively little in oral health care so far. Implementation of Value-Based Oral Health Care (VBOHC) is complicated by a multitude of system-level and contextual factors, especially the siloed innovation culture in dentistry which has been evolving separately from the broader medical system. Previous literature has described 4 key limitations to adaptation of value-based health care, that is creating multidisciplinary units, measuring patient-centered outcomes, attributing and communicating costs, and bundling payments. This paper presents 4 case studies on oral health care which provide relevant learnings about addressing challenges when seeking to implement VBOHC: (i) The Nurse Practitioner-Dental (NPD) Model outlines an approach for creating a multi-disciplinary center in monitoring chronic diseases improving healthcare outcomes; (ii) Treatment of Early Childhood Caries displays the utility of quality measures in value measurement and placing patients at the center of their care; (iii) ClearChoice Dental Implant Centers outlines how cost attribution leads to better management and creation of value centers; and (iv) Proposed Payment Model Changes in Oral Maxillofacial Surgery outlines a method to cover all episodic care of this otherwise expensive disease. Despite the challenges of implementing VBOHC, this paper provides insights into its feasibility and actionability.

Cost-Effective analysis of silver diamine fluoride in comparison to glass ionomer cement along with fluoride varnish in the management of early childhood caries in anganwadi centers of Mangalore: A randomized control trail

Introduction: Early childhood caries (ECC) is a major public health challenge affecting preschool children. Silver diamine fluoride (SDF) is a noninvasive, alternative method to surgical intervention in the treatment of ECC. It has also shown to inhibit the development of new carious lesions. Materials and Methods: An open-labeled randomized controlled trail was conducted among 200 Anganwadi children. They were divided into two groups: Group A received oral prophylaxis and application of 38% SDF and Group B received oral prophylaxis, restoration using glass ionomer cement (GIC) and application of 5% sodium fluoride varnish (FV). The effectiveness in reduction of dental caries was assessed based on its ability to result in a positive outcome postintervention. Cost-effectiveness analysis, from the service provider perspective, was conducted to evaluate the effectiveness of SDF when compared to GIC followed by the application of FV. Average cost-effectiveness ratio and incremental cost-effectiveness ratio (ICER) for all the specific outcomes were assessed. Results: The average cost for converting an individual tooth from active caries to inactive caries using SDF was 67.30 Indian Rupees (INR), whereas the same was 225.5 INR using GIC with FV. The ICER of the interventions for the total number of inactive caries postintervention was measured at −89.9, implying that Incremental costs of one extra tooth of active caries to be converted into inactive caries using SDF will cost 89.9 INR less compared to the same outcome using GIC with FV. Conclusions: Thus, the study showed that SDF was cost-effective when compared to GIC in restoring active carious lesions.

The Effectiveness of Early Childhood Caries Treatment with MI Varnish Fluor in Obese Subjects: A Study from Vietnam.

Objective: We conducted this work to evaluate the effectiveness of treatment for early childhood caries (ECC) using MI Varnish Fluor in obese children aged from 36 to 71 months. Methods: This study was conducted on 300 carious teeth of obese children and normal-weight children in Hanoi, Vietnam, over the period 2019–2020. Diagnodent KaVo 2190 laser equipment was used to diagnose ECC. The children in each group were selected on the basis of similarities in age, gender, and study location, and the teeth in the two groups were selected on the basis of similarities in damage level and jaw position. ECC treatment was performed once a week for four consecutive weeks with MI Varnish Fluor. The child, the child’s family, and the child’s teacher were consulted on diet and oral hygiene during the treatment. Children were examined and monitored throughout the treatment period. Children were re-examined after 3 and 6 months from the start time of treatment. The Mann–Whitney U test and Kruskal–Wallis tests were used, with statistical significance indicated at p < 0.05. Results: After six months of treatment with MI Varnish Fluor, the number of cases of code 0 damage recovery (D0) increased in both groups. The result showed that MI Varnish fluor was effective in ECC treatment. D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children were observed after six months of treatment, but there was no statistically significant difference between the two groups. Furthermore, there was no statistically significant difference between the two groups according to age, tooth position, or tooth surface position in D0 damage recovery. Conclusions: MI Varnish Fluor was effective in ECC treatment, with D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children after six months of treatment.

Applications of Silver Diamine Fluoride in Dentistry

Various studies published in the literature around the world indicate a significant prevalence of early childhood caries (ECC). Treatment of early childhood caries (ECC) using silver diamine fluoride (SDF) has become a viable alternative, particularly for young and anxious children, because traditional restorative treatments is unlikely to combat this prevalent condition. Arrested caries is identified by the hardening of teeth and it changes its color from dark brown to black. More restorative treatments can be performed if necessary. Traditional ECC restorative treatments are not always inexpensive or feasible, as they involve patient cooperation to achieve a satisfactory result. Japan was the first country to promote silver diamine fluoride in 1960. SDF has been used to prevent the spread of caries in various Asian nations, including Japan and China. It was enacted as a fluoride to treat sensitive teeth in the United States by Food and Drug Administration ( FDA). For young children or individuals with specific needs, it is painless and simple to use .The fluoride in SDF stimulates remineralization while the silver ions act as an antimicrobial agent when applied to carious lesions and stop cariogenic biofilms from growing. SDF also prevents future degradation of the dentin's collagen. With a 38 percent use rate, SDF has been utilized in a number of nations. According to a review, SDF is a harmless, economical caries control agent with a wide utilisation in dentistry, and it may meet the WHO Millennium Development Goal (MDG) as well as the United States Institute of Medicine's criteria. The applications of SDF in dental treatment are discussed in this article.