Root caries prevention via sodium fluoride, chlorhexidine and silver diamine fluoride in vitro.

PubMed

Göstemeyer, Gerd; Kohls, Anna; Paris, Sebastian; Schwendicke, Falk

2018-01-31

Uncertainty exists as to how to best prevent root caries development. The aim of the present study was to compare sodium fluoride (NaF), chlorhexidine (CHX) and silver diamine fluoride (SDF) varnishes (V) and rinses (R) regarding their caries preventive effect in an artificial caries biofilm model. 140 bovine root dentin samples were cut, polished and embedded. Samples were allocated to seven treatment groups (n = 20/group): Four varnishes (applied once prior biofilm challenge): 38% SDF (SDFV), 35% CHX-varnish (CHXV), 22,600 ppm NaF-varnish (NaFV), placebo-varnish (PV); two rinses (applied once daily during biofilm challenge): 500 ppm NaF solution (NaFR), 0.1% CHX solution (CHXR); one untreated group. Caries was induced in a multi-station, continuous-culture Lactobacillus rhamnosus GG (LGG) biofilm model. Bacteria were inoculated 1 × daily, while 2% sucrose was supplied 8 ×/day followed by artificial saliva for 10 min. After 12 days, mineral loss (ΔZ) was measured in the effect area and adjacent to the varnished areas. Bacterial counts were assessed on de-Man-Rogosa-Sharpe agar. ΔZ was significantly lower in the NaFR group compared with all other groups. Varnishes did not significantly prevent mineral loss in adjacent areas. None of the agents had a significant antimicrobial effect on LGG. Regular fluoride rinses showed highest root caries-preventive effect.

Revitalising Silver Nitrate for Caries Management

PubMed Central

Zhao, Irene Shuping; Duffin, Steve; Duangthip, Duangporn

2018-01-01

Silver nitrate has been adopted for medical use as a disinfectant for eye disease and burned wounds. In dentistry, it is an active ingredient of Howe’s solution used to prevent and arrest dental caries. While medical use of silver nitrate as a disinfectant became subsidiary with the discovery of antibiotics, its use in caries treatment also diminished with the use of fluoride in caries prevention. Since then, fluoride agents, particularly sodium fluoride, have gained popularity in caries prevention. However, caries is an infection caused by cariogenic bacteria, which demineralise enamel and dentine. Caries can progress and cause pulpal infection, but its progression can be halted through remineralisation. Sodium fluoride promotes remineralisation and silver nitrate has a profound antimicrobial effect. Hence, silver nitrate solution has been reintroduced for use with sodium fluoride varnish to arrest caries as a medical model strategy of caries management. Although the treatment permanently stains caries lesions black, this treatment protocol is simple, painless, non-invasive, and low-cost. It is well accepted by many clinicians and patients and therefore appears to be a promising strategy for caries control, particularly for young children, the elderly, and patients with severe caries risk or special needs. PMID:29316616

Changes in Caries Experience, Untreated Caries, Sealant Prevalence, and Preventive Behavior Among Third-Graders in New York State, 2002-2004 and 2009-2012.

PubMed

Kumar, Jayanth V; Tavares, Vinicius; Kandhari, Priyanka; Moss, Mark; Jolaoso, I Adeyemi

2015-01-01

This study assessed changes in caries experience, untreated caries, sealant prevalence, and preventive behavior among third-grade children in New York State to monitor progress toward state health objectives. We analyzed children's data from the 2002-2004 (n=10,865) and 2009-2012 (n=6,758) New York State Oral Health Survey. We calculated differences in weighted percentages and 95% confidence intervals for caries experience, untreated caries, sealant prevalence, and preventive behavior. We used logistic regression procedures to assess the independent effects and interaction terms on dental caries experience. The percentage of children with dental caries and untreated caries decreased from 54.1% and 33.0% in 2002-2004 to 45.2% and 23.6% in 2009-2012, respectively. While this decrease was not uniform across income subgroups, the prevalence of sealants, a key measure of the use of preventive services, increased significantly from 16.7% to 36.0% among lower-income children. Measurable improvement in reducing dental caries prevalence among third-grade children has been made in New York State, but this improvement was not uniform across subgroups. Specifically, disease prevalence among lower-income children remained high, underscoring the need to strengthen existing programs and identify additional policy and programmatic interventions.

Effectiveness of a caries preventive program in pregnant women and new mothers on their offspring.

PubMed

Gomez, S S; Weber, A A

2001-03-01

The medical centre at Almirante Nef Naval Hospital, Vina del Mar, Chile, operates a mother and child preventive dental program (PDP) which includes women from their fourth month of pregnancy and mothers with their offspring. The aim was to evaluate the effectiveness of this prenatal and postnatal prevention program after the first four years. The prevalence of early childhood caries of 180 1- to 3.5-year-old children enrolled in the PDP was compared with 180 non-participating children. The control group was randomly selected from the rolls of the healthy child system of of the Valparaiso-San Antonio Health Service and was comparable by age, socio-economic status and level of fluoride in the drinking water (1.0 p.p.m. F) with the PDP group. Clinical caries examinations were conducted by two calibrated examiners using the WHO visual criteria. In the PDP group, 97% of the children were caries free compared with the 77% in the control group. The dft (mean +/- SD) of the PDP children was 0.11 +/- 0.78 versus 0.66 +/- 1.55 for the control children, a difference of 83.3%. The differences between the groups in caries-free status and caries prevalence were both statistically significant (P < 0.05). The preventive dental program was effective in inhibiting caries in pre-school children, even in a population already receiving the benefits of community water fluoridation.

Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services

PubMed Central

2011-01-01

Background Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. Methods/Design A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group. The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental questionnaires. Discussion This is a pragmatic trial conducted in general dental practice. It tests a composite caries prevention intervention, which represents an evidence based approach advocated by current guidance from the English Department of Health which is feasible to deliver to all low risk (caries free) children in general dental practice. The trial will provide valuable information to policy makers and clinicians on the costs and effects of caries prevention delivered to young children in general dental practice. Trial registration EudraCT No: 2009 - 010725 - 39 ISRCTN: ISRCTN36180119 Ethics Reference No: 09/H1008/93: PMID:21985746

Titanium tetrafluoride and dental caries: a systematic review.

PubMed

Alves, Rubiane Diógenes; Souza, Tatyana Maria Silva de; Lima, Kenio Costa de

2005-12-01

The aim of this systematic review was to evaluate the effectiveness of titanium tetrafluoride as a preventive or cariostatic agent against caries. The databases used to find the articles analyzed were MEDLINE LILACS, and BBO. In MEDLINE and LILACS the search strategy utilized was "titanium" [Words] and "tetrafluoride" [Words] and Spanish or English or Portuguese [Language], whereas In BBO "titânio" [Words] and "tetrafluoreto" [Words] and Espanhol or Inglês or Português [Language]. Out of a total of 42 studies found, which assessed possible preventive/cariostatic effects of titanium tetrafluoride against caries in vivo, only 2 were selected. In both studies, titanium tetrafluoride was shown to be effective against caries. However, given that the quality and consequently the validity of these two clinical studies are questionable, their results do not allow to conclude that titanium tetrafluoride is effective against caries clinically.

[Serial clinical examinations as the main approach to dental caries prevention in children].

PubMed

Skripkina, G I; Garifullina, A Zh

2015-01-01

Leading scientific and organizational prerequisites for the feasibility of clinical examination of the entire child population of the Russian Federation to the dentist is, above all, the high prevalence and intensity of dental diseases in children of all ages. As a result of many years of research and follow-up of children of preschool and school age we have proved the need to distinguish a group of children with zero activity of dental caries. The referring criteria are determined according to the results of comprehensive clinical and laboratory examination in order to determine the degree of risk of dental caries and individual caries resistance. The age-specific risk group is settled by "Stop caries" software. In order to optimize the preventive activities children are divided in 5 groups for routine preventive dental care. Unfortunately the efforts of modern dental services aimed at eliminating the consequences of caries process by filling cavities. Individualized preventive approach will increase the effectiveness of preventive measures and save public funds allocated in the amount of compulsory health insurance for pediatric dentistry.

Evaluation of preventive programs in high caries active preschool children.

PubMed

Sundell, Anna Lena; Ullbro, Christer; Koch, Göran

2013-01-01

Although caries prevalence in preschool children has dramatically decreased during the last decades it is still a large problem for a minor group of these children. Great efforts have been invested in finding effective preventive programs for the high caries active preschool children. However, few studies have evaluated and discussed which approach will give the best effect. The aim of the present study was to compare the effect of a "standard" preventive program with a series of programs with more extensive measures during a two-year period. At start one hundred and sixty high caries active preschool children (mean age 4 years) were included in the study. The children were randomly distributed to four groups. All groups were exposed to the basic program composed of dietary counselling, oral hygiene instructions and fluoride varnish application. Three groups were exposed to one additional preventive measure e.g. 1% chlorhexidine gel in trays, 0.2% NaF gel in trays or daily tooth brushing with 1% chlorhexidine gel. The programs were repeated seven times during the two-year study period and were executed by trained dental hygienists. Caries examination and saliva sampling for Streptococcus mutans measurements were performed at start of the study and after two years. The mean defs at start was between 10.8 and 12.6 for the four groups (NS). After two years the caries increment was 1.9 ds in the basic preventive group and between 1.9 and 2.6 (NS) in the other groups. Numerically there were more children in the chlorhexidine groups that showed reduction of Streptococcus mutans counts compared to the other groups, but the differences were small. The mean caries increment of about 1.9 ds per year in all groups indicate that all programs were effective taken into account that the children had about 11 defs at start. There were no differences in caries increment between the basic preventive group and the other groups. The conclusion was that addition of preventive measures on top of an effective basic program is a waste of resources. The effect on oral health of individual reinstruction and motivation, by a dental hygienist, seven times during the two-year study period should not be underestimated.

Association between caregiver behaviours to prevent vertical transmission and dental caries in their 3-year-old children.

PubMed

Wakaguri, S; Aida, J; Osaka, K; Morita, M; Ando, Y

2011-01-01

It has been suggested that oral organisms in children are mainly those transmitted from their mothers. That may account for the relationship between caries levels in children and their parents. However, few studies have investigated the effect of trying to prevent vertical transmission of oral organisms on dental caries levels in children, and the findings in the studies are controversial. The aim of this study was to investigate the association between measures to prevent vertical transmission of oral organisms and the caries experience in 3-year-old children. Data were collected from dental examinations for 3-year-old children and a self-administered questionnaire for their caregivers. Absence of maternal sharing of utensils and mouth-to-mouth feeding between caregivers and children was used as the variable about behaviour to prevent vertical transmission of oral organisms. Sex, age in months, dietary behaviour, oral health behaviour and sociodemographic factors were used as covariates. Data for 3,035 children (73.5% of the subjects) were analysed. Caregivers who practised vertical transmission prevention tended to have better oral health behaviours. Multivariate logistic regression analysis did not show any significant association between behaviour to prevent vertical transmission and caries experience (OR = 1.10, 95% CI = 0.86-1.41). This study suggests that caregiver behaviour to prevent vertical transmission was not effective in reducing levels of childhood caries. Copyright © 2011 S. Karger AG, Basel.

A review of the biological and clinical aspects of radiation caries.

PubMed

Aguiar, Gabrielle P; Jham, Bruno C; Magalhães, Cláudia S; Sensi, Luis Guilherme; Freire, Addah R

2009-07-01

The aim of this article is to review the clinical and biological features underlying the development and progression of radiation caries. Although radiotherapy (RT) plays an important role in the management of patients with head and neck cancer (HNC), it is also associated with several undesired side effects such as radiation caries which is a common, yet serious, complication. To review the condition, the Pubmed database was searched using the keywords "radiotherapy," "radiation," "caries," "hyposalivation," "prevention" and "management". Only studies published in the English language were selected. Cross-referencing identified additionally relevant studies. RT leads to alterations in the dentition, saliva, oral microflora, and diet of patients. Consequently, irradiated patients are at increased risk for the development of a rapid, rampant carious process known as radiation caries. Motivation of patients, adequate plaque control, stimulation of salivary flow, fluoride use, and nutritional orientation are essential to reduce the incidence of radiation caries and ultimately improve the quality of life for HNC patients. Radiation caries is an aggressive side effect of RT. Dentists play an important role in the prevention of the condition via comprehensive oral healthcare before, during, and after the active cancer therapy. Dentists should understand the clinical and biological aspects underlying radiation caries to prevent the development of lesions and provide optimal treatment when needed.

Prolonged effect of a mother-child caries preventive program on dental caries in the permanent 1st molars in 9 to 10-year-old children.

PubMed

Gomez, Santiago S; Emilson, Claes-Göran; Weber, Adriana A; Uribe, Sergio

2007-10-01

To evaluate the prevalence of caries in the permanent 1st molars of a group of 9 to 10-year-old children, and to determine the long-term effect of a mother-child preventive dental program (PDP) that started when the women were pregnant and continued until the children were 6 years of age. The permanent 1st molars of 37 children in the PDP group were evaluated for caries, both clinically and radiographically, and compared with those of a control group of 42 children who had not participated in the PDP. Of children in the PDP group, 70% were caries free compared to 33% in the control group (p<0.001). Of permanent 1st molars in the PDP group, 87% were caries-free compared to 61% in the control group (p<0.001). The mean DFS of the PDP children 10 years of age was 0.519+/-0.93 versus 1.57+/-1.38 for the control children (p=0.002). Examination of children 4 years after discontinuation of a caries preventive program reflected a long-term reduction in the DFS score of permanent 1st molars.

Can prevention eliminate caries?

PubMed

O'Mullane, D

1995-07-01

There are four main factors involved in the carious process: at-risk tooth structure, plaque flora, fermentable carbohydrates, and time. Based on our knowledge of the carious process, four main preventive strategies have been developed over the years, namely, fluorides, fissure sealing, dietary choice, and plaque control. Fluorides are having a major impact on smooth-surface caries; hence, strategies combining fluorides and fissure sealing are very effective. However, use of fissure sealing is still problematic. Changing dietary practices with a view to reducing dental caries seems to be having little impact on a global scale. Plaque control, as practiced routinely by the majority of people, is not sufficient to result in caries reductions. Deprivation and poverty are strongly associated with high caries levels. Although the preventive strategies currently available are likely to result in lower caries levels for many, for logistical reasons and because of factors associated with deprivation and poverty, caries is likely to remain a major public health problem in most communities for the foreseeable future.

The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States.

PubMed

Zero, Domenick T; Fontana, Margherita; Martínez-Mier, E Angeles; Ferreira-Zandoná, Andréa; Ando, Masatoshi; González-Cabezas, Carlos; Bayne, Stephen

2009-09-01

Scientific advances in cariology in the past 150 years have led to the understanding that dental caries is a chronic, dietomicrobial, site-specific disease caused by a shift from protective factors favoring tooth remineralization to destructive factors leading to demineralization. Epidemiologic data indicate that caries has changed in the last century; it now is distributed unequally in the U.S. population. People who are minorities, homeless, migrants, children with disabilities and of lower socioeconomic status suffer from the highest prevalence and severity of dental caries. Scientific advances have led to improvements in the prevention, diagnosis and treatment of dental caries, but there is a need for new diagnostic tools and treatment methods. and Future management of dental caries requires early detection and risk assessment if the profession is to achieve timely and cost-effective prevention and treatment for those who need it most. Dental professionals look forward to the day when people of all ages and backgrounds view dental caries as a disease of the past.

Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama

PubMed Central

Morrisey, Michael A.; Sen, Bisakha

2017-01-01

Importance There is a recommendation for children to have a dental home by 6 months of age, but there is limited evidence supporting the effectiveness of early preventive dental care or whether primary care providers (PCPs) can deliver it. Objective To investigate the effectiveness of preventive dental care in reducing caries-related treatment visits among Medicaid enrollees. Design, Setting, and Participants High-dimensional propensity scores were used to address selection bias for a retrospective cohort study of children continuously enrolled in coverage from the Alabama Medicaid Agency from birth between 2008 and 2012, adjusting for demographics, access to care, and general health service use. Exposures Children receiving preventive dental care prior to age 2 years from PCPs or dentists vs no preventive dental care. Main Outcome and Measures Two-part models estimated caries-related treatment and expenditures. Results Among 19 658 eligible children, 25.8% (n = 3658) received early preventive dental care, of whom 44% were black, 37.6% were white, and 16.3% were Hispanic. Compared with matched children without early preventive dental care, children with dentist-delivered preventive dental care more frequently had a subsequent caries-related treatment (20.6% vs 11.3%, P < .001), higher rate of visits (0.29 vs 0.15 per child-year, P < .001), and greater dental expenditures ($168 vs $87 per year, P < .001). Dentist-delivered preventive dental care was associated with an increase in the expected number of caries-related treatment visits by 0.14 per child per year (95% CI, 0.11-0.16) and caries-related treatment expenditures by $40.77 per child per year (95% CI, $30.48-$51.07). Primary care provider–delivered preventive dental care did not significantly affect caries-related treatment use or expenditures. Conclusions and Relevance Children with early preventive care visits from dentists were more likely to have subsequent dental care, including caries-related treatment, and greater expenditures than children without preventive dental care. There was no association with subsequent caries-related treatment and preventive dental care from PCPs. We observed no evidence of a benefit of early preventive dental care, regardless of the provider. Additional research beyond administrative data may be necessary to elucidate any benefits of early preventive dental care. PMID:28241184

Evaluation of an interdisciplinary preventive programme for early childhood caries: findings of a regional German birth cohort study.

PubMed

Wagner, Yvonne; Heinrich-Weltzien, Roswitha

2016-11-01

The aim of this prospective birth cohort study was to evaluate the effect of the interdisciplinary preventive programme (PP) for early childhood caries in 3-year-old children in Germany. From July 2009 to October 2010, all parents of newborns (n = 1162) were visited after birth by the communal newborn visiting service of Jena, Thuringia, and advised on general and dental health. In the first year of life, children were invited to a dental examination in Jena University Hospital. Participating children were included in a risk-related recall system with continuous oral care over 3 years. Caries-risk assessment tool of the AAPD was used for risk categorizing. High-risk children received fluoride varnish biannual. In 2013, the total birth cohort (participants and non-participants) was invited to evaluate the PP. Dental caries was scored using WHO diagnostic criteria expanded to d1-level without radiography. Data were analysed statistically (multivariate logistic regression). Seven hundred fifty-five children (mean age 3.26 ± 0.51 years) were examined. Children in the PP (n = 377) showed significantly lower caries prevalence and experience than non-participants (15.6 vs. 37.8 %, 0.9 ± 3.3 d 1-4 mfs vs. 2.6 ± 5.2 d 1-4 mfs). Lack of vitamin D supplements (OR = 1.9, CI 0.99-3.51), familial caries experience (OR = 2.2, CI 1.27-3.73) and visible plaque on teeth (OR = 6.5, CI 4.41-9.43) were significant risk factors for caries development, whereas regular dental care (OR = 0.5, CI 0.38-0.79) had a protective effect. The PP was an effective interdisciplinary approach for preventing early childhood caries in small children. Early dental visits with caries-risk-related preventive dental care are necessary to prevent early childhood caries (ECC). German Clinical Trials Register DRKS00003438, https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003438.

Cost-effectiveness model for prevention of early childhood caries.

PubMed

Ramos-Gomez, F J; Shepard, D S

1999-07-01

This study presents and illustrates a model that determines the cost-effectiveness of three successively more complete levels of preventive intervention (minimal, intermediate, and comprehensive) in treating dental caries in disadvantaged children up to 6 years of age. Using existing data on the costs of early childhood caries (ECC), the authors estimated the probable cost-effectiveness of each of the three preventive intervention levels by comparing treatment costs to prevention costs as applied to a typical low-income California child for five years. They found that, in general, prevention becomes cost-saving if at least 59 percent of carious lesions receive restorative treatment. Assuming an average restoration cost of $112 per surface, the model predicts cost savings of $66 to $73 in preventing a one-surface, carious lesion. Thus, all three levels of preventive intervention should be relatively cost-effective. Comprehensive intervention would provide the greatest oral health benefit; however, because more children would receive reparative care, overall program costs would rise even as per-child treatment costs decline.

Biological approach of dental caries management.

PubMed

Grigalauskienė, Rūta; Slabšinskienė, Eglė; Vasiliauskienė, Ingrida

2015-01-01

Dental caries is a disease induced by dental plaque, which can be described as a community of microorganisms (biofilm). Because of genetic and environmental factors a number of changes in the oral microbiome takes place; in case of commensalism and mutualism between biofilm microorganisms and the host, homeostasis in oral microbiome is maintained. However, when a risk factor occurs parasitic relationship starts prevailing and activity of the pathogenic cariogenic microorganisms increases leading to a dental caries. According to the newest technologies of molecular microbiology new cariogenic microorganisms species have been determined. Each individual's oral microbiome is as unique as his/her immune system; therefore, commonly taken caries prevention measures cannot be of the same effectiveness for all individuals. Each person has his own caries risk which is determined by the oral microbiome and immune system influenced by the environmental and genetic factors. Early caries diagnostic, risk assessment and individualized caries prevention plan will allow us to control the disease and achieve a desirable effect. For the dentist the most important thing is not to treat the consequences of the disease - cavities - but be aware of the dental caries as a biological phenomenon.

Dental Caries: A Disease Which Needs Attention.

PubMed

Mathur, Vijay Prakash; Dhillon, Jatinder Kaur

2018-03-01

Dental caries is one of the most prevalent disease (about 50%) in children across the globe. If not treated in time, it can affect not only the mastication function but also the speech, smile and psychosocial environment and the quality of life of the child and the family. The treatment of dental diseases is very expensive in all countries and prevention is very simple and effective. The caries in children below 6 y is called early childhood caries (ECC). It is most commonly caused by milk bottle or mother's feed during night. The ECC spreads very fast and can cause severe pain, abscess, swelling, fever and psychological disturbances in children. The treatment of ECC requires multiple appointments and still the prognosis is not very promising in mutilated dentitions. A physician or pediatrician can easily identify early caries and habits of parents leading to caries and can counsel them for prevention and refer them to the specialist. Good oral hygiene, dietary modification with respect to use of sugar and sticky food and healthy diet can help in preventing this disease in children. The need of the time is to appraise all on the methods of dental caries prevention.

Prevention and control of dental caries and periodontal diseases at individual and population level: consensus report of group 3 of joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.

PubMed

Jepsen, Søren; Blanco, Juan; Buchalla, Wolfgang; Carvalho, Joana C; Dietrich, Thomas; Dörfer, Christof; Eaton, Kenneth A; Figuero, Elena; Frencken, Jo E; Graziani, Filippo; Higham, Susan M; Kocher, Thomas; Maltz, Marisa; Ortiz-Vigon, Alberto; Schmoeckel, Julian; Sculean, Anton; Tenuta, Livia M A; van der Veen, Monique H; Machiulskiene, Vita

2017-03-01

The non-communicable diseases dental caries and periodontal diseases pose an enormous burden on mankind. The dental biofilm is a major biological determinant common to the development of both diseases, and they share common risk factors and social determinants, important for their prevention and control. The remit of this working group was to review the current state of knowledge on epidemiology, socio-behavioural aspects as well as plaque control with regard to dental caries and periodontal diseases. Discussions were informed by three systematic reviews on (i) the global burden of dental caries and periodontitis; (ii) socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level; and (iii) mechanical and chemical plaque control in the simultaneous management of gingivitis and dental caries. This consensus report is based on the outcomes of these systematic reviews and on expert opinion of the participants. Key findings included the following: (i) prevalence and experience of dental caries has decreased in many regions in all age groups over the last three decades; however, not all societal groups have benefitted equally from this decline; (ii) although some studies have indicated a possible decline in periodontitis prevalence, there is insufficient evidence to conclude that prevalence has changed over recent decades; (iii) because of global population growth and increased tooth retention, the number of people affected by dental caries and periodontitis has grown substantially, increasing the total burden of these diseases globally (by 37% for untreated caries and by 67% for severe periodontitis) as estimated between 1990 and 2013, with high global economic impact; (iv) there is robust evidence for an association of low socio-economic status with a higher risk of having dental caries/caries experience and also with higher prevalence of periodontitis; (v) the most important behavioural factor, affecting both dental caries and periodontal diseases, is routinely performed oral hygiene with fluoride; (vi) population-based interventions address behavioural factors to control dental caries and periodontitis through legislation (antismoking, reduced sugar content in foods and drinks), restrictions (taxes on sugar and tobacco) guidelines and campaigns; however, their efficacy remains to be evaluated; (vii) psychological approaches aimed at changing behaviour may improve the effectiveness of oral health education; (viii) different preventive strategies have proven to be effective during the course of life; (ix) management of both dental caries and gingivitis relies heavily on efficient self-performed oral hygiene, that is toothbrushing with a fluoride-containing toothpaste and interdental cleaning; (x) professional tooth cleaning, oral hygiene instruction and motivation, dietary advice and fluoride application are effective in managing dental caries and gingivitis. The prevention and control of dental caries and periodontal diseases and the prevention of ultimate tooth loss is a lifelong commitment employing population- and individual-based interventions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A prospective study of a caries prevention program in pregnant women and their children five and six years of age.

PubMed

Gomez, S S; Weber, A A; Emilson, C G

2001-01-01

A preventive dental program (PDP) instituted in pregnant women and comprising an educational and a preventive part was evaluated when their children were five and six years of age. Dental caries was examined in sixty-seven mother-child pairs belonging to the program and in sixty-nine control mother-child pairs. In the five-year-old children 87 percent of the PDP group were caries free compared with the 50 percent in the control group. Comparable figures for six-year-old children were 89 percent and 62 percent in the PDP and control group, respectively. The mean dft of the PDP children five and six years of age was 0.4 and 0.2, respectively, versus 1.3 and 1.4 for the control children. The differences in caries-free status and caries prevalence were statistically significant. In conclusion, the preventive dental program which started in pregnant women and continued in the mothers and their children were highly effective for a long-term reduction of dental caries.

The FiCTION dental trial protocol – filling children’s teeth: indicated or not?

PubMed Central

2013-01-01

Background There is a lack of evidence for effective management of dental caries (decay) in children’s primary (baby) teeth and an apparent failure of conventional dental restorations (fillings) to prevent dental pain and infection for UK children in Primary Care. UK dental schools’ teaching has been based on British Society of Paediatric Dentistry guidance which recommends that caries in primary teeth should be removed and a restoration placed. However, the evidence base for this is limited in volume and quality, and comes from studies conducted in either secondary care or specialist practices. Restorations provided in specialist environments can be effective but the generalisability of this evidence to Primary Care has been questioned. The FiCTION trial addresses the Health Technology Assessment (HTA) Programme’s commissioning brief and research question “What is the clinical and cost effectiveness of restoration caries in primary teeth, compared to no treatment?” It compares conventional restorations with an intermediate treatment strategy based on the biological (sealing-in) management of caries and with no restorations. Methods/Design This is a Primary Care-based multi-centre, three-arm, parallel group, patient-randomised controlled trial. Practitioners are recruiting 1461 children, (3–7 years) with at least one primary molar tooth where caries extends into dentine. Children are randomized and treated according to one of three treatment approaches; conventional caries management with best practice prevention, biological management of caries with best practice prevention or best practice prevention alone. Baseline measures and outcome data (at review/treatment during three year follow-up) are assessed through direct reporting, clinical examination including blinded radiograph assessment, and child/parent questionnaires. The primary outcome measure is the incidence of either pain or infection related to dental caries. Secondary outcomes are; incidence of caries in primary and permanent teeth, patient quality of life, cost-effectiveness, acceptability of treatment strategies to patients and parents and their experiences, and dentists’ preferences. Discussion FiCTION will provide evidence for the most clinically-effective and cost-effective approach to managing caries in children’s primary teeth in Primary Care. This will support general dental practitioners in treatment decision making for child patients to minimize pain and infection in primary teeth. The trial is currently recruiting patients. Trial registration Protocol ID: NCTU: ISRCTN77044005 PMID:23725316

The FiCTION dental trial protocol - filling children's teeth: indicated or not?

PubMed

Innes, Nicola P T; Clarkson, Jan E; Speed, Chris; Douglas, Gail V A; Maguire, Anne

2013-06-01

There is a lack of evidence for effective management of dental caries (decay) in children's primary (baby) teeth and an apparent failure of conventional dental restorations (fillings) to prevent dental pain and infection for UK children in Primary Care. UK dental schools' teaching has been based on British Society of Paediatric Dentistry guidance which recommends that caries in primary teeth should be removed and a restoration placed. However, the evidence base for this is limited in volume and quality, and comes from studies conducted in either secondary care or specialist practices. Restorations provided in specialist environments can be effective but the generalisability of this evidence to Primary Care has been questioned. The FiCTION trial addresses the Health Technology Assessment (HTA) Programme’s commissioning brief and research question “What is the clinical and cost effectiveness of restoration caries in primary teeth, compared to no treatment?” It compares conventional restorations with an intermediate treatment strategy based on the biological (sealing-in) management of caries and with no restorations. This is a Primary Care-based multi-centre, three-arm, parallel group, patient-randomised controlled trial. Practitioners are recruiting 1461 children, (3-7 years) with at least one primary molar tooth where caries extends into dentine. Children are randomized and treated according to one of three treatment approaches; conventional caries management with best practice prevention, biological management of caries with best practice prevention or best practice prevention alone. Baseline measures and outcome data (at review/treatment during three year follow-up) are assessed through direct reporting, clinical examination including blinded radiograph assessment, and child/parent questionnaires. The primary outcome measure is the incidence of either pain or infection related to dental caries. Secondary outcomes are; incidence of caries in primary and permanent teeth, patient quality of life, cost-effectiveness, acceptability of treatment strategies to patients and parents and their experiences, and dentists’ preferences. FiCTION will provide evidence for the most clinically-effective and cost-effective approach to managing caries in children's primary teeth in Primary Care. This will support general dental practitioners in treatment decision making for child patients to minimize pain and infection in primary teeth. The trial is currently recruiting patients. Protocol ID: NCTU: ISRCTN77044005.

Pediatric Dental Care: Prevention and Management Protocols Based on Caries Risk Assessment

PubMed Central

RAMOS-GOMEZ, FRANCISCO J.; CRYSTAL, YASMI O.; NG, MAN WAI; CRALL, JAMES J.; FEATHERSTONE, JOHN D.B.

2012-01-01

Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model.1–3 This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment, CAMBRA, in an effort to stimulate greater adoption of infant oral care programs among clinicians and early establishment of dental homes for young children. PMID:21162350

A systematic map of systematic reviews in pediatric dentistry--what do we really know?

PubMed

Mejàre, Ingegerd A; Klingberg, Gunilla; Mowafi, Frida K; Stecksén-Blicks, Christina; Twetman, Svante H A; Tranæus, Sofia H

2015-01-01

To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry.

A Systematic Map of Systematic Reviews in Pediatric Dentistry—What Do We Really Know?

PubMed Central

Mejàre, Ingegerd A.; Klingberg, Gunilla; Mowafi, Frida K.; Stecksén-Blicks, Christina; Twetman, Svante H. A.; Tranæus, Sofia H.

2015-01-01

Objectives To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. Methods A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. Results Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. Conclusion There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry. PMID:25706629

Use of caries-preventive agents in children: findings from the dental practice-based research network.

PubMed

Riley, J L; Richman, Joshua S; Rindal, D Brad; Fellows, Jeffrey L; Qvist, Vibeke; Gilbert, Gregg H; Gordan, Valeria V

2010-01-01

Scientific evidence supports the application of caries-preventive agents in children and adolescents, and this knowledge must be applied to the practice of dentistry. There are few multi-region data that allow for comparisons of practice patterns between types of dental practices and geographical regions. The objective of the present study was to characterise the use of specific caries-preventive agents for paediatric patients in a large multi-region sample of practising clinicians. The present study surveyed clinicians from the Dental Practice-based Research Network who perform restorative dentistry in their practices. The survey consisted of a questionnaire that presented a range of questions about caries risk assessment and the use of preventive techniques in children aged 6 to 18 years. Dental sealants (69%) or in-office fluoride (82%) were the most commonly used caries-preventive agents of the caries preventive regimens. The recommendation of at-home caries-preventive agents ranged from 36% to 7%,with the most commonly used agent being non-prescription fluoride rinse. Clinicians who practised in a large group practice model and clinicians who come from the Scandinavian region use caries risk assessment more frequently compared to clinicians who come from regions that had, predominantly, clinicians in private practice. Whether or not clinicians used caries risk assessment with their paediatric patients was poorly correlated with the likelihood of actually using caries-preventive treatments on patients. Although clinicians reported the use of some form of in-office caries-preventive agent, there was considerable variability across practices. These differences could represent a lack of consensus across practising clinicians about the benefits of caries-preventive agents, or a function of differing financial incentives, or patient pools with differing levels of overall caries risk.

Concepts of dental caries and their consequences for understanding the disease.

PubMed

Fejerskov, O

1997-02-01

The way in which we conceptually consider dental caries determines our choice of preventive and treatment strategy. In this paper the definition of dental caries is discussed and the related problems concerning causality are addressed. Dental caries reflects symptoms of ongoing and past disease--not the disease itself. As such, it is important to record early stages of signs of the disease, i.e. non-cavitated stages of lesion development. The dynamic nature of the processes leading to net loss of mineral (hence a lesion) is emphasized, and appreciating that caries is ubiquitous in populations around the world and initiation and progression of lesions continues lifelong leads to the logical conclusion that we can control dental caries through a variety of measures--but not truly prevent the disease. We can prevent cavities by controlling the patho-physiological events which may result in a net loss of mineral. The relative role of dental plaque in caries control is discussed in relation to the role of the many determinants which influence the likelihood for lesion development. It is concluded that several paradigms about the nature of dental caries should be reconsidered to provide the most cost-effective dental services.

Cost-effectiveness of preventing dental caries and full mouth dental reconstructions among Alaska Native children in the Yukon–Kuskokwim delta region of Alaska

PubMed Central

Atkins, Charisma Y.; Thomas, Timothy K.; Lenaker, Dane; Day, Gretchen M.; Hennessy, Thomas W.; Meltzer, Martin I.

2016-01-01

Objective We conducted a cost-effectiveness analysis of five specific dental interventions to help guide resource allocation. Methods We developed a spreadsheet-based tool, from the healthcare payer perspective, to evaluate the cost effectiveness of specific dental interventions that are currently used among Alaska Native children (6-60 months). Interventions included: water fluoridation, dental sealants, fluoride varnish, tooth brushing with fluoride toothpaste, and conducting initial dental exams on children <18 months of age. We calculated the cost-effectiveness ratio of implementing the proposed interventions to reduce the number of carious teeth and full mouth dental reconstructions (FMDRs) over 10 years. Results A total of 322 children received caries treatments completed by a dental provider in the dental chair, while 161 children received FMDRs completed by a dental surgeon in an operating room. The average cost of treating dental caries in the dental chair was $1,467 (~258,000 per year); while the cost of treating FMDRs was $9,349 (~1.5 million per year). All interventions were shown to prevent caries and FMDRs; however tooth brushing prevented the greatest number of caries at minimum and maximum effectiveness with 1,433 and 1,910, respectively. Tooth brushing also prevented the greatest number of FMDRs (159 and 211) at minimum and maximum effectiveness. Conclusions All of the dental interventions evaluated were shown to produce cost savings. However, the level of that cost saving is dependent on the intervention chosen. PMID:26990678

Fluoride toothpastes for preventing dental caries in children and adolescents.

PubMed

Marinho, V C; Higgins, J P; Sheiham, A; Logan, S

2003-01-01

Fluoride toothpastes have been widely used for over three decades and remain a benchmark intervention for the prevention of dental caries. To determine the effectiveness and safety of fluoride toothpastes in the prevention of caries in children and to examine factors potentially modifying their effect. We searched the Cochrane Oral Health Group's Trials Register (May 2000), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2000), MEDLINE (1966 to January 2000), plus several other databases. We handsearched journals, reference lists of articles and contacted selected authors and manufacturers. Randomized or quasi-randomized controlled trials with blind outcome assessment, comparing fluoride toothpaste with placebo in children up to 16 years during at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (D(M)FS). Inclusion decisions, quality assessment and data extraction were duplicated in a random sample of one third of studies, and consensus achieved by discussion or a third party. Authors were contacted for missing data. The primary measure of effect was the prevented fraction (PF) that is the difference in caries increments between the treatment and control groups expressed as a percentage of the increment in the control group. Random effects meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random effects meta-regression analyses. Seventy-four studies were included. For the 70 that contributed data for meta-analysis (involving 42,300 children) the D(M)FS pooled PF was 24% (95% confidence interval (CI), 21 to 28%; p<0.0001). This means that 1.6 children need to brush with a fluoride toothpaste (rather than a non-fluoride toothpaste) over three years to prevent one D(M)FS in populations with caries increment of 2.6 D(M)FS per year. In populations with caries increment of 1.1 D(M)FS per year, 3.7 children will need to use a fluoride toothpaste for three years to avoid one D(M)FS. There was clear heterogeneity, confirmed statistically (p<0.0001). The effect of fluoride toothpaste increased with higher baseline levels of D(M)FS, higher fluoride concentration, higher frequency of use, and supervised brushing, but was not influenced by exposure to water fluoridation. There is little information concerning the deciduous dentition or adverse effects (fluorosis). Supported by more than half a century of research, the benefits of fluoride toothpastes are firmly established. Taken together, the trials are of relatively high quality, and provide clear evidence that fluoride toothpastes are efficacious in preventing caries.

Effect of supervised brushing with fluoride gel during primary school, taking into account the group prevention schedule in kindergarten.

PubMed

Winter, Julia; Jablonski-Momeni, Anahita; Ladda, Annett; Pieper, Klaus

2017-07-01

In one region of Germany, a group of children took part in regular fluoride gel applications during primary school following intensified prevention in kindergarten. This observational study aimed to ascertain whether the dental health of primary school children can be improved by introducing a group prevention program based on applications of fluoride gel. The subjects were distributed among six groups with varying preventive measures in kindergarten and at school. The basis for determining caries experience and calculating the caries increment consisted of dental findings gathered in the second and fourth grade. While second graders without professionally supported daily toothbrushing in kindergarten exhibited an average d 3 -6 mft of 2.17, in those who had enjoyed intensive dental prevention, the corresponding value was 19% lower (d 3-6 mft = 1.74). The caries increment was significantly lower mainly among children who had received the maximum of group prevention (intensive prevention in kindergarten and gel program at school). The results show that intensified preventive programs in kindergartens and schools, based mainly on supervised toothbrushing, have a positive effect on the dental health of primary school children. Such programs are efficient in reducing caries experience especially in socially deprived areas.

Periodic health examination, 1995 update: 2. Prevention of dental caries. The Canadian Task Force on the Periodic Health Examination.

PubMed Central

Lewis, D W; Ismail, A I

1995-01-01

OBJECTIVE: To make recommendations, based on current evidence, for practising physicians and dentists on interventions for the prevention of dental caries in their patients. OPTIONS: Systemic fluoride administration, professionally administered fluoride, use of fluoride mouth rinses, fissure sealants, oral-hygiene practices, dietary practices, identification of groups at a high risk of dental caries, and early diagnosis and treatment. OUTCOMES: Reduced prevalence of dental caries and fluorosis, longer retention of teeth and lower treatment costs. EVIDENCE: Several MEDLINE searches were conducted for articles published from January 1980 to December 1992, including relevant review articles. VALUES: Relevant clinical findings were evaluated and categorized with the use of the evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination. Recommendations were developed for each method of caries prevention, with reduced incidence of dental caries and improved prevalence of caries-free teeth given high values. BENEFITS, HARMS AND COSTS: The potential benefits of these measures in the long-term are a lower incidence of tooth decay, longer retention of teeth and prevention of fluorosis. The cost saving can be considerable for patients and insurers; however, implementation of some recommendations will be difficult, since the traditional preventive practices of dentists and dental hygienists are not easily changed. RECOMMENDATIONS: There is good evidence that the following manoeuvres are effective in preventing dental caries: use of dentifrices containing fluoride, fluoridation of drinking water, fluoride supplements for patients in areas where there is a low level (0.3 ppm or less) of fluoride in the drinking water, professionally applied topical fluoride and the use of fluoride mouth rinses for patients with very active decay or at a high risk of dental caries and selective use of professionally applied fissure sealants on permanent molar teeth. There is poor evidence that the following manoeuvres are effective in preventing dental caries: professionally applied topical fluoride and the use of fluoride mouth rinses for patients with a low risk of caries, toothbrushing (without a dentifrice containing fluoride) and flossing, cleaning of teeth by a dentist or dental hygienist before topical application of fluoride or at a dental visit and dietary counselling for the general population. There is good evidence to recommend against the use of over-the-counter fluoride mouth rinses by the general population. VALIDATION: These guidelines are compatible with those of the US Preventive Services Task Force. SPONSOR: These guidelines were developed and endorsed by the task force, which is funded by Health Canada. Major funding was provided by the Faculty of Dentistry of the University of Toronto, Toronto and the Faculty of Dentistry of Dalhousie University, Halifax. PMID:7697577

Effect of risk-based payment model on caries inequalities in preschool children assessed by geo-mapping.

PubMed

Holmén, Anders; Strömberg, Ulf; Håkansson, Gunnel; Twetman, Svante

2018-01-05

To describe, with aid of geo-mapping, the effects of a risk-based capitation model linked to caries-preventive guidelines on the polarization of caries in preschool children living in the Halland region of Sweden. The new capitation model was implemented in 2013 in which more money was allocated to Public Dental Clinics surrounded by administrative parishes inhabited by children with increased caries risk, while a reduced capitation was allocated to those clinics with a low burden of high risk children. Regional geo-maps of caries risk based on caries prevalence, level of education and the families purchasing power were produced for 3-6-year-old children in 2010 (n = 10,583) and 2016 (n = 7574). Newly migrated children to the region (n = 344 in 2010 and n = 522 in 2016) were analyzed separately. A regional caries polarization index was calculated as the ratio between the maximum and minimum estimates of caries frequency on parish-level, based on a Bayesian hierarchical mapping model. Overall, the total caries prevalence (dmfs > 0) remained unchanged from 2010 (10.6%) to 2016 (10.5%). However, the polarization index decreased from 7.0 in 2010 to 5.6 in 2016. Newly arrived children born outside Sweden had around four times higher caries prevalence than their Swedish-born peers. A risk-based capitation model could reduce the socio-economic inequalities in dental caries among preschool children living in Sweden. Although updated evidence-based caries-preventive guidelines were released, the total prevalence of caries on dentin surface level was unaffected 4 years after the implementation.

Caries preventive efficacy of silver diammine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines.

PubMed

Monse, Bella; Heinrich-Weltzien, Roswitha; Mulder, Jan; Holmgren, Christopher; van Palenstein Helderman, Wim H

2012-11-21

Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to caries.The objective of the study was to assess and compare the effect of a single application of 38% SDF with ART sealants and no treatment in preventing dentinal (D3) caries lesions on occlusal surfaces of permanent first molars of school children who participated in a daily school-based toothbrushing program with fluoride toothpaste. The prospective community clinical trial in the Philippines was conducted over a period of 18 months and included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based fluoride toothpaste brushing program. Children were randomly assigned for SDF application or ART sealant treatment. Children from two of the eight schools did not receive SDF or ART sealant treatment and served as controls. SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars. Surfaces that were originally defined as sound at baseline but which changed to dentinal (D3) caries lesions were defined as surfaces with new caries (caries increment). Non-compliance to the daily toothbrushing program in three schools offered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste brushing and in non-toothbrushing children. In the brushing group, caries increment in the SDF treatment group was comparable with the non-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a statistically significant lower hazard ratio of 0.12 (0.02-0.61). In the non-brushing group, caries increment in the SDF treatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only statistically significant for the sealant group (HR 0.33; 0.20-0.54). Caries increment was lower in toothbrushing children than in non-toothbrushing children. Hazard ratios reached statistical significance for the non-treated children (HR 0.43; 0.21-0.87) and the sealant-treated children (HR 0.15; 0.03-0.072). A one-time application of 38% SDF on the occlusal surfaces of permanent first molars of six- to eight-year-old children is not an effective method to prevent dentinal (D3) caries lesions. ART sealants significantly reduced the onset of caries over a period of 18 months. German Clinical Trial Register DRKS00003427.

Caries preventive efficacy of silver diammine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines

PubMed Central

2012-01-01

Background Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to caries. The objective of the study was to assess and compare the effect of a single application of 38% SDF with ART sealants and no treatment in preventing dentinal (D3) caries lesions on occlusal surfaces of permanent first molars of school children who participated in a daily school-based toothbrushing program with fluoride toothpaste. Methods The prospective community clinical trial in the Philippines was conducted over a period of 18 months and included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based fluoride toothpaste brushing program. Children were randomly assigned for SDF application or ART sealant treatment. Children from two of the eight schools did not receive SDF or ART sealant treatment and served as controls. SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars. Surfaces that were originally defined as sound at baseline but which changed to dentinal (D3) caries lesions were defined as surfaces with new caries (caries increment). Non-compliance to the daily toothbrushing program in three schools offered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste brushing and in non-toothbrushing children. Results In the brushing group, caries increment in the SDF treatment group was comparable with the non-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a statistically significant lower hazard ratio of 0.12 (0.02-0.61). In the non-brushing group, caries increment in the SDF treatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only statistically significant for the sealant group (HR 0.33; 0.20-0.54). Caries increment was lower in toothbrushing children than in non-toothbrushing children. Hazard ratios reached statistical significance for the non-treated children (HR 0.43; 0.21-0.87) and the sealant-treated children (HR 0.15; 0.03-0.072). Conclusions A one-time application of 38% SDF on the occlusal surfaces of permanent first molars of six- to eight-year-old children is not an effective method to prevent dentinal (D3) caries lesions. ART sealants significantly reduced the onset of caries over a period of 18 months. Trial registration number German Clinical Trial Register DRKS00003427 PMID:23171244

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial.

PubMed

Agouropoulos, A; Twetman, S; Pandis, N; Kavvadia, K; Papagiannoulis, L

2014-10-01

To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000ppm fluoride toothpaste. 424 preschool children, 2-5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity. The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p=0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments. Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000ppm fluoride toothpaste. In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000ppm fluoride toothpaste is used daily. Copyright © 2014 Elsevier Ltd. All rights reserved.

Relative effects of pre- and posteruption water fluoride on caries experience of permanent first molars.

PubMed

Singh, K A; Spencer, A John; Armfield, J M

2003-01-01

Previous studies have attributed the caries-preventive effects of preeruption (PRE) and posteruption (POST) exposure to fluoridated water based on data collected before and after the commencement or discontinuation of water fluoridation. This study aims to determine the relative pre- and posteruption exposure effects of fluoridated water on caries experience of 6-15-year-old Australian children based on individual residential histories. Parental questionnaires covering residential history of participants were linked to their oral examinations conducted between June 1991 and May 1992 by the School Dental Services of South Australia and Queensland. Percentage of lifetime exposed to optimally fluoridated water PRE and POST was calculated with respect to the eruption age for first permanent molars. Combined pre- and posteruption categories were created to test PRE against POST exposure: PRE & POST = 0, PRE < POST, PRE = POST in the range 0-90 percent of lifetime exposure, PRE > POST, and PRE & POST > or = 90 percent lifetime exposure. These categories were used as indicator variables with PRE and POST = 0 as reference in an analysis of first permanent molar DMFS scores. The linear regression model controlled for important potential confounders. Participation rates were 69.7 percent in South Australia and 55.6 percent in Queensland with 9,690 and 10,195 participants, respectively. Pre- and posteruption exposures were strongly correlated (r =. 74; P < .01). Compared to the reference, the categories PRE > POST, PRE = POSTin the range 0-90 percent, and PRE and POST > or = 90 percent showed significantly lower caries levels. The findings indicated that preeruption exposure was required for a caries-preventive effect and that exposure after eruption alone did not lower caries levels significantly. However, the maximum caries-preventive effects of fluoridated water were achieved by high pre- and posteruption exposure.

Successes and drawbacks in the caries-preventive use of fluorides--lessons to be learnt from history.

PubMed

Marthaler, T M

2003-01-01

Water fluoridation was the first breakthrough in the practice of preventive cariology on a community level and has remained one of the cornerstones of prevention in dentistry. The concepts regarding the mechanisms of the caries-inhibitory effect, however, have changed in several respects. Today there is general agreement that topical effects on the erupted enamel are most important. The contention that there is no pre-eruptive effect whatsoever has created confusion; there is in fact evidence for a minor pre-eruptive protective effect. Around 1980 many experts believed that fluorides should not be used in high concentrations, for instance above those in dentifrices, because this could block remineralisation in the body of pre-cavity lesions. However, it is now known that such undesirable effects are negligible or non-existent. In the fifties and sixties, fluoride tablets were widely used in Europe and helped to make the concept of caries prevention popular. From 1980 onwards, fluoride dentifrices were found to have a much greater impact and were recognized as being able to lead to a decline of caries prevalence in entire countries, and fluoride tablets gradually lost their importance. Antifluoridationists were unable to delay or hinder the widespread use of fluoride toothpastes but in many cases have successfully opposed public health measures such as fluoridation of water or of salt. The spread of these methods, beneficial for all social strata, might have been more rapid if some of the experts had not propounded the erroneous supposition that fluoride dentifrice will be sufficient for caries prevention. Sale of fluoridated salt has been authorized in several countries on a nationwide scale. However, only Latin American countries have introduced salt fluoridation for entire populations. In Central and Eastern Europe where caries prevalence continues to be high and where the level of usage of topical fluorides including dentifrices will presumably remain at a low level for many years, salt fluoridation would be beneficial.

A randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services: the Northern Ireland Caries Prevention In Practice (NIC-PIP) trial.

PubMed

Tickle, Martin; O'Neill, Ciaran; Donaldson, Michael; Birch, Stephen; Noble, Solveig; Killough, Seamus; Murphy, Lynn; Greer, Margaret; Brodison, Julie; Verghis, Rejina; Worthington, Helen V

2016-09-01

Dental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established. To measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services. The study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1. Randomisation was by clinical trials unit, using randomised permuted blocks. Children/families were not blinded; however, outcome assessment was blinded to group assessment. The study took place in 22 NHS dental practices in Northern Ireland, UK. The study participants were children aged 2-3 years, who were caries free at baseline. The intervention was composite in nature, comprising a varnish containing 22,600 parts per million (p.p.m.) fluoride, a toothbrush and a 50-ml tube of toothpaste containing 1450 p.p.m. fluoride; plus standardised, evidence-based prevention advice provided at 6-monthly intervals over 3 years. The control group received the prevention advice alone. The primary outcome measure was conversion from caries-free to caries-active states. Secondary outcome measures were the number of decayed, missing or filled tooth surfaces in primary dentition (dmfs) in caries-active children, the number of episodes of pain, the number of extracted teeth and the costs of care. Adverse reactions (ARs) were recorded. A total of 1248 children (624 randomised to each group) were recruited and 1096 (549 in the intervention group and 547 in the control group) were included in the final analyses. A total of 87% of the intervention children and 85% of control children attended every 6-month visit (p = 0.77). In total, 187 (34%) children in the intervention group converted to caries active, compared with 213 (39%) in the control group [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.64 to 1.04; p = 0.11]. The mean number of tooth surfaces affected by caries was 7.2 in the intervention group, compared with 9.6 in the control group (p = 0.007). There was no significant difference in the number of episodes of pain between groups (p = 0.81). However, 164 out of the total of 400 (41%) children who converted to caries active reported toothache, compared with 62 out of 696 (9%) caries-free children (OR 7.1 95% CI 5.1 to 9.9; p < 0.001). There was no statistically significant difference in the number of teeth extracted in caries-active children (p = 0.95). Ten children in the intervention group had ARs of a minor nature. The average direct dental care cost was £155.74 for the intervention group and £48.21 for the control group over 3 years (p < 0.05). The mean cost per carious surface avoided over the 3 years was estimated at £251.00. The usual limitations of a trial such as generalisability and understanding the underlying reasons for the outcomes apply. There is no mean willingness-to-pay threshold available to enable assessment of value for money. A statistically significant effect could not be demonstrated for the primary outcome. Once caries develop, pain is likely. There was a statistically significant difference in dmfs in caries-active children in favour of the intervention. Although adequately powered, the effect size of the intervention was small and of questionable clinical and economic benefit. Future work should assess the caries prevention effects of interventions to reduce sugar consumption at the population and individual levels. Interventions designed to arrest the disease once it is established need to be developed and tested in practice. Current Controlled Trials ISRCTN36180119 and EudraCT 2009-010725-39. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 71. See the NIHR Journals Library website for further project information.

Absence of Fluoride Varnish–Related Adverse Events in Caries Prevention Trials in Young Children, United States

PubMed Central

Gregorich, Steven E.; Ramos-Gomez, Francisco; Braun, Patricia A.; Wilson, Anne; Albino, Judith; Tiwari, Tamanna; Harper, Maya; Batliner, Terrence S.; Rasmussen, Margaret; Cheng, Nancy F.; Santo, William; Geltman, Paul L.; Henshaw, Michelle; Gansky, Stuart A.

2017-01-01

Introduction Fluoride varnish is an effective prevention intervention for caries in young children. Its routine use in clinical care is supported by meta-analyses and recommended by clinical guidelines, including the US Preventive Services Task Force (B rating). This report is the first prospective systematic assessment of adverse events related to fluoride varnish treatment in young children. Methods We determined the incidence of adverse events related to fluoride varnish treatment in 3 clinical trials on the prevention of early childhood caries, conducted under the auspices of the Early Childhood Caries Collaborating Centers, an initiative sponsored by the National Institute of Dental and Craniofacial Research. Each trial incorporated use of fluoride varnish in its protocol and systematically queried all children’s parents or legal guardians about the occurrence of acute adverse events after each fluoride varnish treatment. Results A total of 2,424 community-dwelling, dentate children aged 0 to 5 years were enrolled and followed for up to 3 years. These children received a cumulative total of 10,249 fluoride varnish treatments. On average, each child received 4.2 fluoride varnish treatments. We found zero fluoride varnish–related adverse events. Conclusion Fluoride varnish was not associated with treatment-related adverse events in young children. Our findings support its safety as an effective prevention intervention for caries in young children. PMID:28207379

Clinical Evidence for Polyol Efficacy

PubMed Central

Milgrom, P.; Söderling, E.M.; Nelson, S.; Chi, D.L.; Nakai, Y.

2012-01-01

Xylitol is a safe dental caries preventive when incorporated into chewing gum or confections used habitually. The goal of this paper is to identify and assess the work on xylitol and other polyols and dental caries since 2008. Xylitol is effective when used by the mother prenatally or after delivery to prevent mutans transmission and subsequent dental caries in the offspring. One new completed trial confirmed that children of mothers who used xylitol lozenges after delivery had less dental caries than a comparison group. A similar study confirmed that the use of xylitol gum by the mother either prevented or postponed MS transmission to the offspring. Xylitol use among schoolchildren delivered via a gummy bear confection reduced S. mutans levels, but a once per day use of xylitol-containing toothpaste did not. Randomized trials, with caries outcomes, assessing xylitol-containing lozenges in adults and xylitol-containing gummy bears in children will release results in the coming year. Other studies are ongoing but are not systematic and will fail to answer important questions about how xylitol, or other polyols, can address the global dental caries problem. PMID:22899692

The Effect of Silver Diamine Fluoride in Preventing Caries in the Primary Dentition: A Systematic Review and Meta-Analysis.

PubMed

Oliveira, Branca Heloisa; Rajendra, Anjana; Veitz-Keenan, Analia; Niederman, Richard

2018-06-06

To investigate whether silver diamine fluoride (SDF) is effective in preventing new caries lesions in primary teeth when compared to placebo or active treatments. Systematic review (CRD42016036963) of controlled clinical trials. Searches were performed in 9 electronic databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two researchers carried out data extraction and quality appraisal independently. The primary outcome was the difference in caries increment (decayed, missing, and filled surfaces or teeth - dmfs or dmft) between SDF and control groups. These differences were pooled as weighted mean differences (WMD) and prevented fractions (PF). Searches yielded 2,366 unique records; 6 reports of 4 trials that randomized 1,118 and analyzed 915 participants were included. Two trials compared SDF to no treatment, 1 compared SDF to placebo and sodium fluoride varnish (FV), and 1 compared SDF to high-viscosity glass ionomer cement (GIC). All studies had at least 1 domain with unclear or high risk of bias. After 24 months of follow-up, in comparison to placebo, no treatment, and FV, SDF applications significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD = -1.15, PF = 77.5%; FV: WMD = -0.43, PF = 54.0%). GIC was more effective than SDF after 12 months of follow-up but the difference between them was not statistically significant (WMD, dmft: 0.34, PF: -6.09%). When applied to caries lesions in primary teeth, SDF compared to no treatment, placebo or FV appears to effectively prevent dental caries in the entire dentition. However, trials specifically designed to assess this outcome are needed. © 2018 S. Karger AG, Basel.

WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME?

PubMed

Afuakwah, Charles; Welbury, Richard

2015-11-01

Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.

Minimal intervention dentistry: part 3. Paediatric dental care--prevention and management protocols using caries risk assessment for infants and young children.

PubMed

Ramos-Gomez, F J; Crystal, Y O; Domejean, S; Featherstone, J D B

2012-11-01

Recent increases in caries prevalence in young children throughout the world highlight the need for a simple but effective infant oral care programme. This programme needs to include a medical disease prevention management model with an early establishment of a dental home and a treatment approach based on individual patient risk. This article presents an updated approach with practical forms and tools based on the principles of caries management by risk assessment, CAMBRA. This method will aid the general practitioner to develop and maintain a comprehensive protocol adequate for infant and young children oral care visits. Perinatal oral health is vitally important in preventing early childhood caries (ECC) in young children. Providing dental treatment to expectant mothers and their young children in a 'dual parallel track' is an effective innovative strategy and an efficient practice builder. It promotes prevention rather than intervention, and this may be the best way to achieve long-lasting oral health for young patients. General dental practice can adopt easy protocols that will promote early preventive visits and anticipatory guidance/counselling rather than waiting for the need for restorative treatment.

The Superior Anti-caries Efficacy of Fluoride Toothpaste Containing 1.5% Arginine.

PubMed

Cummins, D

2016-06-01

Innovation in the dental caries area and the development of new superior efficacy treatments to prevent dental caries are as important today as they have ever been, because caries remains a highly prevalent disease globally. Appropriately designed and well-conducted, randomized clinical trials (RCTs) are best-in-class evidence of the effectiveness of a new intervention in medicine and dentistry, and traditional two- to threeyear caries clinical trials are currently the gold standard for proof of superior caries prevention efficacy. Based upon a detailed understanding of plaque metabolism and the importance of pH rise factors in the prevention of caries, a novel toothpaste containing 1.5% arginine, an insoluble calcium compound, and fluoride has been developed, and its superior efficacy compared to toothpaste with fluoride alone has been validated in an unprecedented series of ten RCTs. The results of these RCTs are summarized, and some of the details of the procedures used in the studies are clarified in order to provide an opportunity for objective assessment of their quality. In addition, the results of studies which explored the mechanism of action of this toothpaste are summarized. The arginine-containing fluoride toothpaste offers its users the opportunity to supplement mechanical plaque control with a new technology that helps maintain the natural oral flora in a state that is compatible with health, so as to retain the beneficial effects of the natural flora while significantly reducing the risk of dental caries compared to conventional fluoride toothpaste. Copyright© by the YES Group, Inc.

The development and validation of a new technology, based upon 1.5% arginine, an insoluble calcium compound and fluoride, for everyday use in the prevention and treatment of dental caries.

PubMed

Cummins, D

2013-08-01

This paper briefly discusses caries prevalence, the multi-factorial nature of caries etiology, caries risk and the role and efficacy of fluoride. The paper also highlights research on bacterial metabolism which provided understanding of the mouth's natural defenses against caries and the basis for the development of a new technology for the everyday prevention and treatment of caries. Finally, evidence that the technology complements and enhances the anti-caries efficacy of fluoride toothpaste is summarized. Global data show that dental caries is a prevalent disease, despite the successful introduction of fluoride. Caries experience depends on the balance between consumption of sugars and oral hygiene and the use of fluoride. Three scientific concepts are fundamental to new measures to detect, treat and monitor caries: (1) dental caries is a dynamic process, (2) dental caries is a continuum of stages from reversible, pre-clinical to irreversible, clinically detectable lesions, and (3) the caries process is a balance of pathological and protective factors that can be modulated to manage caries. Fluoride functions as a protective factor by arresting and reversing the caries process, but fluoride does not prevent pathological factors that initiate the process. A novel technology, based upon arginine and an insoluble calcium compound, has been identified which targets dental plaque to prevent initiation of the caries process by reducing pathological factors. As the mechanisms of action of arginine and fluoride are highly complementary, a new dentifrice, which combines arginine with fluoride, has been developed and clinically proven to provide superior caries prevention. Copyright © 2013 Elsevier Ltd. All rights reserved.

Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study.

PubMed

Chaffee, Benjamin W; Cheng, Jing; Featherstone, John D B

2015-09-24

Consensus guidelines support non-operative preventives for dental caries management; yet, their use in practice is far from universal. The purpose of this study was to evaluate the effectiveness of non-operative anti-caries agents in caries prevention among high caries risk adults at a university clinic where risk-based caries management is emphasized. This retrospective observational study drew data from the electronic patient records of non-edentulous adult patients deemed to be at high risk for dental caries during baseline oral evaluations that were completed between July 1, 2007 and December 31, 2012 at a dental university in the United States. We calculated and compared adjusted mean estimates for the number of new decayed or restored teeth (DFT increment) from baseline to the next completed oral evaluation (N = 2,724 patients with follow-up) across three categories of delivery of non-operative anti-caries agents (e.g., high-concentration fluoride toothpaste, chlorhexidine rinse, xylitol products): never, at a single appointment, or at ≥2 appointments ≥4 weeks apart. Estimates were adjusted for patient and provider characteristics, baseline dental status, losses-to-follow-up, and follow-up time. Approximately half the patients did not receive any form of non-operative anti-caries agent. Most that received anti-caries agents were given more than one type of product in combination. One-time delivery of anti-caries agents was associated with a similar DFT increment as receiving no such therapy (difference in increment: -0.04; 95% CI: -0.28, 0.21). However, repeated, spaced delivery of anti-caries agents was associated with approximately one decayed or restored tooth prevented over 18 months for every three patients treated (difference in increment: -0.35; 95% CI: -0.65, -0.08). These results lend evidence that repeatedly receiving anti-caries agents can reduce tooth decay among high-risk patients engaged in regular dental care.

Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren.

PubMed

Mariño, R; Fajardo, J; Morgan, M

2012-12-01

This study aims to estimate the cost-effectiveness from a societal perspective of seven dental caries prevention programmes among schoolchildren in Chile: three community-based programmes: water-fluoridation, salt-fluoridation and dental sealants; and four school-based programmes: milk-fluoridation; fluoridated mouthrinses (FMR); APF-Gel, and supervised toothbrushing with fluoride toothpaste. Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating each programme, using a societal perspective, were identified and estimated. The comparator was non-intervention. Health outcomes were measured as dental caries averted over a 6-year period. Costs were estimated as direct treatment costs, programmes costs and costs of productivity losses as a result of each dental caries prevention programme. Incremental cost-effectiveness ratios were calculated for each programme. Sensitivity analyses were conducted over key parameters. Primary cost-effectiveness analysis (discounted) indicated that four programmes showed net social savings by the DMFT averted. These savings encompassed a range of values per diseased tooth averted; US$16.21 (salt-fluoridation), US$14.89 (community water fluoridation); US$14.78 (milk fluoridation); and US$8.63 (FMR). Individual programmes using an APF-Gel application, dental sealants, and supervised tooth brushing using fluoridated toothpaste, represent costs for the society per diseased tooth averted of US$21.30, US$11.56 and US$8.55, respectively. Based on cost required to prevent one carious tooth among schoolchildren, salt fluoridation was the most cost-effective, with APF-Gel ranking as least cost-effective. Findings confirm that most community/school-based dental caries interventions are cost-effective uses of society's financial resources. The models used are conservative and likely to underestimate the real benefits of each intervention.

Knowledge, Attitude, and Barriers to Fluoride Application as a Preventive Measure among Oral Health Care Providers

PubMed Central

Al-Sumait, Noura; Al-Yahya, Hanan

2018-01-01

Objective To investigate the knowledge, attitude, and possible barriers to fluoride application among oral health-care providers in Kuwait. Methods A validated self-administered questionnaire was distributed to a random sample of 291 dentists. The questionnaire included four categories: dentists' characteristics, knowledge of and attitude towards fluoride application, factors influencing decision-making on prescription of fluoride, and the clinician's perception of own knowledge. Means, group differences, and logistic regression were calculated. Results 262 completed the questionnaire (response rate of 90%). Half of the participants (49%) reported that water fluoridation is the best method for caries prevention in children. Majority of the participants (80%) acknowledged that topical fluoride prevents dental caries, but only 40% frequently use it in their practices. Fear of overdose was a concern in 57% of the participants. About 31% believed that caries is a multifactorial disease and cannot be prevented. In addition, 32% of the dentists who thought caries is multifactorial and cannot be prevented stated that restorations take precedence over preventive therapy. Conclusion Despite the participants being in favor of topical fluoride application and believing in its effectiveness, certain barriers were apparent such as knowledge deficiencies, products labelling flaw, and lack of participation in effective continuing educational activities. PMID:29849638

Oral health attitudes and caries-preventive behaviour of Czech parents of preschool children.

PubMed

Lenčová, Erika; Dušková, Jana

2013-11-01

To characterize the oral health-related attitudes and behaviour of Czech parents of preschool children. A representative sample of 796 parents was recruited for the cross-sectional questionnaire survey. Study data were collected using a validated questionnaire with 44 attitudinal items related to different aspects of caries prevention. The data were analyzed by explorative factor analysis, extracted factors were subjected to reliability analysis and Kruskal-Wallis ANOVA was used to test differences in the factor scores in respondents with different levels of education and self-perceived SES. The factor analysis extracted 3 factors, labelled "Toothbrushing - perceived significance and parental efficacy" ; "External caries control" and "Internal caries control". They explained 28.9% of the data variability. The comparison of the factor scores in groups with different SES and education of mothers showed highly significant differences. For all three factors, median values of the aggregated Likert scale increased with increasing SES and education of the mother. The parents report that they are aware of their responsibility for the prevention of tooth decay in their children. In caries prevention they concentrate on toothbrushing. Dietary measures do not seem to be of similar importance to them. The increasing self-perceived SES of the family and the education level of the mother have a significantly positive effect on the caries-preventive attitudes of the parents. Based on the study results, the message to the public health sector in the Czech Republic should include the need to highlight the importance of a non-cariogenic diet and the role of fluorides in caries prevention. Copyright © 2013 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Health promotion and dental caries.

PubMed

Maltz, Marisa; Jardim, Juliana Jobim; Alves, Luana Severo

2010-01-01

The central idea of the Brazilian health system is to prevent the establishment of disease or detect it as early as possible. Prevention and treatment of dental caries are related to behavioral factors, including dietary and oral hygiene habits, which are related to many chronic diseases. Dental health promotion therefore should be fully integrated into broadly based health-promoting strategies and actions such as food and health policies, and general hygiene (including oral hygiene), among others. For decades, a linear relationship between sugar consumption and caries has been observed. Recent data has indicated that this relationship is not as strong as it used to be before the widespread use of fluoride. However, diet is still a key factor acting in the carious process. Oral hygiene is a major aspect when it comes to caries, since dental biofilm is its etiological factor. Oral hygiene procedures are effective in controlling dental caries, especially if plaque removal is performed adequately and associated with fluoride. An alternative to a more efficient biofilm control in occlusal areas is the use of dental sealants, which are only indicated for caries-active individuals. If a cavity is formed as a consequence of the metabolic activity of the biofilm, a restorative material or a sealant can be placed to block access of the biofilm to the oral environment in order to prevent caries progress. The prevention of dental caries based on common risk-factor strategies (diet and hygiene) should be supplemented by more disease-specific policies such as rational use of fluoride, and evidence-based dental health care.

Cost-effectiveness of preventing dental caries and full mouth dental reconstructions among Alaska Native children in the Yukon-Kuskokwim delta region of Alaska.

PubMed

Atkins, Charisma Y; Thomas, Timothy K; Lenaker, Dane; Day, Gretchen M; Hennessy, Thomas W; Meltzer, Martin I

2016-06-01

We conducted a cost-effectiveness analysis of five specific dental interventions to help guide resource allocation. We developed a spreadsheet-based tool, from the healthcare payer perspective, to evaluate the cost effectiveness of specific dental interventions that are currently used among Alaska Native children (6-60 months). Interventions included: water fluoridation, dental sealants, fluoride varnish, tooth brushing with fluoride toothpaste, and conducting initial dental exams on children <18 months of age. We calculated the cost-effectiveness ratio of implementing the proposed interventions to reduce the number of carious teeth and full mouth dental reconstructions (FMDRs) over 10 years. A total of 322 children received caries treatments completed by a dental provider in the dental chair, while 161 children received FMDRs completed by a dental surgeon in an operating room. The average cost of treating dental caries in the dental chair was $1,467 (∼258,000 per year); while the cost of treating FMDRs was $9,349 (∼1.5 million per year). All interventions were shown to prevent caries and FMDRs; however tooth brushing prevented the greatest number of caries at minimum and maximum effectiveness with 1,433 and 1,910, respectively. Tooth brushing also prevented the greatest number of FMDRs (159 and 211) at minimum and maximum effectiveness. All of the dental interventions evaluated were shown to produce cost savings. However, the level of that cost saving is dependent on the intervention chosen. © 2016 The Authors. Journal of Public Health Dentistry published by Wiley Periodicals, Inc. on behalf of American Association of Public Health Dentistry.

Early Childhood Caries: A Review.

PubMed

Alazmah, Abdulfatah

2017-08-01

To review and update the current knowledge about early childhood caries (ECC) and its etiology, prevalence, risk factors, management, and preventive strategies. Early childhood caries is a disease affecting significantly both well-developed and industrial nations. The ECC can significantly affect the child's quality of life, as it may lead to infection, swelling, pain, and other symptoms. The ECC affects children after eruption of primary teeth until age of around 5 years. The ECC affects all parts of the tooth including the smooth surface. Upper anterior teeth and primary molars are usually affected. The lower anterior teeth are less likely affected. The risk factors for ECC are diet, bacteria, and host susceptibility. The additional factors, such as presence of enamel defect and the feeding practices also contribute to the initiation and progress of ECC. Dentists must focus on utilizing existing techniques to distinguish indications of right on time and propelled caries and give guidance on the best way to counteract and control caries in children. Approaches should be directed to preventive caries control strategies among children. Preventing and controlling the development of ECC among children is important to maintain effective eating, speech development, and formation of a positive self-image.

The potential of dental-protective chewing gum in oral health interventions.

PubMed

Ly, Kiet A; Milgrom, Peter; Rothen, Marilynn

2008-05-01

The authors provide an overview of chewing gum as a delivery vehicle for dental-protective agents, highlighting xylitol and its potential application in caries-prevention programs for children. The authors reviewed selected clinical investigations and previous reviews associated with chewing gum containing substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol and their effects on reducing caries. They searched the MEDLINE database by using the key words "dental caries," "oral health," "calcium," "bicarbonate," "carbamide," "chlorhexidine," "fluoride" and "xylitol." Chewing gum is being used as a delivery vehicle for substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol to improve oral health and reduce caries. These substances exhibit properties that are protective of the oral environment and mediate common oral diseases. The debate for advocating xylitol use in caries prevention is advancing; however, chewing gum use by young schoolchildren in the United States is hindered by choking hazard concerns and lack of specific xylitol dosing recommendations. The use of chewing gum containing dental-protective substances, particularly xylitol, in caries-prevention programs can reduce the tooth decay epidemic. Chewing gum use by children in the school setting should be reconsidered.

Urban Mexican-American mothers’ beliefs about caries etiology in children

PubMed Central

HOEFT, Kristin S.; BARKER, Judith C.; MASTERSON, Erin E.

2012-01-01

Objectives Caries is a severe condition which disproportionately affects Latino children in the U.S. This study sought contextual understanding of urban, low-income Mexican-American mothers’ beliefs, perceptions, knowledge and behavior surrounding causes of caries. Methods In urban San José, CA, a qualitative study was conducted with a convenience sample of Mexican-American mothers of young children about their beliefs and knowledge about the causes of caries. Audio-taped in-depth interviews with open-ended questions, primarily in Spanish, were translated to English and then transcribed verbatim. Texts were independently read and thematically analyzed by two researchers. Results Even while expressing uncertainty, all 48 mothers mentioned specific causes of caries, most frequently citing candy or juice consumption (85%), poor oral hygiene (65%) and use of the bottle (52%). Mothers rarely recognized cariogenic foods beyond candy, did not know or perform recommended oral hygiene routines, and demonstrated confusion and uncertainty about exactly how baby bottles are detrimental to teeth. Nearly half of these mothers also mentioned secondary cavity causes, such as genetics, lack of calcium, not going to the dentist, or lack of fluoride. Mothers did not mention the role of bacteria. While mothers recognize that oral hygiene can counteract the detrimental effects of candy consumption, they did not recognize its beneficial effects in other contexts. Nor did they know about other preventive activities. Conclusions Mothers recognized the three major important factors causing caries: sugar consumption, poor oral hygiene, and bottle use. However, their knowledge is limited in depth and specificity which restricts development of caries prevention behaviors. More comprehensive education is needed, including on caries prevention (oral hygiene) behaviors, which could lead to an increased sense of self-efficacy with respect to their children’s oral health. PMID:20156233

Value for money: economic evaluation of two different caries prevention programmes compared with standard care in a randomized controlled trial.

PubMed

Vermaire, J H; van Loveren, C; Brouwer, W B F; Krol, M

2014-01-01

A cost-effectiveness analysis was conducted during a 3-year randomized controlled clinical trial in a general dental practice in the Netherlands in which 230 6-year-old children (± 3 months) were assigned to either regular dental care, an increased professional fluoride application (IPFA) programme or a non-operative caries treatment and prevention (NOCTP) programme. Information on resource use during the 3-year period was documented by the dental nurse at every patient visit, such as treatment time, travel time and travel distance. Caries increment scores (at D3MFS level) were used to assess effectiveness. Cost calculations were performed using bottom-up micro-costing. Incremental cost-effectiveness ratios (ICERs) were expressed as additional average costs per prevented DMFS. The ICERs compared with regular dental care from a health care system perspective and societal perspective were, respectively, EUR 269 and EUR 1,369 per prevented DMFS in the IPFA programme, and EUR 30 and EUR 100 in the NOCTP programme. The largest investments for the NOCTP group were made in the first year of the study; they decreased in the second and equalled the costs of control group in third year of the study. From both medical and economic points of view, the NOCTP strategy may be considered the preferred strategy for caries prevention.

Preventing Childhood Caries

PubMed Central

Albino, J.; Tiwari, T.

2016-01-01

The etiology of dental caries reflects a complex interplay of biochemical, microbial, genetic, social and physical environmental, and health-influencing behavioral factors. This review updates the literature on the efficacy of behavioral approaches to caries prevention for children up to 18 y of age. Included were studies of behavioral interventions implemented at individual, family, and community levels that assessed results in terms of reductions in caries increments. Only those reports published since 2011 were considered. Outcomes were variable, although motivational interviewing, which involves individuals in decisions about oral health within the context of their respective life circumstances, proved effective in 3 of 4 reported studies, and more definitive trials are underway. Recommendations for future research include examinations of the cost-effectiveness of interventions, as well as work focused on understanding the mechanisms underlying oral health behavior change and variables that may mediate or moderate responses to interventions. PMID:26438210

Dental students' knowledge, attitudes, and intended behaviors regarding caries risk assessment: impact of years of education and patient age.

PubMed

Calderón, Sophia H; Gilbert, Paul; Zeff, Rasika N; Gansky, Stuart A; Featherstone, John D B; Weintraub, Jane A; Gerbert, Barbara

2007-11-01

Dental caries remains the single most common chronic childhood disease; without intervention, the prevalence and severity of caries increase into adulthood. Dental schools have begun to integrate caries risk assessment (CRA) and prevention counseling into the curriculum. We sought to assess the knowledge, attitudes, and intended behaviors of dental students regarding CRA and prevention counseling with children and adults. We also examined the extent to which these findings were influenced by the years of instruction that students received on these topics. We conducted a cross-sectional survey of dental students at the University of California, San Francisco. All first-year (D1) through fourth-year (D4) students were eligible to participate. Of the 322 eligible students, 290 (90 percent) participated. D4 students correctly answered a mean of 70.4 percent of the knowledge-based questions on CRA; the mean score among D1 students was 50.4 percent. Whereas 95 percent of D4 students identified themselves as confident in their ability to assess adult patients for caries risk, only 68 percent had such confidence with patients less than five years. To effectively prevent early childhood caries, dental schools should provide students with the skills necessary to be confident and willing to perform CRA and prevention counseling for all age groups.

General practitioners' use of caries-preventive agents in adult patients versus pediatric patients: findings from the dental practice-based research network.

PubMed

Riley, Joseph L; Gordan, Valeria V; Rindal, D Brad; Fellows, Jeffrey L; Williams, O Dale; Ritchie, Lloyd K; Gilbert, Gregg H

2010-06-01

In this study, the authors tested the frequency of dentists' recommendations for and use of caries-preventive agents for children as compared with adults. The authors surveyed 467 general dentists in the Dental Practice-Based Research Network who practice within the United States and treat both pediatric and adult patients. They asked dentists to identify the percentage of their patients for whom they had administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse and xylitol gum. Dentists were less likely to provide adult patients than pediatric patients with in-office caries-preventive agents. However, the rate at which they recommended at-home preventive regimens for the two groups of patients was similar. Dentists with a conservative approach to caries treatment were the most likely to use and recommend the use of caries-preventive agents at similar rates in adults as in children. In addition, dentists in practices with a greater number of patients who had dental insurance were significantly more likely to provide in-office fluoride or sealants to adult patients than to pediatric patients. General dentists use in-office caries-preventive agents more commonly with their pediatric patients than with their adult patients. General dentists should consider providing additional in-office caries-preventive agents for their adult patients who are at increased risk of experiencing dental caries.

Prevention of early childhood caries: a public health perspective.

PubMed

Weintraub, J A

1998-01-01

This paper proposes strategies for preventing early childhood caries (ECC), preferably for the greatest number of children at the lowest cost. Population-based, public health approaches are more likely to reach the target population groups at risk of developing ECC than individual, private practice-based approaches. Different prevention and early intervention strategies are discussed and the following recommendations are made: 1) Continue to promote community water fluoridation. 2) Evaluate the effectiveness of other public health oriented measures to prevent ECC. 3) Develop a national ECC and rampant caries registry. 4) Link oral health screening and easily implemented, low-cost interventions with immunization schedules and public health nursing activities. 5) Increase opportunities for community-based interventions conducted by dental hygienists. 6) Change insurance reimbursement schedules to provide incentives for dentists to prevent disease. 7) Include dentistry in new child health insurance legislation for children as well as parents of infants and preschool children.

[Preventive dentistry 5. Secondary caries].

PubMed

Hollanders, A C C; Kuper, N K; Opdam, N J M; Huysmans, M C D N J M

2017-05-01

Secondary caries is reported as one of the most important reasons for replacing restorations. The patient's general caries risk plays an important role in the development of secondary caries. The connection, at the patient level, between various factors, the risk of caries and restoration factors, such as the presence of a gap and the kind of restoration material, deserves additional investigation. The minimum gap width in which secondary caries can develop is most likely less than 100 µm and could depend on the patient's caries risk. Composite restorations seem more susceptible to secondary caries than amalgam restorations in patients with high caries risk. So far, there is no unambiguous explanation for this difference. The prevention of secondary caries is comparable to that of primary caries and stresses the importance of fluoride, diet and oral hygiene.

Effectiveness of Xylitol in Reducing Dental Caries in Children.

PubMed

Marghalani, Abdullah A; Guinto, Emilie; Phan, Minhthu; Dhar, Vineet; Tinanoff, Norman

2017-03-15

The purpose of this study was to evaluate the effectiveness of xylitol in reducing dental caries in children compared to no treatment, a placebo, or preventive strategies. MEDLINE via PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 1, 1995 through Sept. 26, 2016 for randomized and controlled trials on children consuming xylitol for at least 12 months. The primary endpoint was caries reduction measured by mean decayed, missing, and filled primary and permanent surfaces/ teeth (dmfs/t, DMFS/T, respectively). The I2 and chi-square test for heterogeneity were used to detect trial heterogeneity. Meta-analyses were performed and quality was evaluated using GRADE profiler software. Analysis of five randomized controlled trials (RCTs) showed that xylitol had a small effect on reducing dental caries (standardized mean difference [SMD] equals -0.24; 95 percent confidence interval [CI] equals -0.48 to 0.01; P = 0.06) with a very low quality of evidence and considerable heterogeneity. Studies with higher xylitol doses (greater than four grams per day) demonstrated a medium caries reduction (SMD equals -0.54; 95 percent CI equals -1.14 to 0.05; P = 0.07), with these studies also having considerable heterogeneity and very low quality of evidence. The present systematic review examining the effectiveness of xylitol on caries incidence in children showed a small effect size in randomized controlled trials and a very low quality of evidence that makes preventive action of xylitol uncertain.

Effect of caries preventive measures directed to expectant mothers on caries experience in their children.

PubMed

Zanata, Régia Luzia; Navarro, Maria Fidela de Lima; Pereira, José Carlos; Franco, Eduardo Batista; Lauris, José Roberto P; Barbosa, Sílvia Helena

2003-01-01

The aim of this prospective study was to determine the effectiveness of caries preventive measures started during pregnancy on the caries experience of first-time mothers and their infants. Eighty-one pregnant women with low social background were selected on the basis of the presence of active carious lesions and were randomly divided into control (38) and experimental (43) groups. The initial dental status (DMFS and white spot lesions) was established through clinical examination. The prophylactic measures were repeated during pregnancy and 6 and 12 months after delivery. Both groups received primary care intervention. They were instructed in relation to the etiologic factors of dental caries and received oral hygiene kits. Oral hygiene instructions were reinforced through interactive brushing. The experimental group also received antimicrobial treatment (topical application of NaF and iodine solution immediately after prophylaxis and 3 and 5 days later) and restorative care using glass ionomer cement. By the time the children were 2 years of age, 33.3% of the infants in the control group and 14.7% in the experimental group had caries activity. A significant difference in caries prevalence was observed between children with and without visible dental plaque. The mean number of tooth surfaces with carious lesions (including areas of demineralization) was higher among the children in the control group compared to the experimental group (6.3 x 3.2), however, with no statistical significance. Maternal caries increase was a significant factor influencing the caries experience of the children. These data support the evidence of an association between caries prevalence in young children and clinical (dental plaque) and maternal factors.

Pit and fissure sealants for preventing dental decay in permanent teeth.

PubMed

Ahovuo-Saloranta, Anneli; Forss, Helena; Walsh, Tanya; Nordblad, Anne; Mäkelä, Marjukka; Worthington, Helen V

2017-07-31

Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria growth that can lead to dental decay. Evidence suggests that fissure sealants are effective in preventing caries in children and adolescents compared to no sealants. Effectiveness may, however, be related to caries incidence level of the population. This is an update of a review published in 2004, 2008 and 2013. To compare the effects of different types of fissure sealants in preventing caries in occlusal surfaces of permanent teeth in children and adolescents. Cochrane Oral Health's Information Specialist searched: Cochrane Oral Health's Trials Register (to 3 August 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 7), MEDLINE Ovid (1946 to 3 August 2016), and Embase Ovid (1980 to 3 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 3 August 2016. No restrictions were placed on language or date of publication. Randomised controlled trials (RCTs) comparing sealants with no sealant or a different type of sealant material for preventing caries of occlusal surfaces of premolar or molar teeth in children and adolescents aged up to 20 years. Studies required at least 12 months follow-up. We excluded studies that compared compomers to resins/composites. Two review authors independently screened search results, extracted data and assessed risk of bias of included studies. We presented outcomes for caries or no caries on occlusal surfaces of permanent molar teeth as odds ratio (OR) or risk ratio (RR). We used mean difference (MD) for mean caries increment. All measures were presented with 95% confidence intervals (CI). We conducted meta-analyses using a random-effects model for comparisons where there were more than three trials; otherwise we used the fixed-effect model. We used GRADE methods to assess evidence quality. We included 38 trials that involved a total of 7924 children; seven trials were new for this update (1693 participants). Fifteen trials evaluated the effects of resin-based sealant versus no sealant (3620 participants in 14 studies plus 575 tooth pairs in one study); three trials with evaluated glass ionomer sealant versus no sealant (905 participants); and 24 trials evaluated one type of sealant versus another (4146 participants). Children were aged from 5 to 16 years. Trials rarely reported background exposure to fluoride of trial participants or baseline caries prevalence. Resin-based sealant versus no sealant: second-, third- and fourth-generation resin-based sealants prevented caries in first permanent molars in children aged 5 to 10 years (at 24 months follow-up: OR 0.12, 95% CI 0.08 to 0.19, 7 trials (5 published in the 1970s; 2 in the 2010s), 1548 children randomised, 1322 children evaluated; moderate-quality evidence). If we were to assume that 16% of the control tooth surfaces were decayed during 24 months of follow-up (160 carious teeth per 1000), then applying a resin-based sealant would reduce the proportion of carious surfaces to 5.2% (95% CI 3.13% to 7.37%). Similarly, assuming that 40% of control tooth surfaces were decayed (400 carious teeth per 1000), then applying a resin-based sealant would reduce the proportion of carious surfaces to 6.25% (95% CI 3.84% to 9.63%). If 70% of control tooth surfaces were decayed, there would be 19% decayed surfaces in the sealant group (95% CI 12.3% to 27.2%). This caries-preventive effect was maintained at longer follow-up but evidence quality and quantity was reduced (e.g. at 48 to 54 months of follow-up: OR 0.21, 95% CI 0.16 to 0.28, 4 trials, 482 children evaluated; RR 0.24, 95% CI 0.12 to 0.45, 203 children evaluated). Although studies were generally well conducted, we assessed blinding of outcome assessment for caries at high risk of bias for all trials (blinding of outcome assessment is not possible in sealant studies because outcome assessors can see and identify sealant). Glass ionomer sealant versus no sealant: was evaluated by three studies. Results at 24 months were inconclusive (very low-quality evidence). One sealant versus another sealant: the relative effectiveness of different types of sealants is unknown (very low-quality evidence). We included 24 trials that directly compared two different sealant materials. Comparisons varied in terms of types of sealant assessed, outcome measures chosen and duration of follow-up. Adverse events: only four trials assessed adverse events. No adverse events were reported. Resin-based sealants applied on occlusal surfaces of permanent molars are effective for preventing caries in children and adolescents. Our review found moderate-quality evidence that resin-based sealants reduced caries by between 11% and 51% compared to no sealant, when measured at 24 months. Similar benefit was seen at timepoints up to 48 months; after longer follow-up, the quantity and quality of evidence was reduced. There was insufficient evidence to judge the effectiveness of glass ionomer sealant or the relative effectiveness of different types of sealants. Information on adverse effects was limited but none occurred where this was reported. Further research with long follow-up is needed.

Water fluoridation for the prevention of dental caries.

PubMed

Iheozor-Ejiofor, Zipporah; Worthington, Helen V; Walsh, Tanya; O'Malley, Lucy; Clarkson, Jan E; Macey, Richard; Alam, Rahul; Tugwell, Peter; Welch, Vivian; Glenny, Anne-Marie

2015-06-18

Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community water fluoridation was initiated in the USA in 1945 and is currently practised in about 25 countries around the world; health authorities consider it to be a key strategy for preventing dental caries. Given the continued interest in this topic from health professionals, policy makers and the public, it is important to update and maintain a systematic review that reflects contemporary evidence. To evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries.To evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis. We searched the following electronic databases: The Cochrane Oral Health Group's Trials Register (to 19 February 2015); The Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2015); MEDLINE via OVID (1946 to 19 February 2015); EMBASE via OVID (1980 to 19 February 2015); Proquest (to 19 February 2015); Web of Science Conference Proceedings (1990 to 19 February 2015); ZETOC Conference Proceedings (1993 to 19 February 2015). We searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization's WHO International Clinical Trials Registry Platform for ongoing trials. There were no restrictions on language of publication or publication status in the searches of the electronic databases. For caries data, we included only prospective studies with a concurrent control that compared at least two populations - one receiving fluoridated water and the other non-fluoridated water - with outcome(s) evaluated at at least two points in time. For the assessment of fluorosis, we included any type of study design, with concurrent control, that compared populations exposed to different water fluoride concentrations. We included populations of all ages that received fluoridated water (naturally or artificially fluoridated) or non-fluoridated water. We used an adaptation of the Cochrane 'Risk of bias' tool to assess risk of bias in the included studies.We included the following caries indices in the analyses: decayed, missing and filled teeth (dmft (deciduous dentition) and DMFT (permanent dentition)), and proportion caries free in both dentitions. For dmft and DMFT analyses we calculated the difference in mean change scores between the fluoridated and control groups. For the proportion caries free we calculated the difference in the proportion caries free between the fluoridated and control groups.For fluorosis data we calculated the log odds and presented them as probabilities for interpretation. A total of 155 studies met the inclusion criteria; 107 studies provided sufficient data for quantitative synthesis.The results from the caries severity data indicate that the initiation of water fluoridation results in reductions in dmft of 1.81 (95% CI 1.31 to 2.31; 9 studies at high risk of bias, 44,268 participants) and in DMFT of 1.16 (95% CI 0.72 to 1.61; 10 studies at high risk of bias, 78,764 participants). This translates to a 35% reduction in dmft and a 26% reduction in DMFT compared to the median control group mean values. There were also increases in the percentage of caries free children of 15% (95% CI 11% to 19%; 10 studies, 39,966 participants) in deciduous dentition and 14% (95% CI 5% to 23%; 8 studies, 53,538 participants) in permanent dentition. The majority of studies (71%) were conducted prior to 1975 and the widespread introduction of the use of fluoride toothpaste.There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels.There is insufficient information to determine the effect of stopping water fluoridation programmes on caries levels.No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria.With regard to dental fluorosis, we estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12% (95% CI 8% to 17%; 40 studies, 59,630 participants). This increases to 40% (95% CI 35% to 44%) when considering fluorosis of any level (detected under highly controlled, clinical conditions; 90 studies, 180,530 participants). Over 97% of the studies were at high risk of bias and there was substantial between-study variation. There is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation.

Salt fluoridation: a meta-analysis of its efficacy for caries prevention.

PubMed

Yengopal, V; Chikte, U M E; Mickenautsch, S; Oliveira, L B; Bhayat, A

2010-03-01

The aim of this meta-analysis was to assess the caries preventive effect of Salt fluoridation (SF) in the permanent dentition in children. THE OBJECTIVES WERE TO COMPARE: (1) the caries preventive effects of SF versus no exposure in different age cohorts (6-8; 9-12; and 13-15 years old); (2) SF versus other community based interventions (milk or water fluoridation [WF]). 9 English and 2 non-English databases were searched for papers that reported on the caries preventive effect of groups (with controls) that were exposed to SF in the form of mean DMFT scores with standard deviations. Differences in exposed and nonexposed groups were computed on the basis of weighted mean differences (WMDs) with 95% confidence intervals (CIs). For 6-8 year olds, the pooled reduction in DMFT scores was -0.98 [95% CI: -1.68 to -0.29]; for 9-12 year olds, it was -2.13 [95% CI: -2.55 to -1.70] and for the 13-15 year old groups, -4.22 [95% CI: -6.84 to -1.55]. All the analyses favoured the SF groups (p <0.001). For SF versus WF, there was no difference (-0.11 reduction [95% CI: -0.29 to +0.07]). Within limitations, the pooled estimates of the WMDs for the different age cohorts favoured SF versus no exposure.

Optimization of Adhesive Pastes for Dental Caries Prevention.

PubMed

Sodata, Patteera; Juntavee, Apa; Juntavee, Niwut; Peerapattana, Jomjai

2017-11-01

Dental caries prevention products available on the market contain only remineralizing agents or antibacterial agents. This study aimed to develop adhesive pastes containing calcium phosphate and α-mangostin for dental caries prevention using the optimization technique. Calcium phosphate was used as a remineralizing agent, and extracted α-mangostin was used as an antibacterial agent. The effect of the independent variables, which were fumed silica, Eudragit ® EPO, polyethylene glycol, and ethyl alcohol, on the responses was investigated. The drying time, erosion rate, calcium release rate, and α-mangostin release rate were established as the measured responses. An equation and a model of the relationship were constructed. An optimal formulation was obtained, and its effect on dental caries prevention was investigated using the pH-cycling model. The quadratic equation revealed that the drying time, calcium release rate, and α-mangostin release rate tended to decrease when increasing the fumed silica and decreasing other factors. The erosion rate tended to increase when decreasing Eudragit ® EPO and increasing other factors. The observed responses of the optimal adhesive pastes were not significantly different from the predicted responses. This result demonstrated that optimization is an efficient technique in the formulation development of the adhesive pastes. In addition, the optimal adhesive pastes could enhance acid resistance activity to the tooth enamel.

Relative effects of pre- and post-eruption water fluoride on caries experience by surface type of permanent first molars.

PubMed

Singh, Kiran A; Spencer, A John

2004-12-01

To determine the relative pre- and post-eruption exposure effects of fluoridated water on the caries experience of different surface types of first permanent molars. Parental questionnaires covering residential history of participants were linked to the oral examinations of 6-15-year-old Australian children conducted in 1992 by the School Dental Services of South Australia and Queensland. Percentage of lifetime exposed to optimally fluoridated water pre- (PRE) and post-eruption (POST) was calculated with respect to tooth eruption age. Combined pre- and post-eruption categories were created to test PRE against POST exposure: PRE and POST = 0, PRE < POST, PRE = POST and in the range 0-90% of lifetime exposure, PRE > POST and, PRE and POST >or= 90% lifetime exposure. These categories were used as indicator variables in linear regression models with PRE and POST = 0 as reference in an analysis of first permanent molar DMFS scores overall and by surface type. Participation rates were 69.7% in South Australia (n = 9690) and 55.6% in Queensland (n = 10 195). Compared with the reference, the categories PRE > POST (beta = -0.033), PRE = POST (beta = -0.028) in the range 0-90% and, PRE and POST >or= 90% (beta = -0.055) showed significantly lower caries overall (P < 0.01), with a similar pattern for pit and fissure surface caries (beta = -0.035, -0.031 and -0.052, respectively). Only a high PRE and POST exposure decreased caries levels significantly in the approximal (beta = -0.038; P < 0.01) and free smooth surfaces (beta = -0.023; P = 0.03). Pre-eruption exposure was important for a caries preventive effect on first permanent molars in children 6-15 years old since post-eruption exposure alone could not lower caries levels significantly. For pit and fissure surfaces, a high pre-eruption exposure could decrease caries levels significantly. However, for other surface types, only a high pre- and post-eruption exposure produced a caries preventive effect.

Long-Term Effect of Erythritol on Dental Caries Development during Childhood: A Posttreatment Survival Analysis.

PubMed

Falony, Gwen; Honkala, Sisko; Runnel, Riina; Olak, Jana; Nõmmela, Rita; Russak, Silvia; Saag, Mare; Mäkinen, Pirkko-Liisa; Mäkinen, Kauko; Vahlberg, Tero; Honkala, Eino

2016-01-01

To assess the effect of daily consumption of erythritol, xylitol, and sorbitol candies on caries development in mixed dentition during a 3-year intervention and 3 years after the intervention. 485 Estonian first- and second-grade primary school children participated. Children were randomly allocated to an erythritol, xylitol, or sorbitol (control) group. Polyol-containing candies were administered on school days with a daily polyol consumption of 3 × 2.5 g. Yearly, caries development was assessed by calibrated dentists using the ICDAS criteria. Six years after initiation of the study and 3 years after cessation of daily polyol consumption, 420 participants were re-examined to identify potential long-term effects of polyol consumption. Survival curves were generated at the end of the intervention period and 3 years after intervention. The model included age of the subjects, schools, tooth surface ages and years of surface exposure to intervention. ICDAS scoring system-based events included enamel/dentin caries development, dentin caries development, increase in caries score, and dentist intervention. At the end of the intervention, time to enamel/dentin caries development, dentin caries development, increase in caries score, and dentist intervention were significantly longer in the erythritol group as compared to the sorbitol group. Except for increase in caries score, all effects persisted 3 years after cessation of daily polyol consumption. A caries-preventive effect of 3-year erythritol consumption as compared to sorbitol was established in children with mixed dentition. The effect persisted up to 3 years after the end of the intervention. © 2016 S. Karger AG, Basel.

Probiotics reduce mutans streptococci counts in humans: a systematic review and meta-analysis.

PubMed

Laleman, Isabelle; Detailleur, Valentine; Slot, Dagmar Else; Slomka, Vera; Quirynen, Marc; Teughels, Wim

2014-07-01

Systematically review the available literature regarding the caries-preventive effect of probiotics. An electronic search was conducted in three databases (PubMed MEDLINE, ISI Web of Science and Cochrane Library) to identify all suitable studies. The outcomes had to be presented as the effect of probiotics on the incidence of caries or on the levels of mutans streptococci and/or Lactobacillus species. Human studies, written in English, with at least 15 participants, comparing a probiotic product with a placebo/no probiotic were included. Where possible, a meta-analysis was performed to obtain quantitative data. Since only two articles presented useful data on the caries incidence, we focused on the surrogate endpoints: mutans streptococci and/or Lactobacillus counts. The meta-analysis showed that when the probiotic and control group are compared after treatment, significantly more patients in the probiotic group had low mutans streptococci (<10(5) CFU/ml) counts and significantly less patients had high (>10(6) CFU/ml) counts. Regarding the Lactobacillus counts, comparing the probiotic and control group at the end of the probiotic use, no significant differences could be observed, neither in low (<10(4) CFU/ml) nor in high Lactobacillus (>10(6) CFU/ml) counts. Within the limitations of the available data, it may be concluded that probiotics decrease the mutans streptococci counts. This suggests that probiotics could have a positive effect in the prevention of caries. There is insufficient evidence that probiotics can prevent caries, but they can reduce the mutans streptococci counts.

Dental hygiene participation in managing incipient and hidden caries.

PubMed

Barnes, Caren M

2005-10-01

With the advent of new caries detection devices that allow early detection, dental hygienists can intervene in the demineralization process and work with the patient toward remineralization through patient self-care procedures and the professional application of topical fluorides. The focus of this article is on caries detection devices, caries risk assessment, agents used to prevent dental caries, and the development of self-care plans for patients that include prevention, intervention, and therapeutic components.

The modified Ottawa method to establish the update need of a systematic review: glass-ionomer versus resin sealants for caries prevention

PubMed Central

MICKENAUTSCH, Steffen; YENGOPAL, Veerasamy

2013-01-01

Objective To demonstrate the application of the modified Ottawa method by establishing the update need of a systematic review with focus on the caries preventive effect of GIC versus resin pit and fissure sealants; to answer the question as to whether the existing conclusions of this systematic review are still current; to establish whether a new update of this systematic review was needed. Methods: Application of the Modified Ottawa method. Application date: April/May 2012. Results Four signals aligned with the criteria of the modified Ottawa method were identified. The content of these signals suggest that higher precision of the current systematic review results might be achieved if an update of the current review were conducted at this point in time. However, these signals further indicate that such systematic review update, despite its higher precision, would only confirm the existing review conclusion that no statistically significant difference exists in the caries-preventive effect of GIC and resin-based fissure sealants. Conclusion In conclusion, this study demonstrated the modified Ottawa method as an effective tool in establishing the update need of the systematic review. In addition, it was established that the conclusions of the systematic review in relation to the caries preventive effect of GIC versus resin based fissure sealants are still current, and that no update of this systematic review was warranted at date of application. PMID:24212996

Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries-active adults.

PubMed

Brown, John P; Amaechi, Bennett T; Bader, James D; Gilbert, Gregg H; Makhija, Sonia K; Lozano-Pineda, Juanita; Leo, Michael C; Chen, Chuhe; Vollmer, William M

2014-06-01

To better understand the effectiveness of xylitol in caries prevention in adults and to attempt improved clinical trial efficiency. As part of the Xylitol for Adult Caries Trial (X-ACT), non cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 g/day of xylitol, consumed by dissolving in the mouth five 1 g lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21-80, with complete data for four dental examinations, were selected from the 691 randomized into the 3-year trial, conducted at three sites. Acceptable inter- and intra-examiner reliability before and during the trial was quantified using the kappa statistic. The mean annualized noncavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically nonsignificant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non cavitated lesion assessment in this full-scale, placebo-controlled, multisite, randomized, double-blinded clinical trial in adults experiencing dental caries did not achieve added trial efficiency or demonstrate practical benefit of xylitol. ClinicalTrials.Gov NCT00393055. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Visual scoring of non-cavitated caries lesions and clinical trial efficiency, testing xylitol in caries active adults

PubMed Central

Brown, JP; Amaechi, BT; Bader, JD; Gilbert, GH; Makhija, SK; Lozano-Pineda, J; Leo, MC; Chuhe, C; Vollmer, WM

2013-01-01

Objectives To better understand the effectiveness of xylitol in caries prevention in adults, and to attempt improved clinical trial efficiency. Methods As part of the Xylitol for Adult Caries Trial (X-ACT), non-cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 grams/day of xylitol, consumed by dissolving in the mouth five 1 gram lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21–80, with complete data for four dental examinations were selected from the 691 randomized into the three year trial, conducted at three sites. Acceptable inter and intra examiner reliability before and during the trial was quantified using the kappa statistic. Results The mean annualized non-cavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically non-significant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. Conclusions There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non-cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non-cavitated lesion assessment in this full scale, placebo controlled, multi site, randomized, double blinded clinical trial in adults experiencing dental caries, did not achieve added trial efficiency or demonstrate practical benefit of xylitol. Trial Registration ClinicalTrials.Gov NCT00393055 PMID:24205951

The effect of xylitol on dental caries and oral flora

PubMed Central

Nayak, Prathibha Anand; Nayak, Ullal Anand; Khandelwal, Vishal

2014-01-01

Dental caries, the most chronic disease affecting mankind, has been in the limelight with regard to its prevention and treatment. Professional clinical management of caries has been very successful in cases of different severities of disease manifestations. However, tertiary management of this disease has been gaining attention, with numerous methods and agents emerging on a daily basis. Higher intake of nutritive sweeteners can result in higher energy intake and lower diet quality and thereby predispose an individual to conditions like obesity, cardiovascular disorders, and type 2 diabetes mellitus. Non-nutritive sweeteners have gained popularity as they are sweeter and are required in substantially lesser quantities. Xylitol, a five-carbon sugar polyol, has been found to be promising in reducing dental caries disease and also reversing the process of early caries. This paper throws light on the role and effects of various forms of xylitol on dental caries and oral hygiene status of an individual. PMID:25422590

[Preventive dentistry 6. Prevention of caries in frail older people].

PubMed

van der Maarel-Wierink, C D; de Baat, C

2017-06-01

Many older people have a bad oral health, with (root) caries a prevalent cause. Alarming results of research projects raise the question whether sufficient preventive measures are being taken to prevent the development and progress of (root) caries in frail older people. A review of the recent literature revealed that in frail older people and physically or cognitively impaired adults, daily use of a 5,000 ppm fluoride toothpaste and quarterly application of chlorhexidine or sodium fluoride can decrease by half the risk of root caries. In the Netherlands, toothpaste containing 5,000 ppm fluoride is not (yet) on the market. At the present time, only the advice brochure 'Prevention of root caries' is available. Another measure to prevent deterioration of oral health among frail older people is paying attention to frail older people who do not visit their dentist on a regular basis due to physical limitations and care dependency. When this is the case, it is necessary to intensify professional oral healthcare with instructions to personal caregivers and professional care providers in order to fight (root) caries.

THE ROLE OF NUTRITION IN CARIES PREVENTION AND MAINTENANCE OF ORAL HEALTH DURING PREGNANCY.

PubMed

Jevtić, Marija; Pantelinaci, Jelena; Jovanović Ilić, Tatjana; Petrović, Vasa; Grgić, Olja; Blazić, Larisa

2015-01-01

Pregnancy may pose an increased risk for the development of caries and other oral health problems. Continuous screening of oral health status, implementing appropriate preventive measures (particularly oral hygiene, healthy diet plans and education) is of paramount importance not only for oral health but also for the general health status of the future mother and her offspring. EFFECTS OF FOOD ON CARIES DEVELOPMENT: Caries prevention through healthy diet implicates the reduction in frequency and amount of intake of cariogenic food, above all ofrefined carbohydrates, i.e. sugars and sweets. Foods known to have caries-prophylactic effects should predominate in healthy diet plans. They mainly include solid foods, which have mechanical effects on teeth cleaning, as well as foods providing sufficient amounts of vitamins (A, C, D) and a variety of elements and compounds (calcium, phosphates, fluorides) favoring the preservation and remineralization of tooth structures. EDUCATION OF PREGNANT WOMEN ON HEALHY DEIT: In accomplishing these goals, education and direct positive communication between the educator and the pregnant woman play a crucial role. Educative approach is always individual and determined by the patient's specific cultural and socioeconomic features and status, as well as her habits, motivation and willingness to accept relevant recommendations. Accomplishing the aforementioned goals requires the appropriate organization and professional competence within the preventive dental service and its close cooperation with the relevant medical institutions and social support in the framework of public health protection. Preserving of oral health during pregnancy is predominantly influenced by the following factors: 1) healthy diet, 2) oral hygiene, 3) patients' education, 4) regular control of oral health, 5) appropriate organization of dental services and 6) community engagement.

Impact of a Web-based intervention on maternal caries transmission and prevention knowledge, and oral health attitudes.

PubMed

Albert, David; Barracks, Sharifa Z; Bruzelius, Emilie; Ward, Angela

2014-09-01

Poor oral health knowledge is thought to significantly contribute to the incidence of early childhood caries, the most common childhood disease in the U.S. This study assessed the effectiveness of a web-based educational program in increasing oral health and caries transmission knowledge, attitudes and planned behavior among mothers and primary caregivers. Study participants were recruited from subscribers to an online health information newsletter distributed by a national dental insurance company and from visitors to a health information website sponsored by the same company. Participants completed pre- and post-intervention surveys and viewed a brief educational program. Results were analyzed for pre- to post-test changes in knowledge and attitudes. Planned behavior change was also assessed. 459 participants completed pre-and post-test surveys. The sample was typically more insured (91.3 %), and college educated (76.9 %), than the general population. At baseline, respondents were knowledgeable about caries and its prevention; however, their specific knowledge about caries transmission was limited. There was a significant increase in caries knowledge from baseline to follow-up, particularly regarding caries transmission. At baseline less than half of the participants (48.8 %) knew that mothers/primary caregivers play a large role in passing cavity causing germs to children and 43.1 % knew that there is a defined period of time when the risk of transmission of cariogenic bacteria is greatest; however in post-testing 99.6 % and 98.3 % answered these question correctly respectively (p < 0.001). Results indicate that a web-delivered oral health intervention can increase dental knowledge and increase participants' plans to prevent maternal caries transmission. The provision of web-delivered education to primary caregivers can be an effective and low cost strategy for promoting maternal and infant oral health.

Emerging science in the dietary control and prevention of dental caries.

PubMed

Al-Dajani, Mahmoud; Limeback, Hardy

2012-10-01

The key environmental factor involved in caries incidence is fermentable carbohydrates. Because of the high costs of caries treatment, researchers continue to explore dietary control as a promising preventive method. While dietary change has been demonstrated to reduce Streptococcus mutans, a preventive role is expected for "functional foods" and dietary habit alterations. The authors consider how recent advances in the understanding of caries pathology can reveal dietary control as a valuable method in promoting a healthy dentition.

Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride varnish programme with Bifluorid 12 and Duraphat.

PubMed

Bergström, Eva-Karin; Birkhed, Dowen; Granlund, Christina; Sköld, Ulla Moberg

2014-10-01

To evaluate approximal caries increment among 12- to 16-year-olds in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride (F) varnish programme with Bifluorid 12 and Duraphat. The design was a RCT study with 1365 adolescents, divided into following four groups: Group 1 Bifluorid 12 two applications/year; Group 2 Duraphat two applications/year; Group 3 Bifluorid 12 four applications/year and Group 4 no F varnish at school. 1143 children (84%) completed the study. Approximal caries was registered on bitewing radiographs. There were no statistically significant differences in caries prevalence among the groups either at baseline or after 3.5 years . The caries increment for Group 1 was 1.34 ± 2.99 (mean ± SD), 1.24 ± 2.84 for Group 2, 1.07 ± 2.66 for Group 3 and 1.25 ± 2.75 for Group 4, with no statically significant differences either between Bifluorid 12 and Duraphat with the same frequency of F varnish applications or between the F groups and the control group. In an area with low caries prevalence in Sweden, the supplementary caries-preventive effect of school-based F varnish applications, to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics, appears to be nonsignificant regarding approximal caries increment. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effect of fluorine and homeopathic medicines in rats fed cariogenic diet.

PubMed

Almeida, N T; Dalmeida, V; Pustiglione, M

2004-07-01

Although some sectors of dentistry have benefited from technological advances, dental caries is still a major problem. Prevention and treatment of dental caries by fluorine is considered a major advance in public health. Nevertheless fluorosis, caused by ingestion of excessive amounts of fluorine during the period of teeth formation, is of great concern. In accordance with the homeopathic doctrine, minimum doses of fluorine and other substances could prevent and/or treat caries. In this experiment, we compared the preventive action of fluorine and evaluated the effect of homeopathic medicines on the teeth of rats fed a cariogenic diet. None of the groups included in this study developed caries. However, microscopy revealed the presence of precipitate and/or deposit in the groups treated with homeopathic medicines. This phenomenon might be due to deposit in the dental surface or precipitation of bacterial plaque or calcium salts. It was not possible to identify the composition of the deposit/precipitate due for technical reasons. In one of the groups treated with homeopathic medicines fur loss was observed in 40% of animals. These reactions might be caused due to the action of the homeopathic medicines.

Update on Early Childhood Caries since the Surgeon General's Report

PubMed Central

Tinanoff, Norman; Reisine, Susan

2009-01-01

The 2000 Surgeon General's Report on Oral Health (SGROH) included a limited discussion of the condition known as Early Childhood Caries (ECC). Because of its high prevalence, its impact on young children's quality of life and potential for increasing their risk of caries in the permanent dentition, ECC is arguably one of the most serious and costly health conditions among young children. A necessary first step in preventing dental caries in preschool children is understanding and evaluating the child's caries risk factors. Previous caries experience and white spot lesions should automatically classify a preschool child as high risk for caries. Microbial factors, such as presence of visible plaque and tests that identify a child as having high levels of mutans streptococci also predict caries in young children. Frequency of sugar consumption, enamel developmental defects, social factors such as socioeconomic status, psychosocial factors, and being an ethnic minority also have shown to be relevant in determining caries risk. Based on this knowledge of specific risk factors for an individual, different preventive strategies as well as different intensities of preventive therapies can be employed. Caries preventive strategies in preschool children include fluoride therapy, such as supervised tooth brushing with fluoridated dentifrice, systemic fluoride supplement to children living in a non-fluoridated area that are at risk for caries, and professional topical fluoride with fluoride varnish. There is emerging evidence that intensive patient counseling or motivational interviews with parents to change specific behaviors may reduce caries prevalence in their children. Findings regarding antimicrobial interventions, efforts to modify diets, and traditional dental health education are less consistent. PMID:19945074

Focus on Fluorides: Update on the Use of Fluoride for the Prevention of Dental Caries

PubMed Central

Carey, Clifton M.

2014-01-01

Declarative Title: Improving the efficacy of fluoride therapies reduces dental caries and lowers fluoride exposure. Background Fluoride is delivered to the teeth systemically or topically to aid in the prevention of dental caries. Systemic fluoride from ingested sources is in blood serum and can be deposited only in teeth that are forming in children. Topical fluoride is from sources such as community water, processed foods, beverages, toothpastes, mouthrinses, gels, foams, and varnishes. The United States Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have proposed changes in their long standing recommendations for the amount of fluoride in community drinking water in response to concerns about an increasing incidence of dental fluorosis in children. Current research is focused on the development of strategies to improve fluoride efficacy. The purpose of this update is to inform the reader about new research and policies related to the use of fluoride for the prevention of dental caries. Methods Reviews of the current research and recent evidence based systematic reviews on the topics of fluoride are presented. Topics discussed include: updates on community water fluoridation research and policies; available fluoride in dentifrices; fluoride varnish compositions, use, and recommendations; and other fluoride containing dental products. This update provides insights into current research and discusses proposed policy changes for the use of fluoride for the prevention of dental caries. Conclusions The dental profession is adjusting their recommendations for fluoride use based on current observations of the halo effect and subsequent outcomes. The research community is focused on improving the efficacy of fluoride therapies thus reducing dental caries and lowering the amount of fluoride required for efficacy. PMID:24929594

Focus on fluorides: update on the use of fluoride for the prevention of dental caries.

PubMed

Carey, Clifton M

2014-06-01

Improving the efficacy of fluoride therapies reduces dental caries and lowers fluoride exposure. Fluoride is delivered to the teeth systemically or topically to aid in the prevention of dental caries. Systemic fluoride from ingested sources is in blood serum and can be deposited only in teeth that are forming in children. Topical fluoride is from sources such as community water, processed foods, beverages, toothpastes, mouthrinses, gels, foams, and varnishes. The United States Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have proposed changes in their long standing recommendations for the amount of fluoride in community drinking water in response to concerns about an increasing incidence of dental fluorosis in children. Current research is focused on the development of strategies to improve fluoride efficacy. The purpose of this update is to inform the reader about new research and policies related to the use of fluoride for the prevention of dental caries. Reviews of the current research and recent evidence based systematic reviews on the topics of fluoride are presented. Topics discussed include: updates on community water fluoridation research and policies; available fluoride in dentifrices; fluoride varnish compositions, use, and recommendations; and other fluoride containing dental products. This update provides insights into current research and discusses proposed policy changes for the use of fluoride for the prevention of dental caries. The dental profession is adjusting their recommendations for fluoride use based on current observations of the halo effect and subsequent outcomes. The research community is focused on improving the efficacy of fluoride therapies thus reducing dental caries and lowering the amount of fluoride required for efficacy. Copyright © 2014 Elsevier Inc. All rights reserved.

Maryland dental hygienists' knowledge, opinions and practices regarding dental caries prevention and early detection.

PubMed

Clovis, Joanne B; Horowitz, Alice M; Kleinman, Dushanka V; Wang, Min Qi; Massey, Meredith

2012-01-01

The purpose of this study was to assess Maryland dental hygienists' knowledge, practices and opinions regarding dental caries prevention and early detection. A 30 item survey was mailed to 1,258 Maryland dental hygienists. Two follow-up mailings and email reminders were sent. The response rate was 43% (n=540). Nearly all respondents were female (98%), and 58% practiced in solo settings. Knowledge and certainty of knowledge were moderate: sealants are needed regardless of topical fluoride use (55% certain, 40% less certain), newly erupted permanent molars are the best candidates for sealants (54%, 36%) and professionally applied fluorides are desirable in areas without fluoridated water (55%, 36%). Fewer were certain that incipient lesions can be remineralized before cavitation (23%, 69%), and dilute, frequently administered fluorides are more effective in caries prevention than concentrated, less frequently administered fluorides (6%, 24%). Opinions regarding effectiveness of protocols for 2 age groups from 6 months to 6 years, the challenges of early childhood caries (ECC), prevention practices regarding sealant and topical fluoride applications varied widely. Eighty-nine percent reported routinely assessing dental caries risk factors of child patients and 90% were interested in continuing education courses. There were no significant differences between different types of practice settings, year of graduation, race/ethnicity or gender. Knowledge of recommended guidelines for fluoride and sealant application support clinical decision-making and self-care counseling. Misinformation and lack of understanding of current research and recommendations identify a need for educational interventions in undergraduate dental hygiene programs and through continuing education for practicing hygienists.

Preventive effect of fluoridated orthodontic resins subjected to high cariogenic challenges.

PubMed

Passalini, Paula; Fidalgo, Tatiana Kelly da Silva; Caldeira, Erika Machado; Gleiser, Rogerio; Nojima, Matilde da Cunha Gonçalves; Maia, Lucianne Cople

2010-01-01

The aim of the present study was to evaluate the in vitro caries preventive effect of fluoridated orthodontic resins under pH cycling with two types of acid demineralizing saliva. Brackets were bonded to 60 bovine incisors, using either Transbond Plus Color Change (n=30) or Orthodontic Fill Magic (n=30) orthodontic resins. Each group of resin was divided into 3 subgroups (n=10): immersion in remineralizing artificial saliva for 14 days, pH cycling with high cariogenic challenge in acid saliva with pH 5.5, and acid saliva with pH 4.5. After 14 days of pH cycling, the caries preventive effect on the development of white spot lesion was evaluated considering the presence of inhibition zones to white spot lesions using two scores: 0= absence and 1= presence. Kruskal Wallis and Mann-Whitney tests (a=0.05) were used. Formation of white spot lesions was observed only under pH cycling using acid saliva with pH 4.5; with Transbond Plus Color Change being significantly more effective (p<0.05) in preventing the appearance of white spot lesions effect than Orthodontic Fill Magic. The acidity of the demineralizing solution influenced the formation of white spot lesions around orthodontic brackets under highly cariogenic conditions. Transbond Plus Color Change resin presented higher caries preventive effect than Orthodontic Fill Magic.

Experts' opinions on the role of diet in caries prevention.

PubMed

van Loveren, C; Duggal, M S

2004-01-01

A questionnaire was sent to 54 experts in preventive dentistry in 23 European countries in order to make an inventory of existing national dietary guidelines for the prevention of dental caries. In addition, the experts were asked to give their personal opinion on several issues concerning the relationship between diet and dental caries. Forty-five experts from 20 countries returned the questionnaire. In 13 European countries dietary guidelines for caries prevention were available issued by a National (Dental) Association or a Government Body. All guidelines emphasised a reduction of the frequency of intakes of cariogenic foods. Two of them included a threshold level for the amount of sugar. When asked for their personal opinions, almost all experts mentioned reduction of frequency of 'cariogenic' intakes as the principal dietary messages for caries prevention. Four experts, however, explicitly mentioned that proper oral hygiene with fluoride toothpaste is more important. There was no agreement among the experts about a daily number of cariogenic intakes in between meals that can be regarded as safe, nor whether the message: 'Use products with sugar substitutes' should be part of the dietary guidelines for the prevention of dental caries. There was no agreement amongst experts on preventive dentistry in Europe on the contemporary validity of the paradigm: 'Sucrose is the arch criminal of dental caries.' Taking the variation in opinions into account and the fact that a balanced diet may lead to a moderate eating and snacking frequency, the authors propose that the emphasis on good versus bad foods for caries prevention should be replaced by an emphasis on good versus bad diets. Copyright 2004 S. Karger AG, Basel

Salt fluoridation--an alternative in automatic prevention of dental caries.

PubMed

Marthaler, T M; Petersen, P E

2005-12-01

Despite great improvements in terms of reduced prevalence and amount of dental caries in populations worldwide, problems still persist particularly among the underprivileged groups of both developed and developing countries. Research and practical experience gained in several countries have demonstrated however, that dental caries can be prevented effectively through establishment of fluoride programmes. Water fluoridation, salt fluoridation, milk fluoridation and use of affordable fluoridated toothpastes play the major roles in public health. The present paper outlines the relevance and some practical aspects in relation to implementation of salt fluoridation programmes. The World Health Organisation Oral Health Programme provides technical assistance to countries in the process of planning, implementing and evaluating salt fluoridation projects.

Cost-effectiveness of a long-term dental health education program for the prevention of early childhood caries.

PubMed

Kowash, M B; Toumba, K J; Curzon, M E J

2006-09-01

To evaluate the benefit-cost (B/C) and cost-effectiveness (C/E) of a long-term dental health education program to prevention early childhood caries (ECC) through home visits. The data collected over a three year period in a dental health education programme (DHE), previously reported [Kowash et al., 2000] for infants aged 8 months at start were analysed for B/C and C/E. Dental caries indices (BASCD) for dmft and dmfs were used. Costs were based on British National Health Service (UK) fees for treating children by general dental practitioners and salaries for community dental officers in the Community Dental Services in the UK. Comparisons were made for B/C and C/E with results from a clinical trial of a slow releasing fluoride device (SRFD), community water fluoridation (CMF) and a school based fissure sealant program (FSP) using the hypothetical community of Niessen and Douglass, [1984]. The cavities, as ECC, saved over the three year period indicated a B/C ratio for the DHE of 5.21 compared with SRFD of 4.17; CWF of 1.15 and FSP of 0.42. The C/E results were 1.92, 2.40, 8.66 and 23.74 respectively. A dental health education program of home visits with mothers of young infants to prevent early childhood caries and starting at 8 months of age, gave better benefit-costs and costs effectiveness ratios than other preventive programs.

Hypoplasia-associated Severe Early Childhood Caries – A Proposed Definition

PubMed Central

Caufield, P.W.; Li, Y.; Bromage, T.G.

2012-01-01

We propose a new classification of severe early childhood caries (S-ECC): hypoplasia-associated severe early childhood caries (HAS-ECC). This form of caries affects mostly young children living at or below poverty, characterized by structurally damaged primary teeth that are particularly vulnerable to dental caries. These predisposing developmental dental defects are mainly permutations of enamel hypoplasia (EHP). Anthropologists and dental researchers consider EHP an indicator for infant and maternal stresses including malnutrition, a variety of illnesses, and adverse birthing conditions. Differentiation of HAS-ECC from other forms of early childhood caries is warranted because of its distinct etiology, clinical presentation, and eventual management. Defining HAS-ECC has important clinical implications: Therapies that control or prevent other types of caries are likely to be less effective with HAS-ECC because the structural integrity of the teeth is compromised prior to their emergence into the oral cavity. By the time these children present to the dentist, the treatment options often become limited to surgical management under general anesthesia. To prevent HAS-ECC, dentists must partner with other health providers to develop interventions that begin with pregnant mothers, with the aim of eliminating or ameliorating the covariates accompanying poverty, including better pre- and post-natal care and nutrition. PMID:22529242

Factors Affecting Dental Caries of Preschool Children in Shiraz, 2014

PubMed Central

Shaghaghian, Soheila; Abolvardi, Masoud; Akhlaghian, Marzieh

2018-01-01

Statement of the Problem: Dental caries, the most common infectious disease, can lead to several consequences, including inflammation and bleeding of the gum, abscess formation, tooth loss, and subsequently loss of available space in the arch. Purpose: This study was designed to determine dental caries status of Shiraz preschool children and its related factors. Materials and Method: This cross-sectional study was conducted on the children registered in Shiraz kindergartens in 2014. The study recruited 453 children by randomized cluster sampling. We evaluated the children’s demographic and oral hygiene factors, and their dental caries status using decayed, missed, and filled tooth (dmft) index and prevalence of the children with untreated dental caries. Relationship between the children’s characteristics and their dental caries status was evaluated. Results: Only 119 children (30.1%) were caries-free. The children’s mean dmft index was 3.88(±3.9). After controlling the effect of confounding factors, the children’s dental caries status was significantly associated with variables indicating their socioeconomic status such as fathers’ job, mothers’ education, and number of children in the family. Furthermore, there was a significant association between the children’s dental caries status and their oral hygiene habits such as frequency of tooth brushing. Conclusion: The dental caries status of the studied preschool children was not desirable which could be indicative of the inadequacy of the current preventive programs. To improve this issue, interventional preventive programs such as tooth brushing are recommended. The programs are more necessary for the children of low socioeconomic families and those with poor oral hygiene habits. PMID:29854883

Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees.

PubMed

Pahel, Bhavna T; Rozier, R Gary; Stearns, Sally C; Quiñonez, Rocio B

2011-03-01

To estimate the effectiveness of a medical office-based preventive dental program (Into the Mouths of Babes [IMB]), which included fluoride varnish application, in reducing treatments related to dental caries. We used longitudinal claims and enrollment data for all children aged 72 months or younger enrolled in North Carolina Medicaid from 2000 through 2006. Regression analyses compared subgroups of children who received up to 6 IMB visits at ages 6 to 35 months with children who received no IMB visits. Analyses were adjusted for child and area characteristics. Children enrolled in North Carolina Medicaid with ≥ 4 IMB visits experienced, on average, a 17% reduction in dental-caries-related treatments up to 6 years of age compared with children with no IMB visits. When we simulated data for initial IMB visits at 12 and 15 months of age, there was a cumulative 49% reduction in caries-related treatments at 17 months of age. The cumulative effectiveness declined because of an increase in treatments from 24 to 36 months, an increase in referrals for dental caries occurred with increasing time since fluoride application, and emergence of teeth not initially treated with fluoride. North Carolina's IMB program was effective in reducing caries-related treatments for children with ≥ 4 IMB visits. Multiple applications of fluoride at the time of primary tooth emergence seem to be most beneficial. Referrals to dentists for treatment of existing disease detected by physicians during IMB implementation limited the cumulative reductions in caries-related treatments, but also contributed to improved oral health.

[Paradigm shift in conservative dentistry: from a mechanistic to a prevention-oriented perception].

PubMed

Hellwig, E; Altenburger, M

2011-09-01

The application of different preventive measures has resulted in a decline of clinically detectable carious lesions in children and adolescents. Not only have caries symptoms changed significantly, but the number of extracted teeth in adults has decreased. Due to these epidemiological facts, modern conservative dentistry is based on a careful risk analysis and caries diagnosis, which also takes into consideration biological and psychosocial components of caries etiology. Conservative dentistry will fail if the dentists are only interested in repairing defects. Simultaneous with the positive outcome of prevention, some unanswered problems have arisen, for which there are no adequate solutions. In young children, caries prevalence is still high and the restorative care of these primary teeth should be improved. For adolescents, early detection of carious lesions should be improved and polarization of caries prevalence should be eliminated. In older adults, evidence-based therapy options for treatment of erosions, abrasions, and root caries are lacking. For seniors needing general care, preventive and restorative concepts should be established.

Long-term Hyperglycemia Naturally Induces Dental Caries but Not Periodontal Disease in Type 1 and Type 2 Diabetic Rodents.

PubMed

Nakahara, Yutaka; Ozaki, Kiyokazu; Matsuura, Tetsuro

2017-11-01

Periodontal disease (PD) in patients with diabetes is described as the sixth complication of diabetes. We have previously shown that diabetes increases dental caries, and carious inflammation might have a strong effect on the adjacent periodontal tissue in diabetic rodent models. However, the possibility that hyperglycemia may induce PD in diabetic animals could not be completely eliminated. The goal of this study was to confirm the presence of PD in diabetic animal models by preventing carious inflammation with fluoride administration. F344 rats injected with alloxan (type 1 diabetic model) and db/db mice (type 2 diabetic model) were given either tap water alone or tap water containing fluoride. A cariostatic effect of fluoride was evident in the diabetic animals. Meanwhile, fluoride treatment drastically attenuated periodontal inflammation in addition to preventing dental caries. Furthermore, with fluoride treatment, periodontitis was notably nonexistent in the periodontal tissue surrounding the normal molars, whereas the caries-forming process was clearly observed in the teeth that were enveloped with persistent periodontitis, suggesting that enhanced periodontal inflammation might have been derived from the dental caries in the diabetic rodents rather than from the PD. In conclusion, long-term hyperglycemia naturally induces dental caries but not PD in type 1 and type 2 diabetic rodents. © 2017 by the American Diabetes Association.

[The Nutrition Commission of the Austrian Society of Pediatrics and Adolescent Medicine. Prevention of caries].

PubMed

Haschke, F

1992-01-01

Effective preventive programs must be instituted early in the life of a child. The pediatrician plays an important role in preventive oral health care, because most children do not visit a dentist before 3 years of age. Fluoride therapy decreases the caries vulnerability of the tooth, oral hygiene measures are important to remove bacterial plaque, and dietary modifications reduce the number of carbohydrate exposures per day. Community water fluoridation is proposed in Austrian cities, because it continues to be the most cost-effective caries prevention measure available. As long as the population does not have access to optimally fluoridated water, dietary fluoride supplementation offers an effective alternative. The recommended dosage of fluoride supplements for children depends on the amount of fluoride present in their drinking water and on the child's age. Liquid fluoride supplements and chewable tablets are proposed for children between 0.5 and 3 years and children between 3 and 13 years, respectively. Home use topical fluorides and professionally applied topical fluorides are useful beyond 3 years of age. Teaching of oral hygiene measures should be continued in kindergarten and school. The 3-6 year-old children require parental assistance to achieve effective plaque removal. Semiannual dental visits should begin at the age of three and continue throughout childhood and adolescence. As far as the diet is concerned, the frequency of exposure to sugar appears to be the most important factor in the development of dental caries. It now appears that most sugars are nearly equally cariogenic in a pure form.

Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

PubMed

Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

2018-01-01

Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

Targeting of Streptococcus mutans Biofilms by a Novel Small Molecule Prevents Dental Caries and Preserves the Oral Microbiome.

PubMed

Garcia, S S; Blackledge, M S; Michalek, S; Su, L; Ptacek, T; Eipers, P; Morrow, C; Lefkowitz, E J; Melander, C; Wu, H

2017-07-01

Dental caries is a costly and prevalent disease characterized by the demineralization of the tooth's enamel. Disease outcome is influenced by host factors, dietary intake, cariogenic bacteria, and other microbes. The cariogenic bacterial species Streptococcus mutans metabolizes sucrose to initiate biofilm formation on the tooth surface and consequently produces lactic acid to degrade the tooth's enamel. Persistence of S. mutans biofilms in the oral cavity can lead to tooth decay. To date, no anticaries therapies that specifically target S. mutans biofilms but do not disturb the overall oral microbiome are available. We screened a library of 2-aminoimidazole antibiofilm compounds with a biofilm dispersion assay and identified a small molecule that specifically targets S. mutans biofilms. At 5 µM, the small molecule annotated 3F1 dispersed 50% of the established S. mutans biofilm but did not disperse biofilms formed by the commensal species Streptococcus sanguinis or Streptococcus gordonii. 3F1 dispersed S. mutans biofilms independently of biofilm-related factors such as antigen I/II and glucosyltransferases. 3F1 treatment effectively prevented dental caries by controlling S. mutans in a rat caries model without perturbing the oral microbiota. Our study demonstrates that selective targeting of S. mutans biofilms by 3F1 was able to effectively reduce dental caries in vivo without affecting the overall oral microbiota shaped by the intake of dietary sugars, suggesting that the pathogenic biofilm-specific treatment is a viable strategy for disease prevention.

Water fluoridation: a critical review of the physiological effects of ingested fluoride as a public health intervention.

PubMed

Peckham, Stephen; Awofeso, Niyi

2014-01-01

Fluorine is the world's 13th most abundant element and constitutes 0.08% of the Earth crust. It has the highest electronegativity of all elements. Fluoride is widely distributed in the environment, occurring in the air, soils, rocks, and water. Although fluoride is used industrially in a fluorine compound, the manufacture of ceramics, pesticides, aerosol propellants, refrigerants, glassware, and Teflon cookware, it is a generally unwanted byproduct of aluminium, fertilizer, and iron ore manufacture. The medicinal use of fluorides for the prevention of dental caries began in January 1945 when community water supplies in Grand Rapids, United States, were fluoridated to a level of 1 ppm as a dental caries prevention measure. However, water fluoridation remains a controversial public health measure. This paper reviews the human health effects of fluoride. The authors conclude that available evidence suggests that fluoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect. As part of efforts to reduce hazardous fluoride ingestion, the practice of artificial water fluoridation should be reconsidered globally, while industrial safety measures need to be tightened in order to reduce unethical discharge of fluoride compounds into the environment. Public health approaches for global dental caries reduction that do not involve systemic ingestion of fluoride are urgently needed.

Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention

PubMed Central

2014-01-01

Fluorine is the world's 13th most abundant element and constitutes 0.08% of the Earth crust. It has the highest electronegativity of all elements. Fluoride is widely distributed in the environment, occurring in the air, soils, rocks, and water. Although fluoride is used industrially in a fluorine compound, the manufacture of ceramics, pesticides, aerosol propellants, refrigerants, glassware, and Teflon cookware, it is a generally unwanted byproduct of aluminium, fertilizer, and iron ore manufacture. The medicinal use of fluorides for the prevention of dental caries began in January 1945 when community water supplies in Grand Rapids, United States, were fluoridated to a level of 1 ppm as a dental caries prevention measure. However, water fluoridation remains a controversial public health measure. This paper reviews the human health effects of fluoride. The authors conclude that available evidence suggests that fluoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect. As part of efforts to reduce hazardous fluoride ingestion, the practice of artificial water fluoridation should be reconsidered globally, while industrial safety measures need to be tightened in order to reduce unethical discharge of fluoride compounds into the environment. Public health approaches for global dental caries reduction that do not involve systemic ingestion of fluoride are urgently needed. PMID:24719570

Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

PubMed

Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W

2015-08-29

The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

Early Childhood Caries

PubMed Central

Kawashita, Yumiko; Kitamura, Masayasu; Saito, Toshiyuki

2011-01-01

Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC) is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries. PMID:22007218

An alternate technique of care using silver fluoride followed by stannous fluoride in the management of root caries in aged care.

PubMed

Deutsch, Alan

2016-01-01

An alternate technique of care to prevent, arrest and manage root caries using aqueous silver fluoride followed by stannous fluoride (AgF+SnF2) in aged care is demonstrated by three case studies. With increasing age, the inability to maintain ones own oral care from dementia, illness or frailty and polypharmacy induced salivary gland hypofunction will result in dental caries becoming a progessively greater burden for the elderly. Future generations of elders will live longer and need to maintain many more teeth longer than earlier generations. Both silver diamine fluoride (SDF)and AgF+SnF2 arrest and prevent caries and are easy to use in residential aged care facilities. Clinical differences between SDF and AgF+SnF2 are discussed. However, in aged care, AgF+SnF2 may offer advantages over SDF. AgF+SnF2 used to arrest and prevent caries in children can be modified to provide effective but minimally invasive care for an ageing and frail population. These techniques are rapid, inexpensive and nonthreatening suited to treat frail elders, dementia patients exhibiting challenging behaviours and patients with multiple rapidly progressing decay. Silver fluoride, applied before placing glass-ionomer cement (GIC) restorations is an important adjunct to the atraumatic restorative technique and may retard caries reactivation more than GIC used alone. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

Long-term effect of intensive prevention on dental health of primary school children by socioeconomic status.

PubMed

Winter, Julia; Jablonski-Momeni, Anahita; Ladda, Annett; Pieper, Klaus

2017-12-29

Children in a German region took part in regular toothbrushing with fluoride gel during their time in primary school after having received a preventive program in kindergarten. The study aimed at determining the dental health of the students as a function of prevention in kindergarten and at school while taking into account their socioeconomic status and other confounders. The subjects were in six groups: groups 1 and 2, intensive prevention in kindergarten with and without fluoride gel at school; groups 3 and 4, basic prevention in kindergarten with and without fluoride gel at school; groups 5 and 6, no organized prevention in kindergarten with and without fluoride gel at school. Two dental examinations were performed for assessing caries experience and calculating caries increment from second grade (7-year-olds) to fourth grade (9-year-olds). A standardized questionnaire was used to record independent variables. To compare caries scores and preventive measures of various subgroups, non-parametric tests and a binary logistic regression analysis were performed. A significant difference was found in the mean decayed, missing, and filled tooth/teeth (DMFT) depending on socioeconomic status (no prevention in kindergarten, fluoride gel at school in children with low SES: DMFT = 0.47 vs. DMFT = 0.18 in children with high SES; p = 0.023). Class-specific differences were no longer visible among children who had taken part in an intensive preventive program combining daily supervised toothbrushing in kindergarten and application of fluoride gel in school. Early prevention, focusing on professionally supported training of toothbrushing in kindergarten and at school, has a positive effect on dental health and is able to reduce class-specific differences in caries distribution. Early training of toothbrushing and fissure sealing of first permanent molars are the most important factors for the dental health of primary school children.

Incidence of caries lesions among patients treated with comprehensive orthodontics.

PubMed

Richter, Amy E; Arruda, Airton O; Peters, Mathilde C; Sohn, Woosung

2011-05-01

Dental caries, specifically decalcified white-spot lesions (WSL), is a well-known side-effect of orthodontic treatment. The incidence of labial incipient caries lesions and its relationship with various patient and treatment variables was investigated in patients treated with comprehensive orthodontics. Randomly selected orthodontic patient records (n = 350) were examined to determine incipient caries lesion development. Labial surfaces on pretreatment and posttreatment photographs were scored with a standardized scoring system. Independent variables were collected by chart abstraction. The incidence of patients who developed at least 1 new WSL during treatment was 72.9%, and this incidence was 2.3% for cavitated lesions. Treatment duration was significantly associated with new WSL development (P = 0.03). Development of WSL and cavitated lesions increased (both, P <0.00) despite increased attention to oral hygiene during treatment. Sex, age, extraction therapy, and various fluoridation sources were not associated with WSL development, but initial oral-hygiene score was moderately associated (P <0.06). The incidence of WSL in patients treated with comprehensive orthodontics was significantly high, and the preventive therapy provided appeared to be ineffective. This widespread problem is alarming and warrants significant attention from both patients and providers that should result in greatly increased emphasis on effective caries prevention. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Survey of midwives' knowledge of caries prevention in perinatal care.

PubMed

Ehlers, Vicky; Callaway, Angelika; Azrak, Birgül; Zock, Cornelia; Willershausen, Brita

2014-01-01

To assess midwives' knowledge about oral health and early caries prevention during perinatal care for mothers and babies. A survey developed by the investigators was conducted among midwives to assess their knowledge about caries etiology, their attitude toward their role in early caries prevention, and prophylactic measures recommended during pregnancy, and after birth, for their babies. Self-administered questionnaires were sent to 180 midwives in hospitals and 323 midwives from a midwives' association in Hesse, Germany. Response rates were 46% (83/180) and 56% (181/323); a total of 264 questionnaires were evaluated. Most midwives were familiar with the term Early Childhood Caries (ECC), over 90% knew the role of acidic bacteria, carbohydrates, and insufficient oral hygiene in caries etiology. A vast majority of the midwives considered caries prophylaxis as essential, and saw this topic as part of their core area of competence. Only 60% informed the pregnant women in their care about pregnancy gingivitis. Almost all midwives gave recommendations about caries prophylaxis. The risk for developing ECC was explained to the pregnant women and mothers/parents by 92% of the midwives. Recommendations concerning regular dental visits for small children were given by 80% of the midwives. The time-intensive medical care of families through advanced practice nurses or midwives offers opportunities for better education about caries prophylaxis. A consensus of all the involved healthcare professional groups, including dentists, obstetricians, advanced practice nurses, midwives, pediatric nurses, and pediatricians, is needed to provide uniform recommendations for prophylaxis and prevention of ECC.

Caries prevalence and fluoride use in low SES children in Clermont-Ferrand (France).

PubMed

Tubert-Jeannin, S; Riordan, P J; Manevy, R; Lecuyer, M M; Pegon-Machat, E

2009-03-01

To evaluate the association between dental caries experience and preventive behaviours of children residing in a deprived area in Clermont-Ferrand (France). All 4-5 yr-olds attending nine schools in deprived areas of the city were invited to participate and 81% (n=282) consented and were examined. Dental caries was recorded at the dentine threshold. Parents completed a questionnaire concerning family demographics and the child's use of fluoride. Non-parametric tests and logistic regression assessed the relative importance of SES and fluoride variables on dental status (dt>1). Fifty four (19%) of the examined children were living in families with an immigrant background, 33% were fully covered by the national health insurance programme for deprived families. Caries experience was high; mean dft was 1.94 (3.31) and 30% of the children had >1 carious teeth. Thirty percent of the families reported using fluoridated salt. Tooth brushing once daily was reported for 39% and twice daily for 26%. Parents declared supervising tooth brushing for 60%. Two thirds of the children, according to their parents, used fluoride supplement between birth and two years. Supervised tooth brushing was significantly correlated with lower mean dt scores. Systemic fluoride use was poorly related to dental caries Immigrant background, family size, type of health insurance and mother's unemployment were significantly correlated with caries prevalence. In multivariate analysis, immigrant status, supervised tooth brushing and parental knowledge about fluoride in toothpastes were significant caries predictors. The majority of low SES children did not practice effective caries prevention; few reported twice daily brushing with fluoride toothpaste. Caries experience was very high and much was untreated. Immigrant status, supervised tooth brushing and parental knowledge about fluoride in toothpastes were significant caries predictors.

Efficacy of a public promotion program on children's oral health.

PubMed

Alves, Ana Paula S; Rank, Rise C I C; Vilela, Joana Estela R; Rank, Marcos S; Ogawa, Wataro N; Molina, Omar F

2017-09-25

To assess the efficacy of the Baby's Mouth early dental care prevention and promotion program in preventing oral diseases (caries, gingivitis, or malocclusions) in children attended since 2010. This was a cross-sectional and cohort study that assessed 252 children between 36 and 60 months of age in both sexes. The children were divided into three groups: G1: effective participants of the program from birth; G2: children who have stopped participating for more than 24 months, and G3: children who have never attended a prevention program. The evaluation was carried out in two stages: first, an interview with the mothers and, afterwards, a clinical children examination to assess the presence of caries, gingivitis, and malocclusion. The chi-squared test was used for statistical analysis between groups (p<0.05). The diseases assessed were: caries (G1: 5.9%, G2: 54.7%, G3: 70%), gingivitis (G1: 8.3%, G2: 17.9%, G3: 40.5%), and malocclusion (G1: 22.6%; G2: 28.6%; G3: 50%). For gingivitis, there was no significant difference when comparing G1 and G2 (p=0.107), but it was significant between G1 and G3 (p<0.001). Regarding malocclusion, a statistically significant relationship was observed (p=0.004) among all groups. The prevention and promotion program in public oral health was effective in preventing caries disease, gingivitis, and malocclusion in children under 5 years of age. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Xylitol-containing products for preventing dental caries in children and adults.

PubMed

Riley, Philip; Moore, Deborah; Ahmed, Farooq; Sharif, Mohammad O; Worthington, Helen V

2015-03-26

Dental caries is a highly prevalent chronic disease which affects the majority of people. It has been postulated that the consumption of xylitol could help to prevent caries. The evidence on the effects of xylitol products is not clear and therefore it is important to summarise the available evidence to determine its effectiveness and safety. To assess the effects of different xylitol-containing products for the prevention of dental caries in children and adults. We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 14 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 7), MEDLINE via OVID (1946 to 14 August 2014), EMBASE via OVID (1980 to 14 August 2014), CINAHL via EBSCO (1980 to 14 August 2014), Web of Science Conference Proceedings (1990 to 14 August 2014), Proquest Dissertations and Theses (1861 to 14 August 2014). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We included randomised controlled trials assessing the effects of xylitol products on dental caries in children and adults. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We attempted to contact study authors for missing data or clarification where feasible. For continuous outcomes, we used means and standard deviations to obtain the mean difference and 95% confidence interval (CI). We used the continuous data to calculate prevented fractions (PF) and 95% CIs to summarise the percentage reduction in caries. For dichotomous outcomes, we reported risk ratios (RR) and 95% CIs. As there were less than four studies included in the meta-analysis, we used a fixed-effect model. We planned to use a random-effects model in the event that there were four or more studies in a meta-analysis. We included 10 studies that analysed a total of 5903 participants. One study was assessed as being at low risk of bias, two were assessed as being at unclear risk of bias, with the remaining seven being at high risk of bias.The main finding of the review was that, over 2.5 to 3 years of use, a fluoride toothpaste containing 10% xylitol may reduce caries by 13% when compared to a fluoride-only toothpaste (PF -0.13, 95% CI -0.18 to -0.08, 4216 children analysed, low-quality evidence).The remaining evidence on children, from small single studies with risk of bias issues and great uncertainty associated with the effect estimates, was insufficient to determine a benefit from xylitol products. One study reported that xylitol syrup (8 g per day) reduced caries by 58% (95% CI 33% to 83%, 94 infants analysed, low quality evidence) when compared to a low-dose xylitol syrup (2.67 g per day) consumed for 1 year.The following results had 95% CIs that were compatible with both a reduction and an increase in caries associated with xylitol: xylitol lozenges versus no treatment in children (very low quality body of evidence); xylitol sucking tablets versus no treatment in infants (very low quality body of evidence); xylitol tablets versus control (sorbitol) tablets in infants (very low quality body of evidence); xylitol wipes versus control wipes in infants (low quality body of evidence).There was only one study investigating the effects of xylitol lozenges, when compared to control lozenges, in adults (low quality body of evidence). The effect estimate had a 95% CI that was compatible with both a reduction and an increase in caries associated with xylitol.Four studies reported that there were no adverse effects from any of the interventions. Two studies reported similar rates of adverse effects between study arms. The remaining studies either mentioned adverse effects but did not report any usable data, or did not mention them at all. Adverse effects include sores in the mouth, cramps, bloating, constipation, flatulence, and loose stool or diarrhoea. We found some low quality evidence to suggest that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste for preventing caries in the permanent teeth of children, and that there are no associated adverse-effects from such toothpastes. The effect estimate should be interpreted with caution due to high risk of bias and the fact that it results from two studies that were carried out by the same authors in the same population. The remaining evidence we found is of low to very low quality and is insufficient to determine whether any other xylitol-containing products can prevent caries in infants, older children, or adults.

The anti-caries activity and toxicity of an experimental propolis-containing varnish.

PubMed

DE Luca, Mariana Passos; Freires, Irlan Almeida; Gala-García, Alfonso; Santos, Vagner Rodrigues; Vale, Miriam Pimenta; Alencar, Severino Matias de; Rosalen, Pedro Luiz

2017-06-05

We investigated the anti-caries effects of an experimental propolis varnish in vivo, and further tested its toxicity against fibroblasts. Fifty-six SPF female Wistar rats were infected with Streptococcus mutans UA159 (SM) and allocated into four groups (n = 14/group): G1, propolis varnish (15%/PV); G2, chitosan varnish (CV/vehicle); G3, gold standard (GS/Duraphat®); and G4, untreated. The animals received a single varnish application on their molars and were submitted to a high cariogenic challenge (Diet-2000, 56% sucrose, and 5% sucrose-added water, ad libitum) for 4 weeks. Total cultivable microbiota and SM were counted, and smooth-surface and sulcal caries were scored. PV, CV and GS cytotoxic effects were tested against fibroblasts. The data were analyzed using ANOVA with the Tukey-Kramer test (p ≤ 0.05). Total microbiota and SM counts did not differ among the treatments (p = 0.78), or in relation to the untreated group (p = 0.52). PV reduced development of smooth-surface enamel caries compared with the untreated group (p = 0.0018), with no significant difference from GS (p = 0.92); however, the PV effects were no longer observed when the dentin was affected. Neither PV nor GS prevented enamel sulcal lesion onset, but GS significantly reduced the severity of dentinal sulcal lesions (p < 0.0001). No significant difference was observed in fibroblast viability between PV and GS (p < 0.0001). In conclusion, PV prevented smooth-surface enamel caries and showed low cell toxicity. Nevertheless, due to the high cariogenic challenge, its effects were not sustained throughout the experiment. Further studies are encouraged to establish a protocol to sustain the long-term anti-caries activity of PV in the oral cavity.

Dental caries.

PubMed

Pitts, Nigel B; Zero, Domenick T; Marsh, Phil D; Ekstrand, Kim; Weintraub, Jane A; Ramos-Gomez, Francisco; Tagami, Junji; Twetman, Svante; Tsakos, Georgios; Ismail, Amid

2017-05-25

Dental caries is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues. Caries can occur throughout life, both in primary and permanent dentitions, and can damage the tooth crown and, in later life, exposed root surfaces. The balance between pathological and protective factors influences the initiation and progression of caries. This interplay between factors underpins the classification of individuals and groups into caries risk categories, allowing an increasingly tailored approach to care. Dental caries is an unevenly distributed, preventable disease with considerable economic and quality-of-life burdens. The daily use of fluoride toothpaste is seen as the main reason for the overall decline of caries worldwide over recent decades. This Primer aims to provide a global overview of caries, acknowledging the historical era dominated by restoration of tooth decay by surgical means, but focuses on current, progressive and more holistic long-term, patient-centred, tooth-preserving preventive care.

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6–9 years of Leon, Nicaragua

PubMed Central

del Socorro Herrera, Miriam; Medina-Solis, Carlo Eduardo; Minaya-Sánchez, Mirna; Pontigo-Loyola, América Patricia; Villalobos-Rodelo, Juan José; Islas-Granillo, Horacio; de la Rosa-Santillana, Rubén; Maupomé, Gerardo

2013-01-01

Background Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. Material/Methods A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Results Mean age was 7.49±1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54±3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. Conclusions The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators. PMID:24247119

Development of a multifunctional adhesive system for prevention of root caries and secondary caries

PubMed Central

Zhang, Ning; Melo, Mary A. S.; Chen, Chen; Liu, Jason; Weir, Michael D.; Bai, Yuxing; Xu, Hockin H. K.

2015-01-01

Objectives The objectives of this study were to: (1) develop a novel adhesive for prevention of tooth root caries and secondary caries by possessing a combination of protein-repellent, antibacterial, and remineralization capabilities for the first time; and (2) investigate the effects of 2-methacryloyloxyethyl phosphorylcholine (MPC), dimethylaminohexadecyl methacrylate (DMAHDM), and nanoparticles of amorphous calcium phosphate (NACP) on dentine bond strength, protein-repellent properties, and dental plaque microcosm biofilm response. Methods MPC, DMAHDM and NACP were added into Scotchbond Multi-Purpose primer and adhesive. Dentine shear bond strengths were measured. Adhesive coating thickness, surface texture and dentine-adhesive interfacial structure were examined. Protein adsorption onto adhesive resin surface was determined by the micro bicinchoninic acid method. A human saliva microcosm biofilm model was used to investigate biofilm metabolic activity, colony-forming unit (CFU) counts, and lactic acid production. Results The resin with 7.5% MPC + 5% DMAHDM + 30% NACP did not adversely affect dentine shear bond strength (p > 0.1). The resin with 7.5% MPC + 5% DMAHDM + 30% NACP produced a coating on root dentine with a thickness of approximately 70 μm and completely sealed all the dentinal tubules. The resin with 7.5% MPC + 5% DMAHDM + 30% NACP had 95% reduction in protein adsorption, compared to SBMP control (p < 0.05). The resin with 7.5% MPC + 5% DMAHDM + 30% NACP was strongly antibacterial, with biofilm CFU being four orders of magnitude lower than that of SBMP control. Significance The novel multifunctional adhesive with strong protein-repellent, antibacterial and remineralization properties is promising to coat tooth roots to prevent root caries and secondary caries. The combined use of MPC, DMAHDM and NACP may have wide applicability to bonding agents, cements, sealants and composites to inhibit caries. PMID:26187532

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6-9 years of Leon, Nicaragua.

PubMed

Herrera, Miriam del Socorro; Medina-Solís, Carlo Eduardo; Minaya-Sánchez, Mirna; Pontigo-Loyola, América Patricia; Villalobos-Rodelo, Juan José; Islas-Granillo, Horacio; de la Rosa-Santillana, Rubén; Maupomé, Gerardo

2013-11-19

Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Mean age was 7.49 ± 1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54 ± 3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators.

Antibacterial agents in composite restorations for the prevention of dental caries.

PubMed

Pereira-Cenci, Tatiana; Cenci, Maximiliano S; Fedorowicz, Zbys; Azevedo, Marina

2013-12-17

Dental caries is a multifactorial disease in which the fermentation of food sugars by bacteria from the biofilm (dental plaque) leads to localised demineralisation of tooth surfaces, which may ultimately result in cavity formation. Resin composites are widely used in dentistry to restore teeth. These restorations can fail for a number of reasons, such as secondary caries, and restorative material fracture and other minor reasons. From these, secondary caries, which are caries lesions developed adjacent to restorations, is the main cause for restorations replacement. The presence of antibacterials in both the filling material and the bonding systems would theoretically be able to affect the initiation and progression of caries adjacent to restorations. This is an update of the Cochrane review published in 2009. To assess the effects of antibacterial agents incorporated into composite restorations for the prevention of dental caries. We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 July 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 6), MEDLINE via OVID (1946 to 23 July 2013) and EMBASE via OVID (1980 to 23 July 2013). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov), the metaRegister of Controlled Trials (www.controlled-trials.com) and the World Health Organization International Clinical Trials Registry platform (www.who.int/trialsearch) for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomised controlled trials comparing resin composite restorations containing antibacterial agents with composite restorations not containing antibacterial agents. Two review authors conducted screening of studies in duplicate and independently, and although no eligible trials were identified, the two authors had planned to extract data independently and assess trial quality using standard Cochrane Collaboration methodologies. We retrieved 308 references to studies, none of which matched the inclusion criteria for this review and all of which were excluded. We were unable to identify any randomised controlled trials on the effects of antibacterial agents incorporated into composite restorations for the prevention of dental caries. The absence of high level evidence for the effectiveness of this intervention emphasises the need for well designed, adequately powered, randomised controlled clinical trials. Thus, conclusions remain the same as the previously published review, with no included clinical trials.

Geo-mapping of time trends in childhood caries risk--a method for assessment of preventive care.

PubMed

Strömberg, Ulf; Holmn, Anders; Magnusson, Kerstin; Twetman, Svante

2012-06-11

Dental caries is unevenly distributed within populations with a higher burden in low socio-economy groups. Several attempts have been made to allocate resources to those that need them the most; there is a need for convenient approaches to population-based monitoring of caries risk over time. The aim of this study was to develop the geo-map concept, addressing time trends in caries risk, and demonstrate the novel approach by analyzing epidemiological data from preschool residents in the region of Halland, Sweden. The study population consisted of 9,973 (2006) and 10,927 (2010) children between 3 to 6 years of age (~77% of the eligible population) from whom caries data were obtained. Reported dmfs>0 for a child was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish (66 parishes in the region). Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI® ArcGIS system. Parish-level socioeconomic data were available. The overall proportion of caries-free (dmfs=0) children improved from 84.0% in 2006 to 88.6% in 2010. The ratio of maximum and minimum (parish-level) smoothed relative risks (SmRRs) increased from 1.76/0.44=4.0 in 2006 to 2.37/0.33=7.2 in 2010, which indicated an increased geographical polarization of early childhood caries in the population. Eight parishes showed evidential, positional changes in caries risk between 2006 and 2010; their corresponding SmRRs and statistical certainty ranks changed markedly. No considerable parallel changes in parish-level socioeconomic characteristics were seen during the same time period. Geo-maps based on caries risk can be used to monitor changes in caries risk over time. Thus, geo-mapping offers a convenient tool for evaluating the effectiveness of tailored health promotion and preventive care in child populations.

Effectiveness of fluoride varnish in preventing early childhood caries in rural areas without access to fluoridated drinking water: A randomized control trial.

PubMed

Muñoz-Millán, Patricia; Zaror, Carlos; Espinoza-Espinoza, Gerardo; Vergara-Gonzalez, Carolina; Muñoz, Sergio; Atala-Acevedo, Claudia; Martínez-Zapata, Maria José

2018-02-01

Early childhood caries (ECC) constitutes a serious public health issue, especially in communities without water fluoridation. We assessed the effectiveness of biannual fluoride varnish applications to prevent ECC in children from nonfluoridated rural areas. A triple-blind randomized control trial with two parallel arms was conducted with 275 two- to three-year-old children without cavitated carious lesions from 28 rural public preschools in Chile. The preschools were located in areas of low socioeconomic status without access to fluoridated water. An oral health education component was administered to children, parents and educators. A new toothbrush and toothpaste for each child was delivered to the parents at baseline and at four follow-up visits. The participants were randomly allocated to receive fluoride varnish or placebo applications every six months. Trained, calibrated dentists blind to the treatment arm performed visual dental assessments at 6, 12, 18 and 24 months. The primary endpoint was the development of cavitated carious lesions in children during the 24-month follow-up period using WHO criteria, and the secondary outcomes were an increase in caries measured as a change in the index of decayed, missing or filled teeth (dmft) since the beginning of the study and the development of adverse effects. An intention-to-treat (ITT) approach was used for the primary analysis. We included 131 participants in the intervention group and 144 participants in the placebo group; of these children, 89 (67.9%) in the intervention group and 100 (69.4%) in the control group completed the protocol. The comparative ITT analysis of caries incidence after 24 months of follow-up showed a between-group prevention fraction of 18.9% (-2.9%-36.2%). Caries incidence was 45.0% for the experiment group and 55.6% for the control group (P = .081), with a mean dmft of 1.6 (SD = 2.4) and 2.1 (SD = 2.5), respectively. No adverse effects were reported. In conclusion, biannual fluoride varnish application is not effective in preschool children from rural nonfluoridated communities at a high risk of caries. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Appraisal of the national response to the caries epidemic in children in Nigeria

PubMed Central

2014-01-01

Background This article reviews the caries profile for children in Nigeria and proposes an appropriate framework for addressing the silent caries epidemic. Discussion We reviewed the caries prevalence among children in Nigeria, assessed the existing responses to the caries epidemic including the national oral healthcare delivery situation in the country and discussed the current caries management in children. We then proposed a response framework for Nigeria. We argue that successful interventions will require the adoption of a socio-ecological model. This would ensure that the micro-, meso-, exo- and macrosystems required to support the behavioural, structural and biological interventions for promoting caries prevention are addressed. National oral health surveys are required to help understand the epidemiology, social determinants of and factors that undermine the ability of children to access oral health care. A global caries prevention agenda for children would help get the government’s support for a national response agenda. Currently, there is no global call for action on the caries epidemic in children. This lack of an agenda needs to be urgently addressed. Summary A combination of approaches for the prevention of caries in children in Nigeria is needed. A national survey is needed to generate the needed evidence for the planning of community relevant responses to the national caries epidemic in children. The design of a global health agenda for children is an important first step that can facilitate the development of a national oral health programme for children in Nigeria. PMID:24957148

Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents.

PubMed

Ahovuo-Saloranta, A; Hiiri, A; Nordblad, A; Worthington, H; Mäkelä, M

2004-01-01

Fissure sealants used on occlusal tooth surfaces were introduced in the 1960s for protecting pits and fissures from dental caries. Although sealants have demonstrated to be effective in preventing caries, their efficacy may be related to the background caries prevalence in the population. The primary objective of this review was to evaluate the caries prevention of resin based pit and fissure sealants and glass ionomer cements or sealants in children and adolescents. We searched the Cochrane Oral Health Group's Trials Register (last update December 2002), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 4, 2002), MEDLINE via OVID (1966 to December 2002), EMBASE (1974 to February 2002), SCISEARCH, SIGLE, CAplus, INSPEC, JICST-EPLUS, NTIS, PASCAL (February 2002) and DARE, NHS EED, HTA (March 2002). Reference lists from included articles and review articles were searched for additional relevant articles. All relevant studies in most languages were considered and translated. Randomised or quasi-randomised controlled trials of at least 12 months in duration in which sealants were used for preventing caries in children and adolescents under 20 years of age were included. The primary outcome was the increment in the numbers of carious occlusal surfaces of premolars and molars. In the first phase, two reviewers independently examined whether a given study was likely to be relevant on the basis of the title, key words and abstract. In the second phase, four of the reviewers independently classified studies to be included in final analyses. Study authors were contacted for additional information. In the split-mouth studies relative risk ratios were calculated for the paired differences of tooth surfaces being carious or not. In studies comparing resin based sealant with no treatment, fixed effect meta-analyses were used to combine the estimates of relative risk ratios. In one parallel group study, the mean DFS data as continuous data, the effect estimate being the difference in mean DFS, was calculated from data of occlusal surfaces of teeth included in the test and control groups. Eight trials were included in this review of which seven trials were split-mouth studies and one a parallel group study. Six studies provided data for comparing sealant with no treatment and three studies for comparing glass ionomers with resin based sealants. The overall effectiveness of resin based sealants in preventing dental decay on first molars was high. Based on five split-mouth studies with 5 to 10 year old children there were significant differences in favour of the second-generation resin sealant compared with no treatment with pooled relative risk values of 0.14, 0.24, 0.30, 0.43 at 12, 24, 36 and 48 to 54 months respectively. The reductions in caries therefore ranged from 86% at 12 months to 57% at 48 to 54 months. The 24 month parallel group study comparing second-generation resin sealant with control in 12 to 13 year old children found also significantly more caries in the control group children with DFS = 0.65 (95% CI 0.47 to 0.83). Allocation concealment was classified adequate in three of these six studies. However the information on background levels of caries in the population was insufficient to conduct further analyses to estimate the effectiveness of resin based sealants related to baseline caries prevalence. Only one study provided data for the comparison between glass ionomer sealant and control. Based on this, there is not enough information to say whether ionomer sealants are effective, or not. The results of three studies comparing resin sealants with glass ionomer sealants were conflicting and the meta-analyses were not carried out. Sealing with resin based sealants is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars. However, we recommend that the caries prevalence level of both individuals and the population should be taken into account. In practice, the benefit of sealing should be considered locally and specified guidelines for clinicians should be used. The methodological quality of published studies concerning pit and fissure sealants was poorer than expected.

[Evaluation of the incidence of dental caries in patients with Down syndrome after their insertion in a preventive program].

PubMed

Castilho, Aline Rogéria Freire de; Marta, Sara Nader

2010-10-01

The objective of this work was to verify the incidence of dental caries by means of the CPO-D, CPO-S, ceo-d and ceo-s indexes in patients with Down syndrome regularly enrolled in a preventive program. Twenty four Down syndrome patients of both sexes age range of one to 48 years were examined. The prevalence (initial experimental situation) and incidence (final experimental situation) of dental caries were verified using of the initial and final CPO-D, CPO-S, ceo-d and ceo-s indexes of the participants. From 24 individual examined, 10 (42.0%) were free of caries. The prevalence of dental caries showed values of CPO-D= 2.33; CPO-S= 3.60; ceo-d= 1.75 e ceo-s= 2.80; while the incidence of caries showed values of 2.33; 3.80; 1.10 e 1.90, respectively. Down syndrome individuals evaluated in this study presented low level of caries and small incidence of new lesions, emphasizing the importance of the maintenance of these patients at preventive programs.

A retrospective view on the viability of water fluoridation in South Africa to prevent dental caries.

PubMed

Kroon, Jeroen; Van Wyk, Philippus Johannes

2012-10-01

Despite a Commission of Inquiry into water fluoridation recommending the fluoridation of public water supplies to the optimal fluoride concentration of 0.7 ppm, as well as regulations for the introduction of water fluoridation which compel water providers to fluoridate public water supplies, no artificially fluoridated water scheme exists in South Africa. In view of concerns expressed by South African local authorities about cost and reports urging further investigation into the effectiveness of water fluoridation, the aim of this study was to determine whether water fluoridation is still a viable option to reduce dental caries in South Africa. A model based on a cost evaluation of 44 communities in Florida, United States, and applied to South Africa was used as the basis for this study. Twenty-three input variables were used to create a computerized model which was populated with 2006 and 2011 data. Per capita cost, cost-effectiveness ratio and cost-benefit ratio were calculated as economic outputs to facilitate decision making for projected caries reductions of 15%, 30% and 50%. The average per capita cost of water fluoridation for all category water providers combined is US$0.28 in 2006 and US$0.35 in 2011, an increase of 23.2% over this period. The average cost-effectiveness for all water providers combined varies from US$3.32 for a 50% to US$11.08 for a 15% caries reduction. Despite higher cost-effective values for some cities and towns, the cost per person per year to save one Decayed, Missing or Filled Tooth (DMFT) at a projected caries reduction of at least 15% as a result of the introduction of water fluoridation, is at least 48.4% less than the cost of a two surface restoration. The average cost-benefit for all water providers combined varies from 0.1 at a 50% to 0.34 at a 15% caries reduction. For both cost-effectiveness and cost-benefit ratio better results are achieved when the projected caries reduction increases. The results of this study show that water fluoridation is still a viable option to prevent dental caries in communities in South Africa along with the reduction in the prevalence of dental caries and increases in economically driven variables. © 2012 John Wiley & Sons A/S.

Caries diagnosis using laser fluorescence

NASA Astrophysics Data System (ADS)

Zanin, Fatima A. A.; Pinheiro, Antonio L. B.; Souza-Campos, Dilma H.; Brugnera, Aldo, Jr.; Pecora, Jesus D.

2000-03-01

Caries prevention is a goal to be achieved by dentist in order to promote health. There are several methods used to detect dental caries each one presenting advantages and disadvantages, especially regarding hidden occlusal caries. The improvement of laser technology has permitted the use of laser fluorescence for early diagnosis of hidden occlusal caries. The aim of this study was to assess the efficacy of the use of 655 nm laser light on the detection of hidden occlusal caries. Forty molar teeth from patients of both sexes which ages ranging from 10 - 18 years old were used on this study. Following manufacture's instructions regarding the use of the equipment, the teeth had their occlusal surface examined with the DIAGNOdent. Twenty six of 40 teeth had hidden occlusal caries detected by the DIAGNOdent. However only 17 of these 26 teeth showed radiographic signs of caries the other 9 teeth showed no radiological signs of the lesion. Radiographic examination was able to identify 34,61% of false negative cases. This means that many caries would be left untreated due to the lack of diagnosis using both visual and radiographic examination. The use of the DIAGNOdent was effective in successfully detecting hidden occlusal caries.

Natural Products in Caries Research: Current (Limited) Knowledge, Challenges and Future Perspective

PubMed Central

Jeon, J.-G; Rosalen, P.L.; Falsetta, M.L.; Koo, H.

2011-01-01

Dental caries is the most prevalent and costly oral infectious disease worldwide. Virulent biofilms firmly attached to tooth surfaces are prime biological factors associated with this disease. The formation of an exopolysaccharide-rich biofilm matrix, acidification of the milieu and persistent low pH at the tooth-biofilm interface are major controlling virulence factors that modulate dental caries pathogenesis. Each one offers a selective therapeutic target for prevention. Although fluoride, delivered in various modalities, remains the mainstay for the prevention of caries, additional approaches are required to enhance its effectiveness. Available antiplaque approaches are based on the use of broad-spectrum microbicidal agents, e.g. chlorhexidine. Natural products offer a rich source of structurally diverse substances with a wide range of biological activities, which could be useful for the development of alternative or adjunctive anticaries therapies. However, it is a challenging approach owing to complex chemistry and isolation procedures to derive active compounds from natural products. Furthermore, most of the studies have been focused on the general inhibitory effects on glucan synthesis as well as on bacterial metabolism and growth, often employing methods that do not address the pathophysiological aspects of the disease (e.g. bacteria in biofilms) and the length of exposure/retention in the mouth. Thus, the true value of natural products in caries prevention and/or their exact mechanisms of action remain largely unknown. Nevertheless, natural substances potentially active against virulent properties of cariogenic organisms have been identified. This review focuses on gaps in the current knowledge and presents a model for investigating the use of natural products in anticaries chemotherapy. PMID:21576957

76 FR 10899 - Proposed HHS Recommendation for Fluoride Concentration in Drinking Water for Prevention of Dental...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

... Drinking Water for Prevention of Dental Caries; Extension of Comment Period AGENCY: Office of the Secretary... dental caries while limiting the risk of dental fluorosis. The proposed recommendation was published in... caries has been extended to April 15, 2011. To receive consideration comments must be received no later...

The role of diet in caries prevention.

PubMed

van Loveren, C; Duggal, M S

2001-01-01

Over the last three decades the condition of the teeth of children has improved tremendously. This has generally been attributed to the increased use of fluoride toothpaste. During this period the total amount of sugars disappearing into the population per capita has hardly changed. This suggests that the relationship between diet and caries has to be reassessed, which provokes different opinions among dental experts. Some suggest a maximum threshold level for the daily amount of sugars to prevent caries. Others propose that in general the amount of sugars eaten is not an important determinant of caries experience. The scientific evidence for the various opinions on the role of diet in caries development will be discussed. It is concluded that the role of diet is not so much related to the diet itself but to the individual behaviour of people. Where oral hygiene and fluoride supplementation are adequate, the diet has become a lesser factor in caries prevention. However, those diets may cause caries when there is too little fluoride. It is a mistake to classify a diet as cariogenic it may be potentially cariogenic. When one wants to decrease this potency, one should modify those factors that are actually controlling it, which is, in most cases, the topical presence of fluoride and not the composition of the diet. A model is proposed to guide caries prevention. The (insufficient) use of fluoride, (insufficient) oral hygiene and (insufficient) clearance by saliva form a window of risk. The total burden of cariogenic food that can be seen through the window constitutes the actual caries risk.

Caries-preventive self-care for children. Consistent oral health messages to the public?

PubMed

Løken, S Y; Wang, N J; Wigen, T I

2017-05-01

Recommendations regarding caries-preventive self-care for children are provided by several health authorities. To investigate recommendations given to the public regarding children's caries-preventive self-care by Norwegian dentists, dental hygienists, dental nurses and public health nurses. Questionnaires were sent by e-mail and answered by 808 of 1132 persons who provide oral preventive promotion to children in dental services and health centres. The preventive advice was obtained through questions about the preferred preventive methods, fluoride recommendations and sources of knowledge on which the personnel based the advice about caries prevention in children. The responses were analysed using logistic regression. The majority (59-71%) in all professions judged oral hygiene education to be the most important caries-preventive method. Most personnel (84-98%) recommended all children to use fluoride toothpaste, and half of all personnel (53%) recommended fluoride lozenges for 50% or more of children. Multivariate analysis showed that dental nurses recommended lozenges to more children than dentists (OR 2.5, 95% CI 1.7-3.7), while health nurses recommended lozenges to fewer children than dentists (OR 0.5, 95% CI 0.3-0.8). The most important source of knowledge reported by dental personnel was professional education, while health nurses relied on information from dental personnel. Health professions' recommendations regarding caries-preventive self-care for children were mainly similar, although variation existed both between and within professions. Collaboration between professions and awareness of the evidence base for preventive oral care may improve the consistency of information given by health professionals to the public. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of Family Structure and Behavioral and Eyesight Problems on Caries Severity in Pupils by Using an Ordinal Logistic Model

PubMed Central

JAHANI, Yunes; ESHRAGHIAN, Mohammad Reza; Rahimi FOROUSHANI, Abbas; NOURIJELYANI, Keramat; MOHAMMAD, Kazem; SHAHRAVAN, Arash; ALAM, Mahin

2013-01-01

Background: Dental caries is one of the most preventable yet prevalent chronic diseases worldwide. Our objective was to evaluate the effect of family structure and behavioral and eyesight problems as they relate to caries severity in schoolchildren. Methods: This research was carried out on 845 primary schoolchildren aged 9 yr in Kerman, Iran, in 2012. Ten variables, including health records, family structure information and a dmft/DMFT index, were collected. Children were categorized into three groups based on the WHO caries severity classification. Low caries level was defined as dmft/DMFT<2.6, moderate as dmft/DMFT of 2.7–4.4 and high as dmft/DMFT>4.4. The Cochran–Armitage test and ordinal logistic regression were employed for data analysis. Results: Almost half of pupils had moderate or high caries severity. The odds of being in a higher caries severity category in pupils with behavioral problems (OR=2.37, 95% CI: 1.29–4.38) and girls (OR=1.6, 95% CI: 1.22–2.06) were higher than in other categories. In addition, pupils with eyesight problems (OR=0.58, 95% CI: 0.37–0.90) and overweight pupils (OR=0.46, 95% CI: 0.31–0.71) had lower caries severity than others. The effects of parents’ education, birth rank, living with parents and consanguineous relationship between parents were not significant on caries severity (P>0.05). Conclusions: Female pupils with behavioral problems were at a higher risk of caries severity than other pupils. These pupils need to be educated and coached on proper dental care. In addition, overweight pupils and those with eyesight problems had less caries severity than others. Family structure in this study did not have an effect on the severity of dental caries. PMID:26056644

Fluoridated milk for preventing dental caries.

PubMed

Yeung, C Albert; Chong, Lee Yee; Glenny, Anne-Marie

2015-09-03

Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of schoolchildren and the vast majority of adults. Milk may provide a relatively cost-effective vehicle for fluoride delivery in the prevention of dental caries. This is an update of a Cochrane review first published in 2005. To assess the effects of milk fluoridation for preventing dental caries at a community level. We searched the Cochrane Oral Health Group Trials Register (inception to November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 10), MEDLINE via OVID (1946 to November 2014) and EMBASE via OVID (1980 to November 2014). We also searched the U.S. National Institutes of Health Trials Register (https://clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (http://apps.who.int/trialsearch) for ongoing trials. We did not place any restrictions on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs), with an intervention and follow-up period of at least two years, comparing fluoridated milk with non-fluoridated milk. Two authors independently assessed trial risk of bias and extracted data. We used standard methodological procedures expected by The Cochrane Collaboration. We included one unpublished RCT, randomising 180 children aged three years at study commencement. The setting was nursery schools in an area with high prevalence of dental caries and a low level of fluoride in drinking water. Data from 166 participants were available for analysis. The study carried a high risk of bias. After three years, there was a reduction of caries in permanent teeth (mean difference (MD) -0.13, 95% confidence interval (CI) -0.24 to -0.02) and in primary teeth (MD -1.14, 95% CI -1.86 to -0.42), as measured by the decayed, missing and filled teeth index (DMFT for permanent teeth and dmft for primary teeth). For primary teeth, this is a substantial reduction, equivalent to a prevented fraction of 31%. For permanent teeth, the disease level was very low in the study, resulting in a small absolute effect size. The included study did not report any other outcomes of interest for this review (adverse events, dental pain, antibiotic use or requirement for general anaesthesia due to dental procedures). There is low quality evidence to suggest fluoridated milk may be beneficial to schoolchildren, contributing to a substantial reduction in dental caries in primary teeth. Due to the low quality of the evidence, further research is likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There was only one relatively small study, which had important methodological limitations on the data for the effectiveness in reducing caries. Furthermore, there was no information about the potential harms of the intervention. Additional RCTs of high quality are needed before we can draw definitive conclusions about the benefits of milk fluoridation.

Fluoridated milk for preventing dental caries.

PubMed

Yeung, C Albert; Chong, Lee Yee; Glenny, Anne-Marie

2015-08-31

Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of schoolchildren and the vast majority of adults. Milk may provide a relatively cost-effective vehicle for fluoride delivery in the prevention of dental caries. This is an update of a Cochrane review first published in 2005. To assess the effects of milk fluoridation for preventing dental caries at a community level. We searched the Cochrane Oral Health Group Trials Register (inception to November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 10), MEDLINE via OVID (1946 to November 2014) and EMBASE via OVID (1980 to November 2014). We also searched the U.S. National Institutes of Health Trials Register (https://clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (http://apps.who.int/trialsearch) for ongoing trials. We did not place any restrictions on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs), with an intervention and follow-up period of at least two years, comparing fluoridated milk with non-fluoridated milk. Two authors independently assessed trial risk of bias and extracted data. We used standard methodological procedures expected by The Cochrane Collaboration. We included one unpublished RCT, randomising 180 children aged three years at study commencement. The setting was nursery schools in an area with high prevalence of dental caries and a low level of fluoride in drinking water. Data from 166 participants were available for analysis. The study carried a high risk of bias. After three years, there was a reduction of caries in permanent teeth (mean difference (MD) -0.13, 95% confidence interval (CI) -0.24 to -0.02) and in primary teeth (MD -1.14, 95% CI -1.86 to -0.42), as measured by the decayed, missing and filled teeth index (DMFT for permanent teeth and dmft for primary teeth). For primary teeth, this is a substantial reduction, equivalent to a prevented fraction of 31%. For permanent teeth, the disease level was very low in the study, resulting in a small absolute effect size. The included study did not report any other outcomes of interest for this review (adverse events, dental pain, antibiotic use or requirement for general anaesthesia due to dental procedures). There is low quality evidence to suggest fluoridated milk may be beneficial to schoolchildren, contributing to a substantial reduction in dental caries in primary teeth. Due to the low quality of the evidence, further research is likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There was only one relatively small study, which had important methodological limitations on the data for the effectiveness in reducing caries. Furthermore, there was no information about the potential harms of the intervention. Additional RCTs of high quality are needed before we can draw definitive conclusions about the benefits of milk fluoridation.

Associations of Community Water Fluoridation with Caries Prevalence and Oral Health Inequality in Children

PubMed Central

Kim, Han-Na; Kim, Jeong-Hee; Kim, Se-Yeon; Kim, Jin-Bom

2017-01-01

This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children’s overall oral health. PMID:28608827

Associations of Community Water Fluoridation with Caries Prevalence and Oral Health Inequality in Children.

PubMed

Kim, Han-Na; Kim, Jeong-Hee; Kim, Se-Yeon; Kim, Jin-Bom

2017-06-13

This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children's overall oral health.

Improving Dental Health of DOD Related Persons Assigned to Okinawa by Using Fluoridated Salt in Lieu of Water Fluoridation: A Comparative Analysis

DTIC Science & Technology

1999-04-01

1994-1997). During this time, the 18th Medical Group (MDG) set fluoridating the base water supply as a goal to prevent dental caries – a noble and...related personnel. Supplemental fluoride may be an effective method of improving oral health by reducing dental caries . Water and salt fluoridation ...372-5,381. 9 Colonel Canning and Mr. Noorda, “Talking Paper on Fluoridation of Kadena AB Drinking Water ,” 26 Apr 1995. 5 Chapter 2 Dental Caries The

Topical fluoride (toothpastes, mouthrinses, gels or varnishes) for preventing dental caries in children and adolescents.

PubMed

Marinho, V C C; Higgins, J P T; Logan, S; Sheiham, A

2003-01-01

Topical fluoride therapy (TFT) in the form of varnish, gel, mouthrinse or toothpaste has been used extensively as a caries-preventive intervention for over three decades. To determine the effectiveness and safety of fluoride varnishes, gels, mouthrinses, and toothpastes in the prevention of dental caries in children and to examine factors potentially modifying their effect. We searched the Cochrane Oral Health Group's Trials Register (May 2000), CENTRAL (The Cochrane Library Issue 2, 2000), MEDLINE (1966 to January 2000), plus several other databases. We handsearched journals, reference lists of articles and contacted selected authors and manufacturers. Randomized or quasi-randomized controlled trials with blind outcome assessment, comparing fluoride varnish, gel, mouthrinse, or toothpaste with placebo or no treatment in children up to 16 years during at least 1 year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (D(M)FS). Inclusion decisions, quality assessment and data extraction were duplicated in a random sample of one third of studies, and consensus achieved by discussion or a third party. Authors were contacted for missing data. The primary measure of effect was the prevented fraction (PF) that is the difference in mean caries increments between the treatment and control groups expressed as a percentage of the mean increment in the control group. Random effects meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random effects metaregression analyses. There were 144 studies included. For the 133 that contributed data for meta-analysis (involving 65,169 children) the D(M)FS pooled prevented fraction estimate was 26% (95% CI, 24% to 29%; p < 0.0001). There was substantial heterogeneity, confirmed statistically (p < 0.0001), but the direction of effect was consistent. The effect of topical fluoride varied according to type of control group used, type of TFT used, mode/setting of TFT use, initial caries levels and intensity of TFT application, but was not influenced by exposure to water fluoridation or other fluoride sources. D(M)FS PF was on average 14% (95% CI, 5% to 23%; p = 0.002) higher in non-placebo controlled trials, 14% (95% CI, 2% to 26%; p = 0.25) higher in fluoride varnish trials compared with all others, and 10% (95% CI, -17% to -3%; p = 0.003) lower in trials of unsupervised home use compared with self applied supervised and operator-applied. There was a 0.7% increase in the PF per unit increase in baseline caries (95% CI, 0.2% to 1.2%; p = 0.004). The benefits of topical fluorides have been firmly established on a sizeable body of evidence from randomized controlled trials. While the formal examination of sources of heterogeneity between studies has been important in the overall conclusions reached, these should be interpreted with caution. We were unable to reach definite conclusions about any adverse effects that might result from the use of topical fluorides, because data reported in the trials are scarce.

Fluoride mouthrinses for preventing dental caries in children and adolescents.

PubMed

Marinho, Valeria C C; Chong, Lee Yee; Worthington, Helen V; Walsh, Tanya

2016-07-29

Fluoride mouthrinses have been used extensively as a caries-preventive intervention in school-based programmes and by individuals at home. This is an update of the Cochrane review of fluoride mouthrinses for preventing dental caries in children and adolescents that was first published in 2003. The primary objective is to determine the effectiveness and safety of fluoride mouthrinses in preventing dental caries in the child and adolescent population.The secondary objective is to examine whether the effect of fluoride rinses is influenced by:• initial level of caries severity;• background exposure to fluoride in water (or salt), toothpastes or reported fluoride sources other than the study option(s); or• fluoride concentration (ppm F) or frequency of use (times per year). We searched the following electronic databases: Cochrane Oral Health's Trials Register (whole database, to 22 April 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 3), MEDLINE Ovid (1946 to 22 April 2016), Embase Ovid (1980 to 22 April 2016), CINAHL EBSCO (the Cumulative Index to Nursing and Allied Health Literature, 1937 to 22 April 2016), LILACS BIREME (Latin American and Caribbean Health Science Information Database, 1982 to 22 April 2016), BBO BIREME (Bibliografia Brasileira de Odontologia; from 1986 to 22 April 2016), Proquest Dissertations and Theses (1861 to 22 April 2016) and Web of Science Conference Proceedings (1990 to 22 April 2016). We undertook a search for ongoing trials on the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the World Health Organization International Clinical Trials Registry Platform. We placed no restrictions on language or date of publication when searching electronic databases. We also searched reference lists of articles and contacted selected authors and manufacturers. Randomised or quasi-randomised controlled trials where blind outcome assessment was stated or indicated, comparing fluoride mouthrinse with placebo or no treatment in children up to 16 years of age. Study duration had to be at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in permanent teeth (D(M)FS). At least two review authors independently performed study selection, data extraction and risk of bias assessment. We contacted study authors for additional information when required. The primary measure of effect was the prevented fraction (PF), that is, the difference in mean caries increments between treatment and control groups expressed as a percentage of the mean increment in the control group. We conducted random-effects meta-analyses where data could be pooled. We examined potential sources of heterogeneity in random-effects metaregression analyses. We collected adverse effects information from the included trials. In this review, we included 37 trials involving 15,813 children and adolescents. All trials tested supervised use of fluoride mouthrinse in schools, with two studies also including home use. Almost all children received a fluoride rinse formulated with sodium fluoride (NaF), mostly on either a daily or weekly/fortnightly basis and at two main strengths, 230 or 900 ppm F, respectively. Most studies (28) were at high risk of bias, and nine were at unclear risk of bias.From the 35 trials (15,305 participants) that contributed data on permanent tooth surface for meta-analysis, the D(M)FS pooled PF was 27% (95% confidence interval (CI), 23% to 30%; I(2) = 42%) (moderate quality evidence). We found no significant association between estimates of D(M)FS prevented fractions and baseline caries severity, background exposure to fluorides, rinsing frequency or fluoride concentration in metaregression analyses. A funnel plot of the 35 studies in the D(M)FS PF meta-analysis indicated no relationship between prevented fraction and study precision (no evidence of reporting bias). The pooled estimate of D(M)FT PF was 23% (95% CI, 18% to 29%; I² = 54%), from the 13 trials that contributed data for the permanent teeth meta-analysis (moderate quality evidence).We found limited information concerning possible adverse effects or acceptability of the treatment regimen in the included trials. Three trials incompletely reported data on tooth staining, and one trial incompletely reported information on mucosal irritation/allergic reaction. None of the trials reported on acute adverse symptoms during treatment. This review found that supervised regular use of fluoride mouthrinse by children and adolescents is associated with a large reduction in caries increment in permanent teeth. We are moderately certain of the size of the effect. Most of the evidence evaluated use of fluoride mouthrinse supervised in a school setting, but the findings may be applicable to children in other settings with supervised or unsupervised rinsing, although the size of the caries-preventive effect is less clear. Any future research on fluoride mouthrinses should focus on head-to-head comparisons between different fluoride rinse features or fluoride rinses against other preventive strategies, and should evaluate adverse effects and acceptability.

Fluoride gels for preventing dental caries in children and adolescents.

PubMed

Marinho, Valeria C C; Worthington, Helen V; Walsh, Tanya; Chong, Lee Yee

2015-06-15

Topically applied fluoride gels have been widely used as a caries-preventive intervention in dental surgeries and school-based programmes for over three decades. This updates the Cochrane review of fluoride gels for preventing dental caries in children and adolescents that was first published in 2002. The primary objective is to determine the effectiveness and safety of fluoride gels in preventing dental caries in the child and adolescent population.The secondary objectives are to examine whether the effect of fluoride gels is influenced by the following: initial level of caries severity; background exposure to fluoride in water (or salt), toothpastes, or reported fluoride sources other than the study option(s); mode of use (self applied under supervision or operator-applied), and whether there is a differential effect between the tray and toothbrush methods of application; frequency of use (times per year) or fluoride concentration (ppm F). We searched the Cochrane Oral Health Group Trials Register (to 5 November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2014, Issue 11), MEDLINE via OVID (1946 to 5 November 2014), EMBASE via OVID (1980 to 5 November 2014), CINAHL via EBSCO (1980 to 5 November 2014), LILACS and BBO via the BIREME Virtual Health Library (1980 to 5 November 2014), ProQuest Dissertations and Theses (1861 to 5 November 2014) and Web of Science Conference Proceedings (1945 to 5 November 2014). We undertook a search for ongoing trials on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform on 5 November 2014. We placed no restrictions on language or date of publication in the search of the electronic databases. We also searched reference lists of articles and contacted selected authors and manufacturers. Randomised or quasi-randomised controlled trials where blind outcome assessment was stated or indicated, comparing topically applied fluoride gel with placebo or no treatment in children up to 16 years. The frequency of application had to be at least once a year, and study duration at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in both permanent and primary teeth (D(M)FS and d(e/m)fs). At least two review authors independently performed study selection, data extraction and 'Risk of bias' assessment. We contacted study authors for additional information where required. The primary measure of effect was the prevented fraction (PF), that is, the difference in mean caries increments between the treatment and control groups expressed as a percentage of the mean increment in the control group. We performed random-effects meta-analyses where we could pool data. We examined potential sources of heterogeneity in random-effects metaregression analyses. We collected adverse effects information from the included trials. We included 28 trials (3 of which are new trials since the original review), involving 9140 children and adolescents. Most of these trials recruited participants from schools. Most of the studies (20) were at high risk of bias, with 8 at unclear risk of bias.Twenty-five trials (8479 participants) contributed data for meta-analysis on permanent tooth surfaces: the D(M)FS pooled prevented fraction (PF) estimate was 28% (95% confidence intervals (CI) 19% to 36%; P < 0.0001; with substantial heterogeneity (P < 0.0001; I(2) = 82%); moderate quality evidence). Subgroup and metaregression analyses suggested no significant association between estimates of D(M)FS prevented fractions and the prespecified trial characteristics. However, the effect of fluoride gel varied according to the type of control group used, with D(M)FS PF on average being 17% (95% CI 3% to 31%; P = 0.018) higher in non-placebo-controlled trials (the reduction in caries was 38% (95% CI 24% to 52%; P < 0.0001, 2808 participants) for the 10 trials with no treatment as control group, and 21% (95% CI 15% to 28%; P < 0.0001, 5671 participants) for the 15 placebo-controlled trials. A funnel plot of the 25 trials in the D(M)FS PF meta-analysis indicated a relationship between prevented fraction and study precision, with an apparent lack of small studies with statistically significant large effects.The d(e/m)fs pooled prevented fraction estimate for the three trials (1254 participants) that contributed data for the meta-analysis on primary teeth surfaces was 20% (95% CI 1% to 38%; P = 0.04; with no heterogeneity (P = 0.54; I(2) = 0%); low quality evidence).There was limited reporting of adverse events. Only two trials reported information on acute toxicity signs and symptoms during the application of the gel (risk difference 0.01, 95% CI -0.01 to 0.02; P = 0.36; with no heterogeneity (P = 36; I(2) = 0%); 490 participants; very low quality evidence). None of the trials reported information on tooth staining, mucosal irritation or allergic reaction. The conclusions of this updated review remain the same as those when it was first published. There is moderate quality evidence of a large caries-inhibiting effect of fluoride gel in the permanent dentition. Information concerning the caries-preventive effect of fluoride gel on the primary dentition, which also shows a large effect, is based on low quality evidence from only three placebo-controlled trials. There is little information on adverse effects or on acceptability of treatment. Future trials should include assessment of potential adverse effects.

[Dynamics of tooth decay prevalence in children receiving long-term preventive program in school dental facilities].

PubMed

Avraamova, O G; Kulazhenko, T V; Gabitova, K F

2016-01-01

The paper presents the assessment of tooth decay prevalence in clinically homogenous groups of children receiving long-term preventive program (PP) in school dental facilities. Five-years PP were introduced in clinical practice in 2 Moscow schools. Preventive treatment was performed by dental hygienist. The results show that systematic preventive treatment in school dental offices starting from elementary school allows reducing dental caries incidence 46-53% and stabilize the incidence of caries complications. It should be mentioned though that analysis of individualized outcomes proves heterogeneity of study results despite of equal conditions of PP. Potentially significant hence is early diagnostics and treatment of initial caries forms as demineralization foci, especially in children with intensive tooth decay. Optimization of pediatric dentist and dental hygienist activity in school dental facilities is the main factor of caries prevention efficiency.

[Oral health status evaluation of pre-school children: longitudinal epidemiologic study (1993-1994), Córdoba, Argentina].

PubMed

Battellino, L J; Cornejo, L S; Dorronsoro de Cattoni, S T; Luna Maldonado de Yankilevich, E R; Calamari, S E; Azcura, A I; Virga, C

1997-06-01

A one-year longitudinal survey was carried out on a sample of the Cordoba City 4-year old kindergarten population (n = 820); so as to determine the role of several variables upon the incidence of caries. The dmf-t, dmf-s, oral hygiene and oral health indexes as well as incidence rates and caries relative risks of caries were inversely related to the socioeconomic level (SEL) of the children involved. Thus in the SEL III (typical proletariat, non-typical proletariat and sub-proletariat) children, the relative risk of caries was almost five times higher (RR = 4.9) than in the SEL I (entrepreneureal and managerial bourgeoisie) children. In SEL I, almost all new lesions occurred on smooth surfaces (61.2%), while in SEL III the molar occlusal faces were mainly affected (66.3%). Daily sugar intake was higher in SEL III children but experience of caries showed poor correlation to the amount (r = 0.40) and frequency (r = 0.52) of carbohydrate intake. No significant interlevel differences were observed in the biochemical salivary parameters analyzed. Assisted toothbrushing and fluoride topications strongly lowered the incidence of caries among SEL III children, also making the corresponding rates fall almost to SEL I values (0.31, 0.23 and 0.22 vs. 0.21). In conclusion, SEL III children should be treated prophylactically with effective preventive measures, because of their susceptibility to caries. Such preventive measures include assisted toothbrushing and fluoride topications.

A model to determine the economic viability of water fluoridation.

PubMed

Kroon, Jeroen; van Wyk, Philippus Johannes

2012-01-01

In view of concerns expressed by South African local authorities the aim of this study was to develop a model to determine whether water fluoridation is economically viable to reduce dental caries in South Africa. Microsoft Excel software was used to develop a model to determine economic viability of water fluoridation for 17 water providers from all nine South African provinces. Input variables for this model relate to chemical cost, labor cost, maintenance cost of infrastructure, opportunity cost, and capital depreciation. The following output variables were calculated to evaluate the cost of water fluoridation: per capita cost per year, cost-effectiveness and cost-benefit. In this model it is assumed that the introduction of community water fluoridation can reduce caries prevalence by an additional 15 percent and that the savings in cost of treatment will be equal to the average fee for a two surface restoration. Water providers included in the study serve 53.5 percent of the total population of South Africa. For all providers combined chemical cost contributes 64.5 percent to the total cost, per capita cost per year was $0.36, cost-effectiveness was calculated as $11.41 and cost-benefit of the implementation of water fluoridation was 0.34. This model confirmed that water fluoridation is an economically viable option to prevent dental caries in South African communities, as well as conclusions over the last 10 years that water fluoridation leads to significant cost savings and remains a cost-effective measure for reducing dental caries, even when the caries-preventive effectiveness is modest. © 2012 American Association of Public Health Dentistry.

Oral health behaviours of parents and young children in a practice-based caries prevention trial in Northern Ireland.

PubMed

O'Malley, Lucy; Worthington, Helen V; Donaldson, Michael; O'Neil, Ciaran; Birch, Stephen; Noble, Solveig; Killough, Seamus; Murphy, Lynn; Greer, Margaret; Brodison, Julie; Verghis, Rejina; Tickle, Martin

2018-06-01

The NICPIP trial evaluated the costs and effects of a caries prevention intervention delivered to 2- to 3-year-old children attending dental practices in Northern Ireland. This supplementary study explored the oral health behaviours of children and their parents to help understand the reasons for the trial's findings. A mixed methods study that included a questionnaire completed by all parents (n = 1058) at the time they brought their child for the NICPIP final clinical assessment. The questionnaire collected data on frequency of toothbrushing and sugar consumption. Questionnaire data were analysed by trial group and caries status. Parents of trial participants (n = 42) were invited to take part in telephone interviews. Parents were purposively sampled according to trial group and whether or not their child developed caries. The interviews explored how and why oral health behaviours happened. Interview data were audio-recorded, transcribed verbatim and analysed thematically. The questionnaire data indicated that toothbrushing and between-meal sugar snacking were common in the majority of children. The children of parents who automatically reminded their child to brush their teeth were more likely to remain caries-free (Odds Ratio 1.24; 95% CI 1.08, 1.41; P = .002). Frequency of sweet drink consumption was associated with the child developing caries (Odds Ratio 0.88; 95% CI 0.79, 0.98; P = .021). The interview data showed that parents had positive attitudes towards brushing both in terms of perceived importance and expected outcomes. Attitudes towards sugar snacking were more complex, with parents reporting difficulties in controlling this behaviour. Sugar was described as being something that was "ever present" in children's lives. Toothbrushing was widely adopted from a young age, but between-meal sugar consumption was highly prevalent. The results suggest that effective family-level and population-level interventions are needed to reduce sugar consumption if substantial improvements in caries prevention are to be achieved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Xylitol and caries prevention.

PubMed

Duane, Brett

2015-06-01

Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, Web of Science Conference Proceedings, Proquest Dissertations and Theses, US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No language or year restrictions were used. Randomised controlled trials assessing the effects of xylitol products on dental caries in children and adults. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. Authors were contacted where possible for missing data or clarification where feasible. For continuous outcomes, means and standard deviations were used to obtain the mean difference and 95% confidence interval (CI). Continuous data was used to calculate prevented fractions (PF) and 95% CIs to summarise the percentage reduction in caries. For dichotomous outcomes, reported risk ratios (RR) and 95% CIs were used. As there were fewer than four studies included in the meta-analysis, a fixed effect model was used. Ten studies were included with a total of 5903 participants. One study was assessed as being at low risk of bias, two were assessed as unclear risk of bias with seven at high risk of bias. Over 2.5–3 years, low quality evidence demonstrated that with 4216 children analysed, a fluoride toothpaste with 10% xylitol (exact dosage unsure) reduced caries by 13% when compared to a fluoride only toothpaste. (PF −0.13, 95% CI −0.18 to −0.08. Remaining evidence of the use of xylitol in children has risk of bias and uncertainty of effect and was therefore insufficient to determine a benefit from xylitol. Four studies reported that there were no adverse effects from any of the interventions. Two studies reported similar rates of adverse effects between study arms. The remaining studies either mentioned adverse effects but did not report any usable data, or did not mention them at all. Adverse effects include sores in the mouth, cramps, bloating, constipation, flatulence and loose stool or diarrhoea. Low quality evidence suggested that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste for preventing caries in the permanent teeth of children. The effect estimate should be interpreted with caution due to high risk of bias and the fact that it was derived from two studies that were carried out by the same authors in the same population. The remaining evidence was low to very low quality and is insufficient to determine whether any other xylitol-containing products can prevent caries in infants, older children or adults.

INTRAPUPAL TEMPERATURE VARIATION DURING ER,CR:YSGG ENAMEL IRRADIATION ON CARIES PREVENTION

PubMed Central

de Freitas, Patrícia Moreira; Soares-Geraldo, Débora; Biella-Silva, Ana Cristina; Silva, Amanda Verna; da Silveira, Bruno Lopes; Eduardo, Carlos de Paula

2008-01-01

Studies have shown the cariostatic effect of Er,Cr:YSGG (2.78 μm) laser irradiation on human enamel and have suggested its use on caries prevention. However there are still no reports on the intrapulpal temperature increase during enamel irradiation using parameters for caries prevention. The aim of this in vitro study was to evaluate the temperature variation in the pulp chamber during human enamel irradiation with Er,Cr:YSGG laser at different energy densities. Fifteen enamel blocks obtained from third molars (3 x 3 x 3 mm) were randomly assigned to 3 groups (n=5): G1 – Er,Cr:YSGG laser 0.25 W, 20 Hz, 2.84 J/cm2, G2 – Er,Cr:YSGG laser 0.50 W, 20 Hz, 5.68 J/cm2, G3 – Er,Cr:YSGG laser 0.75 W, 20 Hz, 8.52 J/cm2. During enamel irradiation, two thermocouples were fixed in the inner surface of the specimens and a thermal conducting paste was used. One-way ANOVA did not show statistically significant difference among the experimental groups (α=0.05). There was intrapulpal temperature variation ≤0.1°C for all irradiation parameters. In conclusion, under the tested conditions, the use of Er,Cr:YSGG laser with parameters set for caries prevention lead to an acceptable temperature increase in the pulp chamber. PMID:19089198

Minimal Intervention Dentistry (MID) for managing dental caries – a review

PubMed Central

Frencken, Jo E.; Peters, Mathilde C.; Manton, David J.; Leal, Soraya C.; Gordan, Valeria V.; Eden, Ece

2012-01-01

This publication describes the history of Minimal Intervention Dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI’s policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836

Gender differences in practice patterns for diagnosis and treatment of dental caries: Findings from The Dental PBRN

PubMed Central

Riley, Joseph L.; Gordan, Valeria V.; Rouisse, Kathleen M.; McClelland, Jocelyn; Gilbert, Gregg H.

2011-01-01

Objectives A number of articles have addressed gender differences in the productivity of dentists, but little is known about differences in practice patterns for caries management. This study compared the use of a comprehensive range of specific diagnostic methods, preventive agents, and restorative decision making for caries management between male and female dentists who were members of The Dental Practice-Based Research Network(DPBRN). Methods This study surveyed general dentists who were members of DPBRN and who practiced within the United States. The survey asked about dentist, practice, and patient characteristics, as well as prevention, assessment, and treatment of dental caries. Differences in years since dental school graduation, practice model, full/part-time status, and practice owner/employee were adjusted in the statistical models, before making conclusions about gender differences. Results Three hundred ninety-three male (84%) and seventy-three female (16%) dentists participated. Female dentists recommended at-home fluoride to a significantly larger proportion of their patients, whereas males had a preference for using in-office fluoride treatments with pediatric patients. Female dentists also choose to restore interproximal lesions at a significantly later stage of development, preferring to use preventive therapy more often at earlier stages of dental caries. There were few differences in diagnostic methods, time spent on or charges for restorative dentistry, and busyness of their practices. Conclusion DPBRN female dentists differ from their male counterparts in some aspects of the prevention, assessment, and treatment of dental caries, even with significant covariates taken into account. Practice patterns of female dentists suggest a greater caries preventive treatment philosophy. PMID:21454850

Evaluation of a regional German interdisciplinary oral health programme for children from birth to 5 years of age.

PubMed

Wagner, Y; Heinrich-Weltzien, R

2017-01-01

The aim of this prospective birth cohort study was to evaluate the effect of the interdisciplinary oral health programme (OHP) for early childhood caries (ECC) in 5-year-old German children. All parents of newborns (n = 1162; born 2009/2010) were visited after birth by the communal newborn visiting service of Jena, Thuringia, and advised on general and dental health. In the first year of life, children were invited to attend a dental examination in the Jena University Hospital. Participating children were included in a caries-risk-related recall system with continuous oral care over 5 years. The caries-risk assessment tool of the AAPD was used to determine the likelihood of carious lesion development and to categorize the children at low, moderate or high risk for caries. High-risk children received fluoride varnish. Families (n = 563) who gave their approval for final examination after 5 years were invited again and examined by a blinded clinician. Dental caries was scored using WHO diagnostic criteria expanded to d1-level without radiography. Children were allocated to prevention (PG) and control group (CG) and matched on the basis of age, sex, ethnicity and socio-economic status (SES). Two hundred and eighty-nine children (mean age 5.2 ± 0.7 years; 46.7 % female) were examined. Children in the PG (n = 174) showed significantly lower caries prevalence and experience (10.9 %, 0.2 ± 0.7 d 3-4 mft) than children in the CG (57.4 %, 2.9 ± 3.8 d 3-4 mft). Multivariate analysis found that low SES, early start of tooth brushing, supervision/regular second brush by parent, regular dental visits and duration of breast-/bottle-feeding >1 year were significantly related to d 3-4 mft. The OHP was an effective approach for preventing early childhood caries in preschool children. A programme consisting of early maternal counselling, establishment of a dental home, and inclusion of the children in a caries-risk-related recall system with continuous dental care and fluoride varnish application can prevent ECC. German Clinical Trials Register DRKS00003438, https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003438.

What Maryland Adults With Young Children Know and Do About Preventing Dental Caries

PubMed Central

Kleinman, Dushanka V.; Wang, Min Qi

2013-01-01

Objectives. We sought to determine Maryland adults’ knowledge, understanding, opinions, and practices with respect to prevention and early detection of dental caries. Methods. We conducted a statewide random-digit-dialing, computer-assisted telephone survey in 2010 among 770 adults who had a child aged 6 years or younger living in their home. A traditional random-digit sample and a targeted low-income sample were included. Analyses included frequencies, percentages, the χ2 test, and multivariate logistic regression. Results. Respondents’ overall level of knowledge about preventing dental caries was low. Those with higher levels of education were more likely to have correct information regarding prevention and early detection of dental caries. Nearly all respondents (97.9%) reported that they were aware of fluoride, but only 57.8% knew its purpose. More than one third (35.1%) of the respondents were not aware of dental sealants. Those with lower levels of education were significantly less likely to drink tap water, as were their children, and significantly less likely to have had a dental appointment in the preceding past 12 months. Conclusions. Our results demonstrate the need to increase oral health literacy regarding caries prevention and early detection. PMID:23597372

Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: a randomized controlled trial

PubMed Central

2011-01-01

Background Supervised toothbrushing programs using fluoride dentifrice have reduced caries increment. However there is no information about the effectiveness of the professional cross-brushing technique within a community intervention. The aim was to assess if the bucco-lingual technique can increase the effectiveness of a school-based supervised toothbrushing program on preventing caries. Methods A randomized double-blinded controlled community intervention trial to be analyzed at an individual level was conducted in a Brazilian low-income fluoridated area. Six preschools were randomly assigned to the test and control groups and 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice supervised directly by a dental assistant, was developed four times per year. At the remaining school days the children brushed their teeth under indirect supervising of the teachers. In test group, children also underwent a professional cross-brushing on surfaces of first permanent molar rendered by a specially trained dental assistant five times per year. Enamel and dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars during 18-month follow-up. Exposure time of surfaces was calculated and incidence density ratio was estimated using Poisson regression model. Results Difference of 21.6 lesions per 1,000 children between control and test groups was observed. Among boys whose caries risk was higher compared to girls, incidence density was 50% lower in test group (p = 0.016). Conclusion Modified program was effective among the boys. It is licit to project a relevant effect in a larger period suggesting in a broader population substantial reduction of dental care needs. Trial registration ISRCTN18548869. PMID:21426572

Caries-preventive effect of anti-erosive and nano-hydroxyapatite-containing toothpastes in vitro.

PubMed

Esteves-Oliveira, M; Santos, N M; Meyer-Lueckel, H; Wierichs, R J; Rodrigues, J A

2017-01-01

The aim of the study was to investigate the caries-preventive effect of newly developed fluoride and fluoride-free toothpastes specially designed for erosion prevention. The hypothesis was that these products might also show superior caries-inhibiting effect than regular fluoride toothpastes, since they were designed for stronger erosive acid challenges. Enamel specimens were obtained from bovine teeth and pre-demineralized (pH = 4.95/21 days) to create artificial caries lesions. Baseline mineral loss (ΔZ B ) and lesion depth (LD B ) were determined using transversal microradiography (TMR). Ninety specimens with a median ΔZ B (SD) of 6027 ± 1546 vol% × μm were selected and randomly allocated to five groups (n = 18). Treatments during pH-cycling (14 days, 4 × 60 min demineralization/day) were brushing 2×/day with AmF (1400 ppm F - , anti-caries [AC]); AmF/NaF/SnCl 2 /Chitosan (700 ppm F - /700 ppm F - /3500 ppm Sn 2+ , anti-erosion [AE1]); NaF/KNO 3 (1400 ppm F - , anti-erosion [AE2]); nano-hydroxyapatite-containing (0 ppm F - , [nHA]); and fluoride-free toothpastes (0 ppm F - , negative control [NC]). Toothpaste slurries were prepared with mineral salt solution (1:3 wt/wt). After pH-cycling specimens presenting lesion, surface loss (mainly by NC and nHA) were discarded. For the remaining 77 specimens, new TMR analyses (ΔZ E /LD E ) were performed. Changes in mineral loss (ΔΔZ = ΔZ B  - ΔZ E ) and lesion depth (ΔLD = LD B  - LD E ) were calculated. All toothpastes caused significantly less demineralization (lower ΔΔZ) than NC (p < 0.05, ANOVA) except for nHA. The fluoride toothpastes did not differ significantly regarding ΔΔZ and ΔLD (p > 0.05, ANOVA). While both anti-erosive and anti-caries toothpastes reduced mineral loss to a similar extent, the fluoride-free nano-hydroxyapatite-containing toothpaste seemed not to be suitable for inhibition of caries demineralization in vitro.

Glass ionomer ART sealant and fluoride-releasing resin sealant in fissure caries prevention – results from a randomized clinical trial

PubMed Central

2014-01-01

Background The relative performance of ART sealant and fluoride-releasing resin sealant in preventing fissure caries in permanent molars was compared in a randomized clinical trial conducted in southern China (ClinicalTrials.gov NCT01829334). Methods After obtaining ethical approval, healthy schoolchildren who had permanent first molars with occlusal fissures which were sound but deep or presented with only incipient caries were recruited for the study. Included molars were randomly allocated into one of four parallel study groups in units of left/right teeth per mouth. Two of the four groups adopted the methods of ART or fluoride-releasing resin sealant placement while the other two groups adopted the topical fluoride application methods. Fissure status of the molars in each group was evaluated every 6 months. Development of dentine caries and sealant retention over 24 months in the molars in the two sealant-using groups was compared in this report. Outcome on cost-effectiveness of all four groups over 36 months will be reported elsewhere. Results At baseline, a total of 280 children (383 molars) with mean age 7.8 years were involved for the two sealant groups. After 24 months, 261 children (357 molars) were followed. Proportions of molars with dentine caries were 7.3% and 3.9% in the ART sealant and fluoride-releasing resin sealant groups, respectively (chi-square test, p = 0.171). Life-table survival analysis showed that sealant retention (full and partial) rate over 24 months for the resin sealant (73%) was significantly higher than that (50%) for the ART sealant (p < 0.001). Molar survival (no development of dentine caries) rates in the ART sealant (93%) and fluoride-releasing resin sealant (96%) groups were not significantly different (p = 0.169). Multilevel logistic regression (GEE modeling) accounting for the effects of data clustering and confounding factors confirmed this finding. Conclusions Though the retention of fluoride-releasing resin sealant was better than that of the ART sealant, their effectiveness in preventing fissure caries in permanent molars did not differ significantly over 24 months. ART sealants could be a good alternative when and where resources for resin sealant placement are not readily available. PMID:24886444

Xylitol lozenges were not effective in overall dental caries prevention in adults.

PubMed

Fontana, Margherita; Gonzalez-Cabezas, Carlos

2013-09-01

Results from the xylitol for adult caries trial (X-ACT). Bader JD, Vollmer WM, Shugars DA, Gilbert GH, Amaechi BT, Brown JP, Laws RL, Kunkhouser KA, Makhija SK, Ritter AV, Leo MC. JADA 2013; 144(1): 21-30. Margherita Fontana, DDS, PhD, Carlos Gonzalez-Cabezas, DDS, MSD, PhD PURPOSE/QUESTION: Among an adult population at risk of dental caries, does the use of five 1 g xylitol lozenges per day over 33 months reduce the experience of cavitated caries lesions? Government: National Institute of Dental and Craniofacial Research Multicenter, double blind, placebo-controlled, randomized clinical trial Level 1: Good quality, patient-oriented evidence B: Limited quality patient-oriented evidence. Published by Mosby, Inc.

Early childhood caries: risk-based disease prevention and management.

PubMed

Ng, Man Wai; Chase, Isabelle

2013-01-01

Early childhood caries (ECC), common in preschoolers, can lead to pain and infection if left untreated. Yet, ECC is largely preventable, and if it is identified early and the responsible risk factors are addressed, its progression can be halted or slowed. This article reviews the rationale for a first dental visit by age 1 year, caries risk assessment, and risk-based prevention and management of ECC and discusses strategies for providers to implement these contemporary evidence-based concepts into clinical practice. Copyright © 2013 Elsevier Inc. All rights reserved.

[The effect of daily controlled oral hygiene on the oral health of children in a town with drinking water fluoridation (Karl Marx Stadt)].

PubMed

Georgi, J; Künzel, W

1976-03-01

Under the conditions of an optimized (with regard to caries prevention) fluoride content of the drinking uater, the authors studied (in the framework of an oral hygiene measure covering 32 months) in 149 children 6.5-8 years of age the effects of supervised daily dental and oral care on dental health. The improvement in oral hygiene (OHI) by 33% is in harmony with an additional caries reduction by 33.3% (DMF/S index) and a decrease of the PM index by 47%. A wider use of oral hygiene actions as secondary preventive measures is, therefore, recommended also for towns with fluoridated drinking water.

Caries prevalence in different racial groups of schoolchildren in West Malaysia.

PubMed

Yassin, I; Low, T

1975-08-01

A dental health survey of 15,197 schoolchildren age 6-18 years was conducted in West Malaysia. The caries experience in the permanent teeth of the three racial groups, namely Malay, Chinese and Indian/Pakistani, showed a distinct variation. The prevalence was highest among the Chinese children, being about twice that of the Malay and Indian/Pakistani children. In the primary dentition, however, the caries experience in the three racial groups was comparable. An analysis of the factors contributing to the racial variation showed that dietary influence was not the only factor responsible. The possibility of a racial variation in caries susceptibility has been postulated. In the primary dentition the similar caries experience observed in the three groups of children was most probably due to the widespread occurrence of rampant caries which would heavily weight the dift score of the children in all three groups. The need to fluoridate the public water supply as an effective preventive measure is emphasized.

Exploring the short-term impact of community water fluoridation cessation on children's dental caries: a natural experiment in Alberta, Canada.

PubMed

McLaren, L; Patterson, S; Thawer, S; Faris, P; McNeil, D; Potestio, M L; Shwart, L

2017-05-01

Dental caries (tooth decay) is common and can be serious. Dental caries is preventable, and community water fluoridation is one means of prevention. There is limited current research on the implications of fluoridation cessation for children's dental caries. Our objective was to explore the short-term impact of community water fluoridation cessation on children's dental caries, by examining change in caries experience in population-based samples of schoolchildren in two Canadian cities, one that discontinued community water fluoridation and one that retained it. We used a pre-post cross-sectional design. We examined dental caries indices (deft [number of decayed, extracted, or filled primary teeth] and DMFT [number of decayed, missing, or filled permanent teeth]) among grade 2 schoolchildren in 2004/05 and 2013/14 in two similar cities in the province of Alberta, Canada: Calgary (cessation of community water fluoridation in 2011) and Edmonton (still fluoridated). We compared change over time in the two cities. For Calgary only, we had a third data point from 2009/10, and we considered trends across the three points. We observed a worsening in primary tooth caries (deft) in Calgary and Edmonton, but changes in Edmonton were less consistent and smaller. This effect was robust to adjustment for covariates available in 2013/14 and was consistent with estimates of total fluoride intake from biomarkers from a subsample. This finding occurred despite indication that treatment activities appeared better in Calgary. The worsening was not observed for permanent teeth. For prevalence estimates only (% with >0 deft or DMFT), the three data points in Calgary suggest a trend that, though small, appears consistent with an adverse effect of fluoridation cessation. Our results suggest an increase in dental caries in primary teeth during a time period when community fluoridation was ceased. That we did not observe a worsening for permanent teeth in the comparative analysis could reflect the limited time since cessation. It is imperative that efforts to monitor these trends continue. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing - Consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.

PubMed

Tonetti, Maurizio S; Bottenberg, Peter; Conrads, Georg; Eickholz, Peter; Heasman, Peter; Huysmans, Marie-Charlotte; López, Rodrigo; Madianos, Phoebus; Müller, Frauke; Needleman, Ian; Nyvad, Bente; Preshaw, Philip M; Pretty, Iain; Renvert, Stefan; Schwendicke, Falk; Trombelli, Leonardo; van der Putten, Gert-Jan; Vanobbergen, Jacques; West, Nicola; Young, Alix; Paris, Sebastian

2017-03-01

Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion. Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders. Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A study of mothers' attitudes towards the prevention of caries with particular reference to fluoridation and vaccination.

PubMed

Kay, E J; Blinkhorn, A S

1989-12-01

Three hundred and fifteen mothers of pre-school children from socially deprived areas in Scotland were interviewed to assess their knowledge of, and attitudes towards, caries prevention. Thirty-five per cent of them believed that the dental profession had the most important part to play in the prevention of dental disease, while thirty-five per cent were complacent about their children's teeth and did not feel that preventive measures were necessary. Sixty-seven per cent thought that a caries vaccine would be acceptable if it posed no health risks and reduced caries experience by 50 per cent. This proportion increased to 78 per cent if all caries could be avoided by being immunized. Significantly more mothers held positive attitudes towards a hypothetical vaccine than to the more realistic prospect of fluoridation of public water supplies. This study has shown that mothers in deprived areas have little understanding of how to control dental disease and see little point in taking a personal initiative to alter their children's behaviour to reduce the risk of caries. They prefer to leave the control of disease to the dental profession. The idea that dental disease might be reduced by a vaccine was more acceptable than fluoridation.

The cariostatic mechanisms of fluoride.

PubMed

Rošin-Grget, Kata; Peroš, Kristina; Sutej, Ivana; Bašić, Krešimir

2013-11-01

This article discusses the possible cariostatic mechanisms of the action of fluoride. In the past, fluoride inhibition of caries was ascribed to reduced solubility of enamel due to incorporation of fluoride (F-) into the enamel minerals. The present evidence from clinical and laboratory studies suggests that the caries-preventive mode of action of fluoride is mainly topical. There is convincing evidence that fluoride has a major effect on demineralisation and remineralisation of dental hard tissue. The source of this fluoride could either be fluorapatite (formed due to the incorporation of fluoride into enamel) or calcium fluoride (CaF2)-like precipitates, which are formed on the enamel and in the plaque after application of topical fluoride. Calcium fluoride deposits are protected from rapid dissolution by a phosphate -protein coating of salivary origin. At lower pH, the coating is lost and an increased dissolution rate of calcium fluoride occurs. The CaF2, therefore, act as an efficient source of free fluoride ions during the cariogenic challenge. The current evidence indicates that fluoride has a direct and indirect effect on bacterial cells, although the in vivo implications of this are still not clear. A better understanding of the mechanisms of the action of fluoride is very important for caries prevention and control. The effectiveness of fluoride as a cariostatic agent depends on the availability of free fluoride in plaque during cariogenic challenge, i.e. during acid production. Thus, a constant supply of low levels of fluoride in biofilm/saliva/dental interference is considered the most beneficial in preventing dental caries. Copyright © 2013 by Academy of Sciences and Arts of Bosnia and Herzegovina.

The effectiveness of silver diamine fluoride in arresting caries.

PubMed

Richards, Derek

2017-10-27

Data sourcesPubMed, Embase, Scopus, China National Knowledge Infrastructure (CNKI), Ichushi-web, Biblioteca Virtual en Salud Espana (BVSE) and Biblioteca Virtual em Saude (BVS) databases. There were no limits on language or publication dates.Study selectionTwo reviewers selected prospective clinical studies investigating SDF treatment for caries prevention in children.Data extraction and synthesisData was abstracted independently by two reviewers and risk of bias assessed. Meta-analysis was performed on studies in which the caries-arresting rate using 38% SDF solution on primary teeth could be obtained or calculated.ResultsNineteen studies were included; 16 were conducted in the primary dentition and three in permanent dentition. Fourteen studies used 38% SDF, three 30% SDF, and two 10% SDF. Eight studies using 38% SDF contributed to a meta-analysis and the overall proportion of arrested caries was 81% (95% CI; 68-89%). Percentage reductions were also calculated for 6,12,18,24 and >30 months. Arrested carious lesions stained black but no other adverse effects were reported.ConclusionsSDF commonly used at a high concentration (38%, 44,800ppm fluoride) is effective in arresting caries among children. There is no consensus on its number and frequency of application to arrest caries. Further studies are necessary to develop evidence-based guidelines on its use in children.

Genetic factors affecting dental caries risk.

PubMed

Opal, S; Garg, S; Jain, J; Walia, I

2015-03-01

This article reviews the literature on genetic aspects of dental caries and provides a framework for the rapidly changing disease model of caries. The scope is genetic aspects of various dental factors affecting dental caries. The PubMed database was searched for articles with keywords 'caries', 'genetics', 'taste', 'diet' and 'twins'. This was followed by extensive handsearching using reference lists from relevant articles. The post-genomic era will present many opportunities for improvement in oral health care but will also present a multitude of challenges. We can conclude from the literature that genes have a role to play in dental caries; however, both environmental and genetic factors have been implicated in the aetiology of caries. Additional studies will have to be conducted to replicate the findings in a different population. Identification of genetic risk factors will help screen and identify susceptible patients to better understand the contribution of genes in caries aetiopathogenesis. Information derived from these diverse studies will provide new tools to target individuals and/or populations for a more efficient and effective implementation of newer preventive measures and diagnostic and novel therapeutic approaches in the management of this disease. © 2015 Australian Dental Association.

Effect of health promotion and fluoride varnish on dental caries among Australian Aboriginal children: results from a community-randomized controlled trial*

PubMed Central

Slade, Gary D; Bailie, Ross S; Roberts-Thomson, Kaye; Leach, Amanda J; Raye, Iris; Endean, Colin; Simmons, Bruce; Morris, Peter

2011-01-01

Objectives We tested a dental health program in remote Aboriginal communities of Australia's Northern Territory, hypothesizing that it would reduce dental caries in preschool children. Methods In this 2-year, prospective, cluster-randomized, concurrent controlled, open trial of the dental health program compared to no such program, 30 communities were allocated at random to intervention and control groups. All residents aged 18–47 months were invited to participate. Twice per year for 2 years in the 15 intervention communities, fluoride varnish was applied to children's teeth, water consumption and daily tooth cleaning with toothpaste were advocated, dental health was promoted in community settings, and primary health care workers were trained in preventive dental care. Data from dental examinations at baseline and after 2 years were used to compute net dental caries increment per child (d3mfs). A multi-level statistical model compared d3mfs between intervention and control groups with adjustment for the clustered randomization design; four other models used additional variables for adjustment. Results At baseline, 666 children were examined; 543 of them (82%) were re-examined 2 years later. The adjusted d3mfs increment was significantly lower in the intervention group compared to the control group by an average of 3.0 surfaces per child (95% CI = 1.2, 4.9), a prevented fraction of 31%. Adjustment for additional variables yielded caries reductions ranging from 2.3 to 3.5 surfaces per child and prevented fractions of 24–36%. Conclusions These results corroborate findings from other studies where fluoride varnish was efficacious in preventing dental caries in young children. PMID:20707872

[Epidemiology survey of dental caries and fluorosis of children in Kunming city].

PubMed

Zhou, Qing; Liu, Juan; Zhang, Canhua; Zhang, Shinan; Li, Yanhong

2011-10-01

To determine the feasibility of water fluoridation to prevent caries in Kunming by investigating the epidemiological status of dental caries and dental fluorosis of children, and to provide the longitudinal reference data for the long-term epidemiology survey of dental caries and dental fluorosis in Kunming city. Through stratified cluster sampling method, 212 5-year-old children and 1149 12-year-old children were recruited in the survey. Dental caries condition of each child was clinically examined, dental fluorosis was examined in 12-year-old group. The prevalence of dental caries of primary teeth in 5-year-old group was 73.6%, mean value was 4.47 +/- 4.39. The values of permanent teeth in 12-year-old group were 53.5% and 1.42 +/- 1.83. The prevalence of dental fluorosis in 12-year-old group was 4.1% and the average community fluorosis index was 0.03. Based on the high prevalence of dental caries and the low prevalence of dental fluorosis, it is suggested that using water fluoridation to prevent caries is feasible and necessary in Kunming city.

Radiation-induced dental caries, prevention and treatment - A systematic review.

PubMed

Gupta, Nishtha; Pal, Manoj; Rawat, Sheh; Grewal, Mandeep S; Garg, Himani; Chauhan, Deepika; Ahlawat, Parveen; Tandon, Sarthak; Khurana, Ruparna; Pahuja, Anjali K; Mayank, Mayur; Devnani, Bharti

2015-01-01

Treatment of head and neck cancers (HNCs) involves radiotherapy. Patients undergoing radiotherapy for HNCs are prone to dental complications. Radiotherapy to the head and neck region causes xerostomia and salivary gland dysfunction which dramatically increases the risk of dental caries and its sequelae. Radiation therapy (RT) also affects the dental hard tissues increasing their susceptibility to demineralization following RT. Postradiation caries is a rapidly progressing and highly destructive type of dental caries. Radiation-related caries and other dental hard tissue changes can appear within the first 3 months following RT. Hence, every effort should be focused on prevention to manage patients with severe caries. This can be accomplished through good preoperative dental treatment, frequent dental evaluation and treatment after RT (with the exception of extractions), and consistent home care that includes self-applied fluoride. Restorative management of radiation caries can be challenging. The restorative dentist must consider the altered dental substrate and a hostile oral environment when selecting restorative materials. Radiation-induced changes in enamel and dentine may compromise bonding of adhesive materials. Consequently, glass ionomer cements have proved to be a better alternative to composite resins in irradiated patients. Counseling of patients before and after radiotherapy can be done to make them aware of the complications of radiotherapy and thus can help in preventing them.

Radiation-induced dental caries, prevention and treatment - A systematic review

PubMed Central

Gupta, Nishtha; Pal, Manoj; Rawat, Sheh; Grewal, Mandeep S.; Garg, Himani; Chauhan, Deepika; Ahlawat, Parveen; Tandon, Sarthak; Khurana, Ruparna; Pahuja, Anjali K.; Mayank, Mayur; Devnani, Bharti

2015-01-01

Treatment of head and neck cancers (HNCs) involves radiotherapy. Patients undergoing radiotherapy for HNCs are prone to dental complications. Radiotherapy to the head and neck region causes xerostomia and salivary gland dysfunction which dramatically increases the risk of dental caries and its sequelae. Radiation therapy (RT) also affects the dental hard tissues increasing their susceptibility to demineralization following RT. Postradiation caries is a rapidly progressing and highly destructive type of dental caries. Radiation-related caries and other dental hard tissue changes can appear within the first 3 months following RT. Hence, every effort should be focused on prevention to manage patients with severe caries. This can be accomplished through good preoperative dental treatment, frequent dental evaluation and treatment after RT (with the exception of extractions), and consistent home care that includes self-applied fluoride. Restorative management of radiation caries can be challenging. The restorative dentist must consider the altered dental substrate and a hostile oral environment when selecting restorative materials. Radiation-induced changes in enamel and dentine may compromise bonding of adhesive materials. Consequently, glass ionomer cements have proved to be a better alternative to composite resins in irradiated patients. Counseling of patients before and after radiotherapy can be done to make them aware of the complications of radiotherapy and thus can help in preventing them. PMID:27390489

Epidemiology of dental caries in children in the United Arab Emirates.

PubMed

Al-Bluwi, Ghada S M

2014-08-01

Dental caries has a significant impact on the general health and development of children. Understanding caries epidemiology is an essential task for the United Arab Emirates (UAE) policymakers to evaluate preventive programmes and to improve oral health. The purpose of this review is to collect and summarise all data available in the published literature on the epidemiology of dental caries in the UAE in children aged under 13 years. This will provide dental health planners with a comprehensive data summary, which will help in the planning for and evaluation of dental caries prevention programmes. Data were collected from the various published studies in PubMed, Academic Search Complete, Google, and the reference lists in relevant articles. Four keywords were used in the search: 'dental caries,' 'epidemiology,' 'prevalence,' and 'UAE'. All studies conducted in the UAE in general or any single emirate that sheds light on the prevalence of dental caries of children under 13 years were included in this literature review. Studies on early childhood caries and factors associated with dental caries were also included. The review comprises 11 published surveys of childhood caries in UAE. The earliest study was published in 1991 and the most recent was published in 2011. The range of decayed, missing and filled primary teeth (dmft) in UAE children (age between 4 years and 6 years) was 5.1-8.4. For the 12-year-old group the decayed missing and filled permanent teeth (DMFT) ranged from 1.6 to 3.24. Baseline data on oral health and a good understanding of dental caries determinants are necessary for setting appropriate goals and planning for preventive oral health programmes. The current data available on the dmft and DMFT indicate that childhood dental caries is still a serious dental public health problem in the UAE that warrants immediate attention by the government and policy makers. © 2014 FDI World Dental Federation.

Treatment modalities for caries management, including a new resin infiltration system.

PubMed

Kugel, Gerard; Arsenault, Peter; Papas, Athena

2009-10-01

Seemingly against all odds, dental caries still affects most people in the US. While fluoridated products, school-based screening and cleaning programs, better patient education, and professional and chemotherapeutic interventions have all impacted certain populations, caries is still the most prevalent chronic childhood disease and continues to affect a high percentage of adolescents, young and middle-aged adults, and seniors. Much research has proven that dental caries is not just an occasional cycle of cavitation but a complex and infectious disease process. Historically, addressing the caries challenge has relied on prevention and restoration, with no intermediary means to stop lesion progression. Recently, a technique called caries infiltration was introduced that fills the noncavitated pores of an incipient lesion with a low-viscosity resin by capillary action, creating a barrier that blocks further bacterial diffusion and lesion development. This microinvasive method for stabilizing early lesions requires no drilling or anesthesia and does not alter the tooth's anatomic shape. In cases of white spot lesions in the esthetic zone, it also eliminates opaqueness and blends with surrounding natural teeth. This article presents an overview of caries prevention initiatives and a case demonstrating the new caries infiltration technique. Combined with shifting the focus to caries risk assessment, this promising technology may prove to be a significant addition to the profession's caries treatment armamentarium.

Fluoride Varnish for Caries Prevention: Efficacy and Implementation.

PubMed

Bonetti, Debbie; Clarkson, Jan E

2016-01-01

Many reviews support fluoride varnish (FV) as a caries-inhibitory agent. Evidence from 6 Cochrane systematic reviews involving 200 trials and more than 80,000 participants further confirms the effectiveness of FV, applied professionally 2-4 times a year, for preventing dental caries in both primary and permanent teeth. The relative benefit of FV application seems to occur irrespective of baseline caries risk, baseline caries severity, background exposure to fluorides, use of fluoride toothpaste and application features such as prior prophylaxis, concentration of fluoride or frequency of application. While the efficacy of FV is acknowledged in clinical practice guidelines globally, the implementation of this recommendation may still be an issue. Factors that may facilitate FV application in the USA include Medicaid eligibility, relationships with dentists/community centers and strong cooperation and communication between physicians and support staff. Barriers include insufficient time to integrate oral health services into well-child visits, difficulty in applying FV (lack of skills/training) and resistance among colleagues and staff. Research in the UK/Scotland also suggests encouraging clinicians in their motivation to perform this treatment and addressing professional and parental concerns relating to possible negative consequences may be influential. Further research targeting cost-effectiveness and how FV in routine care may fit in with political agendas relating to, for example, inequalities in health care provision and access will also play a key part in stakeholder decisions to put resources into this issue. © 2016 The Author(s) Published by S. Karger AG, Basel.

Prevalence of dental caries in the municipality gorazde during the period 2007-2012.

PubMed

Deljo, Emsudina; Cavaljuga, Semra; Meskovic, Belma

2013-01-01

Dental caries today, regardless of known multi causal etiology of the disease and the possibility of its effective prevention still represents the most widespread disease of our civilization, which affects about 95% of our population. It affects all populations and age groups and is a disease that is very difficult to completely eradicate due to a complex interaction of biological factors, eating habits, social status Etc. Goal is to report the prevalence of dental caries, DMFT-index and DMFT index in the first and seventh grades of grammar school in the municipality Gorazde during the last six years. Children, which have yet to enroll in school and in the seventh grade children, have required medical examinations. A total of 1198 first grade and 1666 seventh-grade students are included. To determine the prevalence of dental caries DMFT was used. Examinations are carried out in accordance with the methodology and criteria of the WHO, by a dental mirror and dental probe. The prevalence of dental caries is extremely high as well as the values of DMFT index in the first and seventh grades in the municipality Gorazde. In practice it is necessary to introduce prevention programs for pregnant women, toddlers, preschool and school-aged children with a wider use of the mass media.

Comparative effectiveness of water and salt community-based fluoridation methods in preventing dental caries among schoolchildren.

PubMed

Fabruccini, A; Alves, L S; Alvarez, L; Alvarez, R; Susin, C; Maltz, M

2016-12-01

To compare the effectiveness of water and salt community-based fluoridation methods on caries experience among schoolchildren. Data derived from two population-based oral health surveys of 12-year-old schoolchildren exposed to different community-based fluoridation methods were compared: artificially fluoridated water in Porto Alegre, South Brazil and artificially fluoridated salt in Montevideo, Uruguay. Data on socio-demographic characteristics, maternal education and oral hygiene were collected. Dental caries was defined according to the WHO criteria (cavitated lesions) and to the modified WHO criteria (active noncavitated lesions and cavitated ones). The association between community-based fluoridation methods and dental caries was modelled using logistic (caries prevalence) and Poisson regression (DMFT). Odds ratios (OR), rate ratios (RR), and the 95% confidence intervals (CI) were estimated. A total of 1528 in Porto Alegre and 1154 in Montevideo were examined (response rates: 83.2% and 69.6%, respectively). Adjusted estimates for caries prevalence and DMFT showed that schoolchildren from Porto Alegre were less affected by dental caries than their counterparts from Montevideo, irrespective of the criteria used. After adjusting for important characteristics, schoolchildren exposed to fluoridated salt had significantly higher likelihood of having caries (WHO criteria) than those exposed to fluoridated water (OR for prevalence=1.61, 95% CI=1.26-2.07; RR for DMFT=1.32, 95% CI=1.16-1.51). Similar differences were observed using the modified WHO criteria. Fluoridated water appears to provide a better protective effect against dental caries than fluoridated household salt among schoolchildren from developing countries. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Microbiome in Populations with a Low and High Prevalence of Caries.

PubMed

Johansson, I; Witkowska, E; Kaveh, B; Lif Holgerson, P; Tanner, A C R

2016-01-01

The oral microbiota was compared between Romanian adolescents with a high prevalence of caries and no dental care and Swedish caries-active and caries-free adolescents in caries prevention programs and with a low prevalence of caries. Biofilm samples were analyzed by FLX+ pyrosequencing of the V1 to V4 hypervariable regions of the 16S rRNA gene and polymerase chain reaction (PCR)/quantitative PCR (qPCR) for Streptococcus mutans and Streptococcus sobrinus. Sequences obtained blasted to 9 phyla, 66 genera, and 401 human oral taxa (HOT) in the 16S rRNA Human Oral Microbiome Database, of which 295 were represented by ≥20 sequences. The Romanian adolescents had more sequences in Firmicutes and fewer in Actinobacteria phyla and more sequences in the genera Bacteroidetes [G-3], Porphyromonas, Abiotrophia, Filifactor, Peptostreptococcaceae [11][G-4], Pseudoramibacter, Streptococcus, and Neisseria and fewer in Actinomyces, Selenomonas, Veillonella, Campylobacter, and TM7 [G-1] than the Swedish groups. Multivariate modeling employing HOT, S. sobrinus and S. mutans (PCR/qPCR), and sugar snacks separated Romanian from Swedish adolescents. The Romanian adolescents' microbiota was characterized by a panel of streptococci, including S. mutans, S. sobrinus, and Streptococcus australis, and Alloprevotella, Leptotrichia, Neisseria, Porphyromonas, and Prevotella. The Swedish adolescents were characterized by sweet snacks, and those with caries activity were also characterized by Prevotella, Actinomyces, and Capnocytophaga species and those free of caries by Actinomyces, Prevotella, Selenomonas, Streptococcus, and Mycoplasma. Eight species including Streptococcus mitis and Streptococcus species HOT070 were prevalent in Romanian and Swedish caries-active subjects but not caries-free subjects. In conclusion, S. mutans and S. sobrinus correlated with Romanian adolescents with caries and with limited access to dental care, whereas S. mutans and S. sobrinus were detected infrequently in Swedish adolescents in dental care programs. Swedish caries-active adolescents were typically colonized by Actinomyces, Selenomonas, Prevotella, and Capnocytophaga. Hence, the role of mutans streptococci as a primary caries pathogen appears less pronounced in populations with prevention programs compared to populations lacking caries treatment and prevention strategies. © International & American Associations for Dental Research 2015.

Dental Hygienist-Led Chronic Disease Management System to Control Early Childhood Caries.

PubMed

Ng, Man Wai; Fida, Zameera

2016-06-01

Management of the complex chronic disease of early childhood caries requires a system of coordinated health care interventions which can be led by a dental hygienist and where patient self-care efforts are paramount. Even after receiving costly surgical treatment under general anesthesia in the operating room, many children develop new and recurrent caries after only 6-12 months, a sequela that can be prevented. This article describes the chronic disease management (CDM) of dental caries, a science-based approach that can prevent and control caries. In this article, we (1) introduce the concept of CDM of dental caries, (2) provide evidence that CDM improves oral health outcomes, and (3) propose a dental hygienist-led team-based oral health care approach to CDM. Although we will be describing the CDM approach for early childhood caries, CDM of caries is applicable in children, adolescents, and adults. Early childhood caries disease control requires meaningful engagement of patients and parents by the oral health care team to assist them with making behavioral changes in the unique context of their families and communities. The traditional dentist/hygienist/assistant model needs to evolve to a collaborative partnership between care providers and patients/families. This partnership will be focused on systematic risk assessment and behaviorally based management of the disease itself, with sensitivity toward the familial environment. Early pilot study results demonstrate reductions in the rates of new caries, dental pain, and referral to the operating room compared with baseline rates. Dental hygienists are the appropriate team members to lead this approach because of their expertise in behavior change and prevention. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The role of diet and nutrition in the etiology and prevention of oral diseases.

PubMed

Moynihan, Paula J

2005-09-01

Diet plays an important role in preventing oral diseases including dental caries, dental erosion, developmental defects, oral mucosal diseases and, to a lesser extent, periodontal disease. This paper is intended to provide an overview of the evidence for an association between diet, nutrition and oral diseases and to clarify areas of uncertainty. Undernutrition increases the severity of oral mucosal and periodontal diseases and is a contributing factor to life-threatening noma. Undernutrition is associated with developmental defects of the enamel which increase susceptibility to dental caries. Dental erosion is perceived to be increasing. Evidence suggests that soft drinks, a major source of acids in the diet in developed countries, are a significant causative factor. Convincing evidence from experimental, animal, human observational and human intervention studies shows that sugars are the main dietary factor associated with dental caries. Despite the indisputable role of fluoride in the prevention of caries, it has not eliminated dental caries and many communities are not exposed to optimal quantities of fluoride. Controlling the intake of sugars therefore remains important for caries prevention. Research has consistently shown that when the intake of free sugars is < 15 kg/person/year, the level of dental caries is low. Despite experimental and animal studies suggesting that some starch-containing foods and fruits are cariogenic, this is not supported by epidemiological data, which show that high intakes of starchy staple foods, fruits and vegetables are associated with low levels of dental caries. Following global recommendations that encourage a diet high in starchy staple foods, fruit and vegetables and low in free sugars and fat will protect both oral and general health.

The role of diet and nutrition in the etiology and prevention of oral diseases.

PubMed Central

Moynihan, Paula J.

2005-01-01

Diet plays an important role in preventing oral diseases including dental caries, dental erosion, developmental defects, oral mucosal diseases and, to a lesser extent, periodontal disease. This paper is intended to provide an overview of the evidence for an association between diet, nutrition and oral diseases and to clarify areas of uncertainty. Undernutrition increases the severity of oral mucosal and periodontal diseases and is a contributing factor to life-threatening noma. Undernutrition is associated with developmental defects of the enamel which increase susceptibility to dental caries. Dental erosion is perceived to be increasing. Evidence suggests that soft drinks, a major source of acids in the diet in developed countries, are a significant causative factor. Convincing evidence from experimental, animal, human observational and human intervention studies shows that sugars are the main dietary factor associated with dental caries. Despite the indisputable role of fluoride in the prevention of caries, it has not eliminated dental caries and many communities are not exposed to optimal quantities of fluoride. Controlling the intake of sugars therefore remains important for caries prevention. Research has consistently shown that when the intake of free sugars is < 15 kg/person/year, the level of dental caries is low. Despite experimental and animal studies suggesting that some starch-containing foods and fruits are cariogenic, this is not supported by epidemiological data, which show that high intakes of starchy staple foods, fruits and vegetables are associated with low levels of dental caries. Following global recommendations that encourage a diet high in starchy staple foods, fruit and vegetables and low in free sugars and fat will protect both oral and general health. PMID:16211161

[Investigation of the first permanent molar caries in primary school students in Xuhui District of Shanghai Municipality].

PubMed

Su, Hong-ru; Xu, Pei-cheng; Qian, Wen-hao

2012-06-01

To investigate the prevalence and current status of caries about the first permanent molars of students in elementary schools in Xuhui District of Shanghai Municipality in order to provide evidence for prevention and treatment strategies of caries. Random cluster samples of 5698 students aged from 7 to 12 years old were examined with regard to caries epidemic status of the first permanent molars. The results were analyzed by SPASS13.0 software package. The caries prevalent rate of the first permanent molars was 16.18%.The mean DMFT of the caries patients was 1.80. The females' mean caries prevalent rate and DMFT of the first permanent molars were both significantly higher than males'. The caries rate increased rapidly with aging from 7 to 12(P<0.01).The overall filling rate of the first permanent molars was 56.04%.The prevalence of the first permanent molars in the mandible was significantly higher than that in the maxilla (P<0.01).The caries rate of students, who brushed teeth twice a day or more, was significantly lower than those who brushed teeth once a day or less. The caries prevalence of the first permanent molars in students of 7 to 12 years old in elementary schools in Xuhui District of Shanghai municipality was less optimistic. Some concrete measures should be taken to prevent and treat caries.

Managing dental caries in children in Turkey - a discussion paper

PubMed Central

2009-01-01

Background This paper describes the oral healthcare system and disease situation amongst children in Turkey. Considering the high prevalence and severity of dental caries, a proposal for improvement of oral health in this population group is formulated. Discussion A virtual absence of palliative, preventive and restorative care characterises juvenile oral healthcare in Turkey. Consequently, carious cavities remain untreated, which may lead to pain, discomfort and functional limitation and, further, may impact negatively upon general health and cognitive development. As a first step to controlling dental caries, a national health programme including promotional, preventive and minimal intervention approaches for managing dental caries is proposed. The pros and cons of community-oriented caries-preventive measures are discussed. Daily tooth brushing with fluoridated toothpaste at home, in mother- and child-care centres, kindergartens, and schools is highlighted. Summary The dental profession, government, university officials and other stakeholders need to meet and determine how best the oral health of children in Turkey can be improved. The present proposed plan is considered a starting point. PMID:19939240

Managing dental caries in children in Turkey--a discussion paper.

PubMed

Topaloglu-Ak, Asli; Eden, Ece; Frencken, Jo E

2009-11-25

This paper describes the oral healthcare system and disease situation amongst children in Turkey. Considering the high prevalence and severity of dental caries, a proposal for improvement of oral health in this population group is formulated. A virtual absence of palliative, preventive and restorative care characterises juvenile oral healthcare in Turkey. Consequently, carious cavities remain untreated, which may lead to pain, discomfort and functional limitation and, further, may impact negatively upon general health and cognitive development. As a first step to controlling dental caries, a national health programme including promotional, preventive and minimal intervention approaches for managing dental caries is proposed. The pros and cons of community-oriented caries-preventive measures are discussed. Daily tooth brushing with fluoridated toothpaste at home, in mother- and child-care centres, kindergartens, and schools is highlighted. The dental profession, government, university officials and other stakeholders need to meet and determine how best the oral health of children in Turkey can be improved. The present proposed plan is considered a starting point.

Exploration of Human Salivary Microbiomes—Insights into the Novel Characteristics of Microbial Community Structure in Caries and Caries-Free Subjects

PubMed Central

Wang, Shaoguo; Hu, Xiaopan; Jiao, Kangli; He, Xiangyi; Li, Zhiqiang; Wang, Jizeng

2016-01-01

Recently, high-throughput sequencing has improved the understanding of the microbiological etiology of caries, but the characteristics of the microbial community structure in the human oral cavity with and without caries are not completely clear. To better understand these characteristics, Illumina MiSeq high-throughput sequencing was utilized to analyze 20 salivary samples (10 caries-free and 10 caries) from subjects from the same town in Dongxiang, Gansu, China. A total of 5,113 OTUs (Operational Taxonomic Units, 97% cutoff) were characterized in all of the salivary samples obtained from the 20 subjects. A comparison of the two groups revealed that (i) the predominant phyla were constant between the two groups; (ii) the relative abundance of the genera Veillonella, Bifidobacterium, Selenomonas, Olsenella, Parascardovia, Scardovia, Chryseobacterium, Terrimonas, Burkholderia and Sporobacter was significantly higher in the group with caries (P < 0.05); and (iii) four genera with low relative abundance (< 0.01% on average), including two characteristic genera in caries (Chryseobacterium and Scardovia), significantly influenced the microbial community structure at the genus and OTU levels. Moreover, via co-occurrence and principal component analyses, the co-prevalence of the pathogenic genera was detected in the caries samples, but in the caries-free samples, the function of clustered genera was more random. This result suggests that a synergistic effect may be influencing the assembly of the caries microbial community, whereas competition may play a more dominant role in governing the microbial community in the caries-free group. Our findings regarding the characteristics of the microbial communities of the groups with and without caries might improve the understanding of the microbiological etiology of caries and might improve the prevention and cure of caries in the future. PMID:26784334

Effect of Antimicrobial Intervention on Oral Microbiota Associated with Early Childhood Caries

PubMed Central

Li, Yihong; Tanner, Anne

2015-01-01

Purpose The aim of this systematic literature review was to identify research-based evidence for an effect of antimicrobial therapeutic approaches on the cariogenic microbiota and early childhood caries (ECC) outcomes. Additionally, we reviewed methods used to perform microbial assessments in clinical studies of ECC. Methods Multiple database searches were conducted; only clinical cohort studies and randomized controlled trials published from 1998 to 2014 were selected for the review. A total of 471 titles and abstracts were identified; 114 studies met the inclusion criteria for a full review, and finally 41 studies were selected for the meta-analyses. Results Moderate reductions in cariogenic bacterial levels, mainly in mutans streptococci (MS), were demonstrated following the use of antimicrobial agents. The results varied depending on the different approaches used. In most of the reviewed studies MS levels were reduced after treatment, but the bacterial regrowth occurred once the treatment had ceased, and new caries lesions developed, particularly in high-risk children. Relatively consistent findings suggested that anti-cariogenic-microbial interventions in mothers significantly reduced MS acquisition by children. However, studies of the long-term benefits of ECC prevention are lacking. Conclusion Based on the meta-analyses, antimicrobial interventions and treatments show temporary reductions in MS colonization levels. However, insufficient evidence suggest that the approaches used produced sustainable effects on cariogenic microbial colonization, caries reduction, and ECC prevention. PMID:26063552

Effectiveness of maternal counseling in reducing caries in Cree children.

PubMed

Harrison, R L; Veronneau, J; Leroux, B

2012-11-01

This cluster-randomized pragmatic (effectiveness) trial tested maternal counseling based on Motivational Interviewing (MI) as an approach to control caries in indigenous children. Nine Cree communities in Quebec, Canada were randomly allocated to test or control. MI-style counseling was delivered in test communities to mothers during pregnancy and at well-baby visits. Data on outcomes were collected when children were 30 months old. Two hundred seventy-two mothers were recruited from the 5 test and 4 control communities. Baseline characteristics were comparable but not equivalent for both groups. At trial's end, 241 children had follow-up. The primary analysis outcome was enamel caries with substance loss (d2); no statistically significant treatment effect was detected. Prevalence of treated and untreated caries at the d2 level was 76% in controls vs. 65% in test (p = 0.17). Exploratory analyses suggested a substantial preventive effect for untreated decay at or beyond the level of the dentin, d3 (prevalences: 60% controls vs. 35% test), and a particularly large treatment effect when mothers had 4 or more MI-style sessions. Overall, these results provide preliminary evidence that, for these young, indigenous children, an MI-style intervention has an impact on severity of caries (clinical trial registration ISRCTN41467632).

Water fluoridation and oral health.

PubMed

Harding, Máiréad Antoinette; O'Mullane, Denis Martin

2013-11-01

Water fluoridation, is the controlled addition of fluoride to the water supply, with the aim of reducing the prevalence of dental caries. Current estimates suggest that approximately 370 million people in 27 countries consume fluoridated water, with an additional 50 million consuming water in which fluoride is naturally occurring. A pre-eruptive effect of fluoride exists in reducing caries levels in pit and fissure surfaces of permanent teeth and fluoride concentrated in plaque and saliva inhibits the demineralisation of sound enamel and enhances the remineralisation of demineralised enamel. A large number of studies conducted worldwide demonstrate the effectiveness of water fluoridation. Objections to water fluoridation have been raised since its inception and centre mainly on safety and autonomy. Systematic reviews of the safety and efficacy of water fluoridation attest to its safety and efficacy; dental fluorosis identified as the only adverse outcome. Water fluoridation is an effective safe means of preventing dental caries, reaching all populations, irrespective of the presence of other dental services. Regular monitoring of dental caries and fluorosis is essential particularly with the lifelong challenge which dental caries presents. Copyright © 2013 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Managing Early Childhood Caries for Young Children in China.

PubMed

Chen, Kitty Jieyi; Gao, Sherry Shiqian; Duangthip, Duangporn; Lo, Edward Chin Man; Chu, Chun Hung

2018-01-30

The latest national survey found that 70% of 5-year-old children in China had dental caries. The prevalence of early childhood caries (ECC) may not only be attributed to poor oral hygiene and unhealthy diet, but also to limited access to and availability of dental care. The prevailing preventive measures adopted by industrialised countries for ECC management are neither practical nor affordable in China. Hence, an alternative approach to ECC management is necessary. Atraumatic restorative treatment (ART) has been advocated because the simple and short operative time renders ART affordable. However, the success rate of ART in restoring anterior primary teeth is unfavourable. Although there is no water fluoridation in China, topical fluorides may be used to manage ECC. Tooth brushing with fluoride toothpaste is effective for caries control, but not all toothpastes in China are fluoridated. Professionally applied fluorides such as sodium fluoride varnish can be a cost-effective treatment for managing the high prevalence of ECC in China. Silver diamine fluoride (SDF) at 38% is suggested to be effective in arresting ECC in China. It can be a simple, non-invasive and low-cost treatment. However, it stains caries black. Children and their parents must be well informed before SDF treatment.

Managing Early Childhood Caries for Young Children in China

PubMed Central

Chen, Kitty Jieyi; Duangthip, Duangporn; Lo, Edward Chin Man

2018-01-01

The latest national survey found that 70% of 5-year-old children in China had dental caries. The prevalence of early childhood caries (ECC) may not only be attributed to poor oral hygiene and unhealthy diet, but also to limited access to and availability of dental care. The prevailing preventive measures adopted by industrialised countries for ECC management are neither practical nor affordable in China. Hence, an alternative approach to ECC management is necessary. Atraumatic restorative treatment (ART) has been advocated because the simple and short operative time renders ART affordable. However, the success rate of ART in restoring anterior primary teeth is unfavourable. Although there is no water fluoridation in China, topical fluorides may be used to manage ECC. Tooth brushing with fluoride toothpaste is effective for caries control, but not all toothpastes in China are fluoridated. Professionally applied fluorides such as sodium fluoride varnish can be a cost-effective treatment for managing the high prevalence of ECC in China. Silver diamine fluoride (SDF) at 38% is suggested to be effective in arresting ECC in China. It can be a simple, non-invasive and low-cost treatment. However, it stains caries black. Children and their parents must be well informed before SDF treatment. PMID:29385684

Effects of fluoridated drinking water on dental caries in Australian adults.

PubMed

Slade, G D; Sanders, A E; Do, L; Roberts-Thomson, K; Spencer, A J

2013-04-01

Systematic reviews produce conflicting conclusions regarding dental caries-preventive effects of water fluoridation in adults. The authors investigated the relationship using data from the nationally representative 2004-2006 Australian National Survey of Adult Oral Health. Effects were compared between the pre-fluoridation cohort born before 1960 (n = 2,270) and the cohort born between 1960 and 1990 (n = 1,509), when widespread implementation of fluoridation increased population coverage from < 1% to 67%. Residential history questionnaires determined the percentage of each person's lifetime exposed to fluoridated water. Examiners recorded decayed, missing, and filled teeth (DMF-Teeth) and decayed and filled tooth surfaces (DF-Surfaces). Socio-demographic and preventive dental behaviors were included in multivariable least-squares regression models adjusted for potential confounding. In fully adjusted models, > 75% of lifetime exposure to fluoridation relative to < 25% of lifetime exposure was associated with 11% and 10% fewer DMF-Teeth in the pre-1960 (p < .0001) and 1960-1990 cohorts (p = .018), respectively. Corresponding reductions in DF-Surfaces were 30% (p < .001) and 21% (p < .001). Findings for intermediate fluoridation exposure suggested a dose-response relationship. Results were consistent in sensitivity analyses accounting for missing data. In this nationally representative sample of Australian adults, caries-preventive effects of water fluoridation were at least as great in adults born before widespread implementation of fluoridation as after widespread implementation of fluoridation.

Correlation of Risk Factors With Caries Prevalence Among U.S. Military Recruits

DTIC Science & Technology

2012-06-01

the incidence of dental caries in individuals has been a topic of research in the dental community for a long time. If an accurate caries predictive...before the occurrence of a patient’s first caries lesion), it may allow for the truly proactive delivery of preventive dental therapies. The...Epidemiologic research suggests that 60% of dental caries occurs in 20% of the population. Compared to the general population, U.S. military

Community-based assessment and intervention for early childhood caries in rural El Salvador.

PubMed

Dabiri, Darya; Fontana, Margherita; Kapila, Yvonne; Eckert, George; Sokal-Gutierrez, Karen

2016-08-01

The objectives were to assess early childhood caries (ECC) in rural areas of El Salvador and to investigate the changes in caries and mouth pain in the presence of community-based interventions. This study was a retrospective analysis of de-identified and anonymous data obtained from baseline and four annual follow-up visits that focused on the preventive oral health intervention and nutrition in a convenience sample of children 0-6 years of age. The decayed, missing and filled teeth (dmft) index for primary teeth was used as the survey tool. Caries was defined as a cavitated lesion. Descriptive statistics were used to describe the prevalence of ECC in the sample in relation to age and dmft score. Linear mixed model analysis of variance (ANOVA) and generalised linear mixed effects models were used to compare the pre-intervention and post-intervention outcomes. The prevalence of caries was 58%. Incorporation of a community oral health education and fluoride supplementation programme contributed to significant reductions in caries experience (from 74% to 61%) and mouth pain (from 58% to 39%), in children 3-6 years of age. ECC is a common public health problem in rural El Salvador. In an established community-based maternal-child health programme in El Salvador, there appears to be an association between the incorporation of preventive oral health intervention and improvement in children's oral health and quality of life over time. © 2016 FDI World Dental Federation.

Caries prevention through the fluoridation of milk. A review.

PubMed

Bánóczy, Jolán; Rugg-Gunn, Andrew J

2007-10-01

The aim of this review is to give an overview of 50 years experience of milk fluoridation and draw conclusions about the applicability of the method. Fluoridated milk was first investigated in the early 1950s, almost simultaneously in Switzerland, the USA and Japan. Stimulated by the favourable results obtained from these early studies, the establishment of The Borrow Dental Milk Foundation (subsequently The Borrow Foundation) in England gave an excellent opportunity for further research, both clinical and non-clinical, and a productive collaboration with the World Health Organization from the early 1980s onwards. Numerous peer-reviewed publications in international journals showed clearly the bioavailability of fluoride in milk, and increased concentrations of fluoride in saliva, dental plaque, dental enamel and dentine, and urine, after consumption of fluoridated milk. Clinical trials were initiated in the 1980s--some of these can be classed as randomised controlled trials, while most of the clinical studies were community preventive programs. These evaluations showed clearly that the optimal daily intake of fluoride in milk is effective in preventing dental caries. At present, milk fluoridation programs are running continuously in about ten countries of the world. Fluoridation of milk can be recommended as a caries preventive measure where the fluoride concentration in drinking water is suboptimal, caries experience in children is significant, and there is an existing school milk program. The program should aim to provide fluoridated milk for at least 200 days per year and should commence before the children are 4 years of age.

Dynamics of pregnant women's oral health status during preventive programme.

PubMed

Vasiliauskiene, Ingrida; Milciuviene, Simona; Bendoraitiene, Egle; Narbutaite, Julija; Slabsinskiene, Egle; Andruskeviciene, Vilija

2007-01-01

The aim of the study was to determine the efficiency of the applied preventive measures during pregnancy and to improve oral health status to pregnant women. Oral health status of 180 pregnant women was determined according to WHO criteria (WHO: Basic methods, 1997). Dental caries prevalence, DMF-T and DMF-S were evaluated. Gingival status was estimated according to Silness-Loe (GI) index. Women were asked about tooth brushing frequency; oral hygiene was evaluated according to Green-Vermilion (OHI-S) index. Participants were divided into test (89) and control (91) groups. During pregnancy, the following preventive measures were applied to the test group: fluoride varnish applications, mouthrinsing with 0.12% chlorhexine digluconate, professional oral hygiene. Oral health status was evaluated three times during pregnancy. Reduction in dental caries increment of the test group was 56.25% in comparison with the control group. The periodontal status has improved, oral hygiene index (OHI-S) has decreased from 1.48+/-0.05 to 0.94+/-0.06 in the test group, and from 1.49+/-0.06 to 1.9+/-0.06 in the control group. Results of the study showed that selected dental caries preventive measures were effective and significantly improved women's oral health during pregnancy.

Chemical Aspects of Dentistry.

ERIC Educational Resources Information Center

Helfman, Murry

1982-01-01

Dental caries (tooth decay) and periodontal (gum) disease are treated/prevented by procedures utilizing chemical expertise. Procedures and suggestions on how they might be incorporated into the high school chemistry curriculum are described. Specific topics discussed include dental caries, fluoride, diet, tooth decay prevention, silver amalgan,…

Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines.

PubMed

Frame, P S; Sawai, R; Bowen, W H; Meyerowitz, C

2000-02-01

The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low-risk populations.

A model for extending the reach of the traditional dental practice: the ForsythKids program.

PubMed

Niederman, Richard; Gould, Ellen; Soncini, Jennifer; Tavares, Mary; Osborn, Valarie; Goodson, J Max

2008-08-01

The authors describe and evaluate the short-term effectiveness of a community-based program for dental caries prevention in children. The authors enrolled pupils in the ForsythKids program after receiving informed consent. They targeted children at six Massachusetts elementary schools, grades 1 through 3, with pupil populations at high risk of developing caries. The children underwent examination by dentists using calibrated technique and received comprehensive preventive care from dental hygienists. The authors determined effectiveness by means of comparing results of the initial examination with those of a second examination performed six months later. At baseline, 70 percent of the 1,196 participating children had decayed or filled teeth. More troublingly, 42.1 percent of the primary teeth and 31.1 percent of the permanent teeth had untreated decay. Six months after preventive intervention, the proportion of teeth with new decay was reduced 52 percent in primary teeth and 39 percent in permanent teeth. Furthermore, the percentage of children with newly decayed or restored primary and permanent teeth was reduced by 25.4 percent and 53.2 percent, respectively. These results indicate that this care model relatively quickly can overcome multiple barriers to care and improve children's oral health. If widely implemented, comprehensive caries prevention programs such as ForsythKids could accomplish national health goals and reduce the need for new care providers and clinics.

Protocol for “Seal or Varnish?” (SoV) trial: a randomised controlled trial to measure the relative cost and effectiveness of pit and fissure sealants and fluoride varnish in preventing dental decay

PubMed Central

2012-01-01

Background Dental caries remains a significant public health problem, prevalence being linked to social and economic deprivation. Occlusal surfaces of first permanent molars are the most susceptible site in the developing permanent dentition. Cochrane reviews have shown pit and fissure sealants (PFS) and fluoride varnish (FV) to be effective over no intervention in preventing caries. However, the comparative cost and effectiveness of these treatments is uncertain. The primary aim of the trial described in this protocol is to compare the clinical effectiveness of PFS and FV in preventing dental caries in first permanent molars in 6-7 year-olds. Secondary aims include: establishing the costs and the relative cost-effectiveness of PFS and FV delivered in a community/school setting; examining the impact of PFS and FV on children and their parents/carers in terms of quality of life/treatment acceptability measures; and examining the implementation of treatment in a community setting. Methods/design The trial design comprises a randomised, assessor-blinded, two-arm, parallel group trial in 6–7 year old schoolchildren. Clinical procedures and assessments will be performed at 66 primary schools, in deprived areas in South Wales. Treatments will be delivered via a mobile dental clinic. In total, 920 children will be recruited (460 per trial arm). At baseline and annually for 36 months dental caries will be recorded using the International Caries Detection and Assessment System (ICDAS) by trained and calibrated dentists. PFS and FV will be applied by trained dental hygienists. The FV will be applied at baseline, 6, 12, 18, 24 and 30 months. The PFS will be applied at baseline and re-examined at 6, 12, 18, 24, and 30 months, and will be re-applied if the existing sealant has become detached/is insufficient. The economic analysis will estimate the costs of providing the PFS versus FV. The process evaluation will assess implementation and acceptability through acceptability scales, a schools questionnaire and interviews with children, parents, dentists, dental nurses and school staff. The primary outcome measure will be the proportion of children developing new caries on any one of up to four treated first permanent molars. Discussion The objectives of this study have been identified by the National Institute for Health Research as one of importance to the National Health Service in the UK. The results of this trial will provide guidance on which of these technologies should be adopted for the prevention of dental decay in the most susceptible tooth-surface in the most at risk children. Trial registrations ISRCTN ref: ISRCTN17029222 EudraCT: 2010-023476-23 UKCRN ref: 9273 PMID:23167481

Community-oriented administration of fluoride for the prevention of dental caries: a summary of the current situation in Asia.

PubMed

Petersen, P E; Baez, R J; Lennon, M A

2012-02-01

Dental caries is the most prevalent chronic disease affecting human populations around the world. It is recognized that fluoride plays a significant role in dental caries reduction. Meanwhile, several low- and middle-income countries of Asia have not yet implemented systematic fluoride programs; contributing factors relate to misconceptions about the mechanisms of fluoride, low priority given to oral health in national health policy and strategic plans, and lack of interest among public health administrators. A workshop on the effective use of fluoride in Asia took place in Phang-Nga, Thailand, in 2011. A series of country presentations addressed some of the topics mentioned above; in addition, speakers from countries of the region provided examples of successful fluoride interventions and discussed program limitations, barriers encountered, and solutions, as well as possibilities for expanding coverage. Participants acknowledged that automatic fluoridation through water, salt, and milk is the most effective and equitable strategy for the prevention of dental caries. Concerns were expressed that government-subsidized community fluoride prevention programs may face privatization. In addition, the use of affordable fluoride-containing toothpastes should be encouraged. The workshop identified: strengths and weaknesses of ongoing community-based fluoride programs, as well as the interest of countries in a particular method; the requirement for World Health Organization (WHO) technical assistance on various aspects, including fluoridation process, feasibility studies, and implementation of effective epidemiological surveillance of the program; exchange of information; and the need for inter-country collaboration. It was acknowledged that program process and evaluation at the local and country levels need further dissemination. The meeting was co-sponsored by the World Health Organization, the International Association for Dental Research, and the World Dental Federation.

[Preventive and remineralization effect over incipient lesions of caries decay by phosphopeptide-amorphous calcium phosphate].

PubMed

Juárez-López, María Lilia Adriana; Hernández-Palacios, Rosa Diana; Hernández-Guerrero, Juan Carlos; Jiménez-Farfán, Dolores; Molina-Frechero, Nelly

2014-01-01

INTRODUCTION. Dental caries continues to affect a large percentage of Mexican children and currently advises that if diagnosed at an early stage can be reversed with minimally invasive treatments. The casein phosphopeptide amorphous calcium phosphate known as CPP-ACP is a phosphoprotein capable of releasing calcium and phosphate ions in the oral environment promoting remineralization. OBJECTIVE. To evaluate the effect of CPP-ACP with fluoride added in a scholar preventive program. MATERIAL AND METHODS. A cuasi- experimental study was conducted in 104 schools of six years old. The children were classified into three groups and received six months biweekly applications of different treatments: casein phosphopeptide amorphous calcium phosphate added fluoride (CPP-ACPF), sodium fluoride (NaF) and a control group. Clinical evaluation was performed with the laser fluorescence technique (Diagnodent model 2095). 1340 teeth were included: 294 teeth with incipient lesions and 1,046 healthy teeth. Statistical tests of χ2 y Mc Nemar were used. RESULTS. In the group that received the application of CPP-ACPF, 38% of incipient carious lesions were remineralizing compared with 21% in the group receiving the NaF (p < 0.001) and 15% in the control group (p < 0.0001) The percentage of teeth free of caries were preserved in the therapy group phosphoprotein was the biggest. This group also showed the lower proportion of deep carious lesion development (p < 0.0001). CONCLUSION. The application biweekly for six months of CPP-ACPF showed a protective and remineralizing effect on incipient carious lesions. His action was better than the application of NaF. However, to reduce the impact from dental caries in schoolchildren is important to have a comprehensive preventive approach that includes promoting self-care, as well as the application of sealants.

Microstructure and mechanical changes induced by Q-Switched pulse laser on human enamel with aim of caries prevention

NASA Astrophysics Data System (ADS)

Apsari, R.; Pratomo, D. A.; Hikmawati, D.; Bidin, N.

2016-03-01

This study was conducted to determine the effect of Q-Switched Nd: YAG laser energy dose to human enamel caries. The specifications of Q-Switched Nd: YAG laser as followed: wavelength of 1064 nm and 6 ns pulse width. Caries enamel samples taken from human teeth molars of 17-35 ages and the type of media caries. Energy doses used in this study were 723.65 mJ/cm2, 767.72 mJ/cm2, and 1065.515 mJ/cm2; 5 Hz repetition rate, and 20 second exposure time. Samples characterized the surface morphology and the percentage of constituent elements, especially calcium/phosphorus (Ca/P) with FESEM-EDAX. The fraction volume and crystallinity percentage of hydroxyapatite (HA) with XRD and hardness value using Vickers Microhardness Test. The results indicated that exposure of Q-Switched Nd:YAG laser on enamel caries resulting cracks, holes, and melt due to plasma production effects in the surface. Plasma production effect also resulted in micro properties such as percentage of Ca/P was close to normal, the fraction volume and crystallinity percentage of HA went up but did not change the crystal structure (in terms of the lattice structure). The hardness value also rose as linear as exposure energy dose caused by phototermal effect. Based on the results, Q-Switched Nd:YAG laser can be used as contactless drill dental caries replacement candidate with the additional therapy effect such as localized caries in order to avoid the spread, the ratio of Ca/P approaching healthy teeth, the fraction volume and crystallinity percentage of HA rose and established stronger teeth with peak energy dose 1065.515 mJ/cm2.

WHO Global Consultation on Public Health Intervention against Early Childhood Caries.

PubMed

Phantumvanit, Prathip; Makino, Yuka; Ogawa, Hiroshi; Rugg-Gunn, Andrew; Moynihan, Paula; Petersen, Poul Erik; Evans, Wendell; Feldens, Carlos Alberto; Lo, Edward; Khoshnevisan, Mohammad H; Baez, Ramon; Varenne, Benoit; Vichayanrat, Tippanart; Songpaisan, Yupin; Woodward, Margaret; Nakornchai, Siriruk; Ungchusak, Chantana

2018-06-01

Early Childhood Caries (ECC) is prevalent around the world, but in particular the disease is growing rapidly in low- and middle-income countries in parallel with changing diet and lifestyles. In many countries, ECC is often left untreated, a condition which leads to pain and adversely affects general health, growth and development, and quality of life of children, their families and their communities. Importantly, ECC is also a global public health burden, medically, socially and economically. In many countries, a substantial number of children require general anaesthesia for the treatment of caries in their primary teeth (usually extractions), and this has considerable cost and social implications. A WHO Global Consultation with oral health experts on "Public Health Intervention against Early Childhood Caries" was held on 26-28 January 2016 in Bangkok (Thailand) to identify public health solutions and to highlight their applicability to low- and middle-income countries. After a 3-day consultation, participants agreed on specific recommendations for further action. National health authorities should develop strategies and implement interventions aimed at preventing and controlling ECC. These should align with existing international initiatives such as the Sixtieth World Health Assembly Resolution WHA 60.17 Oral health: action plan for promotion and integrated disease prevention, WHO Guideline on Sugars and WHO breastfeeding recommendation. ECC prevention and control interventions should be integrated into existing primary healthcare systems. WHO public health principles must be considered when tackling the effect of social determinants in ECC. Initiatives aimed at modifying behaviour should focus on families and communities. The involvement of communities in health promotion, and population-directed and individual fluoride administration for the prevention and control of ECC is essential. Surveillance and research, including cost-effectiveness studies, should be conducted to evaluate interventions aimed at preventing ECC in different population groups. © 2018 The World Health Organization.

Factors That Drive Dentists towards or Away from Dental Caries Preventive Measures: Systematic Review and Metasummary

PubMed Central

Suga, Uhana Seifert Guimarães; Terada, Raquel Sano Suga; Ubaldini, Adriana Lemos Mori; Fujimaki, Mitsue; Pascotto, Renata Corrêa; Batilana, Adelia Portero; Pietrobon, Ricardo; Vissoci, João Ricardo N.; Rodrigues, Clarissa G.

2014-01-01

Background Dental caries is a serious public health concern. The high cost of dental treatment can be avoided by effective preventive measures, which are dependent on dentists’ adherence. This study aimed to evaluate the factors that drive dentists towards or away from dental caries preventive measures. Methods and Findings This systematic review was registered in PROSPERO (CRD42012002235). Several databases as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines, yielding 18,276 titles and abstracts, which were assessed to determine study eligibility. Seven qualitative studies and 41 surveys (36,501 participants) remained after data extraction and interpretation. A total of 43 findings were abstracted from the reports and were grouped together into 6 categories that were judged to be topically similar: education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. The main findings for adherence based on their calculated frequency effect sizes (ES) were teamwork (21%) and post-graduation (12%), while for non-adherence were biologicism (27%), and remuneration for preventive procedures (25%). Intensity ES were also calculated and demonstrated low prevalence of the findings. Quality assessment of the studies demonstrated that the methodological quality, particularly of surveys, varied widely among studies. Conclusions Despite the questionable quality of the included reports, the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favor of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general. PMID:25296335

Oral diagnosis and treatment planning: part 5. Preventive and treatment planning for dental caries.

PubMed

Yip, K; Smales, R

2012-09-01

The practice of operative dentistry continues to evolve, to reflect the many changes occurring in society and in dental diseases and conditions. However, the belief that all questionable and early carious lesions should be restored still persists. This belief is largely based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. Yet restorations are not permanent and do not cure caries, as the causes remain. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth.

Early Childhood Caries-Related Knowledge, Attitude, and Practice: Discordance between Pediatricians and Dentists toward Medical Office-Based Prevention in Taiwan.

PubMed

Dima, Shinechimeg; Chang, Wei-Jen; Chen, Jung-Wei; Teng, Nai-Chia

2018-05-24

The aim of this study was to assess the knowledge, attitude, and practice regarding early childhood caries (ECC) prevention and implementation of medical setting-based caries prevention among pediatricians and dentists in Taiwan. Data were collected from currently practicing pediatricians and general and pediatric dentists using self-administered questionnaires. A total of 301 questionnaires were completed by the pediatricians ( n = 105), general dentists ( n = 117), and pediatric dentists ( n = 79). The pediatric dentists obtained significantly higher knowledge and practice scores than the general dentists and pediatricians ( p < 0.0001). The pediatricians' attitude score related to engaging physicians in medical office-based caries prevention was significantly higher than the attitude scores of the general and pediatric dentists ( p < 0.05). A Spearman rank correlation analysis indicated a significant positive correlation between knowledge and practice among the general dentists (r s = 0.271, p < 0.01) and pediatricians (r s = 0.262, p < 0.01). The correlation between knowledge and attitude among the pediatricians was significantly positive (r s = 0.242, p < 0.05). Attitude and practice among the pediatricians were significantly positively correlated (r s = 0.271, p < 0.01). Pediatricians lacked ECC-related knowledge; however, they had a more positive attitude toward medical office-based prevention when they had a higher level of knowledge. Oral health-related education for pediatricians is necessary if such medical office-based caries prevention programs are to be implemented in Taiwan.

Dental caries: strategies to control this preventable disease.

PubMed

Rugg-Gunn, Andrew

2013-11-01

To provide a brief commentary review of strategies to control dental caries. Dental decay is one of man's most prevalent diseases. In many counties, severity increased in parallel with importation of sugar, reaching its zenith about 1950s and 1960s. Since then, severity has declined in many countries, due to the wide use of fluoride especially in toothpaste, but dental caries remains a disease of medical, social and economic importance. Within the EU in 2011, the cost of dental treatment was estimated to be €79 billion. The pathogenesis is well understood: bacteria in dental plaque (biofilm) metabolise dietary sugars to acids which then dissolve dental enamel and dentine. Possible approaches to control caries development, therefore, involve: removal of plaque, reducing the acidogenic potential of plaque, reduction in sugar consumption, increasing the tooth's resistance to acid attack, and coating the tooth surface to form a barrier between plaque and enamel. At the present time, only three approaches are of practical importance: sugar control, fluoride, and fissure sealing. The evidence that dietary sugars are the main cause of dental caries is extensive, and comes from six types of study. Without sugar, caries would be negligible. Fluoride acts in several ways to aid caries prevention. Ways of delivering fluoride can be classed as: 'automatic', 'home care' and 'professional care': the most important of these are discussed in detail in four articles in this issue of the Acta Medica Academica. Dental caries is preventable - individuals, communities and countries need strategies to achieve this. Copyright © 2013 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Prevalence of Dental Caries in the Municipality Gorazde During the Period 2007-2012

PubMed Central

Deljo, Emsudina; Cavaljuga, Semra; Meskovic, Belma

2013-01-01

Introduction: Dental caries today, regardless of known multi causal etiology of the disease and the possibility of its effective prevention still represents the most widespread disease of our civilization, which affects about 95% of our population. It affects all populations and age groups and is a disease that is very difficult to completely eradicate due to a complex interaction of biological factors, eating habits, social status Etc. Goal: Goal is to report the prevalence of dental caries, DMFT-index and DMFT index in the first and seventh grades of grammar school in the municipality Gorazde during the last six years. Material and methods: Children, which have yet to enroll in school and in the seventh grade children, have required medical examinations. A total of 1198 first grade and 1666 seventh-grade students are included. To determine the prevalence of dental caries DMFT was used. Examinations are carried out in accordance with the methodology and criteria of the WHO, by a dental mirror and dental probe. Results: The prevalence of dental caries is extremely high as well as the values of DMFT index in the first and seventh grades in the municipality Gorazde. Conclusion: In practice it is necessary to introduce prevention programs for pregnant women, toddlers, preschool and school-aged children with a wider use of the mass media. PMID:24167427

Global oral health inequalities: dental caries task group--research agenda.

PubMed

Pitts, N; Amaechi, B; Niederman, R; Acevedo, A-M; Vianna, R; Ganss, C; Ismail, A; Honkala, E

2011-05-01

The IADR Global Oral Health Inequalities Task Group on Dental Caries has synthesized current evidence and opinion to identify a five-year implementation and research agenda which should lead to improvements in global oral health, with particular reference to the implementation of current best evidence as well as integrated action to reduce caries and health inequalities between and within countries. The Group determined that research should: integrate health and oral health wherever possible, using common risk factors; be able to respond to and influence international developments in health, healthcare, and health payment systems as well as dental prevention and materials; and exploit the potential for novel funding partnerships with industry and foundations. More effective communication between and among the basic science, clinical science, and health promotion/public health research communities is needed. Translation of research into policy and practice should be a priority for all. Both community and individual interventions need tailoring to achieve a more equal and person-centered preventive focus and reduce any social gradient in health. Recommendations are made for both clinical and public health implementation of existing research and for caries-related research agendas in clinical science, health promotion/public health, and basic science.

An early oral health care program starting during pregnancy: results of a prospective clinical long-term study.

PubMed

Meyer, Karen; Geurtsen, Werner; Günay, Hüsamettin

2010-06-01

This study covers phase IV of a prospective clinical long-term study. Objective of this clinical investigation was to analyze the effects of a long-term prevention program on dental and oral health of teenagers at the age of 13 to 14 years. The entire study was subdivided into four phases. Phase I comprised an individual preventive care during pregnancy ("primary-primary prevention"); phase II assessed mothers and their young children until the age of 3 years ("primary prevention"); and in phase III, mothers and children at the age of 6 years were investigated. In phase IV of the study, the oral health of 13- to 14-year-old teenagers was examined (13.4 +/- 0.5 years; n = 29). All phases consisted of an examination, education about oral health care, and treatment based on the concept of an early oral health care promotion. The control group consisted of randomly selected adolescents at the same age (n = 30). The following clinical parameters were assessed: decayed/missing/filled teeth (DMF-T)/decayed, missing, and filled surface teeth index, hygiene index, papilla bleeding index, Periodontal Screening Index, and Streptococcus mutans/Lactobacillus concentration in saliva. The teenagers of the "prevention" group of phase IV of our prospective study revealed a share of 89.7% caries-free dentitions (65.5% sound; 24.2% caries-free with fillings). Mean DMF-T was 0.55 +/- 1.0. The control group showed a significantly higher mean DMF-T of 1.5 +/- 1.5 (p < 0.05) and revealed 56.7% of caries-free dentitions (30% sound, 26.7% caries-free with restorations). Our data clearly document that an early oral health care promotion starting during pregnancy may cause a sustained and long-term improvement of the oral health of children.

Knowledge and beliefs concerning early childhood caries from mothers of children ages zero to 12 months.

PubMed

Azevedo, Marina Sousa; Romano, Ana Regina; Dos Santos, Iná da Silva; Cenci, Maximiliano Sergio

2014-01-01

This study's purpose was to assess mothers' knowledge and beliefs about early childhood caries (ECC) etiology and prevention. This cross-sectional study targeted mothers (N=277) of zero- to 12-month-olds visiting 12 public health care centers in Pelotas, Rio Grande do Sul, Brazil. Information on causes of and recommendations to prevent ECC, as well as socioeconomic and demographic variables, was collected. Chi-square, univariate, and multiple logistic regression analyses were performed (P<.05). Sugar intake and lack of oral hygiene were the most frequently mentioned causes of caries. Ninety percent of the mothers were aware of the need to begin tooth-brushing during their children's first year. Mothers who had more children and were in lower socioeconomic positions were more likely to not know the correct age for the first dental visit. Our findings showed that mothers do not know all the factors that can influence caries in their children. None reported the role of micro-organisms and lack of fluoride in the caries etiology. These findings highlight the importance of providing preventive orientation to the mothers regarding early childhood caries. Information on age of first dental visit should be emphasized, especially among mothers with more than one child and low-income families.

Dentifrices, mouthwashes, and remineralization/caries arrestment strategies

PubMed Central

Zero, Domenick T

2006-01-01

While our knowledge of the dental caries process and its prevention has greatly advanced over the past fifty years, it is fair to state that the management of this disease at the level of the individual patient remains largely empirical. Recommendations for fluoride use by patients at different levels of caries risk are mainly based on the adage that more is better. There is a general understanding that the fluoride compound, concentration, frequency of use, duration of exposure, and method of delivery can influence fluoride efficacy. Two important factors are (1) the initial interaction of relatively high concentrations of fluoride with the tooth surface and plaque during application and (2) the retention of fluoride in oral fluids after application. Fluoride dentifrices remain the most widely used method of delivering topical fluoride. The efficacy of this approach in preventing dental caries is beyond dispute. However, the vast majority of currently marketed dentifrice products have not been clinically tested and have met only the minimal requirements of the FDA monograph using mainly laboratory testing and animal caries testing. Daily use of fluoride dental rinses as an adjunct to fluoride dentifrice has been shown to be clinically effective as has biweekly use of higher concentration fluoride rinses. The use of remineralizing agents (other than fluoride), directed at reversing or arresting non-cavitated lesions, remains a promising yet largely unproven strategy. High fluoride concentration compounds, e.g., AgF, Ag(NH3)2F, to arrest more advanced carious lesions with and without prior removal of carious tissue are being used in several countries as part of the Atraumatic Restorative Treatment (ART) approach. Most of the recent innovations in oral care products have been directed toward making cosmetic marketing claims. There continues to be a need for innovation and collaboration with other scientific disciplines to fully understand and prevent dental caries. PMID:16934126

Personal oral hygiene and dental caries: A systematic review of randomised controlled trials.

PubMed

Hujoel, Philippe Pierre; Hujoel, Margaux Louise A; Kotsakis, Georgios A

2018-05-15

To conduct a systematic review of randomised trials assessing the association between personal oral hygiene and dental caries in the absence of the confounding effects of fluoride. Dental caries continues to affect close to 100% of the global population. There is a century-old conflict on whether dental caries is caused by poor oral hygiene or poorly formed teeth (ie, teeth with dental defects). Resolving this conflict is of significant public health importance as these two hypotheses on dental caries aetiology can lead to different prevention strategies. A systematic search for randomised trials was conducted using predefined criteria in 3 databases. The impact of personal oral hygiene interventions on coronal dental caries incidence was evaluated using random-effects models. Three randomised studies involving a total of 743 participants were included. Personal oral hygiene interventions failed to influence the incidence of dental caries (Δ Decayed, Missing and Filled Surfaces (DFMS) = -0.11; 95% confidence interval: (-0.91, 0.69; P-value < .79)) despite meticulous deplaquing of teeth. There was no significant heterogeneity in the trial results (heterogeneity chi-squared = 1.88, P = .39). The findings were robust to sensitivity analyses, including consideration of the results of nonrandomised studies. Personal oral hygiene in the absence of fluorides has failed to show a benefit in terms of reducing the incidence of dental caries. © 2018 The Authors. Gerodontology published by British Society of Gerodontology, European College of Gerodontology and Geriatric Oral Research Group and John Wiley & Sons Ltd.

Inequalities of caries experience in Nevada youth expressed by DMFT index vs. Significant Caries Index (SiC) over time.

PubMed

Ditmyer, Marcia; Dounis, Georgia; Mobley, Connie; Schwarz, Eli

2011-04-05

With the increasingly polarized distribution of dental caries among children and adolescents, the usual DMFT measure has become a less meaningful population descriptor. To re-focus on identifying the high caries prevalence group the Significant Caries Index (SiC) was created. The aims of this study were to analyze the prevalence and severity of dental caries in Nevada youth over a period of eight years and to compare its expression by means of DMFT and SiC; analyze the caries trends in the population and their underlying factors, and determine whether Nevada youth were at risk for significantly high levels of dental caries. Retrospective data was analyzed from a series of sequential, standardized oral health surveys across eight years (2001/2002-2008/2009) that included over 62,000 examinations of adolescents 13-19 years of age, attending public/private Nevada schools. Mean Decayed-Missing-Filled Teeth index (DMFT) and Significant Caries Index (SiC) were subsequently computed for each academic year. Descriptive statistics were reported for analysis of comparative DMFT and SiC scores in relation to age, gender, racial background, and residence in a fluoridated/non-fluoridated community. Logistic regression analysis was used to analyze the differential impact of the variables on the probability of being in the high caries prevalence group. Comparison of students' mean DMFT to National (NHANES) data confirmed that dental caries remains a common chronic disease among Nevada youth, presenting higher prevalence rates and greater mean scores than the national averages. Downward trends were found across all demographics compared between survey years 1 and 6 with the exception of survey year 3. An upward trend began in survey year six. Over time, the younger group displayed an increasing proportion of caries free individuals while a decreasing proportion was found among older examinees. As expected, the mean SiC score was significantly higher than DMFT scores within each survey year across comparison groups (p < 0.001). Using both caries indices together may help to highlight oral health inequalities more accurately among different population groups within the community in order to identify the need for special preventive oral health interventions in adolescent Nevadans. At the community level, action should focus on retaining and expanding the community fluoridation program as an effective preventive measure. At the individual level the study identifies the need for more targeted efforts to reach children early with a focus on females, Hispanics and Blacks, and uninsured children.

School-Based Fluoride Mouth-Rinse Program Dissemination Associated With Decreasing Dental Caries Inequalities Between Japanese Prefectures: An Ecological Study.

PubMed

Matsuyama, Yusuke; Aida, Jun; Taura, Katsuhiko; Kimoto, Kazunari; Ando, Yuichi; Aoyama, Hitoshi; Morita, Manabu; Ito, Kanade; Koyama, Shihoko; Hase, Akihiro; Tsuboya, Toru; Osaka, Ken

2016-11-05

Dental caries inequalities still severely burden individuals' and society's health, even in countries where fluoride toothpastes are widely used and the incidence of dental caries has been decreasing. School-based fluoride mouth-rinse (S-FMR) programs, a population strategy for dental caries prevention, might decrease dental caries inequalities. This study investigated the association between S-FMR and decreasing dental caries prevalence and caries-related inequalities in 12-year-olds by Japanese prefecture. We conducted an ecological study using multi-year prefecture-level aggregated data of children born between 1994 and 2000 in all 47 Japanese prefectures. Using two-level linear regression analyses (birth year nested within prefecture), the association between S-FMR utilization in each prefecture and 12-year-olds' decayed, missing, or filled permanent teeth (DMFT), which indicates dental caries experience in their permanent teeth, were examined. Variables that could explain DMFT inequalities between prefectures, such as dental caries experience at age 3 years, dentist density, and prefectural socioeconomic circumstances, were also considered. High S-FMR utilization was significantly associated with low DMFT at age 12 (coefficient -0.011; 95% confidence interval, -0.018 to -0.005). S-FMR utilization explained 25.2% of the DMFT variance between prefectures after considering other variables. Interaction between S-FMR and dental caries experience at age 3 years showed that S-FMR was significantly more effective in prefectures where the 3-year-olds had high levels of dental caries experience. S-FMR, administered to children of all socioeconomic statuses, was associated with lower DMFT. Utilization of S-FMR reduced dental caries inequalities via proportionate universalism.

School-Based Fluoride Mouth-Rinse Program Dissemination Associated With Decreasing Dental Caries Inequalities Between Japanese Prefectures: An Ecological Study

PubMed Central

Matsuyama, Yusuke; Aida, Jun; Taura, Katsuhiko; Kimoto, Kazunari; Ando, Yuichi; Aoyama, Hitoshi; Morita, Manabu; Ito, Kanade; Koyama, Shihoko; Hase, Akihiro; Tsuboya, Toru; Osaka, Ken

2016-01-01

Background Dental caries inequalities still severely burden individuals’ and society’s health, even in countries where fluoride toothpastes are widely used and the incidence of dental caries has been decreasing. School-based fluoride mouth-rinse (S-FMR) programs, a population strategy for dental caries prevention, might decrease dental caries inequalities. This study investigated the association between S-FMR and decreasing dental caries prevalence and caries-related inequalities in 12-year-olds by Japanese prefecture. Methods We conducted an ecological study using multi-year prefecture-level aggregated data of children born between 1994 and 2000 in all 47 Japanese prefectures. Using two-level linear regression analyses (birth year nested within prefecture), the association between S-FMR utilization in each prefecture and 12-year-olds’ decayed, missing, or filled permanent teeth (DMFT), which indicates dental caries experience in their permanent teeth, were examined. Variables that could explain DMFT inequalities between prefectures, such as dental caries experience at age 3 years, dentist density, and prefectural socioeconomic circumstances, were also considered. Results High S-FMR utilization was significantly associated with low DMFT at age 12 (coefficient −0.011; 95% confidence interval, −0.018 to −0.005). S-FMR utilization explained 25.2% of the DMFT variance between prefectures after considering other variables. Interaction between S-FMR and dental caries experience at age 3 years showed that S-FMR was significantly more effective in prefectures where the 3-year-olds had high levels of dental caries experience. Conclusions S-FMR, administered to children of all socioeconomic statuses, was associated with lower DMFT. Utilization of S-FMR reduced dental caries inequalities via proportionate universalism. PMID:27108752

Healthy Eating Index Is a Predictor of Early Childhood Caries

PubMed Central

Nunn, M.E.; Braunstein, N.S.; Krall Kaye, E.A.; Dietrich, T.; Garcia, R.I.; Henshaw, M.M.

2009-01-01

Early childhood caries (ECC) is a preventable form of dental caries that affects very young children, particularly among low-income families and certain racial/ethnic minorities. The current study examined the relationship of dietary quality, as measured by the Healthy Eating Index (HEI), to the prevalence of ECC in 2- to 5-year-old children. Data from the Third National Health and Nutrition Examination Survey (NHANES III) were used for the study. We used logistic regression to compute adjusted odds ratios (OR) for ECC and 95% confidence intervals (CI). Children with the best dietary practices (uppermost tertile of the HEI) were 44% less likely to exhibit severe ECC compared with children with the worst dietary practices (lowest tertile of the HEI). A healthy eating pattern geared for promotion of optimal child development and prevention of chronic disease in later life may also reduce the risk of early childhood caries, particularly severe early childhood caries. PMID:19407158

Utility of Dermatoglyphic Pattern in Prediction of Caries in Children of Telangana Region, India.

PubMed

Asif, Shaik M; Babu, Dara Bg; Naheeda, Shaik

2017-06-01

Dermatoglyphics is an extremely useful tool as a preliminary investigation method for diagnosing suspected genetic disorders. Caries being a multifactorial disease with the influence of genetic pattern, early identification of caries risk children with dermatoglyphics can help in using effective and efficient caries preventive measures. The study was undertaken to record and know the frequency of occurrence of fingerprint patterns among children with caries and in children without caries. A total of 400 schoolchildren in the age group of 5 to 12 years were selected from a private school, Warangal, Telangana, India. Of 400 schoolchildren, 200 children were with caries group and 200 children were in caries-free group. Children with dental caries in five or more teeth based on the decayed, missing, filled teeth index performed were considered as study group, and the control group was normal healthy children without any dental caries. The fingerprints of each child were recorded using stamp pad method, and type of dermatoglyphic pattern of each digit was recorded based on Cummins and Midlo method. Data obtained were put for statistical analysis; p < 0.001 was considered statistically significant. Although the frequency of whorl pattern was more prevalent in caries group, it was statistically significant on the left hand third digit of females and on the right hand third digit and the left hand fourth digit of males. Fingerprints of female caries-free group showed maximum of ulnar loop and males showed maximum of arches. There was a decrease in total ridge count in caries group, especially in males. Dermatoglyphics could be an appropriate method to explore the possibility of a noninvasive and an early predictor for dental caries. Dermatoglyphics has a future role in identifying people with or at increased risk for dental caries so that risk reduction measures or earlier therapy may be instituted.

A Review of Emerging Technologies for the Detection and Diagnosis of Dental Caries

DTIC Science & Technology

2016-06-01

of Dental Research . 83:39-42. Featherstone JDB. (2008). Dental caries: a dynamic disease process. Australian Dental Journal . 53:286-291... Research Naval Postgraduate Dental School Objectives:  to address emerging technologies presently available to aid in the detection and... research of dental caries in young children, the term early childhood caries was proposed by the Centers for Disease Control and Prevention in 1994 to

"MI" caries management--an overview.

PubMed

Banerjee, Avijit

2012-04-01

Minimum intervention dentistry, with its non-operative prevention and control of disease, underpins the basis of a patient-centred, team-based approach to managing dental caries in patients, who must take an active responsibility in maintaining their personal oral health. In patients where cavities are present causing pain, poor aesthetics and/or functional problems, restorations will need to be placed. Minimally invasive caries excavation strategies can be deployed depending on the patient's caries risk, lesion-pulp proximity and vitality, the extent of remaining supra-gingival tooth structure and clinical factors (e.g., moisture control, access) present in each case treated. Excavation instruments, including burs/handpieces, hand excavators, chemo-mechanical agents and/or air-abrasives which limit caries removal selectively to the more superficial caries-infected dentine and partial removal of caries-affected dentine when required, help create smaller cavities with healthy enamel/dentine margins. Using adhesive restorative materials, the operator can, if handling with care, optimize the histological substrate coupled with the applied chemistry of the material so helping to form a durable peripheral seal and bond to aid retention of the restoration as well as arresting the carious process within the remaining tooth structure. Achieving a smooth tooth-restoration interface clinically to aid the co-operative, motivated patient in biofilm removal, is an essential pre-requisite to prevent further secondary caries.

Effect of a chlorhexidine/thymol and a fluoride varnish on caries development in erupting permanent molars: a comparative study.

PubMed

Flamee, S; Gizani, S; Caroni, C; Papagiannoulis, L; Twetman, S

2015-12-01

To compare the caries preventive effect of a chlorhexidine/thymol-containing antibacterial varnish with a fluoride varnish when topically applied during the eruption of permanent molars. The study group consisted of 189 patients, 5-14 years of age, with one 1st or 2nd permanent molar in the process of eruption. After stratification for type of molar and stage of eruption, the patients were randomised to either quarterly topical applications with an antibacterial varnish (Cervitec(®) Plus; CV group) or biannual applications with a fluoride varnish plus biannual treatments with placebo varnish (Fluor Protector; FV group). The duration of the study was 2 years. The primary endpoint was caries incidence (initial and cavitated) in the erupting molars and the secondary outcome was salivary mutans streptococci (MS) counts. The groups were balanced with respect to socio-economy, oral hygiene, dietary habits and caries experience at baseline. The dropout rate was 11.6 %. The caries incidence was low (< 10 %) in both groups and there was no significant difference between the CV and FV groups with respect to occlusal caries development in the erupting molars (relative risk 1.08, 95 % CI 0.94-1.25). Significantly lower levels of salivary MS were disclosed in the CV group at the end of the study (p < 0.05). No difference in occlusal caries development in young permanent molars was displayed after topical applications of either a chlorhexidine/thymol varnish or a fluoride varnish during tooth eruption.

Effect of training pediatricians and family physicians in early childhood caries prevention.

PubMed

Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A

2015-04-01

To analyze the effect of postresidency early childhood caries prevention training on physicians' oral health knowledge, confidence, and practice patterns and to identify variations by type of training. We conducted pre- and post-training surveys of pediatricians and family physicians in Florida. Paired t test and repeated-measures ANOVA analyses were used to compare physicians with no oral health training, those with applied in-office training, and those with another type of training on 5 composite measures: fluoride knowledge, nonfluoride oral health knowledge, confidence in advising parents, confidence in conducting oral health screening and caries risk assessment, and frequency in performing recommended oral health practices. The final sample included 229 physicians (162 pediatricians and 67 family physicians). The interaction in the repeated-measures ANOVA between group (training category) and time (pre- and post-training) was significant for the nonfluoride knowledge [F(2, 225) = 4.1, P = .02] and confidence in screening [F(2, 224) = 4.1, P = .02] composite measures, lending support for a positive treatment effect of training on these domains. Greater gains were observed among physicians with in-office training compared with those who received another type of training. A statistically significant treatment effect on oral health practices was not detected. Efforts to engage physicians in oral health training and to incorporate applied components in training curricula may improve physicians' oral health knowledge and increase their confidence in conducting oral health screenings and caries risk assessments. Additional research is needed to evaluate the relative costs and benefits of different training modalities on specific oral health practices. Copyright © 2015 Elsevier Inc. All rights reserved.

[Paradigm shift in dentistry for children: from restorative to preventive treatment of caries].

PubMed

van Amerongen, J P; van Palenstein Helderman, W H

2010-03-01

First, the development of dental health care for children in the Netherlands is discussed. Caries prevalence among children has declined sharply. The present situation, however, makes clear that the majority of carious cavities in the temporary dentition remain untreated. This has led to the conclusion that the level of restorative care has to increase. On the basis of new insights in cariology gained in recent decades, the authors of this article argue for abandoning the old paradigm of restorative treatment in favour of prevention in the treatment of caries.

Long-Wave Infrared Thermophotonic Imaging of Demineralization in Dental Hard Tissue

NASA Astrophysics Data System (ADS)

Ojaghi, A.; Parkhimchyk, A.; Tabatabaei, N.

2016-08-01

Dental caries remains the most prevalent chronic disease in both children and adults worldwide. To address this prevalence through disease prevention and management, dentists need tools capable of detecting caries at early stages of formation. Looking into the physics of light propagation in teeth, this study presents a clinically and commercially viable platform technology for thermophotonic detection of early dental caries using an inexpensive long-wavelength infrared (LWIR; 8 μm to 14 μm) camera. The developed system incorporates intensity-modulated light to generate a thermal-wave field inside enamel and uses the subsequent infrared emission of the thermal-wave field to detect early caries. It was found that the greater light absorption at caries sites shifts the thermal-wave field centroid, providing contrast between early caries and intact enamel. Use of LWIR detection band in dental samples is novel and beneficial over the conventional mid-wavelength infrared band (3 μm to 5 μm) as it suppresses the masking effect of the instantaneous radiative emission from subsurface features due to the minimal transmittance of enamel in the LWIR band. The efficacy of the LWIR system is verified though experiments carried out on nonbiological test samples as well as on teeth with natural and artificially induced caries. The results suggest that the developed LWIR technology is an affordable early dental caries detection system suitable for commercialization/translation to Dentistry.

Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts.

PubMed

Preisser, John S; Long, D Leann; Stamm, John W

2017-01-01

Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two data sets, one consisting of fictional dmft counts in 2 groups and the other on DMFS among schoolchildren from a randomized clinical trial comparing 3 toothpaste formulations to prevent incident dental caries, are analyzed with negative binomial hurdle, zero-inflated negative binomial, and marginalized zero-inflated negative binomial models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the randomized clinical trial were similar despite their distinctive interpretations. The choice of statistical model class should match the study's purpose, while accounting for the broad decline in children's caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. © 2017 S. Karger AG, Basel.

Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts

PubMed Central

Preisser, John S.; Long, D. Leann; Stamm, John W.

2017-01-01

Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two datasets, one consisting of fictional dmft counts in two groups and the other on DMFS among schoolchildren from a randomized clinical trial (RCT) comparing three toothpaste formulations to prevent incident dental caries, are analysed with negative binomial hurdle (NBH), zero-inflated negative binomial (ZINB), and marginalized zero-inflated negative binomial (MZINB) models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the RCT were similar despite their distinctive interpretations. Choice of statistical model class should match the study’s purpose, while accounting for the broad decline in children’s caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. PMID:28291962

Dietary determinants of dental caries and dietary recommendations for preschool children.

PubMed

Tinanoff, N; Palmer, C A

2000-01-01

The purpose of this review, commissioned by the Administration for Children and Families, the Health Resources and Services Administration, the Health Care Financing Administration, and the Department of Agriculture's Food and Nutrition Service, was to update the evidence of the dietary factors that affect dental caries, and subsequently formulate dietary recommendations for preschool children based on principles of cariology. Literature on the dental caries process, dietary factors affecting dental caries initiation and progression, and nutrition education and counseling were reviewed and synthesized. Dietary guidelines for children at various ages were then constructed based on the review. Dental caries in preschool children is due to a combination of factors, including colonization of teeth with cariogenic bacteria, type of foods and frequency of exposure of these foods to the cariogenic bacteria, and susceptible teeth. Caries risk is greatest if sugars are consumed at high frequency and are in a form that is retained in the mouth for long periods. Sucrose is the most cariogenic sugar because it can form glucan that enables firm bacterial adhesion to teeth and limits diffusion of acid and buffers in the plaque. There is emerging interest in the effects of tooth development and its role in the future dental caries risk of the child. Nutrition education and counseling for the purposes of reducing caries in children is aimed at teaching parents the importance of reducing high frequency exposures to obvious and hidden sugars. Guidelines include: avoiding frequent consumption of juice or other sugar-containing drinks in the bottle or sippy cup, discouraging the behavior of a child sleeping with a bottle, promoting noncariogenic foods for snacks, fostering eating patterns consistent with the Food Guide Pyramid, limiting cariogenic foods to mealtimes, rapidly clearing cariogenic foods from the child's oral cavity either by toothbrushing or by consumption of protective foods, and restricting sugar-containing snacks that are slowly eaten (e.g., candy, cough drops, lollipops, suckers). Along with nutritional factors, a comprehensive approach to preventing dental caries in preschool children must include improved general dietary habits, good oral hygiene, appropriate use of fluorides, and access to preventive and restorative dental care.

Dietary determinants of dental caries and dietary recommendations for preschool children.

PubMed

Tinanoff, Norman; Palmer, Carol A

2003-04-01

The purpose of this review, commissioned by the Administration for Children and Families, the Health Resources and Services Administration, the Health Care Financing Administration, and the Department of Agriculture's Food and Nutrition Service, was to update the evidence of the dietary factors that affect dental caries, and subsequently formulate dietary recommendations for preschool children based on principles of cariology. Literature on the dental caries process, dietary factors affecting dental caries initiation and progression, nutrition education and counseling were reviewed and synthesized. Dietary guidelines for children at various ages were then constructed based on the review. Dental caries in preschool children is due to a combination of factors, including colonization of teeth with cariogenic bacteria, type of foods and frequency of exposure of these foods to the cariogenic bacteria, and susceptible teeth. Caries risk is greatest if sugars are consumed at high frequency and are in a form that is retained in the mouth for long periods. Sucrose is the most cariogenic sugar because it can form glucan that enables firm bacterial adhesion to teeth and limits diffusion of acid and buffers in the plaque. There is emerging interest in the effects of tooth development and its role in the future dental caries risk of the child. Nutrition education and counseling for the purposes of reducing caries in children is aimed at teaching parents the importance of reducing high frequency exposures to obvious and hidden sugars. Guidelines include: avoiding frequent consumption of juice or other sugar containing drinks in bottle or sippy cup; discouraging the behavior of a child sleeping with a bottle; promoting non-cariogenic foods for snacks; fostering eating patterns consistent with Food Guide Pyramid; limiting cariogenic foods to mealtimes; rapidly clearing cariogenic foods from the child's oral cavity either by tooth brushing or by consumption of protective foods; and restricting sugar containing snacks that are slowly eaten (e.g., candy, cough drops, lollipops, suckers). Along with nutritional factors, a comprehensive approach to preventing dental caries in preschool children must include improved general dietary habits, good oral hygiene, appropriate use of fluorides, and access to preventive and restorative dental care.

Validity and reliability of the Early Childhood Caries Perceptions Scale (ECCPS) to assess health beliefs related to early childhood caries prevention among primary caregivers of children under 5 years of age.

PubMed

Pisarnturakit, Pagaporn P; Shaw, Bret R; Tanasukarn, Chanuantong; Vatanasomboon, Paranee

2012-09-01

Primary caregivers' child oral health care beliefs and practices are major factors in the prevention of Early Childhood Caries (ECC). This study assessed the validity and reliability of a newly-developed scale--the Early Childhood Caries Perceptions Scale (ECCPS)--used to measure beliefs regarding ECC preventive practices among primary caregivers of young children. The ECCPS was developed based on the Health Belief Model. The construct validity and reliability of the ECCPS were examined among 254 low-socioeconomic status primary caregivers with children under five years old, recruifed from 4 Bangkok Metropolitan Administration Health Centers and a kindergarten school. Exploratory factor analysis (EFA) revealed a four-factor structure. The four factors were labeled as Perceived Susceptibility, Perceived Severity, Perceived Benefits and Perceived Barriers. Internal consistency measured by the Cronbach's coefficient alpha for those four factors were 0.897, 0.971, 0.975 and 0.789, respectively. The ECCPS demonstrated satisfactory levels of reliability and validity for assessing the health beliefs related to ECC prevention among low-socioeconomic primary caregivers.

A School Flouride Mouthrinse Program

ERIC Educational Resources Information Center

Petchel, Karen A.; Mello, Arthur F.

1977-01-01

A weekly "swish and spit" program takes about ten minutes of class time, effectively prevents dental caries, and promotes an awareness and greater concern for good dental practices in the school community. (MJB)

A novel antimicrobial peptide against dental-caries-associated bacteria.

PubMed

Chen, Long; Jia, Lili; Zhang, Qiang; Zhou, Xirui; Liu, Zhuqing; Li, Bingjie; Zhu, Zhentai; Wang, Fenwei; Yu, Changyuan; Zhang, Qian; Chen, Feng; Luo, Shi-Zhong

2017-10-01

Dental caries, a highly prevalent oral disease, is primarily caused by pathogenic bacteria infection, and most of them are anaerobic. Herein, we investigated the activity of a designed antimicrobial peptide ZXR-2, and found it showed broad-spectrum activity against a variety of Gram-positive and Gram-negative oral bacteria, particularly the caries-related taxa Streptococcus mutans. Time-course killing assays indicated that ZXR-2 killed most bacterial cells within 5 min at 4 × MIC. The mechanism of ZXR-2 involved disruption of cell membranes, as observed by scanning electron microscopy. Moreover, ZXR-2 inhibited the formation of S. mutans biofilm, but showed limited hemolytic effect. Based on its potent antimicrobial activity, rapid killing, and inhibition of S. mutans biofilm formation, ZXR-2 represents a potential therapeutic for the prevention and treatment of dental caries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of radiation-induced xerostomia on the human oral microflora. Report no. 12 (final), 1 Jul 1971-30 Jun 1976

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dreizen, S.; Brown, L.R.

1976-06-30

The caries-conducive impact of xerostomia was studied in 42 irradiated cancer patients. The radiation-induced xerostomia was paralleled by changes in the physical, microbial, biochemical, immunologic and dietary parameters of cariogenicity that collectively comprised an overwhelming caries challenge. Microbiologically, significant xerostomia-related increases in Strep. mutans, lactobacilli, staphylococci, yeasts and catalase-positive diphtheroids were accompanied by decreases in Strep. sanguis, bacteroides and fusobacteria in each of the 5 microenvironments tested. The scanty xerostomic saliva contained greater amounts of Na(+), Cl(-), Ca(++), Mg(++), Prot(-), lysozyme, IgA and IgG and considerably less HCO3(-). The increased concentrations of caries protective electrolytes and immunoproteins were negated bymore » huge reductions in total daily saliva output. The xerostomia created caries challenge was almost completely neutralized by a preventive program of daily topical NaF applications and strict oral hygiene. (GRA)« less

Diet intake and caries prevalence in four-year-old children living in a low-prevalence country.

PubMed

Ohlund, I; Holgerson, P L; Backman, B; Lind, T; Hernell, O; Johansson, I

2007-01-01

Preventive measures have dramatically decreased the prevalence of dental caries in children. However, risk factors for the disease in children living in low-prevalence areas remain elusive. In the present study we evaluated associations between dental caries, saliva levels of mutans streptococci and lactobacilli, and diet with special emphasis on the intake of fermentable carbohydrates and dairy products in 4-year-old children living in an area where the overall caries prevalence was low. Dietary intake was recorded in 234 infants as part of the Study of Infant Nutrition in Umeå, Sweden (SINUS). Of these the parents of 124 children gave consent to participate in a follow-up at 4 years of age. Dietary intake, height and weight, dental caries, oral hygiene, including tooth brushing habits, presence of plaque and gingival inflammation, fluoride habits and numbers of mutans streptococci and lactobacilli in saliva were recorded. Using multivariate stepwise logistic regression, caries experience was negatively associated with intake frequency of cheese (OR = 0.67; 95% CI = 0.44-0.98) and positively associated with the salivary level of mutans streptococci (OR = 1.57; 95% CI = 1.21-2.03). Caries experience was not correlated with intake frequency or amounts of carbohydrate-containing foods, with any other particular food, or with daily intake of energy, carbohydrate or any other macro- or micronutrient. We conclude that cheese intake may have a caries-protective effect in childhood populations where the overall caries prevalence and caries experience are low and the children are regularly exposed to fluoride from toothpaste.

Mothers’ Caries Increases Odds of Children’s Caries

PubMed Central

Weintraub, J.A.; Prakash, P.; Shain, S.G.; Laccabue, M.; Gansky, S.A.

2010-01-01

There are many determinants of children’s dental caries. We hypothesized that a mother’s untreated caries was associated with increased likelihood of her children’s untreated caries, after controlling for other factors. This population-based study was conducted in a rural, primarily Hispanic, California community. Interview and dental examination data for mother-child (children < 18 yrs old) dyads were analyzed. In a Generalized Estimation Equation (GEE) logit model for mothers (n = 179) and children (n = 387), maternal untreated caries was a statistically significant correlate of child’s untreated caries, odds ratio (OR) = 1.76 (95%CI: 1.10, 2.70), adjusted for demographic factors. This relationship did not change when behavioral and dental utilization factors were added to the model, OR = 1.85 (95% CI: 1.12, 3.07). Maternal untreated caries almost doubled the odds of children’s untreated caries and significantly increased child’s caries severity by about 3 surfaces. Caries prevention and dental utilization programs for mothers and their children should be increased. PMID:20505046

Relationship between parents' occupational characteristics and untreated dental caries in offspring: A population-based study of data from the Korean National Health and Nutrition Examination Survey, 2008-2015.

PubMed

Lim, Sung-Shil; Kim, Byurira; Yoon, Jin-Ha; Song, Je Seon; Park, Eun-Cheol; Jang, Sung-In

2018-05-01

Objectives We investigated the association between parents' occupational characteristics and untreated dental caries in their children. Methods We analyzed the data of 4764 and 5862 children merged with data of their mothers and fathers, respectively, derived from the Korean National Health and Nutrition Examination Survey, 2008-2015. Dentists assessed untreated dental caries, and occupational characteristics were self-reported. The associations between untreated dental caries in children and their parents' occupational characteristics were assessed with logistic regression analysis. Results The prevalence of untreated dental caries was 18.58% and 16.39% in the mother- and father-matched data, respectively. Compared to children whose mothers worked regular hours, those whose mothers worked overtime had increased odds of untreated dental caries [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.02-1.39]. Children of female self-employed workers/employers/unpaid family workers had higher odds of untreated dental caries than those of wage earners (OR 1.18, 95% CI 1.00-1.39). The OR of untreated dental caries was higher among children with shift-working parents than those whose parents worked daytime hours (mother: OR 1.29, 95% CI 1.11-1.51; father: OR 1.36, 95% CI 1.18-1.58). Conclusions The children of non-white-collar workers, non-wage earners, and workers working overtime or doing shift work had higher odds of untreated dental caries. The effects of parental occupational characteristics on untreated dental caries differed by sex (mother versus father). Public health programs targeting the prevention of dental caries among children should consider parental occupational characteristics.

Inequalities of caries experience in Nevada youth expressed by DMFT index vs. Significant Caries Index (SiC) over time

PubMed Central

2011-01-01

Background With the increasingly polarized distribution of dental caries among children and adolescents, the usual DMFT measure has become a less meaningful population descriptor. To re-focus on identifying the high caries prevalence group the Significant Caries Index (SiC) was created. The aims of this study were to analyze the prevalence and severity of dental caries in Nevada youth over a period of eight years and to compare its expression by means of DMFT and SiC; analyze the caries trends in the population and their underlying factors, and determine whether Nevada youth were at risk for significantly high levels of dental caries. Methods Retrospective data was analyzed from a series of sequential, standardized oral health surveys across eight years (2001/2002-2008/2009) that included over 62,000 examinations of adolescents 13-19 years of age, attending public/private Nevada schools. Mean Decayed-Missing-Filled Teeth index (DMFT) and Significant Caries Index (SiC) were subsequently computed for each academic year. Descriptive statistics were reported for analysis of comparative DMFT and SiC scores in relation to age, gender, racial background, and residence in a fluoridated/non-fluoridated community. Logistic regression analysis was used to analyze the differential impact of the variables on the probability of being in the high caries prevalence group. Results Comparison of students' mean DMFT to National (NHANES) data confirmed that dental caries remains a common chronic disease among Nevada youth, presenting higher prevalence rates and greater mean scores than the national averages. Downward trends were found across all demographics compared between survey years 1 and 6 with the exception of survey year 3. An upward trend began in survey year six. Over time, the younger group displayed an increasing proportion of cariesfree individuals while a decreasing proportion was found among older examinees. As expected, the mean SiC score was significantly higher than DMFT scores within each survey year across comparison groups (p < 0.001). Conclusions Using both caries indices together may help to highlight oral health inequalities more accurately among different population groups within the community in order to identify the need for special preventive oral health interventions in adolescent Nevadans. At the community level, action should focus on retaining and expanding the community fluoridation program as an effective preventive measure. At the individual level the study identifies the need for more targeted efforts to reach children early with a focus on females, Hispanics and Blacks, and uninsured children. PMID:21466692

Modern concepts of caries measurement.

PubMed

Pitts, N B

2004-01-01

Following the consideration of several recent systematic and other reviews, there is a growing professional and scientific consensus that caries measurement methodology in caries clinical trials (CCT) should be updated to reflect progress made elsewhere in cariology. In this paper, therefore, "modern" means accepted in contemporary dental research and dental practice on the basis of sound research evidence--not necessarily new or requiring the use of new technology. Caries measurement should be seen in the context of the objectives of modern clinical caries management and the continuum of disease states, ranging from sub-surface carious changes through to more advanced lesions. Measurement concepts can be applied to at least three levels: the tooth surface, the individual, or the group/population. All are relevant to CCTs. Modern clinical caries management can be seen as comprised of seven discrete but linked steps (Steps 2, 3, and 4 are directly concerned with measurement.): (1) 'Caries detection' represents a yes/no decision as to whether caries is present; (2) lesion measurement assesses defined stages of the caries process, taking into account the histopatholgical morphology and appearance of different sizes and types of lesion and the diagnostic threshold(s) being used; (3) lesion monitoring by repeated measures at a series of examinations is used when lesions are less advanced than the stage judged to require operative intervention (A comparison of serial measurements permits the efficacy of preventive care aiming either to arrest or to reverse the lesion to be assessed.); (4) caries activity measures would be very valuable, but are relatively poorly developed and tested at present; (5) diagnosis, prognosis, and clinical decision-making are the important human processes in which all the information obtained from steps 1 to 4 is synthesised; (6) interventions/treatments, both preventive and operative, are now routinely used for caries management; and (7) outcome of caries control/management assesses caries management by examining evidence on the long-term outcomes. A challenge for the future is to define a range of optimal caries measurement methods--in use or in development in recent trials, in clinical practice, and/or in caries epidemiology--that will best contribute to more efficient, modern caries clinical trials.

Caries occurrence in a fluoridated and a nonfluoridated town in Finland: a retrospective study using longitudinal data from public dental records.

PubMed

Seppä, L; Hausen, H; Kärkkäinen, S; Larmas, M

2002-01-01

The tap water of Kuopio, Finland, was fluoridated from 1959 to 1992. In the first decade of fluoridation, children in Kuopio had lower DMF values than children in Jyväskylä, a nearby low-fluoride town, but later differences between the towns have been small and inconsistent. The present study aimed to gain further insight into caries occurrence in Kuopio and Jyväskylä using longitudinal tooth-specific data from public health records on cohorts born in 1970/71 and 1980/81 (total n = 1,503). Survival analyses were used to summarize the tooth-specific times elapsed between eruption and the first filling (used as a proxy for dental caries). Generally, the first filling was placed sooner after eruption in the 1970/71 cohort than in the 1980/81 cohort. The curves for the two towns were virtually identical except for the first molars of the 1970/71 cohort, for which the percentage of filled first molars was consistently lower in Jyväskylä than in Kuopio. This study indicates that, among children and adolescents whose permanent teeth erupted in the mid-1970s or thereafter, even a longitudinal approach did not reveal a lower caries occurrence in the fluoridated than in the low-fluoride reference community. The main reason for the modest effect of water fluoridation in Finnish circumstances is probably the widespread use of other measures for caries prevention. The children have been exposed to such intense efforts to increase tooth resistance that the effect of water fluoridation does not show up any more. The results must not be extrapolated to countries with less intensive preventive dental care. Copyright 2002 S. Karger AG, Basel

Diet and the microbial aetiology of dental caries: new paradigms.

PubMed

Bradshaw, David J; Lynch, Richard J M

2013-12-01

The microbial and dietary factors that drive caries have been studied scientifically for 120 years. Frequent and/or excessive sugar (especially sucrose) consumption has been ascribed a central role in caries causation, while Streptococcus mutans appeared to play the key role in metabolising sucrose to produce lactic acid, which can demineralise enamel. Many authors described caries as a transmissible infectious disease. However, more recent data have shifted these paradigms. Streptococcus mutans does not fulfil Koch's postulates - presence of the organism leading to disease, and absence of the organism precluding disease. Furthermore, molecular microbiological methods have shown that, even with a sugar-rich diet, a much broader spectrum of acidogenic microbes is found in dental plaque. While simple sugars can be cariogenic, cooked starches are also now recognised to be a caries threat, especially because such starches, while not 'sticky in the hand', can be highly retentive in the mouth. Metabolism of starch particles can yield a prolonged acidic challenge, especially at retentive, caries-prone sites. These changes in the paradigms of caries aetiology have important implications for caries control strategies. Preventing the transmission of S. mutans will likely be inadequate to prevent caries if a sufficiently carbohydrate-rich diet continues. Similarly, restriction of sucrose intake, although welcome, would be unlikely to be a panacea for caries, especially if frequent starch intake persisted. Instead, approaches to optimise fluoride delivery, to target plaque acidogenicity or acidogenic microbes, to promote plaque alkali generation, to increase salivary flow or replace fermentable carbohydrates with non-fermentable alternatives may be more promising. © 2013 FDI World Dental Federation.

Impact of Prolonged Breastfeeding on Dental Caries: A Population-Based Birth Cohort Study.

PubMed

Peres, Karen Glazer; Nascimento, Gustavo G; Peres, Marco Aurelio; Mittinty, Murthy N; Demarco, Flavio Fernando; Santos, Ina Silva; Matijasevich, Alicia; Barros, Aluisio J D

2017-07-01

Few studies have assessed the effect of breastfeeding, bottle feeding, and sugar consumption on children's dental caries. We investigated whether the duration of breastfeeding is a risk factor for dental caries in the primary dentition, independently of sugar consumption. An oral health study ( n = 1303) nested in a birth cohort study was carried out in southern Brazil. The average number of decayed, missing, and filled primary tooth surfaces (dmfs) and severe early childhood caries (S-ECC: dmfs ≥6) were investigated at age 5 years. Breastfeeding was the main exposure collected at birth and at 3, 12, and 24 months of age. Data on sugar consumption were collected at 24, 48, and 60 months of age. Marginal structural modeling was used to estimate the controlled direct effect of breastfeeding (0-12, 13-23, and ≥24 months) on dmfs and on S-ECC. The prevalence of S-ECC was 23.9%. The mean number of dmfs was 4.05. Children who were breastfed for ≥24 months had a higher number of dmfs (mean ratio: 1.9; 95% confidence interval: 1.5-2.4) and a 2.4 times higher risk of having S-ECC (risk ratio: 2.4; 95% confidence interval: 1.7-3.3) than those who were breastfed up to 12 months of age. Breastfeeding between 13 and 23 months had no effect on dental caries. Prolonged breastfeeding increases the risk of having dental caries. Preventive interventions for dental caries should be established as early as possible because breastfeeding is beneficial for children's health. Mechanisms underlying this process should be investigated more deeply. Copyright © 2017 by the American Academy of Pediatrics.

Rise and fall of caries prevalence in German towns with different F concentrations in drinking water.

PubMed

Künzel, W; Fischer, T

1997-01-01

The rise and fall of caries prevalence (DMFT) and its relation to changing F concentration of drinking water and other health-related factors is analysed based on dental findings of more than 286,000 subjects of either sex (6-15 years old) from the two industrial towns Chemnitz and Plauen. Water fluoridation (1.0 +/- 0.1 ppm F) was implemented in Chemnitz (formerly Karl-Marx-Stadt) in 1959. It was in operation until autumn 1990 with an interruption lasting 22 months around the year 1971. In the F-poor town of comparison, Plauen, 55% of the citizens were supplied with F-enriched drinking water (0.9 ppm F) during the years 1972-1984. Another 20% received F-containing mixed water (0.4-0.7 ppm F). During the first three decades of the study the level of caries prevalence was strictly correlated with the availability of an optimal caries preventive F concentration in the drinking water. Water fluoridation was followed by a decrease of caries, and interruptions in fluoridation were followed by increasing caries levels. A different caries trend was observed in the years from 1987 to 1995. There was a significant caries decrease down to the lowest DMFT (2.0) since 1959 in spite of the fact that only F-poor water was available over years in both towns. This improvement of oral health is explained by changes in caries-preventive and environmental conditions.

Prevalence of Dental Caries among School Children in Chennai, Based on ICDAS II

PubMed Central

Arangannal, Ponnudurai; Jayaprakash, Jeevarathan

2016-01-01

Introduction Dental caries is a common dental disease, which occurs during childhood and continues to be a major public health problem. The prevalence of dental caries was associated with oral hygiene practice, sugar consumption and implementation of the preventive oral health program. Aim The purpose of this study was to assess the prevalence of dental caries in school children aged between 6-14 years using the International Caries Detection and Assessment System (ICDAS II). Materials and Methods The study population consisted of 2796 school children living in Pallikkaranai, Chennai, India and studying in government recognized schools. Each student was examined by a single examiner using ICDAS system under natural light during normal school hours. Results The prevalence of dental caries was 68.8% in the total surveyed population. The gender-wise prevalence of dental caries shows, females to have slightly higher prevalence than male. The prevalence of dental caries at the age group of 6 years was 57%, seven year 67%, eight year 63%, nine year 74%, 10 year 76%, 11 year 74%, 12 year 69%, 13 year 71%, and 14 year 69%. The distribution of CARS (Caries associated with Sealants and Restorations) in the surveyed population was only 1.4% Conclusion The distribution of non-cavitated/early enamel lesions was higher in the studied population and indicated a requirement of a sustained dental health preventive program targeting specific segments of the population. PMID:27190939

Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis.

PubMed

Ammari, Michelle Mikhael; Soviero, Vera Mendes; da Silva Fidalgo, Tatiana Kelly; Lenzi, Michele; Ferreira, Daniele Masterson T P; Mattos, Cláudia Trindade; de Souza, Ivete Pomarico Ribeiro; Maia, Lucianne Cople

2014-10-01

The aim of this study was to perform a systematic review and meta-analysis on the effectiveness of sealing non-cavitated proximal caries lesions in primary and permanent teeth. Only controlled clinical trials and randomized controlled clinical trials that evaluated the effectiveness of sealing on non-cavitated proximal caries with a minimum follow-up of 12 months were included in the study. The primary outcome should be arrestment/progression of proximal caries evaluated by bitewing radiographs. A risk of bias evaluation based on the Cochrane Collaboration common scheme for bias was carried out for each study. The meta-analysis was performed on the studies considered low risk of bias and with pair-wise visual reading results through RevMan software. A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs, SIGLE, and on website Clinical trials.gov, through until June 2013. From 967 studies identified, 10 articles and 3 studies with partial results were assessed for eligibility. However three articles were excluded and our final sample included 10 studies. According to the risk of bias evaluation, six studies were considered "high" risk of bias, and four "low" risk of bias. The forest plot of the meta-analysis showed low heterogeneity (I(2)=29%) and a favourable outcome for the Infiltrant. The chance of caries progression when this technique was used was significantly lower (p=0.002) compared with Placebo. Our results suggest that the technique of sealing non-cavitated proximal caries seems to be effective in controlling proximal caries in the short and medium term. Further long-term randomized clinical trials are still necessary to increase this evidence. Contemporary dentistry is focused in minimally invasive approaches that prevent the destruction of sound dental tissues next to carious lesions. This paper searches for evidence of the efficacy of sealing/infiltrating non-cavitated proximal caries in arresting caries progression both in permanent and primary teeth. Copyright © 2014 Elsevier Ltd. All rights reserved.

Caries-Preventive Effect of NaF, NaF plus TCP, NaF plus CPP-ACP, and SDF Varnishes on Sound Dentin and Artificial Dentin Caries in vitro.

PubMed

Wierichs, Richard J; Stausberg, Sabrina; Lausch, Julian; Meyer-Lueckel, Hendrik; Esteves-Oliveira, Marcella

2018-01-01

The aim of this study was to compare the caries-preventive effect of different fluoride varnishes on sound dentin as well as on artificial dentin caries-like lesions. Bovine dentin specimens (n = 220) with one sound surface (ST) and one artificial caries lesion (DT) were prepared and randomly allocated to 11 groups. The interventions before pH cycling were as follows: application of a varnish containing NaF (22,600 ppm F-; Duraphat [NaF0/NaF1]), NaF plus tricalcium phosphate (22,600 ppm F-; Clinpro White Varnish Mint [TCP0/TCP1]), NaF plus casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP; 22,600 ppm F-; MI Varnish [CPP0/CPP1]), or silver diamine fluoride (SDF; 35,400 ppm F-; Cariestop 30% [SDF0/SDF1]) and no intervention (NNB/N0/N1). During pH cycling (14 days, 6 × 120 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 times/day) with either fluoride-free ("0"; e.g., TCP0) or 1,100 ppm F- ("1"; e.g., TCP1) dentifrice slurry. In another subgroup, the specimens were pH cycled but not brushed (NNB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between the values after initial demineralization and those after pH cycling, using transversal microradiography and photographic images. After pH cycling, no discoloration could be observed. Furthermore, NNB, N0, and N1 showed significantly increased ΔZDT/LDDT and ΔZST/LDST values, indicating further demineralization. In contrast, CPP0, CPP1, SDF0, and SDF1 showed significantly decreased ΔZDT/LDDT values, indicating remineralization (p ≤ 0.004; paired t test). CPP0, CPP1, SDF0, and SDF1 showed significantly higher changes in ΔΔZDT/ΔLDDT and ΔΔZST/ΔLDST than NNB, N0, and N1 (p < 0.001; Bonferroni post hoc test). In conclusion, under the conditions chosen, all fluoride varnishes prevented further demineralization. However, only NaF plus CPP-ACP and SDF could remineralize artificial dentin caries-like lesions under net-demineralizing conditions, thereby indicating that NaF plus CPP-ACP and SDF may be helpful to high-caries-risk patients. © 2018 S. Karger AG, Basel.

The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance.

PubMed

Axelsson, P; Nyström, B; Lindhe, J

2004-09-01

The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque. To monitor the incidence of tooth loss, caries and attachment loss during a 30-year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51-65 years old. In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy-five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re-examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self-diagnosis. Once every 2 months during the first 2 years, once every 3-12 months during years 3-30, the participants received, on an individual need basis, additional education in self-diagnosis and self-care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride-containing dentifrice/paste. Few teeth were lost during the 30 years of maintenance; 0.4-1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups. The present study reported on the 30-year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.

76 FR 2383 - Proposed HHS Recommendation for Fluoride Concentration in Drinking Water for Prevention of Dental...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-13

... information: Community water fluoridation is the most cost-effective method of delivering fluoride for the... Drinking Water for Prevention of Dental Caries AGENCY: Office of the Secretary, Department of Health and.... The U.S. Public Health Service recommendations for optimal fluoride concentrations were based on...

Characterization of caries progression on dentin after irradiation with Nd:YAG laser by FTIR spectroscopy and fluorescence imaging

NASA Astrophysics Data System (ADS)

Ana, P. A.; Brito, A. M. M.; Zezell, D. M.; Lins, E. C. C. C.

2015-06-01

Considering the use of high intensity lasers for preventing dental caries, this blind in vitro study evaluated the compositional and fluorescence effects promoted by Nd:YAG laser (λ=1064 nm) when applied for prevention of progression of dentin caries, in association or not with topical application of acidulated phosphate fluoride (APF). Sixty bovine root dentin slabs were prepared and demineralized by 32h in order to create early caries lesions. After, the slabs were distributed into six experimental groups: G1- untreated and not submitted to a pH-cycling model; G2- untreated and submitted to a pH-cycling model; G3- acidulated phosphate fluoride application (APF); G4- Nd:YAG irradiation (84.9 J/cm2, 60 mJ/pulse); G5- treated with Nd:YAG+APF; G6- treated with APF+Nd:YAG. After treatments, the samples of groups G2 to G6 were submitted to a 4-day pH-cycling model in order to simulate the progression of early caries lesions. All samples were characterized by the micro-attenuated total reflection technique of Fourier transformed infrared spectroscopy (μATR-FTIR), using a diamond crystal, and by a fluorescence imaging system (FIS), in which it was used an illuminating system at λ= 405±30 nm. Demineralization promoted reduction in carbonate and phosphate contents, exposing the organic matter; as well, it was observed a significant reduction of fluorescence intensity. Nd:YAG laser promoted additional chemical changes, and increased the fluorescence intensity even with the development of caries lesions. It was concluded that the compositional changes promoted by Nd:YAG, when associated to APF, are responsible for the reduction of demineralization progression observed on root dentin.

Global burden of dental condition among children in nine countries participating in an international oral health promotion programme, 2012-2013.

PubMed

Bourgeois, Denis M; Llodra, Juan Carlos

2014-10-01

The Live.Learn.Laugh. phase 2 programme is a unique global partnership between FDI World Dental Federation and Unilever Oral Care which aims to provide measurable improvement of oral health on a global scale through encouraging twice-daily brushing with a fluoride toothpaste. It was based on international recommendations using the principles of health promotion within school for the implementation of preventive health strategies. This paper is an overview of the dental caries condition of children from 2012 to 2013 in nine countries included in four World Health Organisation (WHO) regions. A cross-sectional study was conducted in each country before the implementation of health-promotion measures focused on twice-daily toothbrushing with fluoride toothpaste. The sample was based on stratified sampling according to the WHO pathfinder recommendations. From a total of 7,949 children examined, there were 517 children (1-2 years of age), 1,667 preschool children (3-5 years of age) and 5,789 schoolchildren (6-13 years of age). The prevalence and severity of primary dental caries, early childhood caries and temporary dental caries were described using decayed, filled teeth (dft), permanent decayed, missing, filled teeth (DMFT) indices and the significant caries index (SCI). The major findings were a high prevalence of caries, identification of high-risk groups and inequality in the distribution of the severity of dental conditions. Aggregated data from this overview should provide justification for implementing an oral health programme. The main point is the need to retain and expand the community fluoridation programme as an effective preventive measure. At the individual level, the aggregated data identify the need for more targeted efforts to reach children early - especially among specific high-risk groups. © 2014 FDI World Dental Federation.

Community water fluoridation reduced dental caries in Australian adults born before its widespread implementation at least as much as after its widespread adoption.

PubMed

Tavares, Vinicius N; Kumar, Jayanth V

2013-09-01

Effects of fluoridated drinking water on dental caries in Australian adults. Slade GD, Sanders AE, Do L, Roberts-Thomson K, Spencer AJ. J Dent Res 2013;92:376. Vinicius N. Tavares, DDS, MPH, Jayanth V. Kumar, DDS, MPH PURPOSE/QUESTION: This study investigated the long term caries-prevention benefits of community water fluoridation for individuals born before its widespread implementation Government: National Health and Medical Research Council grants Industry: Colgate-Palmolive, New York, USA provided gifts for study participants Other: Australian Dental Association and state and territory health departments and dental services Retrospective cohort study Level 2 STRENGTH OF RECOMMENDATION GRADE: Not applicable. Copyright © 2013 Elsevier Inc. All rights reserved.

Fluoride gel effective at reducing caries in children.

PubMed

Richards, Derek

2015-12-01

Data Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline , Embase, CINAHL, LILACS, ProQuest Dissertations and Theses, the Web of Science Conference Proceedings, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Randomised or quasi-randomised controlled trials comparing topically applied fluoride gel with placebo or no treatment in children up to 16 years were considered. Studies had to be at least one year in duration with a frequency of application of at least once a year with blind outcome assessment. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in both permanent and primary teeth (D(M)FS and d(e/m)fs). At least two reviewers extracted data and assessed risk of bias. The primary measure of effect was the prevented fraction (PF). Where data could be pooled random-effects meta-analyses were conducted. Potential sources of heterogeneity were examined in random-effects meta-regression analyses. Twenty-eight trials involving 9140 children and adolescents were included. Most of the studies (20) were at high risk of bias, with eight at unclear risk of bias. Twenty-five trials (8479 participants) provided data for meta-analysis on permanent teeth, with a D(M)FS pooled prevented fraction (PF) estimate of 28% (95% CI; 19-36%; P < 0.0001; with substantial heterogeneity (P < 0.0001; I(2) = 82%); moderate quality evidence). Subgroup and metaregression analyses suggested no significant association between estimates of D(M)FS prevented fractions and the prespecified trial characteristics. However, the effect of fluoride gel varied according to the type of control group used, with D(M)FS PF on average being 17% (95% CI 3% to 31%; P = 0.018) higher in non-placebo-controlled trials (the reduction in caries was 38% (95% CI 24% to 52%; P < 0.0001, 2808 participants) for the ten trials with no treatment as control group, and 21% (95% CI 15% to 28%; P < 0.0001, 5671 participants) for the 15 placebo-controlled trials.A funnel plot of the 25 trials in the D(M)FS PF meta-analysis indicated a relationship between prevented fraction and study precision, with an apparent lack of small studies with statistically significant large effects.For primary teeth the d(e/m)fs pooled prevented fraction estimate for the three trials (1254 participants) = 20% (95%CI; 1% - 38%; P = 0.04; with no heterogeneity (P = 0.54; I(2) = 0%); low quality evidence).There was limited reporting of adverse events. Only two trials reported information on acute toxicity signs and symptoms during the application of the gel (risk difference 0.01, 95% CI -0.01 to 0.02; P = 0.36; with no heterogeneity (P = 36; I(2) = 0%); 490 participants; very low quality evidence). None of the trials reported information on tooth staining, mucosal irritation or allergic reaction. The conclusions of this updated review remain the same as those when it was first published. There is moderate quality evidence of a large caries-inhibiting effect of fluoride gel in the permanent dentition. Information concerning the caries-preventive effect of fluoride gel on the primary dentition, which also shows a large effect, is based on low quality evidence from only three placebo-controlled trials. There is little information on adverse effects or on acceptability of treatment. Future trials should include assessment of potential adverse effects.

Milk fluoridation for the prevention of dental caries.

PubMed

Bánóczy, Jolán; Rugg-Gunn, Andrew; Woodward, Margaret

2013-11-01

The aim of this review is to give an overview of 55 years experience of milk fluoridation and draw conclusions about the applicability of the method. Fluoridated milk was first investigated in the early 1950s, almost simultaneously in Switzerland, the USA and Japan. Stimulated by the favourable results obtained from these early studies, the establishment of The Borrow Dental Milk Foundation (subsequently The Borrow Foundation) in England gave an excellent opportunity for further research, both clinical and non-clinical, and a productive collaboration with the World Health Organization which began in the early 1980s. Numerous peer-reviewed publications in international journals showed clearly the bioavailability of fluoride in various types of milk. Clinical trials were initiated in the 1980s - some of these can be classed as randomised controlled trials, while most of the clinical studies were community preventive programmes. These evaluations showed clearly that the optimal daily intake of fluoride in milk is effective in preventing dental caries. The amount of fluoride added to milk depends on background fluoride exposure and age of the children: commonly in the range 0.5 to 1.0 mg per day. An advantage of the method is that a precise amount of fluoride can be delivered under controlled conditions. The cost of milk fluoridation programmes is low, about € 2 to 3 per child per year. Fluoridation of milk can be recommended as a caries preventive measure where the fluoride concentration in drinking water is suboptimal, caries experience in children is significant, and there is an existing school milk programme. Copyright © 2013 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Correlates of root caries experience in middle-aged and older adults in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network.

PubMed

Chi, Donald L; Berg, Joel H; Kim, Amy S; Scott, JoAnna

2013-05-01

The authors examined the correlates of root caries experience for middle-aged adults (aged 45-64 years) and older adults (65 years and older) to test the hypothesis that the factors related to root caries are different for middle-aged adults than they are for older adults. The authors conducted an observational cross-sectional study that focused on adult patients aged 45 to 97 years recruited from the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network (N = 775). The outcome variable was any root caries experience (no/yes). The authors hypothesized that sociodemographic, intra- oral and behavioral factors were root caries correlates. The authors used Poisson regression models to generate overall and age-stratified prevalence ratios (PRs) of root caries, and they used generalized estimating equations to account for practice-level clustering of participants. A total of 19.6 percent of adults had any root caries. A dentist's assessment that the patient was at high risk of developing any caries was associated with greater prevalence of root caries experience in both middle-aged adults (PR, 2.70; 95 percent confidence interval [CI], 1.63-4.46) and older adults (PR, 1.87; 95 percent CI, 1.19-2.95). The following factors were associated significantly with increased root caries prevalence but only for middle-aged adults: male sex (P = .02), self-reported dry mouth (P < .001), exposed roots (P = .03) and increased frequency of eating or drinking between meals (P = .03). No other covariates were related to root caries experience for older adults. Within a practice-based research network, the factors associated with root caries experience were different for middle-aged adults than they were for older adults. Research is needed to identify relevant root caries correlates for adults 65 years and older. Practical Implications. Interventions aimed at preventing root caries are likely to be different for middle-aged adults than for older adults. Dentists should use root caries prevention programs that address appropriate aged-based risk factors.

Anti-Caries Effects of Dental Adhesives Containing Quaternary Ammonium Methacrylates with Different Chain Lengths

PubMed Central

Han, Qi; Li, Bolei; Zhou, Xuedong; Ge, Yang; Wang, Suping; Li, Mingyun; Ren, Biao; Wang, Haohao; Zhang, Keke; Xu, Hockin H. K.; Peng, Xian; Feng, Mingye; Weir, Michael D.; Chen, Yu; Cheng, Lei

2017-01-01

The objectives of this study were to investigate the effects of dental adhesives containing quaternary ammonium methacrylates (QAMs) with different alkyl chain lengths (CL) on ecological caries prevention in vitro. Five QAMs were synthesized with a CL = 3, 6, 9, 12, and 16 and incorporated into adhesives. Micro-tensile bond strength and surface charge density were used to measure the physical properties of the adhesives. The proportion change in three-species biofilms consisting of Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii was tested using the TaqMan real-time polymerase chain reaction. Lactic acid assay, MTT [3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay, exopolysaccharide staining, live/dead staining, scanning electron microscopy (SEM), and transverse microradiography (TMR) were performed to study the anti-biofilm and anti-demineralization effects of the dental adhesives. The results showed that incorporating QAMs with different alkyl chain lengths into the adhesives had no obvious effect on the dentin bond strength. The adhesives containing QAMs with a longer alkyl chain developed healthier biofilms. The surface charge density, anti-biofilm, and anti-demineralization effects of the adhesives increased with a CL of the QAMs from 3 to 12, but decreased slightly with a CL from 12 to 16. In conclusion, adhesives containing QAMs with a tailored chain length are promising for preventing secondary caries in an “ecological way”. PMID:28773004

Effect of motivational interviewing on rates of early childhood caries: a randomized trial.

PubMed

Harrison, Rosamund; Benton, Tonya; Everson-Stewart, Siobhan; Weinstein, Phil

2007-01-01

The purposes of this randomized controlled trial were to: (1) test motivational interviewing (MI) to prevent early childhood caries; and (2) use Poisson regression for data analysis. A total of 240 South Asian children 6 to 18 months old were enrolled and randomly assigned to either the MI or control condition. Children had a dental exam, and their mothers completed pretested instruments at baseline and 1 and 2 years postintervention. Other covariates that might explain outcomes over and above treatment differences were modeled using Poisson regression. Hazard ratios were produced. Analyses included all participants whenever possible. Poisson regression supported a protective effect of MI (hazard ratio [HR]=0.54 (95%CI=035-0.84)-that is, the M/ group had about a 46% lower rate of dmfs at 2 years than did control children. Similar treatment effect estimates were obtained from models that included, as alternative outcomes, ds, dms, and dmfs, including "white spot lesions." Exploratory analyses revealed that rates of dmfs were higher in children whose mothers had: (1) prechewed their food; (2) been raised in a rural environment; and (3) a higher family income (P<.05). A motivational interviewing-style intervention shows promise to promote preventive behaviors in mothers of young children at high risk for caries.

Introduction to proceedings of healthy futures: engaging the oral health community in childhood obesity prevention national conference.

PubMed

Tinanoff, Norman; Holt, Katrina

2017-06-01

The Robert Wood Johnson Foundation (RWJF) has worked to ensure that all children have healthy weights. To promote this goal, the RWJF has supported the Healthy Futures: Engaging the Oral Health Community in Childhood Obesity Prevention National Conference, held on November 3-4, 2016, and the proceeding of this conference. The goals of the conference were to increase understanding of the science focusing on oral health and childhood obesity, increase understanding of how to prevent childhood obesity, and provide opportunities to network and plan activities to prevent childhood obesity. The papers prepared for the conference identified through systematic reviews or scoping reviews the state of the science related to preventing childhood obesity and reducing children's consumption of sugar-sweetened beverages and strategies that oral health professionals and organizations can employ prevent childhood obesity. Causes of childhood obesity are multifactorial and include genetic components, environmental and lifestyle variables, and nutritional factors. Dental caries also is caused by a combination of factors, including cariogenic diet, inadequate fluoride exposure, a susceptible host, and the presence of caries-causing bacteria in the oral cavity. One key risk factors for both obesity and caries is excessive sugar consumption. To reduce the risk of obesity and dental caries in children, health professionals and parents need to be aware of the sugar content of processed foods and beverages as well as of current daily sugar-consumption recommendations. Additionally, oral health professionals must become more engaged in identifying children who are at risk for obesity and dental caries; and provide education, screening and referral to reduce these risks. © 2017 American Association of Public Health Dentistry.

Cost-effectiveness of an experimental caries-control regimen in a 3.4-yr randomized clinical trial among 11-12-yr-old Finnish schoolchildren.

PubMed

Hietasalo, Pauliina; Seppä, Liisa; Lahti, Satu; Niinimaa, Ahti; Kallio, Jouko; Aronen, Pasi; Sintonen, Harri; Hausen, Hannu

2009-12-01

The aim of this study was to assess the cost-effectiveness of an experimental caries-control regimen in a randomized clinical trial (RCT) conducted in Pori, Finland, in 2001-2005. Children (n = 497) who were 11-12 yr of age and had at least one active initial caries lesion at baseline were studied. The children in the experimental group (n = 250) were offered an individually designed patient-centered regimen for caries control. The children in the control group (n = 247) received standard dental care. Furthermore, the whole population was exposed to continuous community-level oral health promotion. Individual costs of treatment procedures and outcomes (DMFS increment score) for the follow-up period of 3.4 yr were calculated for each child in both groups. The incremental cost-effectiveness ratio was euro 34.07 per averted DMF surface. The experimental regimen was more effective, and also more costly. However, the total costs decreased year after year, and for the last 2 yr the experimental regimen was less expensive than the standard dental care. The experimental regimen would probably have been more cost-effective than standard dental care if the follow-up period had been longer, the regimen less comprehensive, and/or if dental nurses had conducted the preventive procedures.

[Use of dental hygienists in caries prevention].

PubMed

Morch; Barman, O

1976-09-01

Two caries preventive programs were carried out in the Bergen School Dental Service in order to test various modes of topical application of fluorides and the efficacy of using dental hygienists in the delivery of preventive dental care to school children. In the first program, starting in 1951, A 2% netutral sodium fluoride solution was applied topically four times during one month to one quadrant of the maxillary teeth, the other quadrant serving as control. This series of application was repeated one year later, while the caries registration was followed up until 1956. The results are given in Table 1, comprising 128 children who were 11-12 years old at the start of the study and were still present at the same schools in 1956. A reduction in caries incidence of about 25 per cent was obtained during the five years period. In the second program, beginning in 1963, acid stannous hexafluoride as well as neutral sodium fluoride solutions were used separately in groups of children (7-11 years of age). The total number of children was about 2000. Two groups received four topical applications annually within one month, while in two oher groups the applications were given twice a year. This topical application program was continued for four years. For several reasons pure control groups of children of corresponding age could not be established. Instead the treated groups were compared with children who under supervision brushed their teeth (already from 1964) with 0.5% neutral sodium fluoride solutions five times per year during the school hours. All children received appropriate information and motivation for improved oral hygiene and food habits by the dental hygienists individually in the treated groups and in groups in the comparison group. The results are given in Table 2. The caries reduction obtained per year reached maximally about 40 per cent. This investigation shows that dental hygienists are able to carry out valuable caries preventive work at dental clinics, and it is justified to assign this type of health personnel to separate caries preventive tasks which require little supervision time from the responsible dentists.

FLUORIDE: A REVIEW OF USE AND EFFECTS ON HEALTH.

PubMed

Kanduti, Domen; Sterbenk, Petra; Artnik, Barbara

2016-04-01

Appropriate oral health care is fundamental for any individual's health. Dental caries is still one of the major public health problems. The most effective way of caries prevention is the use of fluoride. The aim of our research was to review the literature about fluoride toxicity and to inform physicians, dentists and public health specialists whether fluoride use is expedient and safe. Data we used in our review were systematically searched and collected from web pages and documents published from different international institutions. Fluoride occurs naturally in our environment but we consume it in small amounts. Exposure can occur through dietary intake, respiration and fluoride supplements. The most important factor for fluoride presence in alimentation is fluoridated water. Methods, which led to greater fluoride exposure and lowered caries prevalence, are considered to be one of the greatest accomplishments in the 20th century`s public dental health. During pregnancy, the placenta acts as a barrier. The fluoride, therefore, crosses the placenta in low concentrations. Fluoride can be transmitted through the plasma into the mother's milk; however, the concentration is low. The most important action of fluoride is topical, when it is present in the saliva in the appropriate concentration. The most important effect of fluoride on caries incidence is through its role in the process of remineralization and demineralization of tooth enamel. Acute toxicity can occur after ingesting one or more doses of fluoride over a short time period which then leads to poisoning. Today, poisoning is mainly due to unsupervised ingestion of products for dental and oral hygiene and over-fluoridated water. Even though fluoride can be toxic in extremely high concentrations, it`s topical use is safe. The European Academy of Paediatric Dentistry (EAPD) recommends a preventive topical use of fluoride supplements because of their cariostatic effect.

The cost-effectiveness of adding fluorides to milk-products distributed by the National Food Supplement Programme (PNAC) in rural areas of Chile.

PubMed

Mariño, R; Morgan, M; Weitz, A; Villa, A

2007-06-01

This paper assesses the cost-effectiveness of a community dental caries prevention programme, targeting pre-school children living in non-fluoridated rural areas of Chile. The results of a community trial to measure the effects of using fluoridated powdered milk and milk-cereal to prevent dental caries, together with the cost of running the programmeme, were used to determine its cost-effectiveness when compared to the status-quo alternative. In the experimental community, fluoridated milk products were given to approximately 1,000 children aged between six months and six years, using the standard National Complementary Feeding Programme available in Chile. The control group received the milk products only. Dental caries status was recorded at the beginning and end of the programme in both communities using WHO criteria. The costs that would be incurred by such a programme, using a societal perspective, were identified and measured. Children who received fluoridated products had significantly lower mean levels of dental caries than those who had not. This improvement was achieved with a yearly cost of RCH (1999) $1,839.75 per child (1 US$ = RCH (1999) $527.70). On average, this programme resulted in a net societal savings of RCH (1999) $2,695.61 per diseased tooth averted after four years when compared to the control group. While the analysis has inherent limitations as a result of its reliance on a range of assumptions, the findings suggest that there are important health and economic benefits to be gained from the use of fluoridated milk products in non-fluoridated rural communities in Chile.

UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent

PubMed Central

Horst, Jeremy A; Ellenikiotis, Hellene; Milgrom, Peter M

2016-01-01

The Food and Drug Administration recently cleared silver diamine fluoride for reducing tooth sensitivity. Clinical trials document arrest and prevention of dental caries by silver diamine fluoride; this off-label use is now permissible and appropriate under U.S. law. A CDT code was approved for caries arresting medicaments for 2016 to facilitate documentation and billing. We present a systematic review, clinical indications, clinical protocol, and consent procedure to guide application for caries arrest treatment. PMID:26897901

Clinicians' preventive strategies for children and adolescents identified as at high risk of developing caries.

PubMed

Sarmadi, Roxana; Gahnberg, Lars; Gabre, Pia

2011-05-01

Clinicians handle diagnosis and treatment planning of caries in different ways, and the underlying factors leading to management of risk and choice of treatment strategies are poorly understood. The aim of this study was to investigate dentists' and dental hygienists' choices of preventive strategies for children and adolescents identified as at high risk of developing caries. A sample of dental records from 432 of a total of 3372 children in a Swedish county identified as at high risk of developing caries, aged 3-19 years, was randomly selected for analysis in the study. Information of importance for the therapists' choice of caries management strategies were obtained from the dental records. The results showed that therapists considered tooth brushing instruction and fluoride treatment at the clinic to be of primary importance as treatment given in 60% of the cases, respectively. Fluoride treatment at home and diet counselling were both chosen in half of the cases. Fissure sealant therapy was used in 21% of the cases, and 15% of the patients did not receive any preventive treatment at all. The results also showed that girls more often received fluoride treatment, tooth brushing instruction and oral hygiene information than boys. In the majority of the children and adolescents, several preventive measures were given. The more background factors included in the risk assessment, the more preventive measures were given. The differences between the treatments given to girls and the boys need to be further investigated. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Breast and Bottle Feeding as Risk Factors for Dental Caries: A Systematic Review and Meta-Analysis

PubMed Central

Avila, Walesca M.; Pordeus, Isabela A.; Paiva, Saul M.; Martins, Carolina C.

2015-01-01

Understanding the role that breastfeeding and bottle feeding play in the development of dental caries during childhood is essential in helping dentists and parents and care providers prevent the disease, and also for the development of effective public health policies. However, the issue is not yet fully understood. The aim of this systematic review and meta-analysis was to search for scientific evidence in response to the question: Do bottle fed children have more dental caries in primary dentition than breastfed children? Seven electronic databases and grey literature were used in the search. The protocol number of the study is PROSPERO CRD 42014006534. Two independent reviewers selected the studies, extracted data and evaluated risk of bias by quality assessment. A random effect model was used for meta-analysis, and the summary effect measure were calculated by odds ratio (OR) and 95% CI. Seven studies were included: five cross-sectional, one case-control and one cohort study. A meta-analysis of cross-sectional studies showed that breastfed children were less affected by dental caries than bottle fed children (OR: 0.43; 95%CI: 0.23–0.80). Four studies showed that bottle fed children had more dental caries (p<0.05), while three studies found no such association (p>0.05). The scientific evidence therefore indicated that breastfeeding can protect against dental caries in early childhood. The benefits of breastfeeding until age two is recommended by WHO/UNICEF guidelines. Further prospective observational cohort studies are needed to strengthen the evidence. PMID:26579710

Association between BMI and Dental Caries among School Children and Adolescents in Jiangsu Province, China.

PubMed

Li, Wei; Hussein Musa, Taha; Gao, Rong; Li, Xiao Shan; Wang, Wei Xiang; Hong, Lei; Wei, Ping Min

2017-10-01

Obesity and dental caries are increasing epidemics, especially among children and adolescents. This epidemiological observational cross-sectional study was conducted to assess the possible association between body mass index (BMI) and dental caries among 111,792 school children and adolescents in Jiangsu Province. We found that 13.14% participants of the study sample were overweight, and 7.37% were obese. The prevalence of dental caries was 12.95% in overweight and 7.89% in obese students. There were significant differences in caries prevalence by sex, region, age group, and BMI. Overweight and obesity statuses were associated with dental caries among the study population. BMI and dental caries present a continuous health problem. Thus, we recommend that oral health promotion be used for caries prevention and control. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Preventive care delivered within Public Dental Service after caries risk assessment of young adults.

PubMed

Hänsel Petersson, G; Ericson, E; Twetman, S

2016-08-01

To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative score was constructed and dichotomized to 'basic prevention' and 'additional prevention'. More additional preventive care was provided to the patients in the 'low-risk' and 'some risk' categories than to those classified as 'high' or 'very high' risk (OR = 2.0, 95% CI 1.4-3.0; P < 0.05). Professional tooth cleaning and additional fluorides were most frequently employed in the 'low-risk' and 'some risk' categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the 'very high-risk' group. The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of Total Salivary Secretory Immunoglobulin A and Mi/fans-specific SIgA among Children having Dissimilar Caries Status.

PubMed

Pandey, Sunil; Goel, Mahima; Nagpal, Ravi; Kar, Ankita; Rapsang, Eliezer; Matani, Priya

2018-06-01

The occurrence of dental caries has become quite a common phenomenon nowadays. The varying levels of salivary secretory immunoglobulin A (SIgA) usually determine the progression of caries. The present study was aimed to determine the correlation between SIgA and mutans-specific antigen SIgA in children having different caries status. Scanning electron microscopic analysis was also completed to correlate the results. This study comprised 60 subjects, who were divided into three groups depending on caries status. In all, saliva was collected to determine the level of SIgA and mutans-specific antigen SIgA using enzyme linked immunosorbent assay (ELISA). The World Health Organization (WHO) criteria and method were used to evaluate dental caries. Bradford reagent was used to evaluate the levels of protein in the antigen. Furthermore, 20 sections of enamel were randomly obtained to estimate the severity of caries development among groups. Categorical characteristics among all groups were compared by basic statistical analysis and Chi-squared test. Mean age (years) was found to be 9.214 ± 2.28, 9.5 ± 2.51, and 10.2 ± 2.35 in groups I, II, and III respectively. Mutans-specific IgA level (|jg/mL) was 34.63 ± 7.46, 28.24 ± 4.52, and 23.56 ± 1.62 in groups I, II, and III respectively. Total SIgA (jg/mL) was 142.53 ± 22.4, 186.10 ± 24.70, and 214.8 ± 27.56 in groups I, II, and III respectively. Caries index was 6.74 ± 2.16, 2.32 ± 0.86, and 0 ± 0 in groups I, II, and III respectively. Immunoglobulin A is dominantly present in saliva and it plays a significant role in prevention of dental caries. Hence, dental caries is more likely to develop in subjects with low level of salivary IgA (high caries index). A low level of IgA may be associated with a high risk of developing dental caries. This association may possibly be useful in predicting the future caries status. Accordingly, suitable caries-preventive measures can be selected and employed.

Parents' Attitude towards the Use of Fluorides and Fissure Sealants and its Effect on their Children's Oral Health.

PubMed

Blumer, Sigalit; Ratson, Tal; Peretz, Benjamin; Dagon, Nurit

To characterize the attitudes of Israeli parents towards caries preventive measures. participating parents completed a 21-item questionnaire on their demographics, dental history, attitudes and satisfaction from fluorides and fissure sealants. One hundred parents (average age 41.62±4.9 years, 85 females) participated. Most of the parents (88% of the mothers and 84% of the fathers) had an academic education. Most of the parents (54%) had a favorable attitude towards the use of fluoridated gels, while only 37% of them had a positive opinion regarding fluoridated water. The satisfaction levels were very high regarding fissure sealants, fluoridated mouth rinses and fluoridated gels (78.1%, 73.6% and 72.5% respectively). The satisfaction from fluoridated water was split almost equally (50.8% were 'pleased' and 49.2% 'not pleased'). The main source for parental oral health knowledge was the dentist (83%). Parents' attitude towards caries preventive measures was significantly correlated to their gender, dental experience, level of education and the number of children in the family. positive attitude towards caries preventive measures was found among parents with higher awareness for preventive oral health measures and among bigger families. Mothers were more positive about fissure sealants than fathers. Mothers with up to 12 years of education tended to have a positive opinion regarding water fluoridation.

Disparities in children's oral health and access to dental care.

PubMed

Mouradian, W E; Wehr, E; Crall, J J

Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professionally applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental care is the most prevalent unmet health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they are eligible. Children from low income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children. Childhood oral disease has significant medical and financial consequences that may not be appreciated because of the separation of medicine and dentistry. The infectious nature of dental caries, its early onset, and the potential of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, many pediatricians lack critical knowledge to promote oral health. We recommend financial incentives for prioritizing Medicaid Early and Periodic Screening, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical care, and research; and national leadership. JAMA. 2000;284:2625-2631.

Diet, nutrition and the prevention of dental diseases.

PubMed

Moynihan, Paula; Petersen, Poul Erik

2004-02-01

Oral health is related to diet in many ways, for example, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association between nutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks. Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride. It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is <15-20 kg/yr ( approximately 6-10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.

Prevalence and severity of dental caries among American Indians and Alaska Natives.

PubMed

Niendorff, W J; Jones, C M

2000-01-01

This paper reports findings from the 1991 IHS Patient Oral Health Status and Treatment Needs Survey (1991 IHS patient survey) and presents trends in caries among American Indian and Alaska Native (Native American) populations since 1957. The 1991 IHS patient survey obtained data from approximately 10 percent (25,000) of the dental patients seen annually at IHS, tribal, and urban Indian clinics. The results of this survey are compared descriptively with previous surveys conducted by the IHS beginning in 1957. Findings from the 1991 IHS patient survey indicate that Native Americans experience a much higher prevalence of dental caries in their primary and permanent dentitions than the general US population. However, caries rates in Native American children peaked in 1983-84 and have been going down since that time. While progress has been made in preventing dental caries among Native Americans, the high prevalence and severity at all ages in this rapidly growing population have resulted in a large backlog of untreated disease with an overwhelming demand on the resources available to provide care. Continued emphasis on dental caries prevention and health promotion is an important part of the solution. New strategies such as targeting preventive services toward individuals and groups with the highest risk of disease and the use of modern conservative treatment methods to control disease must be employed. Full implementation of these strategies and identification of the resources required will depend upon new and ongoing partnerships among tribes, federal and state governments, and the private sector.

Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children.

PubMed

Takahashi, Rena; Ota, Erika; Hoshi, Keika; Naito, Toru; Toyoshima, Yoshihiro; Yuasa, Hidemichi; Mori, Rintaro; Nango, Eishu

2017-10-23

Dental caries (tooth decay) is one of the most common chronic childhood diseases. Caries prevalence in most industrialised countries has declined among children over the past few decades. The probable reasons for the decline are the widespread use of fluoride toothpaste, followed by artificial water fluoridation, oral health education and a slight decrease in sugar consumption overall. However, in regions without water fluoridation, fluoride supplementation for pregnant women may be an effective way to increase fluoride intake during pregnancy. If fluoride supplements taken by pregnant women improve neonatal outcomes, pregnant women with no access to a fluoridated drinking water supply can obtain the benefits of systemic fluoridation. To evaluate the effects of women taking fluoride supplements (tablets, drops, lozenges or chewing gum) compared with no fluoride supplementation during pregnancy to prevent caries in the primary teeth of their children. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 25 January 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11) in the Cochrane Library (searched 25 January 2017); MEDLINE Ovid (1946 to 25 January 2017); Embase Ovid (1980 to 25 January 2017); LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 25 January 2017); and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 25 January 2017). We searched the US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 25 January 2017. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) of fluoride supplements (tablets, drops, lozenges or chewing gum) administered to women during pregnancy with the aim of preventing caries in the primary teeth of their children. Two review authors independently screened the titles and abstracts (when available) of all reports identified through electronic searches. Two review authors independently extracted data and assessed risk of bias, as well as evaluating overall quality of the evidence utilising the GRADE approach. We could not conduct data synthesis as only one study was included in the analysis. Only one RCT met the inclusion criteria for this review. This RCT showed no statistical difference on decayed or filled primary tooth surfaces (dfs) and the percentage of children with caries at 3 years (risk ratio (RR) 1.46, 95% confidence interval (CI) 0.75 to 2.85; participants = 938, very low quality of evidence) and 5 years old (RR 0.84, 95% CI 0.53 to 1.33; participants = 798, very low quality of evidence). The incidence of fluorosis at 5 years was similar between the group taking fluoride supplements (tablets) during the last 6 months of pregnancy and the placebo group. There is no evidence that fluoride supplements taken by women during pregnancy are effective in preventing dental caries in their offspring.

The impact of changing dental needs on cost savings from fluoridation.

PubMed

Campain, A C; Mariño, R J; Wright, F A C; Harrison, D; Bailey, D L; Morgan, M V

2010-03-01

Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal. Community water fluoridation remains a cost-effective preventive measure in Australia.

Sustaining elevated levels of nitrite in the oral cavity through consumption of nitrate-rich beetroot juice in young healthy adults reduces salivary pH.

PubMed

Hohensinn, Barbara; Haselgrübler, Renate; Müller, Ulrike; Stadlbauer, Verena; Lanzerstorfer, Peter; Lirk, Gerald; Höglinger, Otmar; Weghuber, Julian

2016-11-30

Dietary inorganic nitrate (NO 3 - ) and its reduced forms nitrite (NO 2 - ) and nitric oxide (NO), respectively, are of critical importance for host defense in the oral cavity. High concentrations of salivary nitrate are linked to a lower prevalence of caries due to growth inhibition of cariogenic bacteria. In-vitro studies suggest that the formation of antimicrobial NO results in an increase of the pH preventing erosion of tooth enamel. The purpose of this study was to prove this effect in-vivo. In a randomized clinical study with 46 subjects we investigated whether NO 3 - rich beetroot juice exhibits a protective effect against caries by an increase of salivary pH. Our results show that, in comparison to a placebo group, consumption of beetroot juice that contains 4000 mg/L NO 3 - results in elevated levels of salivary NO 2 - , nitrite NO 3 - , and NO. Furthermore, we determined an increase of the mean pH of saliva from 7.0 to 7.5, confirming the anti-cariogenic effect of the used NO 3 - -rich beetroot juice. Taken together, we have found that NO 3 - -rich beetroot juice holds potential effects against dental caries by preventing acidification of human saliva. C-87-15 (Ethics Commissions of Upper Austria). Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Effect of phytate and zinc ions on fluoride toothpaste efficacy using an in situ caries model.

PubMed

Parkinson, Charles R; Burnett, Gary R; Creeth, Jonathan E; Lynch, Richard J M; Budhawant, Chandrashekhar; Lippert, Frank; Hara, Anderson T; Zero, Domenick T

2018-06-01

To compare and explore the dose-response of phytate-containing 1150 ppm fluoride toothpastes on model caries lesions and to determine the impact of zinc ions. This was a single-centre, randomised, blinded (examiner/laboratory analyst), six-treatment, four-period crossover, in situ study in adults with a removable bilateral maxillary partial denture. Study treatments were toothpastes containing: 0.425% phytate/F; 0.85% phytate/F; 0.85% phytate/Zn/F; F-only; Zn/F and a 0% F placebo. Where present, F was 1150 ppm as NaF; Zn was 0.3% as ZnCl 2 . Human enamel specimens containing early-stage, surface-softened (A-lesions) or more advanced, subsurface (B-lesions) caries lesions were placed into the buccal flanges of participants' modified partial denture (one of each lesion type per side). A-lesions were removed after 14 days of twice-daily treatment use; B-lesions were removed after a further 14 days. A-lesions were analysed for surface microhardness recovery. Both lesion types were analysed by transverse microradiography and for enamel fluoride uptake, with B-lesions additionally analysed by quantitative light-induced fluorescence. Comparison was carried out using an analysis of covariance model. Statistically significant differences between 1150 ppm F and the placebo toothpastes (p < 0.05) were shown for all measures, validating the model. No differences between fluoride toothpastes were observed for any measure with little evidence of a dose-response for phytate. Study treatments were generally well-tolerated. Results suggest phytate has little impact on fluoride's ability to promote early-stage lesion remineralisation or prevent more advanced lesion demineralisation in this in situ caries model. Similarly, results suggest zinc ions do not impair fluoride efficacy. Toothpastes may contain therapeutic or cosmetic agents that could interfere with fluoride's caries prevention efficacy. The present in situ caries study has demonstrated that phytate, added to provide enhanced extrinsic stain removal/prevention, and zinc, added to inhibit malodour, do not impair fluoride efficacy. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Fluorine uptake into the human enamel surface from fluoride-containing sealing materials during cariogenic pH cycling

NASA Astrophysics Data System (ADS)

Yasuhiro, Matsuda; Katsushi, Okuyama; Hiroko, Yamamoto; Hisanori, Komatsu; Masashi, Koka; Takahiro, Sato; Naoki, Hashimoto; Saiko, Oki; Chiharu, Kawamoto; Hidehiko, Sano

2015-04-01

To prevent the formation of caries and reduce dentin hypersensitivity, sealing materials, either with or without fluoride, are generally applied on the tooth in clinical practice. Application of fluoride-free sealing materials results in the formation of an acid-resistant layer on the tooth surface. On the other hand, fluoride-containing sealing materials might not only form an acid-resistant layer but could possibly further provide fluoride to enhance remineralization and reduce demineralization. In this study, the demineralization prevention ability and fluorine uptake rate in human enamel of fluoride-containing sealing materials ["MS coats F" (MSF)] and fluoride-free sealing materials ("hybrid coats 2" [HI]) were evaluated using an automatic pH cycling system. Each material was applied to the original tooth surface, the cut surfaces were covered with sticky wax, and the automatic pH-cycling system simulated daily acid changes (pH 6.8-4.5) occurring in the oral cavity for 4 weeks. Caries progression was analyzed using transverse microradiography (TMR) taken pre and post the 4 weeks of pH cycling. The fluorine and calcium distributions in the carious lesion in each specimen were evaluated using the proton-induced gamma emission (PIGE) and proton-induced X-ray (PIXE) techniques, respectively. TMR analysis showed that both MSF and HI had a caries-preventing effect after 4 weeks of pH cycling. PIGE/PIXE analysis demonstrated that only MSF resulted in fluoride uptake in the enamel surface. Therefore, MSF can help to form an acid-resistant layer and provide fluoride to the enamel surface. The presence of fluoride on the enamel surface suggested that MSF could prevent demineralization, even if the acid-resistant layer was removed, in clinical settings. The data obtained using the PIGE and PIXE techniques are useful for understanding the benefits of the use of a fluoride-containing sealing material for preventing caries.

Bridging the gap between preventive and restorative dentistry: identification of caries risk factors and strategies for minimizing risk.

PubMed

Maragliano-Muniz, Pamela

2013-10-01

Following the introduction of CAMBRA (Caries Management by Risk Assessment) in 2007, a number of recommendations for office protocols were introduced, and many companies have formulated products and procedures for implementing CAMBRA. As a result, the implementation of a caries management program can be confounding and overwhelming to a dental practitioner. Understanding risk factors as they contribute to the caries process can help mitigate confusion and guide the practitioner when selecting materials for their practice. Ultimately, knowing how the risk factors play a role in the progression of dental caries will lead to appropriate risk management and product recommendations. The purpose of this article is to discuss the contribution of risk factors to the caries process and to introduce strategies that restorative dentists can utilize to minimize caries risk.

How to Prevent Tooth Decay in Your Baby

MedlinePlus

... life-threatening infections. Tooth decay (called early childhood caries) is the most common chronic infectious disease of childhood. Tooth decay may also be called nursing caries or baby bottle tooth decay . Healthy dental habits ...

Dental caries-associated risk factors and type 1 diabetes mellitus.

PubMed

Sampaio, Norma; Mello, Sandra; Alves, Cresio

2011-01-01

Type 1 diabetes mellitus (T1DM) is associated with various oral complications. However there is no consensus regarding the association of T1DM and caries. Critical revision of dental caries-associated risk factors and type 1 diabetes mellitus. Search of the MEDLINE and LILACS databases from 2000 to 2010, using, in different combination, the key words "dental caries", "diabetes mellitus" and "type 1 diabetes mellitus". The association between T1DM and dental caries remains controversial. Although some studies demonstrate a higher prevalence of caries due to the increased concentration of salivary glucose, acidity of the oral cavity, salivary viscosity, reduced salivary flow rate, and salivary gland dysfunction; other studies report a reduction of caries levels, probably caused by decreased ucrose ingestion. Although patients with uncontrolled T1DM and poor oral hygiene may present increased prevalence of dental caries, the literature does not describe a consistent relationship between T1DM and dental caries. Further investigations are warranted. If a true association is substantiated, intervention studies to prevent or reduce the occurrence of caries in this population should follow.

Strategic Protein Target Analysis for Developing Drugs to Stop Dental Caries

PubMed Central

Horst, J.A.; Pieper, U.; Sali, A.; Zhan, L.; Chopra, G.; Samudrala, R.; Featherstone, J.D.B.

2012-01-01

Dental caries is the most common disease to cause irreversible damage in humans. Several therapeutic agents are available to treat or prevent dental caries, but none besides fluoride has significantly influenced the disease burden globally. Etiologic mechanisms of the mutans group streptococci and specific Lactobacillus species have been characterized to various degrees of detail, from identification of physiologic processes to specific proteins. Here, we analyze the entire Streptococcus mutans proteome for potential drug targets by investigating their uniqueness with respect to non-cariogenic dental plaque bacteria, quality of protein structure models, and the likelihood of finding a drug for the active site. Our results suggest specific targets for rational drug discovery, including 15 known virulence factors, 16 proteins for which crystallographic structures are available, and 84 previously uncharacterized proteins, with various levels of similarity to homologs in dental plaque bacteria. This analysis provides a map to streamline the process of clinical development of effective multispecies pharmacologic interventions for dental caries. PMID:22899687

A review of slow-release fluoride devices.

PubMed

Toumba, K J; Al-Ibrahim, N S; Curzon, M E J

2009-09-01

Fluoride has been used to combat dental caries using a number of different clinical approaches. An exciting relatively new development is fluoride slow-releasing devices that consistently elevate intra-oral fluoride levels of plaque and saliva for prolonged periods of up to two years. The literature on the use of slow-releasing fluoride devices in dentistry were reviewed. A Medline search on key words was carried out. All papers in English were individually reviewed. Slow-releasing fluoride devices have been shown to be effective in elevating salivary fluoride levels in both animals and human studies and to enhance the remineralisation of dental enamel. They have been demonstrated to be safe to use and without the risk of fluoride toxicity. A double blind randomised clinical trial demonstrated 76% fewer new carious surface increment in high caries-risk children after two years. These devices have a number of potential uses in dentistry and in particular have great potential for caries prevention of non-compliant high caries-risk groups.

Preventing Advanced Carious Lesions with Caries Atraumatic Restorative Technique.

PubMed

Byrd, Tammi O

2016-06-01

An alternative approach to controlling dental caries and preventing the associated pain, called atraumatic restorative technique (ART), is described for populations in need, where dental hygienists restore decayed teeth with glass ionomer restorations without prior removal of all decayed tooth structure. There are populations whose decay needs are not adequately being met within the current oral health care delivery system. These include those in poverty conditions, vulnerable children, and the elderly who are often in long-term care facilities without adequate resources or opportunities for traditional dentistry. ART provides a viable option for controlling caries and relieving the pain of untreated decay. The purpose of this article is to suggest that the evidence surrounding ART be viewed objectively and that dental hygienists, with additional education in this approach, can contribute to relieving the pain of untreated dental decay. Evidence suggests that teeth can be effectively restored with ART. Dental hygienists represent an appropriate workforce to provide ART with their current background and education combined plus a brief training program; it is suggested that dental hygiene educational programs include ART within the curriculum. Along with dental sealants and fluoride varnish application, ART can be an important component of a comprehensive preventive program to address the unmet needs of vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

The economic value of Quebec's water fluoridation program.

PubMed

Tchouaket, Eric; Brousselle, Astrid; Fansi, Alvine; Dionne, Pierre Alexandre; Bertrand, Elise; Fortin, Christian

2013-01-01

Dental caries is a major public health problem worldwide, with very significant deleterious consequences for many people. The available data are alarming in Canada and the province of Quebec. The water fluoridation program has been shown to be the most effective means of preventing caries and reducing oral health inequalities. This article analyzes the cost-effectiveness of Quebec's water fluoridation program to provide decision-makers with economic information for assessing its usefulness. An approach adapted from economic evaluation was used to: (1) build a logic model for Quebec's water fluoridation program; (2) determine its implementation cost; and (3) analyze its cost-effectiveness. Documentary analysis was used to build the logic model. Program cost was calculated using data from 13 municipalities that adopted fluoridation between 2002 and 2010 and two that received only infrastructure grants. Other sources were used to collect demographic data and calculate costs for caries treatment including costs associated with travel and lost productivity. The analyses showed the water fluoridation program was cost-effective even with a conservatively estimated 1 % reduction in dental caries. The benefit-cost ratio indicated that, at an expected average effectiveness of 30 % caries reduction, one dollar invested in the program saved $71.05-$82.83 per Quebec's inhabitant in dental costs (in 2010) or more than $560 million for the State and taxpayers. The results showed that the drinking-water fluoridation program produced substantial savings. Public health decision-makers could develop economic arguments to support wide deployment of this population-based intervention whose efficacy and safety have been demonstrated and acknowledged.

Dental caries and vitamin D3 in children with growth hormone deficiency

PubMed Central

Wójcik, Dorota; Krzewska, Aleksandra; Szalewski, Leszek; Pietryka-Michałowska, Elżbieta; Szalewska, Magdalena; Krzewski, Szymon; Pels, Elżbieta; Beń-Skowronek, Iwona

2018-01-01

Abstract Vitamin D may prevent dental caries. To date, no attempts have been made to examine the correlation between the incidence of caries and the concentrations of vitamin D in children with pituitary growth hormone deficiency. The study observed patients of the Department of Endocrinology and Diabetology of the University Paediatric Hospital of the Medical University of Lublin treated with human recombinant growth hormone for pituitary growth hormone deficiency (GHD). The study was conducted between October 2014 and June 2015. The study group consisted of 121 children and adolescents (6–17 years old), including 56 children from rural areas and 65 children from urban areas. The study group was stratified by area of residence. In our study, the increase in vitamin D3 [25(OH)D] levels reduced the D component by 0.66 per each 10 ng/mL of vitamin D3 concentration. The percentage of children with active caries in rural areas is 91.07% (n = 51), which is significantly higher than the percentage of children with active caries in urban areas (81.54%, n = 53). To date, information regarding the potential possibility of reducing the incidence of dental caries by means of increasing the levels of vitamin D was sidelined by paediatricians and dentists alike. Therefore, this aspect of caries prevention should be highlighted. PMID:29465564

Dental caries and vitamin D3 in children with growth hormone deficiency: A STROBE compliant study.

PubMed

Wójcik, Dorota; Krzewska, Aleksandra; Szalewski, Leszek; Pietryka-Michałowska, Elżbieta; Szalewska, Magdalena; Krzewski, Szymon; Pels, Elżbieta; Beń-Skowronek, Iwona

2018-02-01

Vitamin D may prevent dental caries. To date, no attempts have been made to examine the correlation between the incidence of caries and the concentrations of vitamin D in children with pituitary growth hormone deficiency.The study observed patients of the Department of Endocrinology and Diabetology of the University Paediatric Hospital of the Medical University of Lublin treated with human recombinant growth hormone for pituitary growth hormone deficiency (GHD). The study was conducted between October 2014 and June 2015. The study group consisted of 121 children and adolescents (6-17 years old), including 56 children from rural areas and 65 children from urban areas. The study group was stratified by area of residence.In our study, the increase in vitamin D3 [25(OH)D] levels reduced the D component by 0.66 per each 10 ng/mL of vitamin D3 concentration. The percentage of children with active caries in rural areas is 91.07% (n = 51), which is significantly higher than the percentage of children with active caries in urban areas (81.54%, n = 53).To date, information regarding the potential possibility of reducing the incidence of dental caries by means of increasing the levels of vitamin D was sidelined by paediatricians and dentists alike. Therefore, this aspect of caries prevention should be highlighted.

Equity in children's dental caries before and after cessation of community water fluoridation: differential impact by dental insurance status and geographic material deprivation.

PubMed

McLaren, Lindsay; McNeil, Deborah A; Potestio, Melissa; Patterson, Steve; Thawer, Salima; Faris, Peter; Shi, Congshi; Shwart, Luke

2016-02-11

One of the main arguments made in favor of community water fluoridation is that it is equitable in its impact on dental caries (i.e., helps to offset inequities in dental caries). Although an equitable effect of fluoridation has been demonstrated in cross-sectional studies, it has not been studied in the context of cessation of community water fluoridation (CWF). The objective of this study was to compare the socio-economic patterns of children's dental caries (tooth decay) in Calgary, Canada, in 2009/10 when CWF was in place, and in 2013/14, after it had been discontinued. We analyzed data from population-based samples of schoolchildren (grade 2) in 2009/10 and 2013/14. Data on dental caries (decayed, missing, and filled primary and permanent teeth) were gathered via open mouth exams conducted in schools by registered dental hygienists. We examined the association between dental caries and 1) presence/absence of dental insurance and 2) small area index of material deprivation, using Poisson (zero-inflated) and logistic regression, for both time points separately. For small-area material deprivation at each time point, we also computed the concentration index of inequality for each outcome variable. Statistically significant inequities by dental insurance status and by small area material deprivation were more apparent in 2013/14 than in 2009/10. Results are consistent with increasing inequities in dental caries following cessation of CWF. However, further research is needed to 1) confirm the effects in a study that includes a comparison community, and 2) explore possible alternative reasons for the findings, including changes in treatment and preventive programming.

Long-term caries development in schoolchildren and the role of educational status.

PubMed

Schmoeckel, Julian; Santamaría, Ruth M; Splieth, Christian H

2015-05-01

After the recent decline in caries, caries development has become harder to predict. The aim of this 10-year cohort study was to monitor long-term caries development with special regard to educational status in schoolchildren. For 521 five- to six-year-olds (mean 5.8 ± 0.5 years) participating in the compulsory pre-school examination, the oral status and the parental educational status was recorded. In the 10-year follow-up, 170 children (5.9 ± 0.3 years at baseline, 16.5 ± 0.4 years at 10 years) could be re-examined. Associations between the children's and parental educational background with the caries increment were analyzed. Drop-outs (n = 351; 5.8 ± 0.6 years) and drop-in 10th-graders (n = 364; 16.9 ± 0.6 years) were used for comparative analyses. Mean caries scores increased from 0.1 DMFS (± 0.5) to 5.0 DMFS (± 6.6), while the other 10th-graders exhibited a significantly higher DMFS (6.6 ± 8.8; P < .001). In children who later attended higher education, caries levels were already significantly lower at school entry (6.1 ± 7.4 dmfs) compared to the other children (11.1 ± 11.4 dmfs; P < .005). Similarly to the baseline dmft (OR 3.6), the 10-year caries increment in the permanent dentition was significantly lower when the father had a university degree (2.7 ± 3.2 ΔDMFS compared with 5.1 ± 6.6; P = .02; OR 4.6). The parental educational status and caries levels in the primary dentition determined strongly the long-term oral health of their children, which means that effective preventive strategies have not been implemented to compensate inequalities in health and education.

Oral health status among 6- and 12-year-old Jordanian schoolchildren.

PubMed

Rajab, Lamis Darwish; Petersen, Poul Erik; Baqain, Zaid; Bakaeen, Ghazi

2014-01-01

No nationwide oral health survey has previously been carried out in Jordan. The aims of the study were to assess the burden of dental caries and gingival health among children aged 6 and 12 years in relation to sociodemographic factors and to ascertain the trend over time in the occurrence of caries and the need for dental care. A cross-sectional epidemiological survey was carried out which included 2496 children aged 6 years and 2560 children aged 12 years selected by stratified cluster sampling. Children were examined in schools and data comprised information about caries and gingival health status. WHO methodology and criteria were applied. Structured questionnaires were used to collect information about oral hygiene, dental visits, consumption of sugars and parents' level of education. The caries prevalence rates were 76.4% in 6-year-olds and 45.5% in 12-year-olds, and caries experience was 3.3 dmft and 1.1 DMFT, respectively. The prevalence of caries varied significantly by sex and geographical region. In both age groups, children of the social low and middle groups had significantly higher levels of caries experience, more untreated decayed teeth and fewer filled teeth than did children of the upper socioeconomic group. Multivariate regression analysis showed that social class was the most important independent variable for caries. The results from 2005 were compared with similar data collected in the capital, Amman, in 1993. For all social classes, the mean caries experience and the amount of untreated dental caries increased over time. Moreover, 17.7% of 6-year-old children and 49.1% of the 12-year-olds had gingival bleeding. Significant differences in gingival health were found by sex, location, geographical areas and socioeconomic group. Oral disease is a significant public health problem in Jordan. Strengthening of the school oral health programme is needed for effective prevention and control of caries and promoting gingival health. A systematic school oral health programme including oral health promotion should be established.

National strategy for prevention of oral diseases in children from 0 to 14 years old age in the Republic of Macedonia for the period 2008-2018.

PubMed

Sarakinova, Olivera; Carcev, Mile; Getova, Biljana; Carceva Salja, Sofija; Janevska, Sevdalina

2013-01-01

Human principles and the fundamental values are the main principles stipulated in the Constitution of Republic of Macedonia. The Government of the Republic of Macedonia, within its program objectives, implementing the laws in the country, the international standards and the global health care as the worlds objective of the Constitution of WHO. According to the information received through the health monitoring system, as well as the results from target and selective studies, they have shown that the condition of oral health, especially the condition with the dental caries is serious health problem of all groups. The alarm was activated by the state of increase of the caries incidence, showing a value of DMFT=6.88 in children at 12 years of age, which is considered as a high value compared to the WHO recommendations for oral health (DMFT=3). The experience from the developed countries, as well as the knowledge based on scientific and professional evidence in RM, prove that this desease may be successfully prevented, eliminated and eradicated by conduction of primary preventive measures. The program objectives of the National Strategy for prevention of oral deseases are shared in shorth term, medium term and long term objectives, which aim is eradication of the caries. The Strategy include a prevention of periodontal desease and orthodontic anomalies. The prevention of the caries will be performed by using a five preventive measures: 1. mechanical and chemical control of the dental plaque 2. Discipline of sugar take regime 3. Application of fluorides (systemic and topic) 4. sealing fissures and cavities 5. Education and motivation for sustainnability of oral health. In the frame of the Strategy, we planed a dental dispensarisation of children through registering data in the patients file, as propose by WHO, and arrangement of preventive teams and professional assistance of paediatrics and gynecologists. The evaluation of the effects from the preventive program shall be performed two years from the initiation of the program implementation and the follow-up evaluations shall be performed every year, on the representative sample from the group of children at 6, 8 and 12 years of age covered with the program. The statistical data processing shall be presented at professional and scientific forums and published in the annual report of WHO.

The association between enamel fluorosis and dental caries in U.S. schoolchildren.

PubMed

Iida, Hiroko; Kumar, Jayanth V

2009-07-01

The authors assessed the association between enamel fluorosis and dental caries to determine if there is any beneficial effect of enamel fluorosis in U.S. schoolchildren. The authors used data from a National Institute of Dental Research survey of the oral health of U.S. children conducted in 1986 and 1987 to determine the prevalence of caries and mean decayed, missing or filled surfaces on permanent maxillary right first molars in children 7 to 17 years of age who had a history of a single residence. (To date, this is the only national oral health data set in the United States with detailed information on fluoride exposures.) They examined the association between enamel fluorosis and caries using logistic regression analysis, controlling for potential confounders in communities with water at or above optimal fluoridation levels and in communities with nonfluoridated or suboptimally fluoridated water. Permanent maxillary right first molars with fluorosis consistently had lower levels of caries experience than did normal molars. Adjusted odds ratios for caries prevalence in molars with fluorosis were 0.71 (95 percent confidence interval [CI], 0.56-0.89) in communities with nonfluoridated or suboptimally fluoridated water and 0.89 (95 percent CI, 0.74-1.06) in communities with water at or above optimal fluoridation levels. This study's findings suggest that molars with fluorosis are more resistant to caries than are molars without fluorosis. The results highlight the need for those considering policies regarding reduction in fluoride exposure to take into consideration the caries-preventive benefits associated with milder forms of enamel fluorosis.

Knowledge, attitude and skills of dental practitioners of Puducherry on minimally invasive dentistry concepts: A questionnaire survey

PubMed Central

Rayapudi, Jasmine; Usha, Carounanidy

2018-01-01

Background: Minimally invasive dentistry (MID) encompasses early caries diagnosis through caries risk assessment (CRA), early detection of incipient carious lesion including primary and secondary prevention based on scientific evidence that remineralization of demineralized enamel and dentin is possible if detected early. Although the dental curriculum focuses on the advantages of MID in tooth preservation, this science is not usually translated into practice. Aim: This study aimed to evaluate the knowledge, attitude, and skills of dental practitioners of Puducherry regarding the concepts of MID. Subjects and Methods: Data were collected through an online survey questionnaire based on awareness and practice of MID. Statistical evaluation was done on SPSS by Chi-square test. Results: A total of 126 dentists responded of which only 55% were trained in MID during their undergraduate and internship period, mainly through lectures (49.6%). Nearly 81% agreed that CRA should be conducted for all patients. Almost 42.7% had heard about International Caries Detection and Assessment System, but only 25.9% used a blunt explorer for caries detection. About 13.7% use magnification (loupes/microscope), but majority (84.7%) use radiographs. More than 70% were unaware of newer methods of caries detection. Statistically significant differences were found (P < 0.05) regarding qualification and experience about the effectiveness of Atraumatic Restorative Treatment and sandwich technique for treatment of caries in permanent teeth and high caries-risk children. Conclusion: Although there is knowledge about advantages of MID among dentists of Puducherry, it does not benefit patients, as many practitioners still follow the traditional principles of total caries removal. PMID:29899626

Recruitment for health disparities preventive intervention trials: the early childhood caries collaborating centers.

PubMed

Tiwari, Tamanna; Casciello, Alana; Gansky, Stuart A; Henshaw, Michelle; Ramos-Gomez, Francisco; Rasmussen, Margaret; Garcia, Raul I; Albino, Judith; Batliner, Terrence S

2014-08-07

Four trials of interventions designed to prevent early childhood caries are using community-engagement strategies to improve recruitment of low-income, racial/ethnic minority participants. The trials are being implemented by 3 centers funded by the National Institute of Dental and Craniofacial Research and known as the Early Childhood Caries Collaborating Centers (EC4): the Center for Native Oral Health Research at the University of Colorado, the Center to Address Disparities in Children's Oral Health at the University of California San Francisco, and the Center for Research to Evaluate and Eliminate Dental Disparities at Boston University. The community contexts for the EC4 trials include urban public housing developments, Hispanic communities near the US-Mexican border, and rural American Indian reservations. These communities have a high prevalence of early childhood caries, suggesting the need for effective, culturally acceptable interventions. Each center's intervention(s) used community-based participatory research approaches, identified community partners, engaged the community through various means, and developed communication strategies to enhance recruitment. All 3 centers have completed recruitment. Each center implemented several new strategies and approaches to enhance recruitment efforts, such as introducing new communication techniques, using media such as radio and newspapers to spread awareness about the studies, and hosting community gatherings. Using multiple strategies that build trust in the community, are sensitive to cultural norms, and are adaptable to the community environment can enhance recruitment in underserved communities.

Remineralization of initial enamel caries in vitro using a novel peptide based on amelogenin

NASA Astrophysics Data System (ADS)

Li, Danxue; Lv, Xueping; Tu, Huanxin; Zhou, Xuedong; Yu, Haiyang; Zhang, Linglin

2015-09-01

Dental caries is the most common oral disease with high incidence, widely spread and can seriously affect the health of oral cavity and the whole body. Current caries prevention measures such as fluoride treatment, antimicrobial agents, and traditional Chinese herbal, have limitations to some extent. Here we design and synthesize a novel peptide based on the amelogenin, and assess its ability to promote the remineralization of initial enamel caries lesions. We used enamel blocks to form initial lesions, and then subjected to 12-day pH cycling in the presence of peptide, NaF and HEPES buffer. Enamel treated with peptide or NaF had shallower, narrower lesions, thicker remineralized surfaces and less mineral loss than enamel treated with HEPES. This peptide can promote the remineralization of initial enamel caries and inhibit the progress of caries. It is a promising anti-caries agent with various research prospects and practical application value.

The investigations of changes in mineral-organic and carbon-phosphate ratios in the mixed saliva by synchrotron infrared spectroscopy

NASA Astrophysics Data System (ADS)

Seredin, Pavel; Goloshchapov, Dmitry; Kashkarov, Vladimir; Ippolitov, Yuri; Bambery, Keith

The objective of this study was to investigate the efficiency of the saturation of mixed saliva by mineral complexes and groups necessary for the remineralisation of tooth enamel using exogenous and endogenous methods of caries prevention. Using IR spectroscopy and high-intensity synchrotron radiation, changes in the composition of the human mixed saliva were identified when exogenous and endogenous methods of caries prevention are employed. Based on the calculations of mineral/organic and carbon/phosphate ratios, changes in the composition of the human mixed saliva depending on a certain type of prevention were identified. It is shown that the use of a toothpaste (exogenous prevention) alone based on a multi-mineral complex including calcium glycerophosphate provides only a short-term effect of saturating the oral cavity with mineral complexes and groups. Rinsing of the oral cavity with water following the preventive use of a toothpaste completely removes the effect of the saturation of the mixed saliva with mineral groups and complexes. The use of tablets of a multi-mineral complex with calcium glycerophosphate (endogenous prevention) in combination with exogenous prevention causes an average increase of ∼10% in the content of mineral groups and complexes in the mixed saliva and allows long-term saturation of the oral fluid by them. This method outperforms the exogenous one owing to a long-term effect of optimal concentrations of endogenous and biologically available derivatives of phosphates on the enamel surface.

Modeling an economic evaluation of a salt fluoridation program in Peru.

PubMed

Mariño, Rodrigo J; Fajardo, Jorge; Arana, Ana; Garcia, Carlos; Pachas, Flor

2011-01-01

This article models the cost-effectiveness, from a societal viewpoint, of a dental caries prevention program using salt fluoridation for children 12 years of age, compared with non-intervention (or status quo) in Arequipa, Peru. Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating the salt-fluoridation program were identified and measured using 2009 prices. Health outcomes were measured as dental caries averted over a 6-year period. Clinical effectiveness data was taken from published data. Costs were measured as direct treatment costs, programs costs and costs of productivity losses as a result of dental treatments. The incremental cost-effectiveness ratio was calculated. A hypothetical population of 25,000 12-year-olds living in Arequipa, Peru was used in this analysis. Two-way sensitivity analyses were conducted over a range of values for key parameters. Our primary analysis estimated that if a dental caries prevention program using salt-fluoridation was available for 25,000 6-year-old children for 6 years, the net saving from a societal perspective would total S/. 11.95 [1 US$ = S/. (2009) 3.01] per diseased tooth averted when compared with the status quo group. That is, after 6 years, an investment of S/.0.32 per annum per child would result in a net saving of S/.11.95 per decayed/missing/filled teeth prevented. While the analysis has inherent limitations as a result of its reliance on a range of assumptions, the findings indicate that for the situations prevailing in Peru, there are significant health and economic benefits to be gained from the use of salt fluoridation.

Comparison of Composition and Anticaries Effect of Galla Chinensis Extracts with Different Isolation Methods

PubMed Central

Huang, Xuelian; Deng, Meng; Liu, Mingdong; Cheng, Lei; Exterkate, R.A.M.; Li, Jiyao; Zhou, Xuedong; Ten Cate, Jacob. M.

2017-01-01

Objectives: Galla chinensis water extract (GCE) has been demonstrated to inhibit dental caries by favorably shifting the demineralization/remineralization balance of enamel and inhibiting the biomass and acid formation of dental biofilm. The present study focused on the comparison of composition and anticaries effect of Galla chinensis extracts with different isolation methods, aiming to improve the efficacy of caries prevention. Methods: The composition of water extract (GCE), ethanol extract (eGCE) and commercial tannic acid was compared. High performance liquid chromatography coupled to electrospray ionization-time of flight-mass spectrometry (HPLC-ESI-TOF-MS) analysis was used to analyze the main ingredients. In vitro pH-cycling regime and polymicrobial biofilms model were used to assess the ability of different Galla chinensis extracts to inhibit enamel demineralization, acid formation and biofilm formation. Results: All the GCE, eGCE and tannic acid contained a high level of total phenolics. HPLC-ESI-TOF-MS analysis showed that the main ingredients of GCE were gallic acid (GA), while eGCE mainly contained 4-7 galloylglucopyranoses (GGs) and tannic acid mainly contained 5-10 GGs. Furthermore, eGCE and tannic acid showed a better effect on inhibiting enamel demineralization, acid formation and biofilm formation compared to GCE. Conclusions: Galla chinensis extracts with higher tannin content were suggested to have higher potential to prevent dental caries. PMID:28979574

Thirty-eight years of water fluoridation--the Singapore scenario.

PubMed

Loh, T

1996-09-01

The high caries rate in Singapore school children was of great concern to dental administrators. Remedial measures alone were not the solution. The success of water fluoridation in Grand Rapids, USA and in Brantford, Canada in reducing dental caries in children in the early 1950s prompted Singapore to introduce fluoride into its drinking water. Singapore is the first country in Asia to institute a comprehensive fluoridation programme which covers 100 per cent of the population. The water was fluoridated at 0.7 ppm fluoride using sodium silicofluoride. The ten year study on the effects of water fluoridation in Singapore showed a decrease in caries prevalence in the children. In the permanent dentition the reduction was 52.3 per cent for Chinese and 31 per cent for Malays in the 7 to 9 year old age group. A similar trend was observed in the mixed dentition in which the decrease was 32.5 per cent for Chinese and 30.6 per cent for Malays. Because of the availability and use of other fluoride products, dental fluorosis was observed in children in later years. Although the decline in dental caries after 10 years of water fluoridation was not comparable to those achieved in other countries, this study further documents water fluoridation as the most cost-effective public health measure for the prevention of dental caries.

The role of dental hygiene in caries management: a new paradigm.

PubMed

Young, Douglas A; Lyon, Lucinda; Azevedo, Shelly

2010-01-01

Dental caries is the most common disease of children and remains a significant oral health problem worldwide for both children and adults. The traditional paradigm of treating dental caries solely by "drilling and filling," brushing and flossing and lowering sugar intake has evolved. Current science in the management of dental caries suggests a clear focus on the reduction of responsible infectious agents, remineralization of non-cavitated lesions and minimally invasive restorative approaches whenever possible. The paradigm shift is away from a purely surgical approach toward more preventive and curative clinical protocols. This paper provides a review of this caries management methodology and explores the role of the dental hygienist in this paradigm change.

Characteristics of epidemiology of dental caries in children from regions with high and optimum fluorine content in drinking water.

PubMed

Trufanova, Valentina; Sheshukova, Olha; Davydenko, Vadym; Polishchuk, Tetiana; Bauman, Sofia; Dobroskok, Vitalina

2018-01-01

Introduction: Prevention of dental diseases in children is the priority item on the modern dentistry agenda. Among the undeniable factors known as contributing into caries incidence, there is fluoride content in the external environment, especially in drinking water, which is the main source of fluoride intake. The aim: This study is aimed at evaluating dental caries indices in children and adolescents inhabiting in areas with optimal and high-level fluoride concentration in drinking water and assessing their level of oral hygiene. Materials and methods: To explore the caries epidemiology in the regions with optimal and high fluoride content, we examined 315 children aged 6, 12 and 15 who live in the city of Poltava (fluoride content in drinking water is 0.9-1.2 mg / l) and 91 children of the same age residing in the village of a town type Mashivka (fluoride content in drinking water ranges from 1.7 to 2.9 mg / l). Results: More than half of the 6-year-old children of both groups have decayed teeth. The comparative analysis of the prevalence and intensity of caries in the children aged 12 and 15 years demonstrated a significant increase in the number of individuals diagnosed to have caries with increasing age in both groups. Conclusions: Our research suggests that, along with the number of other cariogenic factors, fluorosis contributes to a more intense course of caries progression. This situation demands wider health policy measures to support primary and secondary caries prevention and management among the children.

Time until first dental caries for young children first seen in Federally Qualified Health Centers: a retrospective cohort study.

PubMed

Kuthy, Raymond A; Jones, Michael; Kavand, Golnaz; Momany, Elizabeth; Askelson, Natoshia; Chi, Donald; Wehby, George; Damiano, Peter

2014-08-01

The study assessed the time until first dental caries for young children seen at five Federally Qualified Health Centers (FQHC) in Iowa and the relationship with the frequency and gaps (in months) of dental episodes, the number of topical fluoride treatments, and the number of dentists caring for the subject. Forty children were randomly selected at each FQHC (n = 200). All children were continuously enrolled in the Medicaid program and had their first dental visit prior to age 6. Dental chart findings, claims data for the child and family, and birth certificate information were merged into one dataset. Dental visits were followed for a minimum of 36 months, including dental visits external to the FQHCs. Using time until first caries as the dependent variable, the data were subject to left, interval, and right censoring and were analyzed via Weibull regression. Slightly more than half of the 200 children experienced caries. Regression analysis indicated that the hazard of first dental caries increased by approximately 2% with each additional month that transpired between preventive recall examinations. In addition, children with older siblings who had a dental visit at the same center during the previous year prior to the subject's first visit were more likely to have a longer time until first dental caries. Timing of dental care episodes was associated with caries experience in young children from low income families. Dental professionals should focus on regularity of dental care to prevent or delay caries experience in young children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Time until first dental caries for young children first seen in Federally Qualified Health Centers: a retrospective cohort study

PubMed Central

Kuthy, RA; Jones, M; Kavand, G; Momany, E; Askelson, N; Chi, D; Wehby, G; Damiano, P

2014-01-01

Objective The study assessed the time until first dental caries for young children seen at 5 Federally Qualified Health Centers (FQHC) in Iowa and the relationship with the frequency and gaps (in months) of dental episodes, the number of topical fluoride treatments, and the number of dentists caring for the subject. Methods Forty children were randomly selected at each FQHC (n=200). All children were continuously enrolled in the Medicaid program and had their first dental visit prior to age 6. Dental chart findings, claims data for the child and family, and birth certificate information were merged into one dataset. Dental visits were followed for a minimum of 36 months, including dental visits external to the FQHCs. Using time until first caries as the dependent variable, the data were subject to left, interval, and right censoring and were analyzed via Weibull regression. Results Slightly more than half of the 200 children experienced caries. Regression analysis indicated that the hazard rate of first dental caries increased by approximately 2% with each additional month that transpired between preventive recall examinations. In addition, children with older siblings who had a dental visit at the same center during the previous year prior to the subject’s first visit were more likely to have a longer time until first dental caries. Conclusions Timing of dental care episodes was associated with caries experience in young children from low income families. Dental professionals should focus on regularity of dental care in order to prevent or delay caries experience in young children. PMID:24483730

Effect of Probiotic Lactobacillus reuteri on Salivary Cariogenic Bacterial Counts among Groups of Preschool Children in Jeddah, Saudi Arabia: A Randomized Clinical Trial.

PubMed

Alamoudi, Najlaa M; Almabadi, Eman S; El Ashiry, Eman A; El Derwi, Douaa A

2018-05-15

To evaluate the effect of probiotic Lactobacilli reuteri lozenges on caries-associated salivary bacterial counts (Mutans streptococci and Lactobacillus), dental plaque accumulation, and salivary buffer capacity in a group of preschool children. The study group consisted of 178 healthy children (aged 3-6 years). Children were randomly grouped: the experimental group (n = 90) received L. reuteri probiotic lozenges and the control group (n = 88) received placebo lozenges, twice daily, for 28 days. Salivary Mutans streptococci and Lactobacillus counts, and buffer capacity were assessed using chair-side caries-risk test (CRT®) kits. The Simplified Oral Hygiene index (OHI-S) was used to assess dental plaque accumulation at baseline and after 28 days. After 28 days, the experimental group had a statistically significant reduction in Mutans streptococci and lactobacilli (p = 0.000 and p = 0.020, respectively) and both groups had less plaque accumulation than at baseline. While the buffer capacity in the experimental group increased more than in the control group, it was not statistically significant (p = 0.577). Compliance was 90%, with no adverse events. Consumption of probiotic lozenges containing L. reuteri reduces caries-associated bacterial counts significantly. Probiotics consumption may have a beneficial caries-preventive effect.

Salivary proteins and microbiota as biomarkers for early childhood caries risk assessment

PubMed Central

Hemadi, Abdullah S; Huang, Ruijie; Zhou, Yuan; Zou, Jing

2017-01-01

Early childhood caries (ECC) is a term used to describe dental caries in children aged 6 years or younger. Oral streptococci, such as Streptococcus mutans and Streptococcus sorbrinus, are considered to be the main etiological agents of tooth decay in children. Other bacteria, such as Prevotella spp. and Lactobacillus spp., and fungus, that is, Candida albicans, are related to the development and progression of ECC. Biomolecules in saliva, mainly proteins, affect the survival of oral microorganisms by multiple innate defensive mechanisms, thus modulating the oral microflora. Therefore, the protein composition of saliva can be a sensitive indicator for dental health. Resistance or susceptibility to caries may be significantly correlated with alterations in salivary protein components. Some oral microorganisms and saliva proteins may serve as useful biomarkers in predicting the risk and prognosis of caries. Current research has generated abundant information that contributes to a better understanding of the roles of microorganisms and salivary proteins in ECC occurrence and prevention. This review summarizes the microorganisms that cause caries and tooth-protective salivary proteins with their potential as functional biomarkers for ECC risk assessment. The identification of biomarkers for children at high risk of ECC is not only critical for early diagnosis but also important for preventing and treating the disease. PMID:29125139

Dental caries in Iraqi 12-year-olds and background fluoride exposure.

PubMed

Matloob, M H

2015-09-01

The aim of this study was to assess the prevalence and severity of dental caries among 12-year-old Iraqi schoolchildren ingesting water and beverages with low fluoride content. A total of 1,526 twelve-year-olds were clinically examined in autumn 2013 for dental caries in accordance with the WHO criteria. Two questionnaires were distributed to gather data concerning daily intakes of drinking water, beverages and tea extracts and how often participants brushed their teeth, visiting doctors and eating snacks between meals. The fluoride content of 279 brands of drinking water, beverages, tea, toothpaste and table salts were determined using fluoride ion selective electrode. Results The mean DMFT and SIC index were 1.6 (SD 1.7) and 3.5 (SD 1.4) respectively. The caries prevalence was 64.0%, and the Care Index was 1.9%. The average fluoride content of drinking water, beverages, toothpaste and food was less than 0.50 mg/kg. The mean DMFT value for Iraqi 12-year-olds is still higher than the WHO category of very low caries (<1.2). The daily fluoride exposure by 12-year-old Iraqi children was too low for caries prevention. In order to improve the oral health status, the Iraqi health authorities had to focus more care on the preventive oral health programme.

[Clinical relevance of tooth brushing in relation to dental caries].

PubMed

Pita-Fernández, Salvador; Pombo-Sánchez, Antonio; Suárez-Quintanilla, Juan; Novio-Mallón, Silvia; Rivas-Mundiña, Berta; Pértega-Díaz, Sonia

2010-07-01

To determine the impact and clinical relevance of tooth brushing on oral health. Prevalence study. Fontiñas Health Centre. (Santiago de Compostela, Spain). Prevalence study (n=281 children aged 5-14 years. Odontological examination according to WHO methodology, to determine the frequency of tooth brushing, frequency of sweet consumption and their impact on the prevalence of caries. Logistic regression and estimation of the relative prevalence difference (RPD) and the Number Needed to Treat in order to prevent one additional bad outcome (NNT). The children who never brush their teeth have a 40% (95% CI: 24.3%-57.8%) of early caries, while those who brush their teeth several times a day have 15.3% (95% CI: 9.4%-23.7%). An association between not brushing the teeth and caries in primary teeth (OR=2.3; 95% CI:1.05-5.3) was observed after adjusting for age, sweet consumption and visits to the dentist. The same occurred with final teeth (OR=3.9; 95% CI:1.4-10.3). The RPD was 62%(95% CI: 30%-79%), meaning that prevalence of caries is 62% lower in children who brush their teeth several times a day as compared to those who never brush their teeth. The NNT is 4 (95% CI: 2.4-14), so for every 4 children who brush their teeth several times a day, there is one less case of caries, compared to those who never brush their teeth. There is a dose-response relationship between prevalence of caries and brushing frequency. The same effect was observed with definitive caries: RPD=55% (95% CI:16%-76%), NNT=5 (95% CI:2.8-53.3). Tooth brushing is related to oral health, with a major clinical impact. The positive effect of tooth brushing was superior to that of a correct diet. 2009 Elsevier España, S.L. All rights reserved.

A holistic food labelling strategy for preventing obesity and dental caries.

PubMed

Cinar, A B; Murtomaa, H

2009-05-01

Obesity and dental caries in childhood are among the major public health concerns described as a global pandemic because of their global distribution and severe consequences. A consensus has developed as to a recently emerging and alarming common risk factor that leads to the double burden of dental caries and obesity; energy-dense foods (sugar-coated cereals, high-sugar yogurt, soft drinks) are becoming very popular among children because of their dense marketing, cheaper price, increased supply and variety. Implementation of health-promoting and -supporting marketing strategies for healthy food can be one initial cornerstone for successful application of the common risk factor approach in prevention of obesity and dental caries, as also suggested by World Health Organization. Labelling healthy food with a 'health-friendly' logo, illustrating that the teeth and the heart are both parts of the whole body (standing side by side supporting each other as close friends), both happy and protected because of consumption of healthy food for the whole body, can promote the foods that are friendly to health of the whole body, implementing the common risk factor approach under a single theme. Labelling healthy food as 'health-friendly' based on an international consensus will provide a clear and uniform picture of what is healthy to eat and result in an international integrated programme for prevention of obesity and caries.

Enamel mineral loss.

PubMed

West, Nicola X; Joiner, Andrew

2014-06-01

To summarise the chemical, biological and host factors that impact enamel mineral loss, to highlight approaches to contemporary management of clinical conditions involving mineral loss and summarise emerging trends and challenges in this area. "Medline" and "Scopus" databases were searched electronically with the principal key words tooth, enamel, *mineral*, caries and erosion. Language was restricted to English and original studies and reviews were included. Conference papers and abstracts were excluded. Enamel mineral loss leads to the degradation of the surface and subsurface structures of teeth. This can impact their shape, function, sensitivity and aesthetic qualities. Dental caries is a multifactorial disease caused by the simultaneous interplay of dietary sugars, dental plaque, the host and time. There is a steady decline in dental caries in developed countries and the clinical management of caries is moving towards a less invasive intervention, with risk assessment, prevention, control, restoration and recall. Tooth wear can be caused by erosion, abrasion and attrition. Dental erosion can be the result of acid from intrinsic sources, such as gastric acids, or extrinsic sources, in particular from the diet and consumption of acidic foods and drinks. Its prevalence is increasing and it increases with age. Clinical management requires diagnosis and risk assessment to understand the underlying aetiology, so that optimal preventative measures can be implemented. Overall, prevention of enamel mineral loss from caries and tooth wear should form the basis of lifelong dental management. Evidence based oral hygiene and dietary advice is imperative, alongside preventive therapy, to have a healthy lifestyle, whilst retaining hard tooth tissue. © 2014 Elsevier Ltd. All rights reserved.

Measuring quality of dental care: Caries prevention services for children.

PubMed

Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

2015-08-01

The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P < .01); 18% to 37% of children with an elevated risk of experiencing caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P < .01) compared with sealants for 10- to 14-year-olds (range, 8.4-11.1%; χ(2) = 22.7; P < .01), overall sealant placement rates were lower for 10- to 14-year-olds. These evidence-based, caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention services. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

Barker, Judith C.; Hoeft, Kristin S.

2016-01-01

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. PMID:27391112

Barriers encountered using skill-mix to deliver caries prevention in dental practices.

PubMed

Hatim, Eman; Kendall, Nick

2012-04-01

This opinion paper provides an analysis of the barriers and successes experienced when developing and implementing a pilot scheme to deliver caries prevention using skill-mix in the National Health Service (NHS) General Dental Services. A training programme was initiated to develop the skills of extended duties dental nurses to deliver fluoride varnish to patients in selected dental practices in Croydon, London, UK. In the light of the evaluation of this programme, a recommendation is made that similar preventive schemes should be delivered in the future within the NHS dental contract.

Geo-mapping of caries risk in children and adolescents - a novel approach for allocation of preventive care.

PubMed

Strömberg, Ulf; Magnusson, Kerstin; Holmén, Anders; Twetman, Svante

2011-09-26

Dental caries in children is unevenly distributed within populations with a higher burden in low socio-economy groups. Thus, tools are needed to allocate resources and establish evidence-based programs that meet the needs of those at risk. The aim of the study was to apply a novel concept for presenting epidemiological data based on caries risk in the region of Halland in southwest Sweden, using geo-maps. The study population consisted of 46,536 individuals between 3-19 years of age (75% of the eligible population) from whom caries data were reported in 2010. Reported dmfs/DMFS>0 for an individual was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish. A parish-specific relative risk (RR) was calculated as the observed-to-expected ratio, where the expected number of individuals with dmfs/DMFS>0 was obtained from the age- and sex-specific caries (dmfs/DMFS>0) rates for the total study population. Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI® ArcGIS system. The geo-maps of preschool children (3-6 years), schoolchildren (7-11 years) and adolescents (12-19 years) displayed obvious geographical variations in caries risk, albeit most marked among the preschoolers. Among the preschool children the smoothed relative risk (SmRR) varied from 0.33 to 2.37 in different parishes. With increasing age, the contrasts seemed to diminish although the gross geographical risk pattern persisted also among the adolescents (SmRR range 0.75-1.20). Geo-maps based on caries risk may provide a novel option to allocate resources and tailor supportive and preventive measures within regions with sections of the population with relatively high caries rates.

Preventive Orientation of Iraqi Dentists in Baghdad in 2016

PubMed Central

Aledhari, Fatin Abd Alsttar; Gholami, Mahdia; Shamshiri, Ahmad Reza

2017-01-01

Objectives: The aim of the present study was to assess the preventive orientation of Iraqi dentists in terms of their “knowledge” and “attitude” towards caries prevention and to explore their “preventive practice”. Materials and Methods: A cross-sectional study based on a self-administered questionnaire was conducted among 159 dentists who worked in Baghdad during the summer of 2016. The questionnaires obtained information on variables such as knowledge and attitude towards preventive dentistry, preventive practice and demographic variables and were distributed during the official working time. Logistic and multiple regressions served for statistical analyses. Results: From all the respondents, 71% were females and the response rate was 94% (n=150). The mean age was 40.75±9.88 years (range 27–65 years). After checking for completeness, 90 questionnaires remained for data analysis. The most positive attitude towards preventive dental care was related to the question: “whether preventive dentistry is essential for the community” (n=75, 83%). The highest knowledge was reported in response to three questions: “frequency vs. amount of sugar consumption”, “effect of sealant on caries prevention of newly erupted molars” and “effect of dental problems on general health” (n=83, 92.2%). The regression analysis showed a significant association between attendance in the continuing educational courses and preventive practice (P=0.03). Conclusions: To improve preventive dental orientation of Iraqi dentists, dental schools should put more emphasis on the topics about preventive dentistry. This will consequently improve their practice and oral health of the community. PMID:29296109

Dental caries status and oral health practice among 12-15 year old children in Jorpati, Kathmandu.

PubMed

Khanal, S; Acharya, J

2014-09-01

Oral health is an essential component of health throughout life. There has been a decline in dental caries and periodontal disease in developed countries which can be attributed to the implementation of preventive programmes but in developing countries dental diseases are still on the rise. Therefore this cross sectional study was carried out to assess the prevalence of dental caries and oral hygiene practices among 12 to 15 years old children. Self administered close ended questionnaires were used to assess the oral hygiene practice. The overall dental caries prevalence was 58.3% and the mean DMFT score was 1.2 (± 1.79) and the deft score was 0.6 (± 1.24). Majority of the children (84.1%) presented with the practice of brushing their teeth once everyday using tooth brush and toothpaste. Regular dental check up was very poor (5.6%) but 77.4% reported that they visited a dentist in case of pain or presence of stains in the teeth. Females (63.4%) and children studying in higher secondary class (74.2%) showed a "good" level of oral hygiene practice than males and children in secondary class respectively. Children having "good" practice presented with "low" dental caries severity. The utilization of dental services was poor in the children, therefore highlighting the necessity to implement preventive programmes is important which would help in reducing the incidence of the dental caries as well as aiding in prompt treatment of dental caries at its initial stages.

Prenatal and familial factors of caries in first permanent molars in schoolchildren living in urban area of Łódź, Poland.

PubMed

Borowska-Strugińska, Beata; Żądzińska, Elżbieta; Bruzda-Zwiech, Agnieszka; Filipińska, Renata; Lubowiecka-Gontarek, Beata; Szydłowska-Walendowska, Beata; Wochna-Sobańska, Magdalena

2016-06-01

The objective of the present work is to identify the set of prenatal and familial factors that contribute to dental caries of first permanent molars in preschool and young schoolchildren, which will make it possible to determine a high-risk group that should be considered for special preventive measures. This study contributes to the evidence for the multifactorial nature of dental caries. Material was collected during a 2009-2010 study conducted in randomly selected schools and kindergartens in the city of Łódź (Poland). Only children with first permanent molars present were considered for the analysis, which limited the database to 1131 children. Dental examinations were accompanied by a questionnaire completed by the parents, covering items pertaining to prenatal and familial determinants. The present study shows that there are significant differences in the prevalence of caries in first molars between children of different ages (5-13 lat) and that no such differences exist between boys and girls. The prenatal and familial factors conducive to caries include maternal education level (OR=0.55), mode of delivery (OR=0.63) and birth order (OR=0.63). Mothers' smoking habit is also associated with increased caries prevalence in children. Caries prevention should already begin during the prenatal period primarily in respect of mothers with lower educational attainment who are pregnant with a second or subsequent child. Copyright © 2015 Elsevier GmbH. All rights reserved.

Technological advances in caries diagnosis.

PubMed

Rochlen, Glenn K; Wolff, Mark S

2011-07-01

Understanding the nature of the caries lesion, disease activity, and the patient's caries risk are all used in determining the nature of dental care to be delivered. An examination should include a health and social history and clinical examination using appropriate technologies. This allows proper assessment and suggests a logical management intervention. Minimally invasive dentistry is a concept based on an assessment of a patient's caries risk and the application of the current therapies to prevent, control, and treat the disease. The history of the dental examination and the variety of current technologies are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

Preventive benefit of access to fluoridated water for young adults.

PubMed

Spencer, A John; Liu, Pingzhou; Armfield, Jason Mathew; Do, Loc Giang

2017-06-01

Water fluoridation has been repeatedly associated with lower caries experience in children but uncertainty still exists on strength and extent of the association into adulthood. To analyze the preventive effect of access to fluoridated water on dental caries among young adults. In 1991/92 a cross-section of South Australian children aged 5-17 were recruited. Parents provided information on residential history, socioeconomic status, and behaviors. Children were dentally examined. Across 2006/2011, these participants were traced and recruited to follow-up examination. Similar data were updated. Residential history was used to compute percent lifetime access to fluoridated water (%LAFW). The participants underwent examinations scoring tooth surfaces decayed, missing and filled due to caries (DMFS). Unadjusted and adjusted models were generated using generalized linear modeling to estimate rate ratios (RR). Half of the 1991/92 participants traced could be recruited (n = 1,221) aged 20-35 years. Mean DMFS was 5.57 (95 percent CI: 5.0-6.1). Adjusted RR of DMFS for %LAFW (Birth-2006) 0-75 percent against 100 percent was 1.26 (1.01-1.57). RRs for 0-75 percent against 100 percent of %LAFW (1991-2006) and %LAFW (Birth-2006) were higher than that for %LAFW (Birth-1991). However, these differences were small once the comparisons were adjusted for all covariates. Early life access to fluoridated water was not as strongly associated with caries outcomes than either full lifetime access or access across the more proximal years with the caries outcome of young adults, especially after adjustment for covariates which may become increasingly important across longer spans of the life course. © 2017 American Association of Public Health Dentistry.

[Anticaries effectiveness of fluoride toothpaste: a meta-analysis].

PubMed

Chaves, Sônia Cristina Lima; Vieira-da-Silva, Lígia Maria

2002-10-01

To carry out a meta-analysis on the effectiveness of fluoride toothpaste for reducing dental caries to calculate the effect size of different hypothesis. MEDLINE and LILACS databases were studied in the period from 1980 to 1998. To evaluate the quality of the studies, methodological rigor criteria proposed by Kay & Locker (1996) were applied after the criteria were submitted to an expert committee of CNPq (National Scientific Council of Brazil) senior researchers. Of 43 papers selected, 22 met the proposed criteria. The effect size of intervention was calculated from differences among the groups and the overall effect of five groups of hypothesis. The high concentration of fluoride in the toothpaste is associated with a larger effect (overall effect = -0.17 CI 95% -0.22/-0.12). The largest caries reductions were observed when comparing fluoride toothpastes and no fluoride toothpastes (overall effect = -0.29 IC 95% -0.34/-0.24). The addiction of antimicrobial agents (overall effect = -0.03 IC 95% -0.07/+0.02), differences in abrasive systems (overall effect = -0.02 IC 95% -0.09/+0.04) and active components do not increase the effectiveness of fluoride toothpastes (overall effect = -0.04 IC 95% -0.10/+0.01). The highest caries reductions were seen in studies where there was supervised tooth brushing. This review reinforced the importance of tooth brushing with fluoride toothpastes for controlling dental caries. However it showed the emphasis put on medical approaches for disease control rather than specific educational actions. The heterogeneity of the results shows the need to consider issues such as the scenario for implementing preventive methods in the evaluation process.

Prevalence of dental caries in primary and permanent teeth and its relation with tooth brushing habits among schoolchildren in Eastern Saudi Arabia

PubMed Central

Farooqi, Faraz A.; Khabeer, Abdul; Moheet, Imran A.; Khan, Soban Q.; Farooq, Imran; ArRejaie, Aws S.,

2015-01-01

Objectives: To determine the prevalence of dental caries in the primary and permanent teeth, and evaluate the brushing habits of school children in Dammam, Kingdom of Saudi Arabia (KSA). Methods: This study was conducted at Dammam, KSA. Oral examination of the participants was conducted from February to May 2014. The total sample size for this cross-sectional study was 711. There were 397 children between the age of 6-9 years, who were examined for primary teeth caries, and 314 between the age 10-12 years were examined for permanent teeth caries. Primary and permanent dentitions were studied for decayed, missing, and filled teeth (dmft [primary teeth], DMFT [permanent teeth]). Results: The overall prevalence of dental caries in primary and permanent teeth was almost 73% (n=711). Among the 6-9-year-old, the prevalence of caries was approximately 78% (n=397) whereas, among the 10-12-year-old children, it was approximately 68% (n=314). Mean dmft value among the 6-9-year-olds was 3.66±3.13 with decayed (d) component of 3.28±2.92, missing (m) component of 0.11±0.69, and filled (f) component of 0.26±0.9. Mean DMFT value among the 10-12-year-old children was 1.94±2.0 with decayed (D) component of 1.76±1.85, missing (M) component of 0.03±0.22, and filled (F) of component 0.15±0.73. Daily tooth brushing had a positive effect on caries prevention, and this effect was statistically significant for caries in primary teeth. Conclusion: Although the prevalence of dental caries in primary and permanent teeth was not found to be as high as other researchers reported from different cities of KSA, still the prevalence was high considering the World Health Organization future oral health goals. Awareness should be provided to students, as well as, teachers and parents regarding the importance of good brushing habits and regular dental visits. PMID:25987118

Prevalence of dental caries in primary and permanent teeth and its relation with tooth brushing habits among schoolchildren in Eastern Saudi Arabia‬‬‬‬‬‬‬‬.

PubMed

Farooqi, Faraz A; Khabeer, Abdul; Moheet, Imran A; Khan, Soban Q; Farooq, Imran; ArRejaie, Aws S

2015-06-01

To determine the prevalence of dental caries in the primary and permanent teeth, and evaluate the brushing habits of school children in Dammam, Kingdom of Saudi Arabia (KSA).  Methods. This study was conducted at Dammam, KSA. Oral examination of the participants was conducted from February to May 2014. The total sample size for this cross-sectional study was 711. There were 397 children between the age of 6-9 years, who were examined for primary teeth caries, and 314 between the age 10-12 years were examined for permanent teeth caries. Primary and permanent dentitions were studied for decayed, missing, and filled teeth (dmft [primary teeth], DMFT [permanent teeth]).   The overall prevalence of dental caries in primary and permanent teeth was almost 73% (n=711). Among the 6-9-year-old, the prevalence of caries was approximately 78% (n=397) whereas, among the 10-12-year-old children, it was approximately 68% (n=314). Mean dmft value among the 6-9-year-olds was 3.66±3.13 with decayed (d) component of 3.28±2.92, missing (m) component of 0.11±0.69, and filled (f) component of 0.26±0.9. Mean DMFT value among the 10-12-year-old children was 1.94±2.0 with decayed (D) component of 1.76±1.85, missing (M) component of 0.03±0.22, and filled (F) of component 0.15±0.73. Daily tooth brushing had a positive effect on caries prevention, and this effect was statistically significant for caries in primary teeth.   Although the prevalence of dental caries in primary and permanent teeth was not found to be as high as other researchers reported from different cities of KSA, still the prevalence was high considering the World Health Organization future oral health goals. Awareness should be provided to students, as well as, teachers and parents regarding the importance of good brushing habits and regular dental visits.

Efficacy of chlorhexidine varnish for the prevention of adult caries: a randomized trial.

PubMed

Papas, A S; Vollmer, W M; Gullion, C M; Bader, J; Laws, R; Fellows, J; Hollis, J F; Maupomé, G; Singh, M L; Snyder, J; Blanchard, P

2012-02-01

The Prevention of Adult Caries Study, an NIDCR-funded multicenter, double-blind, randomized clinical trial, enrolled 983 adults (aged 18-80 yrs) at high risk for developing caries (20 or more intact teeth and 2 or more lesions at screening) to test the efficacy of a chlorhexidine diacetate 10% weight per volume (w/v) dental coating (CHX). We excluded participants for whom the study treatment was contraindicated or whose health might affect outcomes or ability to complete the study. Participants were randomly assigned to receive either the CHX coating (n = 490) or a placebo control (n = 493). Coatings were applied weekly for 4 weeks and a fifth time 6 months later. The primary outcome (total net D(1-2)FS increment) was the sum of weighted counts of changes in tooth surface status over 13 months. We observed no significant difference between the two treatment arms in either the intention-to-treat or per-protocol analyses. Analysis of 3 protocol-specified secondary outcomes produced similar findings. This trial failed to find that 10% (w/v) chlorhexidine diacetate coating was superior to placebo coating for the prevention of new caries (Clinicaltrials.gov registration number NCT00357877).

[The impact of childhood caries].

PubMed

Madrid, Carlos; Abarca, Marcelo; Bouferrache, Kahina; Gehri, Mario; Bodenmann, Patrick; Pop, Sabina

2012-04-04

The early childhood caries affect primary dentition before the eruption of the permanent teeth. It is set to extended use of a bottle containing fermentable carbohydrates. The early childhood caries is not only a dental disease: it is a social, cultural and behavioral condition that reflects the practices and beliefs around the child. Swiss data indicate that in aged 2 children, one of for could be affected by this devastating oral disease, mainly in vulnerable populations. The primary care physician has an important role in the screening of preschool children, in determining the risk level of the child for early childhood caries. Physicians can advise families, especially pregnant women, about preventive measures and behavior, leading to a dramatic drop of early childhood caries prevalence.

[Recent achievements in the microbiological etiology of dental caries].

PubMed

Jing, Chen; Lei, Cheng; Xuedong, Zhou; Xian, Peng

2018-02-01

Dental caries is the most common chronic infectious disease of the oral cavity. The bacterium Streptococcus mutans is the sole pathogen that causes this disease. However, substantial evidence suggests that prevention and treatment strategies developed from traditional "cariogenic pathogen theory" are inefficient in reducing the prevalence of dental caries. An increasing number of individuals adopt the ecological view of the microbiota in the pathogenesis of dental caries. Recent technological improvements have enabled the detection and analysis of oral microorganisms, and many studies have focused on this area. The core microbiota is defined as a cluster of microbes playing critical roles in the initial and development phases of dental caries and may provide future direction for microorganism-related etiological studies.

21 CFR 355.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Anticaries drug. A drug that aids in the prevention and prophylactic treatment of dental cavities (decay, caries). (d) Dental caries. A disease of calcified tissues of teeth characterized by demineralization of... of dental plaque, debris, and stain from tooth surfaces. (b) Anhydrous glycerin. An ingredient that...

Caries prevention during pregnancy: results of a 30-month study.

PubMed

Brambilla, E; Felloni, A; Gagliani, M; Malerba, A; García-Godoy, F; Strohmenger, L

1998-07-01

The purpose of this 30-month study was to explore the effectiveness of a caries-preventive regimen in lowering the salivary mutans streptococci level in pregnant women and, subsequently, in inhibiting the growth of these bacteria in their young children. Beginning at the end of the sixth month of pregnancy and continuing until delivery, subjects rinsed daily with 0.05 percent sodium fluoride and 0.12 percent chlorhexidine. The authors monitored the salivary mutans streptococci levels during the last six months of pregnancy and every six months thereafter for 24 months. They also measured bacterial levels in the children every six months until they reached age 24 months. The results show that treatment significantly reduced salivary mutans streptococci levels in mothers and delayed the colonization of bacteria in their children for about four months.

Anti-Streptococcal activity of Brazilian Amazon Rain Forest plant extracts presents potential for preventive strategies against dental caries

PubMed Central

da SILVA, Juliana Paola Corrêa; de CASTILHO, Adriana Lígia; SARACENI, Cíntia Helena Couri; DÍAZ, Ingrit Elida Collantes; PACIÊNCIA, Mateus Luís Barradas; SUFFREDINI, Ivana Barbosa

2014-01-01

Caries is a global public health problem, whose control requires the introduction of low-cost treatments, such as strong prevention strategies, minimally invasive techniques and chemical prevention agents. Nature plays an important role as a source of new antibacterial substances that can be used in the prevention of caries, and Brazil is the richest country in terms of biodiversity. Objective In this study, the disk diffusion method (DDM) was used to screen over 2,000 Brazilian Amazon plant extracts against Streptococcus mutans. Material and Methods Seventeen active plant extracts were identified and fractionated. Extracts and their fractions, obtained by liquid-liquid partition, were tested in the DDM assay and in the microdilution broth assay (MBA) to determine their minimal inhibitory concentrations (MICs) and minimal bactericidal concentrations (MBCs). The extracts were also subjected to antioxidant analysis by thin layer chromatography. Results EB271, obtained from Casearia spruceana, showed significant activity against the bacterium in the DDM assay (20.67±0.52 mm), as did EB1129, obtained from Psychotria sp. (Rubiaceae) (15.04±2.29 mm). EB1493, obtained from Ipomoea alba, was the only extract to show strong activity against Streptococcus mutans (0.08 mg/mL

Profile of Dental Caries in Teenagers in Mumbai City Visiting Nair Hospital Dental College.

PubMed

Banga, Kulvinder Singh; Rastogi, Sweta; Mistry, Siddhi

2018-01-01

Witnessing the alarming rise and pattern of distribution of dental caries worldwide, the need of the hour is to take initiative in preventing the spread further. This survey was conducted to determine the occurrence of dental caries and its associated risk factors in teenagers of Mumbai city who visited Nair Hospital Dental College. The objective of the study was to analyze the current dietary habits, oral hygiene status, and the number of sugar exposures in teenagers by a questionnaire followed by clinical examination which was carried out using International Caries Detection and Assessment System (ICDAS) II to detect the profile of dental caries. The data obtained from the questionnaire and examination were analyzed using Chi-square test. The survey showed that, out of the 300 teenagers examined, 67% visited the dentist only when they were symptomatic. Around 60% consumed sweets 2-3 times/day. A major percentage, 89%, consumed sweets irrespective of meal time and 52% consumed aerated drinks often. Only 16% used appropriate brushing techniques and 93% were not aware if their toothpaste was fluoridated. ICDAS II revealed that a total number of teeth requiring preventive treatment ranged from 8.3% to 14% and total number of teeth requiring definitive treatment ranged from 36% to 48%. It was found that tooth most commonly treated was 36 followed by tooth number 46 showing that the incidence of caries is higher in lower arch. Most of the teenagers had a high rate of sweet consumption in between meals and poor knowledge of brushing techniques, fluoridated toothpaste, interdental aids, and mouthrinses. ICDAS showed a high incidence of caries in teenagers, especially in the lower arch. ICDAS II showed good accuracy in differentiating between noncavitated and cavitated lesions which helps to provide an accurate treatment plan for teenagers so that it prevents the progression of the lesion.

Distal caries of the second molar in the presence of a mandibular third molar - a prevention protocol.

PubMed

Toedtling, V; Coulthard, P; Thackray, G

2016-09-23

Objectives The objectives of the prospective study were to establish the prevalence of distal caries (DC) in the mandibular second molar and to assess the outcomes of these diseased teeth in our population. Further aims were to identify associated risk factors and to design a protocol for prevention.Methods Clinical and radiographic data from 210 consecutive patients were ascertained over a three-month period. The sample population included all patients who had been referred to a hospital oral surgery department for a lower wisdom tooth assessment.Results A total of 224 mandibular third molars were included and assessed. The prevalence of caries affecting the distal aspect of the second molar was 38% (n = 85) in this population. In 18% of patients there was evidence of early enamel caries. Fifty-eight percent of caries was managed with restorative treatment but 11% of patients required second molar extraction and 13% of patients required the removal of the second and third molars. The prevalence of distal caries was significantly higher in patients with partially erupted wisdom teeth positioned below the amelocemental junction (P <0.05) of the adjacent second molar and in patients who presented with mesioangular impactions (P <0.001). However there was no difference in dental health when comparing this group to the remaining study population (P = 0.354). The Pearson chi-square test and Pearson correlation coefficient were used to verify the association between the tested variables.Conclusion This study demonstrates that the eruption status, type of angulation and the nature of tooth contact between both molars are useful disease predictors which can be used to indicate the likelihood of a caries process occurring on the distal aspect of the second mandibular molar. If patients' third molar teeth are not removed then consideration needs to be given to prevention and regular monitoring.

Dental caries in rural Alaska Native children--Alaska, 2008.

PubMed

2011-09-23

In April 2008, the Arctic Investigations Program (AIP) of CDC was informed by the Alaska Department of Health and Social Services (DHSS) of a large number of Alaska Native (AN) children living in a remote region of Alaska who required full mouth dental rehabilitations (FMDRs), including extractions and/or restorations of multiple carious teeth performed under general anesthesia. In this remote region, approximately 400 FMDRs were performed in AN children aged <6 years in 2007; the region has approximately 600 births per year. Dental caries can cause pain, which can affect children's normal growth and development. AIP and Alaska DHSS conducted an investigation of dental caries and associated risk factors among children in the remote region. A convenience sample of children aged 4-15 years in five villages (two with fluoridated water and three without) was examined to estimate dental caries prevalence and severity. Risk factor information was obtained by interviewing parents. Among children aged 4-5 years and 12-15 years who were evaluated, 87% and 91%, respectively, had dental caries, compared with 35% and 51% of U.S. children in those age groups. Among children from the Alaska villages, those aged 4-5 years had a mean of 7.3 dental caries, and those aged 12-15 years had a mean of 5.0, compared with 1.6 and 1.8 dental caries in same-aged U.S. children. Of the multiple factors assessed, lack of water fluoridation and soda pop consumption were significantly associated with dental caries severity. Collaborations between tribal, state, and federal agencies to provide effective preventive interventions, such as water fluoridation of villages with suitable water systems and provision of fluoride varnishes, should be encouraged.

Caries prevalence of school-going boys and girls according to cleaning methods and soft drink-taking frequency in different localities, in and around Guwahati City.

PubMed

Kalita, Chandana; Choudhary, Bapukan; Saikia, Anjan Kumar; Sarma, Pratap Chandra

2016-01-01

Dental caries is a multifactorial disease, causes of which are mostly understood nowadays. This disease is not only treatable but also preventable, if detected in its initial stage. In a developing country like India, facility of dental treatment is available mostly for urban population, whereas a very common approach of dental disease treatment is still traditional for the rural people. The objective of this study was to find out the prevalence of dental caries, teeth cleaning methods, and sweet and soft drink-taking frequency among boys and girls of Guwahati City and its nearby semi-urban and rural areas. Cross sectional study was carried out among school going boys and girls of 3-17 years group, using the modified WHO oral health survey form. The number of population was 2396 from urban locality, 2370 from semi-urban, and 2467 from rural. Caries prevalence is much higher in urban (62.77%), contrary to rural where 76% of the sample is caries free. Those who take sweet occasionally suffered less or almost caries free (7.93% in urban and 0% in rural) than among those who consume it more than five times a day (90.75% in urban, 100% in semi-urban, and 99.33% in rural). Urban localities are two times and semi-urban areas are 1.64 times more at risk of dental caries than rural areas. The odds ratio for cleaning frequency shows that the effect of cleaning by brush on caries is less (78%, not significant) than chewing stick while the risk associated with finger and charcoal use is about 19.63 times and 7.11 times, respectively.

Effective use of fluorides in the People's Republic of China--a model for WHO Mega Country initiatives.

PubMed

Petersen, P E; Kwan, S; Zhu, L; Zhang, B X; Bian, J Y

2008-12-01

Poor dental health has been reported in the Chinese National Surveys of Oral Health. With the changing lifestyle and growing consumption of sugars, the incidence of dental caries may well continue to rise, compounded by limited access to professional care. The increasing oral disease burden could become a major public health problem in China, leading to considerable personal and health service costs. There is a desperate need for systematic implementation of preventive programmes. Currently, China is strengthening the prevention of chronic diseases, which provides an excellent opportunity to integrate oral disease prevention into the overall non-communicable disease (NCD) prevention programmes. In order to address this growing public health problem, the World Health Organization (WHO) Global Oral Health Programme advocates the effective use of fluoride as an essential approach to prevent dental caries in the 21st century--part of the WHO Global Oral Health Strategy. Population-wide automatic fluoridation measures are considered the most effective, complemented by appropriate use of toothpastes containing fluoride. There are wide variations of fluoride levels in drinking water in China and, in many areas, the levels of fluoride in drinking water are lower than the recommended levels. The use of toothpaste containing fluoride is still too low in some areas and decreases with age. Those who live in rural areas have limited access to affordable toothpastes containing fluoride. In March 2006, as part of the WHO Mega Country Health Promotion Network initiatives, the WHO Global Oral Health Programme organised a three-day symposium in Beijing, People's Republic of China. The aim of the symposium was to bring together international experience and Chinese expertise to facilitate policy development for effective use of fluoride in China, highlighting the benefits of, and barriers to, the implementation of different fluoridation programmes at the strategic levels as well as for operational planning. This article reports the proceedings of the meeting. In summary, China is a Mega country with much diversity and disparity. The situation in China is unique with endemic fluorosis due to other non-water sources of fluoride in some areas and a considerable dental caries burden in others. It is important to regulate the appropriate exposure to fluoride to obtain the benefits and avoid adverse effects of fluorides, controlling enamel fluorosis without jeopardising the prevention of dental caries. Various complementary fluoridation programmes can be considered for different population groups with varying needs, strategies that bring about additive effects. A multi-tier policy making approach at national, regional and provincial levels can be employed, based on sound evidence. The roles of WHO, Ministry of Health and the National Committee for Oral Health (NCOH) were emphasised. Lessons learned from the Chinese experience will prove invaluable to other countries with similar socio demographic characteristics that are in the same process of developing and implementing fluoridation policies and programmes.

Dental complications of rickets in early childhood: case report on 2 young girls.

PubMed

Davit-Béal, Tiphaine; Gabay, Julie; Antoniolli, Pauline; Masle-Farquhar, Jeanne; Wolikow, Maryse

2014-04-01

Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Due to inadequate vitamin D intake and/or decreased sunlight exposure, vitamin D deficiency has resurfaced in developed countries despite known inexpensive and effective preventive methods. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Deficiency during pregnancy can cause enamel hypoplasia of primary teeth. Enamel regeneration is currently impossible; hypoplasia is therefore irreversible, and once affected, teeth are prone to fast caries development. Deficiency during early childhood can affect permanent teeth and ensuing caries can sometimes lead to tooth loss at a young age. Oral manifestations of rickets should be diagnosed early by both physicians and dentists to prevent severe dental complications. This case study presents 2 young girls with rickets in early childhood who suffered from subsequent serious tooth decay.

Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

PubMed

Kranz, Ashley M; Preisser, John S; Rozier, R Gary

2015-07-01

Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS. We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regression models estimated the association between number of visits with POHS and (1) decayed, missing, and filled primary teeth (dmft) and (2) untreated decayed teeth while adjusting for confounding. Kindergarten students with ≥4 POHS visits averaged an adjusted 1.82 dmft (95% confidence interval: 1.55 to 2.09), which was significantly less than students with 0 visits (2.21 dmft; 95% confidence interval: 2.16 to 2.25). The mean number of untreated decayed teeth was not reduced for students with ≥4 POHS visits compared with those with 0 visits. POHS provided by nondental providers in medical settings were associated with a reduction in caries experience in young children but were not associated with improvement in subsequent use of treatment services in dental settings. Efforts to promote oral health in medical settings should continue. Strategies to promote physician-dentist collaborations are needed to improve continuity of care for children receiving dental services in medical settings. Copyright © 2015 by the American Academy of Pediatrics.

Erratum to "Clinical evaluation of the intraoral fluoride releasing system in radiation-induced xerostomic subjects. Part 2: Phase I study".

PubMed

Chambers, Mark S; Fleming, Terence J; Toth, Béla B; Lemon, James C; Craven, Timothy E; Bouwsma, Otis J; Garden, Adam S; Espeland, Mark A; Keene, Harris J; Martin, Jack W; Sipos, Tibor

2007-01-01

Radiation-induced xerostomia can result in the rapid onset and progression of dental caries in head and neck cancer patients. Topically applied fluorides have been successfully used to inhibit the formation of dental caries in this population. However, because intensive daily self-application is required, compliance is an issue. The intraoral fluoride-releasing system (IFRS) containing a sodium fluoride core is a newly developed, sustained-release, passive drug delivery system that does not require patient involvement except for periodic replacement, thus reducing the effect of patient compliance on its effectiveness in dental caries prevention. Twenty-two head and neck cancer patients from U. T. M. D. Anderson Cancer Center, with radiation-induced xerostomia, were entered into a pilot study to contrast the daily home use of a 0.4% stannous fluoride-gel-containing tray (control group) to IFRS (study group) with respect to tolerability and adherence, and to obtain information on relative caries preventive efficacy. Participants were stratified on the basis of radiation exposure and randomly assigned to treatment with either IFRS or stannous fluoride gel. Patients in both groups were fitted with two IFRS retainers and also were instructed to use a 1100-ppm fluoride conventional sodium fluoride dentifrice twice daily. The study was conducted as a single-blinded, parallel-cell trial. Pre-existing carious lesions were restored prior to the beginning of the study. The efficacy variable was determined by the mean number of new or recurrent decayed surfaces. Patients were examined for caries 4, 8, 12, 24, 36, and 48 weeks after initiation of treatment. Reports of adverse reactions were based on information volunteered by patients and that were elicited during interviews. At baseline, the resting and stimulated salivary flow rates (g/5min) were significantly greater in the control group than in the study group (p<0.05). Patients in the control group had received significantly more radiation than those in the test group (68Gy vs. 60Gy; p=0.047). No marked differences in follow-up new and recurrent caries were found between the stannous fluoride gel control and IFRS groups during the study period. The rate of new or recurrent carious lesions in the group treated with the fluoride gel was slightly lower than in the IFRS group, based on carious lesions at the baseline examination (Poisson mean number of new or recurrent carious lesions for the control group=0.55 per year vs. 0.83 per year for the study group, p=0.705; odds ratio of the occurrence of any new or recurrent caries during follow-up for control group vs. the study group=0.80; p=0.781). This pilot study revealed that the IFRS was well-tolerated and safe in this study population associated with minimal complications during the duration of this study and was comparable in efficacy to a SnF(2) gel in preventing caries development. The IFRS provided similar rates of control for caries formation to a fluoride-gel-containing tray. The IFRS is designed to release a daily dose of 0.12mg of sodium fluoride, which can be evenly distributed throughout the oral cavity for a single application of 4 months. It would be more convenient than the daily home application of a tray of 0.4% stannous fluoride or 1.1% sodium fluoride gel, and avoids the problem of variable patient compliance.

Clinical evaluation of the intraoral fluoride releasing system in radiation-induced xerostomic subjects. Part 2: Phase I study.

PubMed

Chambers, Mark S; Mellberg, James R; Keene, Harris J; Bouwsma, Otis J; Garden, Adam S; Sipos, Tibor; Fleming, Terence J

2006-10-01

Radiation-induced xerostomia can result in the rapid onset and progression of dental caries in head and neck cancer patients. Topically applied fluorides have been successfully used to inhibit the formation of dental caries in this population. However, because intensive daily self-application is required, compliance is an issue. The intraoral fluoride-releasing system (IFRS) containing a sodium fluoride core is a newly developed, sustained-release, passive drug delivery system that does not require patient involvement except for periodic replacement, thus reducing the effect of patient compliance on its effectiveness in dental caries prevention. Twenty-two head and neck cancer patients from U. T. M. D. Anderson Cancer Center, with radiation-induced xerostomia, were entered into a pilot study to contrast the daily home use of a 0.4% stannous fluoride-gel-containing tray (control group) to IFRS (study group) with respect to tolerability and adherence, and to obtain information on relative caries preventive efficacy. Participants were stratified on the basis of radiation exposure and randomly assigned to treatment with either IFRS or stannous fluoride gel. Patients in both groups were fitted with two IFRS retainers and also were instructed to use a 1100-ppm fluoride conventional sodium fluoride dentifrice twice daily. The study was conducted as a single-blinded, parallel-cell trial. Pre-existing carious lesions were restored prior to the beginning of the study. The efficacy variable was determined by the mean number of new or recurrent decayed surfaces. Patients were examined for caries 4, 8, 12, 24, 36, and 48 weeks after initiation of treatment. Reports of adverse reactions were based on information volunteered by patients and that were elicited during interviews. At baseline, the resting and stimulated salivary flow rates (g/5min) were significantly greater in the control group than in the study group (p<0.05). Patients in the control group had received significantly more radiation than those in the test group (68Gy vs. 60Gy; p=0.047). No marked differences in follow-up new and recurrent caries were found between the stannous fluoride gel control and IFRS groups during the study period. The rate of new or recurrent carious lesions in the group treated with the fluoride gel was slightly lower than in the IFRS group, based on carious lesions at the baseline examination (Poisson mean number of new or recurrent carious lesions for the control group=0.55 per year vs. 0.83 per year for the study group, p=0.705; odds ratio of the occurrence of any new or recurrent caries during follow-up for control group vs. the study group=0.80; p=0.781). This pilot study revealed that the IFRS was well-tolerated and safe in this study population associated with minimal complications during the duration of this study and was comparable in efficacy to a SnF(2) gel in preventing caries development. The IFRS provided similar rates of control for caries formation to a fluoride-gel-containing tray. The IFRS is designed to release a daily dose of 0.12mg of sodium fluoride, which can be evenly distributed throughout the oral cavity for a single application of 4 months. It would be more convenient than the daily home application of a tray of 0.4% stannous fluoride or 1.1% sodium fluoride gel, and avoids the problem of variable patient compliance.

Simple predictive model for Early Childhood Caries of Chilean children.

PubMed

Fierro Monti, Claudia; Pérez Flores, M; Brunotto, M

2014-01-01

Early Childhood Caries (ECC), in both industrialized and developing countries, is the most prevalent chronic disease in childhood and it is still a health public problem, affecting mainly populations considered as vulnerable, despite being preventable. The purpose of this study was to obtain a simple predictive model based on risk factors for improving public health strategies for ECC prevention for 3-5 year-old children. Clinical, environmental and psycho-socio-cultural data of children (n=250) aged 3-5 years, of both genders, from the Health Centers, were recorded in a Clinical History and Behavioral Survey. 24% of children presented behavioral problems (bizarre behavior was the main feature observed as behavioral problems). The variables associated to dmf ?4 were: bad children temperament (OR=2.43 [1.34, 4.40]) and home stress (OR=3.14 [1.54, 6.41]). It was observed that the model for male gender has higher accuracy for ECC (AUC= 78%, p-value=0.000) than others. Based on the results, we proposed a model where oral hygiene, sugar intake, male gender, and difficult temperament are main factors for predicting ECC. This model could be a promising tool for cost-effective early childhood caries control.

Is mother-child transmission a possible vehicle for xylitol prophylaxis in acute otitis media?

PubMed

Danhauer, Jeffrey L; Kelly, Allison; Johnson, Carole E

2011-10-01

Xylitol can be a prophylaxis for acute otitis media (AOM), especially when administered via chewing gum, but that vehicle has limitations for children. This review sought evidence for links of mother-child transmission of bacteria and as a vehicle for xylitol as a prophylaxis for dental caries and its translation to AOM in infants and young children. Qualitative systematic review. Combining output from 43 search strings used earlier and submitting 20 new strings to PubMed resulted in 14 studies (six were excluded; eight were included). Included studies had to be published in English-language, peer-reviewed journals; involve mothers using xylitol; and assess bacteria or caries in their children. Evaluation forms were completed for search, retrieval, and quality assessment of included studies. The studies showed that mothers' chewing xylitol gum was a prophylaxis against bacteria and caries in their children. A mother-child transmission model was presented as a possible vehicle for use in comprehensive prevention programs for AOM. Potential for xylitol use to prevent AOM warrants further study. A mother-child model may apply to AOM for transmission of bacteria and as a prophylaxis, but alternative vehicles like nasal sprays should be investigated for ease of use and effectiveness.

Global Oral Health Inequalities

PubMed Central

Pitts, N.; Amaechi, B.; Niederman, R.; Acevedo, A.-M.; Vianna, R.; Ganss, C.; Ismail, A.; Honkala, E.

2011-01-01

The IADR Global Oral Health Inequalities Task Group on Dental Caries has synthesized current evidence and opinion to identify a five-year implementation and research agenda which should lead to improvements in global oral health, with particular reference to the implementation of current best evidence as well as integrated action to reduce caries and health inequalities between and within countries. The Group determined that research should: integrate health and oral health wherever possible, using common risk factors; be able to respond to and influence international developments in health, healthcare, and health payment systems as well as dental prevention and materials; and exploit the potential for novel funding partnerships with industry and foundations. More effective communication between and among the basic science, clinical science, and health promotion/public health research communities is needed. Translation of research into policy and practice should be a priority for all. Both community and individual interventions need tailoring to achieve a more equal and person-centered preventive focus and reduce any social gradient in health. Recommendations are made for both clinical and public health implementation of existing research and for caries-related research agendas in clinical science, health promotion/public health, and basic science. PMID:21490233

Relation between Dental Caries and Body Mass Index-for-age among Schoolchildren of Jazan City, Kingdom of Saudi Arabia.

PubMed

Quadri, Mir Fa; Hakami, Bassam M; Hezam, Asma Aa; Hakami, Raed Y; Saadi, Fadwa A; Ageeli, Layla M; Alsagoor, Wafqah H; Faqeeh, Mohammad A; Dhae, Mohammed A

2017-04-01

To analyze and report the type of relation present between dental caries and body mass index (BMI)-for-age among schoolchildren in Jazan region of Kingdom of Saudi Arabia. A cross-sectional study with multi-staged random sampling technique was designed to recruit the sample of schoolchildren. Caries was examined using the World Health Organization recommended "decayed and filled teeth"/"decayed missing and filled teeth (dft/DMFT)" method. The BMI-for-age was calculated using the value obtained from body weight and height (kg/m 2 ) of each child. The obtained results were plotted on age- and gender-specific percentile curves by the Centers for Disease Control and Prevention and categorized accordingly. Chi-squared test was conducted to analyze the relation between BMI-for-age and dental caries. Logistic regression was performed to judge the predictor variables. The p-value < 0.05 was considered as significant. A total of 360 children were part of this study with equal recruitment from both genders. The mean dft/DMFT value for girls (2.52) was more than that for boys (1.88); and the (p = 0.00) calculated value was statistically significant. Most of the children had normal BMI-for-age (60.6%) and very few were obese (4.7%). Dental caries, fast food, and snacks between meals were significant independent predictor variables for BMI (p < 0.05). Dental caries was a strong predictor, and the analysis showed that children with untreated caries had 81% (odds ratio = 0.19; confidence interval = 0.65, 0.58) higher chance of suffering from low BMI. To conclude, this is the first study attempted to see the relationship between BMI-for-age and dental caries among schoolchildren in Jazan city of Kingdom of Saudi Arabia. Negative relation between dental caries and BMI should warrant health promoters about dental caries as a reason for low BMI in a subset of children. High and alarming percentage of untreated dental caries demonstrates the oral health needs among the schoolgoing children in Jazan region. Public health dentists should develop and implement prevention programs so that the oral health issues among schoolchildren are addressed.

Sugar Alcohols, Caries Incidence, and Remineralization of Caries Lesions: A Literature Review

PubMed Central

Mäkinen, Kauko K.

2010-01-01

Remineralization of minor enamel defects is a normal physiological process that is well known to clinicians and researchers in dentistry and oral biology. This process can be facilitated by various dietary and oral hygiene procedures and may also concern dentin caries lesions. Dental caries is reversible if detected and treated sufficiently early. Habitual use of xylitol, a sugar alcohol of the pentitol type, can be associated with significant reduction in caries incidence and with tooth remineralization. Other dietary polyols that can remarkably lower the incidence of caries include erythritol which is a tetritol-type alditol. Based on known molecular parameters of simple dietary alditols, it is conceivable to predict that their efficacy in caries prevention will follow the homologous series, that is, that the number of OH-groups present in the alditol molecule will determine the efficacy as follows: erythritol ≥ xylitol > sorbitol. The possible difference between erythritol and xylitol must be confirmed in future clinical trials. PMID:20339492

Contemporary multilevel analysis of the effectiveness of water fluoridation in Australia.

PubMed

Do, Loc; Spencer, A John

2015-02-01

Water fluoridation was extended in Queensland, Australia, across 2009-2011. A research program was commenced to inform the rationale for and the outcome of this program, to estimate the effectiveness of water fluoridation in preventing caries and to predict changes in caries experience as a result of the extension of fluoridation. Queensland children were selected through a stratified random sample selection in 2010-2012. Oral epidemiological examinations provided individual-level outcomes for decayed, missing or filled primary or permanent tooth surfaces: dmfs (among 5-8-year-olds) and DMFS (9-14-year-olds). Explanatory factors at the individual-level, school-level and area-level fluoridation status were derived. Data were weighted to represent the population. Three-level multilevel multivariable models were sequentially specified for negative binomial distribution of dmfs/DMFS to estimate rate ratios (RR). The effectiveness of area-level water fluoridation was evaluated in the full models controlling for other factors. Data from 2,214 5-8 year-olds and 3,186 9-14 year-olds from 207 schools in 16 areas were analysed. Queensland's average dmfs was 4.23 and DMFS 1.47. The lowest levels of dental caries were observed in long-term fluoridated Townsville. In the full models, Townsville children had significantly lower caries experience (RR for dmfs: 0.61 (95%CI: 0.44-0.82); RR for DMFS 0.60 (95%CI: 0.42-0.88)) compared with children in non-fluoridated areas. Comparison of caries experience of children at the time of the extension of water fluoridation supported the rationale for this population health measure. © 2014 Public Health Association of Australia.

Analysis of health behaviour change interventions for preventing dental caries delivered in primary schools.

PubMed

Adair, P M; Burnside, G; Pine, C M

2013-01-01

To improve oral health in children, the key behaviours (tooth brushing and sugar control) responsible for development of dental caries need to be better understood, as well as how to promote these behaviours effectively so they become habitual; and, the specific, optimal techniques to use in interventions. The aim of this paper is to describe and analyse the behaviour change techniques that have been used in primary school-based interventions to prevent dental caries (utilizing a Cochrane systematic review that we have undertaken) and to identify opportunities for improving future interventions by incorporating a comprehensive range of behaviour change techniques. Papers of five interventions were reviewed and data were independently extracted. Results indicate that behaviour change techniques were limited to information-behaviour links, information on consequences, instruction and demonstration of behaviours. None of the interventions were based on behaviour change theory. We conclude that behaviour change techniques used in school interventions to reduce dental caries were limited and focused around providing information about how behaviour impacts on health and the consequences of not developing the correct health behaviours as well as providing oral hygiene instruction. Establishing which techniques are effective is difficult due to poor reporting of interventions in studies. Future design of oral health promotion interventions using behaviour change theory for development and evaluation (and reporting results in academic journals) could strengthen the potential for efficacy and provide a framework to use a much wider range of behaviour change techniques. Future studies should include development and publication of intervention manuals which is becoming standard practice in other health promoting programmes. © 2013 S. Karger AG, Basel.

Prevention of maternal bacterial transmission on children's dental-caries-development: 4-year results of a pilot study in a rural-child population.

PubMed

Ercan, Ertuğrul; Dülgergil, C Türksel; Yildirim, Işil; Dalli, Mehmet

2007-08-01

Dental caries with its bacterial agent is an infectious disease, and shows a vertical transmission. The control of bacterial transmission of Mutans streptococci (MS) from mother to child has been studied, and its results on their children's caries development, and on their siblings' bacterial levels, have been analysed in a field-trial (for 4 years) in rural area. In the same tribe, 8 mothers and their 11 children (test children [TC]), and then (following years) their 9 siblings (test sibling [TSb]), were followed for 4 years. The study started when the TC group had just started to erupt. Test mothers were subjected to a preventive regime. Examination of caries development as well as determination of plaque levels of MS in TC and TSb were carried out annually and at 6-month intervals. At the end of 4 years, two control groups (control children [CC] and control siblings [CSb]) resembling TC and TSb were selected from the other tribe living in the same village, and bacterial data and caries status were compared to both test groups. Microbial data demonstrated that the test children (p<0.01) and test siblings (p<0.05) had significantly low bacterial level in plaque samples. Accordingly, TC had significantly low dmf-t and -s number compared to corresponding control group (p<0.001 for dmf-t, p<0.0001 for dmf-s). The preventive regimen was applicable in rural southeastern Anatolia, where an introverted life style with a great tribal system is prevailing, any other preventive measures may have been practical or available, and babies are basically cared by mothers.

Childhood obesity and dental caries in homeless children.

PubMed

Chiu, Sheau-Huey; Dimarco, Marguerite A; Prokop, Jessica L

2013-01-01

Childhood obesity and dental caries are increasing epidemics, especially among children who are living below the poverty level. This study was conducted to determine the relationship between body mass index (BMI) and caries in homeless children. A secondary data analysis with a correlational design was used. A convenience sample of 157 children was recruited from a homeless shelter. Pearson's and partial correlations were used to explore the relationships among age, BMI, and caries. Most of the children were girls and were African American. Slightly more than half of the children were overweight (19.7%) or obese (30.6%) and had caries (50.3%). Significant positive correlations between age and BMI (p = .03) as well as between age and caries (p = .003) were found. As BMI increased, so did caries (p = .08). Consistent with reports from the Centers for Disease Control and Prevention, homeless children had higher BMI and caries rates than the national averages. Although a definitive conclusion between obesity and dental caries cannot be drawn, these two health issues are important areas for all pediatric health care providers to address at every visit. Copyright © 2013 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Cluster-randomized xylitol toothpaste trial for early childhood caries prevention.

PubMed

Chi, Donald L; Tut, Ohnmar; Milgrom, Peter

2014-01-01

The purpose of this study was to assess the efficacy of supervised tooth-brushing with xylitol toothpaste to prevent early childhood caries (ECC) and reduce mutans streptococci. In this cluster-randomized efficacy trial, 196 four- to five-year-old children in four Head Start classrooms in the Marshall Islands were randomly assigned to supervised toothbrushing with 1,400 ppm/31 percent fluoride xylitol or 1,450 ppm fluoride sorbitol toothpaste. We hypothesized that there would be no difference in efficacy between the two types of toothpaste. The primary outcome was the surface-level primary molar caries increment (d(2-3)mfs) after six months. A single examiner was blinded to classroom assignments. Two classrooms were assigned to the fluoride-xylitol group (85 children), and two classrooms were assigned to the fluoride-sorbitol group (83 children). The child-level analyses accounted for clustering. There was no difference between the two groups in baseline or end-of-trial mean d(2-3)mfs. The mean d(2-3)mfs increment was greater in the fluoride-xylitol group compared to the fluoride-sorbitol group (2.5 and 1.4 d(2-3)mfs, respectively), but the difference was not significant (95% confidence interval: -0.17, 2.37; P=.07). No adverse effects were reported. After six months, brushing with a low-strength xylitol/fluoride tooth-paste is no more efficacious in reducing ECC than a fluoride-only toothpaste in a high caries-risk child population.

The growing problems of dental caries and obesity: an Australian perspective.

PubMed

Hopcraft, M S; Beaumont, S

2016-10-07

Preventable diet-related diseases such as dental caries and obesity are a growing global problem, causing a significant burden on public health systems. Although there has been good evidence for the links between sugar consumption and dental caries for many decades, we are now seeing stronger links implicating sugar in obesity. There is a growing worldwide movement to tackle these problems by targeting the consumption of sugar-sweetened beverages through a range of public policy measures.

Topical fluoride for caries prevention

PubMed Central

Weyant, Robert J.; Tracy, Sharon L.; Anselmo, Theresa (Tracy); Beltrán-Aguilar, Eugenio D.; Donly, Kevin J.; Frese, William A.; Hujoel, Philippe P.; Iafolla, Timothy; Kohn, William; Kumar, Jayanth; Levy, Steven M.; Tinanoff, Norman; Wright, J. Timothy; Zero, Domenick; Aravamudhan, Krishna; Frantsve-Hawley, Julie; Meyer, Daniel M.

2015-01-01

Background A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. Types of Studies Reviewed The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents—including mouthrinses, varnishes, gels, foams and pastes—with caries increment outcomes published in English through October 2012. Results The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research. Practical Implications The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.5 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from “in favor” to “expert opinion for.” As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. PMID:24177407

Cluster-randomized trial of infant nutrition training for caries prevention.

PubMed

Chaffee, B W; Feldens, C A; Vítolo, M R

2013-07-01

The objective of this study was to estimate the caries impact of providing training in infant feeding guidelines to workers at Brazilian public primary care clinics. In a cluster-randomized controlled trial (n = 20 clinics), health care workers either were trained in guidelines for infant nutrition, stressing healthful complementary feeding, or were assigned to a 'usual practices' control, which allowed for maternal counseling at practitioner discretion. Training occurred once; the amount of counseling provided to mothers was not assessed. Eligible pregnant women were enrolled to follow health outcomes in their children. Early childhood caries (ECC) was measured at age three years (n = 458 children). The overall reductions in ECC (relative risk, 0.92; 95%CI, 0.75, 1.12) and severe ECC (RR, 0.87; 95%CI, 0.64, 1.19) were not statistically significant. There was a protective effect among mothers who remained exclusively at the same health center (S-ECC RR, 0.68; 95%CI, 0.47, 0.99) and among those naming the health center as their principal source of feeding advice (S-ECC RR, 0.53; 95%CI, 0.29, 0.97). Health care worker training did not yield a statistically significant reduction in caries overall, although caries was reduced among children of mothers more connected to their health centers.

[Do they have to fluoridate water for public usage?].

PubMed

Vargas Marcos, F; Robledo de Dios, T

1993-01-01

In order to facilitate the convenience of fluorating or not the public use waters, a bibliographic review about the positive or negative aspects of this public health measure has been made. The different epidemiologic surveys about dental health conditions in our country, since 1969 till the present time, have been reviewed. From the analysis of these works, it can be deduced that the degree of caries severity index (DMF) is situated at a moderate to low level, according to the classification of the World Health Organization. The advantages, inconvenience, cost and percentage of caries reduction of the different methods to prevent dental caries are studied. It is considered positive to go on with the policy of public use waters fluoration, provided that is is based on a series of prerequisites which guarantee the highest level of effectiveness and efficiency. Among the different objective criteria to fluorate waters, the following ones stand out: a high prevalence of caries, a good system of waters out: a high prevalence of caries, a good system of waters diffusion, a natural fluor concentration lower than 0.7 grams/litre, the cost-benefit analysis, the population size. The elaboration of studies to determine the total quantity of fluorides, ingested by the population from various sources, is recommended.

Evidence on existing caries risk assessment systems: are they predictive of future caries?

PubMed

Tellez, M; Gomez, J; Pretty, I; Ellwood, R; Ismail, A I

2013-02-01

To critically appraise evidence for the prediction of caries using four caries risk assessment (CRA) systems/guidelines (Cariogram, Caries Management by Risk Assessment (CAMBRA), American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD)). This review focused on prospective cohort studies or randomized controlled trials. A systematic search strategy was developed to locate papers published in Medline Ovid and Cochrane databases. The search identified 539 scientific reports, and after title and abstract review, 137 were selected for full review and 14 met the following inclusion criteria: (i) used as validating criterion caries incidence/increment, (ii) involved human subjects and natural carious lesions, and (iii) published in peer-reviewed journals. In addition, papers were excluded if they met one or more of the following criteria: (i) incomplete description of sample selection, outcomes, or small sample size and (ii) not meeting the criteria for best evidence under the prognosis category of the Oxford Centre for Evidence-Based Medicine. There are wide variations among the systems in terms of definitions of caries risk categories, type and number of risk factors/markers, and disease indicators. The Cariogram combined sensitivity and specificity for predicting caries in permanent dentition ranges from 110 to 139 and is the only system for which prospective studies have been conducted to assess its validity. The Cariogram had limited prediction utility in preschool children, and a moderate to good performance for sorting out elderly individuals into caries risk groups. One retrospective analysis on CAMBRA's CRA reported higher incidence of cavitated lesions among those assessed as extreme-risk patients when compared with those at low risk. The evidence on the validity for existing systems for CRA is limited. It is unknown if the identification of high-risk individuals can lead to more effective long-term patient management that prevents caries initiation and arrests or reverses the progression of lesions. There is an urgent need to develop valid and reliable methods for caries risk assessment that are based on best evidence for prediction and disease management rather than opinions of experts.

Antibacterial activity against Streptococcus mutans and inhibition of bacterial induced enamel demineralization of propolis, miswak, and chitosan nanoparticles based dental varnishes.

PubMed

Wassel, Mariem O; Khattab, Mona A

2017-07-01

Using natural products can be a cost-effective approach for caries prevention especially in low income countries where dental caries is highly prevalent and the resources are limited. Specially prepared dental varnishes containing propolis, miswak, and chitosan nanoparticles (CS-NPs) with or without sodium fluoride (NaF) were assessed for antibacterial effect against Streptococcus mutans ( S. mutans ) using disk diffusion test. In addition, the protective effect of a single pretreatment of primary teeth enamel specimens against in vitro bacterial induced enamel demineralization was assessed for 3 days. All natural products containing varnishes inhibited bacterial growth significantly better than 5% NaF varnish, with NaF loaded CS-NPs (CSF-NPs) showing the highest antibacterial effect, though it didn't significantly differ than those of other varnishes except miswak ethanolic extract (M) varnish. Greater inhibitory effect was noted with varnish containing freeze dried aqueous miswak extract compared to that containing ethanolic miswak extract, possibly due to concentration of antimicrobial substances by freeze drying. Adding natural products to NaF in a dental varnish showed an additive effect especially compared to fluoride containing varnish. 5% NaF varnish showed the best inhibition of demineralization effect. Fluoride containing miswak varnish (MF) and CSF-NPs varnish inhibited demineralization significantly better than all experimental varnishes, especially during the first 2 days, though CSF-NPs varnish had a low fluoride concentration, probably due to better availability of fluoride ions and the smaller size of nanoparticles. Incorporating natural products with fluoride into dental varnishes can be an effective approach for caries prevention, especially miswak and propolis when financial resources are limited.

Effect of Punica granatum on the virulence factors of cariogenic bacteria Streptococcus mutans.

PubMed

Gulube, Zandiswa; Patel, Mrudula

2016-09-01

Dental caries is caused by acids produced by biofilm-forming Streptococcus mutans from fermentable carbohydrates and bacterial byproducts. Control of these bacteria is important in the prevention of dental caries. This study investigated the effect of the fruit peel of Punica granatum on biofilm formation, acid and extracellular polysaccharides production (EPS) by S. mutans. Pomegranate fruit peels crude extracts were prepared. The Minimum bactericidal concentrations (MBC) were determined against S. mutans. At 3 sub-bactericidal concentrations, the effect on the acid production, biofilm formation and EPS production was determined. The results were analysed using Kruskal-Wallis and Wilcoxon Rank Sum Tests. The lowest MBC was 6.25 mg/mL. Punica granatum significantly inhibited acid production (p < 0.01). After 6 and 24 h, it significantly reduced biofilm-formation by 91% and 65% respectively (p < 0.01). The plant extract did not inhibit the production of soluble EPS in either the biofilm or the planktonic growth. However, it significantly reduced the insoluble EPS in the biofilm and the plantktonic (p = < 0.01) form of S. mutans. The crude extract of P. granatum killed cariogenic S. mutans at high concentrations. At sub-bactericidal concentrations, it reduced biofilm formation, acid and EPS production. This suggests that P. granatum extract has the potential to prevent dental caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of 7-Epiclusianone on Streptococcus mutans and Caries Development in Rats

PubMed Central

Branco-de-Almeida, Luciana Salles; Murata, Ramiro Mendonça; Franco, Eliane Melo; dos Santos, Marcelo Henrique; de Alencar, Severino Matias; Koo, Hyun; Rosalen, Pedro Luiz

2011-01-01

The aim of this study was to evaluate the effects of 7-epiclusianone (7-epi) on specific virulence attributes of Streptococcus mutans in vitro and on development of dental caries in vivo. 7-Epi was obtained and purified from fruits of Rheedia brasiliensis. We investigated its influence on surface-adsorbed glucosyltransferase (Gtf) B activity, acid production, and viability of S. mutans in biofilms, as well as on caries development using a rodent model. 7-Epi (100 μg/mL) significantly reduced the activity of surface-adsorbed GtfB (up to 48.0 ± 1.8 of inhibition at 100 μg/mL) and glycolytic pH-drop by S. mutans in biofilms (125 and 250 μg/mL) (vs. vehicle control, p < 0.05). In contrast, the test compound did not significantly affect the bacterial viability when compared to vehicle control (15% ethanol, p > 0.05). Wistar rats treated topically with 7-epi (twice daily, 60-s exposure) showed significantly smaller number of and less severe smooth- and sulcal-surface carious lesions (p < 0.05), without reducing the S. mutans viable population from the animals’ dental biofilms. In conclusion, the natural compound 7-epiclusianone may be a potentially novel pharmacological agent to prevent and control dental caries disease. PMID:20665370

Oral lactic acid bacteria related to the occurrence and/or progression of dental caries in Japanese preschool children

PubMed Central

SHIMADA, Ayumi; NODA, Masafumi; MATOBA, Yasuyuki; KUMAGAI, Takanori; KOZAI, Katsuyuki; SUGIYAMA, Masanori

2015-01-01

Previous studies have demonstrated that the presence of lactic acid bacteria (LAB), especially those classified into the genus Lactobacillus, is associated with the progression of dental caries in preschool children. Nevertheless, the kinds of species of LAB and the characteristics that are important for dental caries have been unclear. The aims of this study were: (1) to investigate the distribution of oral LAB among Japanese preschool children with various prevalence levels of caries; and (2) to reveal the characteristics of these isolated LAB species. Seventy-four Japanese preschool children were examined for caries scores and caries progression, and their dental cavity samples were collected for LAB isolation and identification. The saliva-induced agglutination rate and the resistance to acidic environments of the identified strains were measured. Statistical analysis showed that preschool children carrying Lactobacillus (L.) salivarius or Streptococcus mutans have a significantly higher prevalence of dental caries, the growth ability in acidic environments correlates with the caries scores of individuals with L. salivarius, and the caries scores exhibit positive correlation with saliva-induced agglutination in L. salivarius. These results show that specific Lactobacillus species are associated with dental caries based on the level of carious lesion severity. The present study suggests that these specific Lactobacillus species, especially those with easily agglutinated properties and acid resistance, affect the dental caries scores of preschool children, and that these properties may provide useful information for research into the prevention of dental caries. PMID:25918670

Oral lactic acid bacteria related to the occurrence and/or progression of dental caries in Japanese preschool children.

PubMed

Shimada, Ayumi; Noda, Masafumi; Matoba, Yasuyuki; Kumagai, Takanori; Kozai, Katsuyuki; Sugiyama, Masanori

2015-01-01

Previous studies have demonstrated that the presence of lactic acid bacteria (LAB), especially those classified into the genus Lactobacillus, is associated with the progression of dental caries in preschool children. Nevertheless, the kinds of species of LAB and the characteristics that are important for dental caries have been unclear. The aims of this study were: (1) to investigate the distribution of oral LAB among Japanese preschool children with various prevalence levels of caries; and (2) to reveal the characteristics of these isolated LAB species. Seventy-four Japanese preschool children were examined for caries scores and caries progression, and their dental cavity samples were collected for LAB isolation and identification. The saliva-induced agglutination rate and the resistance to acidic environments of the identified strains were measured. Statistical analysis showed that preschool children carrying Lactobacillus (L.) salivarius or Streptococcus mutans have a significantly higher prevalence of dental caries, the growth ability in acidic environments correlates with the caries scores of individuals with L. salivarius, and the caries scores exhibit positive correlation with saliva-induced agglutination in L. salivarius. These results show that specific Lactobacillus species are associated with dental caries based on the level of carious lesion severity. The present study suggests that these specific Lactobacillus species, especially those with easily agglutinated properties and acid resistance, affect the dental caries scores of preschool children, and that these properties may provide useful information for research into the prevention of dental caries.

Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries in Australia.

PubMed

Cobiac, Linda J; Vos, Theo

2012-08-01

Fluoride was first added to the Australian water supply in 1953, and by 2003, 69% of Australia's population was receiving the minimum recommended dose. Extending coverage of fluoridation to all remaining communities of at least 1000 people is a key strategy of Australia's National Oral Health Plan 2004-2013. We evaluate the cost-effectiveness of this strategy from an Australian health sector perspective. Health gains from the prevention of caries in the Australian population are modelled over the average 15-year lifespan of a treatment plant. Taking capital and on-going operational costs of fluoridation into account, as well as costs of caries treatment, we determine the dollars per disability-adjusted life years (DALY) averted from extending coverage of fluoridation to all large (≥ 1000 people) and small (<1000 people) communities in Australia. Extending coverage of fluoridation to all communities of at least 1000 people will lead to improved population health (3700 DALYs, 95% uncertainty interval: 2200-5700 DALYs), with a dominant cost-effectiveness ratio and 100% probability of cost-savings. Extending coverage to smaller communities leads to 60% more health gains, but is not cost-effective, with a median cost-effectiveness ratio of A$92 000/DALY and only 10% probability of being under a cost-effectiveness threshold of A$50 000/DALY. Extension of fluoridation coverage under the National Oral Health Plan is highly recommended, but given the substantial dental health disparities and inequalities in access to dental care that currently exist for more regional and remote communities, there may be good justification for extending coverage to include all Australians, regardless of where they live, despite less favourable cost-effectiveness. © 2012 John Wiley & Sons A/S.

A new primary dental care service compared with standard care for child and family to reduce the re-occurrence of childhood dental caries (Dental RECUR): study protocol for a randomised controlled trial.

PubMed

Pine, Cynthia; Adair, Pauline; Burnside, Girvan; Robinson, Louise; Edwards, Rhiannon Tudor; Albadri, Sondos; Curnow, Morag; Ghahreman, Marjan; Henderson, Mary; Malies, Clare; Wong, Ferranti; Muirhead, Vanessa; Weston-Price, Sally; Whitehead, Hilary

2015-11-04

In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions. This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrollment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrollment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment. The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have also added to the challenges in implementing the Dental RECUR protocol during the recruitment phase. ISRCTN24958829 (date of registration: 27 September 2013), Current protocol version: 5.0.

Glass-ionomer cements as restorative and preventive materials.

PubMed

Ngo, Hien

2010-07-01

This article focuses on glass-ionomer cement (GIC) and its role in the clinical management of caries. It begins with a brief description of GIC, the mechanism of fluoride release and ion exchange, the interaction between GIC and the external environment, and finally the ion exchange between GIC and the tooth at the internal interface. The importance of GIC, as a tool, in caries management, in minimal intervention dentistry (MI), and Caries Management by Risk Assessment (CAMBRA) also will be highlighted. Copyright 2010. Published by Elsevier Inc.

Effect of endurance training on dental erosion, caries, and saliva.

PubMed

Frese, C; Frese, F; Kuhlmann, S; Saure, D; Reljic, D; Staehle, H J; Wolff, D

2015-06-01

The aim of this investigation was to give insights into the impact of endurance training on oral health, with regard to tooth erosion, caries, and salivary parameters. The study included 35 triathletes and 35 non-exercising controls. The clinical investigation comprised oral examination, assessment of oral status with special regard to caries and erosion, saliva testing during inactivity, and a self-administered questionnaire about eating, drinking, and oral hygiene behavior. In addition, athletes were asked about their training habits and intake of beverages and sports nutrition. For saliva assessment during exercise, a subsample of n = 15 athletes volunteered in an incremental running field test (IRFT). Athletes showed an increased risk for dental erosion (P = 0.001). No differences were observed with regard to caries prevalence and salivary parameters measured during inactivity between athletes and controls. Among athletes, a significant correlation was found between caries prevalence and the cumulative weekly training time (r = 0.347, P = 0.04). In athletes after IRFT and at maximum workload, saliva flow rates decreased (P = 0.001 stimulated; P = 0.01 unstimulated) and saliva pH increased significantly (P = 0.003). Higher risk for dental erosions, exercise-dependent caries risk, and load-dependent changes in saliva parameters point out the need for risk-adapted preventive dental concepts in the field of sports dentistry. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay.

PubMed

Chestnutt, Ivor Gordon; Hutchings, Simon; Playle, Rebecca; Morgan-Trimmer, Sarah; Fitzsimmons, Deborah; Aawar, Nadine; Angel, Lianna; Derrick, Sharron; Drew, Cheney; Hoddell, Ceri; Hood, Kerenza; Humphreys, Ioan; Kirby, Nigel; Lau, Tin Man Mandy; Lisles, Catherine; Morgan, Maria Zeta; Murphy, Simon; Nuttall, Jacqueline; Onishchenko, Kateryna; Phillips, Ceri; Pickles, Timothy; Scoble, Charlotte; Townson, Julia; Withers, Beverley; Chadwick, Barbara Lesley

2017-04-01

Fissure sealant (FS) and fluoride varnish (FV) have been shown to be effective in preventing dental caries when tested against a no-treatment control. However, the relative clinical effectiveness and cost-effectiveness of these interventions is unknown. To compare the clinical effectiveness and cost-effectiveness of FS and FV in preventing dental caries in first permanent molars (FPMs) in 6- and 7-year-olds and to determine their acceptability. A randomised controlled allocation-blinded clinical trial with two parallel arms. A targeted population programme using mobile dental clinics (MDCs) in schools located in areas of high social and economic deprivation in South Wales. In total, 1016 children were randomised, but one parent subsequently withdrew permission and so the analysis was based on 1015 children. The randomisation of participants was stratified by school and balanced for sex and primary dentition baseline caries levels using minimisation in a 1 : 1 ratio for treatments. A random component was added to the minimisation algorithm, such that it was not completely deterministic. Of the participants, 514 were randomised to receive FS and 502 were randomised to receive FV. Resin-based FS was applied to caries-free FPMs and maintained at 6-monthly intervals. FV was applied at baseline and at 6-month intervals over the course of 3 years. The proportion of children developing caries into dentine (decayed, missing, filled teeth in permanent dentition, i.e. D 4-6 MFT) on any one of up to four treated FPMs after 36 months. The assessors were blinded to treatment allocation; however, the presence or absence of FS at assessment would obviously indicate the probable treatment received. Economic measures established the costs and budget impact of FS and FV and the relative cost-effectiveness of these technologies. Qualitative interviews determined the acceptability of the interventions. At 36 months, 835 (82%) children remained in the trial: 417 in the FS arm and 418 in the FV arm. The proportion of children who developed caries into dentine on a least one FPM was lower in the FV arm (73; 17.5%) than in the FS arm (82, 19.6%) [odds ratio (OR) 0.84, 95% confidence interval (CI) 0.59 to 1.21; p  = 0.35] but the difference was not statistically significant. The results were similar when the numbers of newly decayed teeth (OR 0.86, 95% CI 0.60 to 1.22) and tooth surfaces (OR 0.85, 95% CI 0.59 to 1.21) were examined. Trial fidelity was high: 95% of participants received five or six of the six scheduled treatments. Between 74% and 93% of sealants (upper and lower teeth) were intact at 36 months. The costs of the two technologies showed a small but statistically significant difference; the mean cost to the NHS (including intervention costs) per child was £500 for FS, compared with £432 for FV, a difference of £68.13 (95% CI £5.63 to £130.63; p  = 0.033) in favour of FV. The budget impact analysis suggests that there is a cost saving of £68.13 (95% CI £5.63 to £130.63; p  = 0.033) per child treated if using FV compared with the application of FS over this time period. An acceptability score completed by the children immediately after treatment and subsequent interviews demonstrated that both interventions were acceptable to the children. No adverse effects were reported. There are no important limitations to this study. In a community oral health programme utilising MDCs and targeted at children with high caries risk, the twice-yearly application of FV resulted in caries prevention that is not significantly different from that obtained by applying and maintaining FSs after 36 months. FV proved less expensive. The clinical effectiveness and cost-effectiveness of FS and FV following the cessation of active intervention merits investigation. EudraCT number 2010-023476-23, Current Controlled Trials ISRCTN17029222 and UKCRN reference 9273. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 21. See the NIHR Journals Library website for further project information.

Early childhood caries in Indigenous communities

PubMed Central

Irvine, JD; Holve, S; Krol, D; Schroth, R

2011-01-01

The oral health of Indigenous children of Canada (First Nations, Inuit and Métis) and the United States (American Indian and Alaska Native) is a major child health issue. This is exemplified by the high prevalence of early childhood caries (ECC) with resulting adverse health effects, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. The present statement includes recommendations for oral health preventive and clinical care for young infants and pregnant women by primary health care providers, community-based health promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride varnish program access. Further community-based research on the epidemiology, prevention, management and microbiology of ECC in Indigenous communities would be beneficial. PMID:22654547

Early childhood caries in indigenous communities.

PubMed

2011-06-01

The oral health of Indigenous children of Canada (First Nations, Inuit, and Métis) and the United States (American Indian, Alaska Native) is a major child health issue: there is a high prevalence of early childhood caries (ECC) and resulting adverse health effects in this community, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. This statement includes recommendations for preventive oral health and clinical care for young infants and pregnant women by primary health care providers, community-based health-promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride-varnish program access. Further community-based research on the epidemiology, prevention, management, and microbiology of ECC in Indigenous communities would be beneficial.

Early childhood caries in Indigenous communities: A joint statement with the American Academy of Pediatrics.

PubMed

Irvine, Jd; Holve, S; Krol, D; Schroth, R

2011-06-01

The oral health of Indigenous children of Canada (First Nations, Inuit and Métis) and the United States (American Indian and Alaska Native) is a major child health issue. This is exemplified by the high prevalence of early childhood caries (ECC) with resulting adverse health effects, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. The present statement includes recommendations for oral health preventive and clinical care for young infants and pregnant women by primary health care providers, community-based health promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride varnish program access. Further community-based research on the epidemiology, prevention, management and microbiology of ECC in Indigenous communities would be beneficial.

Economic Models of Preventive Dentistry for Australian Children and Adolescents: A Systematic Review.

PubMed

Tonmukayakul, Utsana; Sia, Kah-Ling; Gold, Lisa; Hegde, Shalika; de Silva, Andrea M; Moodie, Marj

2015-01-01

To identify economic evaluation models and parameters that could be replicated or adapted to construct a generic model to assess cost-effectiveness of and prioritise a wide range of community-based oral disease prevention programmes in an Australian context. The literature search was conducted using MEDLINE, ERIC, PsycINFO, CINHAL (EBSCOhost), EMBASE (Ovid), CRD, DARE, NHSEED, HTA, all databases in the Cochrane library, Scopus and ScienceDirect databases from their inception to November 2012. Thirty-three articles met the criteria for inclusion in this review (7 were Australian studies, 26 articles were international). Existing models focused primarily on dental caries. Periodontal disease, another common oral health problem, was lacking. Among caries prevention studies, there was an absence of clear evidence showing continuous benefits from primary through to permanent dentition and the long-term effects of oral health promotion. No generic model was identified from previous studies that could be immediately adopted or adapted for our purposes of simulating and prioritising a diverse range of oral health interventions for Australian children and adolescents. Nevertheless, data sources specified in the existing Australian-based models will be useful for developing a generic model for such purposes.

Innovative interventions to promote positive dental health behaviors and prevent dental caries in preschool children: study protocol for a randomized controlled trial.

PubMed

Gao, Xiaoli; Lo, Edward Chin Man; McGrath, Colman; Ho, Samuel Mun Yin

2013-04-30

Dental caries (tooth decay) is highly prevalent and is largely attributable to unhealthy self-care behaviors (diet and oral hygiene). The conventional (health) education (CE), focusing on disseminating information and giving normative advice, often fails to achieve sustained behavioral changes. This study incorporates two innovative elements into CE: (i) motivational interviewing (MI), a client-centered counseling for changing behaviors, and (ii) an interactive caries risk assessment (RA) tool, which is devised to facilitate dental counseling and may enhance MI in several ways. Through a randomized, controlled, evaluator-blinded trial, three intervention schemes (CE, CE+MI, and CE+MI+RA) will be compared for their effectiveness in eliciting dentally healthy behaviors and preventing caries in preschool children. This study targets 3-year-old children who are at a critical stage for embedding health habits. Children with unfavorable dental behaviors (insufficient toothbrushing and/or frequent snacking) and their parents will be recruited from 12 participating kindergartens. Parent-child dyads (n=690) will be randomly assigned into three groups. In the first group (CE), oral health information and advice will be delivered to parents through pamphlets. In the second group (CE+MI), in addition to the pamphlets, individual MI counseling with each parent will be performed by one of two trained dental hygienists. In the third group (CE+MI+RA), besides pamphlets and MI, interactive RA will be integrated into MI to motivate parents and facilitate their informed decision making and goal planning. At baseline and after 12 and 24 months, parents will complete a questionnaire and children will undergo a dental examination. The effectiveness of the intervention schemes will be compared over 12 and 24 months. The primary outcome will be caries increment in children and proportion of caries-free children. Secondary outcomes will be changes in parental efficacy for protecting children's oral health and changes in children's dental behaviors. Motivating and empowering parents to cultivate dentally healthy habits of young children presents both promises and challenges. With careful methodological considerations, this study is expected to provide scientific evidence for public health workers, dentists, and dental auxiliaries (nurses and hygienists) to choose appropriate interventions to advance children's oral health. HKCTR-1455.

Dentists' opinion and knowledge about preventive dental care in Saudi Arabia: a nationwide cross-sectional study.

PubMed

Togoo, Rafi Ahmed; Al-Rafee, Mohammed A; Kandyala, Reena; Luqam, Master; Al-Bulowey, Mohammed A

2012-05-01

The aim of this study was to determine the dentists' opinions on causes for high prevalence of dental caries in the country and to assess their level of knowledge about preventive dental care. A questionnaire based national crosssectional survey among 500 dentists was conducted under the auspices of Directorate of Dentistry, Ministry of Health. The data was analyzed using SPSS software version 11.0 and descriptive statistics were obtained. The response rate was 87.8% (n = 439). 83% of dentists identified poor oral hygiene as the major reason for high prevalence of caries, only 39% of patients reportedly brushed teeth at least once a day, oral prophylaxis (83%) is the most common preventive practice followed, social factors (62.5%) are the most challenging barriers in preventive dental programs, 71.3% always give chair side dental health education, school based programs (66.6%) are most effective tools for dental health education. Majority of dentists in Saudi Arabia are adequately informed and motivated toward preventive dental care but they are in need of further support from policy makers to enhance preventive dental programs in the Kingdom. Oral hygiene should be improved in the country by reaching out to the entire community through extensive and continued education programs.

Fluoride Varnish Effect on Preventing Dental Caries in a Sample of 3-6 Years Old Children

PubMed Central

Mohammadi, Tayebeh Malek; Hajizamani, Abolghasem; Hajizamani, Hamid Reza; Abolghasemi, Batol

2015-01-01

Background: Early childhood caries is one of the most prevalent chronic diseases of children that affect their life and their family in different aspects. Using different types of fluoride is one of the most effective ways for preventing the disease. Fluoride varnish is a topical fluoride product which could use in the community even by non-professional. This study aimed to assess the effect of fluoride varnish on dental caries in a group of children aged 3-6 years old in Kerman kindergarten during 6 month’s period. Materials and Methods: This community interventional study recruited a sample of volunteer children from 12 kindergartens through a cluster sampling. Kindergarten randomly allocated to test and control group after matching. Dental examination was performed in three phases of the study by a trained dentist using criteria of Intentional Caries Detection and Assessment System. Fluoride varnish was applied for test group in the first phase after dental examination and also 3 and 6 months after this phase. Control group has received varnish product just after 3 and 6 months after the first dental exam. Mean decayed, missed and filled teeth (dmft) were compared between and within groups using T-test. Results: From 476 children who participated in the study 55% were boys and the 6 years group was the most frequent group with 35% (166). Mean dmft difference was significant between Phase 1 and 2 (P = 0.05) in the test group but there was no significant difference between Phase 2 and 3 (P = 0.07). The difference was not significant between Phase 1 and 2 (P = 0.09) but it was significant between Phase 1 and 3 (P = 0.03) in the control group. Conclusion: The study results showed a decrease in mean dmft after applying the fluoride varnish which confirms previous studies. PMID:25709364

Dental caries experience and association to risk indicators of remote rural populations.

PubMed

Cook, Sean L; Martinez-Mier, E Angeles; Dean, Jeffrey A; Weddell, James A; Sanders, Brian J; Eggertsson, Hafsteinn; Ofner, Susan; Yoder, Karen

2008-07-01

Dental caries continues to be the most common infectious disease of childhood; however, it is no longer pandemic, but endemic in specific sectors of populations. Therefore, it is important to identify and target patients at risk of developing caries in order to develop specific preventive measures. This study aims to test dental caries risk indicators for significant associations with caries severity. Five separate, small, isolated rural villages in Mexico with varying degrees of caries prevalence were selected for this observational study. A total of 248 children were examined. Risk indicators were assessed via questionnaire and water and salt fluoride analysis. Caries severity was measured by the International Caries Detection and Assessment System (ICDAS-I). Prevalence of caries ranged from 95% to 100% for the five villages. Mean total DMFS (decayed, missing, or filled surfaces-permanent teeth) and dmfs (decayed, missing, or filled surfaces-primary teeth) scores ranged from 2.5 to 5.0 and from 11.3 to 16.9, respectively. Multivariable models showed age and drinking soda between meals to be significantly associated with DMFS, and drinking juice and being female were significantly associated with dmfs. DMFS and dmfs were high in each village, significantly different between villages, and associated with specific risk indicators.

Dental caries and weight among children in Nuuk, Greenland, at school entry.

PubMed

Madsen, Signe Sloth; Wetterstrand, Vicky Jenny Rebecka; Pedersen, Michael Lynge

2017-01-01

To explore the possible association between weight class and prevalence of caries among children born 2005-2007, living in Nuuk, Greenland, at time of school entry. A cross-sectional register study based on data from electronic medical records(EMR) and oral health data from public health and dental care facilities. Data from routine examinations of children at time of primary school entry, including height and weight, were obtained from the EMRs. Dental charts recording oral health and caries were collected from public dental healthcare service. The prevalence of caries was calculated as the proportion of included children with dft score (decayed and/or filled non-permanent teeth) ≥1. 55%(373/681) had relevant data recorded in EMRs and dental charts, and could be included in the study. The prevalence of dental caries was 57.1%(213/373). The prevalence of caries increased with higher weight class,but no statistically significant trend was observed(p=0.063). Increasing prevalence of caries with increasing weight class was observed in this study. A linear trend could not be confirmed statistically. The high prevalence of caries and overweight indicate the need for continued focus on preventative initiatives and monitoring. A combined strategy targeting both caries and overweight may be considered.

Dental caries experience among Albanian pre-school children: a national survey.

PubMed

Hysi, D; Caglar, E; Droboniku, E; Toti, C; Kuscu, O O

2017-03-01

To determine the dental caries experience and treatment needs among 5-year-olds in Albania. This cross sectional study was conducted in 2015 by using a cluster sampling technique. The dmft was used to assess dental caries experience and caries prevalence as percentages of children with dmf⟩0. Caries treatment needs were assessed with dt/dmft x 100, missing teeth with mt/dmft x 100 and ft /dmft x 100 as the Care Index. 2,039 five-year-olds, from 17 districts of Albania were selected . Children's residency was divided into 3 main regions (South, West, Central and North). WHO 2013 diagnostic criteria were used and dental caries was recorded at cavity level d3. The mean age was 5.4 (SD 0.5) years. The caries prevalence (dmf⟩0) was 84.1%. The prevalence of children without cavitated lesions (d=0) was 20.1%. The mean dmft index was 4.41 (SD 3.83). The caries treatment needs were 84% (SD 26%). The Albanian 5-year-olds assessed in this survey had a high dental caries experience and untreated cavities in the primary dentition. The national health authorities should introduce preventive programs and improved dental care access for this age group. Copyright© 2017 Dennis Barber Ltd

Dental caries experience and treatment needs of an adult female population in Nigeria.

PubMed

Lawal, Folake; Alade, Omolola

2017-09-01

Experience and awareness of adult females concerning dental caries is important in its prevention particularly in children because of their natural role as care givers. To determine the prevalence of dental caries and treatment needs in an adult female Nigerian population. In this cross-sectional study, adult females attending outreach programmes were examined for dental caries using the Decayed Missing and Filled Teeth caries index (DMFT). Socio-demographic variables were also recorded and statistical analysis done with SPSS software. A total of 430 females aged 16 to 59 years participated in the outreach programme out of which 109 (25.3%) had a DMFT score > 0. Mean DMFT was 0.7 ± 1.6. Fifty-five (12.8%) participants had decayed teeth, 78 (18.1 %) had missing teeth and 10(2.3%) had filled teeth. The treatment need was 34.3%, restorative index was 13.3% and significant caries index was 2.0. There were significant differences in caries experience based on age, marital status and educational qualifications of participants p < 0.05. The prevalence of dental caries among the study group was low but the treatment need was high. Younger females, singles and those with lower educational qualifications had a higher dental caries experience.

Dental disease indices and caries-related microflora in children with glycogen storage disease.

PubMed

Kidd, S A; Rademeyer, C; Roberts, G J; Lee, P J; Lucas, V S

2002-01-01

To establish the levels of dental caries, bacterial dental plaque, gingivitis and caries-related microflora in children with glycogen storage disease (GSD). Patients with GSD are treated with regular intakes of glucose polymer and uncooked cornstarch to prevent hypoglycaemia. Dental health data are scarce. The study group comprised 21 children with GSD attending the Great Ormond Street Hospital for Children. These included the number of decayed, missing and filled teeth, and surfaces in both the primary and permanent dentitions, plaque and gingivitis scores. Both plaque and saliva were collected from each child and cultured for Mutans streptococci, Lactobacilli and Candida. The study group included 13 boys and eight girls, aged from 2.7 to 15.5 years. Four of the 21 children had some caries experience. The mean dmft was 0.5 and the mean DMFT, 0.06. Mean plaque and gingivitis scores were 4.8 and 5.9, respectively, for plaque and gingivitis adjacent to the primary teeth, and 11.6 and 12 for those related to permanent teeth. Only a small proportion of the children had caries experience but most were found to have plaque associated with both primary and permanent teeth. Preventive care should be targeted to improve plaque control thus minimizing the risk of developing periodontal disease as adults.

Pyrosequencing analysis of oral microbiota in children with severe early childhood dental caries.

PubMed

Jiang, Wen; Zhang, Jie; Chen, Hui

2013-11-01

Severe early childhood caries are a prevalent public health problem among preschool children throughout the world. However, little is known about the microbiota found in association with severe early childhood caries. Our study aimed to explore the bacterial microbiota of dental plaques to study the etiology of severe early childhood caries through pyrosequencing analysis based on 16S rRNA gene V1-V3 hypervariable regions. Forty participants were enrolled in the study, and we obtained twenty samples of supragingival plaque from caries-free subjects and twenty samples from subjects with severe early childhood caries. A total of 175,918 reads met the quality control standards, and the bacteria found belonged to fourteen phyla and sixty-three genera. Our results show the overall structure and microbial composition of oral bacterial communities, and they suggest that these bacteria may present a core microbiome in the dental plaque microbiota. Three genera, Streptococcus, Granulicatella, and Actinomyces, were increased significantly in children with severe dental cavities. These data may facilitate improvements in the prevention and treatment of severe early childhood caries.

Water Fluoridation and Dental Caries in U.S. Children and Adolescents.

PubMed

Slade, G D; Grider, W B; Maas, W R; Sanders, A E

2018-05-01

Fluoridation of America's drinking water was among the great public health achievements of the 20th century. Yet there is a paucity of studies from the past 3 decades investigating its dental health benefits in the U.S. This cross-sectional study sought to evaluate associations between availability of community water fluoridation (CWF) and dental caries experience in the U.S. child and adolescent population. County-level estimates of the percentage of population served by CWF (% CWF) from the Centers for Disease Control and Prevention's Water Fluoridation Reporting System were merged with dental examination data from 10 y of National Health and Nutrition Examination Surveys (1999 to 2004 and 2011 to 2014). Dental caries experience in the primary dentition (decayed and filled tooth surfaces [dfs]) was calculated for 7,000 children aged 2 to 8 y and in the permanent dentition (decayed, missing, and filled tooth surfaces [DMFS]) for 12,604 children and adolescents aged 6 to 17 y. Linear regression models estimated associations between % CWF and dental caries experience with adjustment for sociodemographic characteristics: age, sex, race/ethnicity, rural-urban location, head-of-household education, and period since last dental visit. Sensitivity analysis excluded counties fluoridated after 1998. In unadjusted analysis, caries experience in the primary dentition was lower in counties with ≥75% CWF (mean dfs = 3.3; 95% confidence limit [CL] = 2.8, 3.7) than in counties with <75% CWF (mean dfs = 4.6; 95% CL = 3.9, 5.4), a prevented fraction of 30% (95% CL = 11, 48). The difference was also statistically significant, although less pronounced, in the permanent dentition: mean DMFS (95% CL) was 2.2 (2.0, 2.4) and 1.9 (1.8, 2.1), respectively, representing a prevented fraction of 12% (95% CL = 1, 23). Statistically significant associations likewise were seen when % CWF was modeled as a continuum, and differences tended to increase in covariate-adjusted analysis and in sensitivity analysis. These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth.

Aggressive strategic planning for oral health in Kuwait: a decade of post-war successes.

PubMed

Morris, R E; Gillespie, G M; Al Za'abi, F; Al Rashed, B; Al Mahmeed, B E

2008-01-01

Strategic planning and implementation of oral health care and disease prevention programmes after the 1990/91 Gulf war are discussed. The key concept was to develop access to care and disease prevention for all Kuwaiti children in government kindergarten/primary schools and to eliminate emphasis on extractions and restorations. Resources were restored to pre-war levels and then increased. Prevention programmes for 150 000 children were established. Prevention funds increased from 7% to 20% of the oral health budget. Prevention-based dentists increased from 9.7% to 28.0% of staff. Rising caries trends were stabilized or reduced by up to 36.8%. Percentage of caries-free primary dentition in children increased up to 37.6%, permanent dentition up to 27.0%. A dentistry school was established.

Implementation. Improving caries detection, assessment, diagnosis and monitoring.

PubMed

Pitts, N B

2009-01-01

This chapter deals with improving the detection, assessment, diagnosis and monitoring of caries to ensure optimal personalized caries management. This can be achieved by delivering what we have (synthesized evidence and international consensus) better and more consistently, as well as driving research and innovation in the areas where we need them. There is a need to better understand the interrelated pieces of the jigsaw that makes up evidence-based dentistry, i.e. the linkages between (a) research and synthesis, (b) dissemination of research results and (c) the implementation of research findings which should ensure that research findings change practice at the clinician-patient level. The current situation is outlined; it is at the implementation step where preventive caries control seems to have failed in some countries but not others. Opportunities for implementation include: capitalizing on the World Health Organization's global policy for improvement of oral health, which sets out an action plan for health promotion and integrated disease prevention; utilizing the developments around the International Caries Detection and Assessment System wardrobe of options and e-learning; building on initiatives from the International Dental Federation and the American Dental Association and linking these to patients' preferences, the wider moves to wellbeing and health maintenance. Challenges for implementation include the slow pace of evolution around dental remuneration systems and some groups of dentists failing to embrace clinical prevention. In the future, implementation of current and developing evidence should be accompanied by research into getting research findings into routine practice, with impacts on the behaviour of patients, professionals and policy makers. Copyright 2009 S. Karger AG, Basel

Caries experience of Egyptian adolescents: does the atraumatic restorative treatment approach offer a solution?

PubMed

Mobarak, E H; Shabayek, M M; Mulder, J; Reda, A H; Frencken, J E

2011-01-01

To assess the prevalence and severity of dental caries amongst Egyptian adolescents and the prevalence of carious lesions treatable through the atraumatic restorative treatment (ART) approach. Using a convenient sample procedure, two secondary schools with a dental clinic were selected (967 students, average age: 13.7 ± 0.8 years, range: 12-15). Dental caries was diagnosed using the ART caries criteria, and plaque and calculus were assessed using the Green and Vermillion criteria amongst students grades 1-3 in the dental clinic by 3 calibrated examiners. The effect of the independent variables gender, age, tooth surface, jaw side (left or right) and type of jaw (mandible/maxilla) on dependent caries experience variables and D(2) and D(3) variables were tested using ANOVA. The prevalence of dental caries including enamel lesion (D(2)MFT) amongst the 967 students was 51.4% and that of dental caries excluding enamel lesions (D(3)MFT) was 38.1%. The mean D(2)MFT and D(3)MFT scores were 1.5 and 0.8, respectively. The percentage of teeth filled and extracted was low. Female students had statistically significantly higher mean D(3)MFT/S and D(2)MFT/S scores than males (p < 0.0001). The prevalence of cavitated carious lesions (D(3)) treatable through ART was 48% for score 2 and 28% for score 3. Most of the cavitated lesions were found untreated despite the presence of a dental clinic and a dentist on the school premises. The majority of cavitated lesions without pulp involvement could be treated using the preventive and restorative components of the ART approach. Copyright © 2011 S. Karger AG, Basel.

[Individual and contextual determinants of the prevalence of untreated caries in Brazil].

PubMed

Frias, Antônio Carlos; Antunes, José Leopoldo Ferreira; Junqueira, Simone Rennó; Narvai, Paulo Capel

2007-10-01

To describe the prevalence of untreated caries among adolescents in Brazil and to analyze the association between caries and individual and contextual factors in the municipalities where these adolescents live. A Ministry of Health database (projeto SB-Brasil) provided health records on 16 833 adolescents from 15-19 years of age. The study variable used was the presence of at least one permanent tooth having been lost to caries. The individual variables considered were: sex, ethnic group, living in an urban versus a rural area, and being a student or not. Contextual variables related to the municipality were: municipal human development index (MHDI), proportion of households connected to the water system, and water fluoridation for 5 years or more. Multilevel logistic regression analysis was carried out to adjust the outcome to the individual and contextual variables. Individual determinants related to a higher probability of untreated caries were: the ethnic group described as "black or brown," (adjusted odds ratio, OR(adjust) = 1.79; 1.68 to 1.92); and living in a rural area (OR(adjust) = 1.31; 1.19 to 1.45). Being a student was identified as a protective factor (OR(adjust) = 0.67; 0.62 to 0.73). Secondary variables identified as contextual determinants of caries were MHDI (adjusted coefficient beta = -0.213), water fluoridation (beta = -0.201), and households connected to the water system (beta = -0.197). The results show inequalities in the distribution of health services in the various Brazilian regions, and suggest that inequalities may also be present in the effectiveness of the services provided. Policies to increase access to fluoride-treated water and school enrollment may contribute to preventing caries in adolescents.

The VicGeneration study - a birth cohort to examine the environmental, behavioural and biological predictors of early childhood caries: background, aims and methods

PubMed Central

2010-01-01

Background Dental caries (decay) during childhood is largely preventable however it remains a significant and costly public health concern, identified as the most prevalent chronic disease of childhood. Caries in children aged less than five years (early childhood caries) is a rapid and progressive disease that can be painful and debilitating, and significantly increases the likelihood of poor child growth, development and social outcomes. Early childhood caries may also result in a substantial social burden on families and significant costs to the public health system. A disproportionate burden of disease is also experienced by disadvantaged populations. Methods/Design This study involves the establishment of a birth cohort in disadvantaged communities in Victoria, Australia. Children will be followed for at least 18 months and the data gathered will explore longitudinal relationships and generate new evidence on the natural history of early childhood caries, the prevalence of the disease and relative contributions of risk and protective biological, environmental and behavioural factors. Specifically, the study aims to: 1. Describe the natural history of early childhood caries (at ages 1, 6, 12 and 18 months), tracking pathways from early bacterial colonisation, through non-cavitated enamel white spot lesions to cavitated lesions extending into dentine. 2. Enumerate oral bacterial species in the saliva of infants and their primary care giver. 3. Identify the strength of concurrent associations between early childhood caries and putative risk and protective factors, including biological (eg microbiota, saliva), environmental (fluoride exposure) and socio-behavioural factors (proximal factors such as: feeding practices and oral hygiene; and distal factors such as parental health behaviours, physical health, coping and broader socio-economic conditions). 4. Quantify the longitudinal relationships between these factors and the development and progression of early childhood caries from age 1-18 months. Discussion There is currently a lack of research describing the natural history of early childhood caries in very young children, or exploring the interactions between risk and protective factors that extend to include contemporary measures of socio-behavioural factors. This study will generate knowledge about pathways, prevalence and preventive opportunities for early childhood caries, the most prevalent child health inequality. PMID:20181292

Oral health status among children and adolescents in governmental and private schools of the Palestinian Territories.

PubMed

Abuhaloob, Lamis; Petersen, Poul Erik

2018-04-01

Political conflicts in the Palestinian Territories (PT) have resulted in systematic deterioration of socio-economic conditions and health. The World Health Organization (WHO) has emphasised the negative impacts of social crisis on children' oral health and quality of life. To assess the prevalence and trends in dental caries and poor gingival health of schoolchildren in the PT through the scholastic years 1998/1999 to 2012/2013. This is a retrospective study. Prevalence data on dental caries of primary and permanent dentitions among children 6, 12 and 16 years of age were gathered from annual oral health reports of the School Dental Health Programme (SDHP)-Ministry of Health. Caries was recorded according to WHO methods and criteria. Decayed, missing and filled teeth indices for primary (dmft) and permanent (DMFT) teeth were calculated. Gingival health status was examined according to the Community Periodontal Index (scores 1 and 2). Statistical analysis used SPSS. In 2012/2013, dental caries prevalence rates and the index scores among schoolchildren were as follows, respectively: 56.4% and 2.7 dmft at age 6; 42.0% and 1.4 DMFT at age 12; and 38.7% and 1.7 DMFT at age 16. For all age groups, the d/D-component of the caries indices was high. Trends of dental-caries prevalence, caries experience and gingival bleeding were fairly constant over time from 1998/1999. The SDHP was established in order to prevent and control oral diseases among schoolchildren in the PT. The Programme is fairly passive and the survey indicates an urgent need for reorientation of activities towards population-based prevention and health promotion. The application of the WHO Health Promoting Schools concept is highly recommended. © 2017 FDI World Dental Federation.

Milk Sweetened with Xylitol: A Proof-of-Principle Caries Prevention Randomized Clinical Trial.

PubMed

Chi, Donald L; Zegarra, Graciela; Vasquez Huerta, Elsa C; Castillo, Jorge L; Milgrom, Peter; Roberts, Marilyn C; Cabrera-Matta, Ailin R; Merino, Ana P

2016-09-15

To evaluate the efficacy of xylitol-sweetened milk as a caries-preventive strategy. In this nine-month prospective proof-of-principle trial, Peruvian schoolchildren were randomized to one of five different milk groups: (1) eight g of xylitol per 200 mL milk once per day; (2) four g of xylitol per 100 mL milk twice per day; (3) eight g of sorbitol per 200 mL milk once per day; (4) four g of sorbitol per 100 mL milk twice per day; or (5) eight g of sucrose per 200 mL milk once per day. The primary outcome was plaque mutans streptococci (MS) at nine months. A secondary outcome was caries incidence. We hypothesized that children in the xylitol groups would have a greater MS decline and lower caries incidence. One hundred fifty-three children were randomized in the intent-to-treat analyses. Children receiving xylitol had a greater decline in MS than children receiving sucrose (P=0.02) but were not different from children receiving sorbitol (P=0.07). Dental caries incidence for xylitol once per day or twice per day was 5.3±3.4 and 4.3±4.0 surfaces, respectively, compared to sorbitol once per day, sorbitol twice per day, or sucrose (4.1±2.8, 3.7±4.2, and 3.2±3.4 surfaces, respectively). There were no differences in caries incidence between xylitol and sucrose (rate ratio [RR] = 1.51; 95 percent confidence interval [CI] = 0.88, 2.59; P=0.13) or between xylitol and sorbitol (RR = 1.28; 95 percent CI = 0.90, 1.83; P=0.16). Xylitol-sweetened milk significantly reduced mutans streptococci levels compared to sucrose-sweetened milk, but differences in caries incidence were not detected.

Pyrosequencing analysis of oral microbiota shifting in various caries states in childhood.

PubMed

Jiang, Wen; Ling, Zongxin; Lin, Xiaolong; Chen, Yadong; Zhang, Jie; Yu, Jinjin; Xiang, Charlie; Chen, Hui

2014-05-01

Dental caries is one of the most prevalent childhood diseases worldwide, but little is known about the dynamic characteristics of oral microbiota in the development of dental caries. To investigate the shifting bacterial profiles in different caries states, 60 children (3-7-year-old) were enrolled in this study, including 30 caries-free subjects and 30 caries-active subjects. Supragingival plaques were collected from caries-active subjects on intact enamel, white spot lesions and carious dentin lesions. Plaques from caries-free subjects were used as a control. All samples were analyzed by 454 pyrosequencing based on 16S rRNA gene V1-V3 hypervariable regions. A total of 572,773 pyrosequencing reads passed the quality control and 25,444 unique phylotypes were identified, which represented 18 phyla and 145 genera. Reduced bacterial diversity in the cavitated dentin was observed as compared with the other groups. Thirteen genera (including Capnocytophaga, Fusobacterium, Porphyromonas, Abiotrophia, Comamonas, Tannerella, Eikenella, Paludibacter, Treponema, Actinobaculum, Stenotrophomonas, Aestuariimicrobium, and Peptococcus) were found to be associated with dental health, and the bacterial profiles differed considerably depending on caries status. Eight genera (including Cryptobacterium, Lactobacillus, Megasphaera, Olsenella, Scardovia, Shuttleworthia, Cryptobacterium, and Streptococcus) were increased significantly in cavitated dentin lesions, and Actinomyces and Corynebacterium were present at significant high levels in white spot lesions (P < 0.05), while Flavobacterium, Neisseria, Bergeyella, and Derxia were enriched in the intact surfaces of caries individuals (P < 0.05). Our results showed that oral bacteria were specific at different stages of caries progression, which contributes to informing the prevention and treatment of childhood dental caries.

Dermatoglyphics: a genetic marker of early childhood caries.

PubMed

Anitha, C; Konde, Sapna; Raj, N Sunil; Kumar, N C; Peethamber, Preetha

2014-01-01

It is an accepted fact that genetics plays an important role in determination of palmar dermatoglyphic patterns. Since caries is a multifactorial disease with the influence of genetic pattern, this study was undertaken to explore the possibility of dermatoglyphics as a noninvasive and early predictor of dental caries in children, so as to initiate preventive oral health measures at an early age. The study group comprised of 200 children aged between 4 and 5 years. The dmfs score was evaluated. The experimental group (Group 1), comprised of 100 children with early childhood caries (ECC) with dmfs >5. The control group (Group 2) comprised of 100 children with dmfs score of 0. An increased frequency of ulnar loops in caries-free children and whorls in children with ECC was observed. Low mean atd angle and low mean. Total ridge count was observed in the ECC group. There is definite variation in dermatoglyphics between the ECC and caries-free group, indicating that dermatoglyphic patterns can be used as a predictive tool for children with ECC.

Social inequalities and dental caries in six-year-old children from the Netherlands.

PubMed

van der Tas, Justin T; Kragt, Lea; Elfrink, Marlies E C; Bertens, Loes C M; Jaddoe, Vincent W V; Moll, Henriëtte A; Ongkosuwito, Edwin M; Wolvius, Eppo B

2017-07-01

The purpose of our study was to investigate the association of different socioeconomic and sociodemographic factors with dental caries in six-year-old children. Furthermore, we applied a district based approach to explore the distribution of dental caries among districts of low and high socioeconomic position (SEP). In our cross-sectional study 5189 six-year-olds were included. This study was embedded in a prospective population-based birth cohort study in Rotterdam, the Netherlands, the Generation R Study. Parental education level, parental employment status, net household income, single parenting, and teenage pregnancy were considered as indicators for SEP. Dental caries was scored on intraoral photographs by using the decayed, missing, and filled teeth (dmft) index. We compared children without caries (dmft=0) to children with mild caries (dmft=1-3) or severe caries (dmft >3). Multinomial logistic regression analyses and binary logistic regression analyses were performed to study the association between SEP and caries, and between district and caries, respectively. Only maternal education level remained significantly associated with mild caries after adjusting for all other SEP-indicators. Paternal educational level, parental employment status, and household income additionally served as independent indicators of SEP in children with severe caries. Furthermore, living in more disadvantaged districts was significantly associated with higher odds of dental caries. Dental caries is more prevalent among six-year-old children with a low SEP, which is also visible at the district level. Maternal educational level is the most important indicator of SEP in the association with caries. Our results should raise concerns about the existing social inequalities in dental caries and should encourage development of dental caries prevention strategies. New knowledge about the distribution of oral health inequalities between districts should be used to target the right audience for these strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation.

PubMed

Pithon, Matheus M; Dos Santos, Mariana J; Andrade, Camilla S S; Leão Filho, Jorge César B; Braz, Ana Karla S; de Araujo, Renato E; Tanaka, Orlando M; Fidalgo, Tatiana K S; Dos Santos, Adrielle M; Maia, Lucianne C

2015-04-01

To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets. For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed. Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not. The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts. Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

An oral health education video game for high caries risk children: study protocol for a randomized controlled trial.

PubMed

Aljafari, Ahmad; Rice, Colm; Gallagher, Jennifer Elizabeth; Hosey, Marie Therese

2015-05-28

Tooth decay is the most common chronic disease of childhood in the world. Many children develop caries early in their lives, and go on to develop further caries and sepsis as they grow up, indicating failure in prevention. As a result, many end up requiring general anaesthesia to undergo treatment for a disease that is completely preventable. Previous studies have suggested that the families of these children need better oral health education as well as better support in implementing healthy practices at home, as they feel impeded by broader life challenges. Parents of these children have suggested utilizing modern technologies, such as the internet, DVDs and video games as methods of delivery of education that might fit in with their busy lifestyles. The aim of this investigation is to assess the acceptability and efficiency of an oral health education video game directed at these children and their families. A two-armed phase-II randomized controlled trial will assess a children's oral health education video game in comparison with verbal oral health education in terms of: family satisfaction, effect on oral health knowledge, and effect on dietary and oral hygiene habits. Up to 110 four- to ten-year-old children, referred for tooth extraction under general anaesthesia due to caries, will be recruited. A sample of 45 participants in each group will be needed to provide 80% statistical power. The primary outcome measures for this study are: (1) parent and child satisfaction with the intervention, as indicated using a visual analogue scale; (2) improvement in the child's dietary knowledge measured by a pictorial dietary quiz; and (3) changes in the child's diet and oral hygiene habits, measured using a children's dietary questionnaire completed by the parent, and snacking and toothbrushing diaries completed by the child. Measures will be taken at baseline, directly after the intervention, and three months later. This study is a phase-II randomized controlled trial of an oral health education video game for high caries risk children and their families. Few protocols such as this are available in this much-needed research area. ISRCTN94617251.

Use of occlusal sealant in a community program and caries incidence in high- and low-risk children.

PubMed

Baldini, Vânia; Tagliaferro, Elaine Pereira da Silva; Ambrosano, Gláucia Maria Bovi; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos

2011-08-01

The aims of this study were to investigate the effectiveness of sealant placement under the guidelines of the Oral Health Promotion Program for Children and Adolescents (Portugal), and to test the influence of clinical and socioeconomic variables on the DMFT increment in 277 children, born in 1997. A dental hygienist performed the initial examinations and sealant placement (Helioseal, Vivadent) on the permanent first molars in 2005. These activities were registered in dental records that were assessed in 2007. Children were classified according to caries risk at baseline [high (HR: DMFT+dmft>0); low (LR: DMFT+dmft=0) risk] and sealant placement as follows: HR-S and LR-S Groups (with sealant placement); HR-NS and LR-NS Groups (without sealant placement). A calibrated dentist performed the final examination in 2007 at school, based on the World Health Organization recommendations. The variables collected were: dental caries, visible dental plaque, malocclusions, and socioeconomic level (questionnaire sent to children's parents). For univariate (Chi-square or Fisher tests) and multivariate (Multiple logistic regression) analyses the DMFT increment >0 was selected as dependent variable. Approximately 17.0% of the children showed DMFT increment>0 (mean=0.25). High-risk children presented a significant increase in the number of decayed and/or filled teeth. These children had 7.94 more chance of developing caries. Children who did not receive sealant were 1.8 more prone to have DMFT increment >0. It appears that sealant placement was effective in preventing dental caries development. Moreover, the variables "risk" and "sealant placement" were predictors for DMFT increment in the studied children.

Marginal regression models for clustered count data based on zero-inflated Conway-Maxwell-Poisson distribution with applications.

PubMed

Choo-Wosoba, Hyoyoung; Levy, Steven M; Datta, Somnath

2016-06-01

Community water fluoridation is an important public health measure to prevent dental caries, but it continues to be somewhat controversial. The Iowa Fluoride Study (IFS) is a longitudinal study on a cohort of Iowa children that began in 1991. The main purposes of this study (http://www.dentistry.uiowa.edu/preventive-fluoride-study) were to quantify fluoride exposures from both dietary and nondietary sources and to associate longitudinal fluoride exposures with dental fluorosis (spots on teeth) and dental caries (cavities). We analyze a subset of the IFS data by a marginal regression model with a zero-inflated version of the Conway-Maxwell-Poisson distribution for count data exhibiting excessive zeros and a wide range of dispersion patterns. In general, we introduce two estimation methods for fitting a ZICMP marginal regression model. Finite sample behaviors of the estimators and the resulting confidence intervals are studied using extensive simulation studies. We apply our methodologies to the dental caries data. Our novel modeling incorporating zero inflation, clustering, and overdispersion sheds some new light on the effect of community water fluoridation and other factors. We also include a second application of our methodology to a genomic (next-generation sequencing) dataset that exhibits underdispersion. © 2015, The International Biometric Society.

Probiotics as oral health biotherapeutics.

PubMed

Saha, Shyamali; Tomaro-Duchesneau, Catherine; Tabrizian, Maryam; Prakash, Satya

2012-09-01

Oral health is affected by its resident microorganisms. Three prominent oral disorders are dental caries, gingivitis and periodontitis, with the oral microbiota playing a key role in the initiation/progression of all three. Understanding the microbiota and the diseases they may cause is critical to the development of new therapeutics. This review is focused on probiotics for the prevention and/or treatment of oral diseases. This review describes the oral ecosystem and its correlation with oral health/disease. The pathogenesis and current prevention/treatment strategies of periodontal diseases (PD) and dental caries (DC) are depicted. An introduction of probiotics is followed by an analysis of their role in PD and DC, and their potential role(s) in oral health. Finally, a discussion ensues on the future research directions and limitations of probiotics for oral health. An effective oral probiotic formulation should contribute to the prevention/treatment of microbial diseases of the oral cavity. Understanding the oral microbiota's role in oral disease is important for the development of a therapeutic to prevent/treat dental diseases. However, investigations into clinical efficacy, delivery/dose optimization, mechanism(s) of action and other related parameters are yet to be fully explored. Keeping this in mind, investigations into oral probiotic therapies are proving promising.

Advances in the microbial etiology and pathogenesis of early childhood caries

PubMed Central

Hajishengallis, Evlambia; Parsaei, Yassmin; Klein, Marlise I.; Koo, Hyun

2016-01-01

Early childhood caries (ECC) is one of the most prevalent infectious diseases affecting children worldwide. ECC is an aggressive form of dental caries, which left untreated, can result in rapid and extensive cavitation in teeth (rampant caries) that is painful and costly to treat. Furthermore, it affects mostly children from impoverished background, and thus constitutes a major challenge in public health. The disease is a prime example of the consequences arising from complex, dynamic interactions between microorganisms, host and diet, leading to the establishment of highly pathogenic (cariogenic) biofilms. To date, there are no effective methods to identify those at risk of developing ECC or control the disease in affected children. Recent advances in deep-sequencing technologies, novel imaging methods and (meta)proteomics-metabolomics approaches provide an unparalleled potential to reveal new insights to illuminate our current understanding about the etiology and pathogenesis of the disease. In this concise review, we provide a broader perspective about the etiology and pathogenesis of ECC based on previous and current knowledge on biofilm matrix, microbial diversity and host-microbe interactions which could have direct implications for developing new approaches for improved risk assessment and prevention of this devastating and costly childhood health condition. PMID:26714612

The economics of pit and fissure sealants in preventive dentistry: a review.

PubMed

Kitchens, Dinah H

2005-08-15

Oral diseases are progressive, cumulative, and become more intricate to treat with advancement. While dental caries is an infectious transmissible disease with children being at the highest risk, primary prevention can reduce this risk. Primary prevention in dentistry is usually considered to be community fluoridated water supplies, professional fluoride treatments, and pit and fissure sealants. While community fluoridated water supplies have been proven to be cost-effective, the cost-effectiveness of pit and fissure sealants has primarily been studied in school-based programs of children from low socio-economic backgrounds. Dental sealant programs are just one way to help increase primary prevention in the oral health disparities of children. The purpose of this paper is to review the literature regarding the cost-effectiveness of pit and fissure sealants as a preventive strategy in preventive dentistry.

Effectiveness of water fluoridation in the prevention of dental caries across adult age groups.

PubMed

Do, Loc; Ha, Diep; Peres, Marco A; Skinner, John; Byun, Roy; Spencer, A John

2017-06-01

Lifetime access to fluoridated water (FW) is associated with lower caries experience. However, assessing this association in adults is likely affected by age. Cohort stratification and categorization of per cent lifetime access to fluoridated water (% LAFW) within cohorts are current approaches to this assessment. These approaches require an examination of the % LAFW and caries experience variation within and across age groups and their association to inform future analyses. This secondary analysis aimed to examine the age group variation in % LAFW and caries experience; and the association of % LAFW with caries within and across age groups of adults. A secondary analysis was undertaken using the Australian National Survey of Adult Oral Health 2004-2006 data on 4090 persons aged 15-91 years randomly sampled by a stratified, multistage probability method. Study participants underwent an interview, an oral examination by trained and standardized dentists to determine decayed, missing or filled tooth surfaces (DMFS) and a mailed self-complete questionnaire which collected residential history to calculate % LAFW. Variations in % LAFW and DMFS across age groups (15-34; 35-44; 45-54; 55+) were examined. Multivariable regression log-link models were generated for DMFS score within each age group. The age groups varied in values and distribution of % LAFW. Caries experience was strongly associated with age. % LAFW was significantly associated with DMFS score in the two younger age groups, but not in the others. Multivariable regression models showed that the highest % LAFW quartile had significantly lower DMFS count than the lowest quartile in the two younger age groups (mean ratios: 0.67 and 0.78, respectively), controlling for other covariates. Access to FW was associated with caries experience in Australian adults. The magnitude of associations varied between age groups, dependent on the natural history of caries and its measurement by DMFS. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Early childhood caries--a public oral health problem].

PubMed

Dănilă, I; Evghenikos, Adina

2007-01-01

The purpose of this study was to determine the prevalence and severity of dental caries in preschool children from nurseries and kindergartens in Iaşi, an urban city in Romania. The study assessed the dental health status in 2 age groups. The first group included 366 children aged 2, 5-3 years and the second group included 455 children aged 4,5-5 years in 2005. The children were subjected to dental examination in 2005 and 2006 and the prevalence and severity of caries for each age group were determined. Evaluation was based on questionnaire completed by mothers and on clinical assessment of preschool children's oral health status. The mean number of decayed, missing and filled primary teeth (dmft) in the first group was 1.76 in 2005 and 2.39 in 2006, while the significant caries index increased from 4.79 to 6.35 during this period of time. For the 4.5-5 year children, the mean values for the dmft index were 3.95 in 2005 and 3.67 in 2006, while significant caries index increased from 7.89 to 8.4. Early childhood caries are the result of both inadequate diet behavior and cariogenic germs transmission from mother. The presence and extension of carious lesions in primary teeth are the most important predictors of permanent teeth disease. The high prevalence and severity of dental caries in pre-school children indicated that dental health program that include both prevention and treatment services targeted for young children and their parents is urgently needed. Socio-economic status improvement, changes in lifestyle, effective use of oral health services, and most of all, oral hygiene and use of fluoride would lead to obvious changes in caries prevalence and severity of disease. The study high-lights the importance of change of attitudes and improvement of knowledge in parents, children and educators in order to reach a healthy lifestyle.

Contemporary evidence on the effectiveness of water fluoridation in the prevention of childhood caries.

PubMed

Spencer, A John; Do, Loc G; Ha, Diep H

2018-06-05

Water fluoridation's effectiveness has been reaffirmed by systematic reviews. However, most of the included nonrandomised controlled before and after studies were conducted pre-1975. Opportunity for such studies is limited in a steady state of community fluoridation programmes. As an alternative for evidence to support or refute the effectiveness of water fluoridation, this study used data from a recent national child oral health study to examine associations between lifetime exposure to fluoridated water (%LEFW) and childhood caries. A population-based study of child oral health in Australia was conducted in 2012-2014, using complex sampling and weighting procedures. Parents provided detailed household information and children underwent oral epidemiological examination by trained examiners. Residential history from birth was used to calculate %LEFW. Caries prevalence (dmfs/DMFS>0) and experience (dmfs/DMFS) in both primary (age 5-8) and permanent dentitions (age 9-14) were estimated. Socioeconomic factors that were significantly different by %LEFW were then used as covariates in multivariable log-Poisson regression models for each caries outcome by %LEFW. A total of 24 664 children had complete data. Caries prevalence and experience were higher among 5-8-year-old children with lower %LEFW (46.9%; 4.27 surfaces) than those with 100%LEFW (31.5%; 1.98 surfaces) and for the 9-14-year-old children with lower %LEFW (37.0%; 1.34 surfaces) than those with 100%LEFW (25.0%; 0.67 surfaces). In the multivariable models, the prevalence ratios for primary and permanent caries were significant for the two lower exposure groups against the 100%LEFW group. Similarly, the mean ratios for primary dmfs were significant for all three lower exposure groups and for permanent DMFS were significant for the two lower exposure groups against the 100%LEFW group. Mean ratios for the 0%LEFW compared to the 100%LEFW group were 2.10 (1.83-2.40) for dmfs and 1.82 (1.57-2.10) for DMFS. Analysis of contemporary data representative of the Australian child population found consistent associations between %LEFW and childhood caries, which persisted when socioeconomic differences were adjusted across exposure groups, supporting the continued effectiveness of water fluoridation. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Oral health knowledge and practices of dentists practicing in a teaching hospital in Nigeria.

PubMed

Jegede, Akinlolu Tolulope; Oyedele, Titus Ayodeji; Sodipo, Babasola Olufemi; Folayan, Morenike Oluwatoyin

2016-01-01

To assess the oral health practices and knowledge of practicing dentists at a tertiary health institution in Nigeria, and the possible association of age and sex with caries prevention practices. A cross-sectional study was conducted. All practicing dentists in the institution were eligible to participate in the study. A questionnaire that assessed oral health practices and knowledge was administered. Respondents were expected to select the most appropriate responses that reflected their knowledge of oral health practices and caries prevention practices. Questions included assessment of knowledge and practice of tooth brushing, flossing, refined carbohydrate intake, and dental service utilization. Participants' responses were scored and dichotomized to poor and good knowledge, and poor and good practices, using the median scores. Bivariate analysis was conducted to identify factors associated with good and poor oral health practices, and good and poor knowledge. Fifty-two eligible study participants were accessible at the time of questionnaire administration. Only 46 respondents returned the filled questionnaire giving a response rate of 88.5%. The age of respondents ranged between 25 and 48 years. The majority of respondents had good oral health practices (65.2%) and good oral health knowledge (85%). However, few respondents had good caries prevention practices: 39.2% brushed at least twice daily, 45.7% took refined carbohydrate less than once daily, 36.9% used dental floss at least once daily, and 60.9% undertook preventive dental care. The correlation between the dentists' oral health knowledge score and oral health practices score was insignificant (0.90; P = 0.55). A large number of dentists practicing in the tertiary hospital had good oral health practices and good oral health knowledge. However, the proportion of dentists with good caries prevention practices was low.

Reducing early childhood caries in a Medicaid population: a systems model analysis.

PubMed

Edelstein, Burton L; Hirsch, Gary; Frosh, Marcy; Kumar, Jayanth

2015-04-01

Despite early childhood caries (ECC) being largely preventable, its repair accounts for a disproportionate share of Medicaid expenditures. In this study, the authors model disease reductions and cost savings from ECC management alternatives. The authors apply system dynamics modeling to the New York State Medicaid population of young children to compare potential outcomes of 9 preventive interventions (water fluoridation, fluoride varnish, fluoride toothpaste, medical screening and fluoride varnish application, bacterial transmission reduction, motivational interviewing, dental prevention visits, secondary prevention, and combinations) and the effect of defluoridating New York City. Model simulations help project 10-year disease reductions and net savings from water fluoridation, motivational interviewing, and fluoride toothpaste. Interventions requiring health professionals cost more than they save. Interventions that target children at high risk, begin early, and combine multiple strategies hold greatest potential. Defluoridating New York City would increase disease and costs dramatically. The variety of population-level and individual-level interventions available to control ECC differ substantially in their capacity to improve children's oral health and reduce state Medicaid expenditures. Using Medicaid and health department dollars to deliver ECC preventive and management interventions holds strong promise to improve children's oral health while reducing state dental expenditures in Medicaid. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Bariatric surgery as a risk factor in the development of dental caries: a systematic review.

PubMed

Salgado-Peralvo, A O; Mateos-Moreno, M V; Arriba-Fuente, L; García-Sánchez, Á; Salgado-García, A; Peralvo-García, V; Millán-Yanes, M

2018-02-01

Obesity is one of the most prevalent chronic pathologies in the world and has become a public health problem. At the present time, bariatric surgery (BS) is considered the best option and the only effective method of treatment, but it can occasionally result in a series of alterations at the oral level. This study aims to review the current literature to establish the possible association of patients who have undergone BS and a greater risk of dental caries. This study is a systematic review of the literature. A search was made in the database of Medline (via PubMed), over the last 10 years, using the keywords 'bariatric surgery' OR 'gastrectomy' OR 'obesity surgery,' combined independently with the terms 'saliva' and 'dental caries' by means of the connector 'AND.' The criteria used were those described in the PRISMA® Declaration for performing systematic reviews. Inclusion criteria and study selection: (a) studies done with humans; (b) articles published in English and Spanish; (c) series of cases; and (d) clinical trials. The risk of bias was assessed independently by two authors. In both data extraction and risk of bias assessment, disagreements were resolved through discussion with a third author. Two independent reviewers read the titles and summaries of the 79 articles found. Finally, nine of them were included in the study. In the various articles, the parameters that had clinical relevance to the risk of dental caries were evaluated. Within the limitations of this study, it is plausible to think that patients who have undergone BS have a greater risk of dental caries. The oral complications associated with BS could be prevented or minimized by including in the multidisciplinary treatment of these patients a team of odontologists who would be responsible for prevention and oral assessment. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Caries Risk Assessment Item Importance

PubMed Central

Chaffee, B.W.; Featherstone, J.D.B.; Gansky, S.A.; Cheng, J.; Zhan, L.

2016-01-01

Caries risk assessment (CRA) is widely recommended for dental caries management. Little is known regarding how practitioners use individual CRA items to determine risk and which individual items independently predict clinical outcomes in children younger than 6 y. The objective of this study was to assess the relative importance of pediatric CRA items in dental providers’ decision making regarding patient risk and in association with clinically evident caries, cross-sectionally and longitudinally. CRA information was abstracted retrospectively from electronic patient records of children initially aged 6 to 72 mo at a university pediatric dentistry clinic (n = 3,810 baseline; n = 1,315 with follow-up). The 17-item CRA form included caries risk indicators, caries protective items, and clinical indicators. Conditional random forests classification trees were implemented to identify and assign variable importance to CRA items independently associated with baseline high-risk designation, baseline evident tooth decay, and follow-up evident decay. Thirteen individual CRA items, including all clinical indicators and all but 1 risk indicator, were independently and statistically significantly associated with student/resident providers’ caries risk designation. Provider-assigned baseline risk category was strongly associated with follow-up decay, which increased from low (20.4%) to moderate (30.6%) to high/extreme risk patients (68.7%). Of baseline CRA items, before adjustment, 12 were associated with baseline decay and 7 with decay at follow-up; however, in the conditional random forests models, only the clinical indicators (evident decay, dental plaque, and recent restoration placement) and 1 risk indicator (frequent snacking) were independently and statistically significantly associated with future disease, for which baseline evident decay was the strongest predictor. In this predominantly high-risk population under caries-preventive care, more individual CRA items were independently associated with providers’ risk determination than with future caries status. These university dental providers considered many items in decision making regarding patient risk, suggesting that, in turn, these comprehensive CRA forms could also aid individualized care, linking risk assessment to disease management. Knowledge Transfer Statement: Caries risk assessment (CRA) is widely recommended for patient-tailored, prevention-focused caries management. Studies show mixed predictive performance of pediatric CRA instruments, but little is known regarding how information captured in CRA forms guides clinical decision making. This study, in high-caries prevalence 6- to 72-mo-olds, demonstrates the following: 1) most items in a CRA instrument were independently associated with practitioners’ risk designations, 2) practitioners’ risk designations were significantly associated with future disease, and 3) of baseline measures associated with future caries, evident decay was the strongest independent indicator of future caries status. Although current disease (resulting from existing pathological and protective factor imbalance) may sufficiently predict future caries status in populations, other CRA items incorporated during risk categorization could aid practitioners to develop individualized intervention strategies against identified risk factors. PMID:27403458

Knowledge, attitudes and self-reported practices toward children oral health among mother's attending maternal and child's units, Salé, Morocco.

PubMed

Chala, Sanaa; Houzmali, Soumia; Abouqal, Redouane; Abdallaoui, Faïza

2018-05-11

The occurrence of severe dental caries is particularly prevalent and harmful in children. A better understanding of parental factors that may be indicators of children's risk of developing dental caries is important for the development of preventive measures. This study was conducted to assess knowledge, attitudes, and practices (KAP) of mothers in Salé, Morocco regarding oral health and their predictors. A cross-sectional KAP study was conducted of Mother and Child units in Salé, Morocco. Mothers attending the selected units from November 2014 to 29 January 2015 were recruited. Data were collected using a semi-structured questionnaire, administered by face-to-face interviews, to record socio-demographic factors and KAPs. The main outcome measures included knowledge about oral health diseases and preventive measures, and attitudes and practices related to oral health prevention measures and dental care. KAPs scores were then recoded based on responses and scores were determined for each KAP domain. Linear regression analysis was conducted to assess predictors of KAP scores. Among 502 mothers included, 140 (27.8%) were illiterate and 285 (60.9%) were aware that fluoride has a beneficial effect in caries prevention. Mothers' own practices about dental care were statistically related to their children's use of dental care services (p < 0.001). Multiple linear regression analysis revealed that the knowledge score was associated with mother's age (β = 0.05; 95% CI; p < 0.001), education level, and median income (β = 0.38; p = 0.04). Significant predictors of oral health-related practices were mother's education level and children's health status. Limited KAP scores were observed among the studied population. A great emphasis on oral health education and some risk factor modifications are recommended.

Dentists' perspectives on caries-related treatment decisions.

PubMed

Gomez, J; Ellwood, R P; Martignon, S; Pretty, I A

2014-06-01

To assess the impact of patient risk status on Colombian dentists' caries related treatment decisions for early to intermediate caries lesions (ICDAS code 2 to 4). A web-based questionnaire assessed dentists' views on the management of early/intermediate lesions. The questionnaire included questions on demographic characteristics, five clinical scenarios with randomised levels of caries risk, and two questions on different clinical and radiographic sets of images with different thresholds of caries. Questionnaires were completed by 439 dentists. For the two scenarios describing occlusal lesions ICDAS code 2, dentists chose to provide a preventive option in 63% and 60% of the cases. For the approximal lesion ICDAS code 2, 81% of the dentists chose to restore. The main findings of the binary logistic regression analysis for the clinical scenarios suggest that for the ICDAS code 2 occlusal lesions, the odds of a high caries risk patient having restorations is higher than for a low caries risk patient. For the questions describing different clinical thresholds of caries, most dentists would restore at ICDAS code 2 (55%) and for the question showing different radiographic thresholds images, 65% of dentists would intervene operatively at the inner half of enamel. No significant differences with respect to risk were found for these questions with the logistic regression. The results of this study indicate that Colombian dentists have not yet fully adopted non-invasive treatment for early caries lesions.

Dental caries experience and barriers to care in young children with disabilities in Ireland.

PubMed

Sagheri, Darius; McLoughlin, Jacinta; Nunn, June H

2013-02-01

Dental caries among preschool children remains a significant dental public health problem. In Ireland, there are no national data available regarding dental caries levels in preschool children. Furthermore, the number of young children with disabilities and their dental caries levels remains unknown. The aim of the present study was to measure the dental caries levels in a sample of preschool children with disabilities. A team of trained and calibrated dentists examined a sample of all 0- to 6-year old preschool children with disabilities in two health service administrative areas under standardized conditions. Dental caries was recorded using WHO criteria. Of a total of 422 participants, 337 datasets were included in the study. Of these 337 examined children, approximately 75.1% had a cognitive disability and 12.9% had a noncognitive disability. In 12% of the children, a diagnosis had not yet been established. Dental caries at dentin level was detected from the age of 4 years. The overall mean decayed/missing/ filled teeth (dmft) was 0.49 (SD, 1.39). The analysis of mean dmft levels in children with positive (dmft > 0) scores revealed a mean dmft of 1.14. The evidence from this study demonstrated that dental caries levels in preschool children with disabilities in Ireland are low when compared with the general population. Furthermore, children aged 3 years or younger exhibited no dental caries at dentin level and therefore were not affected by early childhood caries. An adjustment of current oral health prevention practice may lead to a further reduction in dental caries levels in this section of the child population.

Occurrence of dental caries in primary and permanent dentition, oral health status and treatment needs among 12-15 year old school children of Jorpati VDC, Kathmandu.

PubMed

Shrestha, N; Acharya, J; Sagtani, A R; Shrestha, R; Shrestha, S

2014-12-01

Dental caries occurrence, distribution, oral health status and corresponding treatment needs in 12 - 15 year old children are useful tools for evaluation of oral health. Dental caries status along with its treatment needs was recorded according to World Health Organization (WHO) index (1997) in 366 children from five schools within Jorpati Village Development Committee (VDC), Kathmandu. Dental caries was diagnosed in 156 (42.6%) children, out of which 122 (78.21%) had caries in permanent teeth, 26 (16.67%) had caries in primary teeth, and 8 (5.13%) had caries in both dentition. The age wise distribution of dental caries showed the highest prevalence among 12 year old students (23.8%) and the lowest among 15 year olds (3.8%). Among the female students (177), 43.5% showed presence of dental caries, while the prevalence among male students (179) was 41.8%.Out of the total number of teeth affected by dental caries (336), 273 (81.25%) were permanent teeth and 63 (18.75%) were primary teeth. The intra arch distribution of dental caries in permanent as well as primary dentition was statistically significant (P < 0.05). Restorative treatment (89.38%) was the main need in permanent dentition, and endodontic treatment (60.32%) in primary dentition. Chronologic enamel hypoplasia was found in 14 (3.83%) of the total population, and 62 (16.94%) required oral prophylaxis. These findings are significant as they can initiate further research in this area, which may help establish reliable baseline data for implementation of preventive oral health programs.

Characterization of enamel caries lesions in rat molars using synchrotron X-ray microtomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Free, R. D.; DeRocher, K.; Stock, S. R.

Dental caries is a ubiquitous infectious disease with a nearly 100% lifetime prevalence. Rodent caries models are widely used to investigate the etiology, progression and potential prevention or treatment of the disease. To explore the suitability of these models for deeper investigations of intact surface zones during enamel caries, the structures of early-stage carious lesions in rats were characterized and compared with previous reports on white spot enamel lesions in humans. Synchrotron X-ray microcomputed tomography non-destructively mapped demineralization in carious rat molar specimens across a range of caries severity, identifying 52 lesions across the 30 teeth imaged. Of these lesions,more » 13 were shown to have intact surface zones. Depth profiles of fractional mineral density were qualitatively similar to lesions in human teeth. However, the thickness of the surface zone in the rat model ranges from 10 to 58 µm, and is therefore significantly thinner than in human enamel. These results indicate that a fraction of lesions in rat caries possess an intact surface zone and are qualitatively similar to human lesions at the micrometer scale. This suggests that rat caries models may be a suitable analog through which to investigate the structure of surface zone enamel and its role during dental caries.« less

A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research.

PubMed

Chi, Donald L; Luu, Monique; Chu, Frances

2017-06-01

What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children? Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children. The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed. Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health). Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children. © 2017 American Association of Public Health Dentistry.

The effect of tobacco and marijuana use on dental health status in Nevada adolescents: a trend analysis.

PubMed

Ditmyer, Marcia; Demopoulos, Christina; McClain, Mildred; Dounis, Georgia; Mobley, Connie

2013-05-01

Tobacco use is the leading cause of preventable death worldwide. If current trends persist, tobacco will kill more than 8 million people worldwide by 2030 and 1 billion by the end of the century. The purpose of this study was to determine trends in tobacco/marijuana use in Nevada adolescents and their effect on dental health status. Relative comparative data were compared with nationally reported data. Retrospective data in this cohort study was from an ongoing statewide, school-based, dental health screening initiative that was conducted across 8 years (2002-2010) in public/private middle/high schools in Nevada. A total of 66,941 dental health screenings of adolescents between ages 13-18 were conducted. Self-reported data were collected on tobacco/marijuana use. Descriptive statistics and trends were reported. Means (SE) were computed for caries prevalence and severity. Effect size was reported on dental caries and use of tobacco/marijuana. Overall, percentage prevalence of tobacco use was approximately the same as the national average; however, there were significantly higher rates of marijuana use (12.0% vs. 3.3%). Prevalence and severity of dental caries was significantly higher in those who used tobacco/marijuana than those who did not across all variables and across all 8 years controlling for gender, race/ethnicity, where they lived, and exposure to secondhand smoke. Tobacco use negatively affected dental health status with marijuana having the largest negative effect. The findings from this study identified the need for tobacco/marijuana prevention services targeting adolescents residing in the geographic areas most at risk. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Emerging technologies for diagnosis of dental caries: The road so far

NASA Astrophysics Data System (ADS)

Amaechi, Bennett T.

2009-05-01

It is now universally recognized that the development of new technologies for early detection and quantitative monitoring of dental decay at an early stage of formation could provide health and economic benefits ranging from timely preventive interventions to reduction in the time required for clinical trials of anticaries agents. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time. The need and the importance of these technologies were also discussed. The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, and in vitro and in vivo studies. References have been traced manually by MEDLINE® or through manufacturer's websites. While some of the devices are fully developed and commercially available, others are still under development. The devices vary in their modes of action as well as their capability as caries diagnostic aids. It is clear that the differences in caries presentations and behavior in different anatomical sites make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection of carious lesions for all sites; a combination of diagnostic tools will help us diagnose lesions earlier and detect failing restorations sooner, all to avoid more costly, destructive dental procedures and truly take dentistry into the preventive rather than the reactive mode.

Enhanced adhesion of Streptococcus mutans to hydroxyapatite after exposure to saliva.

PubMed

Spengler, Christian; Thewes, Nicolas; Nolle, Friederike; Faidt, Thomas; Umanskaya, Natalia; Hannig, Matthias; Bischoff, Markus; Jacobs, Karin

2017-07-01

Streptococcus mutans cells form robust biofilms on human teeth and are strongly related to caries incidents. Hence, understanding the adhesion of S. mutans in the human oral cavity is of major interest for preventive dentistry. In this study, we report on atomic force microscopy-based single-cell force spectroscopy measurements of S. mutans cells to hydroxyapatite surfaces. We observe for almost all measurements a significant difference in adhesion strength for S. mutans as well as for Staphylococcus carnosus cells. However, the increase in adhesion strength after saliva exposure is much higher for S. mutans cells compared to S. carnosus cells. Our results demonstrate that S. mutans cells are well adapted to their natural environment, the oral cavity. This ability promotes the biofilm-forming capability of that species and hence the production of caries-provoking acids. In consequence, understanding the fundamentals of this mechanism may pave a way towards more effective caries-reducing techniques. Copyright © 2017 John Wiley & Sons, Ltd.

[Caries and fluorine: role of water factor, problems and solutions].

PubMed

Rakhmanin, Iu A; Kir'ianova, L F; Mikhaĭlova, R I; Sevost'ianova, E M

2001-01-01

The epidemiological studies of the severity and spread of caries of deciduous and permanent teeth in Moscow schoolchildren (n = > 20,000) aged 7-17 years in relation to the content of fluoride in the drinking water, to the use of fluorine-containing tablets and varnishes have provided evidence for the high efficiency of drinking water fluorination for the primary prevention of caries as compared with other preventive alternatives. Based on sanitary studies, two main lines are now under way in solving the problem connected with low dietary fluoride intake: the introduction of routine water-purifying fluorine generators (based on a new technology of fluorination of limited water volumes for drinking and cooking) and the setting-up of plants manufacturing bottled drinking waters containing the optimum or higher fluorine levels for provision of different population groups, primarily children and pregnant women in particular.

Caries-preventive effect of fissure sealant containing surface reaction-type pre-reacted glass ionomer filler and bonded by self-etching primer.

PubMed

Shimazu, Kisaki; Ogata, Kiyokazu; Karibe, Hiroyuki

2012-01-01

We aimed to evaluate the caries-preventive effect of a fissure sealant containing surface reaction-type pre-reacted glass ionomer (S-PRG) filler and bonded by self-etching primer versus those of 2 conventional resin-based sealants bonded by acid etching in terms of its impact on enamel demineralization and remineralization, enamel bond strength, and integrity of debonded enamel surfaces. Demineralization, remineralization, and bond strength on untreated enamel and enamel subsurface lesions of bovine incisors were assessed among the sealants by polarizing microscopy and microradiography; debonded enamel surfaces were examined by scanning electron microscopy. The conventional resin-based sealants bonded by acid etching caused surface defects on the enamel subsurface lesions and significantly increased the lesion depth (p = 0.014), indicative of enamel demineralization. However the S-PRG filler-containing sealant bonded by self-etching primer maintained the enamel surface integrity and inhibited enamel demineralization. No difference in bond strength on both untreated enamel and enamel subsurface lesions was noted among the sealants. An S-PRG filler-containing fissure sealant bonded by self-etching primer can prevent enamel demineralization, microleakage, and gaps without the tags created by acid etching regardless of the enamel condition. Such sealants are suitable for protecting the pits and fissures of immature permanent teeth.

Effects of subpressure on the sealing ability of dental sealant in vitro.

PubMed

Tian, Y M; Zhuge, R S; Zhang, Z T; Zheng, D X; Ding, N; Li, Y M

2018-06-06

Pits and fissures sealing with flowable materials is a popular method for preventing caries in preventive dentistry while there is still microleakage existed. This in vitro study aimed to explore the effects of subpressure technique on the sealing ability of pit and fissure sealant. One hundred and forty-one extracted human premolars were collected in this study and treated with different pressure (atmosphere pressure as group C, -0.04 MPa as group S 4 and -0.08 MPa as group S 8 ). Thermocycling (×5000) was also performed. Penetration percentage, microleakage, cross-sectional microhardness (Knoop, KMH) and mineral loss were evaluated. Kappa tests, Friedman nonparametric and two-way ANOVA were used for data analysis. Penetration percentages of group S 4 and S 8 were significant higher compared to that of group C. Microleakage of groups was similar before thermocycling, while subpressure groups showed lower scale of microleakage after thermocycling. Data of KMH and mineral loss showed significant differences between subpressure and thermocycling groups. Subpressure technique could increase the penetration of pit and fissure sealant, decrease microleakage and increase resistance of demineralization after thermocycling. This novel technique may have great potential for preventing from secondary caries. Copyright © 2018 Elsevier Ltd. All rights reserved.

Equine peripheral dental caries: An epidemiological survey assessing prevalence and possible risk factors in Western Australian horses.

PubMed

Jackson, K; Kelty, E; Tennant, M

2018-01-01

Peripheral dental caries is defined as macroscopic destruction of the calcified dental tissues and can cause considerable dental pathology and pain. It appears to occur at a high prevalence in Western Australian horses. At present, risk factors for the condition are poorly understood, making treatment and prevention difficult. To assess the prevalence of and potential risk factors for peripheral caries in Western Australian horses. Cross-sectional, epidemiological study. A survey of 500 Western Australian horses was administered in two sections. The first section was completed by the owner and referred to the horse's signalment, diet and husbandry conditions. The second section was completed by veterinarians and focused on the horse's oral health. A multivariable logistic regression model was used to assess risk factors associated with peripheral caries. Peripheral caries was present in 58.8% (95% confidence interval [CI] 54.5-63.1%) of surveyed horses. Breed was significantly associated with peripheral caries, with Warmbloods (odds ratio [OR] 0.44, 95% CI 0.24-0.82; P = 0.009) and Western breeds (OR 0.38, 95% CI 0.19-0.78; P = 0.008) being less likely to have peripheral caries than Thoroughbreds. Dietary risk factors included oaten hay (OR 2.90, 95% CI 1.87-4.53; P<0.001). A meadow hay-based diet was protective (OR 0.47, 95% CI 0.27-0.80; P = 0.005). Horses with access to quality pasture all year were less likely to have peripheral caries than horses without access to grazing (OR 0.31, 95% CI 0.15-0.66; P = 0.002), as were horses on groundwater compared with horses on rainwater (OR 3.35, 95% CI 1.65-6.78; P = 0.001), drinking water (OR 2.03, 95% CI 1.14-3.62; P = 0.016) or dam water (OR 3.53, 95% CI 1.08-11.53; P = 0.037). Peripheral caries was positively correlated with periodontal disease (OR 4.53, 95% CI 2.91-7.06; P<0.001) and feed packing (feed present between the teeth without significant periodontal pocketing) (OR 1.94, 95% CI 1.32-2.85; P = 0.001). Not every owner of eligible horses seen during the study period agreed to participate. An epidemiological study is unable to show causality. Western Australian horses have a high prevalence of peripheral caries. Management factors that may help to prevent or reduce peripheral caries include more access to quality pasture, use of groundwater, feeding on meadow hay and avoidance of oaten hay. © 2017 EVJ Ltd.

Total Breast-Feeding Duration and Dental Caries in Healthy Urban Children.

PubMed

Wong, Peter D; Birken, Catherine S; Parkin, Patricia C; Venu, Isvarya; Chen, Yang; Schroth, Robert J; Maguire, Jonathon L

2017-04-01

To determine if there is an association between longer breast-feeding duration and dental caries in healthy urban children. We conducted a cross-sectional study of urban children aged 1 to 6 years recruited through The Applied Research Group for Kids (TARGet Kids!) practice-based research network between September 2011 and August 2013. The main outcome measure was parental report of dental caries. The adjusted predicted probability of dental caries was 7%, 8%, 11%, and 16% with total duration of breast-feeding duration of 12, 18, 24, and 36 months, respectively. In the adjusted logistic regression analyses, relative to breast-feeding 0 to 5 months, the odds of dental caries with total breast-feeding duration >24 months was 2.75 (95% confidence interval 1.61-4.72). Among healthy urban children, longer breast-feeding duration was associated with higher odds of dental caries. These findings support heightened awareness and enhanced anticipatory guidance for preventive dental care, particularly among children who breast-feed beyond 2 years of age. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Comprehensive Oral Health Care to Reduce the Incidence of Severe Early Childhood Caries (s-ECC) in Urban China.

PubMed

Si, Yan; Guo, Yan; Yuan, Chao; Xu, Tao; Zheng, Shu Guo

2016-03-01

To explore the effectiveness of comprehensive oral health care to reduce the caries incidence for children with severe early childhood caries (s-ECC) in an urban area in China. A total of 357 children aged 3 to 4 years old and diagnosed with s-ECC were recruited in this randomised controlled, single-blinded clinical trial for 1 year. Children of two different kindergarten classes were enrolled in this study and randomly divided into a test group (205 children) and a control group (152 children). The test group received comprehensive oral health care, which included: oral health examination, oral health education, topical fluoride application and dental treatment, and the children in the control group only received the oral health examination. The evaluation of the oral health questionnaire for parents was also performed. An evaluation was carried out at the time of recruitment and 1 year later to explore the effectiveness of the comprehensive oral health care model. The differences in decayed teeth (dt), decayed tooth surfaces (ds), filled teeth (ft), filled tooth surfaces (fs) and the ratio of ft /(dt + ft) between the two groups were statistically significant (P < 0.001) at 1 year. The incidence of caries in the control group was higher than that of the test group (P = 0.02). The rate of awareness of oral health knowledge (P = 0.01) and the practice of good diet habits (P = 0.02) by parents in the test group were significantly higher than those in the control group. The present study demonstrated that the comprehensive oral health care program reduces and prevents caries amongst children with s-ECC.

Prevalence of Dental Caries and Periodontal Disease in Mexican American Children Aged 5 to 17 Years: Results from Southwestern HHANES, 1982-83.

ERIC Educational Resources Information Center

Ismail, Amid L.; And Others

1987-01-01

Dental caries and periodontal disease in Mexican American children of the southwestern United States occur mainly in molars, lending strong support for the use of fissure sealants as a preventive procedure. This study also reports on the prevalence of fillings decay and gingivitis in this population. (VM)

Caries Risk Assessment for Determination of Focus and Intensity of Prevention in a Dental School Clinic.

ERIC Educational Resources Information Center

Dodds, Michael W. J.; Suddick, Richard P.

1995-01-01

A study at the University of Texas, San Antonio's dental school resulted in development of a system of caries risk assessment, applied to all undergraduate clinic patients. The rationale, structure, elements, and application of the system are outlined, and course content supporting the system is noted. Need for validation and other improvements is…

Taking the Pain out of Waiting: The Oral Health Counselling Experiences of Parents of Children with Extensive Dental Caries

ERIC Educational Resources Information Center

Cashmore, Aaron W.; Noller, Jennifer; Johnson, Bronwyn; Ritchie, Jan; Blinkhorn, Anthony S.

2011-01-01

Objective: The Tooth Smart Programme is a hospital-based parent-counselling programme established to stabilize existing carious lesions and prevent new caries in children. The purpose of this qualitative study was to: explore participating parents' experiences of and views about parent counselling; identify and describe factors that influence the…

Feasibility Study on a Process for Electroless Metal Deposition in Pits and Fissures of Teeth for Use in Preventive Dentistry.

DTIC Science & Technology

1980-08-01

been used in topical fluoride solutions applied to prevent caries . The use of SnF 2 . and similar chemical compounds, in the plating process appears to...Methods Tin fluoride solutions are prepared by dissolving SnF 2 in demineralized water at concentrations of 1, 5, 5.7, and 10%. The pH ranges from...saturated FeSO4 with or without 1 gpl thiourea a. .4 34 REFERENCES 1. P. Gron, "Chemistry of Topical Fluorides ", Caries Res. 11 (Suppl. 1): 172-204

Disease Management of Early Childhood Caries: ECC Collaborative Project

PubMed Central

Lee, Jessica Y.

2014-01-01

Until recently, the standard of care for early childhood caries (ECC) has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM) approach to address ECC in preschool children was implemented as a quality improvement (QI) collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR) for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice. PMID:24723953

Disease Management of Early Childhood Caries: ECC Collaborative Project.

PubMed

Ng, Man Wai; Ramos-Gomez, Francisco; Lieberman, Martin; Lee, Jessica Y; Scoville, Richard; Hannon, Cindy; Maramaldi, Peter

2014-01-01

Until recently, the standard of care for early childhood caries (ECC) has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM) approach to address ECC in preschool children was implemented as a quality improvement (QI) collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR) for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice.

[Fluoride mouth-rinsing to prevent dental caries in a Brazilian municipality with fluoridated drinking water].

PubMed

Iwakura, Maria Luiza Hiromi; Morita, Maria Celeste

2004-04-01

To compare the prevalence of dental caries in two groups of schoolchildren: (1) schoolchildren participating in a weekly 0.2% sodium fluoride mouth-rinsing program and (2) schoolchildren not participating in the program. This cross-sectional study was conducted in the city (municipality) of Londrina, in the state of Paraná, Brazil; the city has fluoridated drinking water. We examined 367 12-year-old children: 190 participants in the weekly mouth-rinsing program (51.8%) and 177 nonparticipants (48.2%). The prevalence of caries was determined based on the scores for decayed, missing, and filled teeth and for decayed, missing, and filled surfaces. The examinations were performed by three examiners, with nearly perfect agreement in their diagnosis of caries (kappa = 0.90). The dependent variable was dental caries. The independent variables were: participation or nonparticipation in the mouth-rinsing program, attending a private school or a public school, frequency of tooth-brushing, amount of toothpaste used, consumption of sweets between meals, and visits to the dentist. The decayed, missing, and filled teeth score (mean and standard deviation) at 12 years of age was 0.85 +/- 0.059 overall, 1.0 +/- 0.058 for program participants, and 0.70 +/- 0.060 for nonparticipants. The decayed, missing, and filled surfaces score (mean and standard deviation) was 1.16 +/- 0.017, with it ranging from a low of 0.34 in one private school to a high of 1.66 in one public school. Bivariate analysis showed an association between caries (P < 0.05) and the following variables: attending a public school, participating in the mouth-rinsing program, and consuming sweets between meals more than once a day. In the multivariate analysis, attending a public school (P = 0.0004) and consuming sweets (P = 0.001) remained associated with the presence of caries. The weekly mouth-rinsing program was not associated with a decreased prevalence of caries, in either the public schools or the private schools. However, additional research is needed to assess the cost-effectiveness of fluoride mouthrinsing programs in populations with a higher prevalence of caries. Given the caries prevalence that we found in the schoolchildren whom we studied, the resources allocated to the fluoride mouth-rinsing program for them should probably be used to pay for other health-promotion activities with them.

Potential of nano-silver fluoride for tooth enamel caries prevention

NASA Astrophysics Data System (ADS)

Silva, Amitis V. C.; Mota, Cláudia C. B. O.; Teixeira, Joás. A.; Lins, Emery C.; Gomes, Anderson S. L.; Rosenblatt, Aronita

2018-02-01

This ex vivo study evaluated the efficiency of nano-silver fluoride (NSF) to enamel remineralization of deciduous teeth submitted to a high cariogenic challenge. 33 specimens of sound enamel were distributed into three groups: treated with sodium fluoride, with NSF, and deionized water. All specimens were submitted to microhardness test before chemical caries induction; post-induction of caries; and post-cariogenic challenge. The high cariogenic challenge was carried out in 14 daily cycles. There was no significant statistical difference (p=0.958) of enamel microhardness between NSFtreated and NaF-treated specimens. However, it presented significant difference between water-treated specimens and both NSF-treated and NaF-treated specimens (p=0.003).Furthermore, optical coherence tomography was employed for caries diagnosis, as it can be used in clinical environment.

Increasing inequalities in the distribution of dental caries in the Brazilian context in Finland.

PubMed

Antunes, José Leopoldo Ferreira; Jahn, Graciela Medeiros Jabôr; de Camargo, Marcela Aparecida Ferreira

2005-06-01

To document the process of concurrent decline and polarization of dental caries distribution in the Brazilian context. Ecologic assessment of dental outcomes of surveys performed in 1998 and 2002, and several covariates using data aggregated at city-level. 9,327 (1998) and 5,722 (2002) 12-year-old schoolchildren surveyed for oral health status in 131 and 34 towns respectively of the state of São Paulo, Brazil. DMFT index and Gini coefficient for caries distribution. The DMFT index declined from 3.72 in 1998 to 2.52 in 2002, while the Gini coefficient for the distribution of caries increased from 0.479 to 0.565. An improved profile of socio-economic standings, preventive dental treatment, access to fluoridated tap water and initiatives of dental education associated significantly with reduced levels of caries distribution. However, as these conditions were non-homogeneously distributed in the population, they are also associated with increasing levels of inequality in the distribution of caries. These observations indicate that there is room for further reduction of caries levels, by targeting the expansion of dental services and access to fluoridated water to groups and areas with higher levels of needs. Improved characterisation of the skewed distribution of caries experience demands that monitoring of the inequality in the distribution of caries by statistics such as the Gini coefficient be used. This information will inform programmes aimed at reducing levels of caries without reinforcing inequalities in the experience of the disease, a strategy that may contribute to the development of socially appropriate programmes of oral health promotion.

Sugars and Dental Caries: Evidence for Setting a Recommended Threshold for Intake123

PubMed Central

Moynihan, Paula

2016-01-01

Dental caries affects ≤80% of the world’s population with almost a quarter of US adults having untreated caries. Dental caries is costly to health care and negatively affects well-being. Dietary free sugars are the most important risk factor for dental caries. The WHO has issued guidelines that recommend intake of free sugars should provide ≤10% of energy intake and suggest further reductions to <5% of energy to protect dental health throughout life. These recommendations were informed by a systematic review of the evidence pertaining to amount of sugars and dental caries risk, which showed evidence of moderate quality from cohort studies that limiting free sugars to ≤10% of energy reduced, but did not eliminate, dental caries. Even low levels of dental caries in children are of concern because caries is a lifelong progressive and cumulative disease. The systematic review therefore explored if there were further benefits to dental health if the intake of free sugars was limited to <5% of energy. Available data were from ecologic studies and, although classified as being of low quality, showed lower dental caries when free sugar intake was <5% of energy compared with when it was >5% but ≤10% of energy. The WHO recommendations are intended for use by policy makers as a benchmark when assessing intake of sugars by populations and as a driving force for policy change. Multiple strategies encompassing both upstream and downstream preventive approaches are now required to translate the recommendations into policy and practice. PMID:26773022

Sugars and Dental Caries: Evidence for Setting a Recommended Threshold for Intake.

PubMed

Moynihan, Paula

2016-01-01

Dental caries affects ≤80% of the world's population with almost a quarter of US adults having untreated caries. Dental caries is costly to health care and negatively affects well-being. Dietary free sugars are the most important risk factor for dental caries. The WHO has issued guidelines that recommend intake of free sugars should provide ≤10% of energy intake and suggest further reductions to <5% of energy to protect dental health throughout life. These recommendations were informed by a systematic review of the evidence pertaining to amount of sugars and dental caries risk, which showed evidence of moderate quality from cohort studies that limiting free sugars to ≤10% of energy reduced, but did not eliminate, dental caries. Even low levels of dental caries in children are of concern because caries is a lifelong progressive and cumulative disease. The systematic review therefore explored if there were further benefits to dental health if the intake of free sugars was limited to <5% of energy. Available data were from ecologic studies and, although classified as being of low quality, showed lower dental caries when free sugar intake was <5% of energy compared with when it was >5% but ≤10% of energy. The WHO recommendations are intended for use by policy makers as a benchmark when assessing intake of sugars by populations and as a driving force for policy change. Multiple strategies encompassing both upstream and downstream preventive approaches are now required to translate the recommendations into policy and practice. © 2016 American Society for Nutrition.

Caries Risk Assessment of 12-13-year-old Government and Private School Going Children of Mysore City Using Cariogram: A Comparative Study.

PubMed

Naik, Sandhya P; Moyin, Shabna; Patel, Bhakti; Warad, Lata Prabhu; Punathil, Sameer; Sudeep, C B

2018-01-01

The aim of this study is to assess the caries risk assessment of 12-13-year-old government and private school going children of Mysore city using Cariogram. A cross-sectional examination was carried out on a total of 104 government and private schoolchildren aged 12-13 years. Ten factors from the Cariogram software(D Bratthall, Computer software, Malmo, Sweden) were included from study participant's records to complete the Cariogram. The percentage of "chances of avoiding new lesions" (caries risk) among government and private school study participants were obtained from Cariogram, and the participants were classified into five risk groups. Statistical analysis was performed using the software program Statistical Package of Social Science (version 17.0, SPSS Inc., Chicago IL, USA). Findings revealed that there is slight difference in caries risk among government and private schoolchildren, where 48% caries risk development and 52% chance to avoid dental caries were showed in government schoolchildren, and 51% caries risk development and 49% chance to avoid dental caries were showed in private schoolchildren, according to Cariogram. Decayed, missing, and filled teeth component, mutans streptococci, and Lactobacillus counts were slightly higher in private schoolchildren compared with government schoolchildren. The private schoolchildren had less favorable values than government schoolchildren for most of the caries-related factors. Cariogram can be the most modest and reliable tool for caries prediction, thus aiding in identifying different risk groups in a community so that appropriate preventive strategies can be provided to overcome new carious lesion formation.

Dental Caries and Associated Factors in Children Aged 2-4 Years Old in Mbeya City, Tanzania

PubMed Central

Mwakayoka, Hery; Masalu, Joyce Rose; Namakuka Kikwilu, Emil

2017-01-01

Statement of the Problem: Dental caries in infants and young children is prevalent worldwide; its magnitude and associated factors vary between communities because of cultural and social economic differences. No such information was available for pre-school children in Mbeya city. Purpose: To determine dental caries status and associated factors in 2 to 4-year-old children in Mbeya city. Materials and Method: A cross sectional study was conducted among 525 children aged 2-4 years and their parents/caregivers. Caries was assessed using caries assessment spectrum and treatment index, oral hygiene by visual inspection for visible plaque on index teeth, and dietary and oral hygiene habits by a questionnaire. Kappa statistics was used to test reliability of study instruments, χ2-test and logistic regression was employed for studying associations. Results: Caries free children for dmft1, dmft2 and dmft3 were 79.8%, 83.8% and 94.7% and caries experience was 0.49 (1.23), 0.4 (1.14) and 0.10 (0.53) respectively. Older age [(OR =2.722 (1.617-4.582) p=< 0.001)]; and frequent consumption of factory made sugary foods/snacks at age 1-2 years [(OR=3.061 (1.188-7.887) p=0.021] were associated with caries. Prolonged breastfeeding for more than 1 year and breastfeeding at night had no association with dental caries. Conclusion: The prevalence of dental caries was very low. Older age and frequent consumption of factory made sugary foods at age 1-2 years were associated with higher odds of developing dental caries. Prolonged breasfeeding and breastfeeding at night had no association with dental caries. Prevention of dental caries should be instituted as soon as primary teeth start erupting, especially through discouraging consumption of factory made sugary foods/snacks. PMID:28620634

Evaluating the Dental Caries-Related Information on Brazilian Websites: Qualitative Study.

PubMed

Aguirre, Patricia Estefania Ayala; Coelho, Melina Martins; Rios, Daniela; Machado, Maria Aparecida Andrade Moreira; Cruvinel, Agnes Fátima Pereira; Cruvinel, Thiago

2017-12-13

Dental caries is the most common chronic oral disease, affecting 2.4 billion people worldwide who on average have 2.11 decayed, missing, or filled teeth. It impacts the quality of life of patients, socially and economically. However, the comprehension of dental caries may be difficult for most people, as it involves a multifactorial etiology with the interplay between the tooth surface, the dental biofilm, dietary fermentable carbohydrates, and genetic and behavioral factors. Therefore, the production of effective materials addressed to the education and counseling of patients for the prevention of dental caries requires a high level of specialization. In this regard, the dental caries-related contents produced by laypersons and their availability on the Internet may be low-quality information. The aim of this study was to assess the readability and the quality of dental caries-related information on Brazilian websites. A total of 75 websites were selected through Google, Bing, Yahoo!, and Baidu. The websites were organized in rankings according to their order of appearance in each one of the 4 search engines. Furthermore, 2 independent examiners evaluated the quality of websites using the DISCERN questionnaire and the Journal of American Medical Association (JAMA) benchmark criteria. The readability of the websites was assessed by the Flesch Reading Ease adapted to Brazilian Portuguese (FRE-BP). In addition, the information presented on the websites was categorized as etiology, prevention, and treatment of dental caries. The statistical analysis was performed using Spearman rank correlation coefficient, Mann-Whitney U test, hierarchical clustering analysis by Ward minimum variance method, Kruskal-Wallis test, and post hoc Dunn test. P<.05 was considered significant. The Web contents were considered to be of poor quality by DISCERN (mean 33.48, standard deviation, SD 9.06) and JAMA (mean 1.12, SD 0.97) scores, presenting easy reading levels (FRE-BP: mean 62.93, SD 10.15). The rankings of the websites presented by Google (ρ=-.22, P=.08), Baidu (ρ=-.19, P=.53), Yahoo! (ρ=.22, P=.39), and Bing (ρ=-.36, P=.23) were not correlated with DISCERN scores. Moreover, the quality of websites with health- and nonhealth-related authors was similar (P=.27 for DISCERN and P=.47 for JAMA); however, the pages with a greater variety of dental caries information showed significantly higher quality scores than those with limited contents (P=.009). On the basis of this sample, dental caries-related contents available on Brazilian websites were considered simple, accessible, and of poor quality, independent of their authorship. These findings indicate the need for the development of specific policies focused on the stimulus for the production and publication of Web health information, encouraging dentists to guide their patients in searching for recommended oral health websites. ©Patricia Estefania Ayala Aguirre, Melina Martins Coelho, Daniela Rios, Maria Aparecida Andrade Moreira Machado, Agnes Fátima Pereira Cruvinel, Thiago Cruvinel. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.12.2017.

Evaluating the Dental Caries-Related Information on Brazilian Websites: Qualitative Study

PubMed Central

2017-01-01

Background Dental caries is the most common chronic oral disease, affecting 2.4 billion people worldwide who on average have 2.11 decayed, missing, or filled teeth. It impacts the quality of life of patients, socially and economically. However, the comprehension of dental caries may be difficult for most people, as it involves a multifactorial etiology with the interplay between the tooth surface, the dental biofilm, dietary fermentable carbohydrates, and genetic and behavioral factors. Therefore, the production of effective materials addressed to the education and counseling of patients for the prevention of dental caries requires a high level of specialization. In this regard, the dental caries-related contents produced by laypersons and their availability on the Internet may be low-quality information. Objective The aim of this study was to assess the readability and the quality of dental caries-related information on Brazilian websites. Methods A total of 75 websites were selected through Google, Bing, Yahoo!, and Baidu. The websites were organized in rankings according to their order of appearance in each one of the 4 search engines. Furthermore, 2 independent examiners evaluated the quality of websites using the DISCERN questionnaire and the Journal of American Medical Association (JAMA) benchmark criteria. The readability of the websites was assessed by the Flesch Reading Ease adapted to Brazilian Portuguese (FRE-BP). In addition, the information presented on the websites was categorized as etiology, prevention, and treatment of dental caries. The statistical analysis was performed using Spearman rank correlation coefficient, Mann-Whitney U test, hierarchical clustering analysis by Ward minimum variance method, Kruskal-Wallis test, and post hoc Dunn test. P<.05 was considered significant. Results The Web contents were considered to be of poor quality by DISCERN (mean 33.48, standard deviation, SD 9.06) and JAMA (mean 1.12, SD 0.97) scores, presenting easy reading levels (FRE-BP: mean 62.93, SD 10.15). The rankings of the websites presented by Google (ρ=−.22, P=.08), Baidu (ρ=−.19, P=.53), Yahoo! (ρ=.22, P=.39), and Bing (ρ=−.36, P=.23) were not correlated with DISCERN scores. Moreover, the quality of websites with health- and nonhealth-related authors was similar (P=.27 for DISCERN and P=.47 for JAMA); however, the pages with a greater variety of dental caries information showed significantly higher quality scores than those with limited contents (P=.009). Conclusions On the basis of this sample, dental caries-related contents available on Brazilian websites were considered simple, accessible, and of poor quality, independent of their authorship. These findings indicate the need for the development of specific policies focused on the stimulus for the production and publication of Web health information, encouraging dentists to guide their patients in searching for recommended oral health websites. PMID:29237585

The role of health behavior in preventing dental caries in resource-poor adults: a pilot intervention.

PubMed

Wu, Andrew; Switzer-Nadasdi, Rhonda

2014-01-01

Dental caries is a highly prevalent, yet preventable disease that is commonly overlooked in the adult population. It is strongly related to health-related behaviors and knowledge, and therefore, is potentially receptive to a behavioral health intervention. However, prevention strategies that target health behaviors in adults are fundamentally different from those in children, whom most current intervention strategies for dental caries target. This study attempts to pilot design, implement, and assess health behavior intervention tools for adults, in order to improve their oral health. To increase knowledge about dental caries by 80% and increase positive self-reported oral hygiene behaviors by 80% in low-income adult participants at Interfaith Dental Clinic by piloting novel interventional and educational tools based on the Transtheoretical Model of Health Behavior. A convenience sample of newly registered participants to the Interfaith Dental Clinic between August 2011 and May 2013, were interviewed on each participant's first appointment, exposed to the interventional tools, and subsequently interviewed at their next appointment. A control group, comprised of participants who had completed their caries care as deemed by the clinic and had not been exposed to the interventional tools, were also interviewed on their last appointment before graduating the clinic's program. A total of 112 participants were exposed to the intervention, and forty-two participants comprised the control group. Follow-up for the intervention group was 20.5% (n = 23). Knowledge about the cause of caries increased by 29.9%, and positive self-reported oral hygiene behaviors increased by 25.4%. A Wilcoxon rank sum test showed no significance between the interview scores of the post-intervention group and that of the control group (p = 0.18 for knowledge, p = 0.284 for behaviors). Qualitative results show the vast majority of participants blamed diet for cause of caries, that this participant population prioritized practical advice over factual education, and that flossing was perceived to be the largest barrier to proper oral care, citing pain, lack of time, and technique as common reasons. Educational tools based on current models of health behavior theory have the potential to improve participant knowledge and health behaviors, while also remaining low-cost and convenient for clinical use.

Factors related to tooth loss due to dental caries among workers in an industrial estates in Thailand.

PubMed

Chatrchaiwiwatana, Supaporn; Ratanasiri, Amornrat; Jaidee, Jeeratip; Soontorn, Surasak

2012-11-01

The present study aimed to evaluate the prevalence and factors related to tooth loss due to dental caries among workers in industrial estates in Pathumthani and Phranakhorn Si Ayutthaya provinces in central Thailand. The present study utilized quantitative and qualitative methodologies. A quantitative study was done using a cross-sectional analytic method with a sample group of 457 adults (283 males; 174 females) between 19 and 53 years. Data were obtained through an oral examination and oral health behavior questionnaire. Data analyses were done using descriptive, bivariate and multivariable logistic regression statistics. In-depth interviews were used to collect qualitative data from 11 subjects. Most (62.2%) participants had tooth loss due to caries and findings from the final multivariable logistic regression model revealed that such loss was associated with education, residency, use of social security welfare, decayed teeth and filled teeth. Relatedly, the in-depth interview confirmed that tooth loss due to dental caries was related to (1) lack of time to visit a dentist (2) have a negative attitude toward or a phobia regarding dental treatment (3) inability to afford the high cast of dental treatment (4) lack of knowledge in regarding dental caries prevention, root canal treatment and the harmful effects of losing teeth (5) choosing to get an extraction upon having caries exposed pulp and (6) lack of oral health promotion programs provided by either the government or private sectors. The government and non-government organizations should promote oral health in an industrial estates and provide services and welfare for dental health of workers in an industrial estate appropriate to their socio-economic needs.

Comparative salivary proteomics analysis of children with and without dental caries using the iTRAQ/MRM approach.

PubMed

Wang, Kun; Wang, Yufei; Wang, Xiuqing; Ren, Qian; Han, Sili; Ding, Longjiang; Li, Zhongcheng; Zhou, Xuedong; Li, Wei; Zhang, Linglin

2018-01-19

Dental caries is a major worldwide oral disease afflicting a large proportion of children. As an important host factor of caries susceptibility, saliva plays a significant role in the occurrence and development of caries. The aim of the present study was to characterize the healthy and cariogenic salivary proteome and determine the changes in salivary protein expression of children with varying degrees of active caries, also to establish salivary proteome profiles with a potential therapeutic use against dental caries. In this study, unstimulated saliva samples were collected from 30 children (age 10-12 years) with no dental caries (NDC, n = 10), low dental caries (LDC, n = 10), and high dental caries (HDC, n = 10). Salivary proteins were extracted, reduced, alkylated, trypsin digested and labeled with isobaric tags for relative and absolute quantitation, and then they were analyzed with GO annotation, biological pathway analysis, hierarchical clustering analysis, and protein-protein interaction analysis. Targeted verifications were then performed using multiple reaction monitoring mass spectrometry. A total of 244 differentially expressed proteins annotated with GO annotation in biological processes, cellular component and molecular function were identified in comparisons among children with varying degrees of active caries. A number of caries-related proteins as well as pathways were identified in this study. As compared with caries-free children, the most significantly enriched pathways involved by the up-regulated proteins in LDC and HDC were the ubiquitin mediated proteolysis pathway and African trypanosomiasis pathway, respectively. Subsequently, we selected 53 target proteins with differential expression in different comparisons, including mucin 7, mucin 5B, histatin 1, cystatin S and cystatin SN, basic salivary proline rich protein 2, for further verification using MRM assays. Protein-protein interaction analysis of these proteins revealed complex protein interaction networks, indicating synergistic action of salivary proteins in caries resistance or cariogenicity. Overall, our results afford new insight into the salivary proteome of children with dental caries. These findings might have bright prospect in future in developing novel biomimetic peptides with preventive and therapeutic benefits for childhood caries.

Retention Strategies for Health Disparities Preventive Trials: Findings from the Early Childhood Caries Collaborating Centers

PubMed Central

Garcia, Raul I.; Tiwari, Tamanna; Ramos-Gomez, Francisco; Heaton, Brenda; Orozco, Mario; Rasmussen, Margaret; Braun, Patricia; Henshaw, Michelle; Borrelli, Belinda; Albino, Judith; Vargas, Clemencia; Diamond, Courtney; Gebel, Christina; Batliner, Terrence S.; Barker, Judith; Gregorich, Steven; Gansky, Stuart A.

2017-01-01

Objectives To identify successful strategies for retention of participants in multi-year, community-based randomized controlled trials (RCTs) aiming to reduce early childhood caries in health disparities populations from diverse racial/ethnic backgrounds and across diverse geographic settings. Methods Four RCTs conducted by the Early Childhood Caries Collaborating Centers (EC4), an initiative of the National Institute of Dental and Craniofacial Research, systematically collected information on the success of various strategies implemented to promote participant retention in each RCT. The observational findings from this case series of four RCTs were tabulated and the strategies rated by study staff. Results Participant retention at 12 months of follow-up ranged from 52.8% to 91.7%, and at 24 months ranged from 53.6% to 85.9, across the four RCT. For the three RCT that had a 36 month follow-up, retention ranged from 53.6% to 85.1%. Effectiveness of different participant retention strategies varied widely across the RCT. Conclusions Findings from this case series study may help to guide the design of future RCTs to maximize retention of study participants and yield needed data on effective interventions to reduce oral health disparities. PMID:27759164

Does ozone enhance the remineralizing potential of nanohydroxyapatite on artificially demineralized enamel? A laser induced fluorescence study

NASA Astrophysics Data System (ADS)

Srinivasan, Samuelraj; Prabhu, Vijendra; Chandra, Subhash; Koshy, Shalini; Acharya, Shashidhar; Mahato, Krishna K.

2014-02-01

The present era of minimal invasive dentistry emphasizes the early detection and remineralization of initial enamel caries. Ozone has been shown to reverse the initial demineralization before the integrity of the enamel surface is lost. Nano-hydroxyapatite is a proven remineralizing agent for early enamel caries. In the present study, the effect of ozone in enhancing the remineralizing potential of nano-hydroxyapatite on artificially demineralized enamel was investigated using laser induced fluorescence. Thirty five sound human premolars were collected from healthy subjects undergoing orthodontic treatment. Fluorescence was recorded by exciting the mesial surfaces using 325 nm He-Cd laser with 2 mW power. Tooth specimens were subjected to demineralization to create initial enamel caries. Following which the specimens were divided into three groups, i.e ozone (ozonated water for 2 min), without ozone and artificial saliva. Remineralization regimen was followed for 3 weeks. The fluorescence spectra of the specimens were recorded from all the three experimental groups at baseline, after demineralization and remineralization. The average spectrum for each experimental group was used for statistical analysis. Fluorescence intensities of Ozone treated specimens following remineralization were higher than that of artificial saliva, and this difference was found to be statistically significant (P<0.0001). In a nutshell, ozone enhanced the remineralizing potential of nanohydroxyapatite, and laser induced fluorescence was found to be effective in assessing the surface mineral changes in enamel. Ozone can be considered an effective agent in reversing the initial enamel caries there by preventing the tooth from entering into the repetitive restorative cycle.

Head and Neck Cancer Patients – Information for the General Dental Practitioner.

PubMed

Noone, Jennifer; Barclay, Craig

2017-03-01

Salivary gland damage is the most common adverse effect associated with radiation therapy to the head and neck. A combination of hyposalivation and dietary changes, with a reduced emphasis on oral hygiene practices can contribute to a massive increase in a person’s caries risk status. This can be further complicated by limited mouth opening. To enable optimal dental care for head and neck cancer patients before, during and after radiation therapy, patients must be informed and educated about the potential risks of dental caries and the preventive strategies available. All patients should receive a pre-radiotherapy dental assessment by a Restorative Dentistry Consultant. This information will be delivered to the patient, often at an emotionally charged time, and can be lost amongst all the information related to other aspects of his/her cancer management. General Dental Practitioners (GDPs) are therefore in a pivotal position to reiterate this information post radiation therapy and ensure compliance with preventive strategies, with the overall aim to improve quality of life and avoid the need for future extractions and the resulting risk of osteoradionecrosis. Clinical relevance: This article highlights the GDP’s role in the shared management of head and neck cancer patients who have received radiotherapy as part of their cancer treatment. The critical issue of dental caries, one of the late effects of radiation-induced hyposalivation, will be focused upon. Other side-effects, such as trismus and osteoradionecrosis, will also be discussed. This article aims to supply GDPs with accurate information to provide to their patients with post radiation therapy, whilst highlighting what treatment is within their remit and when it may be appropriate to refer.

Review on fluoride-releasing restorative materials--fluoride release and uptake characteristics, antibacterial activity and influence on caries formation.

PubMed

Wiegand, Annette; Buchalla, Wolfgang; Attin, Thomas

2007-03-01

The purpose of this article was to review the fluoride release and recharge capabilities, and antibacterial properties, of fluoride-releasing dental restoratives, and discuss the current status concerning the prevention or inhibition of caries development and progression. Information from original scientific full papers or reviews listed in PubMed (search term: fluoride release AND (restorative OR glass-ionomer OR compomer OR polyacid-modified composite resin OR composite OR amalgam)), published from 1980 to 2004, was included in the review. Papers dealing with endodontic or orthodontic topics were not taken into consideration. Clinical studies concerning secondary caries development were only included when performed in split-mouth design with an observation period of at least three years. Fluoride-containing dental materials show clear differences in the fluoride release and uptake characteristics. Short- and long-term fluoride releases from restoratives are related to their matrices, setting mechanisms and fluoride content and depend on several environmental conditions. Fluoride-releasing materials may act as a fluoride reservoir and may increase the fluoride level in saliva, plaque and dental hard tissues. However, clinical studies exhibited conflicting data as to whether or not these materials significantly prevent or inhibit secondary caries and affect the growth of caries-associated bacteria compared to non-fluoridated restoratives. Fluoride release and uptake characteristics depend on the matrices, fillers and fluoride content as well as on the setting mechanisms and environmental conditions of the restoratives. Fluoride-releasing materials, predominantly glass-ionomers and compomers, did show cariostatic properties and may affect bacterial metabolism under simulated cariogenic conditions in vitro. However, it is not proven by prospective clinical studies whether the incidence of secondary caries can be significantly reduced by the fluoride release of restorative materials.

Near infrared transillumination compared with radiography to detect and monitor proximal caries: A clinical retrospective study.

PubMed

Abdelaziz, Marwa; Krejci, Ivo; Perneger, Thomas; Feilzer, Albert; Vazquez, Lydia

2018-03-01

To compare near infrared transillumination device, DIAGNOcam (DC) and bitewing radiography (BW) for the detection of proximal caries. This retrospective analysis of DC and BW images of 18 students in dental medicine who had consented to the anonymous use of their dental record. The data included BW and DC images performed for a check-up in 2013, and corresponding follow-up images performed in 2015. Two observers rated 376 proximal surfaces on a 4-level dentin lesion scale and reached a unanimous rating for each surface. Calculated measures of agreement for each assessment method over time provided the reproducibility of the information obtained by each method. Agreement between 2013 and 2015 within each method was excellent (intraclass correlation coefficient, BW: 0.86, DC: 0.90). Agreement between DC and BW was similar for dentin lesion detection, but was low for enamel caries detection; DC detected more enamel caries than BW. Agreement between DC and BW was modest (0.33 in 2013 and 0.36 in 2015), chiefly because DC identified more enamel caries. This study shows that DC is as reliable as BW to detect proximal dentin lesions. DC detects proximal enamel lesions at an earlier stage than BW. DC enables clinicians to differentiate lesions limited to the enamel from lesions that have reached the enamel dentin junction. Regular monitoring with DC should help provide individualized preventive measures and early non-invasive caries management. The early detection of enamel lesions with near infrared transillumination can help clinicians undertake early non invasive treatments to prevent or slow down the progression of initial proximal lesions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of oral environment stabilization procedures on Streptococcus mutans counts in pregnant women.

PubMed

Volpato, Flavia Cristina; Jeremias, Fabiano; Spolidório, Denise Madalena Palomari; Silva, Silvio Rocha Corrêa da; Valsecki Junior, Aylton; Rosell, Fernanda Lopez

2011-01-01

The aim of this study was to determine the effect of oral environment stabilization (OES) on the counting of Streptococcus mutans in high-caries-risk pregnant women participants of a prevention program in a public teaching institution. The sample was composed of 30 pregnant women aged 18 to 43 years, who looked for treatment at the Preventive Dentistry Clinic of the Araraquara Dental School, UNESP. Saliva samples were collected before and after the OES procedures and were forwarded to the pathology for observation and quantification of S. mutans CFU. There was a decrease in the number of S. mutans CFU, which was significantly different (p<0.0001) between samples. Considering the age group, 70.0% were between 18 to 30 years old and 30.0% belonged to the 31-43-year-old age group. Data related to the pregnancy period showed that 73.4% were in the second trimester, 13.3% in the first and 13.3% in third trimester. OES showed to be an effective clinical procedure in diminishing the number of S. mutans CFU in the saliva of high-caries-risk pregnant women. This management is simple and effective, corresponding to the basic treatment needs of pregnant women that search dental care in this public service.

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries.

PubMed

Blinkhorn, Fiona; Brown, Ngiare; Freeman, Ruth; Humphris, Gerry; Martin, Andrew; Blinkhorn, Anthony

2012-08-21

Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. ACTRN12612000712808.

Caregiver knowledge and attitudes of preschool oral health and early childhood caries (ECC).

PubMed

Schroth, Robert J; Brothwell, Douglas J; Moffatt, Michael E K

2007-04-01

Prevention strategies are integral to improving the oral health for young Aboriginal children. For such to be effective, it is important to understand the social value that parents and caregivers ascribe to primary teeth. The purpose of this paper is to report caregiver knowledge and attitudes toward preschool oral health and early childhood caries (ECC) from 4 communities in Manitoba. Cross-sectional study, including a retrospective interview with caregivers. Children and their main caregivers served as the sample. Preschoolers underwent a comprehensive dental screening while caregivers completed a questionnaire that explored knowledge and attitudes toward preschool dental health. Caregiver responses were matched with findings from each child's examination. A majority agreed that primary teeth were important, that dental disease could lead to health problems and that a first dental visit should be made by age 1. Caregivers of children with ECC were more likely to believe that caries could not affect a child's health while those who believed primary teeth are important had children with significantly less decay. Most caregivers believed that primary teeth are important and correctly responded to inquiries about knowledge and attitudes toward oral health. Attitudes on the importance of baby teeth and bottle feeding after one year of age, the effect of rotten teeth on childhood health and night-time nursing emerged as variables most associated with the absence/presence of ECC and deft rates. Incorporating such questioning into caries risk assessments may be a useful means to determine a child's risk for ECC.

KNOWLEDGE AND ATTITUDE OF PARENTS OR CARETAKERS REGARDING TRANSMISSIBILITY OF CARIES DISEASE

PubMed Central

Sakai, Vivien T.; Oliveira, Thais M.; Silva, Thiago C.; Moretti, Ana Beatriz S.; Geller-Palti, Dafna; Biella, Vivian A.; Machado, Maria Aparecida A. M.

2008-01-01

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease. PMID:19089208

Knowledge and attitude of parents or caretakers regarding transmissibility of caries disease.

PubMed

Sakai, Vivien T; Oliveira, Thais M; Silva, Thiago C; Moretti, Ana Beatriz S; Geller-Palti, Dafna; Biella, Vivian A; Machado, Maria Aparecida A M

2008-01-01

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease.

Dental caries and oral health practice among 12 year old school children from low socio-economic status background in Zimbabwe.

PubMed

Mafuvadze, Brighton Tasara; Mahachi, Lovemore; Mafuvadze, Benford

2013-01-01

Dental caries is one of the most prevalent chronic diseases affecting children in Sub-Saharan Africa. Previous studies show a higher prevalence of dental caries in children from low socio-economic status backgrounds. The purpose of this study was to determine the prevalence of dental caries among 12 year old children in urban and rural areas of Zimbabwe and establish preliminary baseline data. A descriptive cross-sectional study was conducted among 12 year old children at primary schools in Harare and Bikita district. A Pre-tested questionnaire was administered to elicit information from the participants on tooth cleaning, dietary habits and dental experience. Dental caries status was assessed using the DMFT index following World Health Organization (WHO) guidelines. Our results showed a high prevalence of dental caries in both urban (59.5%) and rural (40.8%) children. The mean DMFT in urban and rural areas was 1.29 and 0.66, respectively. Furthermore, our data showed a general lack of knowledge on oral health issues by the participants. There is high prevalence of dental caries among 12 years old school children in both urban and rural areas of Zimbabwe. This calls for early preventive strategies and treatment services. We recommend incorporation of oral health education in the elementary school curricula.

Marginal Fit of CEREC Crowns at Different Finish Line Curvatures

DTIC Science & Technology

2015-06-01

percolation of bacteria {Beschnidt & Strub, 1999). This will compromise 13 the longevity of the tooth, increasing the risk of dental caries caused...and Practice of Caries Prevention. Journal of american dental association, 131, 887-899. Ferrari, M. {1991). Cement thickness and microlikage under...Prosthodontic Graduate Program Naval Postgraduate Dental School Uniformed Services University of the Health Sciences in partial fulfillment of the

Prevalence of Dental Caries and Fissure Sealants in a Portuguese Sample of Adolescents

PubMed Central

Veiga, Nélio J.; Pereira, Carlos M.; Ferreira, Paula C.; Correia, Ilidio J.

2015-01-01

Introduction The aims of this study were to assess the prevalence of dental caries and the DMFT index, as well as the distribution pattern of pit and fissure sealants on permanent teeth in a Portuguese sample of adolescents, and to assess whether the existing usage of sealants and socio-demographic factors are correlated to caries prevalence on the examined sample. Materials and Methods A cross-sectional study was designed with a sample of 447 adolescents aged 12 to 18 years old, attending a public school in Sátão, Portugal. A self-administered questionnaire with questions about oral health behaviours and socio-economic status was answered by adolescents in the classroom. Clinical examination of oral health status and assessment of fissure sealants were accomplished by only one trained member of the research team. Results We obtained a DMFT index of 3.32 (2.92), which indicates a moderate level of prevalence of dental caries. When considering a DMFT = 0, we found significant statistical differences between the parents´ level of education (≤ 4th grade = 26.3 vs 5th–12th grade = 18.8 vs <12th grade = 43.3, p = 0.001), gender (male = 27.3 vs female = 19.6, p = 0.04), age (≤15 years = 27.1 vs <15 years = 18.5, p = 0.02), presence of fissure sealants (yes = 30.6 vs no = 13.5, p = 0.001) and experience of dental pain (no = 25.4 vs yes = 16.8, p = 0.02). When analyzing the prevalence of fissure sealants, we verified that 58.8% of adolescents had at least one fissure sealant applied. Significant statistical differences were found when analyzing the presence of fissure sealants related with parents´educational level (<9th grade, OR = 1.56 CI95% = 1.05–2.54), gender (female, OR = 1.86 CI95% = 1.19–2.98), experience of dental pain (yes, OR = 0.62 CI95% = 0.39–0.97) and presence of dental caries (yes, OR = 0.35 CI95% = 0.19–0.65). Conclusions The moderate level of caries prevalence reveals the need of improvement of primary prevention interventions among Portuguese adolescents. The establishment of a more targeted preventive program with better and more effective oral health education is essential, having into account socio-demographic aspects. PMID:25803849

Dental caries - not just holes in teeth! A perspective.

PubMed

Bowen, W H

2016-06-01

Cavitation in teeth results from a pathogenic process termed dental caries that has occurred on the tooth surface for weeks or even years. Accumulation of dental plaque (biofilm) on the tooth is usually the first manifestation of the disease. Although acid production is the immediate and proximal cause of dissolution of teeth; it is the milieu within which the acid is formed that should be of primary concern. Focusing on the 'critical pH' has detracted attention from the more biological aspects (biofilm formation) of dental caries. Dental caries is unique; it is a biological process occurring on essentially an inert surface. Investigation of the multitude of interactions occurring in plaque ranging from enamel interfaces to surfaces of bacteria and matrices poses challenges worthy of the best scientific minds. The mouth clearly offers unique opportunities to investigate the multi facets of biofilm formation in vivo, generating data that have relevance way beyond the mouth. Prevention of this ubiquitous disease, dental caries, continues to present serious challenges. The public health benefits of fluoride delivered in its various formats are well recognized. Nevertheless, additional preventive approaches are required. Overcoming the rapid clearance of agents from the mouth is particularly challenging. Building on the polymerizing capacity of glucosyltransferases it may be possible to incorporate a therapeutic agent into the matrix plaque, thereby delivering therapeutic agents precisely to where they are needed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Fluoride toothpaste efficacy and safety in children younger than 6 years: a systematic review.

PubMed

Wright, J Timothy; Hanson, Nicholas; Ristic, Helen; Whall, Clifford W; Estrich, Cameron G; Zentz, Ronald R

2014-02-01

The authors conducted a systematic review to assess the efficacy and safety of fluoride toothpaste use in children younger than 6 years. The authors defined research questions to formulate a search strategy. They screened studies, extracted data and assessed risk of bias systematically. They conducted meta-analyses to determine the effects of brushing with fluoride toothpaste. Use of fluoride toothpaste brushing had a statistically significant effect on mean decayed, missing and filled primary tooth surfaces and decayed, missing and filled primary teeth for populations at high risk of developing caries (standard mean difference [95 percent confidence interval {CI}], -0.25 [-0.36 to -0.14] and -0.19 [-0.32 to -0.06], respectively). The effects of using different fluoride concentration toothpastes on caries varied. Study findings showed either a decrease in the odds of having fluorosis (odds ratio [OR] [95 percent CI] = 0.66 [0.48-0.90]) when the use of fluoride toothpaste was initiated after 24 months or no statistically significant difference (OR [95 percent CI] = 0.92 [0.71-1.18]). Beginning use after 12 or 14 months of age decreased the risk of fluorosis (OR = 0.70 [0.57-0.88]). Limited scientific evidence demonstrates that for children younger than 6 years, fluoride toothpaste use is effective in caries control. Ingesting pea-sized amounts or more can lead to mild fluorosis. Practical Implications. To minimize the risk of fluorosis in children while maximizing the caries-prevention benefit for all age groups, the appropriate amount of fluoride toothpaste should be used by all children regardless of age. Dentists should counsel caregivers by using oral description, visual aids and actual demonstration to help ensure that the appropriate amount of toothpaste is used.

A simulation model for designing effective interventions in early childhood caries.

PubMed

Hirsch, Gary B; Edelstein, Burton L; Frosh, Marcy; Anselmo, Theresa

2012-01-01

Early childhood caries (ECC)--tooth decay among children younger than 6 years--is prevalent and consequential, affecting nearly half of US 5-year-olds, despite being highly preventable. Various interventions have been explored to limit caries activity leading to cavities, but little is known about the long-term effects and costs of these interventions. We developed a system dynamics model to determine which interventions, singly and in combination, could have the greatest effect in reducing caries experience and cost in a population of children aged birth to 5 years. System dynamics is a computer simulation technique useful to policy makers in choosing the most appropriate interventions for their populations. This study of Colorado preschool children models 6 categories of ECC intervention--applying fluorides, limiting cariogenic bacterial transmission from mothers to children, using xylitol directly with children, clinical treatment, motivational interviewing, and combinations of these--to compare their relative effect and cost. The model projects 10-year intervention costs ranging from $6 million to $245 million and relative reductions in cavity prevalence ranging from none to 79.1% from the baseline. Interventions targeting the youngest children take 2 to 4 years longer to affect the entire population of preschool-age children but ultimately exert a greater benefit in reducing ECC; interventions targeting the highest-risk children provide the greatest return on investment, and combined interventions that target ECC at several stages of its natural history have the greatest potential for cavity reduction. Some interventions save more in dental repair than their cost; all produce substantial reductions in repair cost. By using data relevant to any geographic area, this system model can provide policy makers with information to maximize the return on public health and clinical care investments.

The effect of CO2 laser irradiation plus fluoride dentifrice on the inhibition of secondary caries on root surfaces adjacent to glass ionomer cement or composite resin restorations

NASA Astrophysics Data System (ADS)

Rodrigues, S. R.; Moraes, M.; Hanashiro, F. S.; Youssef, M. N.; Brugnera Junior, A.; Nobre-dos-Santos, M.; de Souza-Zaroni, W. C.

2016-02-01

Although the cariostatic effects of CO2 laser on the root surface have been shown, there is scarce information regarding its effects on root secondary caries. The objective of this research was to investigate the effect of the association of CO2 laser and a fluoride dentifrice on the inhibition of secondary caries on root surfaces adjacent to composite-resin or glass-ionomer-cement restorations. Dental blocks of human roots were divided into two groups: composite resin (CR) or glass ionomer cement (GIC). Subsequently, the blocks were divided into four subgroups (n  =  10): C, non-fluoride dentifrice; FD, fluoride dentifrice; L, CO2 laser with an energy density of 6.0 J cm-2  +  non-fluoride dentifrice; and L  +  FD, CO2 laser  +  fluoride dentifrice. The blocks were subjected to pH cycling to simulate a high cariogenic challenge. Dental demineralization around the restorations was quantified by microhardness analysis. The results were subjected to analysis of variance (ANOVA) and the Tukey-Kramer test (p  ⩽  0.05). As for mineral loss, it can be observed that all the groups that were treated with a fluoride dentifrice and laser, used alone or not, were statistically similar and superior to the RC-C group. It was concluded that CO2 laser irradiation and a fluoride dentifrice used alone or combined with each other are efficient surface treatments for preventing secondary root caries, regardless of the restorative material used.

Practice of Sealants and Preventive Resin Restorations Among Malaysian Dentists.

PubMed

Chin, Zhe W; Chong, Wai S; Mani, Shani A

2016-01-01

To assess the knowledge, attitude and utilisation regarding fissure sealants (FS) and preventive resin restorations (PRR) among Malaysian dentists. A questionnaire consisting of 35 questions was distributed by mail or an online survey to 425 registered dentists selected according to place of work by stratified random sampling. One hundred fifty-three dentists responded to the survey. A positive attitude towards FS and PRR was noted among most Malaysian dentists. About half of the respondents used FS/PRR occasionally (48.4%), while few (13.7%) applied them routinely. The majority of the dentists agreed that minimally invasive dentistry is important and FS are effective in caries prevention, using them on high caries-risk individuals. Most of the dentists used pumice or paste to clean teeth before placing FS/PRR. A significant number of dentists used a bonding agent prior to placing FS. Although only 57.5% dentists were aware of guidelines for FS use, most dentists agreed that guidelines are important. Although there was a positive attitude towards FS/PRR, few dentists applied them routinely. Some of the steps undertaken for placement of FS and PRR were outdated. Updating local guidelines for dentists to ensure uniform practice of FS and PRR is justified.

Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.

PubMed

Chapple, Iain L C; Bouchard, Philippe; Cagetti, Maria Grazia; Campus, Guglielmo; Carra, Maria-Clotilde; Cocco, Fabio; Nibali, Luigi; Hujoel, Philippe; Laine, Marja L; Lingstrom, Peter; Manton, David J; Montero, Eduardo; Pitts, Nigel; Rangé, Hélène; Schlueter, Nadine; Teughels, Wim; Twetman, Svante; Van Loveren, Cor; Van der Weijden, Fridus; Vieira, Alexandre R; Schulte, Andreas G

2017-03-01

Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio-economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report. There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc-γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end-products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub-optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevention of root caries with dentin adhesives.

PubMed

Grogono, A L; Mayo, J A

1994-04-01

This in vitro investigation determined the feasibility of using dentin adhesives to protect root surfaces against caries. The roots of 22 recently extracted human teeth were all painted with a protective lacquer leaving two unprotected small windows. On each specimen, one window (control) was left untreated and the other window (experimental) was treated using a dentin adhesive (Scotchbond Multi-Purpose). The roots were then immersed in an in vitro acetate/calcium/phosphate demineralization model at pH 4.3. After 70 days, the samples were removed and sectioned through the windows. The undecalcified ground sections were examined under transmitted and polarized light. Lesions characteristic of natural root caries were seen in the untreated control windows. No such lesions were apparent in the experimental windows. The results of this preliminary study suggest that dentin adhesives may provide protection against root caries.

Dental caries prevalence among 12-15-year-olds in Lithuania between 1983 and 2005.

PubMed

Milciuviene, Simona; Bendoraitiene, Egle; Andruskeviciene, Vilija; Narbutaite, Julija; Sakalauskiene, Jurgina; Vasiliauskiene, Ingrida; Slabsinskiene, Egle

2009-01-01

To analyze the dynamics of prevalence and severity of dental caries among 12- and 15-year-old schoolchildren in six regions of Lithuania. A total of 5910 schoolchildren aged 12 and 15 years were examined. Dental caries was diagnosed according to the criteria of World Health Organization. The prevalence of dental caries was calculated by dividing the number of children with caries by the number of all children examined and expressed as percentage. Severity of dental caries was described by DMF-T index. DMF-T indices of individual persons as well as each age group were determined. Oral hygiene was evaluated by a simplified oral hygiene index. Fluoride concentration in Kretinga was 1.6-2.2 ppm; in the other regions, it varied between 0.2 to 0.4 ppm. The prevalence of dental caries among 12-year-olds was 88.4% in 1983 and 85.5% in 2005; among 15-year-olds, it was 95.5% and 92.9%, respectively. Mean DMF-T score decreased from 4.5 (in 1983) to 3.7 (in 2005) among 12-year-olds and from 6.4 (in 1983) to 5.6 (in 2005) among 15-year-olds. Oral hygiene index decreased from 1.69 in 1983 to 1.34 in 2005 among 12-year-olds and from 1.46 to 1.22 among 15-year-olds, respectively. A tendency towards decrease in the prevalence and severity of dental caries was observed, when caries prevention program was running. Correlation between oral hygiene and DMF-T was observed in both age groups. Decreased prevalence and intensity of dental caries among 12- and 15-year-olds were associated with improved oral hygiene, usage of fluoride toothpaste, and fluoride content in drinking water.

[Experience, prevalence and severity of dental caries and its association with nutritional status in Mexican infants 17-47 months].

PubMed

Zúñiga-Manríquez, Ana Gabriela; Medina-Solís, Carlo Eduardo; Lara-Carrillo, Edith; Márquez-Corona, María de Lourdes; Robles-Bermeo, Norma Leticia; Scougall-Vilchis, Rogelio José; Maupomé, Gerardo

2013-01-01

To determine the experience, prevalence and severity of dental caries and its relationship with nutritional status in nursery infants 17 to 47 months of age. A cross-sectional study in 152 infants 17 to 47 months of age attending one of five day care centers of the city of Pachuca, Hidalgo was performed. Clinical examinations were performed using the methods recommended by the World Health Organization for epidemiologic studies on dental caries. We calculated the caries index (dmft), the significant caries index (SiC) as well as the treatment needs index (TNI) and the care index (CI). Nutritional status was determined using the weight and height for age, in Federico Gomez's scale. In the statistical analysis nonparametric tests were used. Mean age was 2.52 ± 0.76 years; 51.3% were boys. With regard to nutritional status, 19.1% were classified as malnourished and 19.1% were overweight/obese. The dmft index was 1.53 ± 2.52. The SiC index was 4.14, the TNI 86.3% and the CI 13.7%. Caries prevalence was 48.0%. It was observed that 33.5% of children had 1 to 3 teeth with caries experience and 14.5% had 4 or more teeth affected. Statistically significant differences for tooth decay were identified (p < 0.05) by age, height and weight but not (p> 0.05) by sex and nutritional status. This study shows that nearly half of children examined had caries experience. High treatment needs for dental caries were observed. A correlation was found between dmft index and age, weight and height. No association was identified between experience, prevalence and severity of dental caries and nutritional status of infants. It appears necessary to improve oral health preventive measures in these infants.

Caries Risk Assessment of 12–13-year-old Government and Private School Going Children of Mysore City Using Cariogram: A Comparative Study

PubMed Central

Naik, Sandhya P.; Moyin, Shabna; Patel, Bhakti; Warad, Lata Prabhu; Punathil, Sameer; Sudeep, C. B.

2018-01-01

Aim: The aim of this study is to assess the caries risk assessment of 12–13-year-old government and private school going children of Mysore city using Cariogram. Materials and Methods: A cross-sectional examination was carried out on a total of 104 government and private schoolchildren aged 12–13 years. Ten factors from the Cariogram software(D Bratthall, Computer software, Malmo, Sweden) were included from study participant's records to complete the Cariogram. The percentage of “chances of avoiding new lesions” (caries risk) among government and private school study participants were obtained from Cariogram, and the participants were classified into five risk groups. Statistical analysis was performed using the software program Statistical Package of Social Science (version 17.0, SPSS Inc., Chicago IL, USA). Results: Findings revealed that there is slight difference in caries risk among government and private schoolchildren, where 48% caries risk development and 52% chance to avoid dental caries were showed in government schoolchildren, and 51% caries risk development and 49% chance to avoid dental caries were showed in private schoolchildren, according to Cariogram. Decayed, missing, and filled teeth component, mutans streptococci, and Lactobacillus counts were slightly higher in private schoolchildren compared with government schoolchildren. Conclusion: The private schoolchildren had less favorable values than government schoolchildren for most of the caries-related factors. Cariogram can be the most modest and reliable tool for caries prediction, thus aiding in identifying different risk groups in a community so that appropriate preventive strategies can be provided to overcome new carious lesion formation. PMID:29780742

Genome-wide association Scan of dental caries in the permanent dentition

PubMed Central

2012-01-01

Background Over 90% of adults aged 20 years or older with permanent teeth have suffered from dental caries leading to pain, infection, or even tooth loss. Although caries prevalence has decreased over the past decade, there are still about 23% of dentate adults who have untreated carious lesions in the US. Dental caries is a complex disorder affected by both individual susceptibility and environmental factors. Approximately 35-55% of caries phenotypic variation in the permanent dentition is attributable to genes, though few specific caries genes have been identified. Therefore, we conducted the first genome-wide association study (GWAS) to identify genes affecting susceptibility to caries in adults. Methods Five independent cohorts were included in this study, totaling more than 7000 participants. For each participant, dental caries was assessed and genetic markers (single nucleotide polymorphisms, SNPs) were genotyped or imputed across the entire genome. Due to the heterogeneity among the five cohorts regarding age, genotyping platform, quality of dental caries assessment, and study design, we first conducted genome-wide association (GWA) analyses on each of the five independent cohorts separately. We then performed three meta-analyses to combine results for: (i) the comparatively younger, Appalachian cohorts (N = 1483) with well-assessed caries phenotype, (ii) the comparatively older, non-Appalachian cohorts (N = 5960) with inferior caries phenotypes, and (iii) all five cohorts (N = 7443). Top ranking genetic loci within and across meta-analyses were scrutinized for biologically plausible roles on caries. Results Different sets of genes were nominated across the three meta-analyses, especially between the younger and older age cohorts. In general, we identified several suggestive loci (P-value ≤ 10E-05) within or near genes with plausible biological roles for dental caries, including RPS6KA2 and PTK2B, involved in p38-depenedent MAPK signaling, and RHOU and FZD1, involved in the Wnt signaling cascade. Both of these pathways have been implicated in dental caries. ADMTS3 and ISL1 are involved in tooth development, and TLR2 is involved in immune response to oral pathogens. Conclusions As the first GWAS for dental caries in adults, this study nominated several novel caries genes for future study, which may lead to better understanding of cariogenesis, and ultimately, to improved disease predictions, prevention, and/or treatment. PMID:23259602

Parental psychosocial factors and childhood caries prevention: Data from an American Indian population.

PubMed

Albino, Judith; Tiwari, Tamanna; Henderson, William G; Thomas, Jacob F; Braun, Patricia A; Batliner, Terrence S

2018-04-10

The objective of this study was to examine the association among psychological and social variables reported by American Indian parents/caregivers of preschool children and changes in their Oral Health Knowledge and Behaviors related to care of their children's teeth. We also investigated the relationship of these factors with progression of caries, as reflected by changes in their children's dmfs. The data used for this study were collected at baseline in a clinical trial of an oral health promotion intervention comprising behavioural and clinical interventions for caries prevention delivered by tribal members on a large Southwestern American Indian reservation. Linear regression analyses were performed for changes (baseline to Year 1) in dmfs, Oral Health Knowledge and Oral Health Behavior scores, with baseline psychosocial measures, taken individually, as the independent variables. Parents' attitudes and beliefs were associated with increases in their Oral Health Knowledge and Behavior and also with the progression of caries for their children. When all participants were considered together, increases in children's dmfs were smaller when the caregiver had higher Internal Oral Health Locus of Control (e = -1.33, P = .004), higher Health Literacy (e = -1.55, P < .01), and higher Financial Stability (e = -4.46, P = .03), and lower scores for the Barriers subscale (e = 1.57, P < .01) of the Health Belief Model. For parents in the Intervention group, higher scores on Locus of Control, reflecting beliefs that chance, or other people determine their children's oral health, were associated with larger increases in Oral Health Knowledge (e = 1.73, P = .04) and Behaviors (e = 4.00, P = .005). Prevention of early childhood caries in American Indian children has proved to be especially challenging. Some of the measures identified in this report may suggest promising directions to prevention through approaches that build on competencies and skills to be learned and used within a context more broadly focused on parenting and management of health and family challenges. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Use of new minimum intervention dentistry technologies in caries management.

PubMed

Tassery, H; Levallois, B; Terrer, E; Manton, D J; Otsuki, M; Koubi, S; Gugnani, N; Panayotov, I; Jacquot, B; Cuisinier, F; Rechmann, P

2013-06-01

Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the disease, or keep the oral environment in a state of balance between pathological and preventive factors. Early detection and diagnosis and prediction of lesion activity are of great interest and may change traditional operative procedures substantially. Fluorescence tools with high levels of magnification and observational capacity should guide clinicians towards a more preventive and minimally invasive treatment strategy. © 2013 Australian Dental Association.

Sugar before bed: a simple dietary risk factor for caries experience.

PubMed

Goodwin, M; Patel, D K; Vyas, A; Khan, A J; McGrady, M G; Boothman, N; Pretty, I A

2017-03-01

Clinical care pathways have placed renewed emphasis on caries risk assessment and the ability to predict and prevent further disease. With diet considered a key factor in the development of caries, the level of caries risk posed by dietary habits, such as the frequency of intake and timing of free sugars is questioned. To identify reliable and simple dietary risk factors for caries experience. A cross-sectional observational study of a convenience sample with data gained from clinical examinations, questionnaire and a 24 hour dietary-recall interview. 128 subjects aged 11-12 from comprehensive schools in Greater Manchester and Newcastle upon-Tyne, UK. free sugars consumed between meals, before bed and total % of total free sugars consumed were assessed from dietary assessments led by a dietitian. D4-6MFT was generated with a caries threshold of ICDAS stage 4 from clinical examinations. Analysis revealed no significant differences in caries experience when looking specifically at caries into dentine, referred to as the cavity group (split at D4-6MFT), between high and low deprivation, consumption of free sugars between meals and free sugars (%). The consumption of free sugars within the hour before bed revealed a statistically significant difference between the cavity/no cavity groups (p=0.002). Logistic regression analysis on the cavity/no cavity groups revealed an odds ratio of 2.4 (95%CI 1.3,4.4) for free sugars consumption before bedtime. The study suggests that the consumption of free sugars before bedtime may be an important risk factor for adolescent caries into dentine experience. Copyright© 2017 Dennis Barber Ltd.

Fluorides and Other Preventive Strategies for Tooth Decay.

PubMed

Horst, Jeremy A; Tanzer, Jason M; Milgrom, Peter M

2018-04-01

We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions should occur throughout the life cycle, and need to be age appropriate. Mitigating disease transmission and enhancing resistance are achieved through use of various fluorides, sugar substitutes, mechanical barriers such as pit-and-fissure sealants, and antimicrobials. A key aspect is counseling and other behavioral interventions that are designed to promote use of disease transmission-inhibiting and tooth resistance-enhancing agents. Advocacy for public water fluoridation and sugar taxes is an appropriate dental public health activity. Copyright © 2017 Elsevier Inc. All rights reserved.

[Stevia in the fight against dental caries].

PubMed

Ma, M S; Blanksma, N G

2015-01-01

Stevia is a natural, non-caloric sweetener of plant origin. The sweetening power of stevia is several hundred times larger than that of table sugar (sucrose). On the basis of available research, the European Food Safety Authority concluded that stevia is safe for human consumption. Since then, stevia has been approved as a sweetener for the European market. As a substitute for sucrose, stevia can contribute to a reduced caloric intake and can play a role in the prevention and/or treatment of metabolic disorders. In addition, stevia is non-cariogenic and is, moreover, affordable. Promoting the consumption of stevia can therefore be a preventive means of fighting dental caries.

Effects of early dental office visits on dental caries experience.

PubMed

Beil, Heather; Rozier, R Gary; Preisser, John S; Stearns, Sally C; Lee, Jessica Y

2014-10-01

We determined the association between timing of a first dentist office visit before age 5 years and dental disease in kindergarten. We used North Carolina Medicaid claims (1999-2006) linked to state oral health surveillance data to compare caries experience for kindergarten students (2005-2006) who had a visit before age 60 months (n=11,394) to derive overall exposure effects from a zero-inflated negative binomial regression model. We repeated the analysis separately for children who had preventive and tertiary visits. Children who had a visit at age 37 to 48 and 49 to 60 months had significantly less disease than children with a visit by age 24 months (incidence rate ratio [IRR]=0.88; 95% confidence interval [CI]=0.81, 0.95; IRR=0.75; 95% CI=0.69, 0.82, respectively). Disease status did not differ between children who had a tertiary visit by age 24 months and other children. Medicaid-enrolled children in our study followed an urgent care type of utilization, and access to dental care was limited. Children at high risk for dental disease should be given priority for a preventive dental visit before age 3 years.

Glass ionomer ART sealants in Chinese school children-6-year results.

PubMed

Holmgren, Christopher J; Lo, Edward C M; Hu, Deyu

2013-09-01

To evaluate longitudinally ART sealants placed in Chinese school children under field conditions. 191 ART sealants were placed in 140 children, aged 11-14 years, by five assistant dentists in four secondary schools in Deyang, Sichuan Province, China. Teeth selected for sealing were those with pits and fissures that were deep or showing early enamel caries. Teeth were excluded if there was obvious cavitation extending into dentine. Standard instruments and procedures for ART sealants were used. The material used was a high-viscosity glass-ionomer (Ketac-Molar, 3MESPE) that was inserted into the pits and fissures with the "press-finger" technique. The status of the sealants was evaluated annually over 6 years after placement by the same examiner who was not involved in the placement of the sealants using explorers, mouth-mirrors and an intra-oral fibre-optic light. No missing sealants were replaced during the study. 107 sealants (56% of the original) were examined after 6 years. The cumulative survival rates of the sealants (partially or fully retained) after 2, 4 and 6 years were 79%, 68% and 59%, respectively. Caries prevention lagged the fall in sealant survival but remained high throughout the study period, being over 90% in the first 4 years and 85% after 6 years. ART sealants placed under field conditions in Chinese schoolchildren have a high retention rate. Missing sealants should be replaced to maintain their preventive efficacy. The sealing of pits and fissures can be an effective caries preventive approach. Resin-based sealants have the disadvantage in that they require an optimal level of moisture control during placement. In children and in outreach situations glass ionomer ART sealants, which are more moisture tolerant, can offer a viable alternative. Copyright © 2013 Elsevier Ltd. All rights reserved.

Chronic Disease Management Strategies of Early Childhood Caries: Support from the Medical and Dental Literature.

PubMed

Edelstein, Burton L; Ng, Man Wai

2015-01-01

An Institute of Medicine report places chronic disease management (CDM) as an intervention on a treatment spectrum between prevention and acute care. CDM commonly focuses on conditions in which patient self-care efforts are significant. Framing early childhood caries (ECC) as such a chronic condition invites dentistry to reconsider its approach to caries management and shift gears from a strictly surgical approach to one that also incorporates a medical approach. This paper's purpose was to explore the definition of and concepts inherent in CDM. An explanatory model is introduced to describe the multiple factors that influence ECC-CDM strategies. Reviewed literature suggests that early evidence from ECC-CDM interventions, along with results of pediatric asthma and diabetes CDM, supports CDM of ECC as a valid approach that is independent of both prevention and repair. Early results of ECC-CDM endeavors have demonstrated a reduction in rates of new cavitation, dental pain, and referral to the operating room compared to baseline rates. ECC-CDM strategies hold strong promise to curtail caries activity while complementing dental repair when needed, thereby reducing disease progression and cavity recurrence. Institutionalizing ECC-CDM will both require and benefit from evolving health care delivery and financing systems that reward positive health outcomes.

Application of adenosine triphosphate-driven bioluminescence for quantification of plaque bacteria and assessment of oral hygiene in children.

PubMed

Fazilat, Shahram; Sauerwein, Rebecca; McLeod, Jennifer; Finlayson, Tyler; Adam, Emilia; Engle, John; Gagneja, Prashant; Maier, Tom; Machida, Curtis A

2010-01-01

Dentistry has undergone a shift in caries management toward prevention and improved oral hygiene and diagnosis. Caries prevention now represents one of the most important aspects of modern dental practice. The purpose of this cross-sectional study was to demonstrate the use of adenosine triphosphate- (ATP-) driven bioluminescence as an innovative tool for the rapid chairside enumeration of oral bacteria (including plague streptococci) and assessment of oral hygiene and caries risk. Thirty-three pediatric patients (7- to 12-year-old males and females) were examined, and plague specimens, in addition to stimulated saliva, were collected from representative teeth within each quadrant. Oral specimens (n=150 specimens) were assessed by plating on enriched and selective agars, to enumerate total bacteria and streptococci, and subjected to adenosine triphosphate- (ATP-) driven bioluminescence determinations using a luciferase-based assay system. Statistical correlations, linking ATP values to numbers of total bacteria, oral streptococci and mutans streptococci, yielded highly significant r values of 0.854, 0.840, and 0.796, respectively Our clinical data is consistent with the hypothesis that ATP measurements have a strong statistical association with bacterial number in plague and saliva specimens, including numbers for oral streptococci, and may be used as a potential assessment tool for oral hygiene and caries risk in children.

The status of community water fluoridation in the United States.

PubMed Central

Easley, M W

1990-01-01

Community water fluoridation has served the American public extremely well as the cornerstone of dental caries prevention activities for 45 years. The dental and general health benefits associated with the ingestion of water-borne fluorides have been well known by researchers for an even longer period. Continued research has repeatedly confirmed the safety, effectiveness, and efficiency of community water fluoridation in preventing dental caries for Americans regardless of age, race, ethnicity, religion, educational status, or socioeconomic level. Despite the obvious benefits associated with this proven public health measure, slow progress has been made toward achieving the 1990 national fluoridation objectives as listed in "Promoting Health/Preventing Disease: Objectives for the Nation." This paper documents the lagging pace of community fluoridation by reviewing and analyzing data reported in "Fluoridation Census, 1985," a document published in late 1988 by the Public Health Service's Centers for Disease Control. Failure to attain the 1990 objectives is attributable to a combination of circumstances, including their low priority within many local, State, and Federal health agencies, inadequate funding at all levels of government, lack of a coordinated and focused national fluoridation effort, failure of most States to require fluoridation, lack of Federal legislation mandating fluoridation, general apathy of most health professional organizations toward fluoridation, misconceptions by the public about effectiveness and safety and, finally, unrelenting opposition by a highly vocal minority of the lay public.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2116635

An Effective Psychoeducational Intervention for Early Childhood Caries Prevention: Part I

PubMed Central

Weber-Gasparoni, Karin; Reeve, Johnmarshall; Ghosheh, Natalie; Warren, Joh J.; Drake, David R.; Kramer, Katherine W.O.; Dawson, Deborah V.

2016-01-01

Purpose The purpose was to compare whether mothers exposed to an autonomy-supportive psychoeducational videotaped message, informed by the self-determination theory (SDT), demonstrated greater changes in oral health knowledge and behavioral intentions as a preventive means for early childhood caries (ECC) than mothers exposed to a neutral message delivered by brochure. Methods Data were collected at baseline, one-, and six-month follow-ups from 415 12- to 49-month-old WIC-enrolled children and their mothers: 283 in the video intervention group and 132 in the brochure control group. Mothers completed questionnaires on maternal knowledge and behavioral intentions for oral health care. Chi-square, Wilcoxon rank-sum, and Mann-Whitney tests were used to analyze data (P<.05). Results Relative to their baseline scores, the intervention group showed a greater increase in knowledge than the control group, both at one-month (P=.002) and six-month follow-ups (P<.001). The video group also demonstrated a greater increase in behavioral intentions than controls, both at one-month (P<.05) and six-month follow-ups (P<.001). Knowledge and behavioral intention levels at six-month follow-up did not differ significantly from those at one-month follow-up, indicating that intervention-based increases in these measures were maintained over time. Conclusions Data provided evidence of the effectiveness of the autonomy-supportive psychoeducational intervention for ECC prevention relative to a neutral brochure. PMID:23756308

Effect of Antimicrobial Interventions on the Oral Microbiota Associated with Early Childhood Caries.

PubMed

Li, Yihong; Tanner, Anne

2015-01-01

The purposes of this systematic literature review were to identify research-based evidence for an effect of antimicrobial therapeutic approaches on the cariogenic microbiota and early childhood caries (ECC) outcomes; and to review methods used to perform microbial assessments in clinical studies of ECC. Multiple databases were searched; only clinical cohort studies and randomized controlled trials published from 1998 to 2014 were selected. A total of 471 titles and abstracts were identified; 114 studies met the inclusion criteria for a full review, from which 41 studies were included in the meta-analyses. In most of the reviewed studies, moderate reductions in cariogenic bacterial levels, mainly in mutans streptococci (MS), were demonstrated following the use of antimicrobial agents, but bacterial regrowth occurred and new carious lesions developed once the treatment had ceased, particularly in high-risk children. Relatively consistent findings suggested that anti-cariogenic microbial interventions in mothers significantly reduced MS acquisition by children. However, studies of the long-term benefits of ECC prevention are lacking. Based on the meta-analyses, antimicrobial interventions and treatments show temporary reductions in MS colonization levels. However, there is insufficient evidence to indicate that the approaches used produced sustainable effects on cariogenic microbial colonization or ECC reduction and prevention.

Photodynamic therapy on bacterial reduction in dental caries: in vivo study

NASA Astrophysics Data System (ADS)

Baptista, Alessandra; Araujo Prates, Renato; Kato, Ilka Tiemy; Amaral, Marcello Magri; Zanardi de Freitas, Anderson; Simões Ribeiro, Martha

2010-04-01

The reduction of pathogenic microorganisms in supragingival plaque is one of the principal factors in caries prevention and control. A large number of microorganisms have been reported to be inactivated in vitro by photodynamic therapy (PDT). The purpose of this study was to develop a rat model to investigate the effects of PDT on bacterial reduction in induced dental caries. Twenty four rats were orally inoculated with Streptococcus mutans cells (ATCC 25175) for three consecutive days. The animals were fed with a cariogenic diet and water with 10% of sucrose ad libitum, during all experimental period. Caries lesion formation was confirmed by Optical Coherence Tomography (OCT) 5 days after the beginning of the experiment. Then, the animals were randomly divided into two groups: Control Group: twelve animals were untreated by either light or photosensitizer; and PDT Group: twelve animals were treated with 100μM of methylene blue for 5min and irradiated by a Light Emitting Diode (LED) at λ = 640+/-30nm, fluence of 172J/cm2, output power of 240mW, and exposure time of 3min. Microbiological samples were collected before, immediately after, 3, 7 and 10 days after treatment and the number of total microaerophiles was counted. OCT images showed areas of enamel demineralization on rat molars. Microbiological analysis showed a significant bacterial reduction after PDT. Furthermore, the number of total microaerophiles in PDT group remained lower than control group until 10 days posttreatment. These findings suggest that PDT could be an alternative approach to reduce bacteria in dental caries.

Shaping the future of dental education: Caries as a case-study.

PubMed

Pitts, N B; Mazevet, M E; Mayne, C

2018-03-01

This study reports on the full-day workshop "The Shape of The Future of Dental Education for Dental Caries-and how we get there" held immediately prior to the May 2017 ADEE/ADEA/King's College London meeting "Shaping the Future of Dental Education." A standardised, evidence-led Core Curriculum in Cariology (CCC) was developed jointly and systematically by ORCA and ADEE, starting in 2010. At the same time, the ICDAS Foundation was developing a comprehensive caries management system, ICCMS™. The workshop reported on what has been achieved on a global basis by many building on these initiatives. The CCC has been, or is currently being, localised in a number of places around the world and has, in some countries, been successfully implemented. There are also other areas which are struggling more with the logistics of introducing it. The workshop presented geographical perspectives and experiences on implementing the CCC from Colombia, the United States and Europe, as well as professional perspectives from hygienists, students and policymakers. The workshop then considered the future of the CCC and the roles of Interprofessional Education, Technology, Global Networking and Assessment in a Global Context in 4 breakout groups. Having had reports back and plenary discussion, it was concluded that the caries world has made good progress towards a "futuristic" curriculum with parallel development of a comprehensive, preventive and tooth-preserving caries management system-ICCMS™. The implementation challenge is now to share even more effectively in order to have these developments more widely accepted and adopted worldwide. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The impact of mother's literacy on child dental caries: Individual data or aggregate data analysis?

PubMed

Haghdoost, Ali-Akbar; Hessari, Hossein; Baneshi, Mohammad Reza; Rad, Maryam; Shahravan, Arash

2017-01-01

To evaluate the impact of mother's literacy on child dental caries based on a national oral health survey in Iran and to investigate the possibility of ecological fallacy in aggregate data analysis. Existing data were from second national oral health survey that was carried out in 2004, which including 8725 6 years old participants. The association of mother's literacy with caries occurrence (DMF (Decayed, Missing, Filling) total score >0) of her child was assessed using individual data by logistic regression model. Then the association of the percentages of mother's literacy and the percentages of decayed teeth in each 30 provinces of Iran was assessed using aggregated data retrieved from the data of second national oral health survey of Iran and alternatively from census of "Statistical Center of Iran" using linear regression model. The significance level was set at 0.05 for all analysis. Individual data analysis showed a statistically significant association between mother's literacy and decayed teeth of children ( P = 0.02, odds ratio = 0.83). There were not statistical significant association between mother's literacy and child dental caries in aggregate data analysis of oral health survey ( P = 0.79, B = 0.03) and census of "Statistical Center of Statistics" ( P = 0.60, B = 0.14). Literate mothers have a preventive effect on occurring dental caries of children. According to the high percentage of illiterate parents in Iran, it's logical to consider suitable methods of oral health education which do not need reading or writing. Aggregate data analysis and individual data analysis had completely different results in this study.

The interrelationship between diet and oral health.

PubMed

Moynihan, Paula

2005-11-01

Diet and nutrition impact on many oral diseases, in particular dental caries. Consumption of fluoridated water coupled with a reduction in non-milk extrinsic sugar intake is an effective means of caries prevention. However, studies on the fluoride concentration of bottled waters suggest increased consumption of these waters, in preference to fluoridated tap water, would lead to a marked decrease in caries protection. Concerns have been raised about the bioavailability of fluoride from artificially-fluoridated water compared with naturally-fluoridated water. This issue has been addressed in a human experimental study that has indicated that any differences in fluoride bioavailability are small compared with the naturally-occurring variability in fluoride absorption. Research has unequivocally shown sugars to be the main aetiological factor for dental caries, and information on intakes guides health promotion. Repeat dietary surveys of English children over three decades indicate that levels of sugars intake have remained stable, while sources of sugars have changed considerably, with the contribution from soft drinks more than doubling since 1980. Dental caries eventually leads to tooth loss, which in turn impairs chewing ability causing avoidance of hard and fibrous foods including fruits, vegetables and whole grains. A very low intake (<12 g/d) of NSP and fruit and vegetables has been found in edentulous subjects. Provision of prostheses alone fails to improve diet. However, initial studies indicate that customised dietary advice at the time of denture provision results in increased consumption of fruits and vegetables, and positive movement through the stages of change. Feasible means of integrating dietary counselling into the dental setting warrants further investigation.

Nutritional Disorders of Children. Prevention, Screening, and Followup.

ERIC Educational Resources Information Center

Fomon, Samuel J.

Intended for child health care providers, the text contains information on improving preventive efforts in nutrition, particurlarly those focused on prevention of the major health problems which are nutrition related (obesity, atherosclerosis, dental caries, and anemia). Part I focuses on screening of individual children likely to be at risk of…

The Children's Oral Health Initiative: An intervention to address the challenges of dental caries in early childhood in Canada's First Nation and Inuit communities.

PubMed

Mathu-Muju, Kavita R; McLeod, James; Walker, Mary Lou; Chartier, Martin; Harrison, Rosamund L

2016-08-15

The objective of the Children's Oral Health Initiative (COHI) is to increase access to preventive oral health services provided to First Nations and Inuit (FN/I) children living on federal reserves and in remote communities. COHI targets preschool children; 5-7-year-olds; pregnant women; and parents/caregivers in FN/I communities. The program was piloted in 2004 by Health Canada and is potentially available to all FN/I communities. However, the community must consent to the program's implementation and agree to support a community member to be trained as a COHI aide. Dental therapists and hygienists screen eligible children, apply fluoride varnish and sealants to children's teeth, and stabilize active dental caries with glass ionomer. An innovation was the development of a community oral health worker, the COHI Aide. The COHI Aide is a community member who serves as an advocate for preventive oral health in the community and provides instruction to children, parent/caregivers and expectant mothers in preventing dental caries. COHI was piloted in 41 communities in 2004. By 2014, the program had expanded to 320 FN/I communities, which represents 55% of all eligible FN/I communities. In 2012, 23,085 children had received COHI preventive oral health services. The results demonstrate COHI's success as a preventive oral health care delivery model in remote communities. Implementation and delivery of preventive oral health services has been enhanced by the sustained presence of a community-based COHI Aide.

Potentially preventable dental care in operating rooms for children enrolled in Medicaid.

PubMed

Bruen, Brian K; Steinmetz, Erika; Bysshe, Tyler; Glassman, Paul; Ku, Leighton

2016-09-01

In this study, the authors examined the prevalence and cost of care for children enrolled in Medicaid for potentially preventable dental conditions who receive surgical care in hospital operating rooms (ORs) or ambulatory surgery centers (ASCs). The authors analyzed Medicaid data from 8 states to find cases in which children aged 1 to 20 years received surgical care in ORs or ASCs in 2010 and 2011 for potentially preventable diagnoses, as defined with diagnostic codes. For 6 states with complete data, there were 26,373 cases in 2011 in which children received OR or ASC surgical care for potentially preventable conditions. These cases represent approximately 0.5% of all children enrolled in Medicaid in these states and approximately 1% of children enrolled in Medicaid who received any dental care. There were $68 million in total Medicaid payments for these cases, with an average of $2,581 per case. Diagnostic codes indicated that 98% of cases were related to treatment of dental caries. More than two-thirds of the cases (71%) were children aged 1 to 5 years. Extrapolation to the United States suggests that approximately $450 million in additional expenditures occurred in 2011 because of OR or ASC surgical care for potentially preventable pediatric dental conditions, primarily related to early childhood caries. Strategies to improve prevention of early childhood caries, including community- and family-based education, and to increase access to timely and early dental care for low-income children could reduce the burdens and costs of these dental problems. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Fluoride effects: the two faces of janus.

PubMed

Gazzano, E; Bergandi, L; Riganti, C; Aldieri, E; Doublier, S; Costamagna, C; Bosia, A; Ghigo, D

2010-01-01

The behavior of fluoride ions in the human organism is a classic example of double-edged sword. On the one hand the daily supplementation with fluoride is undoubtedly an important preventing factor in protecting teeth from caries, and, as an important mitogenic stimulus for osteoblasts, it may enhance mineral deposition in bone, but on the other hand fluoride, above a threshold concentration, has been demonstrated to be toxic. We present here a brief review of fluoride metabolism and exposure, its use in caries prevention and its effects on bone, followed by an updating about the main hypotheses concerning its mechanism of action and toxicity. The effects of fluoride have been related mainly to its ability to evoke the activation of G proteins and the inhibition of phosphotyrosine phosphatases, leading to an intracellular increase of tyrosine phosphorylation and activation of the mitogen-activated protein kinase pathway, and its capacity to cause generation of reactive oxygen species. We present also a unifying hypothesis accounting for these apparently different effects, although the available experimental models and conditions are highly variable in the literature. A lot of experiments still need to be performed to clarify the positive and negative effects of fluoride. Finding the mechanisms accounting for fluoride toxicity is an important point: indeed, the use of fluoride has been proposed in the preparation of new biomaterials to be inserted in the bone, in order to improve their stable and safe integration.

Chemico-therapeutic approach to prevention of dental caries. [using stannous fluoride gel

NASA Technical Reports Server (NTRS)

Shannon, I. L.

1975-01-01

The program of chemical preventive dentistry is based primarily upon the development of a procedure for stabilizing stannous fluoride in solution by forcing it into glycerin. New topical fluoride treatment concentrates, fluoride containing gels and prophylaxis pastes, as well as a completely stable stannous fluoride dentifrice are made possible by the development of a rather complicated heat application method to force stannous fluoride into solution in glycerin. That the stannous fluoride is clinically effective in such a preparation is demonstrated briefly on orthodontic patients.

Development of a Core Curriculum Framework in Cariology for U.S. Dental Schools.

PubMed

Fontana, Margherita; Guzmán-Armstrong, Sandra; Schenkel, Andrew B; Allen, Kennneth L; Featherstone, John; Goolsby, Susie; Kanjirath, Preetha; Kolker, Justine; Martignon, Stefania; Pitts, Nigel; Schulte, Andreas; Slayton, Rebecca L; Young, Douglas; Wolff, Mark

2016-06-01

Maintenance of health and preservation of tooth structure through risk-based prevention and patient-centered, evidence-based disease management, reassessed at regular intervals over time, are the cornerstones of present-day caries management. Yet management of caries based on risk assessment that goes beyond restorative care has not had a strong place in curriculum development and competency assessment in U.S. dental schools. The aim of this study was to develop a competency-based core cariology curriculum framework for use in U.S. dental schools. The Section on Cariology of the American Dental Education Association (ADEA) organized a one-day consensus workshop, followed by a meeting program, to adapt the European Core Cariology Curriculum to the needs of U.S. dental education. Participants in the workshop were 73 faculty members from 35 U.S., three Canadian, and four international dental schools. Representatives from all 65 U.S. dental schools were then invited to review and provide feedback on a draft document. A recommended competency statement on caries management was also developed: "Upon graduation, a dentist must be competent in evidence-based detection, diagnosis, risk assessment, prevention, and nonsurgical and surgical management of dental caries, both at the individual and community levels, and be able to reassess the outcomes of interventions over time." This competency statement supports a curriculum framework built around five domains: 1) knowledge base; 2) risk assessment, diagnosis, and synthesis; 3) treatment decision making: preventive strategies and nonsurgical management; 4) treatment decision making: surgical therapy; and 5) evidence-based cariology in clinical and public health practice. Each domain includes objectives and learning outcomes.

Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report.

PubMed

Chu, Chun-Hung; Lee, Angeline Hui-Cheng; Zheng, Liwu; Mei, May Lei; Chan, Godfrey Chi-Fung

2014-01-03

Rampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation. A 14-year-old Chinese boy suffering from β-thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, and depapillation of tongue indicating an underlying condition of anemia. The poor oral condition due to topical and systemic immunosuppressants was seriously aggravated, and rampant caries developed rapidly, affecting all newly erupted, permanent teeth. The teeth were hypersensitive and halitosis was apparent. Strategies for oral health education and diet modification were given to the patient. Xylitol chewing gum was used to stimulate saliva flow to promote remineralization of teeth. Silver diamine fluoride was topically applied to arrest rampant caries and to relieve pain from hypersensitivity. Carious teeth with pulpal involvement were endodontically treated. Stainless steel crowns were provided on molars to restore chewing function, and polycarbonate crowns were placed on premolars, upper canines and incisors. This case report demonstrates success in treating a young teenager with severe rampant dental decay by contemporary caries control and preventive strategy.

Caries Epidemiology and Community Dentistry: Chances for Future Improvements in Caries Risk Groups. Outcomes of the ORCA Saturday Afternoon Symposium, Greifswald, 2014. Part 1.

PubMed

Splieth, Christian H; Christiansen, Jette; Foster Page, Lyndie A

2016-01-01

This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with 'caries epidemiology and community dentistry: chances for future improvements in caries risk groups'. After the caries decline in many countries, there are remaining pockets of higher caries levels, mostly in the primary dentition and/or linked to a low socio-economic status (SES). The review into the evidence of caries-preventive measures clearly points to the use of fluorides, especially toothbrushing with fluoridated toothpaste and collective measures such as water fluoridation. In contrast to several unsuccessful high-risk approaches, community and public health programmes seem to be able to ensure a population-wide access and compliance in risk groups. Their simple and evidence-based measures mostly combine regular plaque removal and fluoride applications via toothbrushing, at least for children and adolescents. For the future, the common risk factor approach which addresses associations between oral health, social deprivation, diet, hygiene, smoking, alcohol use and stress should lead to combined efforts with other community health and education specialists. Further engagement with public policy, community leaders and administration is needed in order to strengthen healthy choices and behaviour, e.g. in 'healthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors. © 2016 S. Karger AG, Basel.

Dental caries prevalence, oral health knowledge and practice among indigenous Chepang school children of Nepal.

PubMed

Prasai Dixit, Lonim; Shakya, Ajay; Shrestha, Manash; Shrestha, Ayush

2013-05-14

Chepang communities are one of the most deprived ethnic communities in Nepal. According to the National Pathfinder Survey, dental caries is a highly prevalent childhood disease in Nepal. There is no data concerning the prevalence of caries along with knowledge, attitude and oral hygiene practices among Chepang schoolchildren. The objectives of this study were to 1) record the prevalence of dental caries 2) report experience of dental pain 3) evaluate knowledge, attitude and preventive practices on oral health of primary Chepang schoolchildren. A cross sectional epidemiological study was conducted in 5 government Primary schools of remote Chandibhanjyang Village Development Committee (VDC) in Chitwan district. Ethical approval was taken from the Institutional Review Board within the Research Department of the Institute of Medicine (IOM) Tribhuvan University. Consent was obtained from parents for conducting clinical examination and administrating questionnaire. Permission was taken from the school principal in all schools. Data was collected using a pretested questionnaire on 131 schoolchildren aged 8-16-year- olds attending Grade 3-5. Clinical examination was conducted on 361 school children aged 5-16 -year-olds attending grade 1-5. Criteria set by the World Health Organization (1997) was used for caries diagnosis. The questionnaires, originally constructed in English and translated into Nepali were administered to the schoolchildren by the researchers. SPSS 11software was used for data analysis. Caries prevalence for 5-6 -year-old was above the goals recommended by WHO and Federation of Dentistry international (FDI) of less than 50% caries free children. Caries prevalence in 5-6-year-olds was 52% and 12-13-year-olds was 41%. The mean dmft/DMFT score of 5-6 -year-olds and 12 -13-year -olds was 1.59, 0.31 and 0.52, 0.84 respectively. The DMFT scores increased with age and the d/D component constituted almost the entire dmft/DMFT index. About 31% of 8-16-year-olds school children who participated in the survey reported having suffered from oral pain. Further, the need for treatment of decayed teeth was reported at 100%. About 76% children perceived teeth as an important component of general health and 75% reported it was required to eat. A total 93% children never visited a dentist or a health care service. Out of 56% children reporting cleaning their teeth daily, only 24% reported brushing their teeth twice daily. About 86% of the children reported using toothbrush and toothpaste to clean their teeth. Although 61% children reported to have received oral health education, 82% children did not know about fluoride and its benefit on dental health. About 50% children reported bacteria as the main cause of tooth decay and 23% as not brushing teeth for gingivitis. Frequency of sugar exposure was low; 75% of children reported eating sugar rich food once daily. Caries prevalence of 5-6 -year- old Chepang school children is above the recommended target set by FDI/WHO. The study reported 31% schoolchildren aged 8-16-year old suffered oral pain and decayed component constituted almost the entire dmft/DMFT index. The brushing habit was reportedly low with only 24% of the children brushing twice daily. A nationwide scientifically proven, cost effective school based interventions is needed for prevention and control of caries in schoolchildren in Nepal.

Patient-, organization-, and system-level barriers and facilitators to preventive oral health care: a convergent mixed-methods study in primary dental care.

PubMed

Templeton, Anna Rose; Young, Linda; Bish, Alison; Gnich, Wendy; Cassie, Heather; Treweek, Shaun; Bonetti, Debbie; Stirling, Douglas; Macpherson, Lorna; McCann, Sharon; Clarkson, Jan; Ramsay, Craig

2016-01-12

Dental caries is the most common chronic disease of adult and childhood, a largely preventable yet widespread, costly public health problem. This study identified patient-, organization-, and system-level factors influencing routine delivery of recommended care for prevention and management of caries in primary dental care. A convergent mixed-methods design assessed six guidance-recommended behaviours to prevent and manage caries (recording risk, risk-based recall intervals, applying fluoride varnish, placing preventive fissure sealants, demonstrating oral health maintenance, taking dental x-rays). A diagnostic questionnaire assessing current practice, beliefs, and practice characteristics was sent to a random sample of 651 dentists in National Health Service (NHS) Scotland. Eight in-depth case studies comprising observation of routine dental visits and dental team member interviews were conducted. Patient feedback was collected from adult patients with recent checkups at case study practices. Key informant interviews were conducted with decision makers in policy, funding, education, and regulation. The Theoretical Domains Framework within the Behaviour Change Wheel was used to identify and describe patient-, organization-, and system-level barriers and facilitators to care. Findings were merged into a matrix describing theoretical domains salient to each behaviour. The matrix and Behaviour Change Wheel were used to prioritize behaviours for change and plan relevant intervention strategies. Theoretical domains associated with best practice were identified from the questionnaire (N-196), case studies (N = 8 practices, 29 interviews), and patient feedback (N = 19). Using the study matrix, key stakeholders identified priority behaviours (use of preventive fissure sealants among 6-12-year-olds) and strategies (audit and feedback, patient informational campaign) to improve guidance implementation. Proposed strategies were assessed as appropriate for immediate implementation and suitable for development with remaining behaviours. Specific, theoretically based, testable interventions to improve caries prevention and management were coproduced by patient-, practice-, and policy-level stakeholders. Findings emphasize duality of behavioural determinants as barriers and facilitators, patient influence on preventive care delivery, and benefits of integrating multi-level interests when planning interventions in a dynamic, resource-constrained environment. Interventions identified in this study are actively being used to support ongoing implementation initiatives including guidance, professional development, and oral health promotion.

Technology-enhanced caries detection and diagnosis.

PubMed

Strassler, Howard E; Sensi, Luis Guilherme

2008-10-01

The prevalence of dental caries in children and adults in the United States has been declining the past 40 years primarily because of increased use of fluoride, improved oral hygiene and better oral hygiene devices, a greater emphasis on disease prevention and control, and better access to dental care made available by the dental profession. Caries diagnosis and detection for pit-and-fissure lesions has changed dramatically in the past 25 years. Research has confirmed that the carious process is bacterially mediated and is accompanied by changes in salivary flow and pH and the intake of refined carbohydrates. In recent years a number of new technologies have become available as adjuncts to traditional methods of diagnosing carious lesions. While using these new technologies, the clinician still needs to understand the concepts of caries risk, diagnosis, detection, and assessment. Working from the evidence, dental practitioners can decide on a sound clinical diagnosis and treatment plan.

Can Bayesian models play a role in dental caries epidemiology? Evidence from an application to the BELCAP data set.

PubMed

Matranga, Domenica; Firenze, Alberto; Vullo, Angela

2013-10-01

The aim of this study was to show the potential of Bayesian analysis in statistical modelling of dental caries data. Because of the bounded nature of the dmft (DMFT) index, zero-inflated binomial (ZIB) and beta-binomial (ZIBB) models were considered. The effects of incorporating prior information available about the parameters of models were also shown. The data set used in this study was the Belo Horizonte Caries Prevention (BELCAP) study (Böhning et al. (1999)), consisting of five variables collected among 797 Brazilian school children designed to evaluate four programmes for reducing caries. Only the eight primary molar teeth were considered in the data set. A data augmentation algorithm was used for estimation. Firstly, noninformative priors were used to express our lack of knowledge about the regression parameters. Secondly, prior information about the probability of being a structural zero dmft and the probability of being caries affected in the subpopulation of susceptible children was incorporated. With noninformative priors, the best fitting model was the ZIBB. Education (OR = 0.76, 95% CrI: 0.59, 0.99), all interventions (OR = 0.46, 95% CrI: 0.35, 0.62), rinsing (OR = 0.61, 95% CrI: 0.47, 0.80) and hygiene (OR = 0.65, 95% CrI: 0.49, 0.86) were demonstrated to be factors protecting children from being caries affected. Being male increased the probability of being caries diseased (OR = 1.19, 95% CrI: 1.01, 1.42). However, after incorporating informative priors, ZIB models' estimates were not influenced, while ZIBB models reduced deviance and confirmed the association with all interventions and rinsing only. In our application, Bayesian estimates showed a similar accuracy and precision than likelihood-based estimates, although they offered many computational advantages and the possibility of expressing all forms of uncertainty in terms of probability. The overdispersion parameter could expound why the introduction of prior information had significant effects on the parameters of the ZIBB model, while ZIB estimates remained unchanged. Finally, the best performance of ZIBB compared to the ZIB model was shown to catch overdispersion in data. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Risk indicators of coronal and root caries in Greek middle aged adults and senior citizens

PubMed Central

2012-01-01

Background Dental caries is the result of a complex interplay of multiple determinants which may change overtime. Therefore, periodic surveys of caries experience and redetermination of the risk indicators of the disease are needed. The aim of this study was to assess the prevalence and severity of coronal and root caries in Greeks aged 35-44 and 65-74-year-old in relation to socio-demographic parameters. Furthermore, trends in coronal caries experience of the 35-44-year-olds were investigated. Methods A sample of 1188 35-44-year-old and 1093 65-74-year-old individuals was selected in 2005 according to WHO guidelines for national pathfinder surveys. Caries was assessed in dentate subjects using the DMFT, DMFS, RDFS and RCI indices. Socio-demographic data were also collected. Univariate and multivariate regression analyses were performed to identify the effect of socio-demographic parameters. Results The mean DMFT and DMFS scores of the adults were 14.06 and 45.78 respectively, while those of the senior citizens were 20.63 and 89.82. Among the 35-44-year-ods, men and those having a higher educational attainment had significantly lower DMFS values (women OR = 1.679, CI: 1.243-2.267 and >12 years of education OR = 0.321, CI: 0.193-0.535 respectively), while educational level was the only predictor of DMFS in senior citizens (OR = 0.279, CI: 0.079-0.992). The mean DMFT score of the 35-44-year-olds has not improved since 1985, but there was a remarkable reduction in the number of DT related to a simultaneous increase in the number of FT. The mean RDFS rose from 0.39 in adults to 2.66 in senior citizens. The mean RDFS score of the middle aged adults was significantly correlated with education (OR = 0.346, CI: 0.180-0.664). The RCI was almost four times greater in seniors (9.73) than in adults (2.53). There were significant differences in caries experience between the surveyed regions. MS and RDS were the major components of the DMFS and RDFS indices respectively, in both age groups. Conclusions Caries experience in Greek adults is similar to what is observed in most industrialized countries. The mean DMFT score of the 35-44-year-olds has not improved since 1985, but a great improvement in restorative care has been observed. Senior citizens had a high percentage of untreated coronal and root surfaces. Region and education were the strongest predictors of caries experience. An increase in oral care utilization and effective prevention over the whole lifespan are needed to improve the dental health of the Greek adult population. PMID:22734655

The impact of restorative treatment on tooth loss prevention.

PubMed

Caldas Junior, Arnaldo de França; Silveira, Renata Cimões Jovino; Marcenes, Wagner

2003-01-01

A cross-sectional study was carried out to analyze tooth loss resulting from caries in relation to the number of times the extracted tooth had been restored, the type of caries diagnosed (primary or secondary), and socioeconomic indicators of patients from the city of Recife, Brazil. Ten public health centres and ten centres associated with health insurance companies were randomly selected. The size of the sample was calculated using a standard error of 2.5%. A confidence interval of 95% and a 50% prevalence of reasons for extractions were used for calculating the sample. The minimum size of the sample for meeting these requirements was 381 patients. Patients were randomly selected from the list of adults registered at each centre. A total of 410 patients were invited to take part in the study. The response rate was 100%, but 6 patients were excluded due to incompleteness of data in the questionnaire applied. An assessment was made to obtain the number of decayed, missing or filled teeth (DMFT index) and the reasons for extraction. The results showed a highly significant (p < 0.001) relationship between the number of times the tooth indicated for extraction had been restored and the reason for extraction being caries. Furthermore, the majority of teeth extracted due to caries had been restored two or more times. A highly statistically significant association was also observed between one indicator of use of dental services (F/DMFT) and extraction due to caries (p < 0.001). The findings questioned the belief that tooth loss can be prevented in the general population by merely providing restorative treatment.

Cluster-randomized xylitol toothpaste trial for early childhood caries prevention

PubMed Central

Chi, Donald L.; Tut, Ohnmar K.; Milgrom, Peter

2013-01-01

Purpose We assessed the efficacy of supervised toothbrushing with xylitol toothpaste to prevent early childhood caries (ECC) and to reduce mutans streptococci (MS). Methods In this cluster-randomized efficacy trial, 4 Head Start classrooms in the Marshall Islands were randomly assigned to supervised toothbrushing with 1,400ppm/31% fluoride-xylitol (Epic Dental, Provo, UT) or 1,450ppm fluoride-sorbitol toothpaste (Colgate-Palmolive, New York, NY) (N=196 children, ages 4–5 yrs). We hypothesized no difference in efficacy between the two types of toothpaste. The primary outcome was primary molar d2-3mfs increment after 6 mos. A single examiner was blinded to classroom assignments. Two classrooms were assigned to the fluoride-xylitol group (85 children) and 2 classrooms to the fluoride-sorbitol group (83 children). The child-level analyses accounted for clustering. Results There was no difference between the two groups in baseline or end-of-trial mean d2-3mfs. The mean d2-3mfs increment was greater in the fluoride-xylitol group compared to the fluoride-sorbitol group (2.5 and 1.4 d2-3mfs, respectively), but the difference was not significant (95% CI:−0.17, 2.37;P=0.07). No adverse effects were reported. Conclusion After 6 mos, brushing with a low strength xylitol/fluoride toothpaste is no more efficacious in reducing ECC than a fluoride only toothpaste in a high caries risk child population. PMID:24709430

Influence of CO2 (10.6 μm) and Nd:YAG laser irradiation on the prevention of enamel caries around orthodontic brackets.

PubMed

Seino, Priscila Yumi; Freitas, Patrícia Moreira; Marques, Márcia Martins; de Souza Almeida, Fernanda Campos; Botta, Sérgio Brossi; Moreira, Maria Stella Nunes Araújo

2015-02-01

One possible undesirable consequence of orthodontic therapy is the development of incipient caries lesions of enamel around brackets. The aim of this study was to compare the effects of CO2 (λ = 10.6 μm) and Nd:YAG (λ = 1,064 nm) lasers associated or not with topical fluoride application on the prevention of caries lesions around brackets. Brackets were bonded to the enamel of 65 premolars. The experimental groups (n = 13) were: G1--application of 1.23% acidulated fluoride phosphate gel (AFP, control); G2--Nd:YAG laser irradiation (0.6 W, 84.9 J/cm(2), 10 Hz, 110 μs, contact mode); G3--Nd:YAG laser irradiation associated with AFP; G4--CO2 laser irradiation (0.5 W, 28.6 J/cm(2), 50 Hz, 5 μs, and 10 mm focal distance); and G5--CO2 laser irradiation associated with AFP. Quantitative light-induced fluorescence was used to assess enamel demineralization. The data were statistically compared (α = 5%). The highest demineralization occurred in the Nd:YAG laser group (G2, 26.15% ± 1.94). The demineralization of all other groups was similar to that of the control group. In conclusion, CO2 laser alone was able to control enamel demineralization around brackets at the same level as that obtained with topical fluoride application.

Dental Caries Experience and Utilization of Oral Health Services Among Tibetan Refugee-Background Children in Paonta Sahib, Himachal Pradesh, India.

PubMed

Bhatt, Sumeet; Gaur, Ambika

2018-06-04

The study was done to describe the dental caries experience and dental care utilization among Tibetan refugee-background children in Paonta Sahib, India. The study was conducted on 254 school children in a Tibetan settlement in Paonta Sahib. Examination was done as per World Health Organization Oral Health Assessment criteria (2013). Data on dental services utilization was obtained from the parents of children using a structured questionnaire. Oral examination of 254 school children aged 6-18 years revealed an overall dental caries prevalence of 79.5%. The dental caries experience was greater in the mixed dentition (84%) than secondary dentition (77.3%). The mean DMFT was associated with sex and dental visiting patterns. About 60% children had never visited a dentist before. The main reason for dental visit was tooth removal (43%). The prevalence of dental caries among Tibetan refugee-background school children was high and utilization of dental care was low. A comprehensive oral health program focusing on preventive care and oral health education is recommended.

Prevalence of dental caries and periodontal disease in Mexican American children aged 5 to 17 years: results from southwestern HHANES, 1982-83. National Health and Nutrition Examination Survey.

PubMed Central

Ismail, A L; Burt, B A; Brunelle, J A

1987-01-01

This paper describes the estimated prevalence of dental caries and periodontal disease in 2,550 children, 5 through 17 years of age, who resided in five southwestern states of the United States and were examined in the Hispanic Health and Nutrition Examination Survey (HHANES) of 1982-84 of the National Center for Health Statistics. Dental caries in the Mexican American children was predominantly a disease of occlusal surfaces of molars; few smooth surfaces of posterior and anterior teeth were affected by caries. This intra-oral distribution of dental caries strongly supports the use of fissure sealants as a preventive procedure. Filled tooth surfaces contributed about 66 per cent of the total DMFS (decayed, missing, filled surfaces) scores. The analysis also shows that about 50 per cent of the 17 year old Mexican Americans had five or more filled or decayed teeth. Mild gingivitis was prevalent (76.9 per cent) in the Mexican American children. PMID:3605476

Distal cervical caries in the mandibular second molar: an indication for the prophylactic removal of third molar teeth? Update.

PubMed

McArdle, Louis W; McDonald, Fraser; Jones, Judith

2014-02-01

In 2005 we reported the clinical findings of 100 patients who had mandibular third molars removed because of distal cervical caries in the mandibular second molar. The aim of this follow-up study was to find out whether the findings in a new group of patients corroborate those of our previous study. We report on the clinical features of 239 patients (mean (SD) age 32.1 (7.85) years, range 20-65) who had 288 mandibular third molars removed because of distal cervical caries in the second molar. Patients had better dental health than average, and 67% had a DMF (decayed, missing, or filled) score of 5 or less. In 89% of third molars the mesial angulation was between 40° and 80°. Distal cervical caries in second molars is a late complication of third molar retention. The prophylactic removal of a partially erupted mesioangular third molar will prevent distal cervical caries forming in the second molar tooth. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Impact of malocclusion and dentofacial anomalies on the prevalence and severity of dental caries among adolescents.

PubMed

Feldens, Carlos Alberto; Dos Santos Dullius, Angela Isabel; Kramer, Paulo Floriani; Scapini, Annarosa; Busato, Adair Luiz Stefanello; Vargas-Ferreira, Fabiana

2015-11-01

To investigate the association between malocclusion/dentofacial anomalies and dental caries among adolescents. A cross-sectional study was conducted with 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório in southern Brazil. Parents/caregivers answered a structured questionnaire on demographic and socioeconomic variables. A trained examiner recorded the presence of malocclusion (Dental Aesthetic Index [DAI]), traumatic dental injury, and dental caries. Data analysis involved the chi-square, Mann-Whitney, and Kruskal-Wallis tests. Poisson regression with robust variance was used for the multivariable analysis. A total of 44.8% of the adolescents had dental caries (mean DFMT  =  1.33 ± 1.84). The DAI index ranged from 15 to 77 (mean  =  29.0 ± 7.9); 43.6% of the sample had severe malocclusion and 11.6% had traumatic dental injury. The prevalence and severity of dental caries were significantly greater among adolescents with severe malocclusion. The multivariate analysis demonstrated that adolescents with severe or handicapping malocclusion had a 31% greater probability of having dental caries (prevalence ratio: 1.31; 95% CI: 1.02-1.67), independently of demographic, socioeconomic, or clinical aspects. The orthodontic characteristics associated with the occurrence and severity of caries were maxillary irregularity ≥3 mm (P  =  .021) and abnormal molar relationship (P  =  .021). Handicapping malocclusion, maxillary irregularity, and abnormal molar relationship were associated with the occurrence and severity of dental caries. The findings suggest that the prevention and treatment of these conditions can contribute to a reduction in dental caries among adolescents.

Oral Microbiota of Children in a School-based Dental Clinic

PubMed Central

Soncini, Jennifer A; Kanasi, Eleni; Lu, Shulin C.; Nunn, Martha E.; Henshaw, Michelle M; Tanner, Anne CR

2010-01-01

Objectives Dental caries disproportionately affects disadvantaged subjects. This study hypothesized that there were greater caries extent and higher levels of caries-associated and anaerobic subgingival bacterial species in oral samples of Hispanic and immigrant children compared with non-Hispanic and US born children. Methods Children from a school-based dental clinic serving a community with a large Hispanic component were examined, and the extent of caries was recorded. Microbial samples were taken from teeth and the tongues of children. Samples were analyzed using DNA probes to 18 oral bacterial species. Results Seventy five children were examined. Extent of caries increased with child age in immigrant, but not in US born or Hispanic children. There were no differences in the microbiota based on ethnicity or whether the child was born in US or not. There was a higher species detection frequency from teeth than tongue samples. Levels of Streptococcus mutans and other Streptococcus species increased with caries extent. Prevotella intermedia, Tannerella forsythia and Selenomonas species were detected at low levels in these children. Conclusions We conclude that, while there was a high rate of dental caries in disadvantaged school children, there were no differences in the caries-associated microbiota, including S. mutans, based on ethnicity or immigration status. Furthermore, while anaerobic subgingival, periodontal pathogens were also detected in children, there was no difference in species detection based on ethnicity or immigration status. Increased levels of streptococci, including S. mutans, however, were detected with high caries levels. This suggested that while it is beneficial to target preventive and treatment programs to disadvantaged populations, there is likely no additional benefit to focus on subgroups within a population already at high risk for dental disease. PMID:19879369

Oral microbiota of children in a school-based dental clinic.

PubMed

Soncini, Jennifer A; Kanasi, Eleni; Lu, Shulin C; Nunn, Martha E; Henshaw, Michelle M; Tanner, Anne C R

2010-06-01

Dental caries disproportionately affects disadvantaged subjects. This study hypothesized that there were greater caries extent and higher levels of caries-associated and anaerobic subgingival bacterial species in oral samples of Hispanic and immigrant children compared with non-Hispanic and US born children. Children from a school-based dental clinic serving a community with a large Hispanic component were examined, and the extent of caries was recorded. Microbial samples were taken from teeth and the tongues of children. Samples were analyzed using DNA probes to 18 oral bacterial species. Seventy five children were examined. Extent of caries increased with child age in immigrant, but not in US born or Hispanic children. There were no differences in the microbiota based on ethnicity or whether the child was born in US or not. There was a higher species detection frequency from teeth than tongue samples. Levels of Streptococcus mutans and other Streptococcus spp increased with caries extent. Prevotella intermedia, Tannerella forsythia and Selenomonas spp were detected at low levels in these children. We conclude that, while there was a high rate of dental caries in disadvantaged school children, there were no differences in the caries-associated microbiota, including S. mutans, based on ethnicity or immigration status. Furthermore, while anaerobic subgingival, periodontal pathogens were also detected in children, there was no difference in species detection based on ethnicity or immigration status. Increased levels of streptococci, including S. mutans, however, were detected with high caries levels. This suggested that while it is beneficial to target preventive and treatment programs to disadvantaged populations, there is likely no additional benefit to focus on subgroups within a population already at high risk for dental disease. 2009 Elsevier Ltd. All rights reserved.

The Triple Functions of D2 Silencing in Treatment of Periapical Disease.

PubMed

Pan, Jie; Wang, Jue; Hao, Liang; Zhu, Guochun; Nguyen, Diep N; Li, Qian; Liu, Yuehua; Zhao, Zhihe; Li, Yi-Ping; Chen, Wei

2017-02-01

Dental caries is the most widespread chronic infectious disease. Inflammation in pulp tissues caused by dental caries will lead to periapical granulomas, bone erosion, loss of the tooth, and severe pain. Despite numerous efforts in recent studies to develop effective treatments for dental caries, the need for a potent therapy is still urgent. In this study, we applied a gene-based therapy approach by administering recombinant adeno-associated virus (AAV)-mediated Atp6v0d2 (d2) RNA interference knockdown of d2 gene expression to prevent periapical bone loss and suppress periapical inflammation simultaneously. The results showed that d2 depletion is simultaneously capable of reducing bone resorption with 75% protection through reducing osteoclasts, enhancing bone formation by increasing osterix expression, and inhibiting inflammation by decreasing T-cell infiltration. Notably, AAV-mediated gene therapy of d2 knockdown significantly reduced proinflammatory cytokine expression, including tumor necrosis factor α, interferon-γ, interleukin-1α, and interleukin 6 levels in periapical diseases caused by bacterial infection. Quantitative real-time polymerase chain reaction revealed that d2 knockdown reduced osteoclast-specific functional genes (ie, Acp5 and Ctsk) and increased osteoblast marker genes (ie, Osx and Opg) in periapical tissues. Collectively, our results showed that AAV-mediated d2 depletion in the periapical lesion area can prevent the progression of endodontic disease and bone erosion while significantly reducing the inflammatory over-response. These findings show that the depletion of d2 simultaneously reduces bone resorption, enhances bone formation, and inhibits inflammation caused by periapical diseases and provide significant insights into the potential effectiveness of AAV-sh-d2-mediated d2 silencing gene therapy as a major endodontic treatment. Copyright © 2016. Published by Elsevier Inc.

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

PubMed Central

2012-01-01

Background Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808 PMID:22909327