Effects of ultrasonic instrumentation on enamel surfaces with various defects.

PubMed

Kim, S-Y; Kang, M-K; Kang, S-M; Kim, H-E

2018-05-01

The aim of this study was to analyse the enamel damage caused by ultrasonic scaling of teeth with various enamel conditions that are difficult to identify by visual inspection, such as enamel cracks, early caries and resin restorations. In total, 120 tooth surfaces were divided into 4 experimental groups using a quantitative light-induced fluorescence-digital system: sound enamel group, enamel cracks group, early caries group and resin restoration group. A skilled dental hygienist performed ultrasonic scaling under a standardized set of conditions: a ≤ 15° angle between the scaler tip and tooth surface and 40-80 g of lateral pressure at the rate of 12 times/10 s. Following scaling, the depth of enamel damage was measured using a surface profilometer and observed using scanning electron microscopy (SEM). The damage depth was the greatest in the enamel cracks group (37.63 ± 34.42 μm), followed by the early caries group (26.81 ± 8.67 μm), resin restoration group (19.63 ± 6.73 μm) and the sound enamel group (17.00 ± 5.66 μm). The damage depth was significantly deeper in the enamel cracks and early caries groups than in the sound enamel group (P < .05). SEM clearly revealed enamel loss in the enamel cracks, early caries and resin restoration groups. The results of this study suggest that ultrasonic scaling can cause further damage to teeth with enamel cracks, early caries and resin restorations. Therefore, accurate identification of tooth conditions and calculus before the initiation of ultrasonic scaling is necessary to minimize damage. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association between developmental defects of enamel and dental caries: A systematic review and meta-analysis.

PubMed

Vargas-Ferreira, F; Salas, M M S; Nascimento, G G; Tarquinio, S B C; Faggion, C M; Peres, M A; Thomson, W M; Demarco, F F

2015-06-01

Dental caries is the main problem oral health and it is not well established in the literature if the enamel defects are a risk factor for its development. Studies have reported a potential association between developmental defects enamel (DDE) and dental caries occurrence. We investigated the association between DDE and caries in permanent dentition of children and teenagers. A systematic review was carried out using four databases (Pubmed, Web of Science, Embase, and Science Direct), which were searched from their earliest records until December 31, 2014. Population-based studies assessing differences in dental caries experience according to the presence of enamel defects (and their types) were included. PRISMA guidelines for reporting systematic reviews were followed. Meta-analysis was performed to assess the pooled effect, and meta-regression was carried out to identify heterogeneity sources. From the 2558 initially identified papers, nine studies fulfilled all inclusion criteria after checking the titles, abstracts, references, and complete reading. Seven of them were included in the meta-analysis with random model. A positive association between enamel defects and dental caries was identified; meta-analysis showed that individuals with DDE had higher pooled odds of having dental caries experience [OR 2.21 (95% CI 1.3; 3.54)]. Meta-regression analysis demonstrated that adjustment for sociodemographic factors, countries' socioeconomic status, and bias (quality of studies) explained the high heterogeneity observed. A higher chance of dental caries should be expected among individuals with enamel defects. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of bleaching on sound enamel and with early artificial caries lesions using confocal laser microscopy.

PubMed

Berger, Sandrine Bittencourt; Pavan, Sabrina; Dos Santos, Paulo Henrique; Giannini, Marcelo; Bedran-Russo, Ana Karina B

2012-01-01

The aim of this study was to evaluate effect of bleaching agents on sound enamel (SE) and enamel with early artificial caries lesions (CL) using confocal laser scanning microscopy (CLSM). Eighty blocks (4 x 5 x 5 mm) of bovine enamel were used and half of them were submitted to a pH cycling model to induce CL. Eight experimental groups were obtained from the treatments and mineralization level of the enamel (SE or CL) (n=10). SE groups: G1 - unbleached (control); G2 - 4% hydrogen peroxide (4 HP); G3 - 4 HP containing 0.05% Ca (Ca); G4 - 7.5% hydrogen peroxide (7.5 HP) containing amorphous calcium phosphate (ACP). CL groups: G5 - unbleached; G6 - 4 HP; G7 - 4 HP containing Ca; G8 - 7.5 HP ACP. G2, G3, G6, G7 were treated with the bleaching agents for 8 h/day during 14 days, while G4 and G8 were exposed to the bleaching agents for 30 min twice a day during 14 days. The enamel blocks were stained with 0.1 mM rhodamine B solution and the demineralization was quantified using fluorescence intensity detected by CLSM. Data were analyzed using ANOVA and Fisher's tests (α=0.05). For the SE groups, the bleaching treatments increased significantly the demineralization area when compared with the unbleached group. In the CL groups, no statistically significant difference was observed (p>0.05).The addition of ACP or Ca in the composition of the whitening products did not overcome the effects caused by bleaching treatments on SE and neither was able to promote remineralization of CL.

Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in vitro.

PubMed

Cardoso, C A B; de Castilho, A R F; Salomão, P M A; Costa, E N; Magalhães, A C; Buzalaf, M A R

2014-11-01

Analyse the effect of varnishes containing xylitol alone or combined with fluoride on the remineralization of artificial enamel caries lesions in vitro. Bovine enamel specimens were randomly allocated to 7 groups (n=15/group). Artificial caries lesions were produced by immersion in 30 mL of lactic acid buffer containing 3mM CaCl2·2H2O, 3mM KH2PO4, 6 μM tetraetil metil diphosphanate (pH 5.0) for 6 days. The enamel blocks were treated with the following varnishes: 10% xylitol; 20% xylitol; 10% xylitol plus F (5% NaF); 20% xylitol plus F (5% NaF); Duofluorid™ (6% NaF, 2.71% F+6% CaF2), Duraphat™ (5% NaF, positive control) and placebo (no-F/xylitol, negative control). The varnishes were applied in a thin layer and removed after 6h. The blocks were subjected to pH-cycles (demineralization-2h/remineralization-22 h during 8 days) and enamel alterations were quantified by surface hardness and transversal microradiography. The percentage of surface hardness recovery (%SHR), the integrated mineral loss and lesion depth were statistically analysed by ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). Enamel surface remineralization was significantly increased by Duraphat™, 10% xylitol plus F and 20% xylitol plus F formulations, while significant subsurface mineral remineralization could be seen only for enamel treated with Duraphat™, Duofluorid™ and 20% xylitol formulations. 20% xylitol varnishes seem to be promising alternatives to increase remineralization of artificial caries lesions. effective vehicles are desirable for caries control. Xylitol varnishes seem to be promising alternatives to increase enamel remineralization in vitro, which should be confirmed by in situ and clinical studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Detection of early caries by laser-induced breakdown spectroscopy

NASA Astrophysics Data System (ADS)

Sasazawa, Shuhei; Kakino, Satoko; Matsuura, Yuji

2015-07-01

To improve sensitivity of dental caries detection by laser-induced breakdown spectroscopy (LIBS) analysis, it is proposed to utilize emission peaks in the ultraviolet. We newly focused on zinc whose emission peaks exist in ultraviolet because zinc exists at high concentration in the outer layer of enamel. It was shown that by using ratios between heights of an emission peak of Zn and that of Ca, the detection sensitivity and stability are largely improved. It was also shown that early caries are differentiated from healthy part by properly setting a threshold in the detected ratios. The proposed caries detection system can be applied to dental laser systems such as ones based on Er:YAG-lasers. When ablating early caries part by laser light, the system notices the dentist that the ablation of caries part is finished. We also show the intensity of emission peaks of zinc decreased with ablation with Er:YAG laser light.

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

Noninvasive diagnosis of early caries with polarization-sensitive optical coherence tomography (PS-OCT)

NASA Astrophysics Data System (ADS)

Everett, Matthew J.; Colston, Bill W., Jr.; Sathyam, Ujwal S.; Da Silva, Luiz B.; Fried, Daniel; Featherstone, John D. B.

1999-05-01

There is no diagnostic technology presently available utilizing non-ionizing radiation that can image the state of demineralization of dental enamel in vivo for the detection, characterization and monitoring of early, incipient caries lesions. In this study, a Polarization Sensitive Optical Coherence Tomography (PS-OCT) system was evaluated for its potential for the non-invasive diagnosis of early carious lesions. We demonstrated clear discrimination in PS-OCT imags between regions of normal and demineralized enamel in bovine enamel blocks containing well-characterized artificial lesions. Moreover, high-resolution, cross- sectional images were acquired that clearly discriminate between the normal and carious regions of extracted human teeth. Regions that appeared to be demineralized in the PS- OCT imags were verified using histological thin sections examined under polarized light. The PS-OCT system discriminates between normal and carious regions by measuring the state of polarization of the back-scattered 1310 nm light, which is affected by the state of demineralization of the enamel. The demineralized regions of enamel have a large scattering coefficient, thus depolarizing the incident light. This initial study shows that PS-OCT has great potential for the detection, characterization, and monitoring of incipient caries lesions.

All-optical photoacoustic imaging and detection of early-stage dental caries

NASA Astrophysics Data System (ADS)

Sampathkumar, Ashwin; Hughes, David A.; Longbottom, Chris; Kirk, Katherine J.

2015-02-01

Dental caries remain one of the most common oral diseases in the world. Current detection methods, such as dental explorer and X-ray radiography, suffer from poor sensitivity and specificity at the earliest (and reversible) stages of the disease because of the small size (< 100 microns) of early-stage lesions. We have developed a fine-resolution (480 nm), ultra-broadband (1 GHz), all-optical photoacoustic imaging (AOPAI) system to image and detect early stages of tooth decay. This AOPAI system provides a non-contact, non-invasive and non-ionizing means of detecting early-stage dental caries. Ex-vivo teeth exhibiting early-stage, white-spot lesions were imaged using AOPAI. Experimental scans targeted each early-stage lesion and a reference healthy enamel region. Photoacoustic (PA) signals were generated in the tooth using a 532-nm pulsed laser and the light-induced broadband ultrasound signal was detected at the surface of the tooth with an optical path-stabilized Michelson interferometer operating at 532 nm. The measured time-domain signal was spatially resolved and back-projected to form 2D and 3D maps of the lesion using k-wave reconstruction methods. Experimental data collected from areas of healthy and diseased enamel indicate that the lesion generated a larger PA response compared to healthy enamel. The PA-signal amplitude alone was able to detect a lesion on the surface of the tooth. However, time- reversal reconstructions of the PA scans also quantitatively depicted the depth of the lesion. 3D PA reconstruction of the diseased tooth indicated a sub-surface lesion at a depth of 0.6 mm, in addition to the surface lesion. These results suggest that our AOPAI system is well suited for rapid clinical assessment of early-stage dental caries. An overview of the AOPAI system, fine-resolution PA and histology results of diseased and healthy teeth will be presented.

Pulsed Nd:YAG laser selective ablation of surface enamel caries: II. Histology and clinical trials

NASA Astrophysics Data System (ADS)

Harris, David M.; Goodis, Harold E.; White, Joel M.; Arcoria, Charles J.; Simon, James; Burkart, John; Yessik, Michael J.; Myers, Terry D.

2000-03-01

High intensity infrared light from the pulsed Nd:YAG dental laser is absorbed by pigmented carious enamel and not absorbed by normal enamel. Therefore, this system is capable of selective removal of surface enamel caries. Safety and efficacy of the clinical procedure was evaluated in two sets of clinical trials at three dental schools. Carious lesions were randomized to drill or laser treatment. Pulp vitality, surface condition, preparations and restorations were evaluated by blinded evaluators. In Study 1 surface caries were removed from 104 third molars scheduled for extraction. One week post-treatment teeth were extracted and the pulp was examined histologically. In Study 2 90 patients with 422 lesions on 376 teeth were randomized to laser or drill and followed for six months. There were no adverse events and both clinical and histological evaluations of pulp vitality showed no abnormalities. Caries were removed in all conditions. A significantly greater number of preparations in the drill groups vs. laser groups entered dentin (drill equals 11, laser equals 1, p less than 0.001). This indicates that the more conservative laser treatment removed the caries but not the sound enamel below the lesion.

Dental enamel defects, caries experience and oral health-related quality of life: a cohort study.

PubMed

Arrow, P

2017-06-01

The impact of enamel defects of the first permanent molars on caries experience and child oral health-related quality of life was evaluated in a cohort study. Children who participated in a study of enamel defects of the first permanent molars 8 years earlier were invited for a follow-up assessment. Consenting children completed the Child Perception Questionnaire and the faces Modified Child Dental Anxiety Scale, and were examined by two calibrated examiners. ANOVA, Kruskal-Wallis, negative binomial and logistic regression were used for data analyses. One hundred and eleven children returned a completed questionnaire and 91 were clinically examined. Negative binomial regression found that oral health impacts were associated with gender (boys, risk ratio (RR) = 0.73, P = 0.03) and decayed, missing or filled permanent teeth (DMFT) (RR = 1.1, P = 0.04). The mean DMFT of children were sound (0.9, standard deviation (SD) = 1.4), diffuse defects (0.8, SD = 1.7), demarcated defects (1.5, SD = 1.4) and pit defects (1.3, SD = 2.3) (Kruskal-Wallis, P = 0.05). Logistic regression of first permanent molar caries found higher odds of caries experience with baseline primary tooth caries experience (odds ratio (OR) = 1.5, P = 0.01), the number of teeth affected by enamel defects (OR = 1.9, P = 0.05) and lower odds with the presence of diffuse enamel defects (OR = 0.1, P = 0.04). The presence of diffuse enamel defects was associated with lower odds of caries experience. © 2016 Australian Dental Association.

Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in situ.

PubMed

Cardoso, C A B; Cassiano, L P S; Costa, E N; Souza-E-Silva, C M; Magalhães, A C; Grizzo, L T; Caldana, M L; Bastos, J R M; Buzalaf, M A R

2016-07-01

Analyze the effect of varnishes containing xylitol compared to commercial fluoridated varnishes on the remineralization of artificial enamel caries lesions in situ. Twenty subjects took part in this crossover, double-blind study performed in four phases of 5days each. Each subject worn palatal appliances containing four predemineralized bovine enamel specimens. Artificial caries lesions were produced by immersion in 30ml of lactic acid buffer containing 3mM CaCl2·2H2O, 3mM KH2PO4, 6μM tetraetil metil diphosphanate (pH 5.0) for 6days. The specimens in each subject were treated once with the following varnishes: 20% xylitol (experimental); Duofluorid™ (6% NaF, 6% CaF2), Duraphat™ (5% NaF, positive control) and placebo (no-F/xylitol, negative control). The varnishes were applied in a thin layer and removed after 6h. Fifteen subjects were able to finish all phases. The enamel alterations were quantified by surface hardness and transversal microradiography. The percentage of surface hardness recovery (%SHR), the integrated mineral loss and lesion depth were statistically analyzed by Friedmann and Dunn's tests test (p<0.05). Enamel surface remineralization was significantly increased by Duraphat™, Duofluorid™ and 20% xylitol formulations. Significant subsurface mineral remineralization could also be seen for the experimental and commercial varnishes, except for Duraphat™, when the parameter "lesion depth" was considered. 20% xylitol varnish seem to be a promising alternative to increase surface and subsurface remineralization of artificial caries lesions in situ. effective vehicles are desirable for caries control. Xylitol varnishes seem to be promising alternatives to increase enamel remineralization in situ, which should be confirmed by clinical studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

In vitro caries lesion rehardening and enamel fluoride uptake from fluoride varnishes as a function of application mode.

PubMed

Lippert, Frank; Hara, Anderson T; Martinez-Mier, Esperanza Angeles; Zero, Domenick T

2013-04-01

To study the laboratory predicted anticaries efficacy of five commercially available fluoride varnishes (FV) by determining their ability to reharden and to deliver fluoride to an early caries lesion when applied directly or in close vicinity to the lesion (halo effect). Early caries lesions were created in 80 polished bovine enamel specimens. Specimens were allocated to five FV groups (n = 16) based on Knoop surface microhardness (KHN) after lesion creation. All tested FV claimed to contain 5% sodium fluoride and were: CavityShield, Enamel Pro, MI Varnish, Prevident and Vanish. FV were applied (10 +/- 2 mg per lesion) to eight specimens per FV group (direct application); the remaining eight specimens received no FV but were later exposed to fluoride released from specimens which received a FV treatment (indirect application). Specimens were paired again and placed into containers (one per FV). Artificial saliva was added and containers placed into an incubator (27 hours at 37 degrees C). Subsequently, FV was carefully removed using chloroform. Specimens were exposed to fresh artificial saliva again (67 hours at 37 degrees C). KHN was measured and differences to baseline values calculated. Enamel fluoride uptake (EFU) was determined using the acid etch technique. Data were analyzed using two-way ANOVA. The two-way ANOVA highlighted significant interactions between FV vs. application mode, for both deltaKHN and EFU (P < 0.001). All FV were able to reharden and deliver fluoride to caries lesions, but to different degrees. Furthermore, considerable differences were found for both variables between FV when applied either directly or in close vicinity to the lesion: MI Varnish and Enamel Pro exhibited greater fluoride efficacy when applied in vicinity rather than directly to the lesion, whereas CavityShield and Vanish did not differ. Prevident exhibited a higher EFU when applied directly, but little difference in rehardening.

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

Dental Caries and Enamel Defects in Very Low Birth Weight Adolescents

PubMed Central

Nelson, S.; Albert, J.M.; Lombardi, G.; Wishnek, S.; Asaad, G.; Kirchner, H.L.; Singer, L.T.

2011-01-01

Objectives The purpose of this study was to examine developmental enamel defects and dental caries in very low birth weight adolescents with high risk (HR-VLBW) and low risk (LR-VLBW) compared to full-term (term) adolescents. Methods The sample consisted of 224 subjects (80 HR-VLBW, 59 LR-VLBW, 85 term adolescents) recruited from an ongoing longitudinal study. Sociodemographic and medical information was available from birth. Dental examination of the adolescent at the 14-year visit included: enamel defects (opacity and hypoplasia); decayed, missing, filled teeth of incisors and molars (DMFT-IM) and of overall permanent teeth (DMFT); Simplified Oral Hygiene Index for debris/calculus on teeth, and sealant presence. A caregiver questionnaire completed simultaneously assessed dental behavior, access, insurance status and prevention factors. Hierarchical analysis utilized the zero-inflated negative binomial model and zero-inflated Poisson model. Results The zero-inflated negative binomial model controlling for sociodemographic variables indicated that the LR-VLBW group had an estimated 75% increase (p < 0.05) in number of demarcated opacities in the incisors and first molar teeth compared to the term group. Hierarchical modeling indicated that demarcated opacities were a significant predictor of DMFT-IM after control for relevant covariates. The term adolescents had significantly increased DMFT-IM and DMFT scores compared to the LR-VLBW adolescents. Conclusion LR-VLBW was a significant risk factor for increased enamel defects in the permanent incisors and first molars. Term children had increased caries compared to the LR-VLBW group. The effect of birth group and enamel defects on caries has to be investigated longitudinally from birth. PMID:20975268

In Vitro Acid-Mediated Initial Dental Enamel Loss Is Associated with Genetic Variants Previously Linked to Caries Experience.

PubMed

Vieira, Alexandre R; Bayram, Merve; Seymen, Figen; Sencak, Regina C; Lippert, Frank; Modesto, Adriana

2017-01-01

We have previously shown that AQP5 and BTF3 genetic variation and expression in whole saliva are associated with caries experience suggesting that these genes may have a functional role in protecting against caries. To further explore these results, we tested ex vivo if variants in these genes are associated with subclinical dental enamel mineral loss. DNA and enamel samples were obtained from 53 individuals. Enamel samples were analyzed for Knoop hardness of sound enamel, integrated mineral loss after subclinical carious lesion creation, and change in integrated mineral loss after remineralization. DNA samples were genotyped for single nucleotide polymorphisms using TaqMan chemistry. Chi-square and Fisher's exact tests were used to compare individuals above and below the mean sound enamel microhardness of the cohort with alpha of 0.05. The A allele of BTF3 rs6862039 appears to be associated with harder enamel at baseline ( p = 0.09), enamel more resistant to demineralization ( p = 0.01), and enamel that more efficiently regain mineral and remineralize ( p = 0.04). Similarly, the G allele of AQP5 marker rs3759129 and A allele of AQP5 marker rs296763 are associated with enamel more resistant to demineralization ( p = 0.03 and 0.05, respectively). AQP5 and BTF3 genetic variations influence the initial subclinical stages of caries lesion formation in the subsurface of enamel.

In Vitro Acid-Mediated Initial Dental Enamel Loss Is Associated with Genetic Variants Previously Linked to Caries Experience

PubMed Central

Vieira, Alexandre R.; Bayram, Merve; Seymen, Figen; Sencak, Regina C.; Lippert, Frank; Modesto, Adriana

2017-01-01

We have previously shown that AQP5 and BTF3 genetic variation and expression in whole saliva are associated with caries experience suggesting that these genes may have a functional role in protecting against caries. To further explore these results, we tested ex vivo if variants in these genes are associated with subclinical dental enamel mineral loss. DNA and enamel samples were obtained from 53 individuals. Enamel samples were analyzed for Knoop hardness of sound enamel, integrated mineral loss after subclinical carious lesion creation, and change in integrated mineral loss after remineralization. DNA samples were genotyped for single nucleotide polymorphisms using TaqMan chemistry. Chi-square and Fisher's exact tests were used to compare individuals above and below the mean sound enamel microhardness of the cohort with alpha of 0.05. The A allele of BTF3 rs6862039 appears to be associated with harder enamel at baseline (p = 0.09), enamel more resistant to demineralization (p = 0.01), and enamel that more efficiently regain mineral and remineralize (p = 0.04). Similarly, the G allele of AQP5 marker rs3759129 and A allele of AQP5 marker rs296763 are associated with enamel more resistant to demineralization (p = 0.03 and 0.05, respectively). AQP5 and BTF3 genetic variations influence the initial subclinical stages of caries lesion formation in the subsurface of enamel. PMID:28275354

Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from The National Dental PBRN

PubMed Central

Fellows, Jeffrey L; Gordan, Valeria V.; Gilbert, Gregg H.; Rindal, D. Brad; Qvist, Vibeke; Litaker, Mark S.; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J.; Johnson, Neil

2014-01-01

Purpose Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. We used actual clinical data to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Methods We combined data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists. Analysis of variance and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Results Network dentists from 5 regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (p<0.05) by patient age and race/ethnicity, dentist use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (p<0.05) by dentist race/ethnicity, network region, and practice type. CLINICAL SIGNIFICANCE Identifying patient, dentist, and practice characteristics associated with enamel caries restorations can guide strategies to improve provider adherence to evidence-based clinical recommendations. PMID:25000667

Early diagnosis of incipient caries based on non-invasive lasers

NASA Astrophysics Data System (ADS)

Velescu, A.; Todea, C.; Vitez, B.

2016-03-01

AIM: The aim of this study is to detect incipient caries and enamel demineralization using laser fluorescence.This serves only as an auxilary aid to identify and to monitor the development of these lesions. MATERIALS AND METHODS: 6 patients were involved in this study, three females and three male. Each patient underwent a professional cleaning, visual examination of the oral cavity, and then direct inspection using DiagnoCam and DIAGNOdent. After data recording each patient was submitted to retro-alveolar X-ray on teeth that were detected with enamel lesions. All data was collected and analyzed statistically. RESULTS: Of 36 areas considered in clinically healthy, 24 carious surfaces were found using laser fluorescence, a totally non-invasive method for detecting incipient carious lesions compared with the radiographic examination. CONCLUSIONS: This method has good applicability for patients because it improves treatment plan by early detection of caries and involves less fear for anxious patients and children.

Near-infrared hyperspectral imaging of water evaporation dynamics for early detection of incipient caries.

PubMed

Usenik, Peter; Bürmen, Miran; Fidler, Aleš; Pernuš, Franjo; Likar, Boštjan

2014-10-01

Incipient caries is characterized as demineralization of the tooth enamel reflecting in increased porosity of enamel structure. As a result, the demineralized enamel may contain increased amount of water, and exhibit different water evaporation dynamics than the sound enamel. The objective of this paper is to assess the applicability of water evaporation dynamics of sound and demineralized enamel for detection and quantification of incipient caries using near-infrared hyperspectral imaging. The time lapse of water evaporation from enamel samples with artificial and natural caries lesions of different stages was imaged by a near-infrared hyperspectral imaging system. Partial least squares regression was used to predict the water content from the acquired spectra. The water evaporation dynamics was characterized by a first order logarithmic drying model. The calculated time constants of the logarithmic drying model were used as the discriminative feature. The conducted measurements showed that demineralized enamel contains more water and exhibits significantly faster water evaporation than the sound enamel. By appropriate modelling of the water evaporation process from the enamel surface, the contrast between the sound and demineralized enamel observed in the individual near infrared spectral images can be substantially enhanced. The presented results indicate that near-infrared based prediction of water content combined with an appropriate drying model presents a strong foundation for development of novel diagnostic tools for incipient caries detection. The results of the study enhance the understanding of the water evaporation process from the sound and demineralized enamel and have significant implications for the detection of incipient caries by near-infrared hyperspectral imaging. Copyright © 2014 Elsevier Ltd. All rights reserved.

Developmental defects of enamel and dental caries in the primary dentition: A systematic review and meta-analysis.

PubMed

Costa, Francine S; Silveira, Ethieli R; Pinto, Gabriela S; Nascimento, Gustavo G; Thomson, William Murray; Demarco, Flávio F

2017-05-01

This systematic review and meta-analysis evaluated the association between developmental defects of enamel and dental caries in the primary dentition. Electronic searches were performed in PubMed, Web of Knowledge, Scopus and Scielo for the identification of relevant studies. Observational studies that examined the association between developmental defects of enamel and dental caries in the deciduous dentition were included. Additionally, meta-analysis, funnel plots and sensitivity analysis were employed to synthesize the available evidence. Multivariable meta-regression analysis was performed to explore heterogeneity among studies. A total of 318 articles were identified in the electronic searches. Of those, 16 studies were included in the meta-analysis. Pooled estimates revealed that children with developmental defects of enamel had higher odds of having dental caries (OR 3.32; 95%CI 2.41-4.57), with high heterogeneity between studies (I 2 80%). Methodological characteristic of the studies, such as where it was conducted, the examined teeth and the quality of the study explained about 30% of the variability. Concerning type of defect, children with hypoplasia and diffuse opacities had higher odds of having dental caries (OR 4.28; 95%CI 2.24-8.15; OR1.42; 95%CI 1.15-1.76, respectively). This systematic review and meta-analysis demonstrates a clear association between developmental defects of enamel and dental caries in the primary dentition. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of enamel matrix genes on dental caries are moderated by fluoride exposures

PubMed Central

Shaffer, John R.; Carlson, Jenna C.; Stanley, Brooklyn O. C.; Feingold, Eleanor; Cooper, Margaret; Vanyukov, Michael M.; Maher, Brion S.; Slayton, Rebecca L.; Willing, Marcia C.; Reis, Steven E.; McNeil, Daniel W.; Crout, Richard J.; Weyant, Robert J.; Levy, Steven M.; Vieira, Alexandre R.; Marazita, Mary L.

2014-01-01

Dental caries (tooth decay) is the most common chronic disease, worldwide, affecting most children and adults. Though dental caries is highly heritable, few caries-related genes have been discovered. We investigated whether 18 genetic variants in the group of nonamelogenin enamel matrix genes (AMBN, ENAM, TUFT1, and TFIP11) were associated with dental caries experience in 13 age- and race-stratified samples from six parent studies (N=3,600). Linear regression was used to model genetic associations and test gene-byfluoride interaction effects for two sources of fluoride: daily tooth brushing and home water fluoride concentration. Meta-analysis was used to combine results across five child and eight adult samples. We observed the statistically significant association of rs2337359 upstream of TUFT1 with dental caries experience via meta-analysis across adult samples (p<0.002) and the suggestive association for multiple variants in TFIP11 across child samples (p<0.05). Moreover, we discovered two genetic variants (rs2337359 upstream of TUFT1 and missense rs7439186 in AMBN) involved in gene-by-fluoride interactions. For each interaction, participants with the risk allele/genotype exhibited greater dental caries experience only if they were not exposed to the source of fluoride. Altogether, these results confirm that variation in enamel matrix genes contributes to individual differences in dental caries liability, and demonstrate that the effects of these genes may be moderated by protective fluoride exposures. In short, genes may exert greater influence on dental caries in unprotected environments, or equivalently, the protective effects of fluoride may obviate the effects of genetic risk alleles. PMID:25373699

Application of NIR Raman spectroscopy for detecting and characterizing early dental caries

NASA Astrophysics Data System (ADS)

Ko, A. C.; Choo-Smith, L.-P.; Zhu, R.; Hewko, M.; Dong, C.; Cleghorn, B.; Sowa, M. G.

2006-02-01

Early dental caries detection facilitates implementation of non-surgical methods for arresting caries progression and promoting tooth remineralization. We present a method based on Raman spectroscopy with near-IR laser excitation to provide biochemical contrast for detecting and characterizing incipient carious lesions found in extracted human teeth. Changes in Raman spectra are observed in PO 4 3- vibrations arising from hydroxyapatite of mineralized tooth tissue. Examination of various intensities of the PO 4 3- ν2, ν3, ν4 vibrations showed consistent increased intensities in spectra of carious lesions compared to sound enamel. The spectral changes are attributed to demineralization-induced alterations of enamel crystallite morphology and/or orientation. This hypothesis is supported by reduced Raman polarization anisotropy derived from polarized Raman spectra of carious lesions. Polarized Raman spectral imaging of carious lesions found on whole (i.e. un-sectioned) tooth samples will also be presented.

Optical analysis of enamel and dentin caries in relation to mineral density using swept-source optical coherence tomography

PubMed Central

Ueno, Tomoka; Shimada, Yasushi; Matin, Khairul; Zhou, Yuan; Wada, Ikumi; Sadr, Alireza; Sumi, Yasunori; Tagami, Junji

2016-01-01

Abstract. The aim of this study was to evaluate the signal intensity and signal attenuation of swept source optical coherence tomography (SS-OCT) for dental caries in relation to the variation of mineral density. SS-OCT observation was performed on the enamel and dentin artificial demineralization and on natural caries. The artificial caries model on enamel and dentin surfaces was created using Streptococcus mutans biofilms incubated in an oral biofilm reactor. The lesions were centrally cross sectioned and SS-OCT scans were obtained in two directions to construct a three-dimensional data set, from the lesion surface (sagittal scan) and parallel to the lesion surface (horizontal scan). The integrated signal up to 200  μm in depth (IS200) and the attenuation coefficient (μ) of the enamel and dentin lesions were calculated from the SS-OCT signal in horizontal scans at five locations of lesion depth. The values were compared with the mineral density obtained from transverse microradiography. Both enamel and dentin demineralization showed significantly higher IS200 and μ than the sound tooth substrate from the sagittal scan. Enamel demineralization showed significantly higher IS200 than sound enamel, even with low levels of demineralization. In demineralized dentin, the μ from the horizontal scan consistently trended downward compared to the sound dentin. PMID:27704033

Dental caries and developmental defects of enamel in relation to fluoride levels in drinking water in an arid area of Sri Lanka.

PubMed

Ekanayake, L; van der Hoek, W

2002-01-01

The study was conducted to assess caries and developmental defects of enamel in relation to fluoride levels in drinking water and the association between caries experience and the severity of diffuse opacities in children living in Uda Walawe, an area with varying concentrations of fluoride in drinking water in Sri Lanka. A total of 518 14-year-old children who were lifelong residents in this area were examined for dental caries and developmental defects of enamel. But the present analysis is confined to 486 children from whom drinking water samples were collected. The prevalence of enamel defects and diffuse opacities ranged from 27 to 57% while the prevalence of caries ranged from 18 to 29% in the different fluoride exposure groups. The prevalence of enamel defects increased significantly with the increase in the fluoride level in drinking water. Both the caries prevalence and the mean caries experience were significantly higher in children with diffuse opacities than in those without in the group consuming water containing >0.70 mg/l of fluoride. The association between dental caries and the severity of diffuse opacities was also significant only in this group. Children with the mildest form of opacities (DDE scores 3 and 4) had the lowest DMFS (0.25 +/- 0.7), and the highest DMFS (1.1 +/- 1.7) was found in those with the most severe form of opacities (DDE score 6). In conclusion, the relationship that was observed in this study between fluoride levels in drinking water, diffuse opacities and caries suggests that the appropriate level of fluoride in drinking water for arid areas of Sri Lanka is around 0.3 mg/l. Also individuals with severe forms of enamel defects in high-fluoride areas are susceptible to dental caries. Copyright 2002 S. Karger AG, Basel

Early childhood caries update: A review of causes, diagnoses, and treatments

PubMed Central

Çolak, Hakan; Dülgergil, Çoruh T.; Dalli, Mehmet; Hamidi, Mehmet Mustafa

2013-01-01

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management. PMID:23633832

First step toward translation of thermophotonic lock-in imaging to dentistry as an early caries detection technology

NASA Astrophysics Data System (ADS)

Ojaghi, Ashkan; Parkhimchyk, Artur; Tabatabaei, Nima

2016-09-01

Early detection of the most prevalent oral disease worldwide, i.e., dental caries, still remains as one of the major challenges in dentistry. The current dental standard of care relies on caries detection methods, such as visual inspection and x-ray radiography, which lack the sufficient specificity and sensitivity to detect caries at early stages of formation when they can be healed. We report on the feasibility of early caries detection in a clinically and commercially viable thermophotonic imaging system. The system incorporates intensity-modulated laser light along with a low-cost long-wavelength infrared (LWIR; 8 to 14 μm) camera, providing diagnostic contrast based on the enhanced light absorption of early caries. The LWIR camera is highly suitable for integration into clinical platforms because of its low weight and cost. In addition, through theoretical modeling, we show that LWIR detection enhances the diagnostic contrast due to the minimal LWIR transmittance of enamel and suppression of the masking effect of the direct thermal Planck emission. Diagnostic performance of the system and its detection threshold are experimentally evaluated by monitoring the inception and progression of artificially induced occlusal and smooth surface caries. The results are suggestive of the suitability of the developed LWIR system for detecting early dental caries.

Ex vivo imaging of early dental caries within the interproximal space

NASA Astrophysics Data System (ADS)

Choo-Smith, Lin-P'ing; Hewko, Mark D.; Dufour, Marc L.; Fulton, Crystal; Qiu, Pingli; Gauthier, Bruno; Padioleau, Christian; Bisaillon, Charles-Etienne; Dong, Cecilia; Cleghorn, Blaine M.; Lamouche, Guy; Sowa, Michael G.

2009-02-01

Optical coherence tomography (OCT) is emerging as a technology that can potentially be used for the detection and monitoring of early dental enamel caries since it can provide high-resolution depth imaging of early lesions. To date, most caries detection optical technologies are well suited for examining caries at facial, lingual, incisal and occlusal surfaces. The approximal surfaces between adjacent teeth are difficult to examine due to lack of visual access and limited space for these new caries detection tools. Using a catheter-style probe developed at the NRC-Industrial Materials Institute, the probe was inserted into the interproximal space to examine the approximal surfaces with OCT imaging at 1310 nm. The probe was rotated continuously and translated axially to generate depth images in a spiral fashion. The probe was used in a mock tooth arch model consisting of extracted human teeth mounted with dental rope wax in their anatomically correct positions. With this ex vivo model, the probe provided images of the approximal surfaces revealing morphological structural details, regions of calculus, and especially regions of early dental caries (white spot lesions). Results were compared with those obtained from OCT imaging of individual samples where the approximal surfaces of extracted teeth are accessible on a lab-bench. Issues regarding access, regions of interest, and factors to be considered in an in vivo setting will be discussed. Future studies are aimed at using the probe in vivo with patient volunteers.

Optical-fiber-based laser-induced breakdown spectroscopy for detection of early caries

NASA Astrophysics Data System (ADS)

Sasazawa, Shuhei; Kakino, Satoko; Matsuura, Yuji

2015-06-01

A laser-induced breakdown spectroscopy (LIBS) system targeting for the in vivo analysis of tooth enamel is described. The system is planned to enable real-time analysis of teeth during laser dental treatment by utilizing a hollow optical fiber that transmits both Q-switched Nd:YAG laser light for LIBS and infrared Er:YAG laser light for tooth ablation. The sensitivity of caries detection was substantially improved by expanding the spectral region under analysis to ultraviolet (UV) light and by focusing on emission peaks of Zn in the UV region. Subsequently, early caries were distinguished from healthy teeth with accuracy rates above 80% in vitro.

Effects of enamel fluorosis and dental caries on quality of life.

PubMed

Onoriobe, U; Rozier, R G; Cantrell, J; King, R S

2014-10-01

The objectives of this study were to determine the impact of enamel fluorosis and dental caries on oral health-related quality of life (OHRQoL) in North Carolina schoolchildren and their families. Students (n = 7,686) enrolled in 398 classrooms in grades K-12 were recruited for a onetime survey. Parents of students in grades K-3 and 4-12 completed the Early Childhood Oral Health Impact Scale (ECOHIS) and Family Impact Scale (FIS), respectively. Students in grades 4-12 completed the Child Perceptions Questionnaire (CPQ8-10 in grades 4-5; CPQ11-14 in grades 6-12). All students were examined for fluorosis (Dean's index) and caries experience (d2-3fs or D2-3MFS indices). OHRQoL scores (sum response codes) were analyzed for their association with fluorosis categories and sum of d2-3fs and D2-3MFS according to ordinary least squares regression with SAS procedures for multiple imputation and analysis of complex survey data. Differences in OHRQoL scores were evaluated against statistical and minimal important difference (MID) thresholds. Of 5,484 examined students, 71.8% had no fluorosis; 24.4%, questionable to very mild fluorosis; and 3.7%, mild, moderate, or severe fluorosis. Caries categories were as follows: none (43.1%), low (28.6%), and moderate to high (28.2%). No associations between fluorosis and any OHRQoL scales met statistical or MID thresholds. The difference (5.8 points) in unadjusted mean ECOHIS scores for the no-caries and moderate-to-high caries groups exceeded the MID estimate (2.7 points) for that scale. The difference in mean FIS scores (1.5 points) for the no-caries and moderate-to-high groups exceeded the MID value (1.2 points). The sum of d2-3fs and D2-3MFS scores was positively associated with CPQ11-14 (B = 0.240, p < .001), ECOHIS (B = 0.252, p ≤ .001), and FIS (B = 0.096, p ≤ .01) scores in ordinary least squares regression models. A child's caries experience negatively affects OHRQoL, while fluorosis has little impact. © International

Trimodal detection of early childhood caries using laser light scanning and fluorescence spectroscopy: clinical prototype

PubMed Central

Kim, Amy S.; Ridge, Jeremy S.; Nelson, Leonard Y.; Berg, Joel H.; Seibel, Eric J.

2013-01-01

Abstract. There is currently a need for a safe and effective way to detect and diagnose early stages of childhood caries. A multimodal optical clinical prototype for diagnosing caries demineralization in vivo has been developed. The device can be used to quickly image and screen for any signs of demineralized enamel by obtaining high-resolution and high-contrast surface images using a 405-nm laser as the illumination source, as well as obtaining autofluorescence and bacterial fluorescence images. When a suspicious region of demineralization is located, the device also performs dual laser fluorescence spectroscopy using 405- and 532-nm laser excitation. An autofluorescence ratio of the two excitation lasers is computed and used to quantitatively diagnose enamel health. The device was tested on five patients in vivo as well as on 28 extracted teeth with clinically diagnosed carious lesions. The device was able to provide detailed images that highlighted the lesions identified by the clinicians. The autofluorescence spectroscopic ratios obtained from the extracted teeth successfully quantitatively discriminated between sound and demineralized enamel. PMID:23986369

Histologic and SEM evaluation of caries removal and restoration in enamel and dentin using a pulsed fiber optic delivered Nd:YAG laser

NASA Astrophysics Data System (ADS)

White, Joel M.; Goodis, Harold E.; Kudler, Joel J.; Eakle, W. S.; Neev, Joseph

1994-09-01

The pulsed Nd:YAG laser has been proposed as an alternative to the dental handpiece for caries removal in enamel and dentin. The purpose of this study was to systematically evaluate, in vitro, the process of caries removal and restoration in enamel and dentin. The effectiveness of this device was investigated utilizing scanning electron microscopy to determine the behavior of dentin after laser treatment of artificially created carious lesions in dentin. Histologic sections of extracted teeth after laser treatment and restoration demonstrated successful caries removal and restoration using the pulsed fiber optic delivered Nd:YAG laser as compared to both high and low speed rotary instrumentation. The adjacent enamel and dentin were unaffected by the laser irradiation although slight carbonization was seen on the dentin surface. Thermocouples placed in the pulp chamber during caries removal confirmed previous studies that showed laser parameters up to 1 W and 10 Hz being the same as conventional caries removal in the amount of heat generated which reaches the pulp. The addition of air/water coolant decreased pulpal temperature.

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.

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

Promotion of enamel caries remineralization by an amelogenin-derived peptide in a rat model.

PubMed

Han, Sili; Fan, Yingying; Zhou, Zhengli; Tu, Huanxin; Li, Danxue; Lv, Xueping; Ding, Longjiang; Zhang, Linglin

2017-01-01

An amelogenin-derived peptide has been shown to promote remineralization of demineralized enamel in an in vitro model of initial caries induced by pH cycling. The present study examines whether the peptide exerts similar effects within the complex oral environment in vivo. Specific pathogen-free Sprague-Dawley rats (n=36) were infected with Streptococcus mutans, given ad libitum access to Diet 2000 and drinking water supplemented with sucrose (10%, w/v), and then randomly divided into three groups treated with 25μM peptide solution, 1g/L NaF or deionized water. Molar teeth were swabbed twice daily with the respective solutions for 24days. Then animals were killed, their jaws were removed and caries lesions were analyzed using the quantitative light-induced fluorescence-digital (QLF-D) technique to measure changes in mineral content. To verify QLF-D results, caries were scored for lesion depth and size using the Keyes method, and analyzed using polarized light microscopy (PLM). Mineral gain was significantly higher in teeth treated with peptide or NaF than in teeth treated with water (p<0.05), based on the QLF-D results (ΔF and ΔQ). Incidence of smooth-surface and sulcal caries based on Keyes scores was similar in rats treated with peptide or NaF, and significantly lower in these groups than in rats treated with water (p<0.05). Lesions on teeth treated with peptide or NaF were shallower, based on PLM. No significant differences were observed between molar enamel caries treated with peptide or NaF. This amelogenin-derived peptide can promote remineralization in a rat caries model, indicating strong potential for clinical use. Copyright © 2016 Elsevier Ltd. All rights reserved.

Spectroscopic Detection of Caries Lesions

PubMed Central

Ruohonen, Mika; Palo, Katri; Alander, Jarmo

2013-01-01

Background. A caries lesion causes changes in the optical properties of the affected tissue. Currently a caries lesion can be detected only at a relatively late stage of development. Caries diagnosis also suffers from high interobserver variance. Methods. This is a pilot study to test the suitability of an optical diffuse reflectance spectroscopy for caries diagnosis. Reflectance visible/near-infrared spectroscopy (VIS/NIRS) was used to measure caries lesions and healthy enamel on extracted human teeth. The results were analysed with a computational algorithm in order to find a rule-based classification method to detect caries lesions. Results. The classification indicated that the measured points of enamel could be assigned to one of three classes: healthy enamel, a caries lesion, and stained healthy enamel. The features that enabled this were consistent with theory. Conclusions. It seems that spectroscopic measurements can help to reduce false positives at in vitro setting. However, further research is required to evaluate the strength of the evidence for the method's performance. PMID:27006907

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.

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

Hyperspectral laser-induced autofluorescence imaging of dental caries

NASA Astrophysics Data System (ADS)

Bürmen, Miran; Fidler, Aleš; Pernuš, Franjo; Likar, Boštjan

2012-01-01

Dental caries is a disease characterized by demineralization of enamel crystals leading to the penetration of bacteria into the dentine and pulp. Early detection of enamel demineralization resulting in increased enamel porosity, commonly known as white spots, is a difficult diagnostic task. Laser induced autofluorescence was shown to be a useful method for early detection of demineralization. The existing studies involved either a single point spectroscopic measurements or imaging at a single spectral band. In the case of spectroscopic measurements, very little or no spatial information is acquired and the measured autofluorescence signal strongly depends on the position and orientation of the probe. On the other hand, single-band spectral imaging can be substantially affected by local spectral artefacts. Such effects can significantly interfere with automated methods for detection of early caries lesions. In contrast, hyperspectral imaging effectively combines the spatial information of imaging methods with the spectral information of spectroscopic methods providing excellent basis for development of robust and reliable algorithms for automated classification and analysis of hard dental tissues. In this paper, we employ 405 nm laser excitation of natural caries lesions. The fluorescence signal is acquired by a state-of-the-art hyperspectral imaging system consisting of a high-resolution acousto-optic tunable filter (AOTF) and a highly sensitive Scientific CMOS camera in the spectral range from 550 nm to 800 nm. The results are compared to the contrast obtained by near-infrared hyperspectral imaging technique employed in the existing studies on early detection of dental caries.

Child oral health-related quality of life (COHQoL), enamel defects of the first permanent molars and caries experience among children in Western Australia.

PubMed

Arrow, P

2013-09-01

Published reports suggest that children with enamel defects, especially where enamel is missing or breaking down, experience considerable discomfort and are generally more fearful of dental treatment. However, children's oral health-related quality of life in relation to enamel defects has not been reported. The aim of this study was to examine the association between oral health-related quality of life among children (COHQoL) with enamel defects of the first permanent molars and deciduous caries experience. Children attending pre-primary schools in metropolitan Perth, Western Australia, were recruited and classified for enamel defects using the modified Developmental Defects of Enamel index. Caries experience of deciduous molars and canines was also recorded. Parents completed a child oral health-related quality of life questionnaire. Data were analysed using Kruskal-Wallis, Spearman's rank correlation, chi-square, multiple linear regression and ordered logistic regression to test the factors for their influence on the COHQoL. From the 550 children assessed (mean age 7.2 years) 522 COHQoL questionnaires were returned. Mean COHQoL score was 8.9 (sd 8.8). Bivariate tests showed no association of COHQoL with enamel defect status of the first permanent molars. COHQoL was associated with dmft (mean dmft 1.96, sd 2.62). Higher caries experience children had poorer reported oral health-related quality of life. The presence of enamel defects in the first permanent molars did not affect the children's oral health-related quality of life.

Evaluation of dental enamel caries assessment using Quantitative Light Induced Fluorescence and Optical Coherence Tomography.

PubMed

Maia, Ana Marly Araújo; de Freitas, Anderson Zanardi; de L Campello, Sergio; Gomes, Anderson Stevens Leônidas; Karlsson, Lena

2016-06-01

An in vitro study of morphological alterations between sound dental structure and artificially induced white spot lesions in human teeth, was performed through the loss of fluorescence by Quantitative Light-Induced Fluorescence (QLF) and the alterations of the light attenuation coefficient by Optical Coherence Tomography (OCT). To analyze the OCT images using a commercially available system, a special algorithm was applied, whereas the QLF images were analyzed using the software available in the commercial system employed. When analyzing the sound region against white spot lesions region by QLF, a reduction in the fluorescence intensity was observed, whilst an increase of light attenuation by the OCT system occurred. Comparison of the percentage of alteration between optical properties of sound and artificial enamel caries regions showed that OCT processed images through the attenuation of light enhanced the tooth optical alterations more than fluorescence detected by QLF System. QLF versus OCT imaging of enamel caries: a photonics assessment. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

PIXE analysis of caries related trace elements in tooth enamel

NASA Astrophysics Data System (ADS)

Annegarn, H. J.; Jodaikin, A.; Cleaton-Jones, P. E.; Sellschop, J. P. F.; Madiba, C. C. P.; Bibby, D.

1981-03-01

PIXE analysis has been applied to a set of twenty human teeth to determine trace element concentration in enamel from areas susceptible to dental caries (mesial and distal contact points) and in areas less susceptible to the disease (buccal surfaces), with the aim of determining the possible roles of trace elements in the curious process. The samples were caries-free anterior incisors extracted for periodontal reasons from subjects 10-30 years of age. Prior to extraction of the sample teeth, a detailed dental history and examination was carried out in each individual. PIXE analysis, using a 3 MeV proton beam of 1 mm diameter, allowed the determination of Ca, Mn, Fe, Cu, Zn, Sr and Pb above detection limits. As demonstrated in this work, the enhanced sensitivity of PIXE analysis over electron microprobe analysis, and the capability of localised surface analysis compared with the pooled samples required for neutron activation analysis, makes it a powerful and useful technique in dental analysis.

Effects of pulsed Nd:YAG laser on tensile bond strength and caries resistance of human enamel.

PubMed

Wen, X; Zhang, L; Liu, R; Deng, M; Wang, Y; Liu, L; Nie, X

2014-01-01

This study aims to evaluate the effects of pulsed Nd:YAG laser on the tensile bond strength (TBS) of resin to human enamel and caries resistance of human enamel. A total of 201 human premolars were used in this in vitro study. A flat enamel surface greater than 4 × 4 mm in area was prepared on each specimen using a low-speed cutting machine under a water coolant. Twenty-one specimens were divided into seven groups for morphology observations with no treatment, 35% phosphoric acid etching (30 seconds), and laser irradiation (30 seconds) of pulsed Nd:YAG laser with five different laser-parameter combinations. Another 100 specimens were used for TBS testing. They were embedded in self-cured acrylic resin and randomly divided into 10 groups. After enamel surface pretreatments according to the group design, resin was applied. The TBS values were tested using a universal testing machine. The other 80 specimens were randomly divided into eight groups for acid resistance evaluation. Scanning electron microscope (SEM) results showed that the enamel surfaces treated with 1.5 W/20 Hz and 2.0 W/20 Hz showed more etching-like appearance than those with other laser-parameter combinations. The laser-parameter combinations of 1.5 W/15 Hz and 1.5 W/20 Hz were found to be efficient for the TBS test. The mean TBS value of 14.45 ± 1.67 MPa in the laser irradiated group was significantly higher than that in the untreated group (3.48 ± 0.35 MPa) but lower than that in the 35% phosphoric acid group (21.50 ± 3.02 MPa). The highest mean TBS value of 26.64 ± 5.22 MPa was identified in the combination group (laser irradiation and then acid etching). Acid resistance evaluation showed that the pulsed Nd:YAG laser was efficient in preventing enamel demineralization. The SEM results of the fractured enamel surfaces, resin/enamel interfaces, and demineralization depths were consistent with those of the TBS test and the acid resistance evaluation. Pulsed Nd:YAG laser as an enamel surface

Clinical monitoring of early caries lesions using cross polarization optical coherence tomography

NASA Astrophysics Data System (ADS)

Fried, Daniel; Staninec, Michal; Darling, Cynthia L.; Chan, Kenneth H.; Pelzner, Roger B.

New methods are needed for the nondestructive measurement of tooth demineralization and remineralization and to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anti-caries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role, since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10-μm. It is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper we present early results from two clinical studies underway to measure the effect of fluoride intervention on early lesions. CP-OCT was used to monitor early lesions on enamel and root surfaces before and after intervention with fluoride varnish. The lesion depth and internal structure were resolved for all the lesions examined and some lesions had well defined surface zones of lower reflectivity that may be indicative of arrested lesions. Changes were also noted in the structure of some of the lesions after fluoride intervention.

Dental caries and enamel fluorosis among the fluoridated population in the Republic of Ireland and non fluoridated population in Northern Ireland in 2002.

PubMed

Whelton, H; Crowley, E; O'Mullane, D; Donaldson, M; Cronin, M; Kelleher, V

2006-03-01

An all Ireland/North South survey of Oral Health was carried out in 2001/2002. To compare levels of dental caries and enamel fluorosis among children and adolescents in the fluoridated Republic of Ireland (RoI) with those in the non fluoridated North of Ireland (NI). Cross sectional oral health survey of a representative, random, stratified sample of 5-, 8-, 12- and 15-year-olds in Rol and in NI (N = 19,950). WHO examination criteria with the addition of visible, non cavitated dentine caries were used for recording caries. Fluorosis was measured using Dean's Index. In the RoI, the mean d(3c)mft / D(3c)MFT for 5-, 8-, 12-, and 15-year-olds with full domestic water fluoridation (n = 9,975), was 1.0, 0.3, 1.1 and 2.1 respectively. The corresponding means in non fluoridated NI (n = 1,475) were 1.8, 0.3, 1.5 and 3.6 respectively. (p < 0.0001, NS, p < 0.0005 and p < 0.0001). The prevalence of enamel fluorosis has increased in RoI since 1984, 23% and 36% of 8- and 15-year olds respectively in fluoridated areas had Dean's Index scores at the questionable or greater level in 2002 compared with 6% and 5% respectively in 1984. In 2002 apart from 8-year-olds, caries levels were lower amongst children resident in fluoridated communities in RoI than amongst corresponding age groups in non-fluoridated NI. Caries has declined in fluoridated and non fluoridated groups in both jurisdictions since the early 1960s. In RoI fluorosis levels were higher amongst lifetime residents of fluoridated communities and have increased since 1984.

Carbon dioxide laser effects on caries-like lesions of dental enamel

NASA Astrophysics Data System (ADS)

Featherstone, John D. B.; Zhang, S. H.; Shariati, M.; McCormack, Sandra M.

1991-05-01

Previous studies by the authors have shown that carbon dioxide (CO2) laser light has marked effects on dental hard tissues and that these effects are wavelength-dependent. The aim of the present study was to determine whether treatment by CO2 laser of caries-like lesions in human enamel would inhibit subsequent lesion progression. Nine groups of 10 teeth each with preformed caries-like lesions were treated with/without CO2 laser (9.32 micrometers , 15 mJ or 25 mJ per pulse) by a pulsed laser (100-200 nsec) for either 200 or 400 pulses. Preformed lesions were then treated with acidulated phosphate fluoride for 5 minutes with control groups with no fluoride treatment. Teeth were subjected to a subsequent pH cycling challenge to determine the protection against lesion progression. Low energy laser treatment coupled with fluoride treatment entirely inhibited subsequent lesion progression in this model system.

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.

The efficiency of child formula dentifrices containing different calcium and phosphate compounds on artificial enamel caries.

PubMed

Rirattanapong, Praphasri; Vongsavan, Kadkao; Saengsirinavin, Chavengkiat; Khumsub, Ploychompoo

2016-01-01

Fluoride toothpaste has been extensively used to prevent dental caries. However, the risk of fluorosis is concerning, especially in young children. Calcium phosphate has been an effective remineralizing agent and is present in commercial dental products, with no risk of fluorosis to users. This in vitro study aimed to compare the effects of different calcium phosphate compounds and fluoride-containing dentifrices on artificial caries in primary teeth. Fifty sound primary incisors were coated with nail varnish, leaving two 1 mm 2 windows on the labial surface before immersion in demineralizing solution for 96 hours to produce artificial enamel lesions. Subsequently, one window from each tooth was coated with nail varnish, and all 50 teeth were divided into five groups ( n = 10); group A - deionized water; group B - casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (Tooth Mousse); group C - 500 ppm F (Colgate Spiderman ® ); group D - nonfluoridated toothpaste with triple calcium phosphate (Pureen ® ); and group E - tricalcium phosphate (TCP). Polarized light microscopy and Image-Pro ® Plus software were used to evaluate lesions. After a 7-day pH-cycle, mean lesion depths in groups A, B, C, D, and E had increased by 57.52 ± 10.66%, 33.28 ± 10.16%, 17.04 ± 4.76%, 32.51 ± 8.99%, and 21.76 ± 8.15%, respectively. All data were processed by the Statistical Package for the Social Sciences (version 16.0) software package. Comparison of percentage changes using one-way analysis of variance and Fisher's least squares difference tests at a 95% level of confidence demonstrated that group A was significantly different from the other groups ( P < 0.001). Lesions in groups B and D had a significant lesion progression when compared with groups C and E. All toothpastes in this study had the potential to delay the demineralization progression of artificial enamel caries in primary teeth. The fluoride 500 ppm and TCP toothpastes were equal in the deceleration of

Casein phosphopeptide-amorphous calcium phosphate remineralization of primary teeth early enamel lesions.

PubMed

Zhou, Chunhua; Zhang, Dongliang; Bai, Yuxing; Li, Song

2014-01-01

Early childhood caries (ECC) is a serious problem that progresses rapidly and often goes untreated. Current traumatic treatments may be replaced by safe and effective remineralization at very early stages. The aim of this in vitro study was to evaluate the remineralization effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on enamel lesions by assessing ultrastructure, nanomechanical properties, and compound and elemental analysis. Enamel specimens from 6-year-old children were divided into groups: (1) native enamel; (2) water as negative control; (3) 500ppm NaF as positive control; and (4-7) CPP-ACP paste for 4, 8, 12, and 24h, as test groups. Ultrastructure and roughness were observed by atomic force microscopy (AFM); nanohardness and elastic modulus were measured by nanoindentation; compound and crystal size of enamel surface patterns were investigated by X-ray diffractometer (XRD). An electron microprobe (EPMA) was used for element analysis. Data were analyzed using one-way ANOVA. The CPP-ACP paste repaired the microstructure of enamel, including prism and interprism, through significantly increased hydroxyapatite crystal size (12.06±0.21nm) and Ca/P molar ratios (1.637±0.096) as compared with NaF (8.56±0.13nm crystal size and 1.397±0.086 Ca/P, p<0.01). Both CPP-ACP and NaF decrease roughness, and increase the nanohardness and elastic modulus, with no significant differences between the materials. The CPP-ACP paste is more suitable for children than NaF, due to advantages for remineralization. The AFM, nanoindentation, EPMA, and XRD are very helpful methods for further understanding of microscale and nanoscale remineralization mechanisms. Copyright © 2013 Elsevier Ltd. All rights reserved.

A tissue-dependent hypothesis of dental caries.

PubMed

Simón-Soro, A; Belda-Ferre, P; Cabrera-Rubio, R; Alcaraz, L D; Mira, A

2013-01-01

Current understanding of dental caries considers this disease a demineralization of the tooth tissues due to the acid produced by sugar-fermenting microorganisms. Thus, caries is considered a diet- and pH-dependent process. We present here the first metagenomic analysis of the bacterial communities present at different stages of caries development, with the aim of determining whether the bacterial composition and biochemical profile are specific to the tissue affected. The data show that microbial composition at the initial, enamel-affecting stage of caries is significantly different from that found at subsequent stages, as well as from dental plaque of sound tooth surfaces. Although the relative proportion of Streptococcus mutans increased from 0.12% in dental plaque to 0.72% in enamel caries, Streptococcus mitis and Streptococcus sanguinis were the dominant streptococci in these lesions. The functional profile of caries-associated bacterial communities indicates that genes involved in acid stress tolerance and dietary sugar fermentation are overrepresented only at the initial stage (enamel caries), whereas other genes coding for osmotic stress tolerance as well as collagenases and other proteases enabling dentin degradation are significantly overrepresented in dentin cavities. The results support a scenario in which pH and diet are determinants of the disease during the degradation of enamel, but in dentin caries lesions not only acidogenic but also proteolytic bacteria are involved. We propose that caries disease is a process of varying etiology, in which acid-producing bacteria are the vehicle to penetrate enamel and allow dentin degrading microorganisms to expand the cavity. © 2013 S. Karger AG, Basel.

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

Weaker dental enamel explains dental decay.

PubMed

Vieira, Alexandre R; Gibson, Carolyn W; Deeley, Kathleen; Xue, Hui; Li, Yong

2015-01-01

Dental caries continues to be the most prevalent bacteria-mediated non-contagious disease of humankind. Dental professionals assert the disease can be explained by poor oral hygiene and a diet rich in sugars but this does not account for caries free individuals exposed to the same risk factors. In order to test the hypothesis that amount of amelogenin during enamel development can influence caries susceptibility, we generated multiple strains of mice with varying levels of available amelogenin during dental development. Mechanical tests showed that dental enamel developed with less amelogenin is "weaker" while the dental enamel of animals over-expressing amelogenin appears to be more resistant to acid dissolution.

Developing laser-based therapy monitoring of early caries in pediatric dental settings

NASA Astrophysics Data System (ADS)

Zhou, Yaxuan; Jiang, Yang; Kim, Amy S.; Xu, Zheng; Berg, Joel H.; Seibel, Eric J.

2017-02-01

Optical imaging modalities and therapy monitoring protocols are required for the emergence of non-surgical interventions for treating infections in teeth to remineralize the enamel. Current standard of visual inspection, tactile probing and radiograph for caries detection is not highly sensitive, quantitative, and safe. Furthermore, the latter two are not viable options for interproximal caries. We present preliminary results of multimodal laser-based imaging and uorescence spectroscopy in a blinded clinical study comparing two topical therapies of early interproximal caries in children. With a spacer placed interproximally both at baseline and followup examinations, the 405-nm excited red porphyrin uorescence imaging with green auto uorescence is measured and compared to a 12-month follow-up. 405-nm laser-induced uorescence spectroscopy is also measured from the center of selected multimodal video imaging frames. These results of three subjects are analyzed both qualitatively by comparing spectra and quantitatively based on uorescence region segmentation, and then are compared to the standard of care(visual examination and radiograph interpretation). Furthermore, this study points out challenges associated with optically monitoring non-surgical dental interventions over long periods of time in clinical practice and also indicates future direction for improvement on the protocol.

The efficiency of child formula dentifrices containing different calcium and phosphate compounds on artificial enamel caries

PubMed Central

Rirattanapong, Praphasri; Vongsavan, Kadkao; Saengsirinavin, Chavengkiat; Khumsub, Ploychompoo

2016-01-01

Objectives: Fluoride toothpaste has been extensively used to prevent dental caries. However, the risk of fluorosis is concerning, especially in young children. Calcium phosphate has been an effective remineralizing agent and is present in commercial dental products, with no risk of fluorosis to users. This in vitro study aimed to compare the effects of different calcium phosphate compounds and fluoride-containing dentifrices on artificial caries in primary teeth. Materials and Methods: Fifty sound primary incisors were coated with nail varnish, leaving two 1 mm2 windows on the labial surface before immersion in demineralizing solution for 96 hours to produce artificial enamel lesions. Subsequently, one window from each tooth was coated with nail varnish, and all 50 teeth were divided into five groups (n = 10); group A – deionized water; group B – casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) paste (Tooth Mousse); group C – 500 ppm F (Colgate Spiderman®); group D – nonfluoridated toothpaste with triple calcium phosphate (Pureen®); and group E – tricalcium phosphate (TCP). Polarized light microscopy and Image-Pro® Plus software were used to evaluate lesions. Results: After a 7-day pH-cycle, mean lesion depths in groups A, B, C, D, and E had increased by 57.52 ± 10.66%, 33.28 ± 10.16%, 17.04 ± 4.76%, 32.51 ± 8.99%, and 21.76 ± 8.15%, respectively. All data were processed by the Statistical Package for the Social Sciences (version 16.0) software package. Comparison of percentage changes using one-way analysis of variance and Fisher's least squares difference tests at a 95% level of confidence demonstrated that group A was significantly different from the other groups (P < 0.001). Lesions in groups B and D had a significant lesion progression when compared with groups C and E. Conclusions: All toothpastes in this study had the potential to delay the demineralization progression of artificial enamel caries in primary teeth. The

Weaker Dental Enamel Explains Dental Decay

PubMed Central

Vieira, Alexandre R.; Gibson, Carolyn W.; Deeley, Kathleen; Xue, Hui; Li, Yong

2015-01-01

Dental caries continues to be the most prevalent bacteria-mediated non-contagious disease of humankind. Dental professionals assert the disease can be explained by poor oral hygiene and a diet rich in sugars but this does not account for caries free individuals exposed to the same risk factors. In order to test the hypothesis that amount of amelogenin during enamel development can influence caries susceptibility, we generated multiple strains of mice with varying levels of available amelogenin during dental development. Mechanical tests showed that dental enamel developed with less amelogenin is “weaker” while the dental enamel of animals over-expressing amelogenin appears to be more resistant to acid dissolution. PMID:25885796

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.

CO2 Laser and Topical Fluoride Therapy in the Control of Caries Lesions on Demineralized Primary Enamel

PubMed Central

Valério, R. A.; Saraiva, M. C. P.; Corona, S. A. M.

2015-01-01

This study evaluated the effect of CO2 laser irradiation and topical fluoride therapy in the control of caries progression on primary teeth enamel. 30 fragments (3 × 3 × 2 mm) from primary canines were submitted to an initial cariogenic challenge that consisted of immersion on demineralizing solution for 3 hours and remineralizing solution for 21 hours for 5 days. Fragments were randomly assigned into three groups (n = 10): L: CO2 laser (λ = 10.6 μm), APF: 1.23% acidulated phosphate fluoride, and C: no treatment (control). CO2 laser was applied with 0.5 W power and 0.44 J/cm2 energy density. Fluoride application was performed with 0.1 g for 1 minute. Cariogenic challenge was conducted for 5 days following protocol previously described. Subsurface Knoop microhardness was measured at 30 μm from the edge. Obtained data were subjected to analysis the variance (ANOVA) and Duncan test with significance of 5%. It was found that the L group showed greater control of deciduous enamel demineralization and were similar to those of APF group, while being statistically different from C group (P ≤ 0.05) that showed the lowest microhardness values. It was concluded that CO2 laser can be an additional resource in caries control progression on primary teeth enamel. PMID:25874248

Effect of ozone to remineralize initial enamel caries: in situ study.

PubMed

Samuel, S R; Dorai, S; Khatri, S G; Patil, S T

2016-06-01

Effect of ozonated water in remineralizing artificially created initial enamel caries was investigated using laser fluorescence and polarized light microscopy in an in situ study. Teeth specimens (buccal sections) were immersed in 5-ml solution of 2 mM CaCl2, 2 mM NaH2P04, and 50 mM CH3COOH at pH of 4.55 for 5 h in an incubator at 37° to create subsurface demineralization. After which, they were randomly allocated into one of the following remineralization regimens: ozone (ozonated water 0.1 mg/l and 10 % nano-hydroxyapatite paste, Aclaim(TM)), without ozone (only 10 % nano-hydroxyapatite paste, Aclaim(TM)), and control (subjects' saliva alone). Specimens were embedded in acrylic retainers worn by orthodontic patients throughout the 21-day study duration and constantly exposed to their saliva. Laser fluorescence was recorded for all the specimens at baseline, after demineralization, and remineralization using DIAGNOdent, and the results were validated using polarized microscopic examination. The results were analyzed using repeated measures, one-way ANOVA with post hoc multiple comparisons. Reduced DIAGNOdent scores and greater depth of remineralization following application of ozonated water and nano-hydroxyapatite were found compared to those of the without ozone and control groups (P < 0.001), and the ozone-treated group exhibited maximum remineralization under the polarized light microscopy. Ozonated water can be considered an effective agent in reversing the initial enamel caries alongside with nano-hydroxyapatite compared to nano-hydroxyapatite alone and saliva. Ozone water can be used to remineralize incipient carious lesions, and it enhances the remineralizing potential of nano-hydroxyapatite thereby preventing the tooth from entering into the repetitive restorative cycle.

Recovery of crystallographic texture in remineralized dental enamel.

PubMed

Siddiqui, Samera; Anderson, Paul; Al-Jawad, Maisoon

2014-01-01

Dental caries is the most prevalent disease encountered by people of all ages around the world. Chemical changes occurring in the oral environment during the caries process alter the crystallography and microstructure of dental enamel resulting in loss of mechanical function. Little is known about the crystallographic effects of demineralization and remineralization. The motivation for this study was to develop understanding of the caries process at the crystallographic level in order to contribute towards a long term solution. In this study synchrotron X-ray diffraction combined with scanning electron microscopy and scanning microradiography have been used to correlate enamel crystallography, microstructure and mineral concentration respectively in enamel affected by natural caries and following artificial demineralization and remineralization regimes. In particular, the extent of destruction and re-formation of this complex structure has been measured. 2D diffraction patterns collected at the European Synchrotron Radiation Facility were used to quantify changes in the preferred orientation (crystallographic texture) and position of the (002) Bragg reflection within selected regions of interest in each tooth slice, and then correlated with the microstructure and local mineral mass. The results revealed that caries and artificial demineralization cause a large reduction in crystallographic texture which is coupled with the loss of mineral mass. Remineralization restores the texture to the original level seen in healthy enamel and restores mineral density. The results also showed that remineralization promotes ordered formation of new crystallites and growth of pre-existing crystallites which match the preferred orientation of healthy enamel. Combining microstructural and crystallographic characterization aids the understanding of caries and erosion processes and assists in the progress towards developing therapeutic treatments to allow affected enamel to regain

Crystal Initiation Structures in Developing Enamel: Possible Implications for Caries Dissolution of Enamel Crystals

PubMed Central

Robinson, Colin; Connell, Simon D.

2017-01-01

Investigations of developing enamel crystals using Atomic and Chemical Force Microscopy (AFM, CFM) have revealed a subunit structure. Subunits were seen in height images as collinear swellings about 30 nM in diameter on crystal surfaces. In friction mode they were visible as positive regions. These were similar in size (30–50 nM) to collinear spherical structures, presumably mineral matrix complexes, seen in developing enamel using a freeze fracturing/freeze etching procedure. More detailed AFM studies on mature enamel suggested that the 30–50 nM structures were composed of smaller units, ~10–15 nM in diameter. These were clustered in hexagonal or perhaps a spiral arrangement. It was suggested that these could be the imprints of initiation sites for mineral precipitation. The investigation aimed at examining original freeze etched images at high resolution to see if the smaller subunits observed using AFM in mature enamel were also present in developing enamel i.e., before loss of the organic matrix. The method used was freeze etching. Briefly samples of developing rat enamel were rapidly frozen, fractured under vacuum, and ice sublimed from the fractured surface. The fractured surface was shadowed with platinum or gold and the metal replica subjected to high resolution TEM. For AFM studies high-resolution tapping mode imaging of human mature enamel sections was performed in air under ambient conditions at a point midway between the cusp and the cervical margin. Both AFM and freeze etch studies showed structures 30–50 nM in diameter. AFM indicated that these may be clusters of somewhat smaller structures ~10–15 nM maybe hexagonally or spirally arranged. High resolution freeze etching images of very early enamel showed ~30–50 nM spherical structures in a disordered arrangement. No smaller units at 10–15 nM were clearly seen. However, when linear arrangements of 30–50 nM units were visible the picture was more complex but also smaller units including

A simplified genetic design for mammalian enamel

PubMed Central

Snead, ML; Zhu, D; Lei, YP; Luo, W; Bringas, P.; Sucov, H.; Rauth, RJ; Paine, ML; White, SN

2011-01-01

A biomimetic replacement for tooth enamel is urgently needed because dental caries is the most prevalent infectious disease to affect man. Here, design specifications for an enamel replacement material inspired by Nature are deployed for testing in an animal model. Using genetic engineering we created a simplified enamel protein matrix precursor where only one, rather than dozens of amelogenin isoforms, contributed to enamel formation. Enamel function and architecture were unaltered, but the balance between the competing materials properties of hardness and toughness was modulated. While the other amelogenin isoforms make a modest contribution to optimal biomechanical design, the enamel made with only one amelogenin isoform served as a functional substitute. Where enamel has been lost to caries or trauma a suitable biomimetic replacement material could be fabricated using only one amelogenin isoform, thereby simplifying the protein matrix parameters by one order of magnitude. PMID:21295848

Remineralization of in vitro dental caries assessed with polarization-sensitive optical coherence tomography

NASA Astrophysics Data System (ADS)

Jones, Robert S.; Darling, Cynthia L.; Featherstone, John D. B.; Fried, Daniel

2006-01-01

Polarization-sensitive optical coherence tomography (PS-OCT) is potentially useful for imaging the nonsurgical remineralization of dental enamel. This study uses an all-fiber-based PS-OCT system operating at 1310 nm to image demineralized and fluoride-enhanced remineralized artificial lesions. PS-OCT images of lesions before and after remineralization are compared with the relative mineral loss ΔZ (%vol×µm), obtained from high resolution digital microradiography (DM), and chemical composition changes by infrared spectroscopy. Severe early artificial caries show a significant increase in perpendicular-axis integrated reflectivity after remineralization. After sectioning the samples, DM demonstrates that the lesions remineralized with new mineral and the lesion surface zone show significant restoration of mineral volume. PS-OCT and DM both do not show a major change in lesion depth. For less severe artificial caries, the perpendicular-axis image resolves the scattering and depolarization of an outer growth layer after remineralization. This outer layer has a mineral volume close to that of sound enamel, and spectroscopic analysis indicates that the layer is a highly crystalline phase of apatite, without carbonate substitutions that increase the solubility of sound enamel. This study determines that PS-OCT can image the effects of fluoride-enhanced remineralization of mild and severe early artificial in vitro caries.

Early detection of dental caries using photoacoustics

NASA Astrophysics Data System (ADS)

Kim, K.; Witte, R.; Koh, I.; Ashkenazi, S.; O'Donnell, M.

2006-02-01

For decades, visual, tactile and radiographic examinations have been the standard for diagnosing caries. Nonetheless, the extent of variation in the diagnosis of dental caries is substantial among dental practitioners using these traditional techniques. Therefore, a more reliable standard for detecting incipient caries would be desirable. Using photoacoustics, near-infrared (NIR) optical contrast between sound and carious dental tissues can be relatively easily and accurately detected at ultrasound resolution. In this paper, a pulsed laser (Nd:YAG, Quanta-Ray) was used to probe extracted human molars at different disease stages determined from periapical radiographs. Both fundamental (1064nm) and first harmonic (532nm) pulses (15ns pulse length, 100mJ at fundamental and 9mJ at first harmonic , 10Hz pulse repetition rate) were used to illuminate the occlusal surface of tooth samples placed in a water tank. The photoacoustic signal was recorded with an unfocused wideband single-element piezoelectric transducer (centered at 12 MHz, bandwidth 15 MHz) positioned at small angle (less than 30 degrees) to the laser beam close to the occlusal surface. At the fundamental wavelength, total photoacoustic energy increases from normal to incipient stage disease by as much as a factor of 10. Differences between photoacoustic energy at the fundamental and first harmonic wavelength further indicate spectral absorption changes of the underlying structure with disease progression. Using a focused laser beam, an extracted molar with suspected incipient caries was scanned along the occulusal surface to help localize the caries inside enamel and dentin. The significantly increasing photoacoustic signal at a specific scan line both at fundamental and first harmonic indicates the local development of the incipient caries. The photoacoustic results compare well with visual inspection after layer by layer dissection. Preliminary results demonstrate the feasibility of detecting incipient

Recovery of Crystallographic Texture in Remineralized Dental Enamel

PubMed Central

Siddiqui, Samera; Anderson, Paul; Al-Jawad, Maisoon

2014-01-01

Dental caries is the most prevalent disease encountered by people of all ages around the world. Chemical changes occurring in the oral environment during the caries process alter the crystallography and microstructure of dental enamel resulting in loss of mechanical function. Little is known about the crystallographic effects of demineralization and remineralization. The motivation for this study was to develop understanding of the caries process at the crystallographic level in order to contribute towards a long term solution. In this study synchrotron X-ray diffraction combined with scanning electron microscopy and scanning microradiography have been used to correlate enamel crystallography, microstructure and mineral concentration respectively in enamel affected by natural caries and following artificial demineralization and remineralization regimes. In particular, the extent of destruction and re-formation of this complex structure has been measured. 2D diffraction patterns collected at the European Synchrotron Radiation Facility were used to quantify changes in the preferred orientation (crystallographic texture) and position of the (002) Bragg reflection within selected regions of interest in each tooth slice, and then correlated with the microstructure and local mineral mass. The results revealed that caries and artificial demineralization cause a large reduction in crystallographic texture which is coupled with the loss of mineral mass. Remineralization restores the texture to the original level seen in healthy enamel and restores mineral density. The results also showed that remineralization promotes ordered formation of new crystallites and growth of pre-existing crystallites which match the preferred orientation of healthy enamel. Combining microstructural and crystallographic characterization aids the understanding of caries and erosion processes and assists in the progress towards developing therapeutic treatments to allow affected enamel to regain

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.

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

Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions.

PubMed

Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A

2014-01-01

Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Dental plaque from children (N=20; aged 3-6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10-20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1-6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric potential of these strains may influence susceptibility in the

Need for new caries detection methods

NASA Astrophysics Data System (ADS)

Young, Douglas A.; Featherstone, John D. B.

1999-05-01

Dental caries (tooth decay) continues to be a major problems for adults as well as children, even though great advances have been made in preventive methods in the last 20 years. New methods for the management of caries will work best if lesions can be detected at an early stage and chemical rather than physical intervention can take place, thereby preserving the natural tooth structure and helping the saliva to heal, or remineralize, the areas of early decay. Clinical detection of caries in the US relies on visual examination, tactile with hand held explorer, and conventional radiographs, all of which are inadequate for the occlusal (biting) surfaces of the teeth where most of the decay now occurs. The dentist often has to explore by drilling with a dental bur to confirm early decay in these areas. New method that can determine the extent and degree of subsurface lesions in these surfaces non-destructively are essential for further advances in the clinical management of dental caries. Optical methods, which exploit the differences between sound and carious enamel and dentin, show great promise for the accurate detection of these lesions. Two or three- dimensional images, which include a measure of severity will be needed.

Histochemical changes of occlusal surface enamel of permanent teeth, where dental caries is questionable vs sound enamel surfaces.

PubMed

Michalaki, M; Oulis, C J; Pandis, N; Eliades, G

2016-12-01

This in vitro study was to classify questionable for caries occlusal surfaces (QCOS) of permanent teeth according to ICDAS codes 1, 2, and 3 and to compare them in terms of enamel mineral composition with the areas of sound tissue of the same tooth. Partially impacted human molars (60) extracted for therapeutic reasons with QCOS were used in the study, photographed via a polarised light microscope and classified according to the ICDAS II (into codes 1, 2, or 3). The crowns were embedded in clear self-cured acrylic resin and longitudinally sectioned at the levels of the characterised lesions and studied by SEM/EDX, to assess enamel mineral composition of the QCOS. Univariate and multivariate random effect regressions were used for Ca (wt%), P (wt%), and Ca/P (wt%). The EDX analysis indicated changes in the Ca and P contents that were more prominent in ICDAS-II code 3 lesions compared to codes 1 and 2 lesions. In these lesions, Ca (wt%) and P (wt%) concentrations were significantly decreased (p = 0.01) in comparison with sound areas. Ca and P (wt%) contents were significantly lower (p = 0.02 and p = 0.01 respectively) for code 3 areas in comparison with codes 1 and 2 areas. Significantly higher (p = 0.01) Ca (wt%) and P (wt%) contents were found on sound areas compared to the lesion areas. The enamel of occlusal surfaces of permanent teeth with ICDAS 1, 2, and 3 lesions was found to have different Ca/P compositions, necessitating further investigation on whether these altered surfaces might behave differently on etching preparation before fissure sealant placement, compared to sound surfaces.

Ex-vivo evaluation of an early caries detector based on integrated OCT and polarized Raman spectroscopy (Conference Presentation)

NASA Astrophysics Data System (ADS)

Lamouche, Guy; Padioleau, Christian; Hewko, Mark; Smith, Michael S. D.; Schattka, Bernie J.; Fulton, Crystal; Gauthier, Bruno; Beauchesne, André; Ko, Alex C.; Choo-Smith, Lin-P'ing; Sowa, Michael G.

2017-02-01

Early detection of incipient caries would allow dentists to provide more effective measures to delay or to reverse caries' progression at earlier stage. Such earlier intervention could lead to improved oral health for the patients and reduced burden to the health system. Previously, we have demonstrated that the combination of morphological and biochemical information furnished by optical coherence tomography (OCT) and polarized Raman spectroscopy (PRS), respectively, provided a unique tool for dental caries management. In this study we will report the first pre-clinical caries detection system that includes a hand-held probe with a size slightly larger than a tooth brush. This probe presents a novel platform combining both OCT and PRS optics in a very tight space ideal for clinical practice. OCT cross-sectional images of near-surface enamel morphology are obtained with miniaturized MEMS scanning device and are processed in real-time to identify culprit regions. These regions are sequentially analyzed with polarized Raman spectroscopy for further confirmation. PRS is performed using 830nm laser line and four detection channels in order to obtain polarized Raman spectroscopic data, i.e. depolarization ratio of the hydroxyapatite Raman band at 960 cm-1. A detailed description of this hand-held caries detector and ex-vivo/in-vivo test results will be presented.

Deep learning classifier with optical coherence tomography images for early dental caries detection

NASA Astrophysics Data System (ADS)

Karimian, Nima; Salehi, Hassan S.; Mahdian, Mina; Alnajjar, Hisham; Tadinada, Aditya

2018-02-01

Dental caries is a microbial disease that results in localized dissolution of the mineral content of dental tissue. Despite considerable decline in the incidence of dental caries, it remains a major health problem in many societies. Early detection of incipient lesions at initial stages of demineralization can result in the implementation of non-surgical preventive approaches to reverse the demineralization process. In this paper, we present a novel approach combining deep convolutional neural networks (CNN) and optical coherence tomography (OCT) imaging modality for classification of human oral tissues to detect early dental caries. OCT images of oral tissues with various densities were input to a CNN classifier to determine variations in tissue densities resembling the demineralization process. The CNN automatically learns a hierarchy of increasingly complex features and a related classifier directly from training data sets. The initial CNN layer parameters were randomly selected. The training set is split into minibatches, with 10 OCT images per batch. Given a batch of training patches, the CNN employs two convolutional and pooling layers to extract features and then classify each patch based on the probabilities from the SoftMax classification layer (output-layer). Afterward, the CNN calculates the error between the classification result and the reference label, and then utilizes the backpropagation process to fine-tune all the layer parameters to minimize this error using batch gradient descent algorithm. We validated our proposed technique on ex-vivo OCT images of human oral tissues (enamel, cortical-bone, trabecular-bone, muscular-tissue, and fatty-tissue), which attested to effectiveness of our proposed method.

Near-infrared transillumination at 1310-nm for the imaging of early dental decay

NASA Astrophysics Data System (ADS)

Jones, Robert S.; Huynh, Gigi D.; Jones, Graham C.; Fried, Daniel

2003-09-01

New imaging technologies are needed for the early detection of dental caries (decay) in the interproximal contact sites between teeth. Previous measurements have demonstrated that dental enamel is highly transparent in the near-IR at 1300-nm. In this study, a near-IR imaging system operating at 1300-nm was used to acquire images through tooth sections of varying thickness and whole teeth in order to demonstrate the utility of a near-IR dental transillumination system for the imaging of early dental caries (decay). Simulated lesions, which model the optical scattering of natural dental caries, were placed in plano-parallel dental enamel sections. The contrast ratio between the simulated lesions and surrounding sound enamel was calculated from analysis of acquired projection images. The results show significant contrast between the lesion and the enamel (>0.35) and a spatial line profile that clearly resolves the lesion in samples as thick as 6.75-mm. This study clearly demonstrates that a near-IR transillumination system has considerable potential for the imaging of early dental decay.

Near-infrared transillumination at 1310-nm for the imaging of early dental decay.

PubMed

Jones, Robert; Huynh, Gigi; Jones, Graham; Fried, Daniel

2003-09-08

New imaging technologies are needed for the early detection of dental caries (decay) in the interproximal contact sites between teeth. Previous measurements have demonstrated that dental enamel is highly transparent in the near-IR at 1300-nm. In this study, a near-IR imaging system operating at 1300-nm was used to acquire images through tooth sections of varying thickness and whole teeth in order to demonstrate the utility of a near-IR dental transillumination system for the imaging of early dental caries (decay). Simulated lesions, which model the optical scattering of natural dental caries, were placed in plano-parallel dental enamel sections. The contrast ratio between the simulated lesions and surrounding sound enamel was calculated from analysis of acquired projection images. The results show significant contrast between the lesion and the enamel (>0.35) and a spatial line profile that clearly resolves the lesion in samples as thick as 6.75-mm. This study clearly demonstrates that a near-IR transillumination system has considerable potential for the imaging of early dental decay.

Near-infrared imaging of developmental defects in dental enamel.

PubMed

Hirasuna, Krista; Fried, Daniel; Darling, Cynthia L

2008-01-01

Polarization-sensitive optical coherence tomography (PS-OCT) and near-infrared (NIR) imaging are promising new technologies under development for monitoring early carious lesions. Fluorosis is a growing problem in the United States, and the more prevalent mild fluorosis can be visually mistaken for early enamel demineralization. Unfortunately, there is little quantitative information available regarding the differences in optical properties of sound enamel, enamel developmental defects, and caries. Thirty extracted human teeth with various degrees of suspected fluorosis were imaged using PS-OCT and NIR. An InGaAs camera and a NIR diode laser were used to measure the optical attenuation through transverse tooth sections (approximately 200 microm). A digital microradiography system was used to quantify the enamel defect severity by measurement of the relative mineral loss for comparison with optical scattering measurements. Developmental defects were clearly visible in the polarization-resolved OCT images, demonstrating that PS-OCT can be used to nondestructively measure the depth and possible severity of the defects. Enamel defects on whole teeth that could be imaged with high contrast with visible light were transparent in the NIR. This study suggests that PS-OCT and NIR methods may potentially be used as tools to assess the severity and extent of enamel defects.

Photoacoustic imaging of teeth for dentine imaging and enamel characterization

NASA Astrophysics Data System (ADS)

Periyasamy, Vijitha; Rangaraj, Mani; Pramanik, Manojit

2018-02-01

Early detection of dental caries, cracks and lesions is needed to prevent complicated root canal treatment and tooth extraction procedures. Resolution of clinically used x-ray imaging is low, hence optical imaging techniques such as optical coherence tomography, fluorescence imaging, and Raman imaging are widely experimented for imaging dental structures. Photoacoustic effect is used in photon induced photoacoustic streaming technique to debride the root canal. In this study, the extracted teeth were imaged using photoacoustic tomography system at 1064 nm. The degradation of enamel and dentine is an indicator of onset of dental caries. Photoacoustic microscopy (PAM) was used to study the tooth enamel. Images were acquired using acoustic resolution PAM system. This was done to identify microscopic cracks and dental lesion at different anatomical sites (crown and cementum). The PAM tooth profile is an indicator of calcium distribution which is essential for demineralization studies.

Dental Calculus Arrest of Dental Caries.

PubMed

Keyes, Paul H; Rams, Thomas E

An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. These observations further document the potential protective effects of dental calculus mineralization against dental caries.

Dental Calculus Arrest of Dental Caries

PubMed Central

Keyes, Paul H.; Rams, Thomas E.

2016-01-01

Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993

Diet and caries-associated bacteria in severe early childhood caries.

PubMed

Palmer, C A; Kent, R; Loo, C Y; Hughes, C V; Stutius, E; Pradhan, N; Dahlan, M; Kanasi, E; Arevalo Vasquez, S S; Tanner, A C R

2010-11-01

Frequent consumption of cariogenic foods and bacterial infection are risk factors for early childhood caries (ECC). This study hypothesized that a short diet survey focused on frequency of foods, categorized by putative cariogenicity, would differentiate severe ECC (S-ECC) from caries-free children. Children's diets were obtained by survey and plaque bacteria detected by PCR from 72 S-ECC and 38 caries-free children. S-ECC children had higher scores for between-meal juice (p < 0.01), solid-retentive foods (p < 0.001), eating frequency (p < 0.005), and estimated food cariogenicity (p < 0.0001) than caries-free children. S-ECC children with lesion recurrence ate fewer putative caries-protective foods than children without new lesions. Streptococcus mutans (p < 0.005), Streptococcus sobrinus (p < 0.005), and Bifidobacteria (p < 0.0001) were associated with S-ECC, and S. mutans with S. sobrinus was associated with lesion recurrence (p < 0.05). S. mutans-positive children had higher food cariogenicity scores. Food frequency, putative cariogenicity, and S. mutans were associated with S-ECC individually and in combination.

Diet and Caries-associated Bacteria in Severe Early Childhood Caries

PubMed Central

Palmer, C.A.; Kent, R.; Loo, C.Y.; Hughes, C.V.; Stutius, E.; Pradhan, N.; Dahlan, M.; Kanasi, E.; Arevalo Vasquez, S.S.; Tanner, A.C.R.

2010-01-01

Frequent consumption of cariogenic foods and bacterial infection are risk factors for early childhood caries (ECC). This study hypothesized that a short diet survey focused on frequency of foods, categorized by putative cariogenicity, would differentiate severe ECC (S-ECC) from caries-free children. Children’s diets were obtained by survey and plaque bacteria detected by PCR from 72 S-ECC and 38 caries-free children. S-ECC children had higher scores for between-meal juice (p < 0.01), solid-retentive foods (p < 0.001), eating frequency (p < 0.005), and estimated food cariogenicity (p < 0.0001) than caries-free children. S-ECC children with lesion recurrence ate fewer putative caries-protective foods than children without new lesions. Streptococcus mutans (p < 0.005), Streptococcus sobrinus (p < 0.005), and Bifidobacteria (p < 0.0001) were associated with S-ECC, and S. mutans with S. sobrinus was associated with lesion recurrence (p < 0.05). S. mutans-positive children had higher food cariogenicity scores. Food frequency, putative cariogenicity, and S. mutans were associated with S-ECC individually and in combination. PMID:20858780

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.

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.

Near-infrared imaging of enamel hypomineralization due to developmental defects

NASA Astrophysics Data System (ADS)

Lee, Robert C.; Jang, Andrew; Fried, Daniel

2017-02-01

The increasing prevalence of mild hypomineralization due to developmental defects on tooth surfaces poses a challenge for caries detection and caries risk assessment and reliable methods need to be developed to discriminate such lesions from active caries lesions that need intervention. Previous studies have demonstrated that areas of hypomineralization are typically covered with a relatively thick surface layer of highly mineralized and transparent enamel similar to arrested lesions. Seventy-six extracted human teeth with mild to moderate degrees of suspicious fluorosis were imaged using near-infrared reflectance and transillumination. Enamel hypomineralization was clearly visible in both modalities. However, it was difficult to distinguish hypomineralization due to developmental defects from caries lesions with contrast measurements alone. The location of the lesion on tooth coronal surface (i.e. generalized vs. localized) seems to be the most important indicator for the presence of enamel hypomineralization due to developmental defects.

Near-infrared imaging of enamel hypomineralization due to developmental defects.

PubMed

Lee, Robert C; Jang, Andrew; Fried, Daniel

2017-01-28

The increasing prevalence of mild hypomineralization due to developmental defects on tooth surfaces poses a challenge for caries detection and caries risk assessment and reliable methods need to be developed to discriminate such lesions from active caries lesions that need intervention. Previous studies have demonstrated that areas of hypomineralization are typically covered with a relatively thick surface layer of highly mineralized and transparent enamel similar to arrested lesions. Seventy-six extracted human teeth with mild to moderate degrees of suspicious fluorosis were imaged using near-infrared reflectance and transillumination. Enamel hypomineralization was clearly visible in both modalities. However, it was difficult to distinguish hypomineralization due to developmental defects from caries lesions with contrast measurements alone. The location of the lesion on tooth coronal surface (i.e. generalized vs. localized) seems to be the most important indicator for the presence of enamel hypomineralization due to developmental defects.

Keratins as components of the enamel organic matrix

PubMed Central

Duverger, Olivier; Beniash, Elia; Morasso, Maria I.

2016-01-01

Dental enamel is a hardest tissue in the human body, and although it starts as a tissue rich in proteins, by the time of eruption of the tooth in the oral cavity only a small fraction of the protein remains. While this organic matrix of enamel represents less than 1% by weight it plays essential roles in improving both toughness and resilience to chemical attacks. Despite the fact that the first studies of the enamel matrix began in the 19th century its exact composition and mechanisms of its function remain poorly understood. It was proposed that keratin or a keratin-like primitive epithelial component exists in mature enamel, however due to the extreme insolubility of its organic matrix the presence of keratins there was never clearly established. We have recently identified expression of a number of hair keratins in ameloblasts, the enamel secreting cells, and demonstrated their incorporation into mature enamel. Mutation in epithelial hair keratin KRT75 leads to a skin condition called pseudofollicularis barbae. Carriers of this mutation have an altered enamel structure and mechanical properties. Importantly, these individuals have a much higher prevalence of caries. To the best of our knowledge, this is the first study showing a direct link between a mutation in a protein-coding region of a gene and increased caries rates. In this paper we present an overview of the evidence of keratin-like material in enamel that has accumulated over the last 150 years. Furthermore, we propose potential mechanisms of action of KTR75 in enamel and highlight the clinical implications of the link between mutations in KRT75 and caries. Finally, we discuss the potential use of keratins for enamel repair. PMID:26709044

Diagnosis and Management of Hidden Caries in a Primary Molar Tooth.

PubMed

Gera, Arwa; Zilberman, Uri

2017-01-01

Hidden caries is a dentinal lesion beneath the dentinoenamel junction, visible on radiographs. A single report described this lesion in primary dentition. This case report describes a case of hidden caries in a mandibular second primary molar, misdiagnosed as malignant swelling. A 3-year-old white girl was referred to the Department of Pediatric Dentistry with a chief complaint of pain and extraoral swelling on the right side of the mandible for the last 3 months. She was earlier referred to the surgical department for biopsy of the lesion. Radiographic and computed tomography scan examination showed a periapical lesion with buccal plate resorption and radiolucency beneath the enamel on the mesial part of tooth 85. The tooth was extracted, and follow-up of 2 years showed normal development of tooth 45. The main problem is early detection and treatment, since the outer surface of enamel may appear intact on tactile examination. Gera A, Zilberman U. Diagnosis and Management of Hidden Caries in a Primary Molar Tooth. Int J Clin Pediatr Dent 2017;10(1):99-102.

The effect of fluoride varnishes on caries lesions: an in vitro investigation.

PubMed

Al Dehailan, Laila; Martinez-Mier, Esperanza Angeles; Lippert, Frank

2016-09-01

The purpose of this study was to investigate the effect of five commercially available fluoride varnishes (FV) on caries lesions. Ninety bovine enamel specimens were assigned to five varnish groups (n = 18). Early caries lesions were created in the specimens and characterized using Vickers surface microhardness number (VHN). FV was applied to each group of specimens. Immediately afterwards, 7.5 ml of artificial saliva (AS) were pipetted over each group of specimens, collected and renewed every 15 min for 6 h. AS samples were analyzed for fluoride using an ion-specific electrode. Enamel fluoride uptake (EFU) was determined using the acid etch technique. Each group was then subjected to a pH cycling regimen for 5 days after which VHN was determined again. One-way analysis of variance (ANOVA) was used for data analysis. FVs differed in their rehardening capability (highest mean value was for Enamel Pro = 32.3 ± 5.8 and lowest mean value was for Vanish = 18.9 ± 11.3). No significant difference in EFU was found among groups. Total fluoride release over 6 h was in the order of MI Varnish (303 μg/ml) > Enamel Pro (217 μg/ml) > Flor-Opal (153 μg/ml) > PreviDent(84 μg/ml) > Vanish(28 μg/ml). ΔVHN and fluoride release characteristics differ among FV products. These differences may be attributed to the different compositions and physical properties of the tested FV. Fundamental, comparable research on FV and how different formulations affect early caries lesion rehardening, fluoride release into saliva, and uptake by teeth is scarce.

Evaluation of cross-polarized near infrared hyperspectral imaging for early detection of dental caries

NASA Astrophysics Data System (ADS)

Usenik, Peter; Bürmen, Miran; Fidler, Aleš; Pernuš, Franjo; Likar, Boštjan

2012-01-01

Despite major improvements in dental healthcare and oral hygiene, dental caries remains one of the most prevalent oral diseases and represents the primary cause of oral pain and tooth loss. The initial stages of dental caries are characterized by demineralization of enamel crystals and are difficult to diagnose. Near infrared (NIR) hyperspectral imaging is a new promising technique for detection of early changes in the surfaces of carious teeth. This noninvasive imaging technique can characterize and differentiate between the sound tooth surface and initial or advanced tooth caries. The absorbing and scattering properties of dental tissues reflect in distinct spectral features, which can be measured, quantified and used to accurately classify and map different dental tissues. Specular reflections from the tooth surface, which appear as bright spots, mostly located around the edges and the crests of the teeth, act as a noise factor which can significantly interfere with the spectral measurements and analysis of the acquired images, degrading the accuracy of the classification and diagnosis. Employing cross-polarized imaging setup can solve this problem, however has yet to be systematically evaluated, especially in broadband hyperspectral imaging setups. In this paper, we employ cross-polarized illumination setup utilizing state-of-the-art high-contrast broadband wire-grid polarizers in the spectral range from 900 nm to 1700 nm for hyperspectral imaging of natural and artificial carious lesions of various degrees.

A construction of standardized near infrared hyper-spectral teeth database: a first step in the development of reliable diagnostic tool for quantification and early detection of caries

NASA Astrophysics Data System (ADS)

Bürmen, Miran; Usenik, Peter; Fidler, Aleš; Pernuš, Franjo; Likar, Boštjan

2011-03-01

Dental caries is a disease characterized by demineralization of enamel crystals leading to the penetration of bacteria into the dentin and pulp. If left untreated, the disease can lead to pain, infection and tooth loss. Early detection of enamel demineralization resulting in increased enamel porosity, commonly known as white spots, is a difficult diagnostic task. Several papers reported on near infrared (NIR) spectroscopy to be a potentially useful noninvasive spectroscopic technique for early detection of caries lesions. However, the conducted studies were mostly qualitative and did not include the critical assessment of the spectral variability of the sound and carious dental tissues and influence of the water content. Such assessment is essential for development and validation of reliable qualitative and especially quantitative diagnostic tools based on NIR spectroscopy. In order to characterize the described spectral variability, a standardized diffuse reflectance hyper-spectral database was constructed by imaging 12 extracted human teeth with natural lesions of various degrees in the spectral range from 900 to 1700 nm with spectral resolution of 10 nm. Additionally, all the teeth were imaged by digital color camera. The influence of water content on the acquired spectra was characterized by monitoring the teeth during the drying process. The images were assessed by an expert, thereby obtaining the gold standard. By analyzing the acquired spectra we were able to accurately model the spectral variability of the sound dental tissues and identify the advantages and limitations of NIR hyper-spectral imaging.

Remineralization of early enamel caries lesions using different bioactive elements containing toothpastes: An in vitro study.

PubMed

Wang, Yu; Mei, Li; Gong, Lin; Li, Jialing; He, Shaowei; Ji, Yan; Sun, Weibin

2016-09-14

found in surface hardness and roughness between Colgate Sensitive Pro-Relief and NovaMin® during the pH-cycling test and acid resistance test (P= 0.45 and P= 0.83, respectively). Colgate Sensitive Pro-Relief and NovaMin® present an advantage in enhancing remineralization and inhibiting demineralization for early enamel carious lesions in comparison with GC Tooth Mousse.

Remineralization of demineralized enamel via calcium phosphate nanocomposite.

PubMed

Weir, M D; Chow, L C; Xu, H H K

2012-10-01

Secondary caries remains the main problem limiting the longevity of composite restorations. The objective of this study was to investigate the remineralization of demineralized human enamel in vitro via a nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP). NACP were synthesized by a spray-drying technique and incorporated into a dental resin. First, caries-like subsurface enamel lesions were created via an acidic solution. Then, NACP nanocomposite or a commercial fluoride-releasing control composite was placed on the demineralized enamel, along with control enamel without a composite. These specimens were then treated with a cyclic demineralization/remineralization regimen for 30 days. Quantitative microradiography showed typical enamel subsurface demineralization before cyclic demineralization/remineralization treatment, and significant remineralization in enamel under the NACP nanocomposite after the demineralization/remineralization treatment. The NACP nanocomposite had the highest enamel remineralization (mean ± SD; n = 6) of 21.8 ± 3.7%, significantly higher than the 5.7 ± 6.9% for fluoride-releasing composite (p < 0.05). The enamel group without composite had further demineralization of -26.1 ± 16.2%. In conclusion, a novel NACP nanocomposite was effective in remineralizing enamel lesions in vitro. Its enamel remineralization was 4-fold that of a fluoride-releasing composite control. Combined with the good mechanical and acid-neutralization properties reported earlier, the new NACP nanocomposite is promising for remineralization of demineralized tooth structures.

Remineralization of Demineralized Enamel via Calcium Phosphate Nanocomposite

PubMed Central

Weir, M.D.; Chow, L.C.; Xu, H.H.K.

2012-01-01

Secondary caries remains the main problem limiting the longevity of composite restorations. The objective of this study was to investigate the remineralization of demineralized human enamel in vitro via a nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP). NACP were synthesized by a spray-drying technique and incorporated into a dental resin. First, caries-like subsurface enamel lesions were created via an acidic solution. Then, NACP nanocomposite or a commercial fluoride-releasing control composite was placed on the demineralized enamel, along with control enamel without a composite. These specimens were then treated with a cyclic demineralization/remineralization regimen for 30 days. Quantitative microradiography showed typical enamel subsurface demineralization before cyclic demineralization/remineralization treatment, and significant remineralization in enamel under the NACP nanocomposite after the demineralization/remineralization treatment. The NACP nanocomposite had the highest enamel remineralization (mean ± SD; n = 6) of 21.8 ± 3.7%, significantly higher than the 5.7 ± 6.9% for fluoride-releasing composite (p < 0.05). The enamel group without composite had further demineralization of −26.1 ± 16.2%. In conclusion, a novel NACP nanocomposite was effective in remineralizing enamel lesions in vitro. Its enamel remineralization was 4-fold that of a fluoride-releasing composite control. Combined with the good mechanical and acid-neutralization properties reported earlier, the new NACP nanocomposite is promising for remineralization of demineralized tooth structures. PMID:22933607

Effects of enamel abrasion, salivary pellicle, and measurement angle on the optical assessment of dental erosion.

PubMed

Lussi, Adrian; Bossen, Anke; Höschele, Christoph; Beyeler, Barbara; Megert, Brigitte; Meier, Christoph; Rakhmatullina, Ekaterina

2012-09-01

The present study assessed the effects of abrasion, salivary proteins, and measurement angle on the quantification of early dental erosion by the analysis of reflection intensities from enamel. Enamel from 184 caries-free human molars was used for in vitro erosion in citric acid (pH 3.6). Abrasion of the eroded enamel resulted in a 6% to 14% increase in the specular reflection intensity compared to only eroded enamel, and the reflection increase depended on the erosion degree. Nevertheless, monitoring of early erosion by reflection analysis was possible even in the abraded eroded teeth. The presence of the salivary pellicle induced up to 22% higher reflection intensities due to the smoothing of the eroded enamel by the adhered proteins. However, this measurement artifact could be significantly minimized (p<0.05) by removing the pellicle layer with 3% NaOCl solution. Change of the measurement angles from 45 to 60 deg did not improve the sensitivity of the analysis at late erosion stages. The applicability of the method for monitoring the remineralization of eroded enamel remained unclear in a demineralization/remineralization cycling model of early dental erosion in vitro.

Effects of enamel abrasion, salivary pellicle, and measurement angle on the optical assessment of dental erosion

NASA Astrophysics Data System (ADS)

Lussi, Adrian; Bossen, Anke; Höschele, Christoph; Beyeler, Barbara; Megert, Brigitte; Meier, Christoph; Rakhmatullina, Ekaterina

2012-09-01

The present study assessed the effects of abrasion, salivary proteins, and measurement angle on the quantification of early dental erosion by the analysis of reflection intensities from enamel. Enamel from 184 caries-free human molars was used for in vitro erosion in citric acid (pH 3.6). Abrasion of the eroded enamel resulted in a 6% to 14% increase in the specular reflection intensity compared to only eroded enamel, and the reflection increase depended on the erosion degree. Nevertheless, monitoring of early erosion by reflection analysis was possible even in the abraded eroded teeth. The presence of the salivary pellicle induced up to 22% higher reflection intensities due to the smoothing of the eroded enamel by the adhered proteins. However, this measurement artifact could be significantly minimized (p<0.05) by removing the pellicle layer with 3% NaOCl solution. Change of the measurement angles from 45 to 60 deg did not improve the sensitivity of the analysis at late erosion stages. The applicability of the method for monitoring the remineralization of eroded enamel remained unclear in a demineralization/remineralization cycling model of early dental erosion in vitro.

Laser methods of caries prophylaxis

NASA Astrophysics Data System (ADS)

Kunin, Anatoly A.; Dergunova, Elvira I.; Kazmina, Svetlana G.

1996-01-01

Low intensive laser irradiation is widely used for the treatment of many stomatological diseases. The caries static activity of HNL light and infrared lasers, its influence on the activation of microcirculation of the pulp enzyme system and on the increase of enamel permeability became clear. These data allow us to suppose that the low intensive laser irradiation may potent the activity of the initial caries by the increase of teeth stability to the factors provoking the caries.

Comparative analysis of optical coherence tomography signal and microhardness for demineralization evaluation of human tooth enamel

NASA Astrophysics Data System (ADS)

de Cara, Ana Claudia Ballet; Zezell, Denise Maria; Ana, Patricia A.; Deana, Alessandro Melo; Amaral, Marcello Magri; Dias Vieira, Nilson, Jr.; de Freitas, Anderson Zanardi

2012-06-01

The diagnosis of dental caries at an early stage enables the implementation of conservative treatments based on dental preservation. Several diagnostic methods have been developed, like visual-tactile and radiographic are the most commons but are limited for this application. The Optical Coherence Tomography is a technique that provides information of optical properties of enamel, which may change due to the decay process. The objective of this study was to evaluate the ability of OCT to detect different stages of demineralization of tooth enamel during the development of artificial caries lesions, taking as a reference standard for comparison sectional microhardness testing. Different stages of caries lesions were simulated using the pH cycling model suggested Feathestone and modified by Argenta. The samples were exposed to 0 (control group), 5, 10, 15, 20 and 25 days at a daily regimen of three hours demineralization followed by remineralization during 20 hours. It was used an OCT system with at 930nm. Sectional images were generated in all lesion region. The results obtained from the OCT technique presented similar behavior to microhardness, except for the group 25 days, due to inability to perform indentations reading in areas of more intense demineralization. A linear relationship was observed between the OCT and microhardness techniques for detection of demineralization in enamel. This relationship will allow the use of OCT technique in quantitative assessment of mineral loss and for the evaluation of incipient caries lesions.

Comparison of reflectance spectra of sound and carious enamel

NASA Astrophysics Data System (ADS)

Analoui, Mostafa; Ando, Masatoshi; Stookey, George K.

2000-03-01

Development of dental caries is associated with the loss of minerals and change in the enamel structure. In this study, we have measured and compared reflectance spectra of sound and carious enamel, to investigate its utility in detection and analysis of dental caries. One hundred twenty, 3-mm diameter human enamel cores, with no sign of fluorosis, tetracycline stain, hypoplasia, fracture and restorations, were prepared. The enamel surfaces then were ground and polished. Specimens were placed on a fitted holder with either black or white color for background, with no fluorescence. The baseline spectra were measured using a spectrophotometer with enclosed diffused illumination. Spectra measured from 380 to 780 nm at 5 nm intervals. All measurements were corrected to compensate for the spectrum of illumination. The specimens were divided into two groups and exposed to a demineralizing solution, for 48 and 96 hours, respectively. Reflectance spectra of specimens were measured following lesion induction. All specimens were sectioned and analyzed by transverse microradiography (TMR), where lesion depth and mineral loss ((Delta) Z) were measured. Dimensionality of multi-spectral data was reduced through its conversion to L*a*b* color coordinates and principal component analysis (PCA). Multiple linear regression analysis showed low correlation between L*a*b* and lesion depth and mineral loss. PCA analysis showed higher correlation coefficient, compared to L*a*b*. Preliminary results of this study suggest that multi-spectral measurement and analysis of the tooth surface could be useful in predicting the depth and severity of an early carious lesion.

Comparing potential early caries assessment methods for teledentistry

PubMed Central

2013-01-01

Background Optical caries detection has the potential to be incorporated in telehealth medicine for preventive dental screening. The objective of this study was to evaluate and compare visible and near infrared detection methods for identifying early non-cavitated ex vivo occlusal demineralization. Methods Six blinded examiners were used to compare the accuracy of the following three examinations in detecting occlusal demineralization: Midwest Caries ID™ (MID), visual photographic examination (CAM) and Cross Polarization Optical Coherence Tomography (CP-OCT). For each diagnostic method, two examiners assessed the extracted tooth samples 1–2 weeks apart. Teeth were then sectioned and lesion depth was confirmed (n = 42) by a blinded histological examination using a glycol based caries indicator dye. The sensitivity (Sen), specificity (Sp), Intraclass Correlation Coefficient (ICC), and Area under the Receiver Operator Curve (AUC) were calculated. Results For detecting any demineralization versus sound pit and fissure enamel, the mean Sen/Sp found was 46.9/85.0 for MID, 80.5/52.5 for CAM, and 83.4/45.0 for CP-OCT. For detecting non-cavitated demineralization that progressed into the dentin, the mean Sen/Sp found was 17.3/88.0 for MID, 48.0/57.8 for CAM, and 44.2/72.7 for CP-OCT. AUC values were statistically significant (P < 0.05) in three out of four examiner assessments when MID and CP-OCT were used to detect any demineralization. AUC values were significant for a single CAM examination. When assessing deeper non-cavitated lesions, none of the assessment methods were able to yield AUC values that were significantly different than a random ‘coin flip’ test. When examining reliability, MID demonstrated the highest ICC score (0.83) and CP-OCT had the lowest (0.49). Conclusion Although MID and CP-OCT were useful in detecting the presence of demineralization, examiners were not able to utilize these devices to adequately assess the depth of the

In-vitro Thermal Maps to Characterize Human Dental Enamel and Dentin.

PubMed

Lancaster, Paula; Brettle, David; Carmichael, Fiona; Clerehugh, Val

2017-01-01

The crown of a human tooth has an outer layer of highly-mineralized tissue called enamel, beneath which is dentin, a less-mineralized tissue which forms the bulk of the tooth-crown and root. The composition and structure of enamel and dentin are different, resulting in different thermal properties. This gives an opportunity to characterize enamel and dentin from their thermal properties and to visually present the findings as a thermal map. The thermal properties of demineralized enamel and dentin may also be sufficiently different from sound tissue to be seen on a thermal map, underpinning future thermal assessment of caries. The primary aim of this novel study was to produce a thermal map of a sound, human tooth-slice to visually characterize enamel and dentin. The secondary aim was to map a human tooth-slice with demineralized enamel and dentin to consider future diagnostic potential of thermal maps for caries-detection. Two human slices of teeth, one sound and one demineralized from a natural carious lesion, were cooled on ice, then transferred to a hotplate at 30°C where the rewarming-sequence was captured by an infra-red thermal camera. Calculation of thermal diffusivity and thermal conductivity was undertaken, and two methods of data-processing used customized software to produce thermal maps from the thermal characteristic-time-to-relaxation and heat-exchange. The two types of thermal maps characterized enamel and dentin. In addition, sound and demineralized enamel and dentin were distinguishable within both maps. This supports thermal assessment of caries and requires further investigation on a whole tooth.

Oral aspects in celiac disease children: clinical and dental enamel chemical evaluation.

PubMed

de Carvalho, Fabrício Kitazono; de Queiroz, Alexandra Mussolino; Bezerra da Silva, Raquel Assed; Sawamura, Regina; Bachmann, Luciano; Bezerra da Silva, Léa Assed; Nelson-Filho, Paulo

2015-06-01

The aim of this study was to evaluate the oral manifestations of celiac disease (CD), the chemical composition of dental enamel, and the occurrence of CD in children with dental enamel defects (DEDs). In the study, 52 children with CD and 52 controls were examined for DEDs, recurrent aphthous stomatitis (RAS), dental caries experience, and salivary parameters. In addition, 10 exfoliated primary enamel molars from each group were analyzed by energy dispersive x-ray spectroscopy and Fourier transform infrared spectroscopy. Fifty children with DEDs were submitted to CD diagnosis. Among the children with CD, a higher prevalence of DEDs (P = .00001) and RAS (P = .0052), lower caries experience (P = .0024), and reduction of salivary flow (P = .0060) were observed. Dental enamel from the children with CD demonstrated a lower calcium-to-phosphorus ratio (P = .0136), but no difference in the carbonate-to-phosphate ratio (P = .5862) was observed. In the multivariate analysis, CD was a protective factor for caries (OR = 0.74) and a risk factor for RAS (OR3.23). The children with CD presented with more RAS, DEDs, reduction of salivary flow, and chemical alterations in the enamel. Copyright © 2015 Elsevier Inc. All rights reserved.

Clonal Analysis of the Microbiota of Severe Early Childhood Caries

PubMed Central

Kanasi, E.; Dewhirst, F.E.; Chalmers, N.I.; Kent, R.; Moore, A.; Hughes, C.V.; Pradhan, N.; Loo, C.Y.; Tanner, A.C.R.

2010-01-01

Background/Aims Severe early childhood caries is a microbial infection that severely compromises the dentition of young children. The aim of this study was to characterize the microbiota of severe early childhood caries. Methods Dental plaque samples from 2- to 6-year-old children were analyzed using 16S rRNA gene cloning and sequencing, and by specific PCR amplification for Streptococcus mutans and Bifidobacteriaceae species. Results Children with severe caries (n = 39) had more dental plaque and gingival inflammation than caries-free children (n = 41). Analysis of phylotypes from operational taxonomic unit analysis of 16S rRNA clonal metalibraries from severe caries and caries-free children indicated that while libraries differed significantly (p < 0.0001), there was increased diversity than detected in this clonal analysis. Using the Human Oral Microbiome Database, 139 different taxa were identified. Within the limits of this study, caries-associated taxa included Granulicatella elegans (p < 0.01) and Veillonella sp. HOT-780 (p < 0.01). The species associated with caries-free children included Capnocytophaga gingivalis (p < 0.01), Abiotrophia defectiva (p < 0.01), Lachnospiraceae sp. HOT-100 (p < 0.05), Streptococcus sanguinis (p < 0.05) and Streptococcus cristatus (p < 0.05). By specific PCR, S. mutans (p < 0.005) and Bifidobacteriaceae spp. (p < 0.0001) were significantly associated with severe caries. Conclusion Clonal analysis of 80 children identified a diverse microbiota that differed between severe caries and caries-free children, but the association of S. mutans with caries was from specific PCR analysis, not from clonal analysis, of samples. PMID:20861633

Restorative Treatment Thresholds for Occlusal Primary Caries by Dentists in “The Dental Practice-Based Research Network”

PubMed Central

Gordan, Valeria V; Bader, James D; Garvan, Cynthia W; Richman, Joshua S; Qvist, Vibeke; Fellows, Jeffrey L; Rindal, D. Brad; Gilbert, Gregg H

2010-01-01

Objectives (1) Quantify at which carious lesion depths dentists intervene surgically for cases of varying caries penetration and caries risk; (2) Identify characteristics that are associated with surgical intervention. Methods Dentists in a practice-based research network who reported doing at least some restorative dentistry were surveyed. Dentists were asked to indicate whether they would surgically intervene in a series of cases depicting occlusal caries. Each case included a photograph of an occlusal surface displaying typical characteristics of caries penetration, and a written description of a patient at a specific level of caries risk. Using logistic regression, we analyzed associations of surgical treatment with dentist and practice characteristics, and patient caries risk levels. Results 519 DPBRN practitioner-investigators responded, of whom 63% indicated that they would surgically restore lesions located on inner enamel surfaces, and 90% of lesions located in outer dentin surfaces in a low caries risk individual. Regarding individuals at high caries risk, 77% reported that they would surgically restore inner enamel lesions and 94% reported restoring lesions located on the outer dentin surface. Dentists who did not assess caries risk were more likely to intervene on dentin lesions (p=.004). Practitioner-investigators who were in private practice were significantly more likely to intervene surgically on enamel lesions, compared to dentists from large group practices (p<.001). Conclusion Most dentists chose to provide some treatment to lesions that were within the enamel surface. Decisions to intervene surgically in the caries process differ by caries lesion depth, patient caries risk, assessment of caries risk, type of practice model, and percent of patients who self-pay. PMID:20123876

Enamel defects and dental caries in 9-year-old children living in fluoridated and nonfluoridated areas of Auckland, New Zealand.

PubMed

Kanagaratnam, Sathananthan; Schluter, Philip; Durward, Callum; Mahood, Robyn; Mackay, Tim

2009-06-01

This epidemiological study aims to investigate the developmental enamel defects and dental caries among 9-year-old children resident in fluoridated and nonfluoridated regions in Auckland, New Zealand. A stratified, two-stage random selection design where strata were defined by fluoridation status, school size, and school decile. After informed consent was obtained, parents completed oral health questionnaires and children underwent dental examinations at school clinics. 612 children from 38 schools participated in the study. Overall, 175 (29%) children had lived continuously in fluoridated areas, 149 (24%) had lived continuously in nonfluoridated areas, and 288 (47%) had resided intermittently in fluoridated areas. Diffuse opacities were present in 117 (19%) children and deciduous teeth dental caries was seen in 370 (60%) children. After adjustment for covariates, a strong dose-response relationship between diffuse opacity and fluoridation status was found, with children who lived continuously in fluoridated areas being 4.17 times as likely to have diffuse opacities as children who lived continuously in nonfluoridated areas (P < 0.001). Conversely, a strong protective dose-response relationship between caries experience and fluoridation status was seen, with children who lived continuously in fluoridated areas being 0.42 times as likely to have dental caries as children who lived continuously in nonfluoridated areas (P < 0.001). Reticulated water fluoridation in Auckland reduces the risk of dental caries but increases the risk of diffuse opacities in 9-year-old children. Guidelines and health-promotion strategies that enable children to minimize their risk to diffuse opacities yet reduce their risk of dental caries should be reviewed.

Patient age and dentists’ decisions about occlusal caries treatment thresholds

PubMed Central

Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Yokoyama, Yoko; Gilbert, Gregg H; Gordan, Valeria V

2014-01-01

Objectives This study was performed to (1) quantify dentists’ treatment thresholds for occlusal primary caries; (2) determine if patient's age affects dentists’ decisions to surgically treat these carious lesions; (3) test the hypothesis that patients’, dentists’, and practices’ characteristics are significantly associated with surgical enamel intervention. Methods The study used a cross-sectional design consisting of a questionnaire survey in Japan. This study queried dentists working in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan (JDPBRN), which aims to allow dentists to investigate research questions and share experiences and expertise (n=282). Participants were asked whether they would surgically intervene in a series of cases depicting occlusal caries. Each case included a photograph of an occlusal surface displaying typical characteristics of caries penetration, and written descriptions of adult and pediatric patients at high caries risk. Results In a case of a carious lesion within inner enamel, the proportion of dentists who indicated surgical intervention was significantly higher in the adult patient (48%) when compared to the pediatric patient (34%) (p< 0.01). Logistic regression analysis showed that using a dental explorer for the diagnosis of primary occlusal caries, type of practice, practice busyness, and percentage of patients who self-pay were significantly associated with dentists’ decisions to intervene surgically into the inner enamel carious lesion. Conclusions These findings demonstrate that over one-third of participants chose to intervene surgically into inner enamel carious lesions, and patients’ age affects dentists’ decisions about when to intervene surgically (clinicaltrials.gov registration number NCT01680848). PMID:24809540

Enhancing Effects Of Nd:YAG Laser On Remineralization Of Incipient Dental Caries

NASA Astrophysics Data System (ADS)

Morioka, Toshio; Tagomori, Shoko

1989-09-01

Artificial caries lesions were made on the buccal surface of human premolars, and the enamel was then treated with laser and fluoride. The acid resistance of the enamel was examined by demineralization in acidic solution. An increase in acid resistance and fluoride uptake was caused by fluoride treatment after laser irradiation. In addition, remarkable remineralization of artificial caries lesions was seen in these specimens after exposure to calcifying fluid.

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

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.

Influence of first-time mothers' early employment on severe early childhood caries in their child.

PubMed

Plutzer, Kamila; Keirse, Marc J N C

2012-01-01

Aim. To examine whether mothers' early employment status is related to the development of severe early childhood caries in their child. Methods. Questionnaire survey of 429 first-time mothers in metropolitan Adelaide, South Australia, and dental examinations of their child at 20 months of age. Results. At 20 ± 2.5 months of age, 5.6% of children exhibited caries defined as one or more demineralized or cavitated lesions on the upper incisors. Of the mothers, 52.2% had no paid employment, 39.6% were part-time and 8.2% full-time employed. Overall, mothers' participation in the workforce had no influence on the frequency of severe early childhood caries in their child, but there was a significant interaction with family structure. For mothers without employment there was no difference between single, and two-parent families, but children with an employed single mother more frequently had caries than those with a working mother in a two-parent family (P < 0.04). However, there were no significant differences in children's reported general health. Conclusions. The data indicate a need to explore strategies that may assist single mothers and especially those in the workforce to prevent severe early childhood caries in their child.

Near-infared hyperspectral imaging of teeth for dental caries detection

NASA Astrophysics Data System (ADS)

Zakian, Christian; Pretty, Iain; Ellwood, Roger

2009-11-01

Near-infrared (NIR) is preferred for caries detection compared to visible light imaging because it exhibits low absorption by stain and deeper penetration into teeth. Hyperspectral images from 1000 to 2500 nm have been obtained for a total of 12 extracted teeth (premolars and molars) with different degrees of natural lesion. Analysis of the reflectance spectra suggests that light scattering by porous enamel and absorption by water in dentin can be used to quantify the lesion severity and generate a NIR caries score. Teeth were ground for histological examination after the measurements. The NIR caries score obtained correlates significantly (Spearman's correlation of 0.89, p<0.01) with the corresponding histological score. Results yield a sensitivity of >99% and a specificity of 87.5% for enamel lesions and a sensitivity of 80% and a specificity >99% for dentine lesions. The nature of the technique offers significant advantages, including the ability to map the lesion distribution rather than obtaining single-point measurements, it is also noninvasive, noncontact, and stain insensitive. These results suggest that NIR spectral imaging is a potential clinical technique for quantitative caries diagnosis and can determine the presence of occlusal enamel and dentin lesions.

Near-infrared hyperspectral imaging of teeth for dental caries detection.

PubMed

Zakian, Christian; Pretty, Iain; Ellwood, Roger

2009-01-01

Near-infrared (NIR) is preferred for caries detection compared to visible light imaging because it exhibits low absorption by stain and deeper penetration into teeth. Hyperspectral images from 1000 to 2500 nm have been obtained for a total of 12 extracted teeth (premolars and molars) with different degrees of natural lesion. Analysis of the reflectance spectra suggests that light scattering by porous enamel and absorption by water in dentin can be used to quantify the lesion severity and generate a NIR caries score. Teeth were ground for histological examination after the measurements. The NIR caries score obtained correlates significantly (Spearman's correlation of 0.89, p<0.01) with the corresponding histological score. Results yield a sensitivity of >99% and a specificity of 87.5% for enamel lesions and a sensitivity of 80% and a specificity >99% for dentine lesions. The nature of the technique offers significant advantages, including the ability to map the lesion distribution rather than obtaining single-point measurements, it is also noninvasive, noncontact, and stain insensitive. These results suggest that NIR spectral imaging is a potential clinical technique for quantitative caries diagnosis and can determine the presence of occlusal enamel and dentin lesions.

Novel calcium phosphate nanocomposite with caries-inhibition in a human in situ model

PubMed Central

Melo, Mary Anne S.; Weir, Michael D.; Rodrigues, Lidiany K.A.; Xu, Hockin H.K.

2013-01-01

Objectives Secondary caries at the restoration margins remains the main reason for failure. Although calcium phosphate (CaP) composites are promising for caries inhibition, there has been no report of CaP composite to inhibit caries in situ. The objectives of this study were to investigate the caries-inhibition effect of nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP) in a human in situ model for the first time, and to determine colony-forming units (CFU) and Ca and P ion concentrations of biofilms on the composite restorations. Methods NACP with a mean particle size of 116 nm were synthesized via a spray-drying technique. Two composites were fabricated: NACP nanocomposite, and control composite filled with glass particles. Twenty-five volunteers wore palatal devices containing bovine enamel slabs with cavities restored with NACP or control composite. After 14 days, the adherent biofilms were collected for analyses. Transverse microradiography determined the enamel mineral profiles at the margins, and the enamel mineral loss ! Z was measured. Results NACP nanocomposite released Ca and P ions and the release significantly increased at cariogenic low pH (p < 0.05). Biofilms on NACP nanocomposite contained higher Ca (p = 0.007) and P ions (p = 0.005) than those of control (n = 25). There was no significant difference in biofilm CFU between the two composites (p > 0.1). Microradiographs showed typical subsurface lesions in enamel next to control composite, but much less lesion around NACP nanocomposite. Enamel mineral loss ! Z (mean ± sd; n = 25) around NACP nanocomposite was 13.8 ± 9.3 μm, much less than 33.5 ± 19.0 μm of the control (p = 0.001). Significance Novel NACP nanocomposite substantially reduced caries formation in a human in situ model for the first time. Enamel mineral loss at the margins around NACP nanocomposite was less than half of the mineral loss around control composite. Therefore, the Ca and P ion-releasing NACP

A Microbeam Small-Angle X-ray Scattering Study on Enamel Crystallites in Subsurface Lesion

NASA Astrophysics Data System (ADS)

Yagi, N.; Ohta, N.; Matsuo, T.; Tanaka, T.; Terada, Y.; Kamasaka, H.; Kometani, T.

2010-10-01

The early caries lesion in bovine tooth enamel was studied by two different X-ray diffraction systems at the SPring-8 third generation synchrotron radiation facility. Both allowed us simultaneous measurement of the small and large angle regions. The beam size was 6μm at BL40XU and 50μm at BL45XU. The small-angle scattering from voids in the hydroxyapatite crystallites and the wide-angle diffraction from the hydroxyapatite crystals were observed simultaneously. At BL40XU an X-ray image intensifier was used for the small-angle and a CMOS flatpanel detector for the large-angle region. At BL45XU, a large-area CCD detector was used to cover both regions. A linear microbeam scan at BL40XU showed a detailed distribution of voids and crystals and made it possible to examine the structural details in the lesion. The two-dimensional scan at BL45XU showed distribution of voids and crystals in a wider region in the enamel. The simultaneous small- and wide-angle measurement with a microbeam is a powerful tool to elucidate the mechanisms of demineralization and remineralization in the early caries lesion.

Antimicrobial peptides in saliva of children with severe early childhood caries.

PubMed

Colombo, Natália H; Ribas, Laís F F; Pereira, Jesse A; Kreling, Paula F; Kressirer, Christine A; Tanner, Anne C R; Duque, Cristiane

2016-09-01

Controversies exist regarding the relationship between the concentrations of antimicrobial peptides (AMPs) and presence of dental caries in children. Thus, the aim of this study was to examine levels of AMPs in saliva of caries-free (CF), early childhood caries (ECC) and severe early childhood caries (S-ECC) children to determine if the levels of these salivary peptides individually or in combinations were related to caries severity and mutans streptococci levels. 36 to 60 month-old children were selected to participate in this study. Children were grouped into CF group (n=29), ECC group (n=25) and S-ECC group (n=29). Saliva was collected from children for microbiological analysis by culture. Salivary concentrations of cathelicidin LL-37, human β-defensin 2 (hBD-2), human β-defensin 3 (hBD-3) and histatin-5 (HTN-5) were determined by ELISA. Salivary concentrations of AMPs did not differ among CF, ECC and S-ECC groups. Data showed positive correlations between mutans streptococci levels and salivary hBD-2 or HTN-5. Positive correlations were found between hBD-2, hBD-3, LL-37 and HTN-5. Combinations among AMPs, mainly LL-37, were positively associated with caries levels. Salivary concentrations of AMPs individually were not associated with the severity of early childhood caries. The stimulus of caries appears to trigger a biological response, however, with a combination of these peptides. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Dental Caries Experience in Texan Children with Cleft Lip and Palate.

PubMed

Sunderji, Sabrina; Acharya, Bhavini; Flaitz, Catherine; Chiquet, Brett

2017-09-15

The purpose of this study was to assess the caries experience in the primary dentition of children born with cleft lip and palate (CLP). A retrospective chart review was conducted on subjects between two and six years old recruited from a university-based pediatric dentistry residency clinic. The number of dental visits and professional fluoride applications, the plaque index and treatment modality, and the presence/location of caries, white spot lesions, and enamel hypoplastic lesions were compared between CLP patients and healthy age- and gender-matched controls. Descriptive statistics, Student's t test, Mann-Whitney U test, and regression analysis were completed. A total of 183 charts were reviewed. Compared to healthy children, CLP children had increases in number of dental visits (P<0.001), decayed-missing-filled surfaces (dmfs; P<0.001), decayed-missing-filled teeth (dmft; P<0.001), enamel hypoplastic lesions (P=0.003), treatment completed under general anesthesia (P<0.001), plaque score (P<0.001), and caries increment between baseline and most recent oral examination (P=0.003). Regression analysis revealed a positive association between age and dmft scores within the CLP group (P=0.018). The caries experience of unilateral and bilateral CLP cases was the same (P>0.05). Children with cleft lip and palate are at a greater risk of enamel hypoplasia and dental caries. No significant caries experience difference was found between unilateral or bilateral CLP cases.

Spectrally enhanced image resolution of tooth enamel surfaces

NASA Astrophysics Data System (ADS)

Zhang, Liang; Nelson, Leonard Y.; Berg, Joel H.; Seibel, Eric J.

2012-01-01

Short-wavelength 405 nm laser illumination of surface dental enamel using an ultrathin scanning fiber endoscope (SFE) produced enhanced detail of dental topography. The surfaces of human extracted teeth and artificial erosions were imaged with 405 nm, 444 nm, 532 nm, or 635 nm illumination lasers. The obtained images were then processed offline to compensate for any differences in the illumination beam diameters between the different lasers. Scattering and absorption coefficients for a Monte Carlo model of light propagation in dental enamel for 405 nm were scaled from published data at 532 nm and 633 nm. The value of the scattering coefficient used in the model was scaled from the coefficients at 532 nm and 633 nm by the inverse third power of wavelength. Simulations showed that the penetration depth of short-wavelength illumination is localized close to the enamel surface, while long-wavelength illumination travels much further and is backscattered from greater depths. Therefore, images obtained using short wavelength laser are not contaminated by the superposition of light reflected from enamel tissue at greater depths. Hence, the SFE with short-wavelength illumination may make it possible to visualize surface manifestations of phenomena such as demineralization, thus better aiding the clinician in the detection of early caries.

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.

A simple dental caries detection system using full spectrum of laser-induced fluorescence

NASA Astrophysics Data System (ADS)

Rocha-Cabral, Renata Maciel; Mendes, Fausto Medeiros; Maldonado, Edison Puig; Zezell, Denise Maria

2015-06-01

Objectives: to develop an apparatus for the detection of early caries lesions in enamel using the full extent of the tooth fluorescence spectrum, through the integration of a laser diode, fiber optics, filters and one portable spectrometer connected to a computer, all commercially available; to evaluate the developed device in clinical and laboratory tests, and compare its performance with commercial equipment. Methods: clinical examinations were performed in patients with indication for exodontics of premolars. After examinations, the patients underwent surgery and the teeth were stored individually. The optical measurements were repeated approximately two months after extraction, on the same sites previously examined, then histological analysis was carried out. Results: the spectral detector has presented high specificity and moderate sensitivity when applied to differentiate between healthy and damaged tissues, with no significant differences from the performance of the commercial equipment. The developed device is able to detect initial damages in enamel, with depth of approximately 300 μm. Conclusions: we successfully demonstrated the development of a simple and portable system based in laser-induced fluorescence for caries detection, assembled from common commercial parts. As the spectral detector acquires a complete recording of the spectrum from each tissue, it is possible to use it for monitoring developments of caries lesions.

Study of the nanoporous CHAP photoluminiscence for developing the precise methods of early caries detection

NASA Astrophysics Data System (ADS)

Goloshchapov, D.; Seredin, P.; Minakov, D.; Domashevskaya, E.

2018-02-01

This paper deals with the luminescence characteristics of an analogue of the mineral component of dental enamel of the nanocrystalline B-type carbonate-substituted hydroxyapatite (CHAP) with 3D defects (i.e. nanopores of ∼2-5 nm) on the nanocrystalline surface. The laser-induced luminescence of the synthesized CHAP samples was in the range of ∼515 nm (∼2.4 eV) and is due to CO3 groups replacing the PO4 group. It was found that the intensity of the luminescence of the CHAP is caused by structurally incorporated CO3 groups in the HAP structure. Furthermore, the intensity of the luminescence also decreases as the number of the above intracentre defects (CO3) in the apatite structure declines. These results are potentially promising for developing the foundations for precise methods for the early detection of caries in human solid dental tissue.

Preventing dental caries in children <5 years: systematic review updating USPSTF recommendation.

PubMed

Chou, Roger; Cantor, Amy; Zakher, Bernadette; Mitchell, Jennifer Priest; Pappas, Miranda

2013-08-01

Screening and preventive interventions by primary care providers could improve outcomes related to early childhood caries. The objective of this study was to update the 2004 US Preventive Services Task Force systematic review on prevention of caries in children younger than 5 years of age. Searching Medline and the Cochrane Library (through March 2013) and reference lists, we included trials and controlled observational studies on the effectiveness and harms of screening and treatments. One author extracted study characteristics and results, which were checked for accuracy by a second author. Two authors independently assessed study quality. No study evaluated effects of screening by primary care providers on clinical outcomes. One good-quality cohort study found pediatrician examination associated with a sensitivity of 0.76 for identifying a child with cavities. No new trials evaluated oral fluoride supplementation. Three new randomized trials were consistent with previous studies in finding fluoride varnish more effective than no varnish (reduction in caries increment 18% to 59%). Three trials of xylitol were inconclusive regarding effects on caries. New observational studies were consistent with previous evidence showing an association between early childhood fluoride use and enamel fluorosis. Evidence on the accuracy of risk prediction instruments in primary care settings is not available. There is no direct evidence that screening by primary care clinicians reduces early childhood caries. Evidence previously reviewed by the US Preventive Services Task Force found oral fluoride supplementation effective at reducing caries incidence, and new evidence supports the effectiveness of fluoride varnish in higher-risk children.

Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue

PubMed Central

Karlsson, Lena

2010-01-01

A conservative, noninvasive or minimally invasive approach to clinical management of dental caries requires diagnostic techniques capable of detecting and quantifying lesions at an early stage, when progression can be arrested or reversed. Objective evidence of initiation of the disease can be detected in the form of distinct changes in the optical properties of the affected tooth structure. Caries detection methods based on changes in a specific optical property are collectively referred to as optically based methods. This paper presents a simple overview of the feasibility of three such technologies for quantitative or semiquantitative assessment of caries lesions. Two of the techniques are well-established: quantitative light-induced fluorescence, which is used primarily in caries research, and laser-induced fluorescence, a commercially available method used in clinical dental practice. The third technique, based on near-infrared transillumination of dental enamel is in the developmental stages. PMID:20454579

Intake of sweet drinks and sweet treats versus reported and observed caries experience.

PubMed

Lee, J G; Messer, L B

2010-02-01

This was to study the intakes of sweet drinks and sweet treats of children and their caries risk using the Paediatric Risk Assessment Tool (PRAT, 2003) and Caries-risk Assessment Tool (CAT, 2007-8). Parents of 266 healthy primary school children completed the PRAT questionnaire during their child's dental appointment at the Royal Dental Hospital of Melbourne, Australia, describing their fluid and sweet treat intakes in the past 24 hours, oral hygiene practices and past caries. A subgroup (n=100) was examined clinically (CAT) for caries requiring restoration, visible plaque, gingivitis, orthodontic appliances, enamel defects, and use of dental care. The estimated mean daily fluid intake was 1.5+/-0.5L; fluids were consumed 3-5/ day by 57% of children and 78% usually had evening/night drinks. Fluids consumed were: tap water by 90%, milk by 74%, juice by 50%, regular soft drink by 30%; sweet treats were consumed by 62% and confectionery by 25%. Most children (69%) brushed their teeth > or =2/day; 5% flossed daily. Parentally-reported caries was associated significantly with increasing treats frequency (p=0.006). In the subgroup, 81% were at high caries risk; 47% had irregular dental care; 21% had sweet drinks/foods frequently between meals; 49% had visible plaque/gingivitis, and 34% had enamel demineralisation. Caries observed in the past 12 months was associated significantly with evening sweet drinks (p=0.004), and suboptimal fluoride exposure (p=0.009). Caries observed in the past 24 months was associated significantly with treats frequency (p=0.006), intake of sweet drinks plus treats (p=0.000), enamel demineralisation (p=0.000) and irregular dental care (p=0.000). The PRAT and CAT are valuable tools in assessing children's caries risk. The risk of caries from frequent intake of sweet drinks, either alone or in addition to sweet treats, must be emphasised to parents. All parents, and particularly those of children assessed at high risk from intakes of sweet drinks

Breastfeeding, Dental Biofilm Acidogenicity, and Early Childhood Caries.

PubMed

Neves, Pierre A M; Ribeiro, Cecília Claudia Costa; Tenuta, Livia Maria Andaló; Leitão, Tarcísio J; Monteiro-Neto, Valério; Nunes, Ana Margarida M; Cury, Jaime Aparecido

2016-01-01

This study evaluated the acidogenicity of human milk by the dental biofilms of children with and without early childhood caries (ECC). Biofilms of 16 children (7 with ECC; 9 caries free) were exposed to human milk or 10% sucrose solution in the crossover design, and the biofilm pH was determined. Breastfeeding did not provoke a decrease in biofilm pH, irrespective of the children's caries status, whereas sucrose decreased the pH for both groups. In addition, higher x0394;pH5min (pH variation occurring at 5 min) was observed in the biofilms of ECC children (p < 0.05). The results suggest that breastfeeding may not contribute to ECC. © 2016 S. Karger AG, Basel.

Detection and Proportion of Very Early Dental Caries in Independent Living Older Adults

PubMed Central

Holtzman, Jennifer S.; Kohanchi, Daniel; Biren-Fetz, John; Fontana, Margherita; Ramchandani, Manisha; Osann, Kathryn; Hallajian, Lucy; Mansour, Stephanie; Nabelsi, Tasneem; Chung, Na Eun; Wilder-Smith, Petra

2015-01-01

Background and Objectives Dental caries is an important healthcare challenge in adults over 65 years of age. Integration of oral health screening into non-dental primary care practice may improve access to preventive dental care for vulnerable populations such as the elderly. Such integration would require easy, fast, and accurate early caries detection tools. Primary goal of this study was to evaluate the diagnostic performance of optical coherence tomography (OCT) imaging for detecting very early caries in the elderly living in community-based settings. The International Caries Detection and Assessment System (ICDAS) served as gold standard. Secondary goal of this study was to provide baseline prevalence data of very early caries lesions in independent living adults aged 65+ years. Materials and Methods Seventy-two subjects were recruited from three sites in Southern California: a retirement community, a senior health fair, and a convalescent hospital. Clinical examination was performed using the ICDAS visual criteria and this was followed by OCT imaging. The two-dimensional OCT images (B-scan) were analyzed with simple software. Locations with a log of back-scattered light intensity (BSLI) below 2.9 were scored as sound, and areas equaling or exceeding 2.9 BSLI were considered carious. Diagnostic performance of OCT imaging was compared with ICDAS score. Results OCT-based diagnosis demonstrated very good sensitivity (95.1%) and good specificity (85.8%). 54.7% of dentate subjects had at least one tooth with very early coronal caries. Conclusions Early coronal decay is prevalent in the unrestored pits and fissures of coronal surfaces of teeth in independent living adults aged 65+ years. Though OCT imaging coupled with a simple diagnostic algorithm can accurately detect areas of very early caries in community-based settings, existing devices are expensive and not well-suited for use by non-dental health care providers. Simple, inexpensive, fast, and accurate tools

Fluoride toothpaste containing 1.5% arginine and insoluble calcium as a new standard of care in caries prevention.

PubMed

ten Cate, J M; Cummins, D

2013-01-01

In spite of obvious achievements in prevention, caries remains a prevalent disease. Fluorides are effective by inhibiting enamel and dentin demineralization and enhancing remineralization, but have little or no influence on bacterial processes in dental plaque. Dental caries is a continuum of stages from reversible, early lesions to irreversible, pre-cavitated lesions and, ultimately, to cavities. Prevention should focus on strengthening protective and reducing pathological factors, and careful monitoring of the disease state. While fluoride and the mineral aspects of caries have been in focus for decades, new insights into the etiology of caries have generated novel concepts and approaches to its prevention and treatment. The observation that some plaque bacteria can produce alkali metabolites and, thus, raise pH or neutralize acid formed in plaque has long been known. Such pH rise factors are related to caries susceptibility. Nourishing the plaque with substrates that encourage alkali-producing reactions is a protective factor in the caries continuum. This article reviews the results of clinical studies with a novel toothpaste containing 1.5% arginine, an insoluble calcium compound, and fluoride which have demonstrated superior remineralization of white spot enamel lesions and rehardening of root surface lesions, favorable effects on the de-/remineralization balance, as well as superior cavity prevention efficacy compared to toothpaste with fluoride alone. Studies have also confirmed formation of ammonia and elevated pH levels in subjects using the arginine-containing toothpaste. This novel toothpaste effectively combines the established effects of fluoride on de- and remineralization with reduction of caries-inducing pathological factors resulting from plaque metabolism.

Vibrational monitor of early demineralization in tooth enamel after in vitro exposure to phosphoridic liquid

NASA Astrophysics Data System (ADS)

Pezzotti, Giuseppe; Adachi, Tetsuya; Gasparutti, Isabella; Vincini, Giulio; Zhu, Wenliang; Boffelli, Marco; Rondinella, Alfredo; Marin, Elia; Ichioka, Hiroaki; Yamamoto, Toshiro; Marunaka, Yoshinori; Kanamura, Narisato

2017-02-01

The Raman spectroscopic method has been applied to quantitatively assess the in vitro degree of demineralization in healthy human teeth. Based on previous evaluations of Raman selection rules (empowered by an orientation distribution function (ODF) statistical algorithm) and on a newly proposed analysis of phonon density of states (PDOS) for selected vibrational modes of the hexagonal structure of hydroxyapatite, a molecular-scale evaluation of the demineralization process upon in vitro exposure to a highly acidic beverage (i.e., CocaCola™ Classic, pH = 2.5) could be obtained. The Raman method proved quite sensitive and spectroscopic features could be directly related to an increase in off-stoichiometry of the enamel surface structure since the very early stage of the demineralization process (i.e., when yet invisible to other conventional analytical techniques). The proposed Raman spectroscopic algorithm might possess some generality for caries risk assessment, allowing a prompt non-contact diagnostic practice in dentistry.

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

Calcium Prerinse before Fluoride Rinse Reduces Enamel Demineralization: An in situ Caries Study.

PubMed

Souza, João Gabriel S; Tenuta, Livia Maria Andaló; Del Bel Cury, Altair Antoninha; Nóbrega, Diego Figueiredo; Budin, Renan R; de Queiroz, Mateus X; Vogel, Gerald L; Cury, Jaime A

2016-01-01

A calcium (Ca) prerinse before a fluoride (F) rinse has been shown to increase oral F levels. We tested the anticaries effect of this combination in a dose-response in situ caries model. In a double-blind, crossover experiment, 10 volunteers carried enamel slabs in palatal appliances for 14 days, during which they rinsed twice/day with one of four rinse combinations: (1) a placebo prerinse (150 mM sodium lactate) followed by a distilled water rinse (negative control); (2) a placebo prerinse followed by a 250 ppm F rinse; (3) a placebo prerinse followed by a 1,000 ppm F rinse, or (4) a Ca prerinse (150 mM Ca, as calcium lactate) followed by a 250 ppm F rinse. Sucrose solution was dripped onto the slabs 8×/day to simulate a high cariogenic challenge. The percent surface hardness loss (%SHL) was significantly lower in the Ca prerinse used with the 250 ppm F rinse group (%SHL = 38.0 ± 21.0) when compared with the F rinse alone (%SHL = 59.5 ± 24.1) and similar to the 1,000 ppm F rinse group (%SHL = 42.0 ± 18.3). Compared with the 250 ppm F rinse, the Ca prerinse increased biofilm fluid F only twice (nonsignificant). However, it greatly increased F in biofilm solids (∼22×). The Ca prerinse had little effect on loosely or firmly bound enamel F. The results showed an increased level of protection against demineralization by the use of a Ca prerinse, which seems to be caused by the enhancement of F concentration in the biofilm. © 2016 S. Karger AG, Basel.

Optical Assessment of Caries Lesion Structure and Activity

NASA Astrophysics Data System (ADS)

Lee, Robert Chulsung

New, more sophisticated diagnostic tools are needed for the detection and characterization of caries lesions in the early stages of development. It is not sufficient to simply detect caries lesions, methods are needed to assess the activity of the lesion and determine if chemical or surgical intervention is needed. Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface lesion structure and measure the thickness of the highly mineralized surface zone. Other studies have demonstrated that the rate of dehydration can be correlated with the lesion activity and that the rate can be measured using optical methods. The main objective of this work was to test the hypothesis that optical methods can be used to assess lesion activity on tooth coronal and root surfaces. Simulated caries models were used to develop and validate an algorithm for detecting and measuring the highly mineralized surface layer using PS-OCT. This work confirmed that the algorithm was capable of estimating the thickness of the highly mineralized surface layer with high accuracy. Near-infrared (NIR) reflectance and thermal imaging methods were used to assess activity of caries lesions by measuring the state of lesion hydration. NIR reflectance imaging performed the best for artificial enamel and natural coronal caries lesion samples, particularly at wavelengths coincident with the water absorption band at 1460-nm. However, thermal imaging performed the best for artificial dentin and natural root caries lesion samples. These novel optical methods outperformed the conventional methods (ICDAS II) in accurately assessing lesion activity of natural coronal and root caries lesions. Infrared-based imaging methods have shown potential for in-vivo applications to objectively assess caries lesion activity in a single examination. It is likely that if future clinical trials are a success, this novel imaging

Early Childhood Dental Caries, Mouth Pain, and Malnutrition in the Ecuadorian Amazon Region

PubMed Central

So, Marvin; Ellenikiotis, Yianni A.; Husby, Hannah M.; Paz, Cecilia Leonor; Seymour, Brittany; Sokal-Gutierrez, Karen

2017-01-01

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1407 children from birth through age 6 in the “Alli Kiru” program (2011–2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth (dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for being underweight (Adjusted Odds Ratio (AOR): 1.27; 95% CI: 1.02–1.54) and decreased odds for being overweight (AOR: 0.76; 95% CI: 0.58–0.97). This relationship was most pronounced among 3–6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions. PMID:28531148

Early Childhood Dental Caries, Mouth Pain, and Malnutrition in the Ecuadorian Amazon Region.

PubMed

So, Marvin; Ellenikiotis, Yianni A; Husby, Hannah M; Paz, Cecilia Leonor; Seymour, Brittany; Sokal-Gutierrez, Karen

2017-05-22

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1407 children from birth through age 6 in the "Alli Kiru" program (2011-2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth (dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for being underweight (Adjusted Odds Ratio (AOR): 1.27; 95% CI: 1.02-1.54) and decreased odds for being overweight (AOR: 0.76; 95% CI: 0.58-0.97). This relationship was most pronounced among 3-6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children's risk for severe early childhood caries and malnutrition, which has implications for community health interventions.

Low-levels of fluoride in plaque and saliva and their effects on the demineralisation and remineralisation of enamel; role of fluoride toothpastes.

PubMed

Lynch, R J M; Navada, R; Walia, R

2004-01-01

To summarise support for current consensus on the likely means by which fluoride toothpastes reduce caries and review some relevant studies of the effect of low levels of fluoride on the demineralisation and remineralisation of enamel. The major anti-caries effect of fluoride toothpastes is thought to result from small but protracted elevations in levels of fluoride in plaque and saliva. Fluoride incorporated into enamel systemically does not reduce enamel solubility sufficiently to exert an anti-caries effect. Fluoride has the potential to exert an anti-caries benefit largely through three mechanisms; inhibition of demineralisation, promotion of remineralisation and interference with bacterial growth and metabolism. However, the low levels of fluoride thought to influence caries are insufficient to have a significant effect via the latter mechanism. Thus reductions in caries resulting from the use of fluoride toothpastes can be linked to modification of the demineralisation/remineralisation balance by direct effects on dental mineral exerted topically by low levels of fluoride. Numerous in vitro studies have shown that low levels of fluoride, typical of those found after many hours in resting plaque and saliva, and resulting from the regular use of fluoride toothpastes, can have a profound effect on enamel demineralisation and remineralisation.

Comparing two quantitative methods for studying remineralization of artificial caries.

PubMed

Lo, E C M; Zhi, Q H; Itthagarun, A

2010-04-01

To compare the detection of changes before and after remineralization of artificial enamel and dentin caries by microCT scanning, polarized light microscopy (PLM) and transverse microradiography (TMR). Fourteen extracted premolars were cut into tooth blocks and painted with an acid-resistant varnish leaving one enamel and one dentin surface exposed. The tooth blocks were immersed into demineralizing solution for 4 days to produce artificial caries-like lesions and scanned by microCT. Then the 14 tooth blocks were randomly allocated into two groups. Seven tooth blocks in Group I were cut longitudinally through the exposed surface into 100-150 microm thick sections and microradiographs were taken. The other seven tooth blocks in Group II were left intact. All the tooth blocks and sections were then immersed into remineralizing solution for 5 days. PLM and TMR of the tooth sections in Group I were taken again. Depth of the lesion on the TMR was measured. Tooth blocks in Group II were scanned by microCT. Mean lesion depth in Group I reduced by 13.0% and 8.2% after remineralization for enamel and dentin, respectively (paired t-test, P<0.001). In Group II, linear attenuation coefficient (LAC) of the region of interest (ROI) increased by 11.1% and 23.8% after remineralization for enamel and dentin lesions, respectively (paired t-test, P<0.001). Both microCT and microradiography are able to detect a change of similar magnitude in the artificial caries lesions after remineralization. MicroCT may be used to substitute TMR and PLM in in vitro studies about caries. Copyright 2010 Elsevier Ltd. All rights reserved.

Real-time porphyrin detection in plaque and caries: a case study

NASA Astrophysics Data System (ADS)

Timoshchuk, Mari-Alina I.; Ridge, Jeremy S.; Rugg, Amanda L.; Nelson, Leonard Y.; Kim, Amy S.; Seibel, Eric J.

2015-02-01

An ultrathin scanning fiber endoscope, originally developed for cancer diagnosis, was used in a case study to locate plaque and caries. The imaging system incorporated software mitigation of background auto-fluorescence (AF). In conventional fluorescence imaging, varying AF across a tooth surface can mask low-level porphyrin signals. Laser-induced auto-fluorescence signals of dental tissue excited using a 405-nm laser typically produce fluorescence over a wavelength range extending from 440-nm to 750-nm. Anaerobic bacterial metabolism produces various porphyrin species (eg. protoporphyrin IX) that are located in carious enamel, dentin, gingivitis sites, and plaque. In our case study, these porphyrin deposits remained as long as one day after prophylaxis. Imaging the tooth surface using 405-nm excitation and subtracting the natural AF enhances the image contrast of low-level porphyrin deposits, which would otherwise be masked by the high background AF. In a case study, healthy tissues as well as sites of early and advanced caries formations were scanned for visual and quantitative signs of red fluorescence associated with porphyrin species using a background mitigation algorithm. Initial findings show increasing amplitudes of red fluorescence as caries severity increases from early to late stages. Sites of plaque accumulation also displayed red fluorescence similar to that found in carious dental tissue. The use of real-time background mitigation of natural dental AF can enhance the detection of low porphyrin concentrations that are indicators of early stage caries formation.

Detection of cavitated or non-cavitated approximal enamel caries lesions using CMOS and CCD digital X-ray sensors and conventional D and F-speed films at different exposure conditions.

PubMed

Bottenberg, Peter; Jacquet, Wolfgang; Stachniss, Vitus; Wellnitz, Johann; Schulte, Andreas G

2011-04-01

To determine the ability of digital sensors (CMOS and CCD sensors) and D and F-speed films to detect cavitated and non-cavitated enamel caries lesions at different exposure conditions compared to a gold standard. 100 extracted human molars and premolars were selected and mounted in a block between two neighboring teeth. Sensors or films were exposed with voltages of 60 or 70 kVp at varying times. Three observers assessed each approximal site independently. Lesion depth was rated according to an anatomical five-point scale (0 = no lesion to 4 = lesion reaching inner half of dentin). Serial sections of resin-embedded teeth were prepared. Gold-standard scores were established by consensus based on histological sectioning. A carious lesion was present at scores of 1 and higher. Statistical evaluation (sensitivity, specificity and receiver-operating curves) was based on caries-free surfaces and those presenting enamel caries (n=116). The ROC curves had "area under the curve" values (Az) from 0.50 (F-speed, 70 kVp, 0.20 seconds) to 0.58 (CCD 60 kVp, 0.08 seconds). The detection percentage of cavitated lesions was generally higher (0-52%, depending on technique and observer) than that of non-cavitated lesions (3-32%). The CMOS sensor showed Az values comparable to the CCD sensors but required higher exposure times. There was no significant difference between 60 and 70 kVp.

[Differential diagnosis of dental enamel focal demineralization and fluorosis by means of spectrophotometry].

PubMed

Makarova, N E; Vinnichenko, Yu A

2018-01-01

The article presents the results of spectrophotometric tooth enamel scanning for differential diagnosis of focal enamel demineralization and fluorosis. Research was conducted in vivo on teeth affected by these diseases. VITA EasyShade spectrophotometer measurements were made on the affected area and on the visually healthy part of enamel. The lightness appeared as the only one differential significant optical characteristics of tooth enamel. Lightness metrics were higher in the case of initial caries than on the healthy part of enamel when these metrics were lower in the case of fluorosis than on the healthy part of enamel.

A Study of the Potential to Detect Caries Lesions at the White-Spot Stage Using V(Z) Technique

NASA Astrophysics Data System (ADS)

Bakulin, E. Y.; Denisova, L. A.; Maev, R. Gr.

Current wide-spread methods of non-destructive methods of caries diagnostics, such as X-ray techniques, do not provide the possibility to efficiently detect enamel caries lesions at the beginning ("white-spot") stage, when the tooth tissue is only slightly altered and no loss of the tissue occurs. Therefore, it is of paramount importance to develop new, more sensitive methods of caries diagnostics. In this paper, certain aspects of the ultrasonic approach to the problem are discussed - in particular, detection of the enamel's surface caries at the white-spot stage with a focused ultrasonic sensor positioned in front of the caries lesion (without cross-sectioning the tooth). Theoretical model using V(z) approach for layered media was applied to perform computer simulations resulting in V(z) curves for the different parameters of carious tissue and the degree of degradation. The curves were analyzed and it was shown that, comparing to a short-pulse/echo technique, V(z) approach provides much better distinction between sound and carious enamel and even makes possible to evaluate the degree of demineralization.

A cluster randomised trial of effectiveness of educational intervention in primary health care on early childhood caries.

PubMed

Mohebbi, S Z; Virtanen, J I; Vahid-Golpayegani, M; Vehkalahti, M M

2009-01-01

Early childhood caries (ECC) remains a serious problem in several developing and developed countries. This cluster randomised trial evaluated the impact of a 6-month educational intervention on ECC. The trial targeted 12- to 15-month-old children (n = 242) and their mothers in Tehran, Iran, visiting 18 public health centres, randomly selected and assigned to two intervention groups and one control group. At baseline, each mother was interviewed and each child underwent a dental examination of all teeth for the number of decayed teeth (dt) and of upper central incisors for the number of teeth with enamel caries (de). All mothers in the two intervention groups (A and B) received oral health instructions from the vaccination staff. In addition, group A received extra reminders. The outcome was defined as increments in the number of teeth with dt or de, as percentages of children developing new dt or de, and as the number needed to treat (NNT). No new de appeared in group A, the mean de increment in group B was 0.2 (SD = 0.6), and in the controls, it was 0.4 (SD = 0.7) (p < 0.05). The percentages of children developing new de were 0, 14, and 26%, respectively. No differences in dt increments were found. Regarding de, NNT for group A was 4 and for B 9; the figures for dt were 13 and 17, respectively. In conclusion, oral health education given to mothers by general health staff is a valuable tool to prevent caries in infants and toddlers. 2009 S. Karger AG, Basel.

[Dental caries and early childhood development: a pilot study].

PubMed

Núñez, F Loreto; Sanz, B Javier; Mejía, L Gloria

2015-01-01

To investigate the association between dental caries and early childhood development in 3-year-olds from Talca, Chile. A pilot study with a convenience sample of 3-year-olds from Talca (n = 39) who attend public healthcare centers. Child development was measured by the Psychomotor Development Index (PDI), a screening tool used nationally among pre-school children to assess language development, fine motor skills and coordination areas. Dental caries prevalence was evaluated by decayed, missing, filled teeth (DFMT) and decayed, missing, filled tooth surfaces (DFMS) ceo-d and ceo-s indexes. The children were divided into two groups according to the PDIscore: those with a score of 40 or more were considered developmentally normal (n = 32), and those with a score below 40 were considered as having impaired development (n = 7). The severity of caries (DMFT) was negatively correlated with PDI (r = -0.82), and children with the lowest TEPSI score had the highest DFMT values. The average DMFT in children with normal development was 1.31, and 3.57 for those with impaired development. This pilot study indicates that the severity of dental caries is correlated with early childhood development. Copyright © 2015. Publicado por Elsevier España, S.L.U.

Dental caries: a dynamic disease process.

PubMed

Featherstone, J D B

2008-09-01

Abstract Dental caries is a transmissible bacterial disease process caused by acids from bacterial metabolism diffusing into enamel and dentine and dissolving the mineral. The bacteria responsible produce organic acids as a by-product of their metabolism of fermentable carbohydrates. The caries process is a continuum resulting from many cycles of demineralization and remineralization. Demineralization begins at the atomic level at the crystal surface inside the enamel or dentine and can continue unless halted with the end-point being cavitation. There are many possibilities to intervene in this continuing process to arrest or reverse the progress of the lesion. Remineralization is the natural repair process for non-cavitated lesions, and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. These remineralized crystals are acid resistant, being much less soluble than the original mineral.

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

Comparative evaluation and correlation of salivary total antioxidant capacity and salivary pH in caries-free and severe early childhood caries children.

PubMed

Muchandi, Sneha; Walimbe, Hrishikesh; Bijle, Mohammed Nadeem Ahmed; Nankar, Meenakshi; Chaturvedi, Srishti; Karekar, Priyanka

2015-03-01

Dental caries is a major problem in preschool children. The contribution of saliva in providing defense during caries process is of primary importance. pH buffer capacity through bicarbonate, phosphate and protein buffer systems have universal acceptance as a caries defense mechanism. Antioxidant capacity of saliva can constitute a first line of defense against chronic degenerative diseases including dental caries. Till date, no study is presented with salivary antioxidant capacity of younger children affected with severe early childhood caries with its salivary pH correlation. Hence, this study was carried out to compare, evaluate and correlate the salivary total antioxidant capacity (TAC) and salivary pH of children with caries-free and severe early childhood caries. Fifty children from ages 3 to 5 years divided into two study groups had undergone screening. Group I (n = 25) with severe early childhood caries (S-ECC) and group II (n = 25) who were caries free. Unstimulated whole saliva of subjects were in the collection during the study by draining method. Salivary pH determination of saliva samples was done using pH indicator paper strips. The TAC was done using an antioxidant assay with the help of a spectrophotometer at wavelength 532 nm. The means of salivary pH and TAC were subjected to analysis using unpaired student 't' test and correlation was determined using Pearsons correlation coefficient analysis. Mean salivary pH was higher in group II (7.46 ± 0.37). Mean TAC was greater in group I (1.82 ± 0.19). A statistically significant negative correlation as seen between TAC and salivary pH in S-ECC patients. The study concludes that salivary TAC increases in patients with S-ECC are by that showing a high indirect relationship with salivary pH.

The Caries Phenomenon: A Timeline from Witchcraft and Superstition to Opinions of the 1500s to Today's Science.

PubMed

Ruby, John D; Cox, Charles F; Akimoto, Naotake; Meada, Nobuko; Momoi, Yasuko

2010-01-01

This historical treatise follows the documented timeline of tooth decay into today's understanding, treatment, and teaching of caries biology. Caries has been attributed to many different causes for several millennia, however, only since the late 1900s has research revealed its complex multifactorial nature. European writers of the 1600s to 1700s held views that general health, mechanical injuries, trauma, and sudden temperature changes all caused caries-holding a common belief that decay was due to chemical agents, faulty saliva, and food particles. Until the early 1800s most writers believed that caries was due to inflammation from surrounding diseased alveolar bone. Today's science has demonstrated that caries is caused by indigenous oral microorganisms becoming a dynamic biofilm, that in the presence of fermentable sugars produce organic acids capable of dissolving inorganic enamel and dentin followed by the proteolytic destruction of collagen leaving soft infected dentin. As bacteria enter the pulp, infection follows.

Er:YAG and CTH:YAG laser radiation: contact versus non-contact enamel ablation and sonic-activated bulk composite placement

NASA Astrophysics Data System (ADS)

Buckova, M.; Kasparova, M.; Dostalova, T.; Jelinkova, H.; Sulc, J.; Nemec, M.; Fibrich, M.; Bradna, P.; Miyagi, M.

2013-05-01

Laser radiation can be used for effective caries removal and cavity preparation without significant thermal effects, collateral damage of tooth structure, or patient discomfort. The aim of this study was to compare the quality of tissue after contact or non-contact Er:YAG and CTH:YAG laser radiation ablation. The second goal was to increase the sealing ability of hard dental tissues using sonic-activated bulk filling material with change in viscosity during processing. The artificial caries was prepared in intact teeth to simulate a demineralized surface and then the Er:YAG or CTH:YAG laser radiation was applied. The enamel artificial caries was gently removed by the laser radiation and sonic-activated composite fillings were inserted. A stereomicroscope and then a scanning electron microscope were used to evaluate the enamel surface. Er:YAG contact mode ablation in enamel was quick and precise; the cavity was smooth with a keyhole shaped prism and rod relief arrangement without a smear layer. The sonic-activated filling material was consistently regularly distributed; no cracks or microleakage in the enamel were observed. CTH:YAG irradiation was able to clean but not ablate the enamel surface; in contact and also in non-contact mode there was evidence of melting and fusing of the enamel.

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.

Caries Detection around Restorations Using ICDAS and Optical Devices.

PubMed

Diniz, Michele Baffi; Eckert, George Joseph; González-Cabezas, Carlos; Cordeiro, Rita de Cássia Loiola; Ferreira-Zandona, Andrea Gonçalves

2016-01-01

Secondary caries is the major reason for replacement of restorations in operative dentistry. New detection methods and technology have the potential to improve the accuracy for diagnosis of secondary carious lesions. This in vitro study evaluated the performance of the ICDAS (International Caries Detection and Assessment System) visual criteria and optical devices for detecting secondary caries around amalgam and composite resin restorations in permanent teeth. A total of 180 extracted teeth with Class I amalgam (N = 90) and resin composite (N = 90) restorations were selected. Two examiners analyzed the teeth twice using the visual criteria (ICDAS), laser fluorescence (LF), light-emitting diode device (MID), quantitative light-induced fluorescence system (QLF), and a prototype system based on the Fluorescence Enamel Imaging technique (Professional Caries Detection System, PCDS). The gold standard was determined by means of confocal laser scanning microscopy. High-reproducibility values were shown for all methods, except for MID in the amalgam group. For both groups the QLF and PCDS were the most sensitive methods, whereas the other methods presented better specificity (p < 0.05). All methods, except the MID device appeared to be potential methods for detecting secondary caries only around resin composite restorations, whereas around amalgam restorations all methods seemed to be questionable. Using Internal Caries Detection and Assessment System (ICDAS), an LF device, quantitative light-induced fluorescence and a novel method based on Fluorescence Enamel Imaging technique may be effective for evaluating secondary caries around composite resin restorations. © 2016 Wiley Periodicals, Inc.

Dental caries risk indicators in early childhood and their association with caries polarization in adolescence: a cross-sectional study.

PubMed

Zemaitiene, Migle; Grigalauskiene, Ruta; Andruskeviciene, Vilija; Matulaitiene, Zivile Kristina; Zubiene, Jurate; Narbutaite, Julija; Slabsinskiene, Egle

2016-07-02

Based on the hypothesis that biological and social risks accumulate during life, it is important to identify possible dental caries risk indicators from the life course of early childhood and assess their association with caries polarization in adolescence. A cross-sectional design was applied to the study, and a multistage cluster sampling method used to draw a representative sample of 1063 18-year-old Lithuanian adolescents. The dental examinations were performed according to the methodology for oral status evaluation recommended by the World Health Organization. Parents of the participating adolescents completed a self-administered questionnaire about their children's life course during early childhood. The interdependence of characteristics was evaluated by chi-square (χ (2)) and Student's (t) criteria. A multivariate logistic regression model with the Significant Caries (SiC) index as an outcome was performed. The mean scores for the number of decayed, missing, and filled teeth (DMFT) and decayed teeth (DT) in the SiC positive group were higher than the corresponding values in the SiC negative group (6.14 [SD, 2.30] and 1.67 [SD, 2.02] vs 1.28 [SD, 1.11] and 0.34 [SD, 0.69], p < 0.001, respectively). Three dental caries risk indicators were identified that were independently associated with a SiC positive outcome: gender(OR = 1.32 [95 % CI: 1.01-1.73]), earlier eruption of the first primary tooth(OR = 1.43 [95 % CI: 1.03-1.97]), and past caries experience in the primary dentition (OR = 1.62 [95 % CI:1.22-2.14]). These study findings provide reliable evidence that gender, earlier eruption of the first primary tooth, and past caries experience in the primary dentition should be considered to be dental caries risk indicators and may have an adverse effect on caries polarization in adolescence.

Radiation-related caries assessment through the International Caries Detection and Assessment System and the Post-Radiation Dental Index.

PubMed

Palmier, Natalia Rangel; Ribeiro, Ana Carolina Prado; Fonsêca, Jéssica Montenegro; Salvajoli, João Victor; Vargas, Pablo Agustin; Lopes, Marcio Ajudarte; Brandão, Thaís Bianca; Santos-Silva, Alan Roger

2017-12-01

Although radiation-related caries (RRC) are a well-known toxicity of head and neck radiotherapy, a clinical classification system for RRC has not yet been clinically validated. Therefore, the aim of this study was to assess whether the International Caries Detection and Assessment System (ICDAS) and the Post-Radiation Dental Index (PRDI) were viable methods for the assessment of RRC. Clinicopathologic data and intraoral digital photographs of 60 patients (833 teeth) affected by RRC were assessed and classified according to the ICDAS and PRDI criteria. A total of 814 (97.7%) teeth presented RRC lesions ranging from early stage to complete tooth destruction. Mean scores for the whole sample were 5 for ICDAS and 3 for PRDI, indicating that RRC were diagnosed predominately in late stages. ICDAS and PRDI criteria underestimate the clinical expressivity of RRC by not including the whole qualitative clinical spectrum of RRC, such as enamel cracks, delamination, dental crown amputation, surface color alterations, and atypical lesions topography (incisal/cuspal caries). ICDAS and PRDI may not be considered viable for the assessment of RRC. The development of a specific clinical classification system is urgently needed to help clinicians recognize the peculiar patterns of RRC, particularly in incipient cases. Copyright © 2017 Elsevier Inc. All rights reserved.

A randomised clinical evaluation of a fluoride mouthrinse and dentifrice in an in situ caries model.

PubMed

Parkinson, Charles R; Hara, Anderson T; Nehme, Marc; Lippert, Frank; Zero, Domenick T

2018-03-01

Fluoride mouthrinses provide advantages for fluoride delivery by maintaining elevated intra-oral fluoride concentrations following fluoride dentifrice use. This in situ caries study investigated potential anti-caries efficacy of a 220 ppm fluoride mouthrinse. This was an analyst-blinded, four-treatment, randomised, crossover study using partially demineralised, gauze-wrapped, human enamel samples mounted in a mandibular partial denture. Participants brushed twice daily for 14 days with either a 1150 ppm fluoride or a fluoride-free placebo dentifrice and either rinsed once daily with the 220 ppm fluoride mouthrinse or not. Following each treatment period, percent surface microhardness recovery (%SMHR) and enamel fluoride uptake (EFU) were assessed. Fifty three participants completed the study. Compared with the placebo dentifrice/no rinse treatment, the fluoride-containing regimens demonstrated greater enamel remineralisation (%SMHR) and fluoridation (EFU): fluoride dentifrice/fluoride rinse (%SMHR difference: 21.55 [95% CI: 15.78,27.32]; EFU difference 8.35 [7.21,9.29]); fluoride dentifrice/no rinse: 19.48 [13.81,25.15]; 6.47 [5.35,7.60]; placebo dentifrice/fluoride rinse: 16.76 [11.06,22.45]; 5.87 [4.72,7.00] (all P < .0001). There were no significant differences in%SMHR between fluoride regimens. The fluoride dentifrice/fluoride rinse regimen was associated with higher EFU than the fluoride dentifrice/no rinse (1.88 [0.75,3.01], P = .0013) and placebo dentifrice/fluoride rinse regimens (2.48 [1.34,3.62], P < .0001). Treatments were generally well-tolerated. The in situ caries model demonstrated that the fluoride mouthrinse is effective in promoting enamel caries lesion remineralisation and fluoridation whether used following a fluoride or non-fluoride dentifrice. Additive (potential) anti-caries benefits of a fluoride rinse after a fluoride dentifrice were confined to enhancements in lesion fluoridation (EFU). In conjunction with a fluoride

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.

Early life factors and dental caries in 5-year-old children in China.

PubMed

Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Gallagher, Jennifer E; Zheng, Shuguo

2017-09-01

This study aimed to explore the association between early life factors and dental caries among 5-year-old Chinese children. Data from 9722 preschool children who participated in the third National Oral Health Survey of China were analysed. Information on early life (birth weight, breastfeeding and age when toothbrushing started), child (sex, ethnicity, birth order and dental behaviours) and family factors (parental education, household income, place of residence, number of children in the family, respondent's age and relation to the child) were obtained from parental questionnaires. Children were also clinically examined to assess dental caries experience using the decayed, missing and filled teeth (dmft) index. The association of early life factors with dmft was evaluated in negative binomial regression models. We found that birth weight was not associated with dental caries experience; children who were exclusively and predominantly formula-fed had lower dmft values than those exclusively breastfed; and children who started brushing later in life had higher dmft values than those who were brushing within the first year. Only one in seven of all children received regular toothbrushing twice per day, and only 34.7% had commenced toothbrushing by the age of 3 years. This study shows certain early life factors play a role in dental caries among Chinese preschool children and provides important insights to shape public health initiatives on the importance of introducing early toothbrushing. The early environment, especially the age when parents introduce toothbrushing to their children, can be an important factor to prevent childhood dental caries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Dental caries detection by optical spectroscopy: a polarized Raman approach with fibre-optic coupling

NASA Astrophysics Data System (ADS)

Ko, A. C.-T.; Choo-Smith, L.-P.; Werner, J.; Hewko, M.; Sowa, M. G.; Dong, C.; Cleghorn, B.

2006-09-01

Incipient dental caries lesions appear as white spots on the tooth surface; however, accurate detection of early approximal lesions is difficult due to limited sensitivity of dental radiography and other traditional diagnostic tools. A new fibre-optic coupled spectroscopic method based on polarized Raman spectroscopy (P-RS) with near-IR laser excitation is introduced which provides contrast for detecting and characterizing incipient caries. Changes in polarized Raman spectra are observed in PO 4 3- vibrations arising from hydroxyapatite of mineralized tooth tissue. Demineralization-induced morphological/orientational alteration of enamel crystallites is believed to be responsible for the reduction of Raman polarization anisotropy observed in the polarized Raman spectra of caries lesions. Supporting evidence obtained by polarized Raman spectral imaging is presented. A specially designed fibre-optic coupled setup for simultaneous measurement of parallel- and cross-polarized tooth Raman spectra is demonstrated in this study.

The oral microbiome in dental caries.

PubMed

Struzycka, Izabela

2014-01-01

Dental caries is one of the most common chronic and multifactorial diseases affecting the human population. The appearance of a caries lesion is determined by the coexistence of three main factors: acidogenic and acidophilic microorganisms, carbohydrates derived from the diet, and host factors. Socio-economic and behavioral factors also play an important role in the etiology of the disease. Caries develops as a result of an ecological imbalance in the stable oral microbiom. Oral microorganisms form dental plaque on the surfaces of teeth, which is the cause of the caries process, and shows features of the classic biofilm. Biofilm formation appears to be influenced by large scale changes in protein expression over time and under genetic control Cariogenic microorganisms produce lactic, formic, acetic and propionic acids, which are a product of carbohydrate metabolism. Their presence causes a decrease in pH level below 5.5, resulting in demineralization of enamel hydroxyapatite crystals and proteolytic breakdown of the structure of tooth hard tissues. Streptococcus mutans, other streptococci of the so-called non-mutans streptococci group, Actinomyces and Lactobacillus play a key role in this process. Dental biofilm is a dynamic, constantly active metabolically structure. The alternating processes of decrease and increase of biofilm pH occur, which are followed by the respective processes of de- and remineralisation of the tooth surface. In healthy conditions, these processes are in balance and no permanent damage to the tooth enamel surface occurs.

Developmental Defects of Enamel in Children with Intellectual Disability.

PubMed

Erika, Vesna; Modrić; Verzak, Željko; Karlović, Zoran

2016-03-01

To investigate the frequency of developmental defects of enamel (DDE) in children with intellectual disability. Children aged 5-18 years (72 children with intellectual disabilities and 72 controls) were included in the study. All the teeth were screened for developmental defects of enamel using the modified Developmental defects of enamel (mDDE) index. Out of the 72 children with intellectual disabilities in this study, 20 (27.78%) presented dental defects of enamel, compared with 8 (11.11%) of those in the control group, which was considered statistically significant (p = 0.021). The majority of children in both groups had white demarcated opacities. Children in both groups were more likely to have maxillary teeth affected than the mandibular teeth and the asymmetrical demarcated enamel defects were more common than the symmetric ones. Majority of opacities in children in both groups were on the maxillary incisors. Children with intellectual disabilities have more developmental defects of enamel than children in the control group. Enamel defects increase caries risk and cause reduction in enamel mechanical properties leading to restoration failures.

Maternal Oral Bacterial Levels Predict Early Childhood Caries Development

PubMed Central

Chaffee, B.W.; Gansky, S.A.; Weintraub, J.A.; Featherstone, J.D.B.; Ramos-Gomez, F.J.

2014-01-01

Objective: To calculate the association of maternal salivary bacterial challenge (mutans streptococci [MS] and lactobacilli [LB]) from pregnancy through 24 months’ postpartum with child caries incidence (≥1 cavitated or restored teeth) at 36 months. Materials & Methods: Dental, salivary bacterial, sociodemographic, and behavioral measures were collected at three- to six-month intervals from a birth cohort of low-income Hispanic mother-child dyads (N = 243). We calculated the relative child caries incidence, adjusted for confounding, following higher maternal challenge of MS (>4500 colony-forming units per milliliter of saliva [CFU/mL]) and LB (>50 CFU/mL) based on multivariable models. Results: Salivary MS and LB levels were greater among mothers of caries-affected children versus caries-free children. Mothers with higher salivary MS challenge were more likely to have MS-positive children (>0 CFU/mL), but maternal LB challenge was not a statistically significant predictor of child LB-positive status. Adjusting for sociodemographics, feeding and care practices, and maternal dental status, higher maternal salivary challenge of both MS and LB over the study period predicted nearly double the child caries incidence versus lower MS and LB (cumulative incidence ratio: 1.9; 95% confidence interval: 1.1, 3.8). Conclusion: Maternal salivary bacterial challenge not only is associated with oral infection among children but also predicts increased early childhood caries occurrence. PMID:24356441

Transillumination and HDR Imaging for Proximal Caries Detection.

PubMed

Lederer, A; Kunzelmann, K H; Hickel, R; Litzenburger, F

2018-02-01

The purpose was to develop an in vitro model for the validation of near-infrared transillumination (NIRT) for proximal caries detection, to enhance NIRT with high-dynamic-range imaging (HDRI), and to compare both methods, using micro-computed tomography (µCT) as a reference standard. Both proximal surfaces of 53 healthy or decayed permanent human teeth were examined using the Diagnocam (DC) (KaVo) and NIRT with HDRI (NIRT-HDRI). NIRT was combined with HDRI to improve the diagnostic performance by reducing under- and overexposed image areas. For NIRT-HDRI, an exposure series was captured and merged into a single HDR image. A classification was applied according to lesion depth. All surfaces were assessed twice by 2 trained examiners, and additionally with µCT for validation. The Kappa statistic was used to calculate inter-rater reliability and agreement between DC and NIRT-HDRI. Inter-rater reliability (weighted Kappa, wκ) showed very good agreement for the DC (0.90) and NIRT-HDRI (0.96). The overall agreement (wκ) was almost perfect (0.85). In the individual categories (0 to 4), the agreement (simple Kappa) ranged from almost perfect (category 4) to moderate (1 and 2) to substantial (categories 0 and 3). Sensitivity and specificity of sound surfaces, enamel, and dentin caries ranged from 0.57 to 0.99 and were similar for both methods in the different categories. NIRT-HDRI had a higher sensitivity for sound surfaces and enamel caries, as well as a higher specificity for dentin caries. Regarding the obtained images, HDRI allowed for the detection of caries within a greater range of luminance levels, resulting in a more detailed visualization of structures without under- or overexposure. However, HDRI this did not improve the diagnostics significantly. Distinguishing between a processed demineralized enamel and dentin lesions appears to be a problem specific to NIRT and cannot be balanced using HDRI.

Laser fluorescence of caries detection in permanent teeth in vitro: a systematic review and meta-analysis.

PubMed

Rosa, Maria I; Schambeck, Vilson S; Dondossola, Eduardo R; Alexandre, Maria Cm; Tuon, Lisiane; Grande, Antonio J; Hugo, Fernando

2016-11-01

The detection of dental caries in the early stages, particularly on the occlusal surfaces, has become a mainstay of contemporary clinical practice. The objective of the study was to verify the accuracy of laser fluorescence for caries detection. A comprehensive search of the MEDLINE (PubMed), EMBase, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, Congress Abstracts, and Grey literature databases was undertaken from 1980 through January 2016. We included cross-sectional studies that evaluated laser fluorescence in caries diagnoses in vitro and compared them with histological analyses. A total of 39 articles were included in the meta-analysis, which included 2082 caries sites. The pooled sensitivity was 0.71 (0.69, 0.73), and the specificity was 0.81 (0.73, 0.82). The diagnostic odds ratio was 14.93 (11.2, 19.9). A summary receiver operating characteristic curve was constructed. The area under the curve was 0.865. This meta-analysis showed that laser fluorescence in vitro had the ability to diagnose occlusal caries lesions in permanent teeth and enamel and dentin caries. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

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

Ph-activated nano-amorphous calcium phosphate-based cement to reduce dental enamel demineralization.

PubMed

Melo, Mary A S; Weir, Michael D; Passos, Vanara F; Powers, Michael; Xu, Hockin H K

2017-12-01

Enamel demineralization is destructive, esthetically compromised, and costly complications for orthodontic patients. Nano-sized amorphous calcium phosphate (NACP) has been explored to address this challenge. The 20% NACP-loaded ortho-cement notably exhibited favorable behavior on reducing demineralization of enamel around brackets in a caries model designed to simulate the carious attack. The 20% NACP-loaded ortho-cement markedly promotes higher calcium and phosphate release at a low pH, and the mineral loss was almost two fold lower and carious lesion depth decreased the by 1/3. This novel approach is promising co-adjuvant route for prevention of dental caries dissemination in millions of patients under orthodontic treatment.

Caretaker's caries experience and its association with early childhood caries and children's oral health-related quality of life: A prospective two-generation study.

PubMed

Birungi, Nancy; Fadnes, Lars Thore; Nankabirwa, Victoria; Tumwine, James Kashugyera; Åstrøm, Anne Nordrehaug

2016-11-01

The first objective of this study is to examine the association between caretakers' caries experience and caries experience of their children. Second, to investigate whether children's and caretaker's caries experience is associated with oral health-related quality of life (OHRQoL) of children and their families. This study is based on the prenatal recruitment interviews and the 5-year follow-up of 417 caretaker-children pairs from the Ugandan site of the PROMISE-EBF trial conducted in Mbale, Eastern Uganda. Face-to-face interviews were conducted with caretakers at the household level. Caries experience of caretakers (DMFT >0) and children (dmft >0) were assessed in accordance with the criteria of the World Health Organization. OHRQoL was assessed using an abbreviated version of the Early Childhood Oral Health Impact Scale (ECOHIS). Adjusted negative binomial regression analysis revealed that caretaker's caries experience was positively associated with early childhood caries of their offspring (IRR 2.0, 95% confidence interval (CI) 1.3-3.0). Children's caries experience (IRR 1.8, 95% CI 1.2-3.0), but not caries experience of caretakers, was associated with worse OHRQoL of children and their families. Caretakers who perceived good child oral health were less likely to report OHRQoL impacts (IRR 0.20, 95% CI 0.12-0.35). Improving caretaker's caries experience and her perception of child's oral health status could improve children's caries experience and the OHRQoL of children and family. Such knowledge is important and should inform public oral health programs for young children.

Enamel Surface with Pit and Fissure Sealant Containing 45S5 Bioactive Glass.

PubMed

Yang, S-Y; Kwon, J-S; Kim, K-N; Kim, K-M

2016-05-01

Enamel demineralization adjacent to pit and fissure sealants leads to the formation of marginal caries, which can necessitate the replacement of existing sealants. Dental materials with bioactive glass, which releases ions that inhibit dental caries, have been studied. The purpose of this study was to evaluate the enamel surface adjacent to sealants containing 45S5 bioactive glass (BAG) under simulated microleakage between the material and the tooth in a cariogenic environment. Sealants containing 45S5BAG filler were prepared as follows: 0% 45S5BAG + 50.0% glass (BAG0 group), 12.5% 45S5BAG + 37.5% glass (BAG12.5 group), 25.0% 45S5BAG + 25.0% glass (BAG25.0 group), 37.5% 45S5BAG + 12.5% glass (BAG37.5 group), and 50.0% 45S5BAG + 0% glass (BAG50.0 group). A cured sealant disk was placed over a flat bovine enamel disk, separated by a 60-µm gap, and immersed in lactic acid solution (pH 4.0) at 37 °C for 15, 30, and 45 d. After the storage period, each enamel disk was separated from the cured sealant disk, and the enamel surface was examined with optical 3-dimensional surface profilometer, microhardness tester, and scanning electron microscopy. The results showed a significant increase in roughness and a decrease in microhardness of the enamel surface as the proportion of 45S5BAG decreased (P< 0.05). In the scanning electron microscopy images, enamel surfaces with BAG50.0 showed a smooth surface, similar to those in the control group with distilled water, even after prolonged acid storage. Additionally, an etched pattern was observed on the surface of the demineralized enamel with a decreasing proportion of 45S5BAG. Increasing the 45S5BAG filler contents of the sealants had a significant impact in preventing the demineralization of the enamel surface within microgaps between the material and the tooth when exposed to a cariogenic environment. Therefore, despite some marginal leakage, these novel sealants may be effective preventive dental materials for inhibiting

EDX-Element Analysis of the In Vitro Effect of Fluoride Oral Hygiene Tablets on Artificial Caries Lesion Formation and Remineralization in Human Enamel.

PubMed

Eggerath, J; Kremniczky, T; Gaengler, P; Arnold, W H

2011-01-01

Aim of this in-vitro-study was to assess the remineralization potential of a tooth cleaning tablet with different fluoride content quantitatively using EDX analysis.Twenty three caries free impacted third molars were examined; enamel surfaces were wax coated leaving two 3x4mm windows for exposure to demineralization/remineralization cycles. The teeth were randomly assigned to 4 groups of 5 control and 6 experimental teeth each. Demineralization by standardized HEC-gel, pH 4.7 at 37°C for 72h, was alternated by rinsing in remineralization solution, pH 7.0 at 37°C for 72h, total challenge time 432h. The negative control group N was treated during remineralization cycles with saline; positive control group P was treated with remineralization solution; experimental group D1 was exposed to remineralization solution containing Denttabs(®)-tablets with 1450 ppm F; experimental group D2 was exposed to remineralization solution and Denttabs(®)-tablets with 4350 ppm F. Each tooth was cut into serial sections and analyzed by scanning electron microscopy with EDX element analysis for assessment of the different zones of the lesions in 3 representative sections. Statistical analysis was based on the AVOVA test for repeated measurements and post hoc Bonferroni adjustment. The results showed a significantly higher Ca and P content in the body of the lesion in both fluoride treated groups compared to the controls. It can be concluded that higher concentrations of NaF may be more effective in remineralization of early advanced caries lesions.

EDX-Element Analysis of the In Vitro Effect of Fluoride Oral Hygiene Tablets on Artificial Caries Lesion Formation and Remineralization in Human Enamel

PubMed Central

Eggerath, J; Kremniczky, T; Gaengler, P; Arnold, W.H

2011-01-01

Aim of this in-vitro-study was to assess the remineralization potential of a tooth cleaning tablet with different fluoride content quantitatively using EDX analysis. Twenty three caries free impacted third molars were examined; enamel surfaces were wax coated leaving two 3x4mm windows for exposure to demineralization/remineralization cycles. The teeth were randomly assigned to 4 groups of 5 control and 6 experimental teeth each. Demineralization by standardized HEC-gel, pH 4.7 at 37°C for 72h, was alternated by rinsing in remineralization solution, pH 7.0 at 37°C for 72h, total challenge time 432h. The negative control group N was treated during remineralization cycles with saline; positive control group P was treated with remineralization solution; experimental group D1 was exposed to remineralization solution containing Denttabs®-tablets with 1450 ppm F; experimental group D2 was exposed to remineralization solution and Denttabs®-tablets with 4350 ppm F. Each tooth was cut into serial sections and analyzed by scanning electron microscopy with EDX element analysis for assessment of the different zones of the lesions in 3 representative sections. Statistical analysis was based on the AVOVA test for repeated measurements and post hoc Bonferroni adjustment. The results showed a significantly higher Ca and P content in the body of the lesion in both fluoride treated groups compared to the controls. It can be concluded that higher concentrations of NaF may be more effective in remineralization of early advanced caries lesions. PMID:21687564

Thermophotonic lock-in imaging of early demineralized and carious lesions in human teeth

NASA Astrophysics Data System (ADS)

Tabatabaei, Nima; Mandelis, Andreas; Amaechi, Bennett Tochukwu

2011-07-01

As an extension of frequency-domain photothermal radiometry, a novel dental-imaging modality, thermophotonic lock-in imaging (TPLI), is introduced. This methodology uses photothermal wave principles and is capable of detecting early carious lesions and cracks on occlusal and approximal surfaces as well as early caries induced by artificial demineralizing solutions. The increased light scattering and absorption within early carious lesions increases the thermal-wave amplitude and shifts the thermal-wave centroid, producing contrast between the carious lesion and the intact enamel in both amplitude and phase images. Samples with artificial and natural occlusal and approximal caries were examined in this study. Thermophotonic effective detection depth is controlled by the modulation frequency according to the well-known concept of thermal diffusion length. TPLI phase images are emissivity normalized and therefore insensitive to the presence of stains. Amplitude images, on the other hand, provide integrated information from deeper enamel regions. It is concluded that the results of our noninvasive, noncontacting imaging methodology exhibit higher sensitivity to very early demineralization than dental radiographs and are in agreement with the destructive transverse microradiography mineral density profiles.

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

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.

Phase Transformations in a Human Tooth Tissue at the Initial Stage of Caries

PubMed Central

Prutskij, Tatiana; Ippolitov, Yury

2015-01-01

The aim of the paper is to study phase transformations in solid tissues of the human teeth during the development of fissure caries by Raman and fluorescence microspectroscopy. The study of the areas with fissure caries confirmed the assumption of the formation of a weak interaction between phosphate apatite enamel and organic acids (products of microorganisms). The experimental results obtained with by Raman microspectroscopy showed the formation of dicalcium phosphate dihydrate - CaHPO4-2H2O in the area of mural demineralization of carious fissure. A comparative analysis of structural and spectroscopic data for the intact and carious enamel shows that emergence of a more soluble phase - carbonate-substituted hydroxyapatite - is typical for the initial stage of caries. It is shown that microareas of dental hard tissues in the carious fissure due to an emerging misorientation of apatite crystals have a higher fluorescence yield than the area of the intact enamel. These areas can be easily detected even prior to a deep demineralization (white spot stage) for the case of irreversibly changed organomineral complex and intensive removal of the mineral component. PMID:25901743

Effect of titanium dioxide nanoparticle addition into orthodontic adhesive resin on enamel microhardness

NASA Astrophysics Data System (ADS)

Andriani, A.; Krisnawati; Purwanegara, M. K.

2017-08-01

White spots are an early sign of enamel demineralization, which may lead to development of dental caries. Enamel demineralization can be determined by examining the microhardness number of the enamel. Addition of antibacterial agents such as TiO2 nanoparticles into the orthodontic adhesive (TiO2 nanocomposite) is expected to prevent enamel demineralization. The objective of this study is to evaluate the effect of TiO2 nanocomposites in maintaining enamel microhardness around orthodontic brackets. The bracket was bonded to the premolar using Transbond XT (group 1), 1% TiO2 nanocomposites (group 2), and 2% TiO2 nanocomposites (group 3). Group 4 was the control group, and it was not given any treatment prior to the microhardness test. The samples of groups 1, 2, and 3 were soaked in BHI solution containing Streptococcus mutans, and then stored in an incubator at 37°C for 30 days. Demineralizations were determined on cross-sectioned tooth 100μm and 200μm cervical to the bracket by the Vickers microhardness test. The microhardness values were significantly different between every group, with the highest value obtained for control group, followed by the 2% TiO2 nanocomposite group, 1% TiO2 nanocomposite group, and then the Transbond XT group. The results of this study reveal that 2% TiO2 nanocomposites have the ability to maintain enamel microhardness around the orthodontic bracket.

Feeding Practices in Infancy Associated with Caries Incidence in Early Childhood

PubMed Central

Chaffee, Benjamin W.; Feldens, Carlos Alberto; Rodrigues, Priscila Humbert; Vítolo, Márcia Regina

2015-01-01

Early-life feeding behaviors foretell later dietary habits and health outcomes. Few studies have examined infant dietary patterns and caries occurrence prospectively. OBJECTIVE Assess whether patterns in food and drink consumption before age 12 months are associated with caries incidence by preschool age. METHODS We collected early-life feeding data within a birth cohort from low-income families in Porto Alegre, Brazil. Three dietary indexes were defined, based on refined sugar content and/or previously reported caries associations: a count of sweet foods or drinks introduced <6-months (e.g., candy, cookies, soft drinks), a count of other, non-sweet items introduced <6-months (e.g., beans, meat), and a count of sweet items consumed at 12 months. Incidence of severe early childhood caries (S-ECC) at age 38 months (N=458) was compared by score tertile on each index, adjusted for family, maternal, and child characteristics using regression modeling. RESULTS Introduction to a greater number of presumably cariogenic items in infancy was positively associated with future caries. S-ECC incidence was highest in the uppermost tertile of the “6-month sweet index” (adjusted cumulative incidence ratio, RR, versus lowest tertile: 1.46; 95% CI: 0.97, 2.04) and the uppermost tertile of the “12-month sweet index” (RR: 1.55; 95% CI: 1.17, 2.23). The association was specific for sweet items: caries incidence did not differ by tertile of the “6-month non-sweet index” (RR: 1.00; 95% CI: 0.70, 1.40). Additionally, each one-unit increase on the 6-month and the 12-month sweet indexes, but not the 6-month non-sweet index, was statistically significantly associated with greater S-ECC incidence and associated with more decayed, missing or restored teeth. Results were robust to minor changes in the items constituting each index and persisted if liquid items were excluded. CONCLUSIONS Dietary factors observed before age 12-months were associated with S-ECC at preschool age

Feeding practices in infancy associated with caries incidence in early childhood.

PubMed

Chaffee, Benjamin W; Feldens, Carlos Alberto; Rodrigues, Priscila Humbert; Vítolo, Márcia Regina

2015-08-01

Early-life feeding behaviors foretell later dietary habits and health outcomes. Few studies have examined infant dietary patterns and caries occurrence prospectively. Assess whether patterns in food and drink consumption before age 12 months are associated with caries incidence by preschool age. We collected early-life feeding data within a birth cohort from low-income families in Porto Alegre, Brazil. Three dietary indexes were defined, based on refined sugar content and/or previously reported caries associations: a count of sweet foods or drinks introduced <6-months (e.g., candy, cookies, soft drinks), a count of other, nonsweet items introduced <6-months (e.g., beans, meat), and a count of sweet items consumed at 12 months. Incidence of severe early childhood caries (S-ECC) at age 38 months (N = 458) was compared by score tertile on each index, adjusted for family, maternal, and child characteristics using regression modeling. Introduction to a greater number of presumably cariogenic items in infancy was positively associated with future caries. S-ECC incidence was highest in the uppermost tertile of the '6-month sweet index' (adjusted cumulative incidence ratio, RR, versus lowest tertile: 1.46; 95% CI: 0.97, 2.04) and the uppermost tertile of the '12-month sweet index' (RR: 1.55; 95% CI: 1.17, 2.23). The association was specific for sweet items: caries incidence did not differ by tertile of the '6-month nonsweet index' (RR: 1.00; 95% CI: 0.70, 1.40). Additionally, each one-unit increase on the 6-month and the 12-month sweet indexes, but not the 6-month nonsweet index, was statistically significantly associated with greater S-ECC incidence and associated with more decayed, missing, or restored teeth. Results were robust to minor changes in the items constituting each index and persisted if liquid items were excluded. Dietary factors observed before age 12-months were associated with S-ECC at preschool age, highlighting a need for timely, multilevel intervention

[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.

Enamel-Caries Prevention Using Two Applications of Fluoride-Laser Sequence.

PubMed

Noureldin, Amal; Quintanilla, Ines; Kontogiorgos, Elias; Jones, Daniel

2016-03-01

Studies demonstrated a significant synergism between fluoride and laser in reduction of enamel solubility. However, minimal research has focused on testing the sequence of their application and no other research investigated the preventive effect of repeated applications of a combined treatment. This study investigated the effect of two applications of fluoride-laser sequence on the resistance of sound enamel to cariogenic challenge compared to one-time application. Sixty enamel slabs were cut from 10 human incisors, ground flat, polished and coated with nail varnish except a 2 x 2 mm window. Specimens were randomly assigned into five groups of 12 specimens; (CON-) negative-control received no treatment, (CON+) positive-control received pH challenge, (FV) treated with M fluoride varnish, (F-L1) one-application fluoride-varnish followed by CO2 laser-treatment (short-pulsed 10.6 µm, 2.4J/ cm2, 10HZ, 10sec), and (F-L2) two-applications of fluoride varnish-laser treatment. Specimens were left in distilled water for one day between applications. Except CON-, all groups were submitted to pH cycling for 9-days (8 demin/ remin + 1 day remineralisation bath) at 37°C. Enamel demineralization was quantitatively evaluated by measurement of Knoop surface-microhardness (SM H) (50-grams/10 seconds). Data were analyzed using one-way ANOVA (p ≤ 0.05) followed by Duncan's Multiple Range Test. Within the limitations of this study, it was found that one or two applications of fluoride-laser sequence significantly improved resistance of the sound enamel surface to acid attack compared to FV-treated group. Although the two applications of fluoride-laser sequence (F-L1 and F-L2) showed higher SMH values, significant resistance to demineralization was only obtained with repeated applications.

Identification of early childhood caries in primary care settings.

PubMed

Nicolae, Alexandra; Levin, Leo; Wong, Peter D; Dave, Malini G; Taras, Jillian; Mistry, Chetna; Ford-Jones, Elizabeth L; Wong, Michele; Schroth, Robert J

2018-04-01

Early childhood caries (ECC) is the most common chronic disease affecting young children in Canada. ECC may lead to pain and infection, compromised general health, decreased quality of life and increased risk for dental caries in primary and permanent teeth. A multidisciplinary approach to prevent and identify dental disease is recommended by dental and medical national organizations. Young children visit primary care providers at regular intervals from an early age. These encounters provide an ideal opportunity for primary care providers to educate clients about their children's oral health and its importance for general health. We designed an office-based oral health screening guide to help primary care providers identify ECC, a dental referral form to facilitate dental care access and an oral health education resource to raise parental awareness. These resources were reviewed and trialled with a small number of primary care providers.

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

Structural color changes in permanent enamel of patients with cleft lip and palate: a case-control study.

PubMed

Kulas, Antje; Illge, Christina; Bekes, Katrin; Eckert, Alexander W; Fuhrmann, Robert A W; Hirsch, Christian

2016-01-01

White spots are more common in patients with cleft lip and palate (CLP) than in the normal population. Whether these are due to the cleft itself or concomitant circumstances (e.g., surgical procedures, orthodontic treatments, systemic fluoridation, increased caries risk) remains unclear. This case-control study evaluated both their prevalence in CLP patients versus control subjects and associated risk factors. A total of 73 CLP patients (average age 8.7 years, range 6-18 years, 42 % male) and a control group of 73 age- and gender-matched non-CLP patients were included. Enamel color changes, subsuming mineralization defects (DDE index), mild dental fluorosis (Dean's index), and initial caries (ICDAS score 2), were recorded. Caries index (dmf-t/DMF-T) scores were also recorded to distinguish between high or low caries risk as defined by the Deutsche Arbeitsgemeinschaft für Jugendzahnpflege criteria. Histories of systemic fluoridation, trauma to primary teeth, surgery, and orthodontic treatment were obtained using a questionnaire. Statistical analysis included t test, χ (2) test, and multivariable logistic regression. Enamel color changes were observed three times more often in the CLP group than in the control group (39.7 vs. 12.3 %; p < 0.001). Significantly more patients in the CLP group had a history of orthodontic treatment (38.4 vs. 15.1 %; p < 0.05). An increased risk for enamel color changes was associated with CLP itself [OR (odds ratio) 3.6; 95 % confidence interval (CI) 1.3-9.9] and table salt plus tablets combined for systemic fluoridation (OR 2.7, 95 % CI 1.1-6.9). No increased risks were identified for increased caries risk, history of primary-tooth trauma, or history of orthodontic treatment. The higher prevalence of enamel color changes in the CLP group (more than threefold compared to the control group) was not related to previous orthodontic treatments; however, systemic fluoridation (table salt and tablets) constituted a risk factor for

Zinc and Metallothionein in the Development and Progression of Dental Caries.

PubMed

Rahman, Mohammad Tariqur; Hossain, Ashfaque; Pin, Chew Hooi; Yahya, Noor Azlin

2018-05-09

Chronic oxidative stress and reactive oxygen species (ROS) in oral cavity as well as acidic pH on dental enamel surface due to the metabolic activities of bacterial plaque are the major contributors in the development and progression of dental caries. Along with other factors, deposition or dissolution Ca and Mg mostly determines the re- or demineralization of dental enamel. Zn plays an important role for both Ca and Mg bioavailability in oral cavity. Metallothionein (MT), a group of small molecular weight, cysteine-rich proteins (~ 7 kDa), is commonly induced by ROS, bacterial infection, and Zn. In the current review, we evaluated MT at the junction between the progression of dental caries and its etiologies that are common in MT biosynthesis.

"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.

Validation of a Cariogenic Biofilm Model to Evaluate the Effect of Fluoride on Enamel and Root Dentine Demineralization.

PubMed

Fernández, Constanza E; Tenuta, Livia M A; Cury, Jaime A

2016-01-01

Due to gingival recession both enamel and root dentine are at risk of developing caries. Both tissues are exposed to a similar environment, however there is not a validated model to evaluate the effect of fluoride on these dental substrates simultaneously. Hence, this study aimed to validate a caries model to evaluate the effect of fluoride to prevent demineralization on enamel and root-dentine. Streptococcus mutans UA159 biofilms were formed on saliva-coated bovine enamel and root dentine slabs (n = 12 per group) mounted in the same well of culture plates. The biofilms were exposed 8×/day to 10% sucrose and treated 2×/day with fluoridated solutions containing 0, 150, 450, or 1,350 ppm F; thus, simulating the use of low to high fluoride concentration toothpastes. The pH values of the culture medium was monitored 2×/day as a biofilm acidogenicity indicator. After 96 h, biofilms were collected for fluoride concentration analysis. The percentage of surface hardness loss (%SHL) was calculated for slabs. The fluoride uptake by the enamel and dentine was also determined. The model showed a dose-response because the biofilm and fluoride uptake increased and %SHL decreased at increasing fluoride concentrations (p < 0.05). Fluoride in the biofilm formed on dentine and fluoride uptake by dentine were higher than those for enamel. With the same fluoride concentration treatment, the percentage of reduction of demineralization was lower for dentine than for enamel. In conclusion, the model was validated in terms of a dose-response effect of fluoride on enamel and root dentine. Furthermore, the findings support the clinical data, suggesting that higher fluoride concentrations are necessary to control caries of root dentine than of enamel.

[Caries patterns and diet in early childhood caries].

PubMed

Faye, M; Ba, A A; Yam, A A; Ba, I

2006-01-01

Early childhood caries (EEC) are multiple carious lesions affecting the primary teeth of infants and preschool children. They are related to a prolonged and night bottle-feeding rich in fermentable carbohydrates. The carious lesions characterised by their patterns and the rapidity of their process can lead to a widespread tooth destruction. The aim of this study was to evaluate the patterns of the carious lesions and their relationship to the diet. This prospective study was carried out in Dakar in public heath structures that have a dental office. It has included 68 children of both sex aged from two to 6 years consisted of 35 boys (51% of the sample) and 33 girls (49%) with the predominance of the 5-year-old children. These children were examined using a plan mouth mirror and probes and their mothers were interviewed. The observed carious lesions were distributed on all tooth surfaces but the complete coronal destruction was the most common lesions observed and represented 25 of the lesions, followed by lesions in three faces of the tooth (17%). The most frequently affected tooth was the association maxillar incisors and molars and the mandibular molars (32.4%). The incisor alone represented 22.1% of the affected teeth. The children were breast-fed associated with either pap or with hard food (52.9%). The bottle was added to this association in 32.4% of the cases and 10% of the children were exclusively breast-fed. The carious lesions were more severe and more frequent in children fed with breast associated with pap and hard food and in those fed with breast associated with the bottle pap and food than to children exclusively breast-fed. These differences were not statistically significant (p = 0.73 > 0.05). Early childhood caries are related to a diet rich in carbon hydrate. They lead to severe tooth destruction. The treatments cost are very high thus prevention by information on the bad effects of sugar on diet and the baby bottle are of great interest.

Frequency of Fluoride Dentifrice Use and Caries Lesions Inhibition and Repair.

PubMed

Nóbrega, Diego Figueiredo; Fernández, Constanza Estefany; Del Bel Cury, Altair Antoninha; Tenuta, Livia Maria Andaló; Cury, Jaime Aparecido

2016-01-01

The clinical relevance of the frequency of fluoride dentifrice (FD) use on enamel caries is based on evidence. However, the relative effect of FD on reduction of demineralization or enhancement of remineralization is unknown and the effect of frequency on root dentine caries has not been explored. The aim of this double-blind, crossover, in situ study, which was conducted in 4 phases of 14 days each, was to evaluate the relationship between the frequency of FD use and enamel and root dentine de- and remineralization. Eighteen volunteers wore palatal appliances containing enamel and root dentine slabs, either sound or carious. Biofilm accumulation on the slab surface was allowed, and 20% sucrose solution was dripped 3 or 8 times per day on the carious and sound slabs, respectively. Volunteers used FD (1,100 μg F/g) in the frequencies 0 (fluoride-placebo dentifrice), 1, 2 and 3 times per day. The demineralization and remineralization that occurred in sound or carious slabs was estimated by the percentage of surface hardness loss (%SHL) or recovery (%SHR). Loosely (CaF2) and firmly (FAp) bound fluoride concentrations were also determined. The relationship between the variables was analyzed by linear regression. The %SHL, CaF2 and FAp concentrations were a function of the frequency of FD use for enamel and dentine, but the %SHR was a function of the frequency of FD use only for enamel (p < 0.05). The results suggest that demineralization in enamel and root dentine is reduced in proportion to the frequency of FD use, but for remineralization the effect of the frequency of FD use was relevant only to enamel. © 2016 S. Karger AG, Basel.

Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community

PubMed Central

Levin, Ana; Sokal-Gutierrez, Karen; Hargrave, Anita; Funsch, Elizabeth; Hoeft, Kristin S.

2017-01-01

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health in indigenous Ecuadorian families participating in a community-based oral health and nutrition intervention. Dental exams of 698 children age 6 months through 6 years determined each child’s caries burden. A convenience sample of 18 “outlier” families was identified: low-caries children with ≤2 carious teeth vs. high-caries children with ≥10 carious teeth. Semi-structured in-depth interviews with parents/caregivers explored the child’s diet, dental habits, and family factors related to nutrition and oral health. Interviews were transcribed and thematically analyzed using grounded theory. In the high-caries families, proximity to highway and stores, consumption of processed-food, and low parental monitoring of child behavior were identified as risk factors for ECC (early childhood caries). In the low-caries families, protective factors included harvesting and consuming food from the family farm, remote geography, and greater parental monitoring of child behavior. The study results suggest that maintaining traditional family farms and authoritative parenting to avoid processed foods/drinks and ensure tooth brushing could improve early childhood nutrition and oral health. PMID:28800116

Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community.

PubMed

Levin, Ana; Sokal-Gutierrez, Karen; Hargrave, Anita; Funsch, Elizabeth; Hoeft, Kristin S

2017-08-11

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health in indigenous Ecuadorian families participating in a community-based oral health and nutrition intervention. Dental exams of 698 children age 6 months through 6 years determined each child's caries burden. A convenience sample of 18 "outlier" families was identified: low-caries children with ≤2 carious teeth vs. high-caries children with ≥10 carious teeth. Semi-structured in-depth interviews with parents/caregivers explored the child's diet, dental habits, and family factors related to nutrition and oral health. Interviews were transcribed and thematically analyzed using grounded theory. In the high-caries families, proximity to highway and stores, consumption of processed-food, and low parental monitoring of child behavior were identified as risk factors for ECC (early childhood caries). In the low-caries families, protective factors included harvesting and consuming food from the family farm, remote geography, and greater parental monitoring of child behavior. The study results suggest that maintaining traditional family farms and authoritative parenting to avoid processed foods/drinks and ensure tooth brushing could improve early childhood nutrition and oral health.

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.

Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions.

PubMed

Mohd Said, Siti N B; Ekambaram, Manikandan; Yiu, Cynthia K Y

2017-05-01

To compare remineralization potential of topical fluoride varnishes with added calcium phosphate-based delivery systems on artificial enamel caries. Human enamel specimens (n = 60) were randomly divided into six groups: Group 0: Control (no varnish), Group 1: Duraphat ® , Group 2: MI Varnish ™ , Group 3: Embrace ™ Varnish, Group 4: Enamel Pro ® Varnish, and Group 5: Clinpro ™ White Varnish. Specimens were immersed in demineralizing solution for 96 h to create artificial caries lesion. Each specimen was then immersed in artificial saliva for 6 h after fluoride varnish application and pH cycling was performed for 8 days. Specimens were evaluated using Knoop surface microhardness (KHN) and transverse microradiography (TMR). One-way anova test was performed to examine the effect of fluoride varnishes on change in percentage of surface hardness recovery (%SHR), change in lesion depth (ΔLD), and change in mineral loss (ΔΔZ) with the significance limit set at 5%. %SHR of enamel following treatment with Group 1 was significantly higher than Group 3 and Group 4. Conversely, ΔLD and ΔΔZ of Group 1 were significantly higher than Group 2, Group 3, and Group 4. No significant differences in %SHR, ΔLD, and ΔΔZ were found between Group 1 and Group 5. Duraphat ® alone achieves significant remineralization of enamel carious lesions. Clinpro ™ White Varnish had similar enamel remineralization effect as Duraphat ® . © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Near-infrared image-guided laser ablation of artificial caries lesions.

PubMed

Tao, You-Chen; Fan, Kenneth; Fried, Daniel

2007-01-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. The objective of this study was to test the hypothesis that two-dimensional NIR images of demineralized tooth surfaces can be used to guide CO(2) laser ablation for the selective removal of artificial caries lesions. Highly patterned artificial lesions were produced by submerging 5 × 5 mm(2) bovine enamel samples in demineralized solution for a 9-day period while sound areas were protected with acid resistant varnish. NIR imaging and polarization sensitive optical coherence tomography (PS-OCT) were used to acquire depth-resolved images at a wavelength of 1310-nm. An imaging processing module was developed to analyze the NIR images and to generate optical maps. The optical maps were used to control a CO(2) laser for the selective removal of the lesions at a uniform depth. This experiment showed that the patterned artificial lesions were removed selectively using the optical maps with minimal damage to sound enamel areas. Post-ablation NIR and PS-OCT imaging confirmed that demineralized areas were removed while sound enamel was conserved. This study successfully demonstrated that near-IR imaging can be integrated with a CO(2) laser ablation system for the selective removal of dental caries.

Near-infrared image-guided laser ablation of artificial caries lesions

PubMed Central

Tao, You-Chen; Fan, Kenneth; Fried, Daniel

2012-01-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. The objective of this study was to test the hypothesis that two–dimensional NIR images of demineralized tooth surfaces can be used to guide CO2 laser ablation for the selective removal of artificial caries lesions. Highly patterned artificial lesions were produced by submerging 5 × 5 mm2 bovine enamel samples in demineralized solution for a 9-day period while sound areas were protected with acid resistant varnish. NIR imaging and polarization sensitive optical coherence tomography (PS-OCT) were used to acquire depth-resolved images at a wavelength of 1310-nm. An imaging processing module was developed to analyze the NIR images and to generate optical maps. The optical maps were used to control a CO2 laser for the selective removal of the lesions at a uniform depth. This experiment showed that the patterned artificial lesions were removed selectively using the optical maps with minimal damage to sound enamel areas. Post-ablation NIR and PS-OCT imaging confirmed that demineralized areas were removed while sound enamel was conserved. This study successfully demonstrated that near-IR imaging can be integrated with a CO2 laser ablation system for the selective removal of dental caries. PMID:22866210

Near-infrared image-guided laser ablation of artificial caries lesions

NASA Astrophysics Data System (ADS)

Tao, You-Chen; Fan, Kenneth; Fried, Daniel

2007-02-01

Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. The objective of this study was to test the hypothesis that two-dimensional NIR images of demineralized tooth surfaces can be used to guide CO II laser ablation for the selective removal of artificial caries lesions. Highly patterned artificial lesions were produced by submerging 5 x 5 mm2 bovine enamel samples in demineralized solution for a 9-day period while sound areas were protected with acid resistant varnish. NIR imaging and polarization sensitive optical coherence tomography (PS-OCT) were used to acquire depth-resolved images at a wavelength of 1310-nm. An imaging processing module was developed to analyze the NIR images and to generate optical maps. The optical maps were used to control a CO II laser for the selective removal of the lesions at a uniform depth. This experiment showed that the patterned artificial lesions were removed selectively using the optical maps with minimal damage to sound enamel areas. Post-ablation NIR and PS-OCT imaging confirmed that demineralized areas were removed while sound enamel was conserved. This study successfully demonstrated that near-IR imaging can be integrated with a CO II laser ablation system for the selective removal of dental caries.

Effect of 5,000 ppm Fluoride Dentifrice or 1,100 ppm Fluoride Dentifrice Combined with Acidulated Phosphate Fluoride on Caries Lesion Inhibition and Repair.

PubMed

Fernández, Constanza E; Tenuta, Livia Maria Andaló; Del Bel Cury, Altair Antoninha; Nóbrega, Diego Figueiredo; Cury, Jaime Aparecido

2017-01-01

High fluoride dentifrice (FD; 5,000 ppm F) has been recommended to arrest root dentine lesions and to control enamel caries in high-risk patients. Also, standard FD (1,100 ppm F) in combination with professional fluoride application has been recommended to control dentine caries, but the effect of this combination on enamel has been considered modest. Considering the lack of evaluation comparing the use of 5,000 ppm FD (5,000-FD) versus acidulated phosphate fluoride (APF) application combined with 1,100 ppm FD (1,100-FD) on the inhibition and repair of caries lesions in both enamel and dentine, we conducted this in situ, double-blind, crossover study of 3 phases of 14 days. In each phase, 18 volunteers wore palatal appliances containing enamel and root dentine specimens, either sound or carious, to evaluate the effect of the treatments on the inhibition or repair of caries lesions, respectively. The treatments were non-FD (negative control), 5,000-FD, or 1 APF gel application on dental specimens combined with 1,100-FD used twice per day (APF + 1,100-FD). The reduction of demineralization and enhancement of remineralization were assessed by surface and cross-sectional hardness. Fluoride concentration was determined on dental specimens and on the formed biofilm. For enamel, APF + 1,100-FD and 5,000-FD did not differ regarding the inhibition of demineralization and repair of caries lesions. However, for dentine the difference between these treatments was inconclusive because while APF + 1,100-FD was more effective than 5,000-FD in caries lesion reduction and repair, 5,000-FD was more effective than APF + 1,100-FD in the reduction of surface demineralization. Therefore, the findings show that the combination of APF + 1,100-FD is as effective as 5,000-FD in enamel inhibition of demineralization and enhancement of remineralization. © 2017 S. Karger AG, Basel.

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.

Early childhood caries lesions in preschool children in Kerala, India.

PubMed

Jose, Babu; King, Nigel M

2003-01-01

No data are available on possible risk indicators or the prevalence of caries lesions for preschool children under 4 years of age in Kerala, southern India. Therefore, the aims of this study were: (1) to gather data on caries lesion frequency and distribution; (2) to determine any possible associations with feeding habits and oral health care practices. A sample of 530 children, aged from 8 to 48 months (mean=2.5+/-0.96 years), who attended 13 day care centers were clinically examined for caries lesions using a disposable mouth mirror, tongue spatula, and a torch light. There were 513 dentate children. The caregiver of each child then completed, by interview, a structured questionnaire. Among the group of 252 girls and 278 boys, the dmft was 1.84+/-2.87 with 56% of the children being caries-lesion free. Fifty-nine (12%) were considered to have early childhood caries (ECC), based on the criteria that smooth surface caries lesions on all 4 maxillary incisor teeth indicated severe ECC. Breast-feeding was practiced by 99% of the mothers, and 5% did so exclusively. Generally, breast-feeding was on demand. Statistically significant correlations were found between caries lesions and the child's dental condition, as perceived by the mother or caregiver (P<.0001), the dental status of the caregiver (P=.0417), consumption of snacks (P=.0177), giving of sweets as a reward (P<.0001), cleaning of the child's mouth (P<.0001), oral hygiene status of the child (P<.0001) and low socioeconomic status, as measured by income (P<.0001). From the results of this study of preschool children in Kerala, the groups at high risk from dental caries lesions are: (1) those with poor oral hygiene status; (2) those who consume snacks and are given sweets as rewards; (3) those belonging to a lower socioeconomic class.

Dental enamel irradiated with infrared diode laser and photo-absorbing cream: part 2--EDX study.

PubMed

de Sant'Anna, Giselle Rodrigues; dos Santos, Edson Aparecido Pereira; Soares, Luís Eduardo Silva; do Espírito Santo, Ana Maria; Martin, Airton Abrahão; Duarte, Danilo Antônio; Pacheco-Soares, Cristina; Brugnera, Aldo

2009-10-01

The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (micro-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive micro-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (lambda = 810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using micro-EDX after two sets of treatments and pH cycling cariogenic challenges. The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. micro-EDX may be able to detect compositional changes in mineral phases of lased enamel under cariogenic challenge. Our results suggest that with a combined laser and photo

Enamel resistance to demineralization following Er:YAG laser etching for bonding orthodontic brackets

PubMed Central

Ahrari, Farzaneh; Poosti, Maryam; Motahari, Pourya

2012-01-01

Background: Several studies have shown that laser-etching of enamel for bonding orthodontic brackets could be an appropriate alternative for acid conditioning, since a potential advantage of laser could or might be caries prevention. This study compared enamel resistance to demineralization following etching with acid phosphoric or Er:YAG laser for bonding orthodontic brackets. Materials and Methods: Fifty sound human premolars were divided into two equal groups. In the first group, enamel was etched with 37% phosphoric acid for 15 seconds. In the second group, Er:YAG laser (wavelength, 2 940 nm; 300 mJ/pulse, 10 pulses per second, 10 seconds) was used for tooth conditioning. The teeth were subjected to 4-day PH-cycling process to induce caries-like lesions. The teeth were then sectioned and the surface area of the lesion was calculated in each microphotographs and expressed in pixel. The total surface of each specimen was 196 608 pixels. Results: Mean lesion areas were 7 171 and 7532 pixels for Laser-etched and Acid-etched groups, respectively. The two sample t-test showed that there was no significant difference in lesion area between the two groups (P = 0.914). Conclusion: Although Er:YAG laser seems promising for etching enamel before bonding orthodontic brackets, it does not reduce enamel demineralization when exposed to acid challenge. PMID:23162591

Microbiomes of Site-Specific Dental Plaques from Children with Different Caries Status.

PubMed

Richards, Vincent P; Alvarez, Andres J; Luce, Amy R; Bedenbaugh, Molly; Mitchell, Mary Lyn; Burne, Robert A; Nascimento, Marcelle M

2017-08-01

The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMI NGS ) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMI NGS , and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different ( P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis , which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans , Scardovia wiggsiae , Parascardovia denticolens , and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression. Copyright © 2017 American Society for Microbiology.

Microbiomes of Site-Specific Dental Plaques from Children with Different Caries Status

PubMed Central

Alvarez, Andres J.; Luce, Amy R.; Bedenbaugh, Molly; Mitchell, Mary Lyn

2017-01-01

ABSTRACT The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMINGS) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMINGS, and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different (P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis, which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans, Scardovia wiggsiae, Parascardovia denticolens, and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression. PMID:28507066

Automated assessment of the remineralization of artificial enamel lesions with polarization-sensitive optical coherence tomography

PubMed Central

Lee, Robert C.; Kang, Hobin; Darling, Cynthia L.; Fried, Daniel

2014-01-01

Accurate measurement of the highly mineralized transparent surface layer that forms on caries lesions is important for diagnosis of the lesion activity because chemical intervention can slow or reverse the caries process via remineralization. Previous in-vitro and in-vivo studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can nondestructively image the subsurface lesion structure and the highly mineralized transparent surface zone of caries lesions. The purpose of this study was to develop an approach to automatically process 3-dimensional PS-OCT images and to accurately assess the remineralization process in simulated enamel lesions. Artificial enamel lesions were prepared on twenty bovine enamel blocks using two models to produce varying degree of demineralization and remineralization. The thickness of the transparent surface layer and the integrated reflectivity of the subsurface lesion were measured using PS-OCT. The automated transparent surface layer detection algorithm was able to successfully detect the transparent surface layers with high sensitivity ( = 0.92) and high specificity ( = 0.97). The estimated thickness of the transparent surface layer showed a strong correlation with polarized light microscopy (PLM) measurements of all regions (R2 = 0.90). The integrated reflectivity, ΔR, and the integrated mineral loss, ΔZ, showed a moderate correlation (R2 = 0.32). This study demonstrates that PS-OCT can automatically measure the changes in artificial enamel lesion structure and severity upon exposure to remineralization solutions. PMID:25401009

Prediction of Early Childhood Caries via Spatial-Temporal Variations of Oral Microbiota.

PubMed

Teng, Fei; Yang, Fang; Huang, Shi; Bo, Cunpei; Xu, Zhenjiang Zech; Amir, Amnon; Knight, Rob; Ling, Junqi; Xu, Jian

2015-09-09

Microbiota-based prediction of chronic infections is promising yet not well established. Early childhood caries (ECC) is the most common infection in children. Here we simultaneously tracked microbiota development at plaque and saliva in 50 4-year-old preschoolers for 2 years; children either stayed healthy, transitioned into cariogenesis, or experienced caries exacerbation. Caries onset delayed microbiota development, which is otherwise correlated with aging in healthy children. Both plaque and saliva microbiota are more correlated with changes in ECC severity (dmfs) during onset than progression. By distinguishing between aging- and disease-associated taxa and exploiting the distinct microbiota dynamics between onset and progression, we developed a model, Microbial Indicators of Caries, to diagnose ECC from healthy samples with 70% accuracy and predict, with 81% accuracy, future ECC onsets for samples clinically perceived as healthy. Thus, caries onset in apparently healthy teeth can be predicted using microbiota, when appropriately de-trended for age. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

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

Nondestructive Clinical Assessment of Occlusal Caries Lesions using Near-IR Imaging Methods

PubMed Central

Staninec, Michal; Douglas, Shane M.; Darling, Cynthia L.; Chan, Kenneth; Kang, Hobin; Lee, Robert C.; Fried, Daniel

2011-01-01

Objective Enamel is highly transparent in the near-IR (NIR) at wavelengths near 1300-nm, and stains are not visible. The purpose of this study was to use NIR transillumination and optical coherence tomography (OCT) to estimate the severity of caries lesions on occlusal surfaces both in vivo and on extracted teeth. Methods Extracted molars with suspected occlusal lesions were examined with OCT and polarization sensitive OCT (PS-OCT), and subsequently sectioned and examined with polarized light microscopy (PLM) and transverse microradiography (TMR). Teeth in test subjects with occlusal caries lesions that were not cavitated or visible on radiographs were examined using NIR transillumination at 1310 nm using a custom built probe attached to an indium gallium arsenide (InGaAs) camera and a linear OCT scanner. After imaging, cavities were prepared using dye staining to guide caries removal and physical impressions of the cavities were taken. Results The lesion severity determined from OCT and PS-OCT scans in vitro correlated with the depth determined using polarized light microscopy (PLM) and transverse microradiography (TMR). Occlusal caries lesions appeared in NIR images with high contrast in vivo. OCT scans showed that most of the lesions penetrated to dentin and spread laterally below the sound enamel. Conclusion This study demonstrates that both NIR transillumination and OCT are promising new methods for the clinical diagnosis of occlusal caries. PMID:22109697

Quantifying the remineralization of artificial caries lesions using PS-OCT

NASA Astrophysics Data System (ADS)

Jones, Robert S.; Fried, Daniel

2006-02-01

New optical imaging methods are needed to determine whether caries lesions (tooth decay) are active and progressing or have become remineralized and arrested and are no longer progressing. The objective of this study was to use Polarization Sensitive Optical Coherence Tomography (PS-OCT) to image the fluoride enhanced remineralization of artificial enamel lesions. Artificial lesions were created by an acetate buffer on smooth enamel surfaces and were exposed for 20 days to a 2 ppm fluoride containing remineralization solution. PS-OCT images revealed the presence of a low scattering surface zone after the artificial lesions were remineralized. These samples displayed intact nondepolarizing surface zones when analyzed with Polarized Light Microscopy (PLM). No statistical difference in lesion depth before and after remineralization was found with both PS-OCT and PLM. The remineralized lesions showed a significant decrease in the overall integrated reflectivity compared with the demineralized lesions. Digital Microradiography confirmed the increase in mineral volume of the remineralized surface zone. This study determined that PS-OCT can image the restoration of the surface zone enamel after fluoride-enhanced remineralization of artificial in vitro dental caries.

Clinical performance of the near-infrared imaging system VistaCam iX Proxi for detection of approximal enamel lesions.

PubMed

Jablonski-Momeni, Anahita; Jablonski, Boris; Lippe, Nikola

2017-01-01

Apart from the visual detection of caries, X-rays can be taken for detection of approximal lesions. The Proxi head of VistaCam iX intraoral camera system uses near-infrared light (NIR) to enable caries detection in approximal surfaces. The aim of this study was to evaluate the performance of the NIR for the detection of approximal enamel lesions by comparison with radiographic findings. One hundred ninety-three approximal surfaces from 18 patients were examined visually and using digital radiographs for presence or absence of enamel lesions. Then digital images of each surface were produced using the near-infrared light. Correlation between methods was assessed using Spearman's rank correlation coefficient ( r s ). Agreement between radiographic and NIR findings was calculated using the kappa coefficient. McNemar's test was used to analyse differences between the radiographic and NIR findings ( α =0.05). Moderate correlation was found between all detection methods ( r s =0.33-0.50, P <0.0001). Agreement between the radiographic and NIR findings was moderate ( κ =0.50, 95% CI=0.37-0.62) for the distinction between sound surfaces and enamel caries. No significant differences were found between the findings ( P =0.07). Radiographs and NIR were found to be comparable for the detection of enamel lesions in permanent teeth.

Further morphological evidence on South African earliest Homo lower postcanine dentition: Enamel thickness and enamel dentine junction.

PubMed

Pan, Lei; Dumoncel, Jean; de Beer, Frikkie; Hoffman, Jakobus; Thackeray, John Francis; Duployer, Benjamin; Tenailleau, Christophe; Braga, José

2016-07-01

The appearance of the earliest members of the genus Homo in South Africa represents a key event in human evolution. Although enamel thickness and enamel dentine junction (EDJ) morphology preserve important information about hominin systematics and dietary adaptation, these features have not been sufficiently studied with regard to early Homo. We used micro-CT to compare enamel thickness and EDJ morphology among the mandibular postcanine dentitions of South African early hominins (N = 30) and extant Homo sapiens (N = 26), with special reference to early members of the genus Homo. We found that South African early Homo shows a similar enamel thickness distribution pattern to modern humans, although three-dimensional average and relative enamel thicknesses do not distinguish australopiths, early Homo, and modern humans particularly well. Based on enamel thickness distributions, our study suggests that a dietary shift occurred between australopiths and the origin of the Homo lineage. We also observed that South African early Homo postcanine EDJ combined primitive traits seen in australopith molars with derived features observed in modern human premolars. Our results confirm that some dental morphological patterns in later Homo actually occurred early in the Homo lineage, and highlight the taxonomic value of premolar EDJ morphology in hominin species. Copyright © 2016 Elsevier Ltd. All rights reserved.

A randomised clinical study to evaluate experimental children's toothpastes in an in-situ palatal caries model in children aged 11-14 years.

PubMed

Newby, Evelyn E; Martinez-Mier, Esperanza A; Hara, Anderson; Lippert, Frank; Kelly, Sue A; Fleming, Nancy; Butler, Andrew; Bosma, Mary Lynn; Zero, Domenick T

2013-12-01

To compare three children's sodium fluoride toothpastes to placebo with respect to enamel remineralisation potential, enamel fluoride uptake and net acid resistance using an in situ palatal caries model in children aged 11-14 years following a single brushing. This was a randomised, single blind (laboratory analyst), single-centre, four-treatment, crossover study with a 7-day washout period between treatments. The treatments were 1,426 ppm fluoride, 1,000 ppm fluoride, 500 ppm fluoride and 0 ppm fluoride (placebo) toothpaste (NaF/silica). A custom made in situ palatal appliance was used by each subject in all treatment periods. At each of the four treatment visits subjects wore the appliance containing four partially demineralised human enamel specimens for 5 minutes and then brushed their teeth using a standardised procedure for 60 seconds under supervision using 1.0 g (±0.1 g) of their assigned toothpaste. After 4 hours the appliance was removed and enamel specimen recovered. This process was repeated until all subjects completed all four study treatment visits. Recovered enamel specimens were analysed for per cent surface microhardness recovery (%SMHR; Knoop) and enamel fluoride uptake (EFU; microdrill biopsy). Subsequently, specimens were demineralised in vitro to determine their % net acid resistance (%NAR; Knoop). All three fluoride toothpastes demonstrated significantly greater %SMHR, EFU and %NAR compared with 0 ppm F toothpaste. The model demonstrated a dose response over the range 0 to 1,426 ppm fluoride for %SMHR, EFU and %NAR. There was no significant difference between 500 ppm F and 1,000 ppm F for %SMHR and between 1,000 ppm F and 1,426 ppm F for %SMHR, EFU and %NAR. The present in situ study demonstrated that the children's fluoride toothpastes tested are capable of delivering cariostatic amounts of fluoride to early caries lesions following a single brushing. © 2013 FDI World Dental Federation.

Genes expressed in dental enamel development are associated with molar-incisor hypomineralization.

PubMed

Jeremias, Fabiano; Koruyucu, Mine; Küchler, Erika C; Bayram, Merve; Tuna, Elif B; Deeley, Kathleen; Pierri, Ricardo A; Souza, Juliana F; Fragelli, Camila M B; Paschoal, Marco A B; Gencay, Koray; Seymen, Figen; Caminaga, Raquel M S; dos Santos-Pinto, Lourdes; Vieira, Alexandre R

2013-10-01

Genetic disturbances during dental development influence variation of number and shape of the dentition. In this study, we tested if genetic variation in enamel formation genes is associated with molar-incisor hypomineralization (MIH), also taking into consideration caries experience. DNA samples from 163 cases with MIH and 82 unaffected controls from Turkey, and 71 cases with MIH and 89 unaffected controls from Brazil were studied. Eleven markers in five genes [ameloblastin (AMBN), amelogenin (AMELX), enamelin (ENAM), tuftelin (TUFT1), and tuftelin-interacting protein 11 (TFIP11)] were genotyped by the TaqMan method. Chi-square was used to compare allele and genotype frequencies between cases with MIH and controls. In the Brazilian data, distinct caries experience within the MIH group was also tested for association with genetic variation in enamel formation genes. The ENAM rs3796704 marker was associated with MIH in both populations (Brazil: p=0.03; OR=0.28; 95% C.I.=0.06-1.0; Turkey: p=1.22e-012; OR=17.36; 95% C.I.=5.98-56.78). Associations between TFIP11 (p=0.02), ENAM (p=0.00001), and AMELX (p=0.01) could be seen with caries independent of having MIH or genomic DNA copies of Streptococcus mutans detected by real time PCR in the Brazilian sample. Several genes involved in enamel formation appear to contribute to MIH. Copyright © 2013 Elsevier Ltd. All rights reserved.

Remineralization of artificial dentinal caries lesions by biomimetically modified Mineral Trioxide Aggregate

PubMed Central

Qi, Yi-pin; Li, Nan; Niu, Li-na; Primus, Carolyn M.; Ling, Jun-Qi; Pashley, David H.; Tay, Franklin R.

2011-01-01

Fluoride-releasing restorative materials are available for remineralization of enamel and root caries. However, dentin remineralization is more difficult than enamel remineralization due to the paucity of apatite seed crystallites along the lesion surface for heterogeneous crystal growth. Extracellular matrix proteins play critical roles in controlling apatite nucleation/growth in collagenous tissues. This study examined the remineralization efficacy of mineral trioxide aggregate (MTA) in phosphate-containing simulated body fluid (SBF) by incorporating polyacrylic acid and sodium tripolyphosphate as biomimetic analogs of matrix proteins for remineralizing caries-like dentin. Artificial caries-like dentin lesions incubated in SBF were remineralized over a 6-week period using MTA or MTA containing biomimetic analogs in the absence or presence of dentin adhesive application. Lesion depths and integrated mineral loss were monitored with micro-computed tomography. Ultrastructure of baseline and remineralized lesions were examined by transmission electron microscopy. Dentin remineralization was best achieved using MTA containing biomimetic analogs regardless of whether an adhesive was applied; dentinal tubules within the remineralized dentin were occluded by apatite. It is concluded that the MTA version employed in the study may be doped with biomimetic analogs for remineralization of unbonded and bonded artificial caries-like lesions in the presence of SBF. PMID:22085925

Optical pen-size reflectometer for monitoring of early dental erosion in native and polished enamels.

PubMed

Rakhmatullina, Ekaterina; Bossen, Anke; Bachofner, Kai K; Meier, Christoph; Lussi, Adrian

2013-11-01

Application of the specular reflection intensity was previously reported for the quantification of early dental erosion. Further development of the technique and assembly of the miniaturized pen-size instrument are described. The optical system was adjusted to fit into a handy device which could potentially access different positions in the oral cavity. The assembled instrument could successfully detect early erosion progression in both polished (n=70) and native (n=20) human enamels. Different severities of enamel erosion were induced by varying incubation time of polished enamel in 1% citric acid (pH=3.60, 0.5 to 10 min), while the native incisors were treated in the commercial orange juice (Tropicana Pure Premium®, pH=3.85, 10 to 60 min). The instrument provided a good differentiation between various severities of the erosion in vitro. The size of the measurement spot affected the erosion monitoring in native enamel (human incisors). The erosion measurement in the 0.7-mm (diameter) cervical spots showed systematically lower reflection intensities compared with the analysis of central and incisal small spots. The application of larger spot areas (2.3 mm) for the erosion monitoring revealed no effect (p>0.05) of the spot position on the reflection signal. High variation of the teeth susceptibility toward in vitro erosion was detected in native enamel.

Profiling of Oral Microbiota in Early Childhood Caries Using Single-Molecule Real-Time Sequencing.

PubMed

Wang, Yuan; Zhang, Jie; Chen, Xi; Jiang, Wen; Wang, Sa; Xu, Lei; Tu, Yan; Zheng, Pei; Wang, Ying; Lin, Xiaolong; Chen, Hui

2017-01-01

Background: Alterations of oral microbiota are the main cause of the progression of caries. The goal of this study was to characterize the oral microbiota in childhood caries based on single-molecule real-time sequencing. Methods: A total of 21 preschoolers, aged 3-5 years old with severe early childhood caries, and 20 age-matched, caries-free children as controls were recruited. Saliva samples were collected, followed by DNA extraction, Pacbio sequencing, and phylogenetic analyses of the oral microbial communities. Results: Eight hundred and seventy six species derived from 13 known bacterial phyla and 110 genera were detected from 41 children using Pacbio sequencing. At the species level, 38 species, including Veillonella spp., Streptococcus spp., Prevotella spp., and Lactobacillus spp., showed higher abundance in the caries group compared to the caries-free group ( p < 0.05). The core microbiota at the genus and species levels was more stable in the caries-free micro-ecological niche. At follow-up, oral examinations 6 months after sample collection, development of new dental caries was observed in 5 children (the transitional group) among the 21 caries free children. Compared with the caries-free children, in the transitional and caries groups, 6 species, which were more abundant in the caries-free group, exhibited a relatively low abundance in both the caries group and the transitional group ( p < 0.05). We conclude that Abiotrophia spp., Neisseria spp., and Veillonella spp., might be associated with healthy oral microbial ecosystem. Prevotella spp., Lactobacillus spp., Dialister spp., and Filifactor spp. may be related to the pathogenesis and progression of dental caries.

Non-destructive clinical assessment of occlusal caries lesions using near-IR imaging methods.

PubMed

Staninec, Michal; Douglas, Shane M; Darling, Cynthia L; Chan, Kenneth; Kang, Hobin; Lee, Robert C; Fried, Daniel

2011-12-01

Enamel is highly transparent in the near-IR (NIR) at wavelengths near 1,300 nm, and stains are not visible. The purpose of this study was to use NIR transillumination and optical coherence tomography (OCT) to estimate the severity of caries lesions on occlusal surfaces both in vivo and on extracted teeth. Extracted molars with suspected occlusal lesions were examined with OCT and polarization sensitive OCT (PS-OCT), and subsequently sectioned and examined with polarized light microscopy (PLM) and transverse microradiography (TMR). Teeth in test subjects with occlusal caries lesions that were not cavitated or visible on radiographs were examined using NIR transillumination at 1,310 nm using a custom built probe attached to an indium gallium arsenide (InGaAs) camera and a linear OCT scanner. After imaging, cavities were prepared using dye staining to guide caries removal and physical impressions of the cavities were taken. The lesion severity determined from OCT and PS-OCT scans in vitro correlated with the depth determined using PLM and TMR. Occlusal caries lesions appeared in NIR images with high contrast in vivo. OCT scans showed that most of the lesions penetrated to dentin and spread laterally below the sound enamel. This study demonstrates that both NIR transillumination and OCT are promising new methods for the clinical diagnosis of occlusal caries. Copyright © 2011 Wiley Periodicals, Inc.

Effectiveness of plant-derived proanthocyanidins on demineralization on enamel and dentin under artificial cariogenic challenge

PubMed Central

da SILVA, Ana Paula Pereira; GONÇALVES, Rafael Simões; BORGES, Ana Flávia Sanches; BEDRAN-RUSSO, Ana Karina; SHINOHARA, Mirela Sanae

2015-01-01

Dental caries is considered a disease of high prevalence and a constant problem in public health. Proanthocyanidins (PAs) are substances that have been the target of recent studies aiming to control or treat caries. Objective The aim of this in vitro study was to evaluate the efficacy of a treatment with grape seed extract, under cariogenic challenge, to minimize or even prevent the onset of caries in the enamel and dentin. Material and Methods Blocks of enamel and dentin (6.0x6.0 mm) were obtained from bovine central incisors, polished, and selected by analysis of surface microhardness (SH). The blocks were randomly divided into 3 groups (n=15), according to the following treatments: GC (control), GSE (grape seed extract), GF (fluoride – 1,000 ppm). The blocks were subjected to 6 daily pH cycles for 8 days. Within the daily cycling, the specimens were stored in buffered solution. The blocks were then analyzed for perpendicular and surface hardness and polarized light microscopy. Results The means were subjected to statistical analysis using the ANOVA and Fisher’s PLSD tests (p<0.05). For enamel SH, GF showed the highest hardness values. In the dentin, GF was also the one that showed higher hardness values, followed by GSE. Regarding the cross-sectional hardness values, all groups behaved similarly in both the enamel and dentin. The samples that were treated with GSE and fluoride (GF) showed statistically higher values than the control. Conclusion Based on the data obtained in this in vitro study, it is suggested that grape seed extract inhibits demineralization of artificial carious lesions in both the enamel and dentin, but in a different scale in each structure and in a smaller scale when compared to fluoride. PMID:26221925

Dental enamel irradiated with infrared diode laser and photoabsorbing cream: Part 1 -- FT-Raman Study.

PubMed

de Sant'anna, Giselle Rodrigues; dos Santos, Edson Aparecido Pereira; Soares, Luís Eduardo Silva; do Espírito Santo, Ana Maria; Martin, Airton Abrahão; Duarte, Danilo Antônio; Pacheco-Soares, Cristina; Brugnera, Aldo

2009-06-01

The aim of this FT-Raman study was to investigate laser-induced compositional changes in enamel after therapy with a low-level infrared diode laser and a photoabsorbing cream, in order to intensify the superficial light absorption before and after cariogenic challenge. Dental caries remains the most prevalent disease during childhood and adolescence. Preventive modalities include the use of fluoride, reduction of dietary cariogenic refined carbohydrates, plaque removal and oral hygiene techniques, and antimicrobial prescriptions. A relatively simple and noninvasive caries preventive regimen is treating tooth enamel with laser irradiation, either alone or in combination with topical fluoride treatment, resulting in reduced enamel solubility and dissolution rates. Due to their high cost, high-powered lasers are still not widely employed in private practice in developing countries. Thus, low-power red and near-infrared lasers appear to be an appealing alternative. Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: control group (no treatment; n = 8); infrared laser treatment (L; n = 8) (810 nm at 100 mW/cm(2) for 90 sec); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and photoabsorbing cream (IVL; n = 8); photoabsorbing cream alone (IV; n = 8); infrared diode laser irradiation (810 nm at 100 mW/cm(2) for 90 sec) and fluorinated photoabsorbing agent (IVLF; n = 8); and fluorinated photoabsorbing agent alone (IVF; n = 8). Samples were analyzed using FT-Raman spectroscopy before and after pH cycling cariogenic challenge. There was a significant laser-induced reduction and possible modification of the organic matrix content in enamel treated with the low-level diode laser (the L, IVL, and IVFL groups). The FT-Raman technique may be suitable for detecting compositional and structural changes occurring in mineral phases and organic phases of lased enamel under cariogenic challenge.

Dental enamel defects in Italian children with cystic fibrosis: an observational study.

PubMed

Ferrazzano, G F; Sangianantoni, G; Cantile, T; Amato, I; Orlando, S; Ingenito, A

2012-03-01

The relationship between cystic fibrosis (CF) and caries experience has already been explored, but relatively little information is available on dental enamel defects prevalence among children affected by cystic fibrosis. The aim of this study was to investigate this issue in deciduous and permanent teeth of children with CF resident in southern Italy. This cross sectional observational study was undertaken between October 2009 and March 2010. 88 CF patients and 101 healthy age-matched participated in this study. The prevalence of dental enamel defects was calculated using a modified Developmental Defects of Enamel (DDE) index. The comparison of dental enamel defects prevalence among groups was carried out using regression binary logistic analysis. In the CF subjects there was a higher prevalence (56%) of enamel defects in comparison to the healthy group (22%). The most prevalent enamel defect was hypoplasia with loss of enamel (23% of CF patients vs 1 1/2% of control group) in permanent teeth. This study confirms that children with cystic fibrosis are at increased risk of developing hypoplastic defects on their permanent teeth.

Global Research Trends on Early-Life Feeding Practices and Early Childhood Caries: a Systematic Review

PubMed Central

Cheng, Ashley

2014-01-01

Objective Describe the epidemiologic literature related to early-life feeding practices and early childhood caries (ECC) with regard to publication attributes and trends in these attributes over time. Methods Systematic literature review including electronic and manual searches (in BIOSIS, CINAHL, Cochrane Library, LILACS, MEDLINE, Web of Science, and WHOLIS), covering the years 1990–2013. Attributes of publications meeting a priori inclusion criteria were abstracted and organized by global region and trends over time. Attributes included country of origin and study design of included publications and age and caries prevalence of the populations studied. Results 244 publications drawn from 196 independent study populations were included. The number of publications and the countries represented increased over time, although some world regions remained underrepresented. Most publications were cross sectional (75%); while this percentage remained fairly constant over time, the percentage of studies to account for confounding factors increased. Publications varied with respect to the caries experience and age range of children included in each study. Conclusions Publication productivity regarding feeding practices and ECC research has grown, but this growth has not been evenly distributed globally. Individual publication attributes (i.e. methods and context) can differ significantly and should be considered when interpreting and synthesizing the literature. PMID:25328911

Oriented and Ordered Biomimetic Remineralization of the Surface of Demineralized Dental Enamel Using HAP@ACP Nanoparticles Guided by Glycine

PubMed Central

Wang, Haorong; Xiao, Zuohui; Yang, Jie; Lu, Danyang; Kishen, Anil; Li, Yanqiu; Chen, Zhen; Que, Kehua; Zhang, Qian; Deng, Xuliang; Yang, Xiaoping; Cai, Qing; Chen, Ning; Cong, Changhong; Guan, Binbin; Li, Ting; Zhang, Xu

2017-01-01

Achieving oriented and ordered remineralization on the surface of demineralized dental enamel, thereby restoring the satisfactory mechanical properties approaching those of sound enamel, is still a challenge for dentists. To mimic the natural biomineralization approach for enamel remineralization, the biological process of enamel development proteins, such as amelogenin, was simulated in this study. In this work, carboxymethyl chitosan (CMC) conjugated with alendronate (ALN) was applied to stabilize amorphous calcium phosphate (ACP) to form CMC/ACP nanoparticles. Sodium hypochlorite (NaClO) functioned as the protease which decompose amelogenin in vivo to degrade the CMC-ALN matrix and generate HAP@ACP core-shell nanoparticles. Finally, when guided by 10 mM glycine (Gly), HAP@ACP nanoparticles can arrange orderly and subsequently transform from an amorphous phase to well-ordered rod-like apatite crystals to achieve oriented and ordered biomimetic remineralization on acid-etched enamel surfaces. This biomimetic remineralization process is achieved through the oriented attachment (OA) of nanoparticles based on non-classical crystallization theory. These results indicate that finding and developing analogues of natural proteins such as amelogenin involved in the biomineralization by natural macromolecular polymers and imitating the process of biomineralization would be an effective strategy for enamel remineralization. Furthermore, this method represents a promising method for the management of early caries in minimal invasive dentistry (MID). PMID:28079165

Oriented and Ordered Biomimetic Remineralization of the Surface of Demineralized Dental Enamel Using HAP@ACP Nanoparticles Guided by Glycine

NASA Astrophysics Data System (ADS)

Wang, Haorong; Xiao, Zuohui; Yang, Jie; Lu, Danyang; Kishen, Anil; Li, Yanqiu; Chen, Zhen; Que, Kehua; Zhang, Qian; Deng, Xuliang; Yang, Xiaoping; Cai, Qing; Chen, Ning; Cong, Changhong; Guan, Binbin; Li, Ting; Zhang, Xu

2017-01-01

Achieving oriented and ordered remineralization on the surface of demineralized dental enamel, thereby restoring the satisfactory mechanical properties approaching those of sound enamel, is still a challenge for dentists. To mimic the natural biomineralization approach for enamel remineralization, the biological process of enamel development proteins, such as amelogenin, was simulated in this study. In this work, carboxymethyl chitosan (CMC) conjugated with alendronate (ALN) was applied to stabilize amorphous calcium phosphate (ACP) to form CMC/ACP nanoparticles. Sodium hypochlorite (NaClO) functioned as the protease which decompose amelogenin in vivo to degrade the CMC-ALN matrix and generate HAP@ACP core-shell nanoparticles. Finally, when guided by 10 mM glycine (Gly), HAP@ACP nanoparticles can arrange orderly and subsequently transform from an amorphous phase to well-ordered rod-like apatite crystals to achieve oriented and ordered biomimetic remineralization on acid-etched enamel surfaces. This biomimetic remineralization process is achieved through the oriented attachment (OA) of nanoparticles based on non-classical crystallization theory. These results indicate that finding and developing analogues of natural proteins such as amelogenin involved in the biomineralization by natural macromolecular polymers and imitating the process of biomineralization would be an effective strategy for enamel remineralization. Furthermore, this method represents a promising method for the management of early caries in minimal invasive dentistry (MID).

Monitoring of enamel lesion remineralization by optical coherence tomography: an alternative approach towards signal analysis

NASA Astrophysics Data System (ADS)

Sadr, Alireza; Mandurah, Mona; Nakashima, Syozi; Shimada, Yasushi; Kitasako, Yuichi; Tagami, Junji; Sumi, Yasunori

Early detection, monitoring and remineralization repair of enamel lesions are top research priorities in the modern dentistry focusing on minimal intervention concept for caries management. We investigate the use of swept-source optical coherence tomography system (SS-OCT) without polarization-sensing at 1319 nm wavelength developed for clinical dentistry (Dental OCT System Prototype 2, Panasonic Healthcare Co., Ltd., Japan) in quantitative assessment of artificial enamel lesions and their remineralization. Bovine enamel blocks were subjected to demineralization to create subsurface lesions approximately 130 μm in depth over 2 weeks, and subjected to remineralization in solution containing bioavailable calcium and 1ppm fluoride at pH 6.5 for 2 weeks. Cross-sectional images of sound, demineralized and remineralized specimens were captured under hydrated conditions by the OCT. Finally, the specimens were cut into sections for nanoindentation to measure hardness through the lesion under 2mN load. Reflectivity had increased with demineralization. OCT images of lesions showed a boundary closely suggesting the lesion depth that gradually progressed with demineralization time. After remineralization, the boundary depth gradually decreased and nanoindentation showed over 60% average hardness recovery rate. A significant negative correlation was found between the slope power-law regression as a measure of attenuation and overall nanohardness for a range of data covering sound, demineralized and remineralized areas. In conclusion, OCT could provide clear images of early enamel lesion extent and signal attenuation could indicate its severity and recovery. Clinical data of natural lesions obtained using Dental OCT and analyzed by this approach will also be presented. Study supported by GCOE IRCMSTBD and NCGG.

Salivary proteins and early childhood caries: A gel electrophoretic analysis

PubMed Central

Bhalla, Sumati; Tandon, Shobha; Satyamoorthy, K.

2010-01-01

Background: Early childhood caries (ECC) is a common disease process that afflicts a large proportion of the child population worldwide. Extensive research in past indicates that it is the result of bacterial infection, also influenced by host and dietary factors. Current caries research seeks to identify risk factors as well as natural oral defenses that may protect against or prevent caries development. Saliva, in spite of being the strongest defense system, still has a wide array of properties and proteins whose role is yet not clearly known. Aim: To compare the resting human whole salivary characteristics in children with ECC and those who are caries free. Settings and Design: The study was conducted over a period of 9 months in 4- to 6-year-old 100 children comprising two groups – 50 with ECC and 50 caries free. Materials and Methods: The whole salivary flow rate, pH, mean protein concentration, and the electrophoretic profile of salivary proteins by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS–PAGE) were compared among both groups. Statistical Analysis: The SPSS (version 11.0) software package was used to conduct the chi-square, Fisher's exact and Pearson's chi-square tests to compare the data. Results: On gel electrophoresis, there was a significant difference among both groups with caries-free subjects having a higher number of proline-rich protein bands, substantiating the protective role of this protein. A significantly higher number of glycoprotein bands were observed in the whole saliva of subjects with ECC. A significant inverse correlation between the mean protein concentration and the whole salivary flow rate was observed in both groups. PMID:22114372

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.

Selective removal of demineralized enamel using a CO2 laser coupled with near-IR reflectance imaging

NASA Astrophysics Data System (ADS)

Tom, Henry; Chan, Kenneth H.; Saltiel, Daniel; Fried, Daniel

2015-02-01

Detection and diagnosis of early dental caries lesions can be difficult due to variable tooth coloration, staining of the teeth and poor contrast between sound and demineralized enamel. These problems can be overcome by using near-infrared (NIR) imaging. Previous studies have demonstrated that lasers can be integrated with NIR imaging devices, allowing image-guided ablation. The aim of this study was to demonstrate that NIR light at 1500 - 1700 nm can be used to guide a 9.3-μm CO2 laser for the selective ablation of early demineralization on tooth occlusal surfaces. The occlusal surfaces of ten sound human molars were used in this in-vitro study. Shallow simulated caries lesions of varying depth and position were produced on tooth occlusal surfaces using a demineralization solution. Sequential NIR reflectance images at 1500 - 1700 nm were used to guide the laser for selective ablation of the lesion areas. Digital microscopy and polarization sensitive optical coherence tomography (PS-OCT) were used to assess the selectivity of removal. This study demonstrates that high contrast NIR reflectance images can be used for the image-guided laser ablation of early demineralization from tooth occlusal surfaces.

Clinical performance of the near-infrared imaging system VistaCam iX Proxi for detection of approximal enamel lesions

PubMed Central

Jablonski-Momeni, Anahita; Jablonski, Boris; Lippe, Nikola

2017-01-01

Objectives/Aims: Apart from the visual detection of caries, X-rays can be taken for detection of approximal lesions. The Proxi head of VistaCam iX intraoral camera system uses near-infrared light (NIR) to enable caries detection in approximal surfaces. The aim of this study was to evaluate the performance of the NIR for the detection of approximal enamel lesions by comparison with radiographic findings. Materials and methods: One hundred ninety-three approximal surfaces from 18 patients were examined visually and using digital radiographs for presence or absence of enamel lesions. Then digital images of each surface were produced using the near-infrared light. Correlation between methods was assessed using Spearman’s rank correlation coefficient (rs). Agreement between radiographic and NIR findings was calculated using the kappa coefficient. McNemar’s test was used to analyse differences between the radiographic and NIR findings (α=0.05). Results: Moderate correlation was found between all detection methods (rs=0.33–0.50, P<0.0001). Agreement between the radiographic and NIR findings was moderate (κ=0.50, 95% CI=0.37–0.62) for the distinction between sound surfaces and enamel caries. No significant differences were found between the findings (P=0.07). Conclusion: Radiographs and NIR were found to be comparable for the detection of enamel lesions in permanent teeth. PMID:29607082

Profiling of Oral Microbiota in Early Childhood Caries Using Single-Molecule Real-Time Sequencing

PubMed Central

Wang, Yuan; Zhang, Jie; Chen, Xi; Jiang, Wen; Wang, Sa; Xu, Lei; Tu, Yan; Zheng, Pei; Wang, Ying; Lin, Xiaolong; Chen, Hui

2017-01-01

Background: Alterations of oral microbiota are the main cause of the progression of caries. The goal of this study was to characterize the oral microbiota in childhood caries based on single-molecule real-time sequencing. Methods: A total of 21 preschoolers, aged 3–5 years old with severe early childhood caries, and 20 age-matched, caries-free children as controls were recruited. Saliva samples were collected, followed by DNA extraction, Pacbio sequencing, and phylogenetic analyses of the oral microbial communities. Results: Eight hundred and seventy six species derived from 13 known bacterial phyla and 110 genera were detected from 41 children using Pacbio sequencing. At the species level, 38 species, including Veillonella spp., Streptococcus spp., Prevotella spp., and Lactobacillus spp., showed higher abundance in the caries group compared to the caries-free group (p < 0.05). The core microbiota at the genus and species levels was more stable in the caries-free micro-ecological niche. At follow-up, oral examinations 6 months after sample collection, development of new dental caries was observed in 5 children (the transitional group) among the 21 caries free children. Compared with the caries-free children, in the transitional and caries groups, 6 species, which were more abundant in the caries-free group, exhibited a relatively low abundance in both the caries group and the transitional group (p < 0.05). We conclude that Abiotrophia spp., Neisseria spp., and Veillonella spp., might be associated with healthy oral microbial ecosystem. Prevotella spp., Lactobacillus spp., Dialister spp., and Filifactor spp. may be related to the pathogenesis and progression of dental caries. PMID:29187843

Aciduric Microbiota and Mutans Streptococci in Severe and Recurrent Severe Early Childhood Caries

PubMed Central

Hughes, Christopher V.; Dahlan, Mohammed; Papadopolou, Eleftheria; Kent, Ralph L.; Loo, Cheen Y.; Pradhan, Nooruddin S.; Lu, Shulin C.; Bravoco, Alexandra; Mathney, Jennifer M.J.; Tanner, Anne C.R.

2011-01-01

Purpose Severe early childhood caries (ECC) results from bacterial acid production in an acidic environment. The current study determined Streptococcus mutans, Streptococcus sobrinus and acid-tolerant counts in severe-ECC. Methods Children (2–6 years) with severe-ECC (n=77) or who were caries-free (n=40) were examined. Plaque samples from teeth and the tongue were cultured anaerobically on blood, acid and S. mutans selective agars. Severe-ECC children were monitored post-treatment for recurrent caries. Results Severe-ECC and caries-free children were balanced by household income and education level. Carious lesions were observed in 75% maxillary incisors and >80% molars in severe-ECC. At baseline, Streptococcus mutans, and Streptococcus sobrinus counts and proportions of S. mutans were higher in severe-ECC than caries-free children. Acid and blood counts were elevated only in anterior samples of severe-ECC children. Baseline counts of S. sobrinus, but not S. mutans, were higher in children with recurrent compared with no recurrent caries. S. mutans counts were lower post treatment than pre-treatment, particularly for children without caries recurrence. Other counts did not differ between before and after therapy. Conclusions We conclude that severe and recurrent ECC were better explained by mutans streptococci than the aciduric microbiota. S. mutans did not predict children with recurrent caries. PMID:22583872

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.

A Randomized in situ Clinical Study of Fluoride Dentifrices on Enamel Remineralization and Resistance to Demineralization: Effects of Zinc.

PubMed

Creeth, Jonathan E; Karwal, Ritu; Hara, Anderson T; Zero, Domenick T

2018-01-01

This study aimed to determine the effect of zinc ions and F concentration in a dentifrice on remineralization of early caries lesions in situ and on resistance to subsequent demineralization. This was a single-center, 6-period, 6-product, blinded (examiner, subject, analyst), randomized (n = 62), crossover study. Products (all NaF) were: 0, 250, 1,150 and 1,426 ppm F (dose-response controls), "Zn-A" (0.3% ZnCl2, 1,426 ppm F), and "Zn-B" (as Zn-A, with high-foaming surfactants) in a conventional silica base. Subjects wore palatal appliances holding partially demineralized bovine enamel specimens. They brushed their teeth with 1.5 g test dentifrice (25 s), then swished the slurry ensuring even exposure of specimens (95 s), expectorated, and rinsed (15 mL water, 10 s). After 4 h intraoral remineralization, specimens were removed and acid-challenged in vitro. Surface microhardness (SMH), measured pre-experimental, post-initial acid exposure, post-remineralization, and post-second acid exposure, was used to calculate recovery (SMHR), net acid resistance (NAR), and a new, specifically demineralization-focused calculation, "comparative acid resistance" (CAR). Enamel fluoride uptake (EFU) was also measured. For the F dose-response controls, all measures showed significant relationships with dentifrice F concentration (p < 0.0001). The presence of zinc counteracted the ability of F to promote remineralization in this model. Compared to the 1,426 ppm F control, the zinc formulations gave reduced SMHR, EFU, and NAR (all p < 0.0001); however, they showed evidence of increased CAR (Zn-A: p = 0.0040; Zn-B: p = 0.0846). Products were generally well tolerated. In this study, increasing dentifrice F concentration progressively increased in situ remineralization and demineralization resistance of early caries enamel lesions. Zinc ions reduced remineralization but could increase demineralization resistance. © 2018 S. Karger AG, Basel.

Dental caries imaging using hyperspectral stimulated Raman scattering microscopy

NASA Astrophysics Data System (ADS)

Wang, Zi; Zheng, Wei; Jian, Lin; Huang, Zhiwei

2016-03-01

We report the development of a polarization-resolved hyperspectral stimulated Raman scattering (SRS) imaging technique based on a picosecond (ps) laser-pumped optical parametric oscillator system for label-free imaging of dental caries. In our imaging system, hyperspectral SRS images (512×512 pixels) in both fingerprint region (800-1800 cm-1) and high-wavenumber region (2800-3600 cm-1) are acquired in minutes by scanning the wavelength of OPO output, which is a thousand times faster than conventional confocal micro Raman imaging. SRS spectra variations from normal enamel to caries obtained from the hyperspectral SRS images show the loss of phosphate and carbonate in the carious region. While polarization-resolved SRS images at 959 cm-1 demonstrate that the caries has higher depolarization ratio. Our results demonstrate that the polarization resolved-hyperspectral SRS imaging technique developed allows for rapid identification of the biochemical and structural changes of dental caries.

FT-Raman spectroscopic characterization of enamel surfaces irradiated with Nd:YAG and Er:YAG lasers

PubMed Central

Shahabi, Sima; Fekrazad, Reza; Johari, Maryam; Chiniforoush, Nasim; Rezaei, Yashar

2016-01-01

Background. Despite recent advances in dental caries prevention, caries is common and remains a serious health problem. Laser irradiation is one of the most common methods in preventive measures in recent years. Raman spectroscopy technique is utilized to study the microcrystalline structure of dental enamel. In this study, FT-Raman spectroscopy was used to evaluate chemical changes in enamel structure irradiated with Nd:YAG and Er:YAG lasers. Methods. We used 15 freshly-extracted, non-carious, human molars that were treated as follows: No treatment was carried out in group A (control group); Group B was irradiated with Er:YAG laser for 10 seconds under air and water spray; and Group C was irradiated with Nd:YAG laser for 10 seconds under air and water spray. After treatment, the samples were analyzed by FT-Raman spectroscopy. Results. The carbonate content evaluation with regard to the integrated area under the curve (1065/960 cm–1) exhibited a significant reduction in its ratio in groups B and C. The organic content (2935/960 cm-1) area exhibited a significant decrease after laser irradiation in group B and C. Conclusion. The results showed that the mineral and organic matrices of enamel structure were affected by laser irradiation; therefore, it might be a suitable method for caries prevention. PMID:28096945

A pilot study of dentists' assessment of caries detection and staging systems applied to early caries: PEARL Network findings.

PubMed

Thompson, Van P; Schenkel, Andrew B; Penugonda, Bapanaiah; Wolff, Mark S; Zeller, Gregory G; Wu, Hongyu; Vena, Don; Grill, Ashley C; Curro, Frederick A

2016-01-01

The International Caries Detection and Assessment System (ICDAS II) and the Caries Classification System (CCS) are caries stage description systems proposed for adoption into clinical practice. This pilot study investigated clinicians' training in and use of these systems for detection of early caries and recommendations for individual tooth treatment. Patient participants (N = 8) with a range of noncavitated lesions (CCS ranks 2 and 4 and ICDAS II ranks 2-4) identified by a team of calibrated examiners were recruited from the New York University College of Dentistry clinic. Eighteen dentists-8 from the Practitioners Engaged in Applied Research and Learning (PEARL) Network and 10 recruited from the Academy of General Dentistry-were randomly assigned to 1 of 3 groups: 5 dentists used only visual-tactile (VT) examination, 7 were trained in the ICDAS II, and 6 were trained in the CCS. Lesion stage for each tooth was determined by the ICDAS II and CCS groups, and recommended treatment was decided by all groups. Teeth were assessed both with and without radiographs. Caries was detected in 92.7% (95% CI, 88%-96%) of the teeth by dentists with CCS training, 88.8% (95% CI, 84%-92%) of the teeth by those with ICDAS II training, and 62.3% (95% CI, 55%-69%) of teeth by the VT group. Web-based training was acceptable to all dentists in the CCS group (6 of 6) but fewer of the dentists in the ICDAS II group (5 of 7). The modified CCS translated clinically to more accurate caries detection, particularly compared to detection by untrained dentists (VT group). Moreover, the CCS was more accepted than was the ICDAS II, but dentists in both groups were open to the application of these systems. Agreement on caries staging requires additional training prior to a larger validation study.

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.

Higher body mass index associated with severe early childhood caries.

PubMed

Davidson, Katherine; Schroth, Robert J; Levi, Jeremy A; Yaffe, Aaron B; Mittermuller, Betty-Anne; Sellers, Elizabeth A C

2016-08-20

Severe Early Childhood Caries (S-ECC) is an aggressive form of tooth decay in preschool children affecting quality of life and nutritional status. The purpose was to determine whether there is an association between Body Mass Index (BMI) and S-ECC. Children with S-ECC were recruited on the day of their slated dental surgery under general anesthesia. Age-matched, caries-free controls were recruited from the community. All children were participating in a larger study on nutrition and S-ECC. Analysis was restricted to children ≥ 24 months of age. Parents completed a questionnaire and heights and weights were recorded. BMI scores and age and gender adjusted BMI z-scores and percentiles were calculated. A p-value ≤ 0.05 was significant. Two hundred thirty-five children were included (141 with S-ECC and 94 caries-free). The mean age was 43.3 ± 12.8 months and 50.2 % were male. Overall, 34.4 % of participants were overweight or obese. Significantly more children with S-ECC were classified as overweight or obese when compared to caries-free children (p = 0.038) and had significantly higher mean BMI z-scores than caries-free children (0.78 ± 1.26 vs. 0.22 ± 1.36, p = 0.002). Those with S-ECC also had significantly higher BMI percentiles (69.0 % ± 29.2 vs. 56.8 % ± 31.7, p = 0.003). Multiple linear regression analyses revealed that BMI z-scores were significantly and independently associated with S-ECC and annual household income as were BMI percentiles. Children with S-ECC in our sample had significantly higher BMI z-scores than caries-free peers.

Effect of Diode Laser Irradiation Combined with Topical Fluoride on Enamel Microhardness of Primary Teeth.

PubMed

Bahrololoomi, Zahra; Lotfian, Malihe

2015-02-01

Laser irradiation has been suggested as an adjunct to traditional caries prevention methods. But little is known about the cariostatic effect of diode laser and most studies available are on permanent teeth.The purpose of the present study was to investigate the effect of diode laser irradiation combined with topical fluoride on enamel surface microhardness. Forty-five primary teeth were used in this in vitro study. The teeth were sectioned to produce 90 slabs. The baseline Vickers microhardness number of each enamel surface was determined. The samples were randomly divided into 3 groups. Group 1: 5% NaF varnish, group 2: NaF varnish+ diode laser at 5 W power and group 3: NaF varnish+ diode laser at 7 W power. Then, the final microhardness number of each surface was again determined. The data were statistically analyzed by repeated measures ANOVA at 0.05 level of significance. In all 3 groups, microhardness number increased significantly after surface treatment (P<0.05). However, Microhardness change after treatment was not significantly different among groups (P >0.05). The combined application of diode laser and topical fluoride varnish on enamel surface did not show any significant additional effect on enamel resistance to caries.

Remineralization of artificial dentinal caries lesions by biomimetically modified mineral trioxide aggregate.

PubMed

Qi, Yi-pin; Li, Nan; Niu, Li-na; Primus, Carolyn M; Ling, Jun-Qi; Pashley, David H; Tay, Franklin R

2012-02-01

Fluoride-releasing restorative materials are available for remineralization of enamel and root caries. However, remineralization of dentin is more difficult than remineralization of enamel due to the paucity of apatite seed crystallites along the lesion surface for heterogeneous crystal growth. Extracellular matrix proteins play critical roles in controlling apatite nucleation/growth in collagenous tissues. This study examined the remineralization efficacy of mineral trioxide aggregate (MTA) in phosphate-containing simulated body fluid (SBF) by incorporating polyacrylic acid and sodium tripolyphosphate as biomimetic analogs of matrix proteins for remineralizing caries-like dentin. Artificial caries-like dentin lesions incubated in SBF were remineralized over a 6 week period using MTA alone or MTA containing biomimetic analogs in the absence or presence of dentin adhesive application. Lesion depths and integrated mineral loss were monitored with microcomputed tomography. The ultrastructure of baseline and remineralized lesions was examined by transmission electron microscopy. Dentin remineralization was best achieved using MTA containing biomimetic analogs regardless of whether an adhesive was applied; dentinal tubules within the remineralized dentin were occluded by apatite. It is concluded that the version of MTA employed in this study may be doped with biomimetic analogs for remineralization of unbonded and bonded artificial caries-like lesions in the presence of SBF. Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Dental Enamel Irradiated with Infrared Diode Laser and Photo-Absorbing Cream: Part 2—EDX Study

PubMed Central

dos Santos, Edson Aparecido Pereira; Soares, Luís Eduardo Silva; do Espírito Santo, Ana Maria; Martin, Airton Abrahão; Duarte, Danilo Antônio; Pacheco-Soares, Cristina; Brugnera, Aldo

2009-01-01

Abstract Objective: The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (μ-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). Background Data: Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive μ-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. Materials and Methods: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (λ = 810 nm, 100 mW/cm2, 90 sec, 4.47 J/cm2, 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using μ-EDX after two sets of treatments and pH cycling cariogenic challenges. Results: The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. Conclusion: μ-EDX may be able to detect compositional changes in mineral phases of lased enamel under

Enhancing caries resistance with a short-pulsed CO2 9.3-μm laser: a laboratory study (Conference Presentation)

NASA Astrophysics Data System (ADS)

Rechmann, Peter; Rechmann, Beate M.; Groves, William H.; Le, Charles; Rapozo-Hilo, Marcia L.; Featherstone, John D. B.

2016-02-01

The objective of this laboratory study was to test whether irradiation with a new 9.3µm microsecond short-pulsed CO2-laser enhances enamel caries resistance with and without additional fluoride applications. 101 human enamel samples were divided into 7 groups. Each group was treated with different laser parameters (Carbon-dioxide laser, wavelength 9.3µm, 43Hz pulse-repetition rate, pulse duration between 3μs to 7μs (1.5mJ/pulse to 2.9mJ/pulse). Using a pH-cycling model and cross-sectional microhardness testing determined the mean relative mineral loss delta Z (∆Z) for each group. The pH-cycling was performed with or without additional fluoride. The CO2 9.3μm short-pulsed laser energy rendered enamel caries resistant with and without additional fluoride use.

Early Childhood Dental Caries. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Platt, Laurence J.; Cabezas, Maritza C.

As part of a series of reports designed to support the implementation of Proposition 10: The California Children and Families Act and to provide comprehensive and authoritative information on critical issues concerning young children and families in California, this report describes the scope and severity of early childhood caries (ECC), a…

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.

Effect of high energy X-ray irradiation on the nano-mechanical properties of human enamel and dentine.

PubMed

Liang, Xue; Zhang, Jing Yang; Cheng, Iek Ka; Li, Ji Yao

2016-01-01

Radiotherapy for malignancies in the head and neck can cause common complications that can result in tooth damage that are also known as radiation caries. The aim of this study was to examine damage to the surface topography and calculate changes in friction behavior and the nano-mechanical properties (elastic modulus, nanohardness and friction coefficient) of enamel and dentine from extracted human third molars caused by exposure to radiation. Enamel and dentine samples from 50 human third molars were randomly assigned to four test groups or a control group. The test groups were exposed to high energy X-rays at 2 Gy/day, 5 days/week for 5 days (10 Gy group), 15 days (30 Gy group), 25 days (50 Gy group), 35 days (70 Gy group); the control group was not exposed. The nanohardness, elastic modulus, and friction coefficient were analyzed using a Hysitron Triboindenter. The nano-mechanical properties of both enamel and dentine showed significant dose-response relationships. The nanohardness and elastic modulus were most variable between 30-50 Gy, while the friction coefficient was most variable between 0-10 Gy for dentine and 30-50 Gy for enamel. After exposure to X-rays, the fracture resistance of the teeth clearly decreased (rapidly increasing friction coefficient with increasing doses under the same load), and they were more fragile. These nano-mechanical changes in dental hard tissue may increase the susceptibility to caries. Radiotherapy caused nano-mechanical changes in dentine and enamel that were dose related. The key doses were 30-50 Gy and the key time points occurred during the 15th-25th days of treatment, which is when application of measures to prevent radiation caries should be considered.

Validation of an early childhood caries risk assessment tool in a low-income Hispanic population.

PubMed

Custodio-Lumsden, Christie L; Wolf, Randi L; Contento, Isobel R; Basch, Charles E; Zybert, Patricia A; Koch, Pamela A; Edelstein, Burton L

2016-03-01

There is a recognized need for valid risk assessment tools for use by both dental and nondental personnel to identify young children at risk for, or with, precavitated stages of early childhood caries (i.e., early stage decalcifications or white spot lesions).The aim of this study is to establish concurrent criterion validity of "MySmileBuddy" (MSB), a novel technology-assisted ECC risk assessment and behavioral intervention tool against four measures of ECC activity: semi-quantitative assays of salivary mutans streptococci levels, visible quantity of dental plaque, visual evidence of enamel decalcifications, and cavitation status (none, ECC, severe ECC). One hundred eight children 2-6 years of age presenting to a pediatric dental clinic were recruited from a predominantly Spanish-speaking, low-income, urban population. All children received a comprehensive oral examination and saliva culture for assessment of ECC indicators. Their caregivers completed the iPad-based MSB assessment in its entirety (15-20 minutes). MSB calculated both diet and comprehensive ECC risk scores. Associations between all variables were determined using ordinal logistic regression. MSB diet risk scores were significantly positively associated with salivary mutans (P < 0.05), and approached significance with visible plaque levels (P < 0.1). MSB comprehensive risk scores were significantly associated with both oral mutans and visible plaque (P < 0.05). Neither was associated with visually evident decalcifications or cavitations. Findings suggest that MSB may have clinical utility as a valid risk assessment tool for identifying children with early precursors of cavitations but does not add value in identifying children with extant lesions. © 2015 American Association of Public Health Dentistry.

[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.

Association between AMELX polymorphisms and dental caries in Koreans.

PubMed

Kang, S W; Yoon, I; Lee, H W; Cho, J

2011-05-01

Dental caries is greatly influenced disease by environmental factors, but recently there are increasing evidences for a genetic component in caries susceptibility. AMELX is the gene coding amelogenin, which is the most important factor for normal enamel development. The aim of this study was to examine the relationship between dental caries and single nucleotide polymorphisms (SNPs) in AMELX. For this study, we used DNA samples collected from 120 unrelated individuals older than 12 years of age. All of them were examined for their oral and dental status under the WHO recommended criteria, and clinical information such as DMFT and DMFS were evaluated. Individuals whose DMFT and DMFS index lower than 2 were designated 'very low caries experience' and higher than 3 were designated 'higher caries experience'. Genomic DNA was extracted from hair samples, and single nucleotide polymorphisms of AMELX were genotyped. Genotyping of three SNPs (rs17878486, rs5933871, rs5934997, intron) in AMELX gene was determined by direct sequencing and analyzed with SNPStats. There were significant associations between rs5933871 and rs5934997 SNP and caries susceptibility in the water fluoridation group. These results suggest that SNPs of AMELX might be associated with dental caries susceptibility in Korean population. © 2010 John Wiley & Sons A/S.

Dentifrice fluoride and abrasivity interplay on artificial caries lesions.

PubMed

Nassar, Hani M; Lippert, Frank; Eckert, George J; Hara, Anderson T

2014-01-01

Incipient caries lesions on smooth surfaces may be subjected to toothbrushing, potentially leading to remineralization and/or abrasive wear. The interplay of dentifrice abrasivity and fluoride on this process is largely unknown and was investigated on three artificially created lesions with different mineral content/distribution. 120 bovine enamel specimens were randomly allocated to 12 groups (n = 10), resulting from the association of (1) lesion type [methylcellulose acid gel (MeC); carboxymethylcellulose solution (CMC); hydroxyethylcellulose gel (HEC)], (2) slurry abrasive level [low (REA 4/ RDA 69); high (REA 7/RDA 208)], and (3) fluoride concentration [0/275 ppm (14.5 mM) F as NaF]. After lesion creation, specimens were brushed in an automated brushing machine with the test slurries (50 strokes 2×/day). Specimens were kept in artificial saliva in between brushings and overnight. Enamel surface loss (SL) was determined by optical profilometry after lesion creation, 1, 3 and 5 days. Two enamel sections (from baseline and post-brushing areas) were obtained and analyzed microradiographically. Data were analyzed by analysis of variance and Tukey's tests (α = 5%). Brushing with high-abrasive slurry caused more SL than brushing with low-abrasive slurry. For MeC and CMC lesions, fluoride had a protective effect on SL from day 3 on. Furthermore, for MeC and CMC, there was a significant mineral gain in the remaining lesions except when brushed with high-abrasive slurries and 0 ppm F. For HEC, a significant mineral gain took place when low-abrasive slurry was used with fluoride. The tested lesions responded differently to the toothbrushing procedures. Both slurry fluoride content and abrasivity directly impacted SL and mineral gain of enamel caries lesions.

[The effects of topical fluoridation of enamel on the growth of cariogenic bacteria contained in the dental plaque].

PubMed

Płuciennik-Stronias, Małgorzata; Zarzycka, Beata; Bołtacz-Rzepkowska, Elzbieta

2013-01-01

Dental caries is a bacterial disease. The most important element used in caries prevention is fluoride, which is derived from the air, diet or fluoride-containing preparations and materials, e.g. glass-ionomer restorations. Fluoride can inhibit metabolism and bacterial growth in the dental plaque. The aim of the study was to evaluate the effect of topical fluoridation of the enamel on the growth of Lactobacillus spp. in the dental plaque. The study was carried out in 15 patients with good oral hygiene, in whom three-day dental plaque from the enamel was examined. Next, fluoride was rubbed on the same surface and the examination of three-day dental plaque was repeated. No statistically significant differences (p = 0.475) in the amounts of Lactobacillus spp. in the plaque collected prior to and after the topical fluoridation were revealed. Fluoride rubbed in the enamel, did not affect the amount of Lactobacillus spp. in the dental plaque growing on this material.

Oral Arginine Metabolism May Decrease the Risk for Dental Caries in Children

PubMed Central

Nascimento, M.M.; Liu, Y.; Kalra, R.; Perry, S.; Adewumi, A.; Xu, X.; Primosch, R.E.; Burne, R.A.

2013-01-01

Arginine metabolism by oral bacteria via the arginine deiminase system (ADS) increases the local pH, which can neutralize the effects of acidification from sugar metabolism and reduce the cariogenicity of oral biofilms. To explore the relationship between oral arginine metabolism and dental caries experience in children, we measured ADS activity in oral samples from 100 children and correlated it with their caries status and type of dentition. Supragingival dental plaque was collected from tooth surfaces that were caries-lesion-free (PF) and from dentinal (PD) and enamel (PE) caries lesions. Regardless of children’s caries status or type of dentition, PF (378.6) had significantly higher ADS activity compared with PD (208.4; p < .001) and PE (194.8; p = .005). There was no significant difference in the salivary arginolytic activity among children with different caries status. Mixed-model analysis showed that plaque caries status is significantly associated with ADS activity despite children’s age, caries status, and dentition (p < .001), with healthy plaque predicting higher ADS activity compared with diseased plaque. Plaque arginine metabolism varies greatly among children and tooth sites, which may affect their susceptibility to caries. PMID:23640952

Comparison of oral microbial profiles between children with severe early childhood caries and caries-free children using the human oral microbe identification microarray.

PubMed

Ma, Chen; Chen, Feng; Zhang, Yifei; Sun, Xiangyu; Tong, Peiyuan; Si, Yan; Zheng, Shuguo

2015-01-01

Early childhood caries (ECC) has become a prevalent public health problem among Chinese preschool children. The bacterial microflora is considered to be an important factor in the formation and progress of dental caries. However, high-throughput and large-scale studies of the primary dentition are lacking. The present study aimed to compare oral microbial profiles between children with severe ECC (SECC) and caries-free children. Both saliva and supragingival plaque samples were obtained from children with SECC (n = 20) and caries-free children (n = 20) aged 3 to 4 years. The samples were assayed using the Human Oral Microbe Identification Microarray (HOMIM). A total of 379 bacterial species were detected in both the saliva and supragingival plaque samples from all children. Thirteen (including Streptococcus) and two (Streptococcus and Actinomyces) bacterial species in supragingival plaque and saliva, respectively, showed significant differences in prevalence between the two groups. Of these, the frequency of Streptococcus mutans detection was significantly higher in both saliva (p = 0.026) and plaque (p = 0.006) samples from the SECC group than in those from the caries-free group. The findings of our study revealed differences in the oral microbiota between the SECC and caries-free groups Several genera, including Streptococcus, Porphyromonas, and Actinomyces, are strongly associated with SECC and can be potential biomarkers of dental caries in the primary dentition.

Tooth enamel surface micro-hardness with dual species Streptococcus biofilm after exposure to Java turmeric (Curcuma xanthorrhiza Roxb.) extract

NASA Astrophysics Data System (ADS)

Isjwara, F. R. G.; Hasanah, S. N.; Utami, Sri; Suniarti, D. F.

2017-08-01

Streptococcus biofilm on tooth surfaces can decrease mouth environment pH, thus causing enamel demineralization that can lead to dental caries. Java Turmeric extract has excellent antibacterial effects and can maintain S. mutans biofilm pH at neutral levels for 4 hours. To analyze the effect of Java Turmeric extract on tooth enamel micro-hardness, the Java Turmeric extract was added on enamel tooth samples with Streptococcus dual species biofilm (S. sanguinis and S. mutans). The micro-hardness of enamel was measured by Knoop Hardness Tester. Results showed that Curcuma xanthorrhiza Roxb. could not maintain tooth enamel surface micro-hardness. It is concluded that Java Turmeric extract ethanol could not inhibit the hardness of enamel with Streptococcus dual species biofilm.

Caries inhibition with a CO2 9.3 μm laser: An in vitro study.

PubMed

Rechmann, Peter; Rechmann, Beate M T; Groves, William H; Le, Charles Q; Rapozo-Hilo, Marcia L; Kinsel, Richard; Featherstone, John D B

2016-07-01

The caries preventive effects of different laser wavelengths have been studied in the laboratory as well as in pilot clinical trials. The objective of this in vitro study was to evaluate whether irradiation with a new 9.3 μm microsecond short-pulsed CO2 -laser could enhance enamel caries resistance with and without additional fluoride applications. One hundred and one human tooth enamel samples were divided into seven groups. Each group was treated with different laser parameters (CO2 -laser, wavelength 9.3 μm, 43 Hz pulse-repetition rate, pulse duration between 3 µs at 1.5 mJ/pulse to 7 µs at 2.9 mJ/pulse). A laboratory pH-cycling model followed by cross-sectional microhardness testing determined the mean relative mineral loss delta Z (ΔZ) for each group to assess caries inhibition in tooth enamel by the CO2 9.3 µm short-pulsed laser irradiation. The pH-cycling was performed with or without additional fluoride. The non-laser control groups with additional fluoride had a relative mineral loss (ΔZ, vol% × µm) that ranged between 646 ± 215 and 773 ± 223 (mean ± SD). The laser irradiated and fluoride treated samples had a mean ΔZ ranging between 209 ± 133 and 403 ± 245 for an average 55% ± 9% reduction in mineral loss (ANOVA test, P < 0.0001). Increased mean mineral loss (ΔZ between 1166 ± 571 and 1339 ± 347) was found for the non-laser treated controls without additional fluoride. In contrast, the laser treated groups without additional fluoride showed a ΔZ between 470 ± 240 and 669 ± 209 (ANOVA test, P < 0.0001) representing an average 53% ± 11% reduction in mineral loss. Scanning electron microscopical assessment revealed that 3 µs pulses did not markedly change the enamel surface, while 7 µs pulses caused some enamel ablation. The CO2 9.3 µm short-pulsed laser energy renders enamel caries resistant with and without additional fluoride use. The observed enhanced

Surface variations affecting human dental enamel studied using nanomechanical and chemical analysis

NASA Astrophysics Data System (ADS)

Dickinson, Michelle Emma

The enamel surface is the interface between the tooth and its ever changing oral environment. Cavity (caries) formation and extrinsic tooth staining are due, respectively, to degradation of the enamel structure under low pH conditions and interactions between salivary pellicle and dietary elements. Both of these occur at the enamel surface and are caused by the local environment changing the chemistry of the surface. The results can be detrimental to the enamel's mechanical integrity and aesthetics. Incipient carious lesions are the precursor to caries and form due to demineralisation of enamel. These carious lesions are a reversible structure where ions (e.g. Ca2+, F -) can diffuse in (remineralisation) to preserve the tooth's structural integrity. This investigation used controlled in vitro demineralisation and remineralisation to study artificial carious lesion formation and repair. The carious lesions were cross-sectioned and characterised using nanoindentation, electron probe micro-analysis and time of flight secondary ion mass spectrometry. Mechanical and chemical maps showed the carious lesion had a significantly reduced hardness and elastic modulus, and the calcium and phosphate content was lower than in sound enamel. Fluoride based remineralisation treatments gave a new phase (possibly fluorohydroxyapatite) within the lesion with mechanical properties higher than sound enamel. The acquired salivary pellicle is a protein-rich film formed by the physisorption of organic molecules in saliva onto the enamel surface. Its functions include lubrication during mastication and chemical protection. However, pellicle proteins react with dietary elements such as polyphenols (tannins in tea) causing a brown stain. This study has used in vitro dynamic nanoindentation and atomic force microscopy to examine normal and stained pellicles formed in vivo. The effects of polyphenols on the pellicle's mechanical properties and morphology have been studied. It was found that the

Association Between Early Childhood Caries and Colonization with Streptococcus mutans Genotypes From Mothers.

PubMed

Childers, Noel K; Momeni, Stephanie S; Whiddon, Jennifer; Cheon, Kyounga; Cutter, Gary R; Wiener, Howard W; Ghazal, Tariq S; Ruby, John D; Moser, Stephen A

2017-03-15

The purpose of this study was to evaluate Streptococcus mutans genotypes (GT) between mother and child (M-C) in a high caries risk cohort to explore the association with early childhood caries (ECC). Sixty-nine infants (each approximately one year old) had periodic oral examinations (dmfs) and microbial samples collected from dental plaque, saliva, and other oral surfaces. Their mothers had an examination and plaque collected. S mutans isolates were genotyped using repetitive extragenic palindromic-PCR (rep-PCR). Statistical analyses were conducted for associations of S mutans in M-C dyads with caries outcomes. Twenty-seven S mutans genotypes (GT) from 3,414 isolates were identified. M-C were categorized as GT match (n equals 40) or no-match (n equals 29). When modeling the severity of ECC at 36 months (approximately four years old), the estimated dmfs in the match group was 2.61 times that of the no-match group (P=.014). Colonization of children with Streptococcus mutans genotypes that matched with mothers was shown to be highly associated with early childhood caries. Although the data suggest vertical transmission of S mutans in 40 of 69 children that shared GT with their mother, it is possible that other individuals transmitted the S mutans. Nonetheless, these findings support the importance of the mother's oral microbial status as a contributing influence to their children's oral health.

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

Imaging in vivo secondary caries and ex vivo dental biofilms using cross-polarization optical coherence tomography

PubMed Central

Lenton, Pat; Rudney, Joel; Chen, Ruoqiong; Fok, Alex; Aparicio, Conrado; Jones, Robert S.

2012-01-01

Objectives Conventional diagnostic methods frequently detect only late stage enamel demineralization under composite resin restorations. The objective of this study is to examine the subsurface tooth-composite interface and to assess for the presence of secondary caries in pediatric patients using a novel Optical Coherence Tomography System with an intraoral probe. Methods A newly designed intraoral cross polarization swept source optical coherence tomography (CP-OCT) imaging system was used to examine the integrity of the enamel-composite interfaces in vivo. Twenty two pediatric subjects were recruited with either recently placed or long standing composite restorations in their primary teeth. To better understand how bacterial biofilms cause demineralization at the interface, we also used the intraoral CP-OCT system to assess ex vivo bacterial biofilm growth on dental composites. Results As a positive control, cavitated secondary carious interfaces showed a 18.2 dB increase (p<0.001), or over 1-2 orders of magnitude higher, scattering than interfaces associated with recently placed composite restorations. Several long standing composite restorations, which appeared clinically sound, had a marked increase in scattering than recently placed restorations. This suggests the ability of CP-OCT to assess interfacial degradation such as early secondary caries prior to cavitation. CP-OCT was also able to image ex vivo biofilms on dental composites and assess their thickness. Significance This paper shows that CP-OCT imaging using a beam splitter based design can examine the subsurface interface of dental composites in human subjects. Furthermore, the probe dimensions and acquisition speed of the CP-OCT system allowed for analysis of caries development in children. PMID:22578989

[Effect of resin infiltration on microhardness of artificial caries lesions].

PubMed

Liu, Yonghong; Deng, Hui; Tang, Longmei; Zhang, Zhiyong

2015-12-01

To compare the changes of enamel surface and cross-sectional microhardness of artificial caries immediately and after the twice demineralization through coating resin infiltration, fluoride varnish and fissure sealant. A total of forty bovine lower incisors enamel samples with artificial caries lesions by the demineralization liquid were used in the experiment. The specimens were then randomly divided into four groups as group A(resin infiltration), B(fluoride varnish), C (fissure sealant), D(control), 10 specimens in each group. The samples were sectioned vertically into two halves through the centre. One half of each sample the surface and cross-sectional microhardness was measured. The other half was put into demineralization liquid for 14 days, then the surface and cross-sectional microhardness was measured again. The cross section morphology of the samples was observed by scanning electron microscope. The surface of enamel had the highest microhardness value, and with the increase of cross- sectional depth, the microhardness value declined gradually. Variance analysis showed that the difference was statistically significant in the cross-section of different depth among the four groups(P<0.05). The microhardness values of the surface and the cross- section at 40 µm of each group in immediate measure showed the values were significantly higher in group A, B and C than in group D. There was no significant difference in the microhardness value of cross-section at 80 µm between group A[(324 ± 17) kg/mm(2)] and group C[(316 ± 20) kg/mm(2)], but they were significantly higher than group D. There was no significant difference between group B[(303 ± 13) kg/mm(2)] and group D[(294 ± 23) kg/mm(2)]. At 120 µm level, the microhardness value of group A was significantly higher than those of the other three groups. After the twice demineralization, the enamel surface microhardness value of the specimens was the same as the first measurement. In the cross-section at 40

Early Childhood Dental Caries: A Rising Dental Public Health Crisis

ERIC Educational Resources Information Center

Gomez, Grace Felix

2013-01-01

The aim of this article is to examine the literature and review the risk factors and disparities contributing to early childhood caries (ECC), which is a major health problem among preschoolers in the United States of America. A search was conducted using MEDLINE, PubMed, Google Scholar, and the Cochrane Library databases and the key terms…

Imaging early demineralization with PS-OCT

NASA Astrophysics Data System (ADS)

Kang, Hobin; Jiao, Jane J.; Lee, Chulsung; Darling, Cynthia L.; Fried, Daniel

2010-02-01

New methods are needed for the nondestructive measurement of tooth demineralization and remineralization to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anti-caries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10-μm, it is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper we attempt to determine the earliest stage at which we can detect significant differences in lesion severity. Automated methods of analysis were used to measure the depth and severity of demineralized bovine enamel produced using a simulated caries model that emulates demineralization in the mouth. Significant differences in the depth and integrated reflectivity from the lesions were detected after only a few hours of demineralization. These results demonstrate that cross polarization OCT is ideally suited for the nondestructive assessment of early demineralization.

The in vitro effect of fluoridated milk in a bacterial biofilm--enamel model.

PubMed

Arnold, Wolfgang H; Forer, Stefan; Heesen, Joerg; Yudovich, Keren; Steinberg, Doron; Gaengler, Peter

2006-07-01

The purpose of this study was to investigate the effect of milk and fluoridated milk on bacterially induced caries-like lesions. Extracted impacted human molars were cut in half and covered with a varnish leaving a 4*4 mm window. The samples were coated with biofilm of S. sobrinus and were further divided into three experimental groups of S. sobrinus, S. sobrinus and milk and S. sobrinus and fluoridated milk. As negative controls served teeth incubated in saline. Of twenty tooth halves serial ground sections were cut through the lesions and investigated with polarization light microscopy (PLM) and scanning electron microscopy (SEM) and EDX element analysis. The PLM photographs were used for 3D reconstruction, volumetric assessment and determination of the extension of the lesion zones. Of eight tooth halves the biofilm on the enamel surface was studied with SEM and EDX element analysis. Volumetric assessment showed a statistically significant difference in the volume of the body of the lesion and the translucent zone between the milk group and fluoridated milk group. Quantitative element analysis demonstrated significant differences between sound enamel and the superficial layer in the fluoridated milk group. The biofilm on the enamel surface showed an increased Ca content in the milk group and fluoridated milk group. Milk as a common nutrient seems to play a complex role in in-vitro biofilm--enamel interactions stimulating bacterial demineralization on one hand, and, as effective fluoride carrier, inhibits caries-like demineralization.

Malnutrition-related early childhood exposures and enamel defects in the permanent dentition: A longitudinal study from the Bolivian Amazon.

PubMed

Masterson, Erin E; Fitzpatrick, Annette L; Enquobahrie, Daniel A; Mancl, Lloyd A; Conde, Esther; Hujoel, Philippe P

2017-10-01

We investigated the relationship between early childhood malnutrition-related measures and subsequent enamel defects in the permanent dentition. This cohort study included 349 Amerindian adolescents (10-17 years, 52% male) from the Bolivian Amazon. Exposures included: stunted growth (height-for-age z-scores), underweight (weight-for-age z-scores), anemia (hemoglobin), acute inflammation (C-reactive protein) and parasitic infection (hookworm). We measured the occurrence (no/yes) and extent (<1/3, 1/3-2/3, >2/3) of enamel defects. We estimated associations between childhood exposures and enamel defect measures using log-binomial and multinomial logistic regression. The prevalence of an enamel defect characterized by an orange peel texture on a large central depression on the labial surface of the central maxillary incisors was 92.3%. During childhood (1-4 years), participants had a high prevalence of stunted growth (75.2%), anemia (56.9%), acute inflammation (39.1%), and hookworm infection (49.6%). We observed associations between childhood height-for-age (OR = 0.65; P = 0.028 for >2/3 extent vs. no EH) and gastrointestinal hookworm infection (OR = 3.43; P = 0.035 for >2/3 extent vs. no defects or <1/3 extent) with enamel defects. The study describes a possibly novel form of enamel hypoplasia and provides evidence for associations of malnutrition-related measures in early childhood, including stunted growth and parasitic helminth infection, with the observed enamel defects. © 2017 Wiley Periodicals, Inc.

Prevalence of developmental dental hard-tissue anomalies and association with caries and oral hygiene status of children in Southwestern, Nigeria.

PubMed

Popoola, Bamidele O; Onyejaka, Nneka; Folayan, Morenike O

2016-07-07

Developmental dental hard tissue anomalies are often associated with oral health problems. This study determined the clinical prevalence of developmental dental hard tissue anomalies in the permanent dentition of children resident in southwestern Nigeria and its association with dental caries and poor oral hygiene status. This was a cross-sectional study recruiting 1565 school children, 12 to 15 year old attending schools in Ibadan, Oyo State and Ile-Ife, Osun State. All eligible study participants had oral examinations conducted to determine presence of developmental hard dental tissue anomalies, caries and oral hygiene status. The prevalence of developmental dental hard tissue anomalies was determined. Logistic Poisson regression was used to determine the association of between developmental dental hard tissue anomalies, caries and oral hygiene status. Only 65 (4.2 %) children had clinically diagnosed developmental dental hard tissue anomalies. The most prevalent anomaly was enamel hypoplasia (2.2 %). More females (p = 0.003) and more children with middle socioeconomic class (p = 0.001) had enamel hypoplasia. The probability of having poor oral hygiene was significantly increased for children with developmental dental anomalies (APR: 0.07; 95 % CI: 0.03 - 0.12; p = 0.002). The probability of having caries was insignificantly increased for children with developmental dental hard tissue anomalies (APR: 0.005; 95 % CI: -0.03 - 0.04; p = 0.08). The most prevalence clinically detectable developmental dental hard tissue anomalies for the study population was enamel hypoplasia. The presence of developmental dental hard tissue anomalies significantly increased the chances of having poor oral hygiene but not caries. Further studies are required to understand if poor oral hygiene is associated with dental caries in children with developmental dental hard tissue anomalies.

Impact of early childhood caries on oral health-related quality of life of preschool children.

PubMed

Li, M Y; Zhi, Q H; Zhou, Y; Qiu, R M; Lin, H C

2015-03-01

Child oral health-related quality of life (COHRQoL) has been assessed in developed areas; however, it remains unstudied in mainland China. Studies on COHRQoL would benefit a large number of children in China suffering from oral health problems such as dental caries. This study explored the relationship between COHRQoL and early childhood caries, adjusted by socioeconomic factors, in 3- to 4-year-old children in a region of southern China. In this study, 1062 children aged 3-4 years were recruited by cluster sampling and their oral health statuses were examined by a trained dentist. The Chinese version of the Early Childhood Oral Health Impact Scale (ECOHIS) and questions about the children's socioeconomic conditions were completed by the children's parents. A negative binomial regression analysis was used to assess the prevalence of early childhood caries among the children and its influence on COHRQoL. The total ECOHIS scores of the returned scale sets ranged from 0 to 31, and their average scores was 3.1±5.1. The negative binomial analysis showed that the dmfs indices were significantly associated with the ECOHIS score and subscale scores (P<0.05). The multivariate adjusted model showed that a higher dmft index was associated with greater negative impact on COHRQoL (RR = 1.10; 95% CI = 1.07, 1.13; P < 0.05). However, demographic and socioeconomic factors were not associated with COHRQoL (P>0.05). The severity of early childhood caries has a negative impact on the oral health-related quality of life of preschool children and their parents.

New approaches to enhanced remineralization of tooth enamel.

PubMed

Cochrane, N J; Cai, F; Huq, N L; Burrow, M F; Reynolds, E C

2010-11-01

Dental caries is a highly prevalent diet-related disease and is a major public health problem. A goal of modern dentistry is to manage non-cavitated caries lesions non-invasively through remineralization in an attempt to prevent disease progression and improve aesthetics, strength, and function. Remineralization is defined as the process whereby calcium and phosphate ions are supplied from a source external to the tooth to promote ion deposition into crystal voids in demineralized enamel, to produce net mineral gain. Recently, a range of novel calcium-phosphate-based remineralization delivery systems has been developed for clinical application. These delivery systems include crystalline, unstabilized amorphous, or stabilized amorphous formulations of calcium phosphate. These systems are reviewed, and the technology with the most scientific evidence to support its clinical use is the remineralizing system utilizing casein phosphopeptides to stabilize and deliver bioavailable calcium, phosphate, and fluoride ions. The recent clinical evidence for this technology is presented and the mechanism of action discussed. Biomimetic approaches to stabilization of bioavailable calcium, phosphate, and fluoride ions and the localization of these ions to non-cavitated caries lesions for controlled remineralization show promise for the non-invasive management of dental caries.

Shear bond strength to enamel after power bleaching activated by different sources.

PubMed

Can-Karabulut, Deniz C; Karabulut, Baris

2010-01-01

The purpose of the present study was to evaluate enamel bond strength of a composite resin material after hydrogen peroxide bleaching, activated by a diode laser (LaserSmile), an ozone device (HealOzone), a light-emitting diode (BT Cool whitening system), and a quartz-Plus. Fifty extracted caries-free permanent incisors were used in this study. Thirty-eight percent hydrogen peroxidegel was applied to sound, flattened labial enamel surfaces and activated by different sources. Enamel surfaces that had received no treatment were used as control samples. Bonding agent was applied according to the manufacturer's instructions and the adhesion test was performed according to ISO/TS 11405. Statistical analysis showed significant influence of the different activation technique of hydrogen peroxide on shear bond strength to enamel (ANOVA, LSD, P < 0.05). The data in this vitro explorative study suggest the activation of hydrogen peroxide by different sources may further affect the shear bond strength of subsequent composite resin restoration to enamel. Within the limitations of this in vitro study, further studies examining the structural changes of activated hydrogen peroxide-treated enamel are needed. Due to the different activation methods; duration of light irradiation effects, longer time periods may be needed before application of adhesive restorations to enamel, compared with non-activated bleaching.

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.

Dental Enamel Irradiated with Infrared Diode Laser and Photoabsorbing Cream: Part 1—FT-Raman Study

PubMed Central

Dos Santos, Edson Aparecido Pereira; Soares, Luís Eduardo Silva; Do Espírito Santo, Ana Maria; Martin, Airton Abrahão; Duarte, Danilo Antônio; Pacheco-Soares, Cristina; Brugnera, Aldo

2009-01-01

Abstract Objective: The aim of this FT-Raman study was to investigate laser-induced compositional changes in enamel after therapy with a low-level infrared diode laser and a photoabsorbing cream, in order to intensify the superficial light absorption before and after cariogenic challenge. Background Data: Dental caries remains the most prevalent disease during childhood and adolescence. Preventive modalities include the use of fluoride, reduction of dietary cariogenic refined carbohydrates, plaque removal and oral hygiene techniques, and antimicrobial prescriptions. A relatively simple and noninvasive caries preventive regimen is treating tooth enamel with laser irradiation, either alone or in combination with topical fluoride treatment, resulting in reduced enamel solubility and dissolution rates. Due to their high cost, high-powered lasers are still not widely employed in private practice in developing countries. Thus, low-power red and near-infrared lasers appear to be an appealing alternative. Materials and Methods: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: control group (no treatment; n = 8); infrared laser treatment (L; n = 8) (810 nm at 100 mW/cm2 for 90 sec); infrared diode laser irradiation (810 nm at 100 mW/cm2 for 90 sec) and photoabsorbing cream (IVL; n = 8); photoabsorbing cream alone (IV; n = 8); infrared diode laser irradiation (810 nm at 100 mW/cm2 for 90 sec) and fluorinated photoabsorbing agent (IVLF; n = 8); and fluorinated photoabsorbing agent alone (IVF; n = 8). Samples were analyzed using FT-Raman spectroscopy before and after pH cycling cariogenic challenge. Results: There was a significant laser-induced reduction and possible modification of the organic matrix content in enamel treated with the low-level diode laser (the L, IVL, and IVFL groups). Conclusion: The FT-Raman technique may be suitable for detecting compositional and structural changes

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.

The aesthetic impact of enamel fluorosis on Irish adolescents.

PubMed

Browne, Deirdre; Whelton, Helen; O'Mullane, Denis; Tavener, Jacqueline; Flannery, Edel

2011-04-01

To assess the impact of differing degrees of enamel fluorosis on dental aesthetics according to Irish adolescents. The same participants also aesthetically rated other variations in dental appearances including a carious lesion, bleached teeth and a demarcated opacity. One hundred and fifty adolescents examined seven identical template photographs of an attractive dental smile displaying varying levels of enamel fluorosis (TF1, TF2, TF3), a demarcated opacity, no fluorosis (TF0), anterior caries and very white or bleached teeth. By indicating their level of agreement or disagreement with five statements on a five-point Likert scale, the participants rated the aesthetic acceptability of each of the photographs. Using paired t-tests with the Bonferroni correction, it was found that the photographs depicting the very white teeth and anterior caries were rated as the most and least aesthetically pleasing images, respectively. There was no significant difference in the ratings of the photographs displaying TF0, TF1 and TF2 levels of fluorosis indicating that these photographs were viewed similarly (P>0.002). The remaining two photographs (TF3 and the demarcated opacity) were rated similarly and significantly worse (P<0.002) than the photographs showing no or low grades of fluorosis (TF0, TF1 and TF2). TF3 level of fluorosis represented the break point at which enamel fluorosis became aesthetically objectionable to these participants. Low grades of fluorosis (TF1 and TF2) were rated similarly to the photograph depicting no fluorosis (TF0). © 2011 John Wiley & Sons A/S.

Dental caries and fluorosis experience of 8-12-year-old children by early-life exposure to fluoride.

PubMed

Do, Loc G; Miller, Jenifer; Phelan, Claire; Sivaneswaran, Shanti; Spencer, A John; Wright, Clive

2014-12-01

It is important to evaluate concurrently the benefit for dental caries and the risk for dental fluorosis from early exposure to fluoride among children. To evaluate associations of different levels of exposure to fluoride in early childhood with dental caries and dental fluorosis experience in school children. A Child Dental Health Survey (CDHS) was conducted among school children in the Australian state of New South Wales (NSW) in 2007. Trained and calibrated examination teams conducted oral epidemiologic examinations to assess caries experience as decayed, missing or filled tooth surfaces of the primary and permanent dentitions (dmfs/DMFS) and fluorosis using the Thylstrup & Fejerskov (TF) index on the maxillary central incisors only. A parental questionnaire collected information on residential histories and tap water usage to enable calculation of percentage of 3-year lifetime exposure to fluoride in water. Use of dietary fluoride supplements was also collected. Dental caries and fluorosis experience were compared among groups by levels of exposure to fluoride from water and fluoride supplements in bivariate and multivariable analysis, controlling for socioeconomic factors. Exposure to different fluoride sources varied in the group of 2611 children aged 8-12 years. Lower household income was significantly associated in both bivariate and multivariable analyses with the greater prevalence and severity of primary tooth caries among 8-10-year-old children and permanent tooth caries among 8-12 year old. Exposure to fluoride in water during the first 3 years of life was associated with both caries and fluorosis experience observed at age 8-12 years. Having higher percentage of 3-year lifetime exposure to fluoride in water was associated with higher prevalence of mostly mild fluorosis, but significantly lower prevalence and severity of caries in the primary and permanent dentitions. There were significant associations of dental caries and fluorosis experience with

Early childhood feeding practices and dental caries in preschool children: a multi-centre birth cohort study.

PubMed

Arora, Amit; Scott, Jane A; Bhole, Sameer; Do, Loc; Schwarz, Eli; Blinkhorn, Anthony S

2011-01-12

Dental caries (decay) is an international public health challenge, especially amongst young children. Early Childhood Caries is a rapidly progressing disease leading to severe pain, anxiety, sepsis and sleep loss, and is a major health problem particularly for disadvantaged populations. There is currently a lack of research exploring the interactions between risk and protective factors in the development of early childhood caries, in particular the effects of infant feeding practises. This is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence. This study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney.

Effectiveness of the Multilayered Caries Model and Visuo-tactile Virtual Reality Simulator for Minimally Invasive Caries Removal: A Randomized Controlled Trial.

PubMed

Dwisaptarini, A P; Suebnukarn, S; Rhienmora, P; Haddawy, P; Koontongkaew, S

This work presents the multilayered caries model with a visuo-tactile virtual reality simulator and a randomized controlled trial protocol to determine the effectiveness of the simulator in training for minimally invasive caries removal. A three-dimensional, multilayered caries model was reconstructed from 10 micro-computed tomography (CT) images of deeply carious extracted human teeth before and after caries removal. The full grey scale 0-255 yielded a median grey scale value of 0-9, 10-18, 19-25, 26-52, and 53-80 regarding dental pulp, infected carious dentin, affected carious dentin, normal dentin, and normal enamel, respectively. The simulator was connected to two haptic devices for a handpiece and mouth mirror. The visuo-tactile feedback during the operation varied depending on the grey scale. Sixth-year dental students underwent a pretraining assessment of caries removal on extracted teeth. The students were then randomly assigned to train on either the simulator (n=16) or conventional extracted teeth (n=16) for 3 days, after which the assessment was repeated. The posttraining performance of caries removal improved compared with pretraining in both groups (Wilcoxon, p<0.05). The equivalence test for proportional differences (two 1-sided t-tests) with a 0.2 margin confirmed that the participants in both groups had identical posttraining performance scores (95% CI=0.92, 1; p=0.00). In conclusion, training on the micro-CT multilayered caries model with the visuo-tactile virtual reality simulator and conventional extracted tooth had equivalent effects on improving performance of minimally invasive caries removal.

Caries and background factors in Swedish 4-year-old children with special reference to immigrant status.

PubMed

Stecksén-Blicks, Christina; Hasslöf, Pamela; Kieri, Catarina; Widman, Kjerstin

2014-11-01

This study assesses the prevalence of caries and some background factors in 4-year-old children in the city of Umeå, northern Sweden, and compares this with data from earlier studies to reveal changes over time. Children from the catchment areas of three Public Dental Health Service clinics in Umeå (n = 224) born during the third quarter of 2008 were invited to undergo a clinical dental examination. Decayed surfaces (including both dentine and enamel, except for enamel lesions on buccal and lingual surfaces), missing and filled surfaces (dmfs) were recorded using the same methods and criteria as in a series of earlier studies performed between 1980-2007. Background data were collected in a case-history and a questionnaire. Results. The proportion of children with caries significantly decreased from 2007 (38%) to 2012 (22%) (p < 0.05). In addition, the distribution of dmfs differed significantly between these years (p < 0.05). More immigrant children had caries (42%) than non-immigrant children (15%) (p < 0.05). For children with caries, there were no significant changes in the distribution of dmfs between 1980-2012 (p > 0.05). An immigrant background was associated with a lower frequency of tooth brushing and a higher intake of ice cream, sweets and chocolate drinks (p < 0.05). Although the proportion of children with caries declined between 2007-2012, this decline was limited to non-immigrant children. Since 1980 the distribution of dmfs remained unchanged among children with caries. More research on interventions for changing oral health behaviours is needed, specifically for immigrant children.

Effect of toothpaste with nano-sized trimetaphosphate on dental caries: In situ study.

PubMed

Danelon, Marcelle; Pessan, Juliano Pelim; Neto, Francisco Nunes Souza; de Camargo, Emerson Rodrigues; Delbem, Alberto Carlos Botazzo

2015-07-01

This in situ study was to evaluate the remineralizing effect of a fluoride toothpaste supplemented with nano-sized sodium trimetaphosphate (TMP). This blind and cross-over study was performed in 4 phases of 3 days each. Twelve subjects used palatal appliances containing four bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned into the following treatment groups: Placebo (without F and TMP); 1100 ppm F (1100), 1100 supplemented with 3% micrometric TMP (1100 TMP) and with nano-sized TMP (1100 TMPnano). Volunteers were instructed to brush their natural teeth with the palatal appliances in the mouth during 1min (3 times/day), so that blocks were treated with natural slurries of toothpastes. After each phase, the percentage of surface hardness recovery (%SHR), integrated mineral recovery (IMR) and integrated differential mineral area profile (ΔIMR) in enamel lesions were calculated. F in enamel was also determined. Data were analyzed by ANOVA and Student-Newman-Keuls test. Enamel surface became 20% harder when treated with 1100 TMPnano in comparison with 1100 (p<0.001). 1100 TMPnano showed remineralizing capacity (IMR; ΔIMR) 66% higher when compared with 1100 TMP (p<0.001). Enamel F uptake in the 1100 TMPnano group was 2-fold higher when compared to its counterpart without TMP (p<0.001). The addition of 3% TMPnano to a conventional toothpaste was able to promote an additional remineralizing effect of artificial caries lesions. Toothpaste containing 1100 ppm F associated with TMPnano showed a potential of higher remineralization to 1100 ppm F and 1100 ppm F micrometric TMP. Copyright © 2015 Elsevier Ltd. All rights reserved.

Self-etching adhesive on intact enamel, with and without pre-etching.

PubMed

Devarasa, G M; Subba Reddy, V V; Chaitra, N L; Swarna, Y M

2012-05-01

Bond strengths of composite resin to enamel using self-etch adhesive (SEA) Clearfil SE bond system on intact enamel and enamel pre-etched with phosphoric acid were compared. The objective was to determine if the pre-etching would increase the bond strengths of the SEA systems to intact enamel and to evaluate the effect of pre-etching on bond formation of self-etch adhesives on intact enamel. Labial surfaces of 40 caries free permanent upper central and lateral incisors were cleaned, sectioned of their roots. All specimens were mounted on acrylic block and divided randomly into four groups. In two groups the application of self-etch adhesive, Clearfil SE bond was carried as per manufacturer's instructions, composite cylinders were built, whereas in the other two groups, 37% phosphoric acid etching was done before the application of self-etching adhesives. Then the resin tags were analyzed using scanning electron microscope and shear bond strength was measured using Instron universal testing machine. When phosphoric acid was used, there was significant increase in the depth of penetration of resin tags and in the Shear Bond Strength of composite to enamel. The results indicate that out of both treatment groups, pre-etching the intact enamel with 37% phosphoric acid resulted in formation of longer resin tags and higher depth of penetration of resin tags of the Clearfil SE bond, and attaining higher bond strength of the Clearfil SE bond to intact enamel. Copyright © 2011 Wiley Periodicals, Inc.

Early childhood caries: prevalence and risk factors in Seoul, Korea.

PubMed

Jin, Bo-Hyoung; Ma, Deuk-Sang; Moon, Hyock-Soo; Paik, Dai-Il; Hahn, Se-Hyun; Horowitz, Alice M

2003-01-01

The purpose of this study was to determine the prevalence of early childhood caries (ECC), including noncavitated lesions (d1), in children 6-59 months of age in relation to socioeconomic factors, feeding practices, and oral health behaviors in Seoul, Korea. The children attended child care facilities and were selected from 32 primary sampling units. Two dentists examined 470 children. Parents of 383 of the subjects were interviewed by phone regarding caries risk factors. For children 6-59 months of age, the prevalence of ECC and severe ECC were 56.5 percent and 47.0 percent respectively. In bivariate analysis, the children whose nursing bottle contained sweetened solution had higher severe ECC prevalence (P=.035), and children whose parents reported a lower frequency of between-meal snacks showed lower ECC prevalence (P=.046). By logistic regression analysis, age and frequency of between-meal snacks were associated with the prevalence of ECC (P<.05). This study demonstrates that the prevalence of ECC was high among children in Seoul. Early educational intervention programs for pregnant women and mothers of young children should be developed based on the risk factors identified in this study.

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.

Near-infrared imaging of secondary caries lesions around composite restorations at wavelengths from 1300-1700-nm.

PubMed

Simon, Jacob C; A Lucas, Seth; Lee, Robert C; Darling, Cynthia L; Staninec, Michal; Vaderhobli, Ram; Pelzner, Roger; Fried, Daniel

2016-04-01

Current clinical methods for diagnosing secondary caries are unreliable for identifying the early stages of decay around restorative materials. The objective of this study was to access the integrity of restoration margins in natural teeth using near-infrared (NIR) reflectance and transillumination images at wavelengths between 1300 and 1700-nm and to determine the optimal NIR wavelengths for discriminating composite materials from dental hard tissues. Twelve composite margins (n=12) consisting of class I, II and V restorations were chosen from ten extracted teeth. The samples were imaged in vitro using NIR transillumination and reflectance, polarization sensitive optical coherence tomography (PS-OCT) and a high-magnification digital microscope. Samples were serially sectioned into 200-μm slices for histological analysis using polarized light microscopy (PLM) and transverse microradiography (TMR). Two independent examiners evaluated the presence of demineralization at the sample margin using visible detection with 10× magnification and NIR images presented digitally. Composite restorations were placed in sixteen sound teeth (n=16) and imaged at multiple NIR wavelengths ranging from λ=1300 to 1700-nm using NIR transillumination. The image contrast was calculated between the composite and sound tooth structure. Intensity changes in NIR images at wavelengths ranging from 1300 to 1700-nm correlate with increased mineral loss measured using TMR. NIR reflectance and transillumination at wavelengths coincident with increased water absorption yielded significantly higher (P<0.001) contrast between sound enamel and adjacent demineralized enamel. In addition, NIR reflectance exhibited significantly higher (P<0.01) contrast between sound enamel and adjacent composite restorations than visible reflectance. This study shows that NIR imaging is well suited for the rapid screening of secondary caries lesions. Copyright © 2016 Academy of Dental Materials. Published by Elsevier

Frequency of radiographic caries examinations and development of dental caries.

PubMed

Lith, A

2001-01-01

The general aim of this thesis was to evaluate whether a change in the threshold for surgical intervention in the caries process can be consistent with a stricter attitude towards the use of radiographic caries diagnosis. Bitewing radiographs of 3 groups of patients were retrospectively studied. Two groups comprised 229 patients, 18 years old at the end of the study in 1984. 102 had lived in an area with 1.2 ppm water-fluoride content (F84-group) and 127 in an area with 0.02 ppm fluoride content (O84-group). In the 3rd group 285 patients, 19 years old at the end of the study in 1993, lived in an area with 1.2 ppm water-fluoride content (F93-group). The latter patients were managed according to a restrictive attitude to surgical intervention and radiographic diagnosis of caries. The prevalence of patients and the frequency of tooth surfaces with caries was significantly lower in the fluoride groups than in the non-fluoride group. The correlation between patients' accumulated number of posterior proximal lesions and fillings at the last examination and the mean interval between their bitewing examinations was weak in all groups. The mean interval between examinations was significantly longer in the F93-group than in the other 2 groups. By applying an algorithm for individualisation of examination intervals these could be prolonged depending on the accepted risk for the development of inner dentin lesions. Future development of proximal dentin lesions was rather well predicted by means of past caries experience as demonstrated by ROC-analysis. The proportion of inner dentin lesions that were operatively treated was significantly higher in patients from the F93-group than in those from the other 2 groups in which a less strict attitude towards operative treatment was used. In the F93-group the average survival time of enamel and outer dentin lesions was 8.0 and 3.4 years, respectively, when right censored data were taken into account. In populations with low caries

[Comparison of reproducibility measurements for calibration of dental caries epidemiological surveys].

PubMed

Assaf, Andréa Videira; Zanin, Luciane; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

2006-09-01

This study compares three measurements (Kappa, general agreement percentage, or GAP, and dice index) used to determine the reproducibility of caries diagnosis in epidemiological surveys under different clinical diagnostic thresholds. Eleven examiners with previous experience in epidemiological surveys were submitted to a theoretical and clinical calibration process. Data analysis used two caries detection thresholds: World Health Organization (WHO) and WHO with the inclusion of initial enamel lesions (WHO + IL). Twenty-three children 6-7 years of age were examined, with and without caries. Mean values for Kappa index, GAP, and Dice were considered high (> 0.90), except for the dice index for the WHO + IL threshold (0.69). Since Kappa is an adjusted agreement index, it can be considered the instrument of choice for calibration of examiners. However, when it is impossible to use, the GAP is recommended together with the dice index in order to orient and improve examiners when examining caries lesions.

Development of caries in permanent first molars adjacent to primary second molars with interproximal caries: four-year prospective radiographic study.

PubMed

Vanderas, Apostole P; Kavvadia, Katerina; Papagiannoulis, Lisa

2004-01-01

This study investigated the effect of the primary second molars' distal surface caries on the incidence of the permanent first molars' mesial surface caries in 613 paired tooth surfaces of children ages 6 to 8 years at baseline examination. Proximal caries and its progression were diagnosed by bite-wing radiographs taken at a 1-year interval over a period of 4 years. The permanent first molars' mesial surfaces and primary second molars' distal surfaces were examined. Recorded were: (1) sound surfaces; (2) carious lesions on the enamel's external and internal half and on the dentin's external, middle, and internal third; (3) filled, extracted, and exfoliated teeth. The logistic model for panel data was employed to estimate the effect of proximal caries of the primary second molars' distal surfaces on the incidence of the permanent first molars' mesial surface caries. The 95% confidence interval probability was used. Sensitivity and specificity as well as the positive and negative predictive rates were computed. The results showed that the presence of proximal caries on each primary second molars' distal surfaces significantly affected the development of proximal caries on the corresponding permanent first molar's mesial surfaces. Age was estimated to exert a positive and highly significant impact, while gender had no effect. The odds ratio values ranged from 4.86 to 63.43. The values of sensitivity and specificity ranged from 45% to 97% and 80% to 89%, respectively, while the positive and negative rates ranged from 40% to 56% and 90% to 99%, respectively. Proximal caries present on the primary second molars' distal surfaces increases the risk of developing caries on the permanent first molars' mesial surfaces. This risk, however, is different among the paired surfaces studied.

Association between early childhood caries and maternal caries status: A cross-section study in São Luís, Maranhão, Brazil

PubMed Central

de Souza, Pedrita Mara do Espírito Santo; Mello Proença, Mariana Almeida; Franco, Mayra Moura; Rodrigues, Vandilson Pinheiro; Costa, José Ferreira; Costa, Elizabeth Lima

2015-01-01

Objective: This study aims to evaluate the association between early childhood caries (ECC) and maternal caries status, and the maternal perception of ECC risk factors. Materials and Methods: A cross-sectional study was carried out with 77 mother-child pairs, the children ranging from 12 to 36 months of age and their mothers, who were seeking dental care at a health center in São Luís, Maranhão, Brazil. Data collection was conducted using a specific questionnaire for mothers. Oral clinical examination of the mother-child binomial to assess caries incidence, gingival bleeding (GB) and visible plaque was done. Home visits were performed in 10% of the sample in order to observe the environmental conditions, dietary habits and dental hygiene practices. Results: The findings showed that the caries prevalence in children was 22.5 times higher in the mother who had decayed tooth (prevalence ratio [PR] = 22.5, confidence interval [CI] 95% = 3.2–156.6, P < 0.001). GB also was observed in 14 mothers and children, the PR in pair was 12.2 (CI95% = 1.6–88.9, P < 0.001). The variables are related for the mother-child binomial in regression linear analysis. Conclusion: The maternal caries status was associated with ECC. PMID:25713495

Pulpotomy to stainless steel crown ratio in children with early childhood caries: a cross-sectional analysis.

PubMed

Thikkurissy, Sarat; McTigue, Dennis; Matracia, Sophie; Casamassimo, Paul

2011-01-01

This study's purpose was to determine the pulpotomy-to-crown ratio (PCR) in a high-early childhood caries patient population and factors associated with choice of pulpotomy and crown treatments. This was a retrospective quality assurance chart review. Five calibrated examiners (kappa=0.86) rated radiographic caries from available films. Demographic data, including age, health status, medications, and pain score, were collected along with pulpotomy- and crown-related treatment characteristics of location of tooth, treatment site, and level of operator skill. The record review of 521 patients (mean age=5.1 ± 1.9 years old) revealed 1,365 stainless steel crowns (SSCs) performed with 461 pulpotomies in a 6-month period, in both operating rooms (1,043 SSCs) and ambulatory settings (322 SSCs). The mean PCR was 0.34, with PCR decreasing with increasing patient age. Pulpotomy and crown treatments increased with radiographic caries severity with a significant association between pulpotomy and radiographic severity (P<.001). More severe pain was associated with greater likelihood of pulpotomy (P<.001). Age, operator type, and site of treatment did not affect choice of pulpotomy. The mean pulpotomy-to-crown ratio in this high-early childhood caries pediatric population was 0.34. Pain, the American Society of Anesthesiologists classification system, and radiographic caries severity were predictors of pulpotomy, but operator type and location of treatment were not.

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.

Baseline dental plaque activity, mutans streptococci culture, and future caries experience in children.

PubMed

Hallett, Kerrod B; O'Rourke, Peter K

2013-01-01

The purpose of this study was to evaluate a chairside caries risk assessment protocol utilizing a caries prediction instrument, adenosine triphosphate (ATP) activity in dental plaque, mutans streptococci (MS) culture, and routine dental examination in five- to 10-year-old children at two regional Australian schools with high caries experience. Clinical indicators for future caries were assessed at baseline examination using a standardized prediction instrument. Plaque ATP activity was measured directly in relative light units (RLU) using a bioluminescence meter, and MS culture data were recorded. Each child's dentition was examined clinically and radiographically, and caries experience was recorded using enamel white spot lesions and decayed, missing, and filled surfaces for primary and permanent teeth indices. Univariate one-way analysis of variance between selected clinical indicators, ATP activity, MS count at baseline, and future new caries activity was performed, and a generalized linear model for prediction of new caries activity at 24 months was constructed. Future new caries activity was significantly associated with the presence of visible cavitations, reduced saliva flow, and orthodontic appliances at baseline (R(2)=0.2, P<.001). Baseline plaque adenosine triphosphate activity and mutans streptococci counts were not significantly associated with caries activity at 24 months.

Early childhood feeding practices and dental caries in preschool children: a multi-centre birth cohort study

PubMed Central

2011-01-01

Background Dental caries (decay) is an international public health challenge, especially amongst young children. Early Childhood Caries is a rapidly progressing disease leading to severe pain, anxiety, sepsis and sleep loss, and is a major health problem particularly for disadvantaged populations. There is currently a lack of research exploring the interactions between risk and protective factors in the development of early childhood caries, in particular the effects of infant feeding practises. Methods/Design This is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence. Discussion This study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney. PMID:21223601

Salivary pH and Buffering Capacity as Risk Markers for Early Childhood Caries: A Clinical Study.

PubMed

Jayaraj, D; Ganesan, S

2015-01-01

The diagnostic utility of saliva is currently being explored in various branches of dentistry, remarkably in the field of caries research. This study was aimed to determine if assessment of salivary pH and buffering capacity would serve as reliable tools in risk prediction of early childhood caries (ECC). Paraffin-stimulated salivary samples were collected from 50 children with ECC (group I) and 50 caries free children (group II). Salivary pH and buffering capacity (by titration with 0.1 N hydrochloric acid) were assessed using a handheld digital pH meter in both groups. The data obtained were subjected to statistical analysis. Statistically, no significant difference was observed between both the groups for all salivary parameters assessed, except for the buffering capacity level at 150 μl titration of 0.1 N hydrochloric acid (p = 0.73; significant at 1% level). Salivary pH and buffering capacity may not serve as reliable markers for risk prediction of ECC. How to cite this article: Jayaraj D, Ganesan S. Salivary pH and Buffering Capacity as Risk Markers for Early Childhood Caries: A Clinical Study. Int J Clin Pediatr Dent 2015;8(3):167-171.

Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study.

PubMed

Charone, Senda; Portela, Maristela Barbosa; Martins, Karol de Oliveira; Soares, Rosangela Maria; Castro, Gloria Fernanda

2017-01-01

This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.

Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study

PubMed Central

CHARONE, Senda; PORTELA, Maristela Barbosa; MARTINS, Karol de Oliveira; SOARES, Rosangela Maria; CASTRO, Gloria Fernanda

2017-01-01

Abstract Objectives This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Material and Methods Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. Results TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Conclusion Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro. PMID:28198976

In vitro caries-inhibitory properties of a silver cermet.

PubMed

Swift, E J

1989-06-01

Recurrent caries is one of the primary causes of failure of dental restorations. One method for reducing the frequency and severity of this problem is the use of fluoride-releasing restorative materials. The glass-ionomer cements are a type of fluoride-releasing material. They have been used extensively in recent years for a variety of clinical applications. However, in comparison with other restorative materials such as amalgam and composite resins, glass ionomers have relatively poor physical properties. Sintering of silver particles to glass-ionomer powder is a means of improving these physical properties. The sintered material is called a silver-glass ionomer or silver cermet. This study examined the in vitro caries-inhibitory potential of a silver cement by means of two methods. First, long-term fluoride release was measured. Second, an artificial caries system was used for evaluation of caries inhibition by cerment restorations in extracted teeth. In comparison with a standard glass-ionomer restorative material, fluoride release from the cermet material was significantly less throughout a 12-month period. The results from the artificial caries system indicated that this decreased fluoride release corresponded with a lesser degree of caries inhibition. Lesions around cermet restorations in both enamel and root surfaces were significantly more severe than those around conventional glass-ionomer restorations. However, in comparison with amalgam and composite resin restorations, the cermet did have some cariostatic activity.

Holes in teeth - Dental caries in Neolithic and Early Bronze Age populations in Central Germany.

PubMed

Nicklisch, Nicole; Ganslmeier, Robert; Siebert, Angelina; Friederich, Susanne; Meller, Harald; Alt, Kurt W

2016-01-01

This study provides diachronic insight into the epidemiology of carious defects in teeth of Neolithic and Early Bronze Age populations in Central Germany over a period of 4000 years. The data were retrieved from skeletal remains uncovered at 21 sites throughout the Middle Elbe-Saale region (MES), comprising a total of 494 individuals with preserved teeth. The data generated were examined for age- and sex-related differences in order to gain information about the dietary habits and socio-economic structures of the period with the goal of identifying potential diachronic changes. The results indicated that dietary habits changed over the course of the Neolithic period: the prevalence of caries significantly decreased between the Early and Late Neolithic. The adults from the Early Neolithic sample, particularly those from the LBK bore the highest rate of caries. This highlights the essential importance of cereals in the diet of the early farmers in the Middle Elbe-Saale region. As time went on, meat and dairy products became more and more important, which had a positive impact on dental health. The data also show sex-specific differences: women were more often affected by caries than men and female jaws also generally exhibited greater numbers of carious teeth than their male counterparts. Dental health is a reflection of both biological factors and of economic and sociocultural structures. Copyright © 2015 Elsevier GmbH. All rights reserved.

Enamel tissue engineering using subcultured enamel organ epithelial cells in combination with dental pulp cells.

PubMed

Honda, Masaki J; Shinmura, Yuka; Shinohara, Yoshinori

2009-01-01

We describe a strategy for the in vitro engineering of enamel tissue using a novel technique for culturing enamel organ epithelial (EOE) cells isolated from the enamel organ using 3T3-J2 cells as a feeder layer. These subcultured EOE cells retain the capacity to produce enamel structures over a period of extended culture. In brief, enamel organs from 6-month-old porcine third molars were dissociated into single cells and subcultured on 3T3-J2 feeder cell layers. These subcultured EOE cells were then seeded onto a collagen sponge in combination with primary dental pulp cells isolated at an early stage of crown formation, and these constructs were transplanted into athymic rats. After 4 weeks, complex enamel-dentin structures were detected in the implants. These results show that our culture technique maintained ameloblast lineage cells that were able to produce enamel in vivo. This novel subculture technique provides an important tool for tooth tissue engineering. Copyright 2008 S. Karger AG, Basel.

Experimental investigation on the caries characteristic of dental tissues by photothermal radiometry scanning imaging

NASA Astrophysics Data System (ADS)

Wang, Fei; Liu, Jun-yan; Wang, Xiao-chun; Wang, Yang

2018-03-01

In this paper, a one-dimensional (1D) thermal-wave model coupled diffuse-photon-density-wave for three-layer dental tissues using modulated laser stimulation was employed to illustrate the relationship between dental caries characteristic (i.e. caries layer thickness, optical absorption coefficient and optical scattering coefficient) and photothermal radiometry (PTR) signal. Experimental investigation of artificial caries was carried out using PTR scanning imaging. The PTR amplitude and phase delay were increased with dental demineralized treatment. The local caries characteristic parameters were obtained by the best-fitting method based on the 1D thermal-wave model. The PTR scanning imaging measurements illustrated that the optical absorption coefficient and scattering coefficient of caries region were much higher than those of the healthy enamel area. The demineralization thickness of caries region was measured by PTR scanning imaging and its average value shows in good agreement with the digital microscope. Experimental results show that PTR scanning imaging has the merits of high contrast for local inhomogeneity of dental caries; furthermore, this method is an allowance to provide a flexibility for non-contact quantitative evaluation of dental caries.

Caries detection: current status and future prospects using lasers

NASA Astrophysics Data System (ADS)

Longbottom, Christopher

2000-03-01

Caries detection currently occupies a good deal of attention in the arena of dental research for a number of reasons. In searching for caries detection methods with greater accuracy than conventional technique researchers have used a variety of optical methods and have increasingly turned to the use of lasers. Several laser-based methods have been and are being assessed for both imaging and disease quantification techniques. The phenomenon of fluorescence of teeth and caries in laser light and the different effects produced by different wavelengths has been investigated by a number of workers in Europe. With an argon ion laser excitation, QLF (Quantified Laser Fluorescence) demonstrated a high correlation between loss of fluorescence intensity and enamel mineral loss in white spot lesions in free smooth surface lesions, both in vitro and in vivo. Recent work with a red laser diode source (655 nm), which appears to stimulate bacterial porphyrins to fluoresce, has demonstrated that a relatively simple device based on this phenomenon can provide sensitivity and specificity values of the order of 80% in vitro and in vivo for primary caries at occlusal sites. In vitro studies using a simulated in vivo methodology indicate that the device can produce sensitivity values of the order of 90% for primary caries at approximal sites.

Near-infrared Imaging of Secondary Caries Lesions around Composite Restorations at Wavelengths from 1300–1700-nm

PubMed Central

Simon, Jacob C.; Lucas, Seth; Lee, Robert; Darling, Cynthia L.; Staninec, Michal; Vanderhobli, Ram; Pelzner, Roger; Fried, Daniel

2016-01-01

Background and Objectives Current clinical methods for diagnosing secondary caries are unreliable for identifying the early stages of decay around restorative materials. The objective of this study was to access the integrity of restoration margins in natural teeth using near-infrared (NIR) reflectance and transillumination images at wavelengths between 1300–1700-nm and to determine the optimal NIR wavelengths for discriminating composite materials from dental hard tissues. Materials and Methods Twelve composite margins (n=12) consisting of class I, II & V restorations were chosen from ten extracted teeth. The samples were imaged in vitro using NIR transillumination and reflectance, polarization sensitive optical coherence tomography (PS-OCT) and a high-magnification digital microscope. Samples were serially sectioned into 200–μm slices for histological analysis using polarized light microscopy (PLM) and transverse microradiography (TMR). Two independent examiners evaluated the presence of demineralization at the sample margin using visible detection with 10× magnification and NIR images presented digitally. Composite restorations were placed in sixteen sound teeth (n=16) and imaged at multiple NIR wavelengths ranging from λ=1300–1700-nm using NIR transillumination. The image contrast was calculated between the composite and sound tooth structure. Results Intensity changes in NIR images at wavelengths ranging from 1300–1700-nm correlate with increased mineral loss measured using TMR. NIR reflectance and transillumination at wavelengths coincident with increased water absorption yielded significantly higher (P<0.001) contrast between sound enamel and adjacent demineralized enamel. In addition, NIR reflectance exhibited significantly higher (P<0.01) contrast between sound enamel and adjacent composite restorations than visible reflectance. Significance This study shows that NIR imaging is well suited for the rapid screening of secondary caries lesions

Dental Caries (Tooth Decay)

MedlinePlus

... Materials Contact Us Home Research Data & Statistics Share Dental Caries (Tooth Decay) Dental caries (tooth decay) remains the most prevalent chronic ... important source of information on oral health and dental care in the United States since the early ...

Physical chemical effects of zinc on in vitro enamel demineralization.

PubMed

Mohammed, N R; Mneimne, M; Hill, R G; Al-Jawad, M; Lynch, R J M; Anderson, P

2014-09-01

Zinc salts are formulated into oral health products as antibacterial agents, yet their interaction with enamel is not clearly understood. The aim was to investigate the effect of zinc concentration [Zn(2+)] on the in vitro demineralization of enamel during exposure to caries-simulating conditions. Furthermore, the possible mechanism of zinc's action for reducing demineralization was determined. Enamel blocks and synthetic hydroxyapatite (HAp) were demineralized in a range of zinc-containing acidic solutions (0-3565ppm [Zn(2+)]) at pH 4.0 and 37°C. Inductively coupled-plasma optical emission spectroscopy (ICP-OES) was used to measure ion release into solution. Enamel blocks were analysed by Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR), and HAp by X-ray diffraction (XRD) and neutron diffraction (ND). ICP-OES analysis of the acidic solutions showed a decrease in [Ca(2+)] and [PO4(3-)] release with increasing [Zn(2+)]. FTIR revealed a α-hopeite (α-Zn3(PO4)2.4H2O)-like phase on the enamel surfaces at >107ppm [Zn(2+)]. XRD and ND analysis confirmed a zinc-phosphate phase present alongside the HAp. This study confirms that zinc reduces enamel demineralization. Under the conditions studied, zinc acts predominantly on enamel surfaces at PO4(3-) sites in the HAp lattice to possibly form an α-hopeite-like phase. These results have a significant implication on the understanding of the fundamental chemistry of zinc in toothpastes and demonstrate its therapeutic potential in preventing tooth mineral loss. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Enamel and dentine demineralization by a combination of starch and sucrose in a biofilm - caries model.

PubMed

Botelho, Juliana Nunes; Villegas-Salinas, Mario; Troncoso-Gajardo, Pía; Giacaman, Rodrigo Andrés; Cury, Jaime Aparecido

2016-05-20

Sucrose is the most cariogenic dietary carbohydrate and starch is considered non-cariogenic for enamel and moderately cariogenic for dentine. However, the cariogenicity of the combination of starch and sucrose remains unclear. The aim of this study was to evaluate the effect of this combination on Streptococcus mutans biofilm composition and enamel and dentine demineralization. Biofilms of S. mutans UA159 were grown on saliva-coated enamel and dentine slabs in culture medium containing 10% saliva. They were exposed (8 times/day) to one of the following treatments: 0.9% NaCl (negative control), 1% starch, 10% sucrose, or 1% starch and 10% sucrose (starch + sucrose). To simulate the effect of human salivary amylase on the starch metabolization, the biofilms were pretreated with saliva before each treatment and saliva was also added to the culture medium. Acidogenicity of the biofilm was estimated by evaluating (2 times/day) the culture medium pH. After 4 (dentine) or 5 (enamel) days of growth, biofilms (n = 9) were individually collected, and the biomass, viable microorganism count, and polysaccharide content were quantified. Dentine and enamel demineralization was assessed by determining the percentage of surface hardness loss. Biofilms exposed to starch + sucrose were more acidogenic and caused higher demineralization (p < 0.0001) on either enamel or dentine than those exposed to each carbohydrate alone. The findings suggest that starch increases the cariogenic potential of sucrose.

Evaluation of primary tooth enamel surface morphology and microhardness after Nd:YAG laser irradiation and APF gel treatment--an in vitro study.

PubMed

Banda, Naveen Reddy; Vanaja Reddy, G; Shashikiran, N D

2011-01-01

Laser irradiation and fluoride has been used as a preventive tool to combat dental caries in permanent teeth, but little has been done for primary teeth which are more prone to caries. The purpose of this study was to evaluate microhardness alterations in the primary tooth enamel after Nd-YAG laser irradiation alone and combined with topical fluoride treatment either before or after Nd-YAG laser irradiation. Ten primary molars were sectioned and assigned randomly to: control group, Nd-YAG laser irradiation, Nd-YAG lasing before APF and APF followed by Nd-YAG lasing. The groups were evaluated for microhardness. Surface morphological changes were observed using SEM. Statistical comparisons were performed. The control group's SEM showed a relatively smooth enamel surface and lasing group had fine cracks and porosities. In the lasing + fluoride group a homogenous confluent surface was seen. In the fluoride + lasing group an irregular contour with marked crack propagation was noted. There was a significant increase in the microhardness of the treatment groups. Nd-YAG laser irradiation and combined APF treatment of the primary tooth enamel gave morphologically hardened enamel surface which can be a protective barrier against a cariogenic attack.

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.

Pulpal and periradicular response to caries: current management and regenerative options.

PubMed

Chogle, Sami M A; Goodis, Harold E; Kinaia, Bassam Michael

2012-07-01

The pulp-dentin complex is a strategic and dynamic barrier to various insults that plague the dentition. Researchers have yet to understand the complete potential of this shifting junction and its components. The most common cause of injury to the pulp-dentin complex is carious breakdown of enamel and dentin. In recent years, there has been a change in restorative management of caries. The emphasis is on strategies to preserve dentin and protect the pulp. This article provides a brief review of the effect of caries on the pulp, of subsequent events on the periradicular tissues, and of current understanding of treatment modalities. Copyright © 2012 Elsevier Inc. 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.

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.

A mimic study on effects of fluoride on tooth enamel structures

NASA Astrophysics Data System (ADS)

Ma, Guobin; Wang, Mu; Liu, Xiang Yang

2010-03-01

Tooth enamel is the hardest tissue in human body, and this superior mechanical property is contributed by its unique microstructures, i.e., oriented growth of rod-like apatite crystals into basic structural units called the prisms Fluoride (F^-) has been recognized to have significant effects on the physical and chemical properties of tooth enamel. However, the role of F^- on microstructures of apatite crystals is not well understood yet. Here we report a detailed investigation on the topic. Mimic in vitro growth of tooth enamel structures is performed at the biophysical conditions in simulated body fluids, using belt-like hydroxyapatite crystals as substrates It shows that F^- on the order of 0.1 mM will dramatically change the morphology of the grown crystals from irregular slabs to nano-needles, and the needles are aligned along the substrate with an average misorientation of ˜12 . Branched growth of bundles of nano-needles occurs with further increase of F^-, and finally, growth of highly porous structures as well as microspheres takes place when the F^- concentration exceeds 5 mM. In comparison with real tooth enamel structures, the relationship between enamel microstructures and tooth caries as well as fluorosis is discussed.

Variation in Enamel Formation Genes Influences Enamel Demineralization In Vitro in a Streptococcus mutans Biofilm Model

PubMed Central

Pang, Liangyue; Zhi, Qinghui; Zhuang, Peilin; Yu, Lixia; Tao, Ye; Lin, Huancai

2017-01-01

Genetic studies have shown that variations in enamel formation genes are associated with caries susceptibility. The aim of this study was to test in vitro whether variants in these genes are associated with dental enamel demineralization in a Streptococcus mutans biofilm model. DNA and enamel samples were obtained from 213 individuals. DNA was extracted from saliva, and 16 single nucleotide polymorphisms were analyzed. The physical and chemical properties of sound enamel samples and the mineral loss and the lesion depth of the demineralized enamel samples under cariogenic challenge were analyzed. Microhardness, enamel chemicals, mineral loss and demineralization depth were compared between different genotypes at each single nucleotide polymorphism. The GG genotype of TUFT1 (rs17640579) and the GT genotype of MMP20 (rs1612069) exhibited increased microhardness (p = 0.044 and 0.016, respectively). The GG genotype of AMBN (rs7694409) had a higher magnesium level, while the CT genotype of TFIP11 (rs2097470) had a lower magnesium level (p = 0.044 and 0.046, respectively). The GT genotype of MMP20 (rs1612069) had a higher calcium level (p = 0.034). The GG genotype of AMBN (rs13115627), the AG genotype of ENAM (rs12640848) and the AA genotype of MMP20 (rs2292730) had a lower phosphorus level (p = 0.012, 0.006, and 0.023, respectively). The GG genotype of AMBN (rs13115627) was also associated with a higher calcium-phosphorus ratio (p = 0.034). Individuals with the CC genotype of TFIP11 (rs134143) exhibited significantly more mineral loss (p = 0.011) and a deeper lesions (p = 0.042). Individuals with the TT genotype of TFIP11 (rs2097470) had more mineral loss (p = 0.018). Individuals with the GG genotype of TUFT1 (rs17640579) exhibited a shallower demineralization depth (p = 0.047). Individuals with the GT genotype of MMP20 (rs1612069) exhibited a shallower demineralization depth (p = 0.042). Individuals with the GG genotype of ENAM (rs12640848) exhibited less mineral loss

Managing Early Childhood Caries with Atraumatic Restorative Treatment and Topical Silver and Fluoride Agents

PubMed Central

Duangthip, Duangporn; Chen, Kitty Jieyi; Gao, Sherry Shiqian

2017-01-01

Early childhood caries (ECC) is a significant global health problem affecting millions of preschool children worldwide. In general, preschool children from families with 20% of the lowest family incomes suffered about 80% of the ECC. Most, if not all, surveys indicated that the great majority of ECC was left untreated. Untreated caries progresses into the dental pulp, causing pain and infection. It can spread systemically, affecting a child’s growth, development and general health. Fundamental caries management is based on the conventional restorative approach. Because preschool children are too young to cope with lengthy dental treatment, they often receive dental treatment under general anaesthesia from a specialist dentist. However, treatment under general anaesthesia poses a life-threatening risk to young children. Moreover, there are few dentists in rural areas, where ECC is prevalent. Hence, conventional dental care is unaffordable, inaccessible or unavailable in many communities. However, studies showed that the atraumatic restorative treatment had a very good success rate in treating dentine caries in young children. Silver diamine fluoride is considered safe and effective in arresting dentine caries in primary teeth. The aim of this paper is to review and discuss updated evidence of these alternative approaches in order to manage cavitated ECC. PMID:28994739

OC28 - Effect of mode of delivery on early oral colonization and childhood dental caries: a systematic review.

PubMed

Antão, Celeste; Teixeira, Cristina; Gomes, Maria José

2016-05-09

Theme: Multidisciplinary team working. Oral colonization starts at birth by vertical transmission. To determine whether mode of delivery influences the oral colonization of infants and contributes to the risk of childhood dental caries. A systematic review was conducted in the electronic database Web of Science for articles published from January 1995 to December 2015 by using a set of keywords. From 2,644 citations identified through electronic search, ten studies met the inclusion criteria. According to the studies mode of delivery influences oral microbial density, oral microbial profile and the timing of oral colonization by cariogenic microbiota. However, there are no consistent results concerning either the prevalence of children harboring cariogenic microbiota or the prevalence of early childhood caries by mode of delivery. Mode of delivery influences early oral colonization. However, it seems that other determinants rather than mode of delivery could be major contributors to the development of early childhood caries.

Association of breast feeding with early childhood dental caries: Japanese population-based study

PubMed Central

Yorifuji, Takashi; Yamakawa, Michiyo; Inoue, Sachiko; Saito, Keiko; Doi, Hiroyuki; Kawachi, Ichiro

2015-01-01

Objectives We investigated the association between breastfeeding duration during the first half year of life and the risk of early childhood caries from the age of 30 to 66 months in Japan. Design Observational study of a longitudinal survey. Setting A secondary data analysis of the Japanese Longitudinal Survey of Babies in the 21st Century. Participants 43 383 infants at the age of 6 months. Outcome measures Early childhood caries—defined as a child's visit to a dentist for treatment of dental caries during the past 12 months—was ascertained from the caregiver from the age of 30 months in the survey. We estimated the risk of dental caries each year according to duration of breast feeding using logistic regression analyses. We controlled for a set of biological factors (birth weight, sex, parity and maternal age at delivery) and socioeconomic factors (maternal educational attainment and smoking status, marital status at delivery, family income and region of birth and residence). Results We found that infants who had been breast fed for at least 6 or 7 months, both exclusively and partially, were at elevated risk of dental caries at the age of 30 months compared with those who had been exclusively formula fed. Adjusted ORs were 1.78 (95% CI, (1.45 to 2.17)) for the exclusively breastfed group and 1.39 (1.14 to 1.70) for the partially breastfed group. However, the associations became attenuated through the follow-up period and were no longer statistically significant beyond the age of 42 months for the partially breastfed group and beyond the age of 54 months for the exclusively breastfed group. Conclusions We found an association between breast feeding for at least 6 or 7 months and elevated risk of dental caries at age 30 months. However, the association became attenuated as children grew older. PMID:25795694

Caries risk assessment in schoolchildren - a form based on Cariogram® software

PubMed Central

CABRAL, Renata Nunes; HILGERT, Leandro Augusto; FABER, Jorge; LEAL, Soraya Coelho

2014-01-01

Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. Conclusion The use of the form based on the Cariogram® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk. PMID:25466473

Dental Pulp Defence and Repair Mechanisms in Dental Caries

PubMed Central

Farges, Jean-Christophe; Alliot-Licht, Brigitte; Renard, Emmanuelle; Ducret, Maxime; Gaudin, Alexis; Smith, Anthony J.; Cooper, Paul R.

2015-01-01

Dental caries is a chronic infectious disease resulting from the penetration of oral bacteria into the enamel and dentin. Microorganisms subsequently trigger inflammatory responses in the dental pulp. These events can lead to pulp healing if the infection is not too severe following the removal of diseased enamel and dentin tissues and clinical restoration of the tooth. However, chronic inflammation often persists in the pulp despite treatment, inducing permanent loss of normal tissue and reducing innate repair capacities. For complete tooth healing the formation of a reactionary/reparative dentin barrier to distance and protect the pulp from infectious agents and restorative materials is required. Clinical and in vitro experimental data clearly indicate that dentin barrier formation only occurs when pulp inflammation and infection are minimised, thus enabling reestablishment of tissue homeostasis and health. Therefore, promoting the resolution of pulp inflammation may provide a valuable therapeutic opportunity to ensure the sustainability of dental treatments. This paper focusses on key cellular and molecular mechanisms involved in pulp responses to bacteria and in the pulpal transition between caries-induced inflammation and dentinogenic-based repair. We report, using selected examples, different strategies potentially used by odontoblasts and specialized immune cells to combat dentin-invading bacteria in vivo. PMID:26538821

Dental Pulp Defence and Repair Mechanisms in Dental Caries.

PubMed

Farges, Jean-Christophe; Alliot-Licht, Brigitte; Renard, Emmanuelle; Ducret, Maxime; Gaudin, Alexis; Smith, Anthony J; Cooper, Paul R

2015-01-01

Dental caries is a chronic infectious disease resulting from the penetration of oral bacteria into the enamel and dentin. Microorganisms subsequently trigger inflammatory responses in the dental pulp. These events can lead to pulp healing if the infection is not too severe following the removal of diseased enamel and dentin tissues and clinical restoration of the tooth. However, chronic inflammation often persists in the pulp despite treatment, inducing permanent loss of normal tissue and reducing innate repair capacities. For complete tooth healing the formation of a reactionary/reparative dentin barrier to distance and protect the pulp from infectious agents and restorative materials is required. Clinical and in vitro experimental data clearly indicate that dentin barrier formation only occurs when pulp inflammation and infection are minimised, thus enabling reestablishment of tissue homeostasis and health. Therefore, promoting the resolution of pulp inflammation may provide a valuable therapeutic opportunity to ensure the sustainability of dental treatments. This paper focusses on key cellular and molecular mechanisms involved in pulp responses to bacteria and in the pulpal transition between caries-induced inflammation and dentinogenic-based repair. We report, using selected examples, different strategies potentially used by odontoblasts and specialized immune cells to combat dentin-invading bacteria in vivo.

Effect of Argon Laser on Enamel Demineralization around Orthodontic Brackets: An In Vitro Study

PubMed Central

Miresmaeili, Amirfarhang; Etrati Khosroshahi, Mohammad; Motahary, Pouya; Rezaei-Soufi, Loghman; Mahjub, Hossein; Dadashi, Maryam; Farhadian, Nasrin

2014-01-01

Objective This study was designed to evaluate the effect of argon laser irradiation on development and progress of enamel demineralization around orthodontic brackets. Materials and Methods: Fifty caries-free, intact human premolars were randomly assigned to one of the following five equal groups: Groups 1 (control) and 2: The brackets were bonded using conventional halogen light for 40s and argon laser for 10s, respectively. Teeth in group 3 were lased with argon laser for 10s before bracket bonding with halogen light. Group 4 was the same as group 3 except that brackets were also bonded with argon laser. In group 5 samples were bonded conventionally, immersed in an artificial caries solution for two days and then irradiated for 10s with argon laser. All samples were subjected to demineralization by artificial caries solution for 10 days. After bracket removal, samples were buccolingually sectioned and evaluated by polarized light microscopy. Decalcified lesion depth in each section was measured by a trained examiner in a blind fashion. Data were analyzed in SPSS 14 using one-way ANOVA and Tukey’s HSD post hoc test. Results: The control group showed the greatest mean lesion depth while group 5 revealed the lowest. The laser-treated groups had significantly lower mean lesion depth compared with the control group (P<0.05) except for group 4 (P=0.192). Conclusion: Argon laser irradiation for 10s before or during bracket bonding can increase caries resistance of intact and demineralized enamel. PMID:25584052

Multimodal imaging system for dental caries detection

NASA Astrophysics Data System (ADS)

Liang, Rongguang; Wong, Victor; Marcus, Michael; Burns, Peter; McLaughlin, Paul

2007-02-01

Dental caries is a disease in which minerals of the tooth are dissolved by surrounding bacterial plaques. A caries process present for some time may result in a caries lesion. However, if it is detected early enough, the dentist and dental professionals can implement measures to reverse and control caries. Several optical, nonionized methods have been investigated and used to detect dental caries in early stages. However, there is not a method that can singly detect the caries process with both high sensitivity and high specificity. In this paper, we present a multimodal imaging system that combines visible reflectance, fluorescence, and Optical Coherence Tomography (OCT) imaging. This imaging system is designed to obtain one or more two-dimensional images of the tooth (reflectance and fluorescence images) and a three-dimensional OCT image providing depth and size information of the caries. The combination of two- and three-dimensional images of the tooth has the potential for highly sensitive and specific detection of dental caries.

Dental enamel defects in German medieval and early-modern-age populations.

PubMed

Lang, J; Birkenbeil, S; Bock, S; Heinrich-Weltzien, R; Kromeyer-Hauschild, K

2016-11-01

Aim of this study was to investigate the frequency and type of developmental defects of enamel (DDE) in a medieval and an early-modern-age population from Thuringia, Germany. Sixty-six skeletons subdivided into 31 single burials (12 th /13 th c.) and 35 individuals buried in groups (15 th /16 th c.) were examined. DDE were classified on 1,246 teeth according to the DDE index. Molar-incisor-hypomineralisation (MIH), a special type of DDE, was recorded according to the European Academy of Paediatric Dentistry (EAPD) criteria. DDE was found in 89.4% of the individuals (single burials 90.3% and group burials 88.6%). Hypoplastic pits were the most frequent defect in primary teeth and linear enamel hypoplasia (LEH) in permanent teeth. 13 individuals (24.1%) showed at least one hypomineralised permanent tooth, 12.2% had MIH on at least one first permanent molar and 10.0% in permanent incisors. Second primary molars were affected in 8.0% of the children and juveniles. No individual suffered from affected molars and incisors in combination. Endogenous factors like nutritional deficiencies and health problems in early childhood could have been aetiological reasons of DDE and MIH. The frequency of DDE and MIH might have been masked by extended carious lesions, dental wear and ante-mortem tooth loss.

Cariogenicity of different commercially available bovine milk types in a biofilm caries model.

PubMed

Giacaman, Rodrigo A; Muñoz-Sandoval, Cecilia

2014-01-01

This study's purpose was to assess the cariogenicity of commercial bovine milk types in an experimental biofilm/caries model. Enamel and dentin slabs were used to grow biofilms of Streptococcus mutans UA159. Slabs/biofilms were exposed three times per day to commercial skim, semi-skim, whole, whole lactose-free, and whole with 10 percent sucrose-added bovine milk and to 10 percent sucrose and 0.9 percent sodium chloride as positive and negative caries-control, respectively. Biofilms were analyzed for bacterial counts, biomass, proteins, and polysaccharide production. Slab's demineralization was assessed by loss of surface microhardness and the biofilm acidogenicity by medium pH. Only whole and whole lactose-free milk kept pH above the demineralization threshold, inducing the lowest demineralization in both enamel and dentin (P<.05). Skim and semi-skim milk induced similar demineralization to the sucrose control, albeit slightly lower for semi-skim milk (P<.05). Whole and whole lactose-free milk produced lower biomass and less insoluble polysaccharides than the other treatments in enamel and dentin (P<.05). Adding 10 percent sucrose to whole milk turned it as cariogenic as 10 percent sucrose solution. Bovine whole milk seemed less cariogenic than sucrose and the other commercial milk types, but not anticariogenic. Fat content in milk seemed to reduce cariogenicity of the fluid.

Analysis of the Early Stages and Evolution of Dental Enamel Erosion.

PubMed

Derceli, Juliana Dos Reis; Faraoni, Juliana Jendiroba; Pereira-da-Silva, Marcelo Assumpção; Palma-Dibb, Regina Guenka

2016-01-01

The aim of this study was to evaluate by atomic force microscopy (AFM) the early phases and evolution of dental enamel erosion caused by hydrochloric acid exposure, simulating gastroesophageal reflux episodes. Polished bovine enamel slabs (4x4x2 mm) were selected and exposed to 0.1 mL of 0.01 M hydrochloric acid (pH=2) at 37 ?#61472;?#61616;C using five different exposure intervals (n=1): no acid exposure (control), 10 s, 20 s, 30 s and 40 s. The exposed area was analyzed by AFM in 3 regions to measure the roughness, surface area and morphological surface. The data were analyzed qualitatively. Roughness started as low as that of the control sample, Rrms=3.5 nm, and gradually increased at a rate of 0.3 nm/s, until reaching Rrms=12.5 nm at 30 s. After 40 s, the roughness presented increment of 0.40 nm only. Surface area (SA) increased until 20 s, and for longer exposures, the surface area was constant (at 30 s, SA=4.40 μm2 and at 40 s, SA=4.43 μm2). As regards surface morphology, the control sample presented smaller hydroxyapatite crystals (22 nm) and after 40 s the crystal size was approximately 60 nm. Short periods of exposure were sufficient to produce enamel demineralization in different patterns and the morphological structure was less affected by exposure to hydrochloric acid over 30 s.

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.

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

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.

Early Childhood Caries: Prevalence, Risk Factors, and Prevention

PubMed Central

Anil, Sukumaran; Anand, Pradeep S.

2017-01-01

Early childhood caries (ECC) is major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. The prevalence of ECC differs according to the group examined, and a prevalence of up to 85% has been reported for disadvantaged groups. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 71 months (5 years) or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases. The major contributing factors for the for the high prevalence of ECC are improper feeding practices, familial socioeconomic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children to maintain the oral functions and is required for eating, speech development, and a positive self-image. The review will focus on the prevalence, risk factors, and preventive strategies and the management of ECC. PMID:28770188

Caries in adolescents in relation to their skeletal status.

PubMed

Kostik, Mikhail M; Kuzmina, Diana A; Novikova, Valeria P; Larionova, Valentina I; Scheplyagina, Larisa A

2015-03-01

Despite well-known evidence of association of caries with bone metabolic diseases, there are only a small number of studies about caries and bone mineral density (BMD) on pediatric population. We evaluated the possibility of bone mineralization and metabolism disturbances in children with caries and compared them with healthy individuals. A total of 123 patients with caries (63 boys and 60 girls), aged 12-15 years, were included. The children were divided according caries stage: the decayed, missing, and filled tooth (DMFT) group (n=73) and the initial caries (IC) group (n=50), which have clinically active initial caries lesions on the enamel ("white spots"). Caries-free (CF) children (n=42) were the healthy controls. Bone mineralization was measured in all children with caries and healthy controls by dual-energy X-ray absorptiometry of the lumbar spine (L1-L4). For the assessment of bone metabolism, osteocalcin, carboxy terminal telopeptide of type I collagen (CTX), parathyroid hormone, Ca²⁺, inorganic phosphate, and total alkaline phosphatase were used. Children with DMFT have low BMD and BMD Z score in association with low osteocalcin and high CTX levels, compared with IC (p=0.008 and p=0.0001, respectively) and CF children (p<0.0000 and p=0.0001, respectively). In DMFT, Ca²⁺ was significantly higher compared with IC (p=0.01) and CF (p=0.003). Caries stages negatively correlated with BMD (r=-0.86, p<0.001). A differently directed correlation between CTX and osteocalcin was detected: CTX was negatively related to osteocalcin in the DMFT group (r=-0.22, p=0.043) and positively related in the IC (r=0.42, p=0.002) and CF children (r=0.58, p=0.0000). Children with any caries stage have decreased BMD accompanied with increased bone resorption. We consider that caries could be a marker of impact bone mineralization and metabolism.

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.

The effect of developer age on the detection of approximal caries using three dental films.

PubMed

Syriopoulos, K; Velders, X L; Sanderink, G C; van Ginkel, F C; van Amerongen, J P; van der Stelt, P F

1999-07-01

To compare the diagnostic accuracy for the detection of approximal caries of three dental X-ray films using fresh and aged processing chemicals. Fifty-six extracted unrestored premolars were radiographed under standardized conditions using the new Dentus M2 (Agfa-Gevaert, Mortsel, Belgium), Ektaspeed Plus and Ultra-speed (Kodak Eastman Co, Rochester, USA) dental films. The films were processed manually using Agfa chemicals (Heraeus Kulzer, Dormagen, Germany). The procedure was repeated once a week until the complete exhaustion of the chemicals (6 weeks). Three independent observers assessed 210 radiographs using the following rating scale: 0 = sound, 1 = enamel lesion; 2 = lesion reaching the ADJ; 3 = dentinal lesion. True caries depth was determined by histological examination (14 sound surfaces, 11 enamel lesions, eight lesions reaching the ADJ and 23 dentinal lesions). True caries depth was subtracted from the values given by the observers and an analysis of variance was performed. The null hypothesis was rejected when P < 0.05. No significant differences were found in the diagnostic accuracy between the three films when using chemicals of up to 3 weeks old (P = 0.056). After the third week, Ultra-speed was significantly better than the other two films (P = 0.012). On average caries depth was underestimated. A similar level of diagnostic accuracy for approximal caries is achieved when using the three films. Dentus M2 and Ektaspeed Plus are at present the fastest available films and they should therefore be recommended for clinical practice. Agfa chemicals should be renewed every 3 weeks. Fifty per cent reduction in average gradient is indicative of renewing processing chemicals.

Removing or Controlling? How Caries Management Impacts on the Lifetime of Teeth.

PubMed

Schwendicke, Falk; Lamont, Thomas; Innes, Nicola

2018-05-24

Historically, traditional carious lesion management focused on the importance of removal of all carious tissue, with little thought to the lesion origins. The surgical removal of any sign of a carious lesion was prioritised with little, or no, consideration to pulp vitality, loss of tooth structure, or caries disease management. This symptomatic approach concentrating on lesions rather than on the cause of the disease, focused on preventing secondary carious lesion development. Early detection and improved understanding of the caries process - that lesion progress can be arrested or slowed - has led to preventive measures and less destructive management as a focus. The choice of lesion management depends on: whether a primary or permanent tooth is involved; which tooth surface(s) is/are involved; whether the lesion is confined to enamel or extends into dentine; the lesion depth, and lesion cleansability. Use of preventive and minimally invasive operative strategies is complicated by the lack of predictable ways of recording lesions' status to allow early detection of failed strategies and early intervention. Because re-restoration usually makes the cavity larger and, consequently, the tooth weaker, the clinician should be certain about initiating the repeat restoration cycle, delaying the first restoration as much as possible. The 3 main principles that support preventing or slowing the repeat restoration cycle are: (1) avoid restoration placement until there is no other option; (2) place them for maximum longevity; (3) if re-restoration is necessary, repair or refurbishment is preferable to replacement of a defective restoration. © 2018 S. Karger AG, Basel.

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.

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

Comparison of CPP-ACP, Tri-Calcium Phosphate and Hydroxyapatite on Remineralization of Artificial Caries Like Lesions on Primary Enamel -An in vitro Study.

PubMed

Bajaj, Meghna; Poornima, P; Praveen, S; Nagaveni, N B; Roopa, K B; Neena, I E; Bharath, K P

To compare CPP-ACP, Tri-calcium phosphate and Hydroxyapatite on remineralization of artificial caries like lesions on primary enamel. Ten extracted Primary molars coated with nail varnish, leaving a window of 2×4 mm on buccal and lingual surface were immersed in demineralizing solution for 96 hours and sectioned longitudinally to obtain 40 sections (4 sections per tooth) and were randomly divided into 4 groups (A to D) n=10; Group A: negative control, Group B: CPP-ACP, Group C: Tri-calcium phosphate, Group D: Hydroxyapatite. Sections were subjected to pH cycling for 10 days and were evaluated by polarized light microscope before and after treatment. Intra group comparison of demineralization and remineralization was done by paired t-test. One way ANOVA was used for multiple group comparisons followed by post HOC TUKEY'S Test for group wise comparisons. Remineralization was found more with Group D followed by Group B, C and A. Hydroxyapatite showed better remineralization when compared to CPP-ACP and Tri-calcium phosphate.

Earliest evidence of dental caries manipulation in the Late Upper Palaeolithic

PubMed Central

Oxilia, Gregorio; Peresani, Marco; Romandini, Matteo; Matteucci, Chiara; Spiteri, Cynthianne Debono; Henry, Amanda G.; Schulz, Dieter; Archer, Will; Crezzini, Jacopo; Boschin, Francesco; Boscato, Paolo; Jaouen, Klervia; Dogandzic, Tamara; Broglio, Alberto; Moggi-Cecchi, Jacopo; Fiorenza, Luca; Hublin, Jean-Jacques; Kullmer, Ottmar; Benazzi, Stefano

2015-01-01

Prehistoric dental treatments were extremely rare, and the few documented cases are known from the Neolithic, when the adoption of early farming culture caused an increase of carious lesions. Here we report the earliest evidence of dental caries intervention on a Late Upper Palaeolithic modern human specimen (Villabruna) from a burial in Northern Italy. Using Scanning Electron Microscopy we show the presence of striations deriving from the manipulation of a large occlusal carious cavity of the lower right third molar. The striations have a “V”-shaped transverse section and several parallel micro-scratches at their base, as typically displayed by cutmarks on teeth. Based on in vitro experimental replication and a complete functional reconstruction of the Villabruna dental arches, we confirm that the identified striations and the associated extensive enamel chipping on the mesial wall of the cavity were produced ante-mortem by pointed flint tools during scratching and levering activities. The Villabruna specimen is therefore the oldest known evidence of dental caries intervention, suggesting at least some knowledge of disease treatment well before the Neolithic. This study suggests that primitive forms of carious treatment in human evolution entail an adaptation of the well-known toothpicking for levering and scratching rather than drilling practices. PMID:26179739

Effect of toothbrushing duration and dentifrice quantity on enamel remineralisation: An in situ randomized clinical trial.

PubMed

Creeth, J E; Kelly, S A; González-Cabezas, C; Karwal, R; Martinez-Mier, E A; Lynch, R J M; Bosma, M L; Zero, D T

2016-12-01

The influence of toothbrushing duration and dentifrice quantity on fluoride efficacy against dental caries is poorly understood. This study investigated effects of these two oral hygiene factors on enamel remineralisation (measured as surface microhardness recovery [SMHR]), enamel fluoride uptake (EFU), and net acid resistance (NAR) post-remineralisation in a randomized clinical study using an in situ caries model. Subjects (n=63) wore their partial dentures holding partially demineralised human enamel specimens and brushed twice-daily for two weeks, following each of five regimens: brushing for 120 or 45s with 1.5g of 1150ppm F (as NaF) dentifrice; for 120 or 45s with 0.5g of this dentifrice; and for 120s with 1.5g of 250ppm F (NaF) dentifrice. Comparing brushing for 120s against brushing for 45s, SMHR and EFU increased by 20.0% and 26.9% respectively when 1.5g dentifrice was used; and by 22.8% and 19.9% respectively when 0.5g dentifrice was used. Comparing brushing with 1.5g against brushing with 0.5g dentifrice, SMHR and EFU increased by 35.3% and 51.3% respectively when brushing for 120s, and by 38.4% and 43.0% respectively when brushing for 45s. Increasing brushing duration and dentifrice quantity also increased the NAR value. The effects of these two oral hygiene factors on SMHR, EFU, and NAR were statistically significant (p<0.05 in all cases). Brushing duration and dentifrice quantity have the potential to influence the anti-caries effectiveness of fluoride dentifrices. Study NCT01563172 on ClinicalTrials.gov. The effect of two key oral hygiene regimen factors - toothbrushing duration and dentifrice quantity - on fluoride's anticaries effectiveness is unclear. This 2-week home-use in situ remineralisation clinical study showed both these factors can influence fluoride bioactivity, and so can potentially affect fluoride's ability to protect against caries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Socio-behavioural factors and early childhood caries: a cross-sectional study of preschool children in central Trinidad.

PubMed

Naidu, Rahul; Nunn, June; Kelly, Alan

2013-07-09

Early childhood caries (ECC) is a public health problem due to its impact on children's health, development and well being. Little is known about early childhood oral health in the West Indies or the influence of social and behavioural factors on the prevalence and severity of early childhood caries in this preschool population. The aims of this study were to describe the prevalence and severity of ECC in preschool children in a region of central Trinidad and to explore its relationship with social and behavioural factors. A cross-sectional survey was undertaken on children aged 3-5 years-old from a random sample of preschools in central Trinidad. Oral health examinations were conducted for children for whom parental consent was given, using WHO criteria (visual diagnosis / cavitation at d3). A self-reported questionnaire was distributed to all parents and caregivers. Variables included socio-demographics, oral health knowledge, attitudes and behaviours, visible caries experience and treatment need. 251 children were examined, 50.2% were male with a mean age of 3.7 years (SD 0.67) and 71% were of Indian ethnicity. The prevalence of ECC was 29.1% and the prevalence of severe early childhood caries (S-ECC) was 17.5%. 29.9% of children had some treatment need, with 12% in need of urgent care or referral. Poisson generalized linear mixed model analysis found a higher rate of visible caries experience for children who ate sweet snacks more than twice a day (p < 0.001), had poorer parental dental health ratings (p < 0.0001), a previous dental visit (p < 0.0001) and difficulty finding dental care (p < 0.001). The prevalence and severity of ECC in central Trinidad was related to oral health behaviours and access to dental care. Oral health promotion should include more supportive and practical advice for parents and caregivers of preschool children along with improved access to dental care to enable primary prevention and management of ECC.

Effect of probiotic chewing tablets on early childhood caries--a randomized controlled trial.

PubMed

Hedayati-Hajikand, Trifa; Lundberg, Ulrika; Eldh, Catarina; Twetman, Svante

2015-09-24

To evaluate the effect of probiotic chewing tablets on early childhood caries development in preschool children living in a low socioeconomic multicultural area. The investigation employed a randomized double-blind placebo-controlled design. The study group consisted of 138 healthy 2-3-year-old children that were consecutively recruited after informed parental consent. After enrollment, they were randomized to a test or a placebo group. The parents of the test group were instructed to give their child one chewing tablet per day containing three strains of live probiotic bacteria (ProBiora3) and the placebo group got identical tablets without bacteria. The duration was one year and the prevalence and increment of initial and manifest caries lesions was examined at baseline and follow-up. All parents were thoroughly instructed to brush the teeth of their off-springs twice daily with fluoride toothpaste. The groups were balanced at baseline and the attrition rate was 20%. Around 2/3 of the children in both groups reported an acceptable compliance. The caries increment (Δds) was significantly lower in the test group when compared with the placebo group, 0.2 vs. 0.8 (p < 0.05). The risk reduction was 0.47 (95% CI 0.24-0.98) and the number needed to treat close to five. No differences were displayed between the groups concerning presence of visible plaque or bleeding-on-brushing. No side effects were reported. The results suggested that early childhood caries development could be reduced through administration of these probiotic chewing tablets as adjunct to daily use of fluoride toothpaste in preschool children. Further studies on a possible dose-response relationship seem justified ClinicalTrials.gov Identifier: NCT01720771 . First received: October 31, 2012.

EFFECT OF DIFFERENT PROPHYLAXIS METHODS ON SOUND AND DEMINERALIZED ENAMEL

PubMed Central

Honório, Heitor Marques; Rios, Daniela; Abdo, Ruy César Camargo; Machado, Maria Aparecida de Andrade Moreira

2006-01-01

Considering the importance of professional plaque control for caries prevention, this study comprised an in vitro evaluation of wear by two prophylaxis methods (sodium bicarbonate jet – Profident and pumice and brush) on sound bovine enamel and with artificial carious lesions. Sixty enamel fragments were employed (4x4mm), which were divided into 4 groups: GI – 15 sound blocks treated with pumice and brush; GII – 15 sound blocks treated with Profident; GIII – 15 demineralized blocks treated with pumice and brush, and GIV – 15 demineralized blocks treated with Profident. In the fragments of Groups III and IV, artificial carious lesions were simulated by immersion in 0.05M acetic acid solution 50% saturated with bovine enamel powder at 37oC for 16h. The specimens were submitted to the prophylactic treatments for 10 seconds. Wear analysis was performed by profilometer and revealed the following results: 0.91μm – GI; 0.42μm – GII; 1.6μm – GIII, and 0.94μm – GIV. The two-way ANOVA and Tukey's test (p<0.05) revealed significant difference between all groups. Scanning electron microscopy images were employed to illustrate the wear pattern, with observation of larger alteration on the demineralized enamel surface (GIII; GIV), round-shaped wear on GI and GIII and blasted aspect on GII and GIV. The study indicated that the demineralized enamel presented more wear than the sound enamel, and the brush led to larger wear when compared to Profident. PMID:19089042

Stress and strain distribution in demineralized enamel: A micro-CT based finite element study.

PubMed

Neves, Aline Almeida; Coutinho, Eduardo; Alves, Haimon Diniz Lopes; de Assis, Joaquim Teixeira

2015-10-01

Physiological oral mechanical forces may play a role on the progression of enamel carious lesions to cavitation. Thus, the aim of this study was to describe, by 3D finite element analysis, stress, and strain patterns in sound and carious enamel after a simulated occlusal load. Micro-CT based models were created and meshed with tetrahedral elements (based on an extracted third molar), namely: a sound (ST) and a carious tooth (CT). For the CT, enamel material properties were assigned according to the micro-CT gray values. Below the threshold corresponding to the enamel lesion (2.5 g/cm(3) ) lower and isotropic elastic modulus was assigned (E = 18 GPa against E1  = 80 GPa, E2  = E3  = 20 GPa for sound enamel). Both models were imported into a FE solver where boundary conditions were assigned and a pressure load (500 MPa) was applied at the occlusal surface. A linear static analysis was performed, considering anisotropy in sound enamel. ST showed a more efficient transfer of maximum principal stress from enamel to the dentin layer, while for the CT, enamel layer was subjected to higher and concentrated loads. Maximum principal strain distributions were seen at the carious enamel surface, especially at the central fossa, correlating to the enamel cavity seen at the original micro-CT model. It is possible to conclude that demineralized enamel compromises appropriate stress transfer from enamel to dentin, contributing to the odds of fracture and cavitation. Enamel fracture over a dentin lesion may happen as one of the normal pathways to caries progression and may act as a confounding factor during clinical diagnostic decisions. © 2015 Wiley Periodicals, Inc.

Bicarbonate Transport During Enamel Maturation.

PubMed

Yin, Kaifeng; Paine, Michael L

2017-11-01

Amelogenesis (tooth enamel formation) is a biomineralization process consisting primarily of two stages (secretory stage and maturation stage) with unique features. During the secretory stage, the inner epithelium of the enamel organ (i.e., the ameloblast cells) synthesizes and secretes enamel matrix proteins (EMPs) into the enamel space. The protein-rich enamel matrix forms a highly organized architecture in a pH-neutral microenvironment. As amelogenesis transitions to maturation stage, EMPs are degraded and internalized by ameloblasts through endosomal-lysosomal pathways. Enamel crystallite formation is initiated early in the secretory stage, however, during maturation stage the more rapid deposition of calcium and phosphate into the enamel space results in a rapid expansion of crystallite length and mineral volume. During maturation-stage amelogenesis, the pH value of enamel varies considerably from slightly above neutral to acidic. Extracellular acid-base balance during enamel maturation is tightly controlled by ameloblast-mediated regulatory networks, which include significant synthesis and movement of bicarbonate ions from both the enamel papillary layer cells and ameloblasts. In this review we summarize the carbonic anhydrases and the carbonate transporters/exchangers involved in pH regulation in maturation-stage amelogenesis. Proteins that have been shown to be instrumental in this process include CA2, CA6, CFTR, AE2, NBCe1, SLC26A1/SAT1, SLC26A3/DRA, SLC26A4/PDS, SLC26A6/PAT1, and SLC26A7/SUT2. In addition, we discuss the association of miRNA regulation with bicarbonate transport in tooth enamel formation.

Dental caries in diabetes mellitus: role of salivary flow rate and minerals.

PubMed

Jawed, Muhammad; Shahid, Syed M; Qader, Shah A; Azhar, Abid

2011-01-01

This study was designed to evaluate the possible protective role of salivary factors like salivary flow rate and adequate level of calcium, phosphate, and fluoride in diabetes mellitus type 2 patients with dental caries. A total of 398 diabetes mellitus type 2 patients with dental caries and 395 age- and sex-matched non-diabetic subjects with dental caries were included as controls, all of whom gave informed consent. All subjects were divided into four groups according to their age. Decayed, missed, and filled teeth (DMFT) were scored to indicate the severity of dental caries. Saliva was collected, flow rate was noted, and calcium, phosphate, and fluoride were analyzed. The blood glucose, HbA1c, and DMFT indices were found to be significantly high in diabetic patients as compared to controls. The salivary flow rate, calcium, phosphate, and fluoride were found to be significantly low whereas no significant difference was found in salivary magnesium in patients as compared to controls. Optimum salivary flow rate is responsible for establishing protective environment against dental caries. Adequate level of salivary calcium, phosphate, and fluoride is also involved in significant deposition of these minerals in plaque, which greatly reduces the development of caries in the adjacent enamel of teeth. Copyright © 2011 Elsevier Inc. All rights reserved.

Preparation of fluoride substituted apatite cements as the building blocks for tooth enamel restoration

NASA Astrophysics Data System (ADS)

Wei, Jie; Wang, Jiecheng; Liu, Xiaochen; Ma, Jian; Liu, Changsheng; Fang, Jing; Wei, Shicheng

2011-06-01

Fluoride substituted apatite cement (fs-AC) was synthesized by using the cement powders of tetracalcium phosphate (TTCP) and sodium fluoride (NaF), and the cement powders were mixed with diluted phosphoric acid (H 3PO 4) as cement liquid to form fs-AC paste. The fs-AC paste could be directly filled into the carious cavities to repair damaged dental enamel. The results indicated that the fs-AC paste was changed into fluorapatite crystals with the atom molar ratio for calcium to phosphorus of 1.66 and the F ion amount of 3 wt% after self-hardening for 2 days. The solubility of fs-AC in Tris-HCl solution (pH 6) was slightly lower than hydroxyapatite cement (HAC) that was similar to the apatite in enamel, indicating the fs-AC was much insensitive to the weakly acidic solution than the apatite in enamel. The fs-AC was tightly combined with the enamel surface because of the chemical reaction between the fs-AC and the apatite in enamel after the caries cavities was filled with fs-AC. The extracts of fs-AC caused no cytotoxicity on L929 cells, which satisfied the relevant criterion on dental biomaterials, revealing good cytocompatibility. The fs-AC had potential prospect for the reconstitution of carious lesion of dental enamel.

Early Childhood Caries, Mouth Pain, and Nutritional Threats in Vietnam.

PubMed

Khanh, Linh Ngo; Ivey, Susan L; Sokal-Gutierrez, Karen; Barkan, Howard; Ngo, Kimberly M; Hoang, Hung T; Vuong, Ivy; Thai, Nam

2015-12-01

We investigated the relationships among early childhood caries (ECC), mouth pain, and nutritional status in children aged 1 to 6 years in Southern and Central Vietnam. A total of 593 parent-child pairs were recruited from 5 kindergartens or preschools in Ho-Chi Minh City and Da Nang. Parents completed surveys about dietary habits, oral health practices, and children's mouth pain experience; children received anthropometric assessment and dental examinations. There was a high prevalence of dental caries (74.4%), mostly untreated, and mouth pain (47.1%). Moderate correlations were found between parents' and children's consumption of soda (ρ = 0.361; P < .001) and salty snacks (ρ = 0.292; P < .001). Severity of ECC was associated with decreased weight- and body mass index-for-age z-scores. Presence of pulp-involved caries was associated with strikingly lower height-for-age (mean difference = 0.66; P = .001), weight-for-age (mean difference = 1.17; P < .001), and body mass index-for-age (mean difference = 1.18; P < .001) z-scores. Mouth pain was associated with lower body mass index-for-age z-scores (mean difference = 0.29; P = .013). ECC might negatively affect children's nutritional status, which might be mediated by the depth of decay, chronic inflammation, and mouth pain. Family-based and prevention-oriented nutrition and oral health programs are needed and should start during pregnancy and infancy.

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.

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

Effects of the CO II laser combined with fluoridated toothpaste on human dental enamel demineralization

NASA Astrophysics Data System (ADS)

Azevedo Rodrigues, Lidiany Karla; Alvarez Vidigal, Evelyn; Silva Soares, Luís Eduardo; Abrahão Martin, Airton; Brugnera-Júnior, Aldo; Aparecida Zanin, Fátima Antonia; Nobre dos Santos, Marinês

2006-02-01

This in vitro pilot study investigated the CO II laser effects on demineralization inhibition in sound human dental enamel. Thirty six human enamel specimens were used and randomly assigned to 6 groups, as follows: I) Control; II) 1W; III) 2W; IV) 3W; V) 4W; VI) 5W. Group I one was kept as control and others were irradiated using a pulsed CO II laser (λ=10.6 μm) with low crescent potencies. Fourier Transform Raman Spectroscopy was used to study the surface composition of specimens after irradiation. One specimen from each group was analyzed by Scanning Electron Microscopy and the remaining ones were submitted to an 8-day pH cycling model with use of fluoridated toothpaste twice a day. After pH-cycling, the cross-sectional microhardness was performed for mineral loss (ΔZ) quantification. The data were analyzed by ANOVA and Tuckey test (α=0.05). No changes were found either in SEM photomicrographies or RAMAN Spectra of the specimens in all groups. The ΔZ values (n=5; mean+/-SD) for I-VI groups were: 1741.6+/-725.3a 1782.7+/-639.0a 1427.2+/-237.0a 1780.6+/-552.4a 1385.2+/-602.2a 943.1+/-228.1a respectively. The highest percentage of caries inhibition was found in group VI (45.8%); however the differences between ΔZ of the groups were not statistically significant. The use of CO II laser with low fluencies did not prevent more caries development than the use of fluoridated toothpaste, even though group VI had present good results in caries inhibition. Energy densities higher than 0.0125 J/cm 2 should be used to promote chemical or morphological changes on enamel surface, which are able of inhibiting mineral.

Microhardness and morphological changes induced by Nd:Yag laser on dental enamel: an in vitro study.

PubMed

Bedini, Rossella; Manzon, Licia; Fratto, Giovanni; Pecci, Raffaella

2010-01-01

The aim of this work was a scanning electron microscopy (SEM) evaluation of the hardness and morphological changes of enamel irradiated by neodymium: yttrium aluminium garnet (Nd:YAG) laser with different energy levels. Twenty-eight human teeth samples were divided into 4 groups: control, where enamel surface was not lased, and 3 test treated with 3 different levels of energy power 0.6, 1.2 and 2.4 Watt, respectively. In each group, 5 samples underwent Vickers micro-hardness test and 2 samples were processed for SEM. No significant differences between treated and non treated samples were found by micro-hardness test. However, by SEM, test samples showed a rougher enamel surface than control. Specifically, the 0.6 Watt treated samples showed vertical scratches and glass-like areas, while in the other 2 groups enamel surface was covered by craters and cracks. These findings suggest that enamel should be lased at a low energy level to preserve its integrity and reduce demineralization, and thus for dental caries prevention purposes; while high energy level creates a retentive surface suitable for sealant or composite anchorage.

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.

Contact fatigue of human enamel: Experiments, mechanisms and modeling.

PubMed

Gao, S S; An, B B; Yahyazadehfar, M; Zhang, D; Arola, D D

2016-07-01

Cyclic contact between natural tooth structure and engineered ceramics is increasingly common. Fatigue of the enamel due to cyclic contact is rarely considered. The objectives of this investigation were to evaluate the fatigue behavior of human enamel by cyclic contact, and to assess the extent of damage over clinically relevant conditions. Cyclic contact experiments were conducted using the crowns of caries-free molars obtained from young donors. The cuspal locations were polished flat and subjected to cyclic contact with a spherical indenter of alumina at 2Hz. The progression of damage was monitored through the evolution in contact displacement, changes in the contact hysteresis and characteristics of the fracture pattern. The contact fatigue life diagram exhibited a decrease in cycles to failure with increasing cyclic load magnitude. Two distinct trends were identified, which corresponded to the development and propagation of a combination of cylindrical and radial cracks. Under contact loads of less than 400N, enamel rod decussation resisted the growth of subsurface cracks. However, at greater loads the damage progressed rapidly and accelerated fatigue failure. Overall, cyclic contact between ceramic appliances and natural tooth structure causes fatigue of the enamel. The extent of damage is dependent on the magnitude of cyclic stress and the ability of the decussation to arrest the fatigue damage. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Detection of proximal caries using digital radiographic systems with different resolutions.

PubMed

Nikneshan, Sima; Abbas, Fatemeh Mashhadi; Sabbagh, Sedigheh

2015-01-01

Dental radiography is an important tool for detection of caries and digital radiography is the latest advancement in this regard. Spatial resolution is a characteristic of digital receptors used for describing the quality of images. This study was aimed to compare the diagnostic accuracy of two digital radiographic systems with three different resolutions for detection of noncavitated proximal caries. Diagnostic accuracy. Seventy premolar teeth were mounted in 14 gypsum blocks. Digora; Optime and RVG Access were used for obtaining digital radiographs. Six observers evaluated the proximal surfaces in radiographs for each resolution in order to determine the depth of caries based on a 4-point scale. The teeth were then histologically sectioned, and the results of histologic analysis were considered as the gold standard. Data were entered using SPSS version 18 software and the Kruskal-Wallis test was used for data analysis. P <0.05 was considered as statistically significant. No significant difference was found between different resolutions for detection of proximal caries (P > 0.05). RVG access system had the highest specificity (87.7%) and Digora; Optime at high resolution had the lowest specificity (84.2%). Furthermore, Digora; Optime had higher sensitivity for detection of caries exceeding outer half of enamel. Judgment of oral radiologists for detection of the depth of caries had higher reliability than that of restorative dentistry specialists. The three resolutions of Digora; Optime and RVG access had similar accuracy in detection of noncavitated proximal caries.

DENTINE CARIES: ACID-TOLERANT MICROORGANISMS AND ASPECTS ON COLLAGEN DEGRADATION.

PubMed

Lager, Anders Hedenbjörk

2014-01-01

Dental caries is a common disease all over the world, despite the fact that it can be both effectively prevented and treated. It is driven by acids produced by oral microorganisms as a consequence of their metabolism of dietary carbohydrates. Given enough acid challenge, eventually the tooth enamel barrier will be broken down, and the carious lesion will extend into underlying hard tissue, forming a macroscopic cavity in the dentine. In comparison to biofilm on enamel, a dentine carious lesion provides a vastly different environment for the residing microorganisms. The environment influences the types and numbers of microorganisms that can colonize the dentine caries lesion. The overall aims for this thesis are to enumerate and further study microorganisms found in established dentine caries lesions and also to illuminate how host-derived proteolytic enzymes might contribute to this degradation, not only to better understand the caries process in dentine but also to find incitements for new methods to influence the natural progression of caries lesions. In Paper I, the numbers of remaining viable microorganisms after completed excavation using two excavation methods were investigated. Samples of carious dentine tissue were collected before and after excavation and cultivated on different agar media in different atmospheres. Analysis was performed by counting the number of colony-forming units (CFUs). Key findings: The number of remaining microorganisms after excavation was low for both methods, but some microorganisms always remained in the cavity floors even when the cavities were judged as caries free using normal clinical criteria. In Paper II, the acid tolerant microbiota in established dentine caries lesions was investigated. Samples were taken as in Paper I, but on three levels (superficial, center of lesion, floor of lesion after completed excavation). The samples were cultivated in anaerobic conditions on solid pH-selective agar media of different acidity

Factors affecting clinical outcome following treatment of early childhood caries under general anaesthesia: a two-year follow-up.

PubMed

El Batawi, H Y

2014-06-01

To investigate factors that might affect the clinical outcome of early childhood caries treatment under dental general anaesthesia (DGA). Retrospective longitudinal study. The medical records of paediatric patients with early childhood caries who underwent full dental rehabilitation under DGA during 2011 in a private medical facility in Jeddah, Saudi Arabia, were investigated. Study parameters were the patient's financial arrangements and compliance with suggested recall plan. Statistical analysis of caries recurrence and the need to repeat the rehabilitation process was also performed. Eighteen percent failed to attend any post-operative visit. Twenty-six percent did not comply with the post-operative preventive plan. The overall relapse rate was high (58.5%), with the highest percentage (68%) among the non-compliant group. The highest frequency of repeat DGA (10%) was in the non-compliant group. Despite the high rate of post-operative caries recurrence, DGA is still an acceptable treatment option as it minimises the need for future dental treatment. Compliance by caregivers with post-operative care plans is as important as the procedure itself. In Saudi Arabia, targeting the actual caregivers with post-operative dental health education presents challenges that might affect the clinical outcome of DGA.

Enamel Carious Lesion Development in Response to Sucrose and Fluoride Concentrations and to Time of Biofilm Formation: An Artificial-Mouth Study

PubMed Central

Arthur, Rodrigo Alex; Kohara, Eduardo Kazuo; Waeiss, Robert Aaron; Eckert, George J.; Zero, Domenick; Ando, Masatoshi

2015-01-01

The aim of this study was to evaluate both sucrose and fluoride concentrations and time of biofilm formation on enamel carious lesions induced by an in vitro artificial-mouth caries model. For Study 1, biofilms formed by streptococci and lactobacilli were grown on the surface of human enamel slabs and exposed to artificial saliva containing 0.50 or 0.75 ppmF (22.5 h/d) and broth containing 3 or 5% sucrose (30 min; 3x/d) over 5 d. In Study 2, biofilms were grown in the presence of 0.75 ppmF and 3% sucrose over 3 and 9 days. Counts of viable cells on biofilms, lesion depth (LD), and the integrated mineral loss (IML) on enamel specimens were assessed at the end of the tested conditions. Counts of total viable cells and L. casei were affected by sucrose and fluoride concentrations as well as by time of biofilm formation. Enamel carious lesions were shallower and IML was lower in the presence of 0.75 ppmF than in the presence of 0.50 ppmF (P < 0.005). No significant effect of sucrose concentrations was found with respect to LD and IML (P > 0.25). Additionally, deeper lesions and higher IML were found after 9 d of biofilm formation (P < 0.005). Distinct sucrose concentrations did not affect enamel carious lesion development. The severity of enamel demineralization was reduced by the presence of the higher fluoride concentration. Additionally, an increase in the time of biofilm formation produced greater demineralization. Our results also suggest that the present model is suitable for studying aspects related to caries lesion development. PMID:25664342

Diet and Dental Caries: The Pivotal Role of Free Sugars Reemphasized.

PubMed

Sheiham, A; James, W P T

2015-10-01

The importance of sugars as a cause of caries is underemphasized and not prominent in preventive strategies. This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic. Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars. These provide a substrate for cariogenic oral bacteria to flourish and to generate enamel-demineralizing acids. Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause--sugars. In this article, we demonstrate the sensitivity of cariogenesis to even very low sugars intakes. Quantitative analyses show a log-linear dose-response relationship between the sucrose or its monosaccharide intakes and the progressive lifelong development of caries. This results in a substantial dental health burden throughout life. Processed starches have cariogenic potential when accompanying sucrose, but human studies do not provide unequivocal data of their cariogenicity. The long-standing failure to identify the need for drastic national reductions in sugars intakes reflects scientific confusion partly induced by pressure from major industrial sugar interests. © International & American Associations for Dental Research 2015.

Effects of XeCl excimer lasers and fluoride application on artificial caries-like lesions

NASA Astrophysics Data System (ADS)

Wilder-Smith, Petra B. B.; Phan, T.; Liaw, Lih-Huei L.; Berns, Michael W.

1994-09-01

In this study the affects of a pulsed excimer laser emitting at 308 nm (XeCl) on enamel susceptibility to artificial caries-like lesions were investigated. Additional effects of fluoride (F) application were also studied and SEC examinations performed. Sixty-four extracted human molar teeth were coated with acid resistant varnish leaving four windows, then sectioned, leaving one window on each tooth quarter. The windows were treated in one of the following ways: untreated (control), or lased, or exposed to 4 min. APF (1.23% F) before lasing, or exposed to 4 min. APF (1.23% F) after lasing. After lasing, microhardness profiles were obtained and SEM was performed. Caries resistance was generally increased at moderate fluences. F application combined with lasing enhanced caries resistance at some parameters. SEM showed effects ranging from minimal to localized effects to extended glazing. Pulsed excimer laser irradiation, especially combined with topical F application can inhibit development of artificial caries-like lesions.

Oral colonization by Streptococcus mutans and caries development is reduced upon deletion of carbonic anhydrase VI expression in saliva.

PubMed

Culp, David J; Robinson, Bently; Parkkila, Seppo; Pan, Pei-Wen; Cash, Melanie N; Truong, Helen N; Hussey, Thomas W; Gullett, Sarah L

2011-12-01

Carbonic anhydrase VI (CA VI), encoded by type A transcripts of the gene Car6, is a secretory product of salivary glands and is found in the enamel pellicle. Because higher caries prevalence is associated with lower salivary concentrations of CA VI in humans, we tested whether CA VI protects enamel surfaces from caries induced by Streptococcus mutans, using Car6(-/-) mice, in which salivary CA VI expression is absent. We detected aberrant Car6 type A transcripts in Car6(-/-) mice, likely targets for nonsense-mediated mRNA decay. Expression of the intracellular stress-induced isoform of CA VI encoded by type B transcripts was restricted to parotid and submandibular glands of wild type mice. The salivary function of Car6(-/-) mice was normal as assessed by the histology and protein/glycoprotein profiles of glands, salivary flow rates and protein/glycoprotein compositions of saliva. Surprisingly, total smooth surface caries and sulcal caries in Car6(-/-) mice were more than 6-fold and 2-fold lower than in wild type mice after infection with S. mutans strain UA159. Recoveries of S. mutans and total microbiota from molars were also lower in Car6(-/-) mice. To explore possible mechanisms for increased caries susceptibility, we found no differences in S. mutans adherence to salivary pellicles, in vitro. Interestingly, higher levels of Lactobacillus murinus and an unidentified Streptococcus species were cultivated from the oral microbiota of Car6(-/-) mice. Collective results suggest salivary CA VI may promote caries by modulating the oral microbiota to favor S. mutans colonization and/or by the enzymatic production of acid within plaque. Copyright © 2011 Elsevier B.V. All rights reserved.

Prevalence of dental caries among school children of Bharatpur city, India.

PubMed

Ingle, Navin Anand; Dubey, Harsh Vardhan; Kaur, Navpreet; Gupta, Rahul

2014-01-01

Healthy teeth and oral tissues and the need for oral health care are important for any section of society. Dental caries is an infectious microbial disease of multifactorial origin in which diet, host, and microbial flora interacts over a period of time in such a way so as to encourage demineralization of the tooth enamel with resultant caries formation. Dental caries, the product of man's progress towards civilization, has a very high morbidity potential and thus, is coming into focus of the mankind. To assess the prevalence of dental caries among 12-15 year old government and private school children of Bharatpur city. This was a cross-sectional study carried out on total 1400 school children, of which 700 school children were from government schools and 700 were from private schools. Simple random sampling methodology was used to select the sample. The subjects were examined for dental caries according to WHO 1997 assessment form. Significant Caries Index was also used to assess the prevalence of dental caries. The prevalence of dental caries was found higher among government school children, that is, 53%, when compared to private school children, that is, 47% and this difference was found to be statistically significant. The mean decayed, missing, and filled teeth were found to be higher in government school children (7.61 ± 2.86) as compared to private school children (4.76 ± 2.42). Dental caries was found to be the major public health problems among both the government and private school children of Bharatpur city, which need immediate attention. Regular dental checkups and practice of routine oral hygiene procedures will enable them to lead a healthier life.

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.

Potential uses of terahertz pulse imaging in dentistry: caries and erosion detection

NASA Astrophysics Data System (ADS)

Longbottom, Christopher; Crawley, David A.; Cole, Bryan E.; Arnone, Donald D.; Wallace, Vincent P.; Pepper, Michael

2002-06-01

TeraHertz Pulse Imaging (TPI) is a relatively new imaging modality for medical and dental imaging. The aim of the present study was to make a preliminary assessment of the potential uses of TPI in clinical dentistry, particularly in relation to caries detection and the detection and monitoring of erosion. Images were obtained in vitro using a new TPI system developed by TeraView Ltd. We present data showing that TPI in vitro images of approximal surfaces of whole teeth demonstrate a distinctive shadowing in the presence of natural carious lesions in enamel. The thickness of this enamel shadowing appears to be related to lesion depth. The use of non-ionizing radiation to image such lesions non-destructively in vitro represents a significant step towards such measurements in vivo. In addition, data is presented which indicates that TPI may have a potential role in the detection and monitoring of enamel erosion. In vitro experiments on whole incisor teeth show that TPI is capable of detecting relatively small artificially induced changes in the buccal or palatal surface of the enamel of these teeth. Imaging of enamel thickness at such a resolution without ionizing radiation would represent a significant breakthrough if applicable in vivo.

Caries lesion remineralization with fluoride toothpastes and chlorhexidine - effects of application timing and toothpaste surfactant

PubMed Central

Almohefer, Sami A.; Levon, John A.; Gregory, Richard L.

2018-01-01

Abstract Habitual toothbrushing with fluoridated toothpaste followed by rinsing with antibacterial mouthwashes is a method to maintain good oral hygiene and to diminish the occurrence and severity of dental caries and periodontal disease. However, our understanding of how antimicrobial agents in mouthwashes affect fluoride-mediated caries lesion remineralization is still poor. Objective: The objectives of this in vitro study were a) to determine the effects of the waiting period of chlorhexidine (CHX) rinsing after fluoride toothpaste use and b) to further determine the effect of the type of toothpaste surfactant [sodium dodecyl sulfate (SDS) or cocamidopropyl betaine (CAPB)] on caries lesion remineralization associated with CHX rinsing. Material and Methods: Caries lesions were formed in bovine enamel specimens and assigned to 10 treatment groups (n=18) based on Vickers surface microhardness (VHN). Lesions were then pH-cycled for 10 days with daily regimen comprised of twice daily toothpaste slurry treatments (1150 ppm fluoride, with SDS or CAPB), followed by CHX solution treatments [0, 15, 30 or 60 minutes following slurry treatment or no CHX treatment (negative control)]. VHN was measured again and the extent of lesion remineralization calculated (∆VHN). Results: ∆VHN with SDS-toothpaste was significantly lower than with CAPB-toothpaste, indicating more remineralization for the CAPB-toothpaste. ∆VHN with 0-minute waiting time was significantly lower than with 30-minute waiting time and with negative control. Conclusions: The absence of CHX as an adjunct to fluoride toothpastes led to greater remineralization of enamel lesions compared with the immediate use of CHX treatment for both SDS- and CAPB-toothpastes. CAPB-toothpastes indicated significantly greater remineralization than SDS-toothpastes, and can be suggested for patients at high risk of caries. A 30-minute waiting time for CHX treatment is recommended after brushing.

A New Sugarcane Cystatin Strongly Binds to Dental Enamel and Reduces Erosion.

PubMed

Santiago, A C; Khan, Z N; Miguel, M C; Gironda, C C; Soares-Costa, A; Pelá, V T; Leite, A L; Edwardson, J M; Buzalaf, M A R; Henrique-Silva, F

2017-08-01

Cystatin B was recently identified as an acid-resistant protein in acquired enamel pellicle; it could therefore be included in oral products to protect against caries and erosion. However, human recombinant cystatin is very expensive, and alternatives to its use are necessary. Phytocystatins are reversible inhibitors of cysteine peptidases that are found naturally in plants. In plants, they have several biological and physiological functions, such as the regulation of endogenous processes, defense against pathogens, and response to abiotic stress. Previous studies performed by our research group have reported high inhibitory activity and potential agricultural and medical applications of several sugarcane cystatins, including CaneCPI-1, CaneCPI-2, CaneCPI-3, and CaneCPI-4. In the present study, we report the characterization of a novel sugarcane cystatin, named CaneCPI-5. This cystatin was efficiently expressed in Escherichia coli, and inhibitory assays demonstrated that it was a potent inhibitor of human cathepsins B, K, and L ( K i = 6.87, 0.49, and 0.34 nM, respectively). The ability of CaneCPI-5 to bind to dental enamel was evaluated using atomic force microscopy. Its capacity to protect against initial enamel erosion was also tested in vitro via changes in surface hardness. CaneCPI-5 showed a very large force of interaction with enamel (e.g., compared with mucin and casein) and significantly reduced initial enamel erosion. These results suggest that the inclusion of CaneCPIs in dental products might confer protection against enamel erosion.

The Relationship of Severe Early Childhood Caries and Body Mass Index in a Group of 3- to 6-year-old Children in Shiraz.

PubMed

Edalat, A; Abbaszadeh, M; Eesvandi, M; Heidari, A

2014-06-01

Early childhood caries can cause pain, discomfort and also inability to have a healthy nutrition .Malnutrition can be characterized when there is a weight, height, and body mass index (BMI) deficiency. The aim of this study was to evaluate the relationship between the severe early childhood caries (based on the dmft index) and BMI in pre-school children in Shiraz. A descriptive analytical cross-sectional study was enrolled on 202 healthy preschool children with the age range of 3-6 years recruited from the kindergartens of different socio- economical parts of Shiraz, Iran. The Anthropometric measurements, weight and height were evaluated. The Z-scores were calculated employing WHO Anthro software (www.who.int/childgrowth/software/en/ index.html) to elucidate the subject's status on the age- and sex-specific growth chart. Every Child who has received two Z-scores under the normal value (< -2) was considered as abnormal. The relationship between dmft index and BMI was then investigated. The mean of dmft was 4.13. From children with severe early childhood caries, 12.5%were under weight, 5% had height deficiency and 19.5% had BMI deficiency, however, there was no significant relationship between increasing dmft and the height, weight and BMI deficiency. There was not a linear correlation between severe early childhood caries and BMI, height, and weight deficiency. An incidence of 55% was yielded for severe early childhood caries which was an additional finding of this study.

In vitro evaluation of casein phosphopeptide-amorphous calcium phosphate effect on the shear bond strength of dental adhesives to enamel.

PubMed

Shadman, Niloofar; Ebrahimi, Shahram Farzin; Shoul, Maryam Azizi; Sattari, Hasti

2015-01-01

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is applied for remineralization of early caries lesions or tooth sensitivity conditions and may affect subsequent resin bonding. This in vitro study investigated the effect of CPP-ACP on the shear bond strength of dental adhesives to enamel. Sixty extracted human molar teeth were selected and randomly divided into three groups and six subgroups. Buccal or lingual surfaces of teeth were prepared to create a flat enamel surface. Adhesives used were Tetric N-Bond, AdheSE and AdheSE One F. In three subgroups, before applying adhesives, enamel surfaces were treated with Tooth Mousse CPP-ACP for one hour, rinsed and stored in 37°C temperature with 100% humidity. This procedure was repeated for 5 days and then adhesives were applied and Tetric N-Ceram composite was adhered to the enamel. This procedure was also fulfilled for the other three subgroups without CPP-ACP treatment. After 24 hour water storage, samples were tested for shear bond strength test in a universal testing machine. Failure modes were determined by stereomicroscope. Data were analyzed by t-test and one-way analysis of variance with P < 0.05 as the level of significance. In comparison between applied and non-applied CPP-ACP subgroups, there was no significant decrease in the shear bond strength to enamel only in Tetric N-Bond (P > 0.05). In non-applied CPP-ACP subgroups, there were statistically significant differences among all subgroups. Tetric N-Bond had the highest and AdheSE One F had the lowest shear bond strength. CPP-ACP application reduces the shear bond strength of AdheSE and AdheSE One F to enamel but not Tetric N-Bond.

In vitro evaluation of casein phosphopeptide-amorphous calcium phosphate effect on the shear bond strength of dental adhesives to enamel

PubMed Central

Shadman, Niloofar; Ebrahimi, Shahram Farzin; Shoul, Maryam Azizi; Sattari, Hasti

2015-01-01

Background: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is applied for remineralization of early caries lesions or tooth sensitivity conditions and may affect subsequent resin bonding. This in vitro study investigated the effect of CPP-ACP on the shear bond strength of dental adhesives to enamel. Materials and Methods: Sixty extracted human molar teeth were selected and randomly divided into three groups and six subgroups. Buccal or lingual surfaces of teeth were prepared to create a flat enamel surface. Adhesives used were Tetric N-Bond, AdheSE and AdheSE One F. In three subgroups, before applying adhesives, enamel surfaces were treated with Tooth Mousse CPP-ACP for one hour, rinsed and stored in 37°C temperature with 100% humidity. This procedure was repeated for 5 days and then adhesives were applied and Tetric N-Ceram composite was adhered to the enamel. This procedure was also fulfilled for the other three subgroups without CPP-ACP treatment. After 24 hour water storage, samples were tested for shear bond strength test in a universal testing machine. Failure modes were determined by stereomicroscope. Data were analyzed by t-test and one-way analysis of variance with P < 0.05 as the level of significance. Results: In comparison between applied and non-applied CPP-ACP subgroups, there was no significant decrease in the shear bond strength to enamel only in Tetric N-Bond (P > 0.05). In non-applied CPP-ACP subgroups, there were statistically significant differences among all subgroups. Tetric N-Bond had the highest and AdheSE One F had the lowest shear bond strength. Conclusion: CPP-ACP application reduces the shear bond strength of AdheSE and AdheSE One F to enamel but not Tetric N-Bond. PMID:25878683

A clinical study comparing digital radiography and near-infrared transillumination in caries detection.

PubMed

Berg, Stephen C; Stahl, Jonathan Miles; Lien, Wen; Slack, Casey M; Vandewalle, Kraig S

2018-01-01

The purpose of this study was to compare the effectiveness of detecting proximal carious lesions utilizing a new near-infrared transillumination (NIRTI) system (CariVu, Dexis) to traditional digital bitewing radiography (BWXR). Thirty patients received four posterior BWXRs and all premolars and molars were individually imaged with the NIRTI device. Sixty-seven proximal carious lesions were classified based on their depth into enamel or dentin for both BWXR and NIRTI images. The caries depth classification between the two systems were strongly correlated (r s  = 0.66; Spearman range: 0.60-0.79 = strong) and significant (P < .001) with a median score of 3 for NIRTI and 2 for BWXR. The new NIRTI system (CariVu) may serve as an adjunct to BWXR in the diagnosis of proximal caries. The NIRTI system could serve as an adjunct diagnostic system that could be used in high-caries risk programs where patients are closely monitored with regimented follow-up appointments. NIRTI could also be beneficial with pregnant or pediatric patients, and in situations where radiography may not be available such as remote humanitarian missions. © 2017 Wiley Periodicals, Inc.

Effectiveness of anchovy substrate application on decreasing acid solubility of Sprague Dawley rats’ tooth enamel (in vivo)

NASA Astrophysics Data System (ADS)

Triputra, F.; Puspitawati, R.; Gunawan, H. A.

2017-08-01

Anchovies (Stolephorus insularis), a natural resource of Indonesia, contain fluoride in the form of CaF2 and can function as a fluoridation material to prevent dental caries. The aim of this study is to study the effectiveness of anchovy substrate, through food or topical application, in decreasing the acid solubility of tooth enamel. This research used 14 Sprague Dawley rats as subjects divided into the following 5 groups: baseline, experimental feeding, experimental smearing, and their negative controls. After 15 days of anchovy substrate application, lower incisors were extracted and the acid solubility of enamel was analyzed qualitatively and quantitatively using a stereo microscope and a Micro-Vickers Hardness Tester. Analysis of enamel surface destruction and enamel surface microscopic hardness shifting after a 60 sec application of H2PO4 (50% concentration) resulted in a decrease in acid solubility of enamel treated with anchovy substrate. This result can be seen with both the chewing and smearing method. S. insularis can be used as an alternative material for fluoridation.

Prevalence and socio-behavioral influence of early childhood caries, ECC, and feeding habits among 6 – 36 months old children in Uganda and Tanzania

PubMed Central

2012-01-01

Background Early childhood caries (ECC) is a serious problem that has remained unexplored in sub-Saharan Africa. This study aimed to identify possible socio-behavioral correlates of ECC focusing 6–36 months old children and their caretakers. Methods Cross sectional studies were conducted in a high fluoride rural area, Manyara, Tanzania and a low fluoride urban area, Kampala, Uganda. Totals of 1221 and 816 child - caretaker pairs attending health care facilities for growth monitoring were recruited in Manyara and Kampala, respectively. All caretakers completed face to face interviews at the health care facility. Children underwent oral clinical examination whereby ECC and Enamel hypoplasia were recorded using the dmft (WHO 1997) and the DDE index (FDI 1992). Results The prevalence of ECC was 3.7% in Manyara and 17.6% in Kampala. According to multiple logistic regression analyses, received oral health information from health worker was the strongest determinant of ECC in Manyara, adjusted OR 0.3, 95% CI 0.09 – 0.93. In Kampala, visible plaque, high sugar intake and presence of enamel hypoplasia associated with ECC, adjusted ORs 2.8 (95% CI 1.61- 4.95), 3.0 (95% CI 1.39 – 6.34) and 2.3 (95% CI 1.36 - 3.95). Conclusion Oral health education aimed at caretakers of 6–36 months, including health care workers’ information regarding the detrimental consequences for oral health of frequent sugar consumption and poor oral hygiene is important for prevention of ECC in Tanzania and Uganda. PMID:22834770

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.

[Influence of Coca-Cola on early erosion and surface microhardness of human enamel: an in situ study].

PubMed

Yuan, M; Zhang, Q; Gao, X J

2016-06-01

Assessed the effect of single dose attack of Coca-Cola on early erosion and surface microhardness of permanent human enamel, in order to provide diet instructions on minimum amount and frequency of carbonated beverage consumption. Eighty enamel slabs were prepared out of 10 extracted human mandibular third molars, and distributed into 8 groups with randomized block design(n=10). Ten generally healthy volunteers with normal saliva secretion wore acrylic palatal appliances containing 2 enamel slabs, with formation of a salivary pellicle 2 h ahead. The volunteers were instructed to drink 100 ml fresh Coca-Cola within 20 s. And then the alterations of the enamel slabs were measured using a Vicker's microhardness tester at 1, 2, 4, 6, 8, 10, 20 and 30 min after the consumption of Coca-Cola. For each volunteer, the experiment was carried out in four days, 2 samples were examined each time. Data were analyzed using Kruskal-Wallis and Wilcoxon tests(α =0.05). Significant decreases in surface microhardness(SMH)were observed in each time point(P<0.01). The percentages of surface microhardness changes on each exposure time were(12.2±3.9)%,(16.8±5.5)%,(16.7±5.6)%,(16.2±6.2)%,(16.6±9.0)%,(15.6±3.7)%,(13.8±4.8)% and(11.4±3.2)%, respectively. Significant differences were observed between G1 min and G2-8 min(P=0.029), G2-8 min and G30 min(P=0.008). Single intake of 100 ml Coca-Cola could lead to significant decrease of enamel microhardness and initiate erosion of enamel surface. Enamel surface microhardness decreased to the lowest points at 2-8 min, and began to recover after 10 min. The enamel surface microhardness could not fully recovered to the baseline level in 30 min if no intervention was performed.

Saliva-promoted adhesion of Streptococcus mutans MT8148 associates with dental plaque and caries experience.

PubMed

Shimotoyodome, A; Kobayashi, H; Tokimitsu, I; Hase, T; Inoue, T; Matsukubo, T; Takaesu, Y

2007-01-01

Colonization of enamel surfaces by Streptococcus mutans is thought to be initiated by the attachment of bacteria to a saliva-derived conditioning film (acquired pellicle). However, the clinical relevance of the contribution of saliva-promoted S. mutans adhesion in biofilm formation has not yet been fully elucidated. The aim of this study was to correlate saliva-promoted S. mutans adhesion with biofilm formation in humans. We correlated all measurements of salivary factors and dental plaque formation in 70 healthy subjects. Dental plaque development after thorough professional teeth cleaning correlated positively with S. mutans adhesion onto saliva-coated hydroxyapatite pellets and the glycoprotein content of either parotid or whole saliva. Saliva-promoted S. mutans adhesion and glycoprotein content were also positively correlated with each other in parotid and whole saliva. By contrast, neither salivary mutans streptococci, Lactobacillus nor Candida correlated with biofilm formation. Parotid saliva-mediated S. mutans adhesion was significantly higher in 12 caries-experienced (CE) subjects than in 9 caries-inexperienced (CI) subjects. Salivary S. mutans adhesion was significantly less (p < 0.01) in the CI group than in the CE group. In conclusion, the present findings suggest the initial S. mutans adhesion, modulated by salivary protein adsorption onto the enamel surface, as a possible correlate of susceptibility to dental plaque and caries. Copyright 2007 S. Karger AG, Basel.

Effect of Kallikrein 4 Loss on Enamel Mineralization

PubMed Central

Smith, Charles E.; Richardson, Amelia S.; Hu, Yuanyuan; Bartlett, John D.; Hu, Jan C-C.; Simmer, James P.

2011-01-01

Enamel formation depends on a triad of tissue-specific matrix proteins (amelogenin, ameloblastin, and enamelin) to help initiate and stabilize progressively elongating, thin mineral ribbons of hydroxyapatite formed during an appositional growth phase. Subsequently, these proteins are eradicated to facilitate lateral expansion of the hydroxyapatite crystallites. The purpose of this study was to investigate changes in enamel mineralization occurring in mice unable to produce kallikrein 4 (Klk4), a proteinase associated with terminal extracellular degradation of matrix proteins during the maturation stage. Mice lacking functional matrix metalloproteinase 20 (Mmp20), a proteinase associated with early cleavage of matrix proteins during the secretory stage, were also analyzed as a frame of reference. The results indicated that mice lacking Klk4 produce enamel that is normal in thickness and overall organization in terms of layers and rod/inter-rod structure, but there is a developmental defect in enamel rods where they first form near the dentinoenamel junction. Mineralization is normal up to early maturation after which the enamel both retains and gains additional proteins and is unable to mature beyond 85% mineral by weight. The outmost enamel is hard, but inner regions are soft and contain much more protein than normal. The rate of mineral acquisition overall is lower by 25%. Mice lacking functional Mmp20 produce enamel that is thin and structurally abnormal. Relatively high amounts of protein remain throughout maturation, but the enamel is able to change from 67 to 75% mineral by weight during maturation. These findings reaffirm the importance of secreted proteinases to enamel mineral acquisition. PMID:21454549

Fluoride releasing and enamel demineralization around orthodontic brackets by fluoride-releasing composite containing nanoparticles.

PubMed

Melo, Mary A S; Morais, Weslanny A; Passos, Vanara F; Lima, Juliana P M; Rodrigues, Lidiany K A

2014-05-01

Fluoride-containing materials have been suggested to control enamel demineralization around orthodontic brackets during the treatment with fixed appliances. The improvement of their properties has been made through innovations, such as the application of nanotechnology by incorporation of nanofillers. This in vitro study evaluated the capacity of fluoride releasing and enamel demineralization inhibition of fluoride-releasing nanofilled cement around orthodontic brackets using an artificial caries biofilm model. Forty bovine enamel discs were selected by evaluating surface microhardness and randomized into four groups (n = 10): non-fluoride-releasing microfilled composite, fluoride-releasing microfilled composite, resin-modified glass ionomer cement (RMGI), and fluoride-releasing nanofilled composite (FN). After brackets bonding in each disc, the specimens were subjected to a cariogenic challenge through a Streptococcus mutans biofilm model. After the experimental period, the biofilm formed around the brackets was collected for fluoride analysis and the mineral loss around the brackets was determined by integrated demineralization via cross-sectional microhardness measurement at 20 and 70 μm from the bracket margin. Additionally, samples of each group were subjected to energy-dispersive X-ray spectroscopy (EDX) analysis examined under a scanning electron microscopy (SEM). ANOVA followed by Tukey test were applied for fluoride concentration and mineral loss data, respectively. At both distances, only RMGI statistically differed from the other groups presenting the lowest demineralization, although there was a trend to a lower demineralization of enamel around brackets in FN group. Similar condition was found to fluoride concentration and EDX/SEM analysis. Under the cariogenic exposure condition of this study, the fluoride-releasing nanofilled material had similar performance to fluoride-releasing microfilled materials. The presence of nanofillers in the fluoride

Fluoride-releasing restorative materials and secondary caries.

PubMed

Hicks, John; Garcia-Godoy, Franklin; Donly, Kevin; Flaitz, Catherine

2003-03-01

Secondary caries is responsible for 60 percent of all replacement restorations in the typical dental practice. Risk factors for secondary caries are similar to those for primary caries development. Unfortunately, it is not possible to accurately predict which patients are at risk for restoration failure. During the past several decades, fluoride-releasing dental materials have become a part of the dentist's armamentarium. Considerable fluoride is released during the setting reaction and for periods up to eight years following restoration placement. This released fluoride is readily taken up by the cavosurface tooth structure, as well as the enamel and root surfaces adjacent to the restoration. Resistance against caries along the cavosurface and the adjacent smooth surface has been shown in both in vitro and in vivo studies. Fluoride-releasing dental materials provide for improved resistance against primary and secondary caries in coronal and root surfaces. Plaque and salivary fluoride levels are elevated to a level that facilitates remineralization. In addition, the fluoride released to dental plaque adversely affects the growth of lactobacilli and mutans streptococci by interference with bacterial enzyme systems. Fluoride recharging of these dental materials is readily achieved with fluoridated toothpastes, fluoride mouthrinses, and other sources of topical fluoride. This allows fluoride-releasing dental materials to act as intraoral fluoride reservoirs. The improvement in the properties of dental materials with the ability to release fluoride has improved dramatically in the past decade, and it is anticipated that in the near future the vast majority of restorative procedures will employ fluoride-releasing dental materials as bonding agents, cavity liners, luting agents, adhesives for orthodontic brackets, and definitive restoratives.

Examiner training and reliability in two randomized clinical trials of adult dental caries.

PubMed

Banting, David W; Amaechi, Bennett T; Bader, James D; Blanchard, Peter; Gilbert, Gregg H; Gullion, Christina M; Holland, Jan Carlton; Makhija, Sonia K; Papas, Athena; Ritter, André V; Singh, Mabi L; Vollmer, William M

2011-01-01

This report describes the training of dental examiners participating in two dental caries clinical trials and reports the inter- and intra-examiner reliability scores from the initial standardization sessions. Study examiners were trained to use a modified International Caries Detection and Assessment System II system to detect the visual signs of non-cavitated and cavitated dental caries in adult subjects. Dental caries was classified as no caries (S), non-cavitated caries (D1), enamel caries (D2), and dentine caries (D3). Three standardization sessions involving 60 subjects and 3,604 tooth surface calls were used to calculate several measures of examiner reliability. The prevalence of dental caries observed in the standardization sessions ranged from 1.4 percent to 13.5 percent of the coronal tooth surfaces examined. Overall agreement between pairs of examiners ranged from 0.88 to 0.99. An intra-class coefficient threshold of 0.60 was surpassed for all but one examiner. Inter-examiner unweighted kappa values were low (0.23-0.35), but weighted kappas and the ratio of observed to maximum kappas were more encouraging (0.42-0.83). The highest kappa values occurred for the S/D1 versus D2/D3 two-level classification of dental caries, for which seven of the eight examiners achieved observed to maximum kappa values over 0.90. Intra-examiner reliability was notably higher than inter-examiner reliability for all measures and dental caries classifications employed. The methods and results for the initial examiner training and standardization sessions for two large clinical trials are reported. Recommendations for others planning examiner training and standardization sessions are offered. © 2011 American Association of Public Health Dentistry.

Dental caries and its relationship to bacterial infection, hypoplasia, diet, and oral hygiene in 6- to 36-month-old children.

PubMed

Milgrom, P; Riedy, C A; Weinstein, P; Tanner, A C; Manibusan, L; Bruss, J

2000-08-01

Caufield et al. (1) have suggested that the acquisition of mutans streptococci in young children most likely takes place during a "window of infectivity" from 19 to 31 months of age. This study determined the prevalence of dental caries and bacterial infection in a randomly selected sample of 199 children 6 to 36 months old from the island of Saipan in the Common-wealth of the Northern Mariana Islands, USA. The relationships between caries and Streptococcus mutans infection, hypoplasia, diet and oral hygiene behavior were investigated. The overall estimated prevalence of caries was high: 46.8% of the children had white spot lesions and 39.1% had enamel cavitation. Colonization was seen in very young children; S. mutans was detected in 25% of the predentate children. The results of multi-variable modeling support the hypothesis that bacterial infection, diet, and hypoplasia are important in the etiology of dental caries in this population. Adjusted for age and ethnicity, children with a high level of S. mutans detected were 5 times more likely to have dental caries than children with a lower level of S. mutans detected. Hypoplasia and a high cariogenicity score (diet) were also significant independent predictors. The odds of having any white spot lesions or enamel cavitation were 9.6 times greater for children with any hypoplasia, and 7.8 times greater for children with high cariogenicity scores relative to those with lower scores after adjusting for level of S. mutans, age and ethnicity. Sleeping with a bottle, maternal sharing of utensils, and high snacking frequency were not significant predictors of caries in this population.

[Helicobacter pylori in the development of dental caries].

PubMed

Moseeva, M V; Belova, E V; Vakhrushev, Ia M

2010-01-01

It is shown, that in patients with erosive and ulcer defects of gastroduodenal zone at settling Helicobacter pylori (Hp) in an oral cavity in 100% of cases caries develops at intensity 13.6 +/- 1.4 teeth. Produced Hp protease and ammonia cause disintegration connected to protein silica acids and reduce activity lysocim, worsening, thus, fluid and protective properties of a saliva. In the subsequent infringement of autopurification of a teeth results in accumulation of a dental strike where protease activity conditionally pathogenic microflora conducts to depolymerization and demineralization enamels of a teeth.

Effect of a Brazilian regional basic diet on the prevalence of caries in rats.

PubMed

Pinheiro, J T; Couto, G B L; Vasconcelos, M M V B; Melo, M M D C; Guedes, R C A; Cordeiro, M A C

2002-07-01

The aim of the present study was to determine the effect of a regional basic diet (RBD) on the prevalence of caries in the molar teeth of rats of both sexes aged 23 days. The animals were divided into six groups of 10 rats each receiving the following diets for 30 and 60 days after weaning: RBD, a cariogenic diet, and a commercial diet. The prevalence and penetration of caries in the molar teeth of the rats was then analyzed. The RBD produced caries in 37.5% of the teeth of animals fed 30 days, and in 83.4% of animals fed 60 days, while the cariogenic diet produced caries in 72.5% and 77.5% of the teeth of animals fed 30 and 60 days, respectively. Rats fed the RBD for 30 days had caries in the enamel in 38% of their teeth, 48% had superficial dentin caries, and 7.5% moderate dentin caries. The effect of the RBD did not differ significantly from that of the cariogenic diet in terms of the presence of caries in rats fed 60 days. The penetration depth of the caries produced by the RBD was the same as that produced by the cariogenic diet. Our results show that the RBD has the same cariogenic potential as the cariogenic diet. Since the RBD is the only option for the low-income population, there should be a study of how to compensate for the cariogenicity of this diet.

Microbial Risk Markers for Childhood Caries in Pediatricians’ Offices

PubMed Central

Kanasi, E.; Johansson, I.; Lu, S.C.; Kressin, N.R.; Nunn, M.E.; Kent, R.; Tanner, A.C.R.

2010-01-01

Dental caries in pre-school children has significant public health and health disparity implications. To determine microbial risk markers for this infection, this study aimed to compare the microbiota of children with early childhood caries with that of caries-free children. Plaque samples from incisors, molars, and the tongue from 195 children attending pediatricians’ offices were assayed by 74 DNA probes and by PCR to Streptococcus mutans. Caries-associated factors included visible plaque, child age, race, and snacking habits. Species were detected more frequently from tooth than tongue samples. Lactobacillus gasseri (p < 0.01), Lactobacillus fermentum, Lactobacillus vaginalis, and S. mutans with Streptococcus sobrinus (all p < 0.05) were positively associated with caries. By multifactorial analysis, the probiotic Lactobacillus acidophilus was negatively associated with caries. Prevotella nigrescens was the only species (p < 0.05) significantly associated with caries by the ‘false discovery’ rate. Analysis of the data suggests that selected Lactobacillus species, in addition to mutans streptococci, are risk markers for early childhood caries. PMID:20164496

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.

Dyes for caries detection: influence on composite and compomer microleakage.

PubMed

Piva, Evandro; Meinhardt, Luciene; Demarco, Flávio F; Powers, John M

2002-12-01

The aim of this study was to evaluate the influence of caries-detecting dyes on the microleakage of adhesive materials. Sixty cubic class V cavities were prepared on buccal and lingual surfaces of 30 human third molars. Coronal margins were located in enamel and gingival margins in cementum. The teeth were randomly divided into six groups of ten restorations each. Cavities were restored with an adhesive system (Single Bond, 3M ESPE, St. Paul, Minn., USA), a compomer (F2000, 3M ESPE), or a composite resin (Z100, 3M ESPE) according to the manufacturer's directions. Acid red dye (Seek, Ultradent, South Jordan, Ut., USA) and basic fuchsin dye (Vide Cárie, Inodon, Porto Alegre, Brazil) were tested. Control groups were prepared without the use of dyes. After 7 days of storage in distilled water, the restorations were polished and the teeth were subjected to thermal cycling followed by immersion in 2% methylene blue. The teeth were sectioned, and microleakage scores were evaluated under magnification (40x). Data were submitted to statistical analysis using the nonparametric Kruskal-Wallis test. A statistically significant difference ( P<0.05) in microleakage was found between the materials in cementum (Z100>F2000) but not in enamel. Control and experimental groups using dyes showed similar results. It was concluded that dyes for caries detection did not increase microleakage of the adhesive materials tested.

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).

Oral colonization by Streptococcus mutans and caries development is reduced upon deletion of carbonic anhydrase VI expression in saliva

PubMed Central

Culp, David J.; Robinson, Bently; Parkkila, Seppo; Pan, Pei-wen; Cash, Melanie N.; Truong, Helen N.; Hussey, Thomas W.; Gullett, Sarah L.

2011-01-01

Carbonic anhydrase VI (CA VI), encoded by type A transcripts of the gene Car6, is a secretory product of salivary glands and is found in the enamel pellicle. Because higher caries prevalence is associated with lower salivary concentrations of CA VI in humans, we tested whether CA VI protects enamel surfaces from caries induced by Streptococcus mutans, using Car6−/− mice, in which salivary CA VI expression is absent. We detected aberrant Car6 type A transcripts in Car6−/− mice, likely targets for nonsense-mediated mRNA decay. Expression of the intracellular stress-induced isoform of CA VI encoded by type B transcripts was restricted to parotid and submandibular glands of wild type mice. The salivary function of Car6−/− mice was normal as assessed by the histology and protein/glycoprotein profiles of glands, salivary flow rates and protein/glycoprotein compositions of saliva. Surprisingly, total smooth surface caries and sulcal caries in Car6−/− mice were more than 6-fold and 2-fold lower than in wild type mice after infection with S. mutans strain UA159. Recoveries of S. mutans and total microbiota from molars were also lower in Car6−/− mice. To explore possible mechanisms for increased caries susceptibility, we found no differences in S. mutans adherence to salivary pellicles, in vitro. Interestingly, higher levels of Lactobacillus murinus and an unidentified Streptococcus species were cultivated from the oral microbiota of Car6−/− mice. Collective results suggest salivary CA VI may promote caries by modulating the oral microbiota to favor S. mutans colonization and/or by the enzymatic production of acid within plaque. PMID:21945428

The association between social deprivation and the prevalence and severity of dental caries and fluorosis in populations with and without water fluoridation.

PubMed

McGrady, Michael G; Ellwood, Roger P; Maguire, Anne; Goodwin, Michaela; Boothman, Nicola; Pretty, Iain A

2012-12-28

To determine the association between social deprivation and the prevalence of caries (including caries lesions restricted to enamel) and enamel fluorosis in areas that are served by either fluoridated or non-fluoridated drinking water using clinical scoring, remote blinded, photographic scoring for caries and fluorosis. The study also aimed to explore the use of remote, blinded methodologies to minimize the effect of examiner bias. Subjects were male and female lifetime residents aged 11-13 years. Clinical assessments of caries and fluorosis were performed on permanent teeth using ICDAS and blind scoring of standardized photographs of maxillary central incisors using TF Index (with cases for fluorosis defined as TF > 0). Data from 1783 subjects were available (910 Newcastle, 873 Manchester). Levels of material deprivation (Index of Multiple Deprivation) were comparable for both populations (Newcastle mean 35.22, range 2.77-78.85; Manchester mean 37.04, range 1.84-84.02). Subjects in the fluoridated population had significantly less caries experience than the non-fluoridated population when assessed by clinical scores or photographic scores across all quintiles of deprivation for white spot lesions: Newcastle mean DMFT 2.94 (clinical); 2.51 (photo), Manchester mean DMFT 4.48 (clinical); 3.44 (photo) and caries into dentine (Newcastle Mean DMFT 0.65 (clinical); 0.58 (photo), Manchester mean DMFT 1.07 (clinical); 0.98 (photo). The only exception being for the least deprived quintile for caries into dentine where there were no significant differences between the cities: Newcastle mean DMFT 0.38 (clinical); 0.36 (photo), Manchester mean DMFT 0.45 (clinical); 0.39 (photo). The odds ratio for white spot caries experience (or worse) in Manchester was 1.9 relative to Newcastle. The odds ratio for caries into dentine in Manchester was 1.8 relative to Newcastle. The odds ratio for developing fluorosis in Newcastle was 3.3 relative to Manchester. Water fluoridation appears

The association between social deprivation and the prevalence and severity of dental caries and fluorosis in populations with and without water fluoridation

PubMed Central

2012-01-01

Background To determine the association between social deprivation and the prevalence of caries (including caries lesions restricted to enamel) and enamel fluorosis in areas that are served by either fluoridated or non-fluoridated drinking water using clinical scoring, remote blinded, photographic scoring for caries and fluorosis. The study also aimed to explore the use of remote, blinded methodologies to minimize the effect of examiner bias. Methods Subjects were male and female lifetime residents aged 11–13 years. Clinical assessments of caries and fluorosis were performed on permanent teeth using ICDAS and blind scoring of standardized photographs of maxillary central incisors using TF Index (with cases for fluorosis defined as TF > 0). Results Data from 1783 subjects were available (910 Newcastle, 873 Manchester). Levels of material deprivation (Index of Multiple Deprivation) were comparable for both populations (Newcastle mean 35.22, range 2.77-78.85; Manchester mean 37.04, range 1.84-84.02). Subjects in the fluoridated population had significantly less caries experience than the non-fluoridated population when assessed by clinical scores or photographic scores across all quintiles of deprivation for white spot lesions: Newcastle mean DMFT 2.94 (clinical); 2.51 (photo), Manchester mean DMFT 4.48 (clinical); 3.44 (photo) and caries into dentine (Newcastle Mean DMFT 0.65 (clinical); 0.58 (photo), Manchester mean DMFT 1.07 (clinical); 0.98 (photo). The only exception being for the least deprived quintile for caries into dentine where there were no significant differences between the cities: Newcastle mean DMFT 0.38 (clinical); 0.36 (photo), Manchester mean DMFT 0.45 (clinical); 0.39 (photo). The odds ratio for white spot caries experience (or worse) in Manchester was 1.9 relative to Newcastle. The odds ratio for caries into dentine in Manchester was 1.8 relative to Newcastle. The odds ratio for developing fluorosis in Newcastle was 3.3 relative to

Histological validation of near-infrared reflectance multispectral imaging technique for caries detection and quantification

NASA Astrophysics Data System (ADS)

Salsone, Silvia; Taylor, Andrew; Gomez, Juliana; Pretty, Iain; Ellwood, Roger; Dickinson, Mark; Lombardo, Giuseppe; Zakian, Christian

2012-07-01

Near infrared (NIR) multispectral imaging is a novel noninvasive technique that maps and quantifies dental caries. The technique has the ability to reduce the confounding effect of stain present on teeth. The aim of this study was to develop and validate a quantitative NIR multispectral imaging system for caries detection and assessment against a histological reference standard. The proposed technique is based on spectral imaging at specific wavelengths in the range from 1000 to 1700 nm. A total of 112 extracted teeth (molars and premolars) were used and images of occlusal surfaces at different wavelengths were acquired. Three spectral reflectance images were combined to generate a quantitative lesion map of the tooth. The maximum value of the map at the corresponding histological section was used as the NIR caries score. The NIR caries score significantly correlated with the histological reference standard (Spearman's Coefficient=0.774, p<0.01). Caries detection sensitivities and specificities of 72% and 91% for sound areas, 36% and 79% for lesions on the enamel, and 82% and 69% for lesions in dentin were found. These results suggest that NIR spectral imaging is a novel and promising method for the detection, quantification, and mapping of dental caries.

Histological validation of near-infrared reflectance multispectral imaging technique for caries detection and quantification.

PubMed

Salsone, Silvia; Taylor, Andrew; Gomez, Juliana; Pretty, Iain; Ellwood, Roger; Dickinson, Mark; Lombardo, Giuseppe; Zakian, Christian

2012-07-01

Near infrared (NIR) multispectral imaging is a novel noninvasive technique that maps and quantifies dental caries. The technique has the ability to reduce the confounding effect of stain present on teeth. The aim of this study was to develop and validate a quantitative NIR multispectral imaging system for caries detection and assessment against a histological reference standard. The proposed technique is based on spectral imaging at specific wavelengths in the range from 1000 to 1700 nm. A total of 112 extracted teeth (molars and premolars) were used and images of occlusal surfaces at different wavelengths were acquired. Three spectral reflectance images were combined to generate a quantitative lesion map of the tooth. The maximum value of the map at the corresponding histological section was used as the NIR caries score. The NIR caries score significantly correlated with the histological reference standard (Spearman's Coefficient=0.774, p<0.01). Caries detection sensitivities and specificities of 72% and 91% for sound areas, 36% and 79% for lesions on the enamel, and 82% and 69% for lesions in dentin were found. These results suggest that NIR spectral imaging is a novel and promising method for the detection, quantification, and mapping of dental caries.