Caries Research最新文献

Introduction The objective of this study was to investigate the treatment success rate of teeth treated with stepwise caries removal procedure (SWP) using SKaPa registry data. Methods Study design was a retrospective analysis of longitudinal SKaPa database data. SWP treated teeth with a minimum of one follow-up visit was included (January 1, 2013 to April 1, 2022). Teeth that had not been treated endodontically or extracted during the follow-up period was considered successful. Kaplan-Meier survival analysis (p<0.01) in combination with descriptive statistics was used for statistics. Results A total of 111 771 teeth were included (50.7% women; 49.3% men). The most frequent tooth group was molars (71.5%). The results demonstrate a treatment success rate of over 60% after 110 months for teeth with deep caries lesions treated with SWP. Age was a statistically significant variable (p = 0.00) with increased survival rate for younger age groups. Conclusions Although SWP is performed on teeth with poor prognoses, the overall treatment success rate is over 60% after nine years. Age, tooth group, localization, and caries risk are factors that could affect the outcome after SWP, with an improved prognosis for premolars, subjects under 40 years of age, and subjects with low or medium caries risk.

: Introduction Evidence suggests that a low copy number (CN) (2-3) of the α-amylase 1 gene (AMY1) may reduce the risk of dental caries, although findings remain inconsistent. Variations observed between studies could potentially be explained by the modulation of third factors, such as obesity, which may amplify the cariogenic potential of high AMY1 CN. This cross-sectional study explored the relationship between AMY1 gene CN variation (CNV) and dental caries experience, assessed with the Decayed and Filled Surfaces (DFS) index in young adults, and whether this association varied by obesity status. Methods A total of 597 participants (52.4% female, aged 26 - 29 years) from the Norwegian Fit Futures 3 study (2021-2022) were included. Salivary AMY1 CN was measured using droplet digital polymerase chain reaction (ddPCR). Obesity was defined as BMI ≥30 kg/m². We analysed AMY1 CN as both continuous and categorical variables (2-3 (17%), 4-6 (53%), and 7-14 (30%) CN) using logistic regression. Results Although AMY1 CN alone was not associated with DFS, its interaction with obesity was significant (p = 0.036). Among obese individuals, a one-unit increase in AMY1 CN raised the probability of DFS ≥9 by 4.7 percentage points, with no association observed in non-obese individuals. In obese participants (n = 103), sex-adjusted odds ratios (ORs) for DFS ≥9 were as follows: OR 1.25 (95% CI: 1.01-1.53) per unit increase in AMY1 CN; OR 3.47 (95% CI: 1.23-9.79) for 4-6 vs. 2-3 CN, and OR 4.48 (95% CI: 1.35-14.89) for 7-14 vs. 2-3 CN. Conclusion This study found that AMY1 gene CN alone was not directly associated with dental caries in young adults. However, obesity was identified as an effect modifier in the relationship between salivary AMY1 CNV and dental caries experience. Specifically, dental caries experience was higher in obese individuals with above-average AMY1 CN. These findings highlight the complex interplay between genetic, metabolic, and behavioural factors in dental caries development. Further research is needed to confirm these results and to explore the underlying mechanisms of this interaction.

Introduction Socioeconomic inequalities in childhood dental caries remain a major public health concern, even in countries with declining overall prevalence. Chile provides a unique setting to examine these inequalities nationally and assess the potential mitigating role of systemic fluoride delivery programmes. Methods This ecological cohort study analysed 1,261,690 dental examinations of 12-year-olds across 325 Chilean municipalities from 2009 to 2023, representing 99.8% of eligible national records. Caries prevalence was modelled against area socioeconomic deprivation (IDSE deciles), adjusting for rurality and systemic fluoride delivery programmes, and weighting for number of total examinations by municipality/year. Inequality metrics included Absolute Rate Difference (ARD), Slope Index of Inequality (SII), and Relative Index of Inequality (RII). Results A strong and persistent socioeconomic gradient was observed: adolescents in the most deprived municipalities had a 17 percentage-point higher caries prevalence than those in the least deprived (β = -0.17, 95% CI: -0.20, -0.14). This gradient followed a dose-response pattern and was confirmed by summary measures (ARD = 0.151; RRR = 1.234). Temporal analysis revealed peak inequality pre-pandemic (SII = 0.17, 95% CI: -0.20, -0.14), followed by a steady decline post-2018, reaching non-significant levels by 2023 (SII = 0.04, 95% CI: -0.15, 0.06). Fluoridation programmes modestly attenuated the deprivation gradient by 24% (β = -0.13), though they explained limited variance (ΔR² = 0.04). Conclusion Socioeconomic inequalities in dental caries among Chilean adolescents remain substantial, despite national declines in prevalence. While systemic fluoridation contributes to modest reductions in inequality, structural determinants are the primary drivers of persistent inequalities.

In the article "Salivary Proteins and Metabolites as Caries Biomarkers in Adolescents" [Caries Res. 2024;58(6):573-588. https://doi.org/10.1159/000540090] by Havsed et al. an error in the headings of Table 1 has been identified. Due to incorrect labelling in Table 1 the CA (caries group) should have been placed in the left panel and CF (caries-free) should have been placed in the right panel.The authors have checked the statistical calculations to confirm the error is in the labelling of Table 1.The corrected Table 1 is shown here:Table 1.Oral hygiene and diet factors in caries-free (CF) and caries-experienced (CA) groups​CA (N = 20)CF (N = 20)p valueTooth brushing (using fluoride toothpaste) frequency ≥2 tpd7 (35)15 (75)0.039 opd10 (50)4 (20) 0-6 tpw3 (15)1 (5)Fluoride supplement ≥opd1 (5)5 (25)0.024 2-6 tpw5 (25)7 (35) 2-7 tpw8 (40)8 (40) ≤opm6 (30)0Diet frequency 1-3 tpd2 (10)3 (15)0.336 4-6 tpd10 (50)12 (60) 7-9 tpd5 (25)5 (25) ≥10 tpd3 (15)0Consumption of sweetened beverages, soda and energy drinks ≤opw2 (10)8 (40)0.002 2-3 tpw4 (20)10 (50) 4-6 tpw8 (40)2 (10) ≥opd6 (30)0Consumption of candies, ice cream, sweet, coffee bread and snacks ≤opw1 (5)8 (40)0.026 2-3 tpw6 (30)7 (35) 4-6 tpw9 (45)4 (20) ≥opd4 (20)1 (5)opd, once per day; opm, once per month; opw, once per week; tpd, times per day; tpw, times per week; tpm, times per month.Data represent number of participants (and percentages) corresponding to different answer options. Four out of the five parameters showed statistically significant differences between the groups (χ2 test), with a lower tooth brushing frequency, lower use of fluoride supplement, higher consumption of sweetened beverages, soda and energy drinks as well as ice cream, sweet, coffee bread and snacks in the CA group.

Background: Artificial intelligence (AI) support is expected to increase accuracy and improve treatment plans in dentistry. Nevertheless, AI's ability to promote better oral healthcare is underexplored. This scoping review explores the influence of AI in supporting dental professionals with caries detection and decision-making regarding interventions.

Summary: Primary articles indexed on PubMed, Web of Science, Embase, Scopus, and Cochrane Library were searched until August 2025. Studies reporting the differences between participants' caries diagnosis process and decision-making with and without AI were included. Studies only reporting algorithm accuracy, in vitro studies, or studies without an outcome related to caries detection with AI support were excluded. No time and language limits were imposed. Outcomes regarding the influence of AI on the diagnostics process and decision-making were retrieved and narratively summarised.

Key messages: Thirteen publications were included. Number of participants ranged from 3 to 74, comprising dentists with varying experience and expertise and dental students. Results showed that AI enhances sensitivity, though its impact on specificity varies (10 studies). AI can promote unnecessary interventions for early-stage caries lesions (1 study). AI increased assessment time in two out of three cases (3 studies). AI's cost-effectiveness is uncertain, as greater sensitivity did not lead to better economic outcomes (1 study). In conclusion, AI has the potential to improve diagnostics and influence treatment choices, but current evidence is limited and inconsistent regarding its impact on specificity, decision quality, and cost-effectiveness. Longitudinal studies in clinical settings with long-term follow-ups are needed to understand AI's impact on decision-making.

Background: Few health topics are as controversial as fluoride, and social media has become a powerful arena where health information and misinformation circulate and compete for attention. This study systematically examined fluoride-related posts across two major platforms (Instagram® and X™) in English and Spanish.

Methods: Using a standardized approach, we identified the first 200 publicly available posts related to fluoride and health on each platform and language (n=800 total). Posts were analyzed in duplicate, assessing perception (positive, negative, neutral), accuracy (accurate or non-accurate), format, account type, among others.

Results: Results revealed differences across language and platform. Spanish-language content was generally more accurate and conveyed a more positive tone, while English-language posts, particularly on X™, showed a higher prevalence of alarmist narratives. Engagement patterns varied by tone, post format and account type. Negative posts attracted more likes overall. Post wrtitten in Spanish generated lower engagement. Carousel and photo-video formats and professional accounts received substantially greater interaction.

Conclusion: These findings provide empirical evidence that language, source and format strongly influence the reach and resonance of fluoride posts. They also suggest that multilingual strategies using engaging formats and credible professional voices can enhance the impact of evidence-based fluoride communication and counter misinformation.

Introduction: Dental caries, the most prevalent noncommunicable disease (NCD) in adolescence, may represent a hidden link to systemic inflammatory processes, a common underlying mechanism shared by all major NCDs. Accordingly, this study investigated whether dental caries was associated with systemic inflammatory burden in adolescents.

Methods: This population-based study utilized data from the RPS Brazilian Birth Cohort Consortium, specifically the 18-19-year follow-up conducted in São Luís, Brazil (n = 441). The main exposures included the visible plaque index (VPI), number of decayed teeth, DMFT index (decayed, missing, and filling), and PUFA index. The outcome was the allostatic inflammatory load, calculated as the sum of biomarkers - IL-6, IL-18, IL-1β, TNF-α, and C-reactive protein (CRP) - that fell within the high-risk range (≥75th percentile of the sample distribution). Each biomarker contributed one point, resulting in a total score ranging from 0 to 5. Crude and adjusted coefficients were estimated using regression models.

Results: The number of decayed teeth (β = 0.031, p = 0.015) and the VPI (β = 0.006, p = 0.001) were positively associated with higher allostatic inflammatory load scores. Among individual biomarkers, both the number of decayed teeth (β = 8.95, SE = 4.09, p = 0.02) and the VPI (β = 1.09, SE = 0.50, p = 0.03) were positively associated with IL-18 levels, whereas no significant associations were observed for the DMFT or PUFA indices (p > 0.05).

Conclusion: Dental caries was associated with systemic inflammation in adolescence, possibly reflecting shared underlying risk factors and highlighting the relevance of integrating oral health into strategies addressing common risk factors for non-communicable diseases.

Background: Advances in next-generation sequencing and multi-omics approaches reinforced the concept of functional diversity within biofilm communities, revealing roles beyond bacterial taxonomy and highlighting metabolic and ecological mechanisms operating at the individual level rather than within isolated caries lesions. Moving toward new clinical solutions will require broader perspectives; to this end, we propose key directions to advance the translational potential of caries microbiome research. We present a perspective that connects ecological theory, molecular evidence, and clinical implications through three central topics: (1) microbial composition, (2) microbial function, and (3) individual-level characteristics.

Summary: From a compositional perspective, caries microbiome research should move beyond the search for bacterial culprits and instead consider the broader microbial ecosystem, including low-abundance and nonbacterial members (such as archaea). Within this framework, microbial taxa and functions should not be viewed as inherently "good" or "bad," but rather as context-dependent components of a dynamic ecosystem shaped by sustained environmental pressures. Functionally, the recurrent enrichment of pathways related to carbohydrate metabolism, sugar transport, and acid production likely reflects microbial adaptation to persistent sugar exposure rather than intrinsic virulence traits. This perspective suggests that progress in caries research depends on moving beyond disease-centered models toward understanding how microbial stability preserves oral health. At the individual level, individuals with previous caries experience may retain disease-associated microbial or functional signatures during remission, a phenomenon referred to here as a microbiological dysbiosis scar. This ecological memory may help explain why past caries experience remains one of the strongest predictors of future lesions and highlights the importance of incorporating individual history into the design and interpretation of caries microbiome studies. Integrating detailed clinical metadata with advanced bioinformatic approaches, including artificial intelligence, will be essential for establishing meaningful biological links.

Key messages: Progress in caries microbiome research depends on refining study design across microbial composition, functional, and individual levels. Strengthening the resilience of the oral microbiome rather than eliminating specific pathogens or the microbiome should be the central goal of caries microbiology. Moving from blame to balance is not merely semantic; it represents a fundamental shift in how we study, prevent, and manage dental caries.

Introduction: Despite evidence supporting the clinical and cost-effectiveness of minimally invasive dentistry (MID), its adoption by the dental profession has been slow. A systematic review in 2016 found the majority of dentists intervene invasively earlier than necessary. The aim was to update this review of the assessment of dental practitioners' thresholds for providing restorative treatment for carious lesions given changes in evidence, teaching, and guidelines since 2016. The primary outcome was dental practitioners' restorative thresholds (the extent of the lesion when they would decide to intervene restoratively). Secondary outcomes were changes over time, caries risk, regional differences, and primary/permanent dentition.

Methods: This updated review replicated the methodology for the initial review, following the PRISMA 2020 guidelines (PROSPERO; CRD42023431906). Embase, MEDLINE (via PubMed), and Web of Science databases were searched (2016-2023) for observational studies reporting on dental clinicians' thresholds for restorative interventions in adults and children without language, time, or quality restrictions. Screening, data extraction, and risk of bias assessment (Modified Newcastle-Ottawa Scale) were carried out independently and in duplicate. Meta-analyses were performed using a random-effects model. No funding sought.

Results: Overall, 47 publications (30 from original publication and 17 from updated search) met the inclusion criteria and 65 datasets were included in the meta-analyses: 19 for occlusal lesions (16 pre-2016 and 3 post-2016; n = 11,946) and 46 for proximal lesions (38 pre-2016 and 8 post 2016; n = 20,428). The meta-analyses found that for occlusal lesions confined to enamel, there were fewer practitioners intervening invasively: 5% (95% confidence interval [CI]; 1-20%) post-2016, compared with 15% (95% CI; 9-23%) pre-2016. The opposite was found for proximal lesions with increased intervention levels, 27% (95% CI; 18-40%) for lesions confined to enamel post-2016, compared with 19% (95% CI; 12-29%) pre-2016, and for lesions extending up to the enamel-dentine junction 61% (95% CI; 36-81%) post-2016, compared with 39% (95% CI; 29-51%) pre-2016. There was variance between regions but too few studies to draw conclusions on individual regions.

Conclusion: There was a suggestion of less invasive treatment of occlusal lesions over time; however, this was not evident for proximal lesions.

Introduction: This study aimed to describe the prevalence of untreated dental caries in early childhood based on intergenerational socioeconomic data and to evaluate the association between intragenerational socioeconomic mobility data and untreated dental caries in children aged 4.

Methods: This is a longitudinal study. Data from three birth cohorts in Pelotas (1982, 1993, and 2015) were used. Data from three generations participating in these cohorts were evaluated. Untreated dental caries in childhood (2015 cohort) was considered the dependent variable. Family income and schooling were independent variables. The social mobility variable was categorized considering income and level of schooling data in the mothers' generation. Poisson regression was performed to estimate prevalence ratios (PRs) and 95% confidence intervals (95% CIs).

Results: A total of 286 pairs of children and mothers/grandmothers were evaluated for the intergenerational sample (1982 and 1993 cohorts), and 3,633 mothers and children for the intragenerational sample (2015 cohort). In the intergenerational analysis, there was a reduction of about 10 percentage points in the prevalence of untreated caries in children from families that experienced upward/downward income mobility compared to children whose generations remained with lower income. In the intragenerational analysis, children belonging to the ascending/descending economic mobility groups had twice the prevalence of untreated dental caries compared to those always with higher salaries (PR 2.04; 95% CI 1.52-2.71 and PR 2.07; 95% CI 1.56-2.74, respectively).

Conclusion: Findings demonstrate an association between untreated dental caries in children and family socioeconomic status, including their mothers' income/education mobility. Thus, intervening in early childhood socioeconomic conditions is needed to improve children's oral health.