Caries Research最新文献

Background Salivary matrix metalloproteinase-8 (MMP-8) concentration is considered a biomarker of oral health in adults, but studies in pediatric populations, especially with longitudinal data, are scarce. Methods We examined the associations of caries experience (DFT index) and gingivitis/calculus (CPITN) retrieved from public dental records with repeated salivary MMP-8 concentrations. Salivary MMP-8 were measured from 403 Finnish adolescents (50% girls) at the mean (SD) age of 11.4 (0.4) and 13.8 (0.5) years, using an ELISA kit. Oral health was determined on average 42 (27) days after saliva collection at baseline. The DFT index was categorized into no caries experience (DFT = 0) and having caries experience (DFT > 0), and CPITN into no gingivitis/calculus (CPITN = 0) or having gingivitis/calculus (CPITN > 0). Results Of the participants, 19.1% presented with caries experience, and 69.5% had gingivitis/calculus. The mean MMP-8 increased during follow-up by 0.125 ng/ml (95% CI 0.05; 0.20, p = 0.006). MMP-8 at the two time points correlated weakly in all participants (r = 0.137, p = 0.006), especially in girls (r = 0.204, p = 0.004). The change in MMP-8 was not associated with caries experience or gingivitis/calculus in all participants or in gender-specific analyses (repeated measures ANOVA p > 0.05). Puberty status and medication use were not related to MMP-8 concentration. Conclusions Oral health indices retrieved from public health records were not associated with changes in MMP-8 concentrations in early adolescents over a 2-year follow-up. Salivary MMP-8 may not be a suitable biomarker of oral health in pediatric populations.

Aim: This study aimed to investigate the association between online social capital and dental caries among adolescents.

Methods: A cross-sectional study was nested within a cohort and conducted with adolescents from Santa Maria, southern Brazil. Dental caries was assessed using the International Caries Detection and Assessment System (ICDAS), considering the number of teeth with cavitated lesions (scores 3, 5, and 6). Online social capital was measured using self-reported items on social media use, perceived digital support, and sense of digital belonging. Poisson regression models were used to estimate associations, adjusting for sociodemographic, behavioral, and psychosocial variables. Results are presented as Rate Ratios (RR) with 95% confidence intervals (CI).

Results: A total of 406 adolescents were included. The mean number of teeth with cavitated caries was 1.45 (SD: 3.48). Adolescents who reported infrequent use of social media had a higher mean number of cavitated lesions compared to those who used social media daily. Higher levels of dental caries were also observed among those who reported low trust in online interactions. Similarly, a lack of perceived belonging in the digital environment was associated with a greater number of cavitated caries.

Conclusion: Infrequent social media use, low trust in online relationships, and a diminished sense of digital belonging were associated with higher levels of dental caries among adolescents.

Introduction: Potential dental health benefits, including pH buffering, have been demonstrated for nitrate in placebo-controlled studies when consumed one or several hours before sugar intake. However, its immediate local effect when co-administered with sugar is unclear. Our aim was to test the local effect of adding nitrate to a sugar rinse on human saliva acidification.

Methods: A double-blind, crossover study was conducted with three periods. In each period, 18 adults, equally distributed between men and women (n = 9 each), aged 25.4 ± 3.8 (mean ± SD), with normal salivary flow, rinsed for 2 min using 10 mL of one of the following rinses: spinach-only (blended spinach providing 8 mm nitrate), spinach+sucrose (blended spinach providing 8 mm nitrate + 20% sucrose), or sucrose-only (20% sucrose). Unstimulated saliva was collected at baseline and every 3 min up to 24 min. pH, lactate, nitrate, and nitrite were measured using Reflectoquant®. The effect of treatment and time was assessed using a linear mixed model (α = 0.05). Nitrate reduction capacity was determined in vitro using baseline saliva.

Results: All saliva samples demonstrated nitrate reduction activity. The lowest pH values were observed 6 min after rinsing, with all groups differing from each other: sucrose only (6.56 ± 0.38; mean ± SD), spinach+sucrose (6.83 ± 0.37), spinach only (7.15 ± 0.44, no pH drop). The pH returned to baseline values 12 min after the spinach+sucrose rinse, but not after the sucrose-only rinse at any time point. Nitrate and nitrite concentrations increased in saliva after using spinach-containing rinses, returning to their baseline levels after 6 min and 12 min. Lower lactate levels were detected after 12 min, suggesting proton consumption during nitrate metabolism in the spinach+sucrose group.

Conclusion: Adding a low dose of nitrate to a sucrose rinse limited sugar-induced salivary acidification in vivo, supporting the potential for topical nitrate strategies to reduce sugar acidogenicity.

Introduction: Dental caries remains a prevalent condition with significant health and economic repercussions. To address persistent oral health disparities and reduce the burden of dental caries among preschoolers in Sweden, this study aimed to evaluate the clinical and economic impact of implementing a theory-based behavioural intervention delivered by health promoters in clinics serving children at elevated risk for caries.

Methods: A retrospective cohort design was applied, comparing clinics using a theory-based behavioural intervention led by health promoters with clinics using the Recommended Programme for Caries Treatment (RPCT). The cohort were children aged 3-6 years identified as being at increased caries risk in Region Västra Götaland during 2021-2023. Three analytic approaches were employed: (1) budget impact analysis (BIA) to measure net costs and resource shifts; (2) difference-in-differences (DiD) to compare mean decayed, extracted, or filled teeth (deft) in intervention versus control clinics; and (3) cost-effectiveness analysis (CEA) to estimate the incremental cost-effectiveness ratio (ICER).

Results: The BIA showed that the theory-based behavioural intervention led by health promoters incurred higher initial personnel costs than the RPCT but required fewer clinical hours - an opportunity cost that, if redeployed to clinical activity, could partially offset these expenses. The DiD showed that, over 3 years, clinics implementing the intervention achieved a statistically significant reduction of 0.26 deft among 6-year-olds. The CEA estimated the ICER to be 2,142 SEK (199 EUR) per deft prevented, which improved to 513-810 SEK (48-75 EUR) when the economic value of the liberated work hours was included.

Conclusion: A theory-based behavioural intervention led by health promoters reduced caries risk among high-risk preschoolers and may enable improved resource allocation, contingent on the redeployment of freed hours. Despite higher initial personnel costs, the approach demonstrated favourable cost-effectiveness over time, supporting its integration into public dental care systems.

Introduction: The restorative threshold of dentists varies considerably. This retrospective study examined the association between the depth of radiolucency in proximal surfaces on bitewing radiographs and the probability of restorative treatment among Finnish dentists.

Methods: The study population comprised 160 patients aged 18-40 years who underwent routine dental examinations by 16 randomly selected dentists within the Public Dental Services of Kuopio, Finland, in 2022. Data on patient characteristics, caries lesions, radiographic findings, and treatment decisions were manually extracted from the local electronic health record system. The depth of radiolucency was measured for all proximal caries lesions that had been registered by the dentists and were visible on the radiographs. The association between radiolucency depth and treatment decisions was estimated using linear regression analyses with cluster-robust standard errors.

Results: Bitewing radiography had been used for 128 (80%) patients. Most of the 394 caries lesions that had been registered were radiographically confined to the enamel (57%) or outermost third of dentin (27%), whereas 12% were in the middle third of dentin, and 4% extended to the inner third of dentin. Regression analyses revealed that the predicted probability of restorative treatment was 8% for lesions reaching the dentinoenamel junction and 75% for those extending to the border between the outer and middle thirds of dentin.

Conclusions: The probability of restorative treatment increased sharply with the depth of radiolucency and was unexpectedly high for lesions confined to enamel or the outer third of dentin.

Introduction: Parental awareness of oral hygiene plays a crucial role in safeguarding children's oral health. This study sought to evaluate the oral health status, habits, and dietary patterns of primary schoolchildren in rural Armenia while investigating the influence of parental oral health knowledge on their children's oral health, as assessed by child's dental plaque index.

Methods: The study involved primary schoolchildren and their parents from two rural communities in Armavir province. It was composed of two key components: (1) a cross-sectional telephone survey conducted with parents to evaluate their knowledge of oral health, their children's oral hygiene practices, dietary habits, and sociodemographic background, and (2) a clinical assessment of the children's oral health, which included measuring plaque index and recording the Decayed, Missing, and Filled Teeth (DMFT/dmft) index. To determine the relationship between parental oral health knowledge and children's plaque index, a multivariable linear regression analysis was performed.

Results: A total of 400 parents participated. Children had a mean plaque index of 3.1 (SD 0.7) and a mean DMFT/dmft index of 7.3 (SD 3.3). The score indicating oral health behavior averaged 3.0 out of 6.0. The mean dietary habits score was 4.5 out of 9.0. The mean score indicating oral health knowledge of parents was 6.9 out of 9.0. After adjusting for potential confounders, each one-point increase in parental oral health knowledge score was associated with a 0.05-point reduction in the child's dental plaque index (95% CI: -0.10; -0.002).

Conclusions: The findings emphasize the need for comprehensive strategies to improve children's oral health, including parental education, behavioral support, caries-prevention efforts, and better access to dental care.

Introduction: Global trends in early childhood caries (ECC) remain unclear, with previous studies reporting either stable or declining rates over the past three decades. Given the short functional lifespan of the primary dentition and the urgency of targeted public health policies, the absence of focused investigation into the most recent decade constitutes a critical gap. This study, therefore, aimed to analyze temporal trends in the global prevalence of caries in deciduous teeth across 204 countries and seven super-regions from 2010 to 2021.

Methods: Prevalence rates (/100,000 population) of dental caries in deciduous teeth among children under 5 years of age were obtained from the Global Burden of Disease Study 2021. Temporal trends were assessed using Prais-Winsten linear regression, and annual percentage change (APC) was calculated.

Results: Over the past decade, the global prevalence of caries in deciduous teeth has exhibited an increasing trend (APC = 0.73%; p < 0.001), with the most marked increases observed in High-Income countries (APC = 6.51%; p = 0.005) and in Latin America and the Caribbean (APC = 2.17%; p < 0.001). The USA (APC = 19.32%; p = 0.002) and Brazil (APC = 5.27%; p < 0.001) recorded the highest increases within their respective super-regions.

Conclusion: Focusing on the last decade underscores in ECC prevalence that may not be evident the aggregated data over the last three decades. The upward trend underscores the urgent need for policies that address both commercial and social determinants, promote reductions in sugar consumption, and ensure equitable access to fluoride for effective caries control.

Introduction: Our previous metagenomic analysis revealed higher frequencies of biotin-related genes (i.e., bioY, bioM, bccP) in caries-active children, indicating a potential role of biotin in caries pathogenesis. This study investigated a biotin limitation strategy against the primary cariogenic bacterium Streptococcus mutans (S. mutans), including its effects on cariogenic phenotypes, gene expression, and metabolomics.

Methods: S. mutans UA159 was cultured in biotin-free medium supplemented with different biotin concentrations. The cariogenic phenotypes of the strain, including growth kinetics, biofilm formation, exopolysaccharide production, lactate synthesis, acid/oxidative tolerance, and membrane fluidity, were measured and compared across biotin concentrations. Biofilm architecture was visualized via confocal laser-scanning microscopy and scanning electron microscopy. Quantitative real-time polymerase chain reaction was employed to analyze the expression of genes associated with virulence and biotin metabolism. Metabolomic analysis was performed to characterize metabolic perturbations induced by biotin limitation in S. mutans.

Results: Under biotin limitation, S. mutans exhibited significantly reduced cariogenic phenotypes, accompanied by cell elongation and reduced membrane fluidity. At the molecular level, biotin limitation suppressed the expression of key virulence-associated genes and induced a compensatory upregulation of genes involved in biotin uptake and biotin-dependent carboxylases. Metabolomic analysis under biotin-limited conditions in S. mutans revealed perturbed pathways in central carbon metabolism and nucleotide metabolism.

Conclusion: Biotin limitation significantly reduced the cariogenic potential of S. mutans by disrupting metabolic flux and virulence gene expression, highlighting biotin uptake and metabolism as potential targets for anticaries therapies.