Caries Research最新文献

Introduction: Finnish conscripts have proven to be an excellent study group for epidemiological research in oral health in recent decades. The aim of this cross-sectional study was to determine the geographical distribution of dental caries prevalence in young healthy males in Finland at the beginning of the 2020s. Associated dental caries risk factors were of interest as well.

Methods: The data were randomly collected from the eight biggest garrisons in Finland in July of 2021 by ten calibrated dentists. The study population consisted of 2077 male conscripts born between 2000 and 2002. Dental caries was recorded according to the ICDAS system. Wisdom teeth were excluded. Mean DMFT and mean DT values were calculated, and geomaps were constructed to visualize the geographical distribution. Generalized linear mixed models with logit link were conducted for the associated risk factors.

Results: The mean DMFT value of all conscripts was 3.29 (SD 3.91), while the mean DT value was 1.19 (SD 2.33). Living in areas with endemic fluoride levels in drinking water ≥0.3 mg/L decreased the odds for restorative treatment need.

Conclusion: While geographical distribution of dental caries prevalence has remained nearly the same as before, the overall restorative treatment need and treatment history have decreased countrywide.

Introduction: This questionnaire-based investigation aimed to assess oral health behaviour (OHB) in 2-year-old children taking part in a birth cohort study and to identify relationships between general health, socioeconomic as well as psychosocial factors and OHB.

Methods: Factors examined were single-parent status, migration background, child's sex, parity, maternal age, education and social support, paternal employment, parental mental and physical health, and child health, data for which were collected at birth, 4 weeks, or 1 year. Participants who answered all OHB questions at 2 years (n = 730) were included. Nutritional score (NS), toothbrushing score (TS), and dental check-up score (CS) were used to calculate overall OHB score.

Results: Overall OHB in this cohort was good. 62% ate fruit or vegetables daily, 75% brushed 2-3 times daily, and 61% had already had a dental check-up. Children of single mothers had significantly lower OHB scores. NS was significantly higher for children with migration background, children of mothers with better physical health or higher educational level, but lower for children of mothers reporting poor social support. TS was significantly lower in children of single mothers and children of fathers reporting poorer mental health. CS was significantly higher in children of multiparous mothers. This study highlights the relevance of social support and parental health, in contributing to OHB patterns.

Conclusion: Families with special healthcare needs or less robust social support may have difficulty maintaining good OHB.

Introduction: Selective outcome reporting (SOR) is a bias that can occur in randomized controlled trials (RCTs), defined as the alteration or omission of primary outcome in the publication compared to the original protocol. Researchers may modify outcomes to highlight statistically significant results. This study aimed to assess the prevalence of SOR in RCTs related to dental caries in children and adolescents.

Methods: We conducted a search on ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP), using a comprehensive search strategy with terms related to pediatric dentistry and dental caries, up to February 2023. Two independent reviewers included trials with two or more arms focusing on dental caries in pediatric dentistry. Registrations that did not result in at least one published article were excluded. Data on the characteristics and outcomes from the protocols and corresponding publications were extracted. The primary outcome was the prevalence of SOR in the included RCTs. A chi-square test, with a significance level of 5%, was used to assess the association between SOR and pre-specified variables, which was the secondary outcome.

Results: A total of 175 protocols and their corresponding publications were included. SOR was identified in 58.9% (n = 103) of the studies, with 41.1% (n = 72) showing discrepancies in the primary outcome's time frame. Retrospective registrations accounted for 73.7% of the studies. SOR was significantly associated with discrepancies in the follow-up period (p < 0.001) and with study design type (parallel assignment, split-mouth, cluster RCT, and no information) (p = 0.048).

Conclusions: The high prevalence of SOR in dental caries RCTs in pediatric dentistry highlights the need for attention to this issue. Ensuring transparency in the research process requires implementing an appropriate pre-registered protocol, disclosing deviations from it, and enabling stakeholders to compare the protocol with the published outcomes which can help reduce research waste.

Introduction: The association between lower socioeconomic status and a higher risk of dental caries is well established, but the independent association between general health status and dental caries on a population level is less investigated. The aim of this study was to assess the association between self-rated general health and caries experience in an adult Norwegian population and to assess if the associations were modified by age and sex.

Methods: Data were collected as part of the Trøndelag Health Study (HUNT4) conducted 2017-2019 and a randomly selected subsample (20%) were invited for the HUNT4 Oral Health Study. This cross-sectional study included 4,880 dentate participants aged 19-94 years (response rate 67%). Participants underwent clinical and radiographic oral examinations and caries experience was measured by numbers of decayed (DT), missing (MT), and filled teeth (FT), DMFT index. The DT component consisted of primary and secondary caries in dentine, cavitated root caries, and remaining roots. Questionnaires were used to assess self-rated general health and socioeconomic position, denoted by education, household income, and employment status. Associations between self-rated health and caries experience (DMFT) and components (DT, MT, and FT) were assessed using negative binomial regression models. Ratios of means (RMs) with 95% confidence intervals (CI) for the associations were estimated, adjusting for socioeconomic position.

Results: Individuals with poor self-rated general health had a 29% higher mean number of MT (RM: 1.29 [95% CI: 1.13-1.46]), a 22% higher mean number of DT (RM: 1.22 [95% CI: 1.07-1.39]), and a 7% higher mean number of DMFT (RM: 1.07 [95% CI: 1.04-1.11]) than individuals reporting very good health. Age-stratified analyses presented a more pronounced association between self-rated health and caries experience for individuals below the age of 55 years than for those 55 years or older. Similarly, the association was more evident in women, with significantly higher mean values for DMFT, MT, and FT among women reporting poor health.

Conclusions: The present study demonstrated an independent association between poor self-rated health and a higher burden of caries experience, adjusted for education, income, and employment status. The association was stronger in women and individuals below the age of 55 years. These findings add new evidence in understanding caries inequalities through self-rated health.

Introduction: Among the wide variety of commercially oral hygiene products, activated charcoal-based toothpastes have irrupted the market, claiming multiple benefits. Although most are fluoride free, others incorporate fluoride into their formulations, yet the chemical availability and stability of fluoride in these products remain unclear. Our study aimed to assess the chemical availability and stability of fluoride in commercially fluoridated toothpastes formulated with activated charcoal.

Methods: We purchased duplicate samples with different lot numbers of different brands containing fluoride (F) and activated charcoal (n = 20) in the USA and Chile. Three toothpastes, one non-fluoridated, one containing sodium fluoride (NaF), and another with sodium monofluorophosphate (Na2FPO3), were used as controls. All toothpastes were evaluated at the time of purchase (fresh) and after their expiration date (aged). We determined total F and available total soluble F (TSF), using a F-specific ion electrode. Values were expressed in mg F/kg (ppm F, w/w).

Results: Most evaluated toothpaste contained NaF (70%) or Na2FPO3 (30%) as the F salt, and all declared to contain silica. The TSF concentration ranged from 952.6 to 1,438.1 and from 925.7 to 1,493.7 ppm F for fresh and aged toothpaste, respectively. TSF remained close to total F and in agreement with the F concentration reported by the manufacturer. After expiring, the commercial toothpastes did not form insoluble F, except the Na2FPO3-/CaCO3-based control.

Conclusion: The silica-based toothpastes formulated with activated charcoal present fluoride potentially bioavailable and chemically stable to control caries. However, concerns regarding abrasiveness, as raised by other researchers, cast doubt on the suitability of these toothpastes for widespread use.

Introduction: The aim of this cross-sectional study was to explore the degree whereby dentists differentiate between repair versus replacement for failed restorations. A random selection of adult patients from North Norway was chosen from the larger Tromsø 7 study.

Methods: A randomized sample of 3,653 persons (11.5% of the total number of individuals invited to the Tromsø 7 study, 51.5% women, aged 40-93 years) were included. Based on FDI's clinical criteria for the evaluation of restorations - 2010, 17 calibrated dentists evaluated patients by clinical and radiographical pictures in a specially designed software developed for this purpose. The dental practitioners' opinions gave rise to the reported treatment decisions. Descriptive statistics and multivariable multilevel mixed-effect logistic regression models (STATA 17/SE) were performed.

Results: The participants' DMFT values ranged from 0 (0.9%) to 24 (8.8%) (median DMFT 21.3, mean 20.0). A total of 90.062 teeth (24.7 teeth per patient) were assessed. Re-treatment suggestions were made for 3,006 restorations, i.e., an average of 3.3% re-treatments. Of these, 25.3% (n = 814) were suggested for repair and 74.7% (n = 2,192) for replacement. Dental treatment was suggested for 1,597 patients and varying from 1 to 14 suggestions per patient. Secondary caries (37.6%) and restoration fracture (15.2%) were found to be most frequently used indications for re-treatment, surface properties the least. No significant difference was found between assessing dentists based on sex or age. Clustering by dentist level was checked using intra-class correlation coefficients, demonstrating that 16% of the variance in suggestions for restoration re-treatment was explained at the dentist level. Thus, a wide range of treatment suggestions was noted among the dentists.

Conclusion: Need for restoration revision seems low in North Norway. There is a tendency towards larger and more indirect restorations, and the diagnosis of secondary caries is still a matter of uncertainty.

Introduction: Streptococcus mutans adherence to the tooth surface and subsequent biofilm development is modulated by the carbohydrate source, but the corresponding effect on bacterial proteome has not been previously studied. This study aimed to assess the effect of different carbohydrates on S. mutans viability and bacterial proteome at 2 time points, early attachment (8 h) and biofilm maturation (24 h).

Methods: Hydroxyapatite (HAp) discs coated with parotid saliva proteins were inoculated with S. mutans UA159 in tryptone soy broth without dextrose supplemented with one of the following carbohydrates (n = 12/treatment/time point): 1% sucrose; 0.525% glucose + 0.525% fructose; 10% xylitol; 10% xylitol + 1% sucrose; or culture medium without supplementation as negative control. Once inoculated, HAp discs were incubated for 8 h or 24 h at 37°C and 10% CO2. After each incubation period, adhered bacteria were quantified using the plate-counting method for 6 HAp discs/group, and the remaining 6 HAp discs/group were used to extract bacterial cell wall proteins. Extracted proteins were analyzed using liquid chromatography coupled with mass spectrometry and then classified by their biological process. The study was conducted in three independent assays, and the number of bacteria adhered to the HAp discs was determined at each time point and analyzed by two-way ANOVA followed by Bonferroni test (α = 5%).

Results: The results suggest that xylitol significantly repressed bacterial adherence and metabolism at 8 h and 24 h; however, bacterial adherence and metabolism were significantly enhanced when xylitol was combined with sucrose, showing no negative effect on S. mutans at both time points. Bacterial proteome was modulated by the carbohydrate source.

Conclusion: The cariogenicity of S. mutans biofilms may be reduced by the alternative sweetener xylitol; however, the combination with fermentable sugars may inhibit such a beneficial effect.

Introduction: This study aimed to investigate the effectiveness of a nutritional counseling program for mothers of newborns to prevent sugar consumption in the first year of life on the occurrence of early childhood caries (ECC).

Methods: A multicentric randomized clinical trial (ClinicalTrials.gov - NCT03841123) was conducted in three state capitals of Brazil (n = 516). Mothers were randomly assigned to the intervention group (IG) or control group (CG) after delivery. The IG received face-to-face nutritional counseling based on UNICEF dietary guidelines after delivery, followed by monthly phone calls. The CG received standard counseling. Dietary intake was measured through structured questionnaires and 24-h recalls at 6 and 12 months. Dental clinical examination for ECC diagnosis was performed by calibrated dentists after the children completed the first year of life.

Results: The prevalence of ECC was 17.4% in the overall sample (49/290). The number of affected teeth ranged from 0 to 6 (mean 0.43). The IG had a 2.4 times probability of not consuming sugar in the first 6 months of life (RR 2.44; 95% CI: 1.18-5.00) and a significantly lower mean number of sweet items consumed at 12 months (p = 0.016). However, no significant differences between groups were found with regard to the occurrence of ECC (RR 1.33; 95% CI: 0.79-2.25) or the number of teeth affected by caries (p = 0.273).

Conclusion: The intervention to prevent and reduce sugar intake in the first year of life was not effective at reducing the occurrence of ECC or the number of teeth with carious lesions.

Introduction: Despite the notable progress in developing artificial intelligence-based tools for caries detection in bitewings, limited research has addressed the detection and staging of secondary caries. Therefore, we aimed to develop a convolutional neural network (CNN)-based algorithm for these purposes using a novel approach for determining lesion severity.

Methods: We used a dataset from a Dutch dental practice-based research network containing 2,612 restored teeth in 413 bitewings from 383 patients aged 15-88 years and trained the Mask R-CNN architecture with a Swin Transformer backbone. Two-stage training fine-tuned caries detection accuracy and severity assessment. Annotations of caries around restorations were made by two evaluators and checked by two other experts. Aggregated accuracy metrics (mean ± standard deviation - SD) in detecting teeth with secondary caries were calculated considering two thresholds: detecting all lesions and dentine lesions. The correlation between the lesion severity scores obtained with the algorithm and the annotators' consensus was determined using the Pearson correlation coefficient and Bland-Altman plots.

Results: Our refined algorithm showed high specificity in detecting all lesions (0.966 ± 0.025) and dentine lesions (0.964 ± 0.019). Sensitivity values were lower: 0.737 ± 0.079 for all lesions and 0.808 ± 0.083 for dentine lesions. The areas under ROC curves (SD) were 0.940 (0.025) for all lesions and 0.946 (0.023) for dentine lesions. The correlation coefficient for severity scores was 0.802.

Conclusion: We developed an improved algorithm to support clinicians in detecting and staging secondary caries in bitewing, incorporating an innovative approach for annotation, considering the lesion severity as a continuous outcome.