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Background. Commercially available sugar-free chewing gums have been claimed to provide oral health benefits. Aim. The aim of this randomized, double-blind crossover in situ study was to compare the efficacy of three commercially available sugar-free chewing gums: Trident White, Orbit, and Orbit Professional, in remineralizing enamel subsurface lesions in situ. Design. Specimens containing enamel subsurface lesions were sectioned into test and control half-slabs with the test half-slabs inserted into removable palatal appliances. For each test chewing period, subjects were randomly allocated one of three test gums. Subjects (n = 10) chewed the randomly allocated gum for a 20-min period four times per day for 14 days. Each subject chewed all three test gums, with a 7-day washout period between crossovers. After each 14-day cycle, test and control half-slabs were paired, embedded in resin, sectioned, and subjected to microradiography to determine remineralization. Results. The gum TW produced significantly greater remineralization (18.4 +/- 0.9%) than Orbit (8.9 +/- 0.5%) and Orbit Professional (10.5 +/- 0.9%). Conclusion. The superior remineralization activity of the TW gum in situ was attributed to the presence of casein phosphopeptide-amorphous calcium phosphate nanocomplexes. [ABSTRACT FROM AUTHOR]

Background: Molar-incisor hypomineralisation (MIH) is a frequently encountered dental condition in the clinical setting, and correct diagnosis can influence management outcomes., Aim: To assess the knowledge of and attitudes towards the management of MIH amongst dentists in the Netherlands., Design: The study was conducted as a cross-sectional web survey. The questionnaire used included questions regarding respondent characteristics, awareness, knowledge and management of MIH and was distributed through the Royal Dutch Association for Dentistry (KNMT) to a random sample of 900 dentists. Variables were analysed using descriptive statistics, and differences between distinct groups of dentists were tested using the chi-squared test., Results: Respondents consisted of 76.6% general dental practitioners, 9.1% paediatric dentists and 14.3% differentiated (specialist) dentists, with a 25.6% overall response rate. The majority knew the term MIH and its clinical characteristics, and could distinguish MIH from other enamel defects. Regarding aetiological factors, 76.6% reported a genetic component. In an asymptomatic case, 47.3% reported non-invasive treatments. In a mild symptomatic case, treatments from non-invasive to invasive were reported (p < .05). In a severe symptomatic case, the majority reported invasive treatments. Two-thirds of respondents were interested in further clinical training about MIH., Conclusions: Most respondents knew the term MIH and its clinical characteristics and would like further clinical training about MIH., (© 2024 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Background: Social disadvantage leads to dental caries during childhood., Aim: This study investigated whether dental caries occur earlier in children from households experiencing social disadvantage than those not experiencing social disadvantage., Design: The overall risk of, and relative time to, early childhood caries (ECC) according to sociodemographic characteristics in Victoria, Australia, was quantified. Records for 134 463 children in Victoria, Australia, from 2009 to 2019 were analysed. Time ratios (TR) and hazard ratios (HR) of carious lesion(s) in early childhood were estimated., Results: Compared with reference groups, Indigenous children had an adjusted TR of 0.80 (95% CI: 0.78, 0.82), children from households with languages other than English had an adjusted TR of 0.83 (95% CI: 0.82, 0.84), and dependants of concession cardholders had an adjusted TR of 0.81 (95% CI: 0.80, 0.81); therefore, 20%, 17% and 19% reduced times to the first carious lesion, respectively. The estimated HRs were 1.57 (95% CI: 1.49, 1.67) for Indigenous children, 1.46 (95% CI: 1.42, 1.50) for children from households with other languages and 1.57 (CI: 1.53, 1.60) for dependants of concession cardholders., Conclusion: Preventive oral health interventions must be targeted early in children from households experiencing social disadvantage to avoid social inequities in ECC., (© 2024 The Author(s). International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Background: Molar-incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) involve qualitative structural developmental anomalies of tooth enamel, affecting the first permanent molars (FPM) and the second primary molars, respectively. This developmental anomaly of systemic origin has important consequences for oral health., Aim: To determine the prevalence of MIH and HSPM in south-western France and explore the distribution of hypomineralised lesions on permanent and primary molars., Design: Amongst 856 children (aged 7-9 years) in schools randomly selected by the Academy of Bordeaux (Ministry of Education), the FPM, permanent incisors and the second primary molars were examined by two examiners trained and calibrated for the diagnostic criteria for MIH and HSPM of the European Academy of Paediatric Dentistry., Results: Molar-incisor hypomineralisation was present in 160 children (18.7%) and HSPM in 81 children (9.5%); 4.9% had both HSPM and MIH (42 of 856). Hypomineralised lesions were present in 1-4 FPM in affected individuals (mean = 2.4) and were distributed in an asymmetrical manner with widely varying severity at the tooth and individual level. A child with HSPM was more likely to have MIH than a child without HSPM (95% CI OR = 6.0 [3.7-9.7]; p < .0001)., Conclusion: Molar-incisor hypomineralisation and HSPM have three main asymmetrical characteristics: tooth location, severity of hypomineralisation and number of teeth affected., (© 2022 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Background: Despite intensive efforts for categorizing demarcated enamel opacities, often related to molar incisor hypomineralization (MIH), there is a lack of descriptive criteria aiming to describe them physically outside the scope of color and size. This is most likely due to the indices focusing on molar, not anterior, teeth., Aim: To map and classify demarcated lesions on permanent anterior teeth using reflected and transilluminated light. The association between classification and related lesion characteristics was also examined., Design: Permanent anterior teeth with demarcated opacities related to MIH were selected. For each tooth, standardized photographs were taken using transmitted and reflected light. Each lesion was mapped and classified according to its color, lesion size, surface integrity, and type. The data were analyzed using the chi-square and Fisher's exact tests. A logistic regression analysis was performed to identify the risk of PEB., Results: There were significant relationships between lesion size, color, and type with surface integrity. Lesion type and size were more important than lesion color for assessing the risk of PEB. There was also a significant relationship between lesion size and lesion color., Conclusions: Lesion size and type are significant clinical parameters for assessing the risk of PEB on enamel opacities related to MIH., (© 2021 BSPD, IAPD and John Wiley & Sons Ltd.)

Background: Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a multifaceted syndrome with a variable phenotype. Few studies have described the associated dental characteristics and their relationship with medical co-morbidities; and no Australian data exist., Aim: To determine the clinical manifestations and correlations between oral and medical conditions in children with 22q11.2DS., Design: A retrospective observational study. Children genetically diagnosed with 22q11.2DS at the Royal Children's Hospital Melbourne were selected; their medical and dental characteristics were collated and analysed., Results: The study population (n = 57; mean age 11.5 years, range 2-27 years) experienced a range of medical conditions involving multiple medical systems; of whom 44 (77.2%) had caries experience, 7 (12.3%) developmentally missing teeth, and 31 (54.4%) developmental defects of enamel (DDE). Smaller proportions of primary teeth were affected by DDE in children with congenital heart disease (2.2% vs 9.7%; P = .02), and cardiac surgery (0.2% vs 9%; P = .001). Conversely, children with hypoparathyroidism (n = 2) had significantly higher proportions of primary teeth affected by DDE (27.5% vs 4%; P = .02)., Conclusions: Significant associations existed between medical conditions (congenital heart disease, history of cardiac surgery, and hypoparathyroidism) and primary dentition DDE in children with 22q11.2 DS., (© 2021 BSPD, IAPD and John Wiley & Sons Ltd.)

Background: Wnt/β-Catenin signalling and DMP1 have key roles in tertiary dentinogenesis., Aim: To compare the relationship between remaining dentine thickness (RDT), tertiary dentine thickness (TDT), β-catenin and dentine matrix protein 1 (DMP1) in carious second primary molar teeth with normal (SPM) and hypomineralised enamel (HSPM)., Design: Extracted carious SPM and HSPM were fixed, sectioned (5 μm) and stained with haematoxylin and eosin or with indirect immunofluorescence for β-catenin and DMP1. Image analysis was performed to determine RDT, TDT, β-catenin and DMP1 intensity in the odontoblast layer and dentine-pulp complex., Results: Carious SPM (n = 11; mean RDT = 1536.1 μm) and HSPM (n = 12; mean RDT = 1179.9 μm) had mean TDT 248.6 μm and 518.1 μm, respectively (P = .02). There were no significant differences in intensity values in the odontoblast layer and dentine-pulp complex for β-catenin and DMP1 for both groups., Conclusion: There was no observable variation in Wnt/β-catenin and DMP1 expression between HSPM and SPM despite a statistically significant twofold increased TDT in HSPM compared with SPM that had similar RDT. Thus, the observed increased TDT in HSPM is more likely due to an earlier onset of repair processes rather than an amplified response to caries., (© 2020 BSPD, IAPD and John Wiley & Sons Ltd.)

Background: Knowledge of molar incisor hypomineralization (MIH) has relevance for paediatric dentists., Aim: To assess final-year German dental students' knowledge, attitudes, and beliefs regarding MIH., Materials and Methods: A previously validated questionnaire was posted to the 31 German dental schools. Demographic covariates as well as knowledge regarding diagnosis and prevalence, and attitudes and beliefs around aetiology and management were collected., Results: Twenty-two (71%) dental schools responded and a total of 877 students participated. Most (97%) were familiar with MIH and 88% were aware of the diagnostic criteria for MIH; however, only 42% knew how to implement them. One-third were able to identify MIH and 16% reported diagnostic confidence when doing so; 90% assumed the MIH prevalence to be <10%. Two-thirds of the respondents implicated genetic components as the main aetiological factor of MIH. Resin composite (60%) and preformed metal crowns (46%) were the dental materials most often suggested for restorative management. Almost all (98%) respondents were interested in receiving more clinical training., Conclusion: German students were familiar with MIH; however, they reported low levels of knowledge and confidence regarding its prevalence and diagnosis. Standardized nationwide, up-to-date curricula should be implemented to educate future dentists in Germany., (© 2020 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Background: To address challenges presented to clinicians to diagnose and treat molar incisor hypomineralisation (MIH), a new assessment tool was created., Aim: To explore the reproducibility and validity of a new instrument developed to assess MIH., Methods: Inter-rater and test-retest reliabilities were examined using Cronbach's alpha. Thirty-five oral health professionals scored clinical photographs for the presence/absence of MIH and other enamel defects using the new index. Face, content, and construct validities were assessed. A panel of six experienced researchers assessed face validity. Construct validity was determined by examining hypothesised associations with clinical variables reported to change concurrently or as modifiers of the MIH outcome. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were also assessed., Results: The index reflected the hypothesised associations regarding the presence, prevalence, and severity of MIH, demonstrating construct validity. Researchers indicated that codes and definitions were clear and suitable for international use. The index showed satisfactory scores of sensitivity/specificity and PPV/NPV. Examiners achieved "Substantial" to "Almost perfect" levels of agreement in clinical presentation and lesion extension., Conclusions: The tested MIH index had reasonably solid properties providing confidence that it is a reliable and valid instrument for use in population-based and clinical screenings for diagnosis of MIH and other enamel defects., (© 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Resin infiltration may alter the mechanical properties of enamel hypomineralised lesions (HL); however, variable surface layer (SL) thickness may affect resin penetration., Aims: To determine the thickness of the SL of HL and to investigate the effect of resin infiltration on the mechanical properties of HL., Design: The thickness of the SL over HL was determined using polarised light microscopy. Etching time using 15% HCl gel to remove the SL of 52 samples was determined. Selected HL and control areas of 21 teeth were infiltrated with Icon ® resin infiltrant, and cross-sectional Knoop microhardness (KHN) measurements were recorded before and after resin infiltration., Results: Ninety-six point five per cent of HL had a detectable SL with mean thickness of 58 ± 29 μm. Application of HCl for 120 s produced a mean MIH erosion depth of 58 ± 12 μm. Eleven of 21 samples had evidence of infiltration using visual examination. The infiltrant penetrated some of the HL leading to an increase in KHN (111 ± 75 KHN) which, when compared to adjacent non-infiltrated HL (96 ± 52 KHN), was not statistically significantly different (P = 0.56)., Conclusions: There was marked variation in the SL thickness of HL. Resin infiltration of HL did not increase microhardness significantly., (© 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Reduced bond strengths of resin composites to hypomineralised enamel increase restorative failure., Aim: To investigate if the adhesion of resin composite to hypomineralised enamel can be improved by pre-treatments: resin infiltration, oxidative pre-treatment followed by a resin infiltration, or oxidative pre-treatment., Design: Twenty-one enamel specimens in each of five Groups: 1) Normal enamel; 2) Hypomineralised enamel; 3) Hypomineralised enamel pre-treated with a resin infiltrant, (Icon(®)); 4) Hypomineralised enamel pre-treated with 5.25% sodium hypochlorite then treatment with resin infiltrant; 5) Hypomineralised enamel pre-treated with 5.25% sodium hypochlorite. A resin composite rod was bonded to each specimen using Clearfil™ SE bond as the adhesive (hereafter termed 'routine bonding'), then subjected to microshear bond strength (MSBS) testing., Results: Overall, the mean MSBS between the five groups differed significantly (P = 0.001). Pre-treatment of hypomineralised enamel with 5.25% sodium hypochlorite with or without subsequent resin infiltration in Groups 4 and 5 prior to routine bonding resulted in increased mean MSBS compared to Groups 2 and 3, with mean MSBS values not differing significantly when compared to routine bonding to normal enamel., Conclusion: Increased bond strength of resin composite to hypomineralised enamel was obtained by pre-treatment of hypomineralised enamel specimens with 5.25% sodium hypochlorite with or without subsequent resin infiltration., (© 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Current molar hypomineralisation (MH) indices do not guide clinicians in management of affected dentitions, and treatment is based on individual judgment., Aim: The aims of this study were to describe characteristics of MH and molar incisor hypomineralisation (MIH) and trial the new Molar Hypomineralisation Severity Index (MHSI)., Design: First permanent molars (FPMs) and permanent incisors (PIs) in 283 affected children were examined for hypomineralisation characteristics [defect colour, location, post-eruptive breakdown (PEB); restorations placed/replaced/atypical; sensitivity]. The MHSI scores were compared with treatment received (152 children)., Results: Mean (SD) affected teeth/dentition were as follows: FPMs: 3.2 (1.0) and PIs: 1.6 (1.6). Affected FPMs showed no arch or quadrant predilection; maxillary central PIs were affected particularly. As affected FPMs/dentition increased, MIH diagnoses also increased (P = 0.009). Among FPMs, defects most prevalent were brown (47%) and cuspal (74%); 67% showed PEB. Before study entry, 43% of FPMs had restorations placed/replaced. Among PIs, white defects were common (65%) on smooth surfaces; sensitivity was rare. Affected FPMs received more restorations and extractions than unaffected FPMs (P = 0.0001). As MHSI scores increased, FPM treatments/dentition increased (number, invasiveness). All characteristics were significant in predicting treatment (logistic regression model)., Conclusions: A spectrum from MH to MIH occurred. The MHSI characteristics were predictive of the treatment of affected FPMs and can guide management., (© 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)