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Since the time that human population comprehended the importance of general health maintenance and the burden of disease, there has been a search for healing properties in the natural environment. Herbal medicine is the use of plants with medical properties for prevention and treatment of conditions that can affect general health. Recently, a growing interest has been observed toward the use of traditional herbal medicine alongside synthetic modern drugs. Around 80% of the population, especially in developing countries relies on it for healthcare. Oral healthcare is considered a major part of general health. According to the world health organization (WHO), oral health is considered an important part of general health and quality of life. The utilization of natural medications for the management of pathologic oro-dental conditions can be a logical alternative to pharmaceutical methods due to their availability, low costs, and lower side effects. The current literature review aimed at exploration of the variety and extent of herbal products application in oral health maintenance including different fields of oral healthcare such as dental caries, periodontal maintenance, microbial infections, oral cancers, and inflammatory conditions., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Better understanding of dental caries and other oral conditions has guided new strategies to prevent disease and manage its consequences at individual and public health levels. This article discusses advances in prevention and minimal intervention dentistry over the last century by focusing on some milestones within scientific, clinical, and public health arenas, mainly in cariology but also beyond, highlighting current understanding and evidence with future prospects. Dentistry was initially established as a surgical specialty. Dental caries (similar to periodontitis) was considered to be an infectious disease 100 years ago. Its ubiquitous presence and rampant nature-coupled with limited diagnostic tools and therapeutic treatment options-meant that these dental diseases were managed mainly by excising affected tissue. The understanding of the diseases and a change in their prevalence, extent, and severity, with evolutions in operative techniques, technologies, and materials, have enabled a shift from surgical to preventive and minimal intervention dentistry approaches. Future challenges to embrace include continuing the dental profession's move toward a more patient-centered, evidence-based, less invasive management of these diseases, focused on promoting and maintaining oral health in partnership with patients. In parallel, public health needs to continue to, for example, tackle social inequalities in dental health, develop better preventive and management options for existing disease risk groups (e.g., the growing aging population), and the development of reimbursement and health outcome models that facilitate implementation of these evolving strategies. A century ago, almost every treatment involved injections, a drill or scalpel, or a pair of forceps. Today, dentists have more options than ever before available to them. These are supported by evidence, have a minimal intervention focus, and result in better outcomes for patients. The profession's greatest challenge is moving this evidence into practice.

The 21(st) century dental practice is quite dynamic. New treatment protocols and new materials are being developed at a rapid pace. Ozone dental therapy falls into the category of new treatment protocols in dentistry, yet ozone is not new at all. Ozone therapy is already a major treatment modality in Europe, South America and a number of other countries. What is provided here will not be an exhaustive scientific treatise so much as a brief general introduction into what dentists are now doing with ozone therapies and the numerous oral/systemic links that make this subject so important for physicians so that, ultimately, they may serve their patients more effectively and productively.

Background/Aim: Children with special healthcare needs (CSHCN) often face oral health challenges. This retrospective cross‐sectional study at a university hospital aimed to determine CSHCN's medical spectrum, dental treatment needs, and mode of treatment: general anesthesia (GA) or outpatient dental care (ODC). Design: Data from the Department of Conservative Dentistry, Heidelberg University Hospital, 2012–2022, were reviewed, considering age, gender, International Classification of Diseases‐10 diagnoses, caries experience (dmft/DMFT), restorative parameters, and treatment under GA/ODC. For patients under GA, their American Society of Anesthesiologists (ASA) classification was considered. Descriptive statistics, Kruskal–Wallis test, Mann–Whitney U‐test and logistic regression were utilized. Results: Of 669 patients, congenital and chromosomal malformations (34.7%), diseases of the nervous system (19.1%), and mental and behavioral disorders (16.0%) were mainly diagnosed. Dentin caries prevalence was high at 79.1%, with treatments performed mainly under GA (51.4%). The odds of receiving treatment under GA decreased with patient age and increased with higher dmft/DMFT scores. Most under GA were classified as ASA 3 (51.7%), indicating high anesthesia risks. Conclusion: Children with special healthcare needs often have diseases that can lead to higher challenges related to cooperation. The high prevalence of dentin caries underscores the substantial need for dental treatments, which were consequently often performed under GA, despite the associated risks. These findings stress the need for trained dental professionals. [ABSTRACT FROM AUTHOR]

Periapical radiographs are routinely used in dental practice for diagnosis and treatment planning purposes. However, they often suffer from artifacts, distortions, and superimpositions, which can lead to potential misinterpretations. Thus, an automated detection system is required to overcome these challenges. Artificial intelligence (AI) has been revolutionizing various fields, including medicine and dentistry, by facilitating the development of intelligent systems that can aid in performing complex tasks such as diagnosis and treatment planning. The purpose of the present study was to verify the diagnostic performance of an AI system for the automatic detection of teeth, caries, implants, restorations, and fixed prosthesis on periapical radiographs. A dataset comprising 1000 periapical radiographs collected from 500 adult patients was analyzed by an AI system and compared with annotations provided by two oral and maxillofacial radiologists. A strong correlation (R > 0.5) was observed between AI perception and observers 1 and 2 in carious teeth (0.7–0.73), implants (0.97–0.98), restored teeth (0.85–0.89), teeth with fixed prosthesis (0.92–0.94), and missing teeth (0.82–0.85). The automatic detection by the AI system was comparable to the oral radiologists and may be useful for automatic identification in periapical radiographs. [ABSTRACT FROM AUTHOR]

Abstract Background Bullying is the intentional, repeated and prolonged aggressive behavior towards victim(s) who feel powerless to defend themselves. It could influence adolescents’ mental health. Some adolescents possess coping skills which enable them to overcome such adversities. The present study assessed the association between bullying, sense of coherence (SOC), resistance to peer influence (RPI) and oral health in Egyptian adolescents. Materials and methods A cross-sectional survey that included 12–16 year old adolescents attending 6 schools in Damanhour, Egypt was conducted from March to December 2023. Data were collected through clinical examination and self-administered questionnaires. Clinical examination assessed dental caries (DMFT), oral hygiene (plaque index) and gingival condition (gingival index). Toothbrushing frequency and sugar consumption were assessed by (World Health Organization-child form), bullying (Revised Olweus Bully Victim Questionnaire), SOC (Sense of Coherence Scale-Short Form) and RPI (Resistance to Peer Influence Questionnaire). The independent variables were bullying, SOC and RPI. The dependent variables were untreated caries, gingival inflammation and toothbrushing frequency. Multivariable multilevel regression assessed the relationship between the independent and dependent variables after adjusting for potential confounders. Adjusted regression coefficients (B), adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated. Effect modifications by SOC and RPI were evaluated. Results The response rate was 95.25% (N = 602), mean (SD) age was 14.01 (1.15). Half of the students (49.83%) were girls. About 42% had untreated caries, only 15.78% brushed their teeth twice daily and the mean (SD) gingival index was 1.57 (0.40). About 25% were victims, (9.30%) bullies and (18.60%) bully-victims. Victims showed significantly lower odds of twice daily toothbrushing (AOR = 0.52, p = 0.04). Bullies and bully-victims showed non-significantly higher odds of untreated caries (AOR = 1.42, p = 0.25), (AOR = 1.21, p = 0.42), respectively. Bullying was not associated with gingival inflammation. Higher SOC and RPI mitigated the impact of bullying on untreated caries and toothbrushing frequency. Conclusion Bullying was associated with higher odds of untreated caries and lower odds of twice daily toothbrushing in Egyptian adolescents. Higher SOC and RPI alleviated this relationship, highlighting the importance of individual coping strategies to oral health.

Abstract Background Early detection of caries is essential for applying non-surgical treatment procedures and preventing the formation of cavitated lesions leading to unnecessary removal of tooth structure. Understanding dentists’ preferences for caries detection tools can inform stakeholders about their strategies and knowledge of contemporary, evidence-based caries management approaches. However, there is a lack of research exploring the detection methods of caries commonly used by dentists in Ontario, Canada. The objective of this study was to investigate the methods of caries detection and diagnosis preferred by dentists in Ontario. Methods A 21-item self-reported survey was mailed to one thousand Ontario dental practices in the Winter of 2022. Descriptive and bivariate data analysis were performed to determine the associations between: demographics and professional practice characteristics (explanatory variables), and methods for detecting and diagnosing dental caries (outcome variables) using SPSS Statistics 29.0. Results A total of 325 dentists (33%) responded to the survey, with 274 answering all of the questions completely. The highest proportion of respondents were 35–44 years of age (32.8%) and male (53.4%). More than half of the respondents reported using a dental explorer to assess primary occlusal caries (57.6%), secondary caries (57.1%), and cervical caries (57.5%). Likewise, 57.9% of the participants reported using dental radiographs to diagnose proximal caries. Among additional caries detection tools, digital radiography (89.8%) and traditional radiography (84.7%) were the most used methods/modalities, while cone beam computed tomography was the least (12.8%). Most study participants did not use any caries classification system (77.7%) or caries risk assessment tool (85.3%). Conclusions Participants preferred conventional methods for caries detection, instead of contemporary visual-tactile caries lesions classification and/or caries risk assessment systems. These findings indicate a need for continuing dental education programs tailored to evidence-based caries management approaches.

Abstract Background Dental caries is still a major disease that affect the oral health of people in China. First permanent molars (FPMs) are the most caries-susceptible teeth among school-aged children. The aim of this study was to investigate the eruption and caries status of first permanent molars in children aged 6–7 years in Shijingshan District, Beijing, China, to provide information for oral health promotion. Methods The study was a cross-sectional survey conducted in 6-7-year-old first grade children from public elementary schools in Shijingshan District, Beijing. Participants were invited to receive a clinical oral examination. The eruption status and caries experience of FPMs were recorded. Questionnaires assessing children’s sociodemographic information and oral health-related behaviors were completed by the children’s parents or guardians. Results A total of 3,176 children, including 1,644 boys (51.8%) and 1,532 girls (48.2%) were included in the oral examination and questionnaire. Eruption status of FPMs was as follows: 37.5% fully erupted, 28.3% partially erupted, 34.2% not erupted. Girls had more erupted FPMs than boys (70.1% VS 61.8%, P

Background: Oral health issues have received significant attention from most global health agencies, which have integrated these issues into their noncommunicable disease, sustainable development, and universal health coverage objectives. Methods: This paper provides an update on the progress made in the last 2 decades and aims to highlight some of the challenges faced by the oral health care system in Kuwait. Results: Despite the nation's rising expenditure on oral health care, the prevalence of oral diseases remains high in Kuwait. The lack of reliable data on periodontitis and edentulism limits the ability of researchers to comment on the trends of these conditions. This emphasises the critical need for a nationwide household-level oral health survey in both pediatric and adult populations that would provide valuable information on the oral health status of these populations. Conclusion: In the future, Kuwait must invest more in oral disease prevention programs, especially among children and the high-risk communities of the population.

Objectives: During caries progression, dental pulp is increasingly pathologically affected. Since the accurate assessment of pulp is of vital importance in clinical decision-making, this study aimed to evaluate pulpal condition in the early stages of caries via laser Doppler (LD) flowmetry and histologic analysis and determine their agreement. Methods: Fourteen patients with severe dental crowding were included. Prior to extractions and orthodontic treatment, dental pulp condition of 52 premolars was evaluated via LD flowmetry. Teeth were assessed for the presence of caries and lesions were graded according to the International Caries Detection and Assessment System (ICDAS). After extractions, teeth were split and histologically stained for endothelial cells with anti–von Willebrand factor and Movat pentachrome for collagen. Volume densities of vessels (Vvasc) and collagen were calculated. Results: There was a significant negative correlation between LD flow and Vvasc of the dental pulp with ICDAS grade. Pulpal LD flow and Vvasc in teeth with the initial lesion were increased, decreasing with progressing stages of caries. A significant positive correlation between the the pulpal LD flow and Vvasc, and a negative correlation of LD flow with collagen fibre density were noted. Conclusions: Caries affects the physiology of the dental pulp, initially with increasing vascularity, and decreasing vascularity at later stges of caries progression. Collagen contents increase with grades of ICDAS. LD flow shows good agreement with the histologic constitution of the dental pulp. Use of clinical measurements of pulpal LD flow could provide a good noninvasive indication of pulpal vascular state and its health.

The aim of study was to assess CARS criteria and two optical methods used in the detection of carious lesions adjacent to posterior composite resins restorations (DiagnoDent Pen, VistaCam ix). Material and Methods. Study group included 10 patients aged between 22-28 years with 15 composite resins restorations (Class I) located in molars, with suspicion of caries adjacent to restorations, were evaluated at 3-5 years post-treatment. A clinical evaluation of the aesthetic coronal restorations was performed clinically, establishing the CARS index values. Subsequently, a paraclinical evaluation was carried out using the DiagnoDent Pen (KaVo) and VistacamIX (Dürr Dental), following the protocol indicated for each device used. Initially, images of each evaluated tooth were captured using VistaCam with the intraoral camera tip, followed by an assessment of the fillings using the Proof tip of the same device. Afterward, the DiagnoDent Pen was used to evaluate each coronal restoration included in the study. Distribution of CARS scores, DiagnoDent Pen values and VistaCam IX values was calculated and exposed in Microsoft Excel graphs. Results. Most frequent CARS scores were 3.3. (46,62%), followed by 3.2 (40,06%), 3.4. (6,66%), 3.5 (6,66%). Most frequent DiagnoDent pen values were >25 (40%), followed by 20-25 (33,30%), 13-19 (20%), and

Abstract Objective To explore the main factors affecting early dental caries among preschool children aged 3–6 years in Xingtai City to formulate effective preventive measures. Methods A cross-sectional study was conducted on 570 preschool children aged 3–6 years in Xingtai City through questionnaire surveys and oral examinations to understand their dental caries situation. Multifactorial logistic regression analysis was used to analyse the main influencing factors for the occurrence of dental caries in preschool children. Results Univariate analysis showed statistically significant differences in age (χ 2 = 2.636, p = 0.008), father’s education level (χ 2 = 4.207, p

Abstract Background Studies on oral health status of adults are sparse and rarely include data on endodontic treatment and trauma. In the military, those data are available because recruits are routinely assessed with a clinical and radiological examination at the start of their career. This study aimed to identify differences in oral health status of Dutch Armed Forces recruits between cohorts, departments, sex, age and rank, with DMF-T, endodontic treatment and dental trauma as outcome measures. Methods Data from Electronic Patient Files from all recruits enlisted in 2000, 2010 and 2020 were used for analysis in a hurdle model resulting in the estimated cohort effect, controlled for the demographic variables. The total number of recruits was 5,764. Due to the retrospective character of the study a proxy was used to compose D-T and dental trauma. Results The mean DMF-T number in recruits decreases from 5.3 in cohort 2000 to 4.13 in cohort 2010 and 3.41 in cohort 2020. The percentage of endodontically treated teeth increases from 6% in cohort 2000 to respectively 9% in 2010 and 8% in 2020. The percentage of recruits showing signs of dental trauma did not change significantly between cohort 2000 (3.1%) and cohort 2010 and 2020 (both 2.7%). Conclusions Oral health in Armed Forces recruits is improving over the years, following a similar trend as the general population in the Netherlands. Lower SES represented by enlisted rank showed substantial lower oral health status.

Abstract Background Dental caries are common and troublesome and may affect individuals’ health conditions. It is crucial to comprehend the caries experience for prevention, management, and enhancing oral health. Techniques such as CAMBRA can help assess an individual’s risk factors for caries lesions. This study aims to assess the caries risk in five distinct regions of Saudi Arabia, utilizing the CAMBRA methodology. Methods This multiregional cross-sectional study was conducted at university dental clinics across the five regions of Saudi Arabia, using a Caries Management by Risk Assessment (CAMBRA) tool. This study used binary logistic regression analysis, the Pearson Chi-square test, and descriptive analysis as statistical methods. Results A total of 551 respondents participated in the study, with 59.7% being male and 40.3% being female. The age group with the highest proportion was 20–29, making up 31.6% of the participants. All participants exhibited at least one caries lesion (100%), with white spots (66.4%) and enamel lesions (56.1%) being the most prevalent. The moderate-risk category encompassed the largest proportion of participants, accounting for 60% of the total. High caries risk had a significant association with age group (P

Abstract Background The global rise in the elderly population has increased the prevalence of root caries. Streptococcus mutans, Lactobacilli and Actinomyces are considered the primary pathogens of dental caries in culture-based studies. This study aimed to investigate bacterial profiles in coronal and root caries lesions and determine the association of specific bacterial genera at each site. Methods Dentine samples from carious lesions were collected from 22 extracted teeth using an excavator. Microbial DNA was extracted from the samples using a protocol developed for this study. 16S rRNA gene amplicon sequencing was employed for microbial analysis. PCR amplification targeted the V3-V4 region of the bacterial 16S rRNA, and the amplicon sequencing used an Illumina MiSeq system (2 × 300 bp paired-end reads). Statistical analysis was performed by the Phyloseq and DESeq2 packages in R. Results In coronal caries, Olsenella, Lactobacillus and Prevotella were the most prevalent genera, comprising approximately 70% of the microbiome community. In the root caries, however, although Olsenella , Prevotella and Lactobacillus remained the dominant genera, they accounted for only half of the microbiome community. This study identified significant differences in alpha diversity indices between the coronal and root caries. LEfSE analysis revealed several unique genera in each caries lesion. Conclusion The microbiome of root caries lesions was richer and more complex than the coronal caries microbiota. The results suggest that lesion-related variations in the oral microflora may be detected in carious dentine.

Abstract Objectives The present study systematically reviewed and provided a meta-analysis on early childhood caries (ECC) global prevalence and its association with socioeconomic indicators, both geographical and regarding unemployment rate, national income as well as income inequalities. Methods Only cross-sectional or cohort studies covering ECC prevalence and experience in children younger than 71 months, reporting sample size, diagnostic criteria and conducted in urban and rural communities were considered. No language restriction was selected. Studies published from 2011 to 2022 available in PubMed, Web of Science, Embase and Open Grey literature were retrieved by ad hoc prepared search strings. The meta-analyses were conducted for both overall ECC prevalence and experience stratified by country of publication as well as measures of socioeconomic indicators using a random effects model using STATA 18®. Results One hundred publications reporting ECC data from 49 countries (published from 2011 to 2022) were included and summarized by meta-analysis. The lowest prevalence was reported in Japan (20.6%) and Greece (19.3%). The global estimated random-effect pooled prevalence of ECC was 49% (95%CI: 0.44–0.55). The random-effect pooled caries prevalence (ECC) was 34% (95%CI: 02.20–0.48) (Central/South America), 36% (95%CI: 0.25–0.47) (Europe), 42% (95%CI: 0.32–0.53) (Africa), 52% (95%CI: 0.45–0.60) (Asia-Oceania), 57% (95%CI: 0.36–0.77) (North America) and 72% (95%CI: 0.58–0.85) (Middle East). When stratified by gross national income (GNI) the ECC prevalence ranged from 30% ($20,000-$39,999) to 57% in countries with the lowest GNI (

Abstract Integrating artificial intelligence (AI) into medical and dental applications can be challenging due to clinicians’ distrust of computer predictions and the potential risks associated with erroneous outputs. We introduce the idea of using AI to trigger second opinions in cases where there is a disagreement between the clinician and the algorithm. By keeping the AI prediction hidden throughout the diagnostic process, we minimize the risks associated with distrust and erroneous predictions, relying solely on human predictions. The experiment involved 3 experienced dentists, 25 dental students, and 290 patients treated for advanced caries across 6 centers. We developed an AI model to predict pulp status following advanced caries treatment. Clinicians were asked to perform the same prediction without the assistance of the AI model. The second opinion framework was tested in a 1000-trial simulation. The average F1-score of the clinicians increased significantly from 0.586 to 0.645.

Background: The relationship between vitamin D deficiency with dental caries, periodontitis and oral cancer is controversial. Objectives: This review aimed to systematically evaluate the published literature and summarise the available evidence about the impact of vitamin D deficiency (VDD) on the oral diseases mentioned above. Methods: PubMed, Web of Science, Scopus and ScienceDirect databases were used. The search terms included were vitamin D, caries, periodontitis, and oral cancer. All papers published between January 2017 and November 2022 were included. The PRISMA process was used for the screening and selection studies. Results: Initially, 3001 studies were identified. However, after evaluating 46 full-text articles that explored the link between VDD and caries, periodontitis, and oral cancer, only 32 studies met the inclusion criteria for this systematic review. Among these, 15 studies focused on caries, 16 on periodontitis, and only one on oral cancer. Regarding study quality and risk of bias, 25 out of the 32 studies were deemed to have low risk. A total of 12 studies on periodontitis showed the impact of VDD. Conclusion: The review highlights that most evidence suggests an association between VDD and periodontitis. However, findings concerning the association between VDD and dental caries were controversial. Thus, further research is required to clarify the impacts of VDD on caries and oral cancer.

Abstract Objectives This study investigated the effectiveness of a deep convolutional neural network (CNN) in diagnosing and staging caries lesions in quantitative light-induced fluorescence (QLF) images taken by a self-manufactured handheld device. Methods A small toothbrush-like device consisting of a 400 nm UV light-emitting lamp with a 470 nm filter was manufactured for intraoral imaging. A total of 133 cases with 9,478 QLF images of teeth were included for caries lesion evaluation using a CNN model. The database was divided into development, validation, and testing cohorts at a 7:2:1 ratio. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) were calculated for model performance. Results The overall caries prevalence was 19.59%. The CNN model achieved an AUC of 0.88, an accuracy of 0.88, a specificity of 0.94, and a sensitivity of 0.64 in the validation cohort. They achieved an overall accuracy of 0.92, a sensitivity of 0.95 and a specificity of 0.55 in the testing cohort. The model can distinguish different stages of caries well, with the best performance in detecting deep caries followed by intermediate and superficial lesions. Conclusions Caries lesions have typical characteristics in QLF images and can be detected by CNNs. A QLF-based device with CNNs can assist in caries screening in the clinic or at home. Trial registration The clinical trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2300073487, Date: 12/07/2023).

Abstract Background Streptococcus mutans (S. mutans) is an important pathogenic bacterium that causes dental caries, while Streptococcus gordonii (S. gordonii) is a non-cariogenic bacterium that inhibits the growth of S. mutans. The SepM protein can promote the inhibitory ability of S. mutans against S. gordonii by cleaving CSP-21 and activating the ComDE two-component system. This study was designed to explore sepM mutation in S. mutans clinical isolates and related function in the regulation of interactions with S. gordonii. Methods The S. mutans clinical strains that can inhibit the growth of S. gordonii constitute the inhibitory group. 286 C-serotype S. mutans strains were categorized into S. gordonii inhibitory (n = 114) and non-inhibitory bacteria (n = 172). We detected sanger sequencing of sepM gene, the expression levels of related genes and proteins in clinical isolates, obtained prokaryotic expression and purification of mutated proteins, and analyzed the effect of the target mutations on the binding between SepM and CSP-21. Results We found that C482T, G533A, and G661A missense mutations were presented at significantly higher frequency in the inhibitory group relative to the non-inhibitory group. There was no significant difference in the expression of the sepM gene between selected clinical isolates harboring the G533A mutation and the control group. The expression levels of SepM, phosphorylated ComD, and ComE in the mutation group were significantly higher than those in the control group. SepM_control and SepM_D221N (G661A at the gene level) were found to contain two residues close to the active center while SepM_G178D (G533A at the gene level) contained three residues close to the active center. At 25 °C and a pH of 5.5, SepM_D221N (G661A) exhibited higher affinity for CSP-21 (KD = 8.25 µM) than did the SepM control (KD = 33.1 µM), and at 25 °C and a pH of 7.5, SepM_G178D (G533A) exhibited higher affinity (KD = 3.02 µM) than the SepM control (KD = 15.9 µM). It means that it is pH dependent. Conclusions Our data suggest that increased cleavage of CSP-21 by the the mutant SepM may be a reason for the higher inhibitory effect of S. mutans on S. gordonii .

Aim of the study. The aim of the study was to evaluate the Romanian children’s perception regarding 2 of the most common oral pathologies, dental caries and gingivitis in correlation with oral health behaviours. Methods. This was a cross-sectional study. The answers to 2 questionnaires distributed to children 12-15 years old from 2 schools in Bucharest, Romania were analyzed. One questionnaire included questions related to oral pathology, and the other to oral health maintenance behaviour. In our dental research study we made use of descriptive statistics in order to summarize continuous and categorical variables. The test used to examine relationship between children’s perceptions and their behaviours was Roa-Scott chi-square test Results. All 137 children who participated in the study completed both questionnaires. Among them, 62% considered that a broken tooth is not a form of disease, but still 94.8% of them would go to the dentist. Regarding gingival bleeding, even if its presence as a sign of illness was not conclusive, most children (78.8%) considered that this sign requires medical attention. The frequency of sugar consumption in our study was low in 80.3% of children, and the frequency of brushing was more than once a day for 77.4% of subjects. Conclusions. Although most children perceived dental cavity as a disease and, gingival bleeding as not a sign of illness., there was a consensus regarding both conditions, that is, the necessity of dental treatment. Awareness of the need for dental treatment in case of signs for these two diseases is very important for promoting preventive dental programs for children.

Dental caries occurs from the interaction between oral bacteria and sugars, generating acids that damage teeth over time. The importance of X-ray images for detecting oral problems is undeniable in dentistry. With technological advances, it is feasible to identify these lesions using techniques such as deep learning, machine learning, and image processing. Therefore, the survey and systematization of these methods are essential to determining the main computational approaches for identifying caries in X-ray images. In this systematic review, we investigated the primary computational methods used for classifying, detecting, and segmenting caries in X-ray images. Following the PRISMA methodology, we selected relevant studies and analyzed their methods, strengths, limitations, imaging modalities, evaluation metrics, datasets, and classification techniques. The review encompassed 42 studies retrieved from the Science Direct, IEEExplore, ACM Digital, and PubMed databases from the Computer Science and Health areas. The results indicate that 12% of the included articles utilized public datasets, with deep learning being the predominant approach, accounting for 69% of the studies. The majority of these studies (76%) focused on classifying dental caries, either in binary or multiclass classification. Panoramic imaging was the most commonly used radiographic modality, representing 29% of the cases studied. Overall, our systematic review provides a comprehensive overview of the computational methods employed in identifying caries in radiographic images and highlights trends, patterns, and challenges in this research field. [ABSTRACT FROM AUTHOR]

Evidence of porcine oral pathology in client-owned domestic pigs has been reported in recent literature. The most common abnormalities are missing teeth and periodontal disease. This case series reviews the diagnosis and treatment of dental disease in 8 pet Vietnamese Pot-Bellied Pigs (Sus scrofa domesticus) over a 6-year period (2015-2021). Inclusion criteria included pigs over 1 year of age that had at least 2 sequential visits involving photographs, full-mouth intraoral radiographs, and dental charting. Eight pigs were identified for study inclusion. The study population included 4 castrated males, 3 spayed females, and 1 intact female. The 8 subjects had a total of 28 visits. Fifty-five intraoral dental extractions were performed and complete healing of 44 extraction sites was observed (11 sites were lost to follow up). Canine tooth reduction was performed on 52 tusks in 7 pigs with exposure of 1 pulp that was treated by partial pulpectomy and direct pulp capping. Restoration of carious lesions was performed on 4 teeth. The most commonly extracted teeth were the right and left maxillary first molars (10 of 47 teeth). Reasons for tooth extraction included: periodontal disease, complicated crown fracture, nonvital +/− periapical pathology, and persistent deciduous teeth. Additional treatments ranged from type 1 crown lengthening with restoration of carious lesions, tusk trimming, closed and open root planing, dental extractions, ultrasonic scaling, and polishing. This article stresses the importance of routine dental healthcare and early intervention for periodontal disease in pigs. [ABSTRACT FROM AUTHOR]

Objective: To explore experiences of caries prevention in adult patients with recurrent cavities among experienced dentists. Method: Five focus group discussions consisting of seven men and nine women, 38–61 years of age, and with working experience as dentists between 5 and 35 years, were conducted. The participants represented Public Dental Health Service clinics and private practitioners. Qualitative content analysis was used to analyze data. Results: The participants emphasized the importance of effective communication and patient engagement in caries prevention. They described their experiences as an endless trail, making fillings. They expressed their inability to take necessary responsibility and being stuck in the dental care system due to various circumstances. The understanding of caries was contradictory, and an inadequate mandate to control time to fulfill their preventive work was evident. They felt responsible to do the best for their patients, but how to share responsibility with colleagues and patients and having enough time for this seemed difficult and unclear. These problems did not motivate to further education in cariology. Conclusion: The findings underscore the urgent need for improvement in preventive caries treatment and the necessity of allocating sufficient time for dentists to engage in this crucial aspect of their work.

The oral microbiome is a complex community of microorganisms residing in the oral cavity interacting with each other and with the host in a state of equilibrium. Disruptions in this balance can result in both oral and systemic conditions. Historically, studying the oral microbiome faced limitations due to culture-dependent techniques that could not capture the complexity and diversity of the microbial community. The emergence of advanced genomic technologies and the ease of sample collection from the oral cavity has revolutionized the understanding of the oral microbiome, providing valuable insights into the bacterial community in both health and disease. This review explores the oral microbiome in children, discussing its formation and dynamics in both states of health and disease, its role in various conditions such as dental caries, periodontal disease, oral cancer, cleft lip and palate, and explores its connection to several systemic consequences.

AimDentistry is uniquely positioned as a healthcare profession, distinguished from allied health or paramedical fields. It operates within a university-based structure, maintaining primary care responsibilities. Oral diseases impose a substantial worldwide health and economic burden, profoundly affecting the well-being of those affected. This cross-sectional study is centered on the Irula tribes in Tamil Nadu, India. Investigating the extent of tooth morbidity and loss, identifying possible risk factors, looking at oral hygiene habits, and evaluating the oral health-associated quality of life (OHRQoL) in this population are the main goals. As this population is at high risk for dental issues, promoting good oral hygiene becomes crucial. Indigenous populations, including the Irula tribes, have been underrepresented in research studies. The vulnerability of the Irula tribes is exacerbated by their remote locations, resulting in limited access to fundamental healthcare facilities.Materials and methodsThis study employs a cluster sampling approach, aiming to include 880 individuals aged 60 and above from Kancheepuram and Chengalpattu districts. The methodology encompasses a community-based questionnaire, clinical assessments utilizing standardized indices, and the assessment of the Oral Health-Related Quality of Life (OHRQoL). The Statistical Package for Social Services, version 20, will be used to analyze all of the data that has been gathered (SPSS).Categorical variables will undergo analysis, with descriptive statistics and frequency percentages computed.ConclusionThis study evaluates tooth morbidity and dentistry's role in screening chronic diseases like diabetes among the Irula tribes. It explores risk factors, oral hygiene practices, treatment seeking behavior, and oral health-related quality of life to gain a comprehensive understanding.

Abstract Objectives To predict the dental caries outcomes in young adults from a set of longitudinally-obtained predictor variables and identify the most important predictors using machine learning techniques. Methods This study was conducted using the Iowa Fluoride Study dataset. The predictor variables - sex, mother’s education, family income, composite socio-economic status (SES), caries experience at ages 9, 13, and 17, and the cumulative estimates of risk and protective factors, including fluoride, dietary, and behavioral variables from ages 5–9, 9–13, 13–17, and 17–23 were used to predict the age 23 D2+MFS count. The following machine learning models (LASSO regression, generalized boosting machines (GBM), negative binomial (NegGLM), and extreme gradient boosting models (XGBOOST)) were compared under 5-fold cross validation with nested resampling techniques. Results The prevalence of cavitated level caries experience at age 23 (mean D2+MFS count) was 4.75. The predictive analysis found LASSO to be the best performing model (compared to GBM, NegGLM, and XGBOOST), with a root mean square error (RMSE) of 0.70, and coefficient of determination (R2) of 0.44. After dichotomization of the predicted and observed values of the LASSO regression, the classification results showed accuracy, precision, recall, and ROC AUC of 83.7%, 85.9%, 93.1%, 68.2%, respectively. Previous caries experience at age 13 and age 17 and sugar-sweetened beverages intakes at age 13 and age 17 were found to be the four most important predictors of cavitated caries count at age 23. Conclusion Our machine learning model showed high accuracy and precision in the prediction of caries in young adults from a longitudinally-obtained predictor variables. Our model could, in the future, after further development and validation with other diverse population data, be used by public health specialists and policy-makers as a screening tool to identify the risk of caries in young adults and apply more targeted interventions. However, data from a more diverse population are needed to improve the quality and generalizability of caries prediction.

Objective: To identify the potential factors that induce procedural errors during posterior proximal resin composite restorations placed by dental students. Materials and Methods: This retrospective study evaluated 803 bitewing radiographs of posterior proximal resin composite restorations placed by dental students at Imam Abdulrahman bin Faisal University. Atypical radiographic signs of failure were screened, and different patient-, operator-, and clinical-related factors were recorded. Chi-square test was used to examine the relationship between procedural errors and recorded factors. Stepwise adjusted logistic regression model was performed to identify predictors of procedural errors. Results: The most observed errors were internal gaps at the bonding interface and internal voids. Molars had 0.39 the risk of internal voids (odds ratio [OR] = 0.39; confidence interval [CI] = 0.25–0.60; P = 40 years of age had 1.79 the risk of overhang compared to younger patients (OR = 1.79; CI = 1.04–3.11; P =

Silver metal and compounds have antibacterial properties, although their action's mechanisms are not fully understood. Scientists generally consider that silver disrupts the bacterial cell wall. It causes a structural change in the bacterial cell membrane and cytoplasm. It also stops deoxyribonucleic acid replication, resulting in inactivating enzymatic activity and cell death. The antimicrobial effect of silver-containing compounds relies on the release of bioactive silver ions. Hence, silver metal and compounds have been used in medicine to prevent infection for hundreds of years. Silver metal and compounds are also used as antibacterial agents in dentistry. Studies have shown that silver compounds are effective in the management of dental caries. Fluoride-containing silver compounds have been found in experiments to be beneficial at remineralising dental cavities. Silver diamine fluoride (SDF) can assist in preventing and arresting tooth cavities. The World Health Organization included SDF in its Model List of Essential Medicine for both adults and children in 2021. Clinicians also use SDF to manage dentine hypersensitivity as well as to inhibit growth of periodontal pathogens. However, traditional silver compounds cause tooth discolouration because of the silver-staining effect. These side effects of their applications depend on the amount applied and the frequency of application. Researchers are developing nanosilver fluoride and silver nanoparticles to overcome the staining. This review gives an overview of the antibacterial mechanism of silver compounds, namely silver nitrate, silver fluoride, SDF, silver nanoparticles, and nano silver fluoride for caries management. The outlook for the future development of silver compounds will be discussed.

ObjectivesThe aim of this study was to analyze the precipitation of Cerium(III)nitrate hexahydrate [Ce(NO3)3] or Samarium(III)nitrate hexahydrate [Sm(NO3)3] solutions on human enamel with and without a salivary pellicle. Investigated parameters were At%Ce and At%Sm measured using energy dispersive x-ray spectroscopy (EDX) after test solution (two concentrations) application.Materials and methodsPrecipitation of Ce(NO3)3 and Sm(NO3)3 solutions was examined on human enamel with and without a salivary pellicle. 6 enamel specimens each were obtained from 12 freshly extracted human third molars. These specimens were ground flat and polished. A salivary pellicle was created on 3 of the 6 specimens per tooth by storing the samples in human saliva. Subsequently, an aqueous solution of Ce(NO3)3 was applied to 2 of the 6 specimens (one with, one without salivary pellicle) for 60 s. The same was carried out with an aqueous solution of Sm(NO3)3 on 2 further specimens. The remaining 2 specimens from each tooth were treated with demineralized water (negative control). Ce(NO3)3 and Sm(NO3)3 solutions were applied at 25 or 50 wt% (aqueous solutions). The test materials and concentrations were distributed using a randomization table. After 60 s exposure and rinsing with demineralized water, the elemental composition (Ce, Sm, Ca, P, O, N, Na, Mg) of the enamel surface was analyzed by EDX. Atomic percentages (At%), differences (ΔAt%) and calcium/phosphorous-ratios (Ca/P-ratios) were calculated and analyzed non-parametrically (α = 0.05).Results2.0–2.3 At%Ce (median) was detected on Ce(NO3)3-treated enamel and 0.4–0.7 At% Sm (median) was detected on Sm(NO3)3-treated enamel. Ce was only detected on the surfaces after application of Ce(NO3)3, Sm only after application of Sm(NO3)3. The Ca/P-ratio was significantly lower (1.37–1.59; p = 0.028) after the application of 25% and 50%Ce(NO3)3 as well as 50%Sm(NO3)3 compared to the control treatment (demineralized water; 1.61–1.63). After treatment with Ce(NO3)3, At%Ca and At%Na were significantly lower (p ≤ 0.043) compared to treatment with Sm(NO3)3. No significant differences were found between specimens treated with 25% or 50% lanthanide nitrate solution. Presence of a salivary pellicle had no significant influence on the measured At% with the exception of specimens treated with 50% Sm(NO3)3 with increased At%Sm (p ≤ 0.046).ConclusionsCe(NO3)3 and Sm(NO3)3 precipitate on human enamel independently of the presence of a salivary pellicle.

BackgroundObesity and caries have become increasingly prevalent. As of yet, research results on the relationship between obesity and caries in children and adolescents have been inconclusive. This study aimed to evaluate the association between caries and obesity in adolescents.MethodsThis was a cross-sectional study of a convenience sample of 187 Puerto Rican adolescents aged 13–19 years, attending, among them, five high schools. Each participant received dental exams for caries using the criteria of the International Caries Detection and Assessment System (ICDAS), had his or her body mass index (BMI) determined, and took a 19-item risk factor questionnaire. The Significant Caries (SiC) index (for DMFT) was calculated to compare obese and healthy adolescents. Statistical analysis was performed using descriptive and inferential statistics.ResultsNearly 60% of the sample population was female, with a mean age of 15.7 (±1.25). The mean BMI percentile was 72.24 (±28.78); 48.66% of the participants had a healthy weight, 19.79% were overweight, and 30.48% were obese. Dental caries was observed in 68% of the participants; the mean caries index D3-6MFS was 5.17(±5.92) and the mean D3-6MFT was 3.59 (±3.97). No significant differences were found between caries indexes and obesity status (P > 0.05). The median (p25, p75) SiC index among overweight/obese adolescents was 9.5 (7, 12), whereas for healthy weight/underweight participants was 7 (5, 8) (p

La caries dental es una enfermedad multifactorial, no transmisible y dinámica, determinada por factores biológicos, conductuales, psicosociales y ambientales. Esta situación puede tener un impacto significativo en la calidad de vida de los niños, ya que puede resultar en dolor, infecciones y dificultades para comer y hablar. Uno de los factores que se ha identificado como contribuyente clave a la caries dental es la alta ingesta de alimentos procesados, especialmente cuando estos son consumidos de manera frecuente y en cantidades excesivas. Objetivo Evaluar la asociación entre caries dental y el consumo de alimentos procesados y no procesados en las loncheras de niños preescolares. Metodología, diseño de investigación cuantitativa, tipo descriptivo, bibliográfica, de campo y conjunta utilizando de instrumento la historian clínica 033, la historia de dieta de la ficha clínica de Odontopediatría y la encuesta validada por expertos de la Facultad. Resultados: de los 50 niños que asistieron a la clínica de la facultad de Odontología, 36 tienen un moderado riesgo de caries, 14 en un alto riesgo y no se encontraron niños con bajo riesgo en la historia dietética que consta en la historia clínica utilizada en la clínica. En el índice ceod de los 50 niños 35 presentan dientes cariados, 6 dientes extraídos y 0 dientes obturados, observando solo 15 niños sanos. Conclusión: lamayoría de los padres envían alimentos procesados que contienen una alta cantidad de azúcares por ello la alta prevalencia de caries debido al poco conocimiento de los padres sobre la relación de las dos variables ya mencionadas.

The objective of this study was to investigate the relationship amongst early childhood caries (ECC), economic development, and dental public health programmes in Hong Kong. We searched exhaustively qualitative and quantitative data on the oral health policy, dental service, public health strategies of caries control and epidemiologic surveys on ECC. We then performed meta-regression to explore the impact of the Human Development Index (HDI), gross domestic product (GDP) growth, water fluoridation, oral health promotion, dental school establishment, free education, and dental workforce on ECC prevalence in 5-year-olds. We found that the first government oral health survey was conducted in 1960, when Hong Kong experienced significant growth, as the HDI indicated. The survey revealed that 97% of 6- to 8-year-old children experienced ECC. Water fluoridation was implemented in 1961 at 0.7 ppm (0.9 ppm in winter) to prevent caries. The government offered free 9-year education in 1978. In 1981, the government established a dental school to improve a low dentist-to-population ratio of 1:9000. The ECC prevalence amongst 5- to 6- year-old children was reduced from 84% in 1968 to 63% in 1986. The Department of Health created an oral health education division in 1989. The ECC prevalence for 5-year-old children was further reduced to 44% in 1997. The ECC prevalence amongst 5-year-old children was stabilised at 51% both in 2001 and 2011. However in 2021, the prevalence of untreated ECC increased to 57% during the outbreak of COVID-19. Meta-regression analysis showed that ECC prevalence was not linked to GDP growth but decreased with improvements in HDI, the provision of 9-year free education, the establishment of a dental school, fluoridation of water supply, and implementation of territory-wide oral health promotion. In conclusion, better education, living conditions, and dental public health programmes have improved children's oral health in Hong Kong.

Objectives: This study aimed to systemically review the tools developed for evaluating oral health–related quality of life (OHRQoL) in preschool children. Methods: Two reviewers systematically searched English-language publications within PubMed, Embase, Scopus, and Web of Science. They screened the titles and abstracts and retrieved the full texts of the selected publications. Studies which developed, validated, or culturally adapted an OHRQoL tool used in preschool children were included. They recorded information regarding tool characteristics, item configuration, discriminative validation, the aim of assessment, and the target group. Results: The study included 59 publications and identified 12 tools for assessing OHRQoL in preschool children. Seven tools were tailored for preschool ages. Most of the scales were generic oral health measures. Dental caries was the most commonly used oral condition for assessing a tool's discriminative validity. Eight tools required parental proxy reports. Three tools were both child-administrated and parent-administrated. One tool was designed to be answered solely by children. Ten tools assessed the oral health–related impact on children, including oral condition–related, functioning, environmental, and emotional/social domains. Four tools included items regarding the impact on both children and family. Conclusions: This review identified 12 tools developed for evaluating OHRQoL in preschool children, 7 of which were tailored for preschool age. The 12 tools were validated but incomprehensive due to the subjective and multidimensional nature of the OHRQoL concept. Researchers can choose a suitable tool for their studies by understanding the basic characteristics and item setting of the tools. Researchers can have an overview of the tools developed for evaluating OHRQoL in preschool children. They can use the findings from this review to choose a suitable tool for their studies regarding the OHRQoL in preschool children.

Abstract Backgrounds The pathogenic microorganisms and clinical manifestations of caries and periodontitis are different, caries and periodontitis are usually discussed separately, and the relationship between them is ignored. Clinically, patients prone to dental caries generally have a healthier periodontal status, whereas patients with periodontitis generally have a lower incidence of dental caries. The relationship between dental caries and periodontitis remains unclear. Objectives This study aimed to explain the clinical phenomenon of antagonism between dental caries and periodontitis by exploring the ecological chain and bacterial interactions in dental caries, periodontitis, and other comorbid diseases. Methods The dental plaque microbiomes of 30 patients with oral diseases (10 each with caries, periodontitis, and comorbid diseases) were sequenced and analysed using 16 S rRNA gene sequencing. The Kyoto Encyclopaedia of Genes and Genomes (KEGG) database was used for a differential functional analysis of dental plaque microbial communities in caries, periodontitis, and comorbid diseases. Results The coinfection group had the greatest bacterial richness in dental plaque. The principal coordinate analysis showed that caries and periodontitis were separate from each other, and comorbid diseases were located at the overlap of caries and periodontitis, with most of them being periodontitis. Simultaneously, we compared the microbiomes with significant differences among the three groups and the correlations between the microbiome samples. In addition, KEGG pathway analysis revealed significant differences in functional changes among the three groups. Conclusions This study revealed the composition of the dental plaque microbial communities in caries, periodontitis, and comorbidities and the differences among the three. Additionally, we identified a possible antagonism between periodontitis and caries. We identified a new treatment strategy for the prediction and diagnosis of caries and periodontitis.

Tobacco smoke contains a variety of harmful chemicals such as tar, benzopyrene, formaldehyde and hydrogen cyanide. These substances can affect both the quality and quantity of saliva, thus disrupting remineralization processes. Smoking can have a significant impact on the inorganic component of saliva and, consequently, can affect its viscosity and degree of mineralization.The aim of this study was to evaluate the impact of smoking and the correlations of some cariogenic risk parameters such as DMFT Index, resting and stimulated salivary flow rate, salivary pH and buffer capacity and micro-crystallization index in smokers using classic and electronic cigarettes. Material and method:The study was performed on 50 patients from the Clinical Base of the Faculty of Dental Medicine, “Grigore T. Popa” University of Iași, Romania with a medium number of carious lesions and a medium carious risk. The patients aged between 19 and 35 years, were divided into five groups (n=10): I – non-smokers, II – light smokers (1-10 classic cigarettes/day), III – moderate smokers (10-20 classic cigarettes/day), IV – high consumption (over 20 classic cigarettes/day) and V – electronic cigarette smokers. Results showed that the DMFT index values were very low in non-smokers while the highest values were reached by the electronic cigarettes users. Regarding the resting and stimulated salivary flow rate, the values decreased significantly in classic cigarettes medium and high consumers and in electronic cigarettes users when compared to non-smokers. When analyzing the pH and buffer capacity values it can be observed that smoking more than 10 cigarettes per day or the use electronic cigarettes can significantly reduce the values. The micro-crystallization index is also reduced in electronic cigarettes smokers or in medium or high classic cigarettes consumers. Conclusions: Consumption of more than 10 classic cigarettes per day or electronic cigarette affects the resting and stimulated salivary flow rate, the salivary pH value, the buffer capacity and the micro-crystallization index. E-cigarette users or smokers of more than 20 cigarettes per day are associated with an increased number of decayed, missing or filled teeth.

Dental caries is a microbe-mediated disease, and immature permanent teeth are more susceptible to caries. The aim of this study was to assess the relationship between diet, caries and oral microbiome in school-aged children and adolescents. Material and method: 25 healthy school-aged children and adolescents filled in a questionnaire regarding food and drink consumption with recognized cariogenic and erosive potential. For each subject, an oral examination was performed, and a sample of dental plaque was collected. Gram staining was used to identify the bacteria strains. Results. The Gram-positive cocci are the predominant bacteria strain in this group. There are changes in diet and oral flora with advancing age. The consumption of sweetened and carbonated drinks is increasing. The number of Gram-positive cocci and bacilli is increasing, while the number of Gram-negative cocci and bacilli is decreasing. Conclusions. This study has found a positive association between caries and the daily consumption of sweets, sweetened drinks, and carbonated drinks. Artificial sweeteners do not have a protective effect against caries in the condition of daily consumption of foods with cariogenic and erosive potential.

Aim: This nationwide study assessed the prevalence and severity of dental caries in 6-, 12-, and 15-year-old school children across Saudi Arabia. This study examined differences between genders and among regions regarding the mean values of decayed, missing, and filled teeth (dmft/DMFT), the care index (CI), and the significant caries index (SiC index). Materials and methods: Data from 19,870 participants, 10,435 males and 9435 females, were collected using stratified multistage cluster random sampling. The survey team divided Saudi Arabia into five regions (northern, eastern, western, southern, and middle). To represent each respective region, a large city, two random towns (peri-urban), and four random rural areas were selected for surveying. Lastly, the sampling technique was applied by choosing random schools and random classes within the selected schools. Dental caries were assessed using the dmft/DMFT score, CI, and the top 30% and 10% of the sample dmft/DMFT scores (SiC30 and SiC10, respectively). Results: The overall prevalence of caries was 65.6%, with 72.1 occurring in primary teeth and 61.7% in permanent teeth. The percentages of individuals with missing teeth and filled teeth were 9.0% and 20.5%, respectively. The mean dmft was 3.93 ± 3.60, while the mean DMFT was 2.42 ± 2.52; most of the DMFT components were significantly higher in females than males, while the dmft components were higher in males. The northern region had the highest and worst DMFT/dmft ratios of the five regions. The mean SiC30 and SiC10 values were significantly higher than the overall average DMFT/dmft values (P

Objective: This study aims to determine the stability, alkalinity, and fluoride and silver ion concentrations of 5 commercially available 38% silver diamine fluoride (SDF) solutions—namely Advantage Arrest, e-SDF, Riva Star, Saforide, and Topamine—in 180 days. Methods: Alkalinity was determined using a pH electrode. The fluoride and silver ion concentrations were obtained using a calibrated ion-selective electrode and optical emission spectrometer, respectively. Six bottles of each product were examined on days 0 (freshly opened), 30, 60, 90, and 180. The time taken for each freshly opened product to form a black silver precipitate under room light (500 lx) and 25 °C was also recorded. Results: For 180 days, Advantage Arrest, e-SDF, Riva Star, Saforide, and Topamine had the pH range of 9.8–9.8, 10.5–10.6, 13.0–13.1, 9.8–9.8, and 9.3–9.4; fluoride ion concentration range (nearest 1000 ppm) of 40.9%–42.4%, 46.7%–50.9%, 37.0%–39.0%, 37.0%–45.7%, and 47.7%–53.4%; silver ion concentration range (nearest 1000 ppm) of 283.4–307.0, 307.3–315.4, 418.6–435.7, 266.3–281.0, and 416.2–456.1 ppm; and precipitation time (nearest hour) of 17, 12, 6, 7, and 7 hours, respectively. The percentage change of fluoride and silver could be more than 5% after 60 days. Conclusions: The alkalinity of the 5 SDF solutions remained stable after 180 days. In addition, their fluoride and silver concentrations decreased substantially after 60 days. The freshly opened SDF solutions did not precipitate within 5 hours under ambient room conditions. The alkalinity and fluoride and silver concentrations of the 38% SDF solutions could be less stable after 60 days; thereafter, the fluoride and silver concentrations decreased. Thus, the SDF solution should be used within 60 days after opening.

Periapical radiographs are routinely used in dental practice for diagnosis and treatment planning purposes. However, they often suffer from artifacts, distortions, and superimpositions, which can lead to potential misinterpretations. Thus, an automated detection system is required to overcome these challenges. Artificial intelligence (AI) has been revolutionizing various fields, including medicine and dentistry, by facilitating the development of intelligent systems that can aid in performing complex tasks such as diagnosis and treatment planning. The purpose of the present study was to verify the diagnostic performance of an AI system for the automatic detection of teeth, caries, implants, restorations, and fixed prosthesis on periapical radiographs. A dataset comprising 1000 periapical radiographs collected from 500 adult patients was analyzed by an AI system and compared with annotations provided by two oral and maxillofacial radiologists. A strong correlation (R > 0.5) was observed between AI perception and observers 1 and 2 in carious teeth (0.7–0.73), implants (0.97–0.98), restored teeth (0.85–0.89), teeth with fixed prosthesis (0.92–0.94), and missing teeth (0.82–0.85). The automatic detection by the AI system was comparable to the oral radiologists and may be useful for automatic identification in periapical radiographs.

ObjectivesThe purpose of this study was to show that optical coherence tomography (OCT) and thermal imaging can be used to monitor changes in the structure and activity of caries lesions over time after treatment with silver diamine fluoride (SDF).MethodsArtificial caries lesions were formed on enamel and dentin bovine blocks. Each block was partitioned into five windows with the central three windows exposed to a demineralization solution to create lesions: one sound window served as a sound control (SC), one sound window was exposed to SDF to serve as a test control (SCT), one lesion window served as a lesion control (LC), one lesion window received one application of SDF (L1), while the other lesion window received two applications of SDF (L2). Each window was scanned using OCT before SDF application, and every week subsequently, for 12 weeks after initial SDF treatment. Changes in the mean intensity and the width of the peak of increased reflectivity due to the lesion and SDF along with the intensity at a depth of 180 µm from the surface representing optical penetration through the lesion were monitored. Changes in the heat lost, ΔQ (temperature integrated over time) of each window during drying with air were also monitored using a thermal imaging camera. Transverse microradiography (TMR), and high-resolution microscopy were also used for the analysis of selected samples.ResultsThe reflectivity and optical penetration of sound and lesion areas of enamel and dentin manifested significant changes in OCT images after SDF application. Thermal imaging showed significant differences in ΔQ indicative of permeability changes in the sound and lesion areas of enamel and dentin after SDF application.

Aim of the study Since a century ago, xylitol, a white, crystalline carbohydrate, has been known as a naturally occurring five-carbon sugar polyol. Its impact on dental caries has been extensively researched during the previous forty years. It can be derived from plant materials rich in xylan, like the wood of birch and beech trees, and is naturally present in fruits, vegetables, and berries. The amount of MS in dental plaque and saliva is reduced because xylitol interferes with the energy-producing processes of Mutans Streptococci (MS), causing their death. It also reduces the adhesion of these microorganisms to the surface of teeth and, as a result, decreases their acid-producing potential. Conclusions Despite all the information available on xylitol, further study is still required to fully understand its mechanisms of action, the clinical implications of xylitol resistance, and how it affects Streptococcus Mutans and the plaque-saliva complex. Properly planned randomised controlled clinical trials must be conducted in conjunction with research to show that xylitol prevention is feasible in a variety of groups with various dietary and dental hygiene practices. It is also necessary to thoroughly confirm the best delivery methods for xylitol and the degree to which it can be “diluted” with other polyols without losing its ability to prevent dental caries. It is necessary to calibrate the minimal daily dose and frequency required for xylitol’s effects on MS, dental plaque, and caries.

Mohamed Skitioui, Dounia Jaoui, Lauzan Haj Khalaf, Babacar Tour&#x00E9Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, MoroccoCorrespondence: Mohamed Skitioui, Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco, Email mohamed.skitioui@uir.ac.maObjective: The aim of this study was to determine the prevalence of mandibular third molar malposition and its impact in relation to the lower second molar using panoramic radiography.Methods and Materials: This was a cross-sectional descriptive study of 353 panoramic images of patients who visited the Dental Clinic of the International University of Rabat. Panoramic images were analyzed in order to determine the number of second molar pathologies associated with the positions of third molars. The following radiographic lesions on the second molar were recorded: caries, root resorption and distal alveolysis. The Chi-square test was used to assess the association between different variables.Results: Of these 353 radiographies, 169 were males, ie, 48%, and 184 were females, ie, 52%. The age range was from 18 to 63 years. The prevalence of the impacted position of the lower third molar was noted in 60%. Distal caries on the second mandibular molar was present in 47.5% of instances having an impacted third molar. Caries was present in 65.5% of wisdom teeth in a normal position and was also present in 79.6% of the impacted teeth. This difference was statistically significant with p = 0.01. The angulation of the third molar is a factor of caries of the second molar: 58.56% of them were carious. Of all the teeth in association with an angulation, 72.03% showed distal alveolysis in the second molar. In addition, root resorption was found in 20.4% of second molars linked to a wisdom tooth in all angulation occurrences.Conclusion: It has been noted that among the pathologies seen on the mandibular second molar, distal alveolysis accounts for the majority of cases (58%), followed by caries (47.5%) and root resorption (13.3%). This study illustrated the importance of performing Orthopantomogram X-rays at each new consultation in patients over the age of 18.Keywords: impacted, partially-erupted, panoramic radiography, mandibular third molar, root resorption, caries, alveolysis, prevalence

Abstract Background Adverse childhood experiences (ACEs) are associated with poor oral health. Using a life course theoretical framework, this study explored the associations of specific and cumulative ACEs with caries and toothbrushing frequency in a Norwegian adolescent population. Methods Participants were adolescents (n = 6351) age 13–17 years from The Young-HUNT4 Survey. Clinical data were retrieved from dental health records. Oral health outcomes were toothbrushing frequency, dentine caries experience (Decayed, Missing, and Filled Teeth – DMFT), and enamel caries. ACE exposure variables were physical abuse, sexual abuse, witness to violence, parental separation/divorce, parental alcohol problems, and bully victimization. Negative binominal regression models (incident rate ratios, IRRs; 95% confidence intervals, CIs) were used to determine the associations of the various ACEs with caries; logistic regression analyses (odds ratios, ORs; 95% CIs) were used to estimate associations with toothbrushing frequency. Potential effect modification by age was assessed using likelihood ratio test. Results Adolescents exposed to physical abuse by others, sexual abuse by peers, parental separation/divorce, bullying, or who had witnessed violence, were more likely to report non-daily toothbrushing compared with those with no exposure to the given ACEs. Each cumulative increase in ACE exposure was associated with a 30% higher likelihood of non-daily toothbrushing (OR 1.30, 95% CI 1.19–1.42). Similarly, increasing number of adversities were associated with both higher dentine caries experience (IRR 1.06, 95% CI 1.02–1.09) and higher enamel caries (IRR 1.07, 95% CI 1.03–1.11). This effect was modified by age (13–15 vs. 16–17 years) for dentine caries experience. Furthermore, there was evidence of effect modification by age with bully victimization for both toothbrushing frequency (Pinteraction = 0.014) and dentine caries experience (Pinteraction < 0.001). Specifically, bully victimization was associated with a higher likelihood of non-daily toothbrushing (OR 2.59, 95% CI 1.80–3.72) and higher dentine caries experience (IRR 1.30, 95% CI 1.14–1.50) among 16–17-year-olds. Conclusions Several specific ACEs were associated with non-daily toothbrushing and a higher caries experience among Norwegian adolescents in the Young-HUNT4 Survey.

Objective: This clinical trial aimed to compare the caries-preventive effect of annual application of 38% silver diamine fluoride solution (SDF) with 5% sodium fluoride varnish (FV) to the anterior primary teeth of children. The hypothesis was that SDF was superior to FV at 1 year. Secondary objectives were to determine the child's cooperation and the parent's satisfaction and assess adverse effects. Method: We recruited 688 3- to 4-year-old children and randomly allocated them to receive SDF or FV (positive control) on their 6 upper anterior teeth. Tooth-surface status was recorded using the decayed, missing, and filled surfaces index. A trained observer rated the child's cooperation as “totally cooperative” or “not totally cooperative.” We used a questionnaire to determine the parent's satisfaction as “satisfied,” “neutral,” or “dissatisfied.” Adverse effects (yes/no) were evaluated 1 day and about 1 year after treatment. Results: Of the children, 434 (SDF, n = 209; FV, n = 225) completed the trial. The mean new decayed tooth surfaces developed for SDF and FV groups were 0.4 ± 1.5 and 0.4 ± 1.3, respectively (P = .65). Child's cooperation for SDF and FV therapy was 71% (244/344) and 70% (241/344), respectively (P = .89). Parent's satisfaction for SDF and FV therapy was 71% (148/209) and 69% (155/225), respectively (P = .29). Adverse effects were found neither at 1 day nor at about 1 year after treatment for either treatment arm. Conclusions: SDF is not superior to FV for caries prevention in primary upper anterior teeth at 1-year follow-up. Child's cooperation and parent's satisfaction were similarly high with SDF and FV therapy at 1-year follow-up. Neither short-term nor long-term adverse effects were observed. This study is registered at ClinicalTrials.gov (NCT04399369).

Early childhood caries (ECC) is prevalent and affects more than half of 5-year-old children in Hong Kong. This study aims to report the development of an outreach dental service using silver diamine fluoride (SDF) to arrest ECC amongst kindergarten children in Hong Kong. A pilot outreach service was initiated in 2008 in 14 kindergartens. The pilot service provided screening to 1,749 3- to 5-year-old children. SDF was applied to 3,262 carious teeth of 786 children with parental consent. No significant complications were reported. The pilot service's success allowed the service to expand to 100 kindergartens in 2013. From 2010 to 2019, the service delivered 161,354 dental screenings and SDF therapy on 218,333 carious primary teeth in 53,821 children. ECC prevalence amongst the participating children declined from 43% in 2010 to 34% in 2019. A follow-up of 222 3-year-old children revealed that annual SDF therapy arrested 67% of ECC over 3 years. The children's participation rate and their parents’ satisfaction rate with the service were greater than 90% each year. Moreover, the acceptance rate of SDF therapy to control ECC was 88%, although SDF stained carious lesions black. No adverse effects of SDF therapy were reported. A cross-sectional survey on a sample of 498 3- to 5-year-old children showed that 96% of the participating children had no dental fear or anxiety in this service, with encouragement and support from their peers and teachers. In 2019, the service was made available to all 1,024 kindergartens in Hong Kong. This kindergarten outreach dental service (Case Study HKU/04/003) was selected as an Impact Case Study in the thematic report “Health & Healthcare” by the Hong Kong University Grant Council (UGC). The UGC publishes thematic reports to give members of the public some concrete idea on what contributions academic research has brought to the society.

Dental health is closely linked to an individual's health and diet. This bioarcheological study presents dental caries and stable isotope data obtained from prehistoric individuals (n = 101) from three Early Neolithic sites (c. 5500-4800 BCE) in central Germany. Dental caries and ante-mortem tooth loss (AMTL) were recorded and related to life history traits such as biological sex and age at death. Further, we correlate evidence on caries to carbon and nitrogen isotope data obtained from 83 individuals to assess the relationship between diet and caries. In 68.3% of the adults, carious lesions were present, with 10.3% of teeth affected. If AMTL is considered, the values increase by about 3%. The prevalence of subadults (18.4%) was significantly lower, with 1.8% carious teeth. The number of carious teeth correlated significantly with age but not sex. The isotopic data indicated an omnivorous terrestrial diet composed of domestic plants and animal derived protein but did not correlate with the prevalence of carious lesions. The combined evidence from caries and isotope analysis suggests a prevalence of starchy foods such as cereals in the diet of these early farmers, which aligns well with observations from other Early Neolithic sites but contrasts to Late Neolithic and Early Bronze Age populations in Germany.

The objective of this prospective 12-month observational study is to examine the oral health-related quality of life (OHRQoL) among Hong Kong young children aged 3–4 years old receiving silver diamine fluoride (SDF) therapy for carious upper anterior primary teeth. A parental questionnaire was used to collect each child’s sociodemographic background and oral health habits at baseline. Data on parents’ satisfaction with their child’s dental aesthetics were collected at baseline and during a 12-month visit. The Chinese Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to measure OHRQoL. A trained dentist performed examinations and recorded caries experience (dmft) and oral hygiene (visible plaque index) at baseline and 12 months. SDF was applied to the carious lesions. Out of 286 invited children, 248 (87%, 248/286) participated, and 211 (85%, 211/248) attended the 12-month examination. All SDF-treated carious lesions were discoloured at the 12-month examination. Regression analysis showed that the baseline C-ECOHIS score was associated with dmft (p < 0.001). The baseline and 12-month C-ECOHIS scores were 4.6 ± 5.5 and 5.0 ± 5.6, respectively (p = 0.42). The scores for parental satisfaction with dental aesthetics at baseline and 12 months were 59% to 46% (p < 0.001). Satisfaction was negatively associated with the number of discoloured upper anterior teeth (p < 0.001). In conclusion, SDF discoloured the carious upper anterior teeth of the Hong Kong kindergarten children. However, the discoloured lesions had no significant effects on the OHRQoL of these children. However, more parents became dissatisfied with their child’s dental aesthetics after SDF therapy. Hence, clinicians should inform parents well before they perform SDF therapy on children.

Silver diamine fluoride (SDF) is a topical solution used for managing dental caries. The mixed-methods study consists of a quantitative study (questionnaire survey) and a qualitative study (in-depth interview) to explore the knowledge, attitudes, and practices towards SDF among dentists in Vietnam. A descriptive approach and a thematic approach were performed to analyze data, respectively. The questionnaire survey invited 436 licensed dentists registered for the national annual dental meeting and 226 dentists participated (response rate: 52%). Among them, 174 (77%, 174/226) dentists knew SDF, and 69 (40%, 69/174) dentists used SDF for caries management. Most of them considered SDF therapy as non-invasive (84%, 146/174) and simple (80%, 140/174). However, most of them expressed concern that SDF could discolor the tooth (74%, 128/174). Their most preferred teeth for SDF therapy were primary posterior teeth (92%, 160/174). The in-depth interview consulted 16 dentists to reach data saturation. They learned about SDF from outside curriculum resources as an effective anti-caries agent. They understood the advantages (simple, non-invasive, timesaving) and disadvantages (tooth discoloring, ammonia odor) of SDF. They used SDF to arrest caries in uncooperative children in the clinic and people living in rural areas in outreach services. Most dentists in Vietnam are supportive of SDF therapy, and they know its advantages and disadvantages for caries management. The results addressed the aim of the study to investigate Vietnamese dentists’ perspectives towards SDF.

Silver diamine fluoride (SDF) is a dental biomaterial used to arrest dental caries. To better understand SDF's mechanism of action, we examined the localization of silver within the tissues of SDF-treated teeth. Carious primary teeth fixed within 2 min of SDF application (SDF-minutes, n = 3), at 3 wk after SDF application in vivo (SDF-weeks, n = 4), and at 2 y after multiple SDF applications in vivo (SDF-multiple, n = 1) were investigated in this study. Carious primary teeth without SDF application (no-SDF, n = 3) served as controls. Mineral density and structural analyses were performed via micro-X-ray computed tomography and scanning electron microscopy. Elemental analyses were performed through X-ray fluorescence microprobe and energy-dispersive X-ray spectroscopic techniques. SDF-treated teeth revealed higher X-ray-attenuated surface and subsurface regions within carious lesions, and similar regions were not present in no-SDF teeth. Regions of higher mineral density correlated with regions of silver abundance in SDF-treated teeth. The SDF penetration depth was approximated to 0.5 ± 0.02 mm and 0.6 ± 0.05 mm (mean ± SD) for SDF-minutes and SDF-weeks specimens, respectively. A higher percentage of dentin tubular occlusion by silver or calcium phosphate particles was observed in primary teeth treated with SDF-weeks as compared with SDF-minutes. Elemental analysis also revealed zinc abundance in carious lesions and around the pulp chamber. SDF-weeks teeth had significantly increased tertiary dentin than SDF-minutes and no-SDF teeth. These results suggest that SDF treatment on primary teeth affected by caries promotes pathologic biomineralization by altering their physicochemical properties, occluding dentin tubules, and increasing tertiary dentin volume. These seemingly serendipitous effects collectively contribute to the cariostatic activity of SDF.