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Zadik Y, Raber-Durlacher JE, Epstein JB, Majorana A, Laheij A, Bardellini E, Blijlevens N, Elad S. MASCC/ISOO Clinical Practice Statement: Management of oral manifestations of chronic graft-versus-host-disease. Support Care Cancer 2024; 32:546. [PMID: 39048807 PMCID: PMC11269426 DOI: 10.1007/s00520-024-08686-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians, which concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the management of oral manifestations of chronic graft-versus-host-disease (cGVHD). METHODS This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and table to generate a short manual about the best standard of care. RESULTS The treatment goals in oral cGVHD are to relieve pain and xerostomia, improve oral function, prevent secondary infection, prevent deterioration of the dentition, and detect malignant transformation as early as possible. The prevention and treatment measures for oral mucosal lesions, hypofunction of the salivary glands, and sclerodermatous changes in the oral and perioral tissues are detailed, as well as the possible complications and side effects of these interventions. CONCLUSIONS Patients post allogeneic hematopoietic cell transplantations, with cGVHD manifest in the oral and perioral tissues, should be regularly monitored and treated as needed by an oral care practitioner. This CPS provides the clinician with practical tools for examining, preventing, and treating the various sequalae that may affect the oral cavity in these patients.
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Affiliation(s)
- Yehuda Zadik
- Department of Oral Medicine, Faculty of Dental Medicine, The Hebrew University of Jerusalem, and Hadassah-University Medical Center, P.O.B. 12272, 9112002, Jerusalem, Israel.
- Saligman Clinics, Faculty of Dental Medicine, The Hebrew University of Jerusalem, and Hadassah-University Medical Center, Jerusalem, Israel.
| | - Judith E Raber-Durlacher
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Joel B Epstein
- Cedars-Sinai Health System, Los Angeles, CA, USA
- Dental Oncology Service, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Alessandra Majorana
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Brescia, Italy
| | - Alexa Laheij
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Elena Bardellini
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Brescia, Italy
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Sharon Elad
- Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
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Sarvas E, Webb J, Landrigan-Ossar M, Yin L. Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report. Pediatrics 2024:e2024067603. [PMID: 39034828 DOI: 10.1542/peds.2024-067603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 07/23/2024] Open
Abstract
Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child's dental home, and advocating for safe and accessible dental procedures.
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Affiliation(s)
| | | | | | - Larry Yin
- Associate Professor of Clinical Pediatrics, Keck School of Medicine of USC and Children's Hospital Los Angeles, Los Angeles, California
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Niemeyer SH, Boss Y, Maniewicz S, Campus G, Tennert C, Carvalho TS, Wierichs RJ. Decision making and management of root caries: A practice-based survey. J Dent 2024; 146:105062. [PMID: 38762078 DOI: 10.1016/j.jdent.2024.105062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES With increasing life expectancy and improved preventive measures, teeth are retained longer, leading to a rise in prevalence of root caries lesions (RCL). However, little is known about how dentists manage this condition. The present survey aimed to evaluate the knowledge of Swiss dentists on decision making and management of RCL. METHOD The survey evaluated dentists' knowledge, clinical routines, and demographics concerning RCL. Dentists were contacted via email and local newsletters, and 383 dentists from 25 (out of 26) cantons responded. Mann-Whitney U test, χ2 test, intraclass correlation coefficients, Spearman correlation and Chi Square were used. RESULTS The dentists had a mean(SD) working experience of 22.5(12) years. Most dentists correctly classified an inactive (67%) and an active (81%)RCL. Although the inactive lesion did not call for restorative treatments, 61% of the dentist declared they would restore it. From the active lesion,83% would restore it. The invasive treatments leaned toward complete caries excavation with composite resin as preferred restorative material. There were significant correlations between material choice and expected success rates. Among the non-invasive options, oral hygiene instructions and (highly-)fluoridated toothpaste were favored. Most dentists declared having a recall system for such patients, with biannual follow-ups preferred. The dentists' place of education significantly influenced restorative decisions (p < 0.001), while participants' age (≥60years) impacted activity status (p = 0.048) and restorative decisions (p = 0.02). CONCLUSION Material preferences for non-invasive or invasive management varied greatly and there were minimal differences in the management of inactive or an active RCL. Moreover, diagnosing active lesions appeared easier than diagnosing inactive ones. CLINICAL SIGNIFICANCE Despite diverse material preferences for (non-)invasive treatments, a strong positive correlation existed between the chosen restorative material and its expected 2-year success rate. Moreover, diagnosing active lesions appeared easier than diagnosing inactive ones. The outcome emphasis the need to align guideline recommendations with their application in private dental practices.
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Affiliation(s)
- Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Switzerland
| | - Yanik Boss
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Switzerland; Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Italy
| | - Christian Tennert
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Switzerland
| | - Thiago S Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Switzerland
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Switzerland.
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Zadik Y. Reflections on Clinical Decision-Making in Contemporary Dental Practice. JAMA Intern Med 2024; 184:714-715. [PMID: 38709528 DOI: 10.1001/jamainternmed.2024.0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Yehuda Zadik
- Department of Oral Medicine, and Saligman Clinics, Faculty of Dental Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
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Menon A, Schroth RJ, Hai-Santiago K, Yerex K, Bertone M. The Canadian dental care plan and the senior population. FRONTIERS IN ORAL HEALTH 2024; 5:1385482. [PMID: 38933118 PMCID: PMC11199732 DOI: 10.3389/froh.2024.1385482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Affiliation(s)
- Anil Menon
- Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Childrens Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Robert J. Schroth
- Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Childrens Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Shared Health Manitoba, Winnipeg, MB, Canada
| | | | - Katherine Yerex
- School of Dental Hygiene, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
| | - Mary Bertone
- Childrens Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
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Hegde D, Suprabha BS, Rao A. Silver modified atraumatic restorative treatment: a paradigm shift in dental caries management. Prim Dent J 2024; 13:29-35. [PMID: 38888074 DOI: 10.1177/20501684241249545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) are treatment modalities that are minimally invasive and used for the prevention and control of dental caries. The amalgamation of these two techniques has led to the development of silver modified atraumatic restorative treatment (SMART). In this approach the carious lesion is restored with glass-ionomer cement (GIC) after SDF application. SMART effectively arrests caries without removing additional tooth structure, making it a promising option for caries management in children who lack cooperative ability.This article reviews the literature on SMART, the evidence regarding its applications in dental practice, its advantages, drawbacks, the scope for research, and clinical use.
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Affiliation(s)
- Damodar Hegde
- Damodar Hegde MDS Former Postgraduate Student, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Baranya Shrikrishna Suprabha MDS Professor and Head, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Arathi Rao MDS Professor and Associate Dean, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Baranya Shrikrishna Suprabha
- Damodar Hegde MDS Former Postgraduate Student, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Baranya Shrikrishna Suprabha MDS Professor and Head, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Arathi Rao MDS Professor and Associate Dean, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Arathi Rao
- Damodar Hegde MDS Former Postgraduate Student, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Baranya Shrikrishna Suprabha MDS Professor and Head, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Arathi Rao MDS Professor and Associate Dean, Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Beresescu L, Stoica AM, Stepco E, Kovacs-Ivacson CA, Vlasa A, Benedek C, Beresescu GF. The Assessment of Resin-Based Composite Sealants' Effectiveness in Arresting Non-Cavitated Dentin Carious Lesions (ICDAS 3)-A 12 Month Follow-Up Preliminary Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:734. [PMID: 38792917 PMCID: PMC11123296 DOI: 10.3390/medicina60050734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: The therapeutic management of carious lesions remains a significant focus for researchers, given their persistently high prevalence despite being largely preventable. This study aimed to compare the effectiveness of a composite resin-based sealant material in halting extended non-cavitated dentin carious lesions when used therapeutically versus preventively on caries-free teeth over a period of twelve months. Materials and Methods: out of the 236 children examined, 45 were excluded from the study due to non-compliance with the inclusion criteria. Thus, the study included 191 children aged 10-12 years, and 764 molars in total. Results: among these molars, 171 were caries-free (ICDAS II code 0), forming the Control group, while 180 molars were classified with an ICDAS II score of 3, forming the Study group. All molars were sealed and evaluated at 6- and 12-month follow-up intervals. Both intervals revealed statistically significant differences (p < 0.05) in sealant retention and carious lesion development between sound (ICDAS code 0) and decayed (ICDAS code 3) teeth. Conclusions: the findings did not support the effectiveness of sealants in halting non-cavitated dentin carious lesions classified as ICDAS II with code 3 compared to their preventive application in sound teeth classified as ICDAS II with code 0.
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Affiliation(s)
- Liana Beresescu
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Alexandra Mihaela Stoica
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Elena Stepco
- Faculty of Dental Medicine, The State University of Medicine and Pharmacy “Nicolae Testemitanu”, MD-2004 Chisinau, Moldova
| | - Csinszka Andrea Kovacs-Ivacson
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Alexandru Vlasa
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Csilla Benedek
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Gabriela Felicia Beresescu
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
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Ruff RR, Barry Godín TJ, Niederman R. Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence: A Randomized Clinical Trial. JAMA Pediatr 2024; 178:354-361. [PMID: 38436947 PMCID: PMC10913007 DOI: 10.1001/jamapediatrics.2023.6770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 03/05/2024]
Abstract
Importance Dental caries is the world's most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure. Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment. Objective To determine whether school-based application of SDF is noninferior to dental sealants and atraumatic restorative treatment (ART) in the prevalence of dental caries. Design, Setting, and Participants The Silver Diamine Fluoride Versus Therapeutic Sealants for the Arrest and Prevention of Dental Caries in Low-Income Minority Children (CariedAway) study was a pragmatic noninferiority cluster-randomized clinical trial conducted from February 2018 to June 2023 to compare silver diamine fluoride vs therapeutic sealants for the arrest and prevention of dental caries. Children at primary schools in New York, New York, with at least 50% of the student population reporting as Black or Hispanic and at least 80% receiving free or reduced lunch were included. This population was selected as they are at the highest risk of caries in New York. Students were randomized to receive either SDF or sealant with ART; those aged 5 to 13 years were included in the analysis. Treatment was provided at every visit based on need, and the number of visits varied by child. Schools with preexisting oral health programs were excluded, as were children who did not speak English. Of 17 741 students assessed for eligibility, 7418 were randomized, and 4100 completed follow-up and were included in the final analysis. Interventions Participants were randomized at the school level to receive either a 38% concentration SDF solution or glass ionomer sealants and ART. Each participant also received fluoride varnish. Main Outcomes and Measures Primary study outcomes were the prevalence and incidence of dental caries. Results A total of 7418 children (mean [SD] age, 7.58 [1.90] years; 4006 [54.0%] female; 125 [1.7%] Asian, 1246 [16.8%] Black, 3648 [49.2%] Hispanic, 153 [2.1%] White, 114 [1.5%] multiple races or ethnicities, 90 [1.2%] other [unspecified], 2042 [27.5%] unreported) were enrolled and randomized to receive either SDF (n = 3739) or sealants with ART (n = 3679). After initial treatment, 4100 participants (55.0%) completed at least 1 follow-up observation. The overall baseline prevalence of dental caries was approximately 27.2% (95% CI, 25.7-28.6). The odds of decay prevalence decreased longitudinally (odds ratio [OR], 0.79; 95% CI, 0.75-0.83) and SDF was noninferior compared to sealants and ART (OR, 0.94; 95% CI, 0.80-1.11). The crude incidence of dental caries in children treated with SDF was 10.2 per 1000 tooth-years vs 9.8 per 1000 tooth-years in children treated with sealants and ART (rate ratio, 1.05; 95% CI, 0.97-1.12). Conclusions and Relevance In this school-based pragmatic randomized clinical trial, application of SDF resulted in nearly identical caries incidence compared to dental sealants and ART and was noninferior in the longitudinal prevalence of caries. These findings suggest that SDF may provide an effective alternative for use in school caries prevention. Trial Registration ClinicalTrials.gov Identifier: NCT03442309.
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Affiliation(s)
- Ryan Richard Ruff
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York
- New York University School of Global Public Health, New York
| | - Tamarinda J. Barry Godín
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York
| | - Richard Niederman
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York
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Tassery H, Miletic I, Turkun LS, Sauro S, Gurgan S, Banerjee A, Basso M, Khelafia S, Terrer E, Pilliol V, Slimani A. Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions. Br Dent J 2024; 236:603-610. [PMID: 38671111 DOI: 10.1038/s41415-024-7292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 04/28/2024]
Abstract
Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.
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Affiliation(s)
- Hervé Tassery
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France; LBN, Université de Montpellier, UR-UM104, Montpellier, France.
| | - Ivana Miletic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva ul. 5, 10000 Zagreb, Croatia
| | - Lezize Sebnem Turkun
- Department of Restorative Dentistry, Ege University School of Dentistry, Izmir 35040, Turkey
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, CEU Cardenal Herrera University, CEU Universities, 46115 Valencia, Spain; Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Avijit Banerjee
- Conservative and Minimally Invasive Dentistry, Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, SE1 9RT, UK
| | - Matteo Basso
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Saber Khelafia
- Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Elodie Terrer
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Virginie Pilliol
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Amel Slimani
- LBN, Université de Montpellier, UR-UM104, Montpellier, France; Faculté d'Odontologie, Université de Montpellier, 34193 Montpellier, France
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Wierichs RJ, Kaspari I, Maniewicz S, Campus G, Tennert C, Carvalho TS, Niemeyer SH. Diagnosing and recording root caries: A survey among Swiss dentists. J Dent 2024; 142:104870. [PMID: 38311018 DOI: 10.1016/j.jdent.2024.104870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/06/2024] Open
Abstract
OBJECTIVES Despite the increase in the root caries prevalence, little is still known about how dentists manage this condition. The present study aimed to evaluate the knowledge of dentists on diagnosing and recording root caries lesions (RCL). METHODS The survey consisted of three domains: (1) dentists' knowledge on diagnosing, recording and managing RCL; (2) information about their current general clinical routines; and (3) their demographics. The four Swiss Universities distributed the survey via e-mail lists for alumni or professionals participating in continuing education. The data was quality checked. Construct validity, internal reliability and intraclass correlation (ICC) were assessed. RESULTS The survey was answered by 383 dentists from 25(out of 26) cantons [mean(SD) working experience: 22.5(12) years]. The majority replied that they see less than 5 patients with RCL per week, whereas 41 have at least 5 per week, and 40 % (157 dentists) do not distinguish RCL from coronal caries in their patients' medical records. When diagnosing active RCL, tactile sensation was the most predominant criterion (n = 380), whereas color (n = 224) and visual appearance (n = 129) of the lesion were less often selected. The most often chosen risk factors for RCL were poor oral hygiene and presence of biofilm.The responses were significantly influenced by the participants' place of education, their age and working area. CONCLUSION The present survey highlights the huge diversity in diagnosing, recording and assessing risk factors of RCL. The benefits of an appropriate diagnosis, recording and management of risk factors of RCL should be highlighted in under- and postgraduate dental education. CLINICAL SIGNIFICANCE A great diversity in diagnosing, recording and assessing risk factors of RCL was observed, which migh strongly impact how dentists manage RCL. The study emphasizes the necessity for intensive efforts to bridge the gap between guideline recommendations and their implementation in private dental practices.
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Affiliation(s)
- Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, Bern CH-3010, Switzerland.
| | - Isabelle Kaspari
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, Bern CH-3010, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, Bern CH-3010, Switzerland; Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Italy
| | - Christian Tennert
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, Bern CH-3010, Switzerland
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, Bern CH-3010, Switzerland
| | - Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, Bern CH-3010, Switzerland
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Lee G, Zhang Y, Yang Q, Angley M, Lu L, Kahe K. The Association between Lead Exposure and Dental Caries: A Systematic Review. Caries Res 2024; 58:141-152. [PMID: 38354711 DOI: 10.1159/000537826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/12/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Dental caries has declined over the years, but it remains a major public health issue. This review aimed to investigate the association between lead (Pb) and caries experience in either deciduous or permanent teeth. METHODS A comprehensive search of PubMed, Embase, and Google Scholar was conducted to identify relevant studies published up until December 2022. Included were human observational studies that investigated the association between Pb exposure and dental caries. The review adhered to the PRISMA guideline. RESULTS Sixteen studies were included in this review, with nine focusing on deciduous teeth, thirteen on permanent teeth, and six examining both types of teeth. Most of the studies (5 of 6) found a positive association between blood lead (PbB) levels and caries in deciduous teeth, while the findings for permanent teeth were less conclusive, with only 3 of 10 studies finding an association. One of the two studies assessing salivary lead levels found a weak association for permanent teeth. All four studies that measured Pb concentration from teeth found a positive association for both deciduous and permanent teeth. CONCLUSION Many published studies have indicated a positive association between Pb exposure and caries experience in deciduous dentition. Children with elevated PbB level should be considered having higher caries experience. Due to lack of consensus on measurement and examination technique, there remains insufficient evidence to make any definitive conclusions, especially in permanent dentition, and so more studies are warranted.
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Affiliation(s)
- Gajin Lee
- College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Yijia Zhang
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Qiannan Yang
- College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Meghan Angley
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Liping Lu
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Ka Kahe
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Lipsky MS, Singh T, Zakeri G, Hung M. Oral Health and Older Adults: A Narrative Review. Dent J (Basel) 2024; 12:30. [PMID: 38392234 PMCID: PMC10887726 DOI: 10.3390/dj12020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Oral health's association with general health, morbidity, and mortality in older adults highlights its importance for healthy aging. Poor oral health is not an inevitable consequence of aging, and a proactive, multidisciplinary approach to early recognition and treatment of common pathologies increases the likelihood of maintaining good oral health. Some individuals may not have regular access to a dentist, and opportunities to improve oral health may be lost if health professionals fail to appreciate the importance of oral health on overall well-being and quality of life. The authors of this narrative review examined government websites, the American Dental Association Aging and Dental Health website, and the Healthy People 2030 oral objectives and identified xerostomia, edentulism, caries, periodontitis, and oral cancer as five key topics for the non-dental provider. These conditions are associated with nutritional deficiencies, poorer quality of life, increased risk of disease development and poorer outcomes for cardiovascular disease, diabetes, and other systemic conditions prevalent among older adults. It is important to note that there is a bi-directional dimension to oral health and chronic diseases, underscoring the value of a multidisciplinary approach to maintaining oral health in older adults.
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Affiliation(s)
- Martin S Lipsky
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
- College of Urban and Public Affairs, Portland State University, Portland, OR 97201, USA
| | - Tejasvi Singh
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Golnoush Zakeri
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
- Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA
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13
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Souza TF, Leonel Martins M, Jural LA, Maciel IP, Magno MB, da Silva Coqueiro R, Pithon MM, Leal SC, Fonseca-Gonçalves A, Maia LC. Brazilian dentist's knowledge of minimum intervention dentistry for caries management: application of a developed knowledge scale (MIDDeC-KS) and evaluation of its psychometric properties. Eur Arch Paediatr Dent 2024; 25:27-38. [PMID: 37770814 DOI: 10.1007/s40368-023-00844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 09/02/2023] [Indexed: 09/30/2023]
Abstract
AIM To assess the knowledge of Brazilian dentists about Minimum Intervention (MI) using a Minimum Intervention Dentistry to Dental Caries-Knowledge Scale (MIDDeC-KS) and evaluate its psychometric properties. MATERIALS AND METHODS An online scale was developed to evaluate dentists' knowledge about MI. The higher the score, the greater the knowledge and vice versa. A preliminary study was carried out with 143 dentists to validate the MIDDeC-KS. For psychometric properties analysis, convergent and discriminant validity, test-retest reliability, and internal consistency of the instrument were assessed. After validation, MIDDeC-KS was applied to a representative sample of Brazilian dentists. T test for independent samples, Chi-square, and/or ANOVA one-way tests were applied. RESULTS The MIDDeC-KS convergent (Spearman's = 0.48) and discriminant (P = 0.001) validity and reliability (ICC = 0.85, α = 0.72 and ω = 0.74) were proved. The participants (n = 637) obtained an overall mean score of 7.4 ± 2.5. The sample was mainly composed of females (P < 0.01), who graduated over 10 years prior (P = 0.02), from public colleges (P < 0.01), and most were pediatric dentists (38.2%). The highest and lowest scores were reached by pediatric dentists (9.2 ± 1.6) and bucomaxillofacial professionals (3.1 ± 2.1), respectively. Brazilian dentists demonstrated more knowledge about diet, biofilm, and topical fluoride control (84.3%), while the Hall technique (31.9%), resin infiltrant (47.6%), and chemical mechanical caries removal (48.4%) were the least known MI techniques. CONCLUSION Brazilian dentists demonstrated more knowledge about preventive measures and less about more recent protocols, such as the Hall technique, resin infiltrant, and chemical mechanical caries tissue removal. Sufficient psychometric evidence of the MIDDeC-KS was found. CLINICAL RELEVANCE Identify dentist's knowledge about MI.
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Affiliation(s)
- T F Souza
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - M Leonel Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - L A Jural
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - I P Maciel
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - M B Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - R da Silva Coqueiro
- Department of Health I, Universidade Estadual Do Sudoeste da Bahia (UESB), Jequié, Bahia, Brazil
| | - M M Pithon
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - S C Leal
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - A Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - L C Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil.
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Levesque J, Ghotra S, Mittermuller BA, DeMaré D, Lee VHK, Cruz de Jesus V, Olatosi OO, Alai-Towfigh H, Schroth RJ. Canadian dentists' awareness and views on early childhood caries and its prevention and management. FRONTIERS IN ORAL HEALTH 2024; 4:1268350. [PMID: 38260718 PMCID: PMC10800460 DOI: 10.3389/froh.2023.1268350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The Canadian Dental Association (CDA) recommends children visit a dentist within 6 months of the eruption of their first tooth or by 12 months of age. The aim of this study was to investigate Canadian dentists' awareness and views on early childhood caries (ECC) and its prevention and management. Methods This study analyzed a subset of questions relating to dentists' knowledge of ECC and prevention strategies, from a national survey of general and pediatric dentists, commissioned by the CDA in 2013. Analyses included descriptive, bivariate, and multivariate analyses. A p-value of ≤0.05 was considered significant. Results Three thousand two hundred thirty-two out of 14,747 dentists responded (response rate of 21.9%), with 95.1% having heard of ECC. Overall, 60.9% of respondents reported that they were comfortable providing treatment to children with ECC. Significant differences were found between the number of years in practice and whether dentists were or were not comfortable providing prevention (19.5 ± 12.6 years vs. 25.4 ± 12.1 years; p < 0.001) or treatment for patients with ECC (19.1 ± 12.7 years vs. 22.5 ± 12.3 years; p < 0.001). Pediatric dentists (OR = 6.92; 95% CI: 2.57, 18.61), female dentists (OR = 1.13; 95% CI: 1.03, 1.24), dentists practicing in smaller urban areas (OR = 1.17; 95% CI: 1.07, 1.28), and dentists who were aware of the CDA's position on ECC (OR = 1.26; 95% CI: 1.13, 1.41) were more likely to be comfortable providing treatment for children with ECC. Conclusions While the majority of Canadian dentists have sufficient knowledge of ECC, not all are comfortable providing oral health care services to children at a young age. It is encouraging however, that most dentists are wanting additional oral health resources designed for education on ECC prevention for parents of young children.
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Affiliation(s)
- Joshua Levesque
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Suhird Ghotra
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Betty-Anne Mittermuller
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Daniella DeMaré
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Victor H. K. Lee
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Vivianne Cruz de Jesus
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Oral Biology, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Olubukola O. Olatosi
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Oral Biology, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Hamideh Alai-Towfigh
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Robert J. Schroth
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Shared Health Inc., Winnipeg, MB, Canada
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15
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Sartori CHM, Mazzetti T, Júnior FAV, Daneris ÂP, Cenci MS, van de Sande FH, Montagner AF. Methodological quality of evidence-based clinical practice guidelines in cariology. Clin Oral Investig 2023; 28:66. [PMID: 38159154 DOI: 10.1007/s00784-023-05429-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The present study aimed to appraise the methodological quality of evidence-based Clinical Practice Guidelines (CPGs) in the cariology field. MATERIALS AND METHODS A systematic search on electronic databases (MEDLINE/Pubmed, EMBASE, DARE and Epistemonikos), websites, and guideline organizations were undertaken. Evidence-based CPGs including at least one recommendation for clinical prevention and/or management of dental caries, developed for any clinical setting, were included. The quality of each guideline was evaluated using the AGREE II tool. Descriptive analysis was performed and the average overall score for each domain was calculated. RESULTS Thirty-two guidelines were included. Most of the CPGs achieved higher scores for the domains of clarity of presentation (66.7%, 95% IC 37.3-52.2) and scope and purpose (59.6%, 95% IC 53.7-65.5) domains; and lower scores for editorial independence (46.1%, 95% IC 37.8-55.7) and applicability domain (44.7%, 95% IC 37-55.3). The reviewers assessed 12 CPGs (37.5%) as recommended for use, 15 (46.9%) recommended with modifications, and 5 (15.6%) as not recommended. CONCLUSION The overall methodological quality of evidence-based CPGs in the cariology field is moderate, and there is a need for improvements in reporting related to most domains. The poorest reporting was found in the description of the domains' applicability of its recommendations and editorial independence. CLINICAL RELEVANCE Clinical Practice Guidelines provide guidance to patients, healthcare professionals, and stakeholders. The quality of these documents is essential for establishing trust in their recommendations.
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Affiliation(s)
| | - Thais Mazzetti
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | | | | | - Maximiliano Sérgio Cenci
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Françoise Hélène van de Sande
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
| | - Anelise Fernandes Montagner
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil.
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Fujita Y. Comparison of the Knowledge, Attitudes, and Practices Regarding Silver Diamine Fluoride (SDF) between Japanese Dental Students with Experience Using SDF and Those with No Experience Using SDF: A Cross-Sectional Study. Dent J (Basel) 2023; 11:282. [PMID: 38132420 PMCID: PMC10742726 DOI: 10.3390/dj11120282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/17/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the differences in the knowledge and attitude regarding silver diamine fluoride (SDF) between two groups, differentiated by whether they had experience in SDF use, of dental students and clinical trainee dentists in Japan. METHODS A survey was designed consisting of three dental classes (fourth, fifth, and sixth years) and clinical trainees at Kyushu Dental University. A survey was designed consisting of 32 questions about the knowledge, attitudes, esthetic acceptability, and potential barriers regarding the use of SDF. RESULTS A total of 286 surveys (response rate of 85.4%) were collected. Among all respondents, 21.7% had experience with SDF use in their clinical practice. Regarding the knowledge score for SDF (0 to 12 points), in the respondents with no experience of using SDF, the mean score was 3.06, and that of respondents with experience of using SDF was 1.66, which was a significant difference (p < 0.001). The mean esthetic acceptability score for SDF use (-8 to 8 points) of the clinical trainees was -1.00 and that of the fourth-year students was 0.74, which was a significant difference (p < 0.05). CONCLUSIONS the results indicate that dental students and clinical trainees need to increase their clinical experience with SDF.
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Affiliation(s)
- Yuko Fujita
- Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, Kitakyushu City 803-8580, Japan
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17
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Abudrya M, Splieth CH, Mourad MS, Santamaría RM. Efficacy of Different Fluoride Therapies on Hypersensitive Carious Lesions in Primary Teeth. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2042. [PMID: 38004091 PMCID: PMC10672976 DOI: 10.3390/medicina59112042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: This prospective, comparative, double-cohort study aimed to compare the efficacy of silver diamine fluoride and potassium iodide (38% SDF+KI; Riva Star®) with sodium fluoride varnish (5% NaF; Duraphat®) in hypersensitive carious lesions in primary teeth to evaluate caries arrest and hypersensitivity relief. Materials and Methods: This study included thirty 2-5-year-olds (mean age = 3.67 ± 1.06 years; 16 males and 14 females) who required a desensitizing treatment for hypersensitive carious defects with visible dentin. A total of 15 of the participants were consecutively allocated to treatment with 5% NaF, and they were further compared to an equal number of participants treated with 38% SDF+KI solutions (n = 15). The treatments were performed following clinical evaluation of caries activity using the International Caries Classification and Management System (ICCMSTM) and the Bjørndal criteria (score of 0-9). Parental-reported hypersensitivity was evaluated using a visual analogue scale (0-10 = no to severe pain). Results: Clinical variables were evaluated at baseline and three months after treatment. Thereafter, a significant decline in hypersensitivity/pain led to lower final scores in the Riva Star® group (0.40 ± 1.12, p = 0.002) than in the Duraphat® group (1.40 ± 2.20, p = 0.004). The caries arrest effect was significantly higher in the Riva Star® group (86.7%) compared to the Duraphat® group three months after treatment (13.3%, p < 0.001). In both groups, there were no statistically significant differences in the children's behavior before, during, and after treatment. Conclusions: Ultimately, with both fluoride therapies reducing hypersensitivity/pain significantly, treatment with 38% SDF+KI was clearly more effective in caries arrest than 5% NaF varnish after a 3-month period.
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Affiliation(s)
- Mohamed Abudrya
- Department of Preventive and Pediatric Dentistry, University Medicine of Greifswald, 17475 Greifswald, Germany; (M.A.); (C.H.S.); (M.S.M.)
| | - Christian H. Splieth
- Department of Preventive and Pediatric Dentistry, University Medicine of Greifswald, 17475 Greifswald, Germany; (M.A.); (C.H.S.); (M.S.M.)
| | - Mhd Said Mourad
- Department of Preventive and Pediatric Dentistry, University Medicine of Greifswald, 17475 Greifswald, Germany; (M.A.); (C.H.S.); (M.S.M.)
- Department of Orthodontics, University Medicine of Greifswald, 17475 Greifswald, Germany
| | - Ruth M. Santamaría
- Department of Preventive and Pediatric Dentistry, University Medicine of Greifswald, 17475 Greifswald, Germany; (M.A.); (C.H.S.); (M.S.M.)
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Silva CAM, de Sousa FB, Martinez-Mier EA, Vieira BR, do Nascimento JM, Hara AT. Fluorotic Enamel Susceptibility to Dental Erosion and Fluoride Treatment. Braz Dent J 2023; 34:75-81. [PMID: 38133094 PMCID: PMC10742357 DOI: 10.1590/0103-6440202305595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
The purpose of this in vitro study was to test the hypothesis that fluoride treatment can prevent dental erosion on fluorotic enamel of different severities. It followed a 3×2 factorial design, considering a) fluorosis severity: sound (TF0, Thylstrup-Fejerskov Index), mild (TF1-2), moderate (TF3-4); and b) fluoride treatment: 0 (negative control) and 1150ppmF. Human molars with the three fluorosis severities (n=16, each) were selected and randomly assigned to the two fluoride treatments (n=8). Enamel blocks (4×4mm) were prepared from each tooth and subjected to a dental erosion cycling model, for 10 days. The daily cycling protocol consisted of erosive challenges (1% citric acid, pH 2.4), interspersed by periods of immersion in artificial saliva, and three 2-minute treatments with either 0 or 1150ppm F. The enamel volume loss (mm3) was calculated by subtracting values obtained by microtomography before and after cycling. Two-Way ANOVA showed no significant interaction between fluorosis severity and fluoride treatment (p=0.691), and no significant effect for either fluorosis severity (TF0 mean±standard-deviation: 13.5(10-2±0.42(10-2, TF1-2: 1.50(10-2±0.52(10-2, TF3-4: 1.24(10-2±0.52(10-2, p=0.416) or treatment (0ppmF: 1.49(10-2±0.53(10-2; 1150ppmF: 1.21(10-2±0.42(10-2; p=0.093), when evaluated independently. Considering the limitations of this in vitro study, the presence and severity of fluorosis in enamel do not appear to affect its susceptibility to dental erosion. Fluoride treatment was not effective in preventing the development of dental erosion in both sound and fluorotic enamel substrates under our experimental conditions.
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Affiliation(s)
| | - Frederico Barbosa de Sousa
- Department of Morphology, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Paraíba, Brazil
| | - Esperanza Angeles Martinez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | | | | | - Anderson Takeo Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
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Lu D, Li F, Zhao C, Ye Y, Zhang X, Yang P, Zhang X. A Remineralizing and Antibacterial Coating for Arresting Caries. J Dent Res 2023; 102:1315-1325. [PMID: 37697863 DOI: 10.1177/00220345231189992] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
Dental caries is a dynamic disease induced by the unbalance between demineralization of dental hard tissues caused by biofilm and remineralization of them; however, although various effective remineralization methods have been well documented, it is a challenge to reestablish the balance by enhancing remineralization alone while ignoring the antibacterial therapy. Therefore, the integration of remineralizing and antibacterial technologies offers a promising strategy to halt natural caries progression in clinical practice. Here, the conception of interrupting dental caries (IDC) was proposed based on the development of dual-functional coating with remineralizing and antibacterial properties. In this study, bovine serum albumin (BSA) loaded octenidine (OCT) successfully to form a BSA-OCT composite. Subsequently, through fast amyloid-like aggregation, the phase-transited BSA-OCT (PTB-OCT) coating can be covered on teeth, resin composite, or sealant surfaces in 30 min by a simple smearing process. The PTB-OCT coating showed satisfactory effects in promoting the remineralization of demineralized enamel and dentin in vitro. Moreover, this coating also exerted significant acid-resistance stability and anti-biofilm properties. Equally importantly, this coating exhibited promising abilities in reducing the microleakage between the tooth and resin composite in vitro and preventing primary and secondary caries in vivo. In conclusion, this novel dual-functional PTB-OCT coating could reestablish the balance between demineralization and remineralization in the process of caries, thereby potentially preventing or arresting caries.
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Affiliation(s)
- D Lu
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - F Li
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - C Zhao
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - Y Ye
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - X Zhang
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
| | - P Yang
- Key Laboratory of Applied Surface and Colloid Chemistry Ministry of Education, School of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi'an, China
| | - X Zhang
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, Tianjin, China
- Institute of Stomatology, Tianjin Medical University, Tianjin, China
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Wnuk K, Świtalski J, Miazga W, Tatara T, Religioni U, Gujski M. Evaluation of the effectiveness of prophylactic sealing of pits and fissures of permanent teeth with fissure sealants - umbrella review. BMC Oral Health 2023; 23:806. [PMID: 37891656 PMCID: PMC10612169 DOI: 10.1186/s12903-023-03499-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue destruction. In addition to proper oral hygiene, prophylactic sealing of fissures and cavities with a sealant is a method of preventing the development of caries. The aim of this study is to summarise the effectiveness of fissure sealing of permanent teeth with fissure sealants compared to other preventive methods or no intervention. METHOD An umbrella review was carried out to achieve the purpose of our study. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. Quality assessment of the included studies was performed using the AMSTAR2 tool. In addition, a manual search for recommendations/clinical practice guidelines on dental prophylaxis was performed. RESULTS 204 publications were identified, of which 15 met the inclusion criteria. Based on the results of 3 systematic reviews, there was a statistically significant reduced odds of caries occurrence or development with prophylactic sealing of permanent teeth compared with no intervention - depending on the review and follow-up period odds ratio (OR) ranged from 0.06 [95%CI: (0.01-0.32)] to 0.28 [95%CI: (0.20-0.38)]. In the eight systematic reviews that analysed different sealants, there were no statistically significant differences between the types of materials used for prophylactic tooth sealing. For systematic reviews comparing the efficacy of fissure sealants with fluoride varnish, three reported no statistically significant difference in the efficacy of caries incidence, with only one systematic review based on 1 RCT finding a statistically significant difference in favour of fissure sealants. CONCLUSION Compared to the no intervention, dental sealing is an effective method for the prevention of dental caries. However, it is not possible to conclude conclusively which type of sealant and which of the available prophylactic methods is more effective in preventing caries.
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Affiliation(s)
- Katarzyna Wnuk
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, Warsaw, 00032, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, Warsaw, 01826, Poland
| | - Jakub Świtalski
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, Warsaw, 00032, Poland
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, 01445, Poland
| | - Wojciech Miazga
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, Warsaw, 00032, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, Warsaw, 01826, Poland
| | - Tomasz Tatara
- Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, Warsaw, 00032, Poland.
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, 02091, Poland.
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, Warsaw, 01826, Poland.
| | - Mariusz Gujski
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, 02091, Poland
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21
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Vidal CMP, Carrilho MR. Dentin Degradation: From Tissue Breakdown to Possibilities for Therapeutic Intervention. CURRENT ORAL HEALTH REPORTS 2023; 10:99-110. [PMID: 37928132 PMCID: PMC10624336 DOI: 10.1007/s40496-023-00341-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 11/07/2023]
Abstract
Purpose of the Review Presently, dental materials science is driven by the search for new and improved materials that can trigger specific reactions from the affected tissue to stimulate repair or regeneration while interacting with the oral environment to promote or maintain oral health. In parallel, evidence from the past decades has challenged the exclusive role of bacteria in dentin tissue degradation in caries, questioning our understanding of caries etiopathogenesis. The goal of this review is to recapitulate the current evidence on the host and bacterial contributions to degradation, inflammation, and repair of the dentin-pulp complex in caries. Recent Findings Contrasting findings attribute dentin breakdown to the activity of endogenous enzymes, such as matrix metalloproteinases (MMPs) and cathepsins, while the role of bacteria and their by-products in the destruction of dentin organic matrix and pulp inflammation has been for decades supported as an incontestable paradigm. Aiming to better understand the mechanisms involved in collagen degradation by host enzymes in caries, studies have showed that these proteinases are expressed in the mature dentin (i.e., after dentin formation) and become activated by the low pH in the acidic environment resulted by bacterial metabolism in caries. However, different host sources other than dentin-bound proteinases seem to also contribute to caries progression, such as saliva and pulp. Interestingly, studies evaluating pulp responses to bacteria invasion and inflammation in caries report higher levels of MMPs and cathepsins in inflamed tissue, but also showed MMP potential to resolve inflammation and stimulate wound healing. Notably, as reported for other tissues, MMPs exert dual roles in the dentin-pulp complex in caries, participating or regulating both degradative and reparative mechanisms. Summary The specific roles of host and bacteria and their by-products in caries progression have yet to be clarified. The complex interactions between inflammation and repair in caries pose challenges to a clear understanding of the dentin-pulp complex responses and changes to bacteria invasion. However, it opens new venues for the development of novel therapies and dental biomaterials based on the modulation of specific mechanisms to favor tissue repair and healing.
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Affiliation(s)
- Cristina M. P. Vidal
- Department of Operative Dentistry, College of Dentistry, The University of Iowa, 801 Newton Road, DSB S245, Iowa City, IA 52242, USA
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22
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Hoxie AM, Neves ADA, Moss K, de Vasconcellos AB, Zandona AF, Ribeiro AA. Microcomputed Tomography Mineral Density Profile as Reference Standard for Early Carious Lesion Activity Assessment. Caries Res 2023; 57:220-230. [PMID: 37586341 PMCID: PMC10641798 DOI: 10.1159/000533563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 08/08/2023] [Indexed: 08/18/2023] Open
Abstract
Early caries diagnosis is crucial to treatment decisions in dentistry and requires identification of lesion activity: whether a carious lesion is active (progressively demineralizing) or arrested (progressively remineralizing). This study aimed to identify microtomographic (micro-CT) differences between active and arrested smooth surface enamel lesions, to quantify those micro-CT differences by creating thresholds for ex vivo caries activity assessment to serve as a future reference standard, and to validate those thresholds against the remaining sample. Extracted human permanent teeth (n = 59) were selected for sound surfaces and non-cavitated smooth surface carious lesions. Each surface was then examined for caries activity by calibrated individuals via visual-tactile examination using the International Caries Classification and Management System (ICCMS) activity criteria. Each tooth was scanned via micro-CT and the mineral density was plotted against lesion depth. The area under the curve (AUC) was calculated and represented the loss of density for the outermost 96 μm of enamel. AUC thresholds obtained from micro-CT were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner's lesion assessment of sound, inactive, and active lesions, respectively. The established AUC thresholds demonstrated moderate agreement with the assessment in identifying demineralized lesions (k = 0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrated quantifiable differences among demineralized lesions, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and laboratorial dental caries evaluations.
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Affiliation(s)
- Adam Michael Hoxie
- Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Craniofacial and Surical Care, Department of Orthodontics, UNC Adams School of Dentistry, Chapel Hill, NC, USA
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Kevin Moss
- Statistics, Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adalberto Bastos de Vasconcellos
- Division of Comprehensive Oral Health, Operative Dentistry, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrea Ferreira Zandona
- Department of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Apoena Aguiar Ribeiro
- Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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AlKhodier H, Molla G, AlAjaji N, Alkanhal NA, AlSaykhan M. A Wider Scope of Analysis on 38% Silver Diamine Fluoride. Cureus 2023; 15:e44010. [PMID: 37746492 PMCID: PMC10517233 DOI: 10.7759/cureus.44010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
This research was conducted to further support previous studies on the effectiveness of 38% silver diamine fluoride on caries arrest. In addition, the number of applications, time between subsequent applications, type of teeth (primary vs. permanent), final restoration following treatment, and the type of restoration, if any, were assessed. It is a retrospective longitudinal study that was conducted using a chart review technique for which a waiver of informed consent was obtained. The research participants' privacy was ensured and protected. All participants' identities remained anonymous and confidential. Furthermore, consent was collected from participants' sitters during their appointments as a protocol prior to applying 38% silver diamine fluoride (SDF). The current research was reviewed and approved by the Research Ethics Committee at King Faisal Specialist Hospital and Research Center (KFSH&RC). All investigators abided by the rules and regulations of the Government of Saudi Arabia, KFSH&RC, and the Research Advisory Council. A population of pediatric patients with primary and/or mixed dentition at a tertiary care hospital who were treated at the dental office between the period from March 2020 to December 2022 were recruited. A consecutive non-random sampling technique was used. The inclusion criteria include cavitated, asymptomatic, and teeth with no signs or symptoms of pulpal involvement. The sample size estimation was done by considering different percentages of success in arresting dental carries by using 38% SDF, with different levels of precision of 95% confidence intervals and with 0.05 level of significance. A 95% success was assumed in arresting dental carries by using 38% SDF, with a precision of ±5%, and with α=0.05, the required teeth sample size was 101. Anticipating some incomplete information and documentation, the sample size may be dynamic. Nighty-seven teeth both primary and permanent were included in this study. Data were analyzed using IBM SPSS Statistical software version 26.0 (Armonk, NY: IBM Corp.) for Windows. Descriptive statistics (mean standard deviation, frequencies, and percentages) were used to describe the quantitative and categorical outcome variables. Pearson's chi-square test and Fisher's exact test were used to compare the proportion success of 38% SDF in relation to the characteristics of study subjects. The odds ratios were used to quantify the measure of association between the success and other categorical study variables. A binary multiple logistic regression was used to identify the independent variables associated with the success of 38% SDF in arresting dental caries. A p-value of <0.05 and 95% confidence intervals were used to report the statistical significance and precision of results. Our current research concluded that different variables associated with 38% SDF, such as the number of applications and the time-lapse between applications, had no significant effect on the successful results of the application. Moreover, receiving a final restoration did not affect the success of the treatment when compared to treating with 38% SDF alone. Additionally, the type of final restoration had no impact on the prognosis. Further research using standardized protocols for study designs, detection criteria, outcomes, and statistical designs is needed to support findings and establish treatment guidelines.
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Affiliation(s)
- Haifa AlKhodier
- Pediatric Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
| | - Ghadeer Molla
- General Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
| | - Nouf AlAjaji
- Pediatric Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
| | - Nuha A Alkanhal
- Pediatric Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
| | - Mona AlSaykhan
- Pediatric Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, SAU
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24
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Shakir H, Marwaha RS, Shah P, Challa S. Effectiveness of silver diamine fluoride in arresting dental caries in residents living in nursing homes: A randomized controlled trial. J Public Health Dent 2023; 83:292-298. [PMID: 37309070 DOI: 10.1111/jphd.12578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/25/2023] [Accepted: 05/17/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The primary objective of this randomized controlled trial was to determine the effectiveness of a single application of 38% silver diamine fluoride (SDF) solution in arresting and controlling active accessible caries compared to no treatment among adults aged 18 years and older residing in nursing homes or long-term care facilities. Many patients cannot receive standard-of-care dental treatment due to their medical conditions and inability to undergo anesthesia. All teeth in the control group will be treated with SDF at the conclusion of the study. METHODS This study enrolled 39 adults aged 18 or older with 188 active lesions from nine San Antonio, Texas, nursing home facilities. Teeth were randomized and divided into two treatment and control groups. Each treatment tooth was paired with a control in the same oral cavity. Accessible carious lesions were treated with a single application of 38% SDF solution. Teeth were re-evaluated at 3 weeks where control groups also received SDF treatment. RESULTS The treatment group demonstrated caries arrest in 77 (81.9%) teeth compared to 0 in the control group (0%). Notably, within the treatment group 14 of the 17 teeth with no caries arrest were posterior teeth (82.4%). CONCLUSIONS Our results suggest that a single application of 38% SDF solution is an effective measure for arresting and controlling caries compared to standard oral hygiene maintenance. Our research team recommends the regular use of a single application of SDF solution in marginalized populations given the possible public health, oral health, social, and economic benefits.
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Affiliation(s)
- Hala Shakir
- Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio School of Dentistry, San Antonio, USA
| | - Rochisha Singh Marwaha
- Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio School of Dentistry, San Antonio, USA
| | - Pankil Shah
- Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio School of Dentistry, San Antonio, USA
| | - Suman Challa
- Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio School of Dentistry, San Antonio, USA
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25
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Lamloum D, Arghittu A, Ferrara P, Castiglia P, Dettori M, Gaeta M, Odone A, Campus G. A Systematic Review of Clinical Practice Guidelines for Caries Prevention following the AGREE II Checklist. Healthcare (Basel) 2023; 11:1895. [PMID: 37444729 DOI: 10.3390/healthcare11131895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/07/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Untreated oral diseases are detrimental to overall well-being and quality of life and are in close relationship with social and economic consequences. The presence of strong evidence for caries primary and secondary prevention is a compulsory tool for the development of clinical practice guidelines (CPGs). This paper was aimed to assess systematically the importance of clinical practice guidelines in caries prevention management considering both the adult and pediatric populations and evaluate them using the Appraisal of Guidelines for Research and Evaluation (AGREE II) Checklist. Records were extracted from EMBASE, SCOPUS, PubMed/Medline and seven other relevant guideline databases between 6 January and 14 February 2023. Two reviewers independently conducted the appraisal using the web-based platform My AGREE PLUS. Twenty-one guidelines/papers met the inclusion criteria and were reviewed. Eight CPGs included both primary and secondary prevention interventions, whereas thirteen presented a single preventive model. Overall, 12 guidelines were published in the USA. The mean AGREE II scores ranged from 35.4% to 84.3%. Of the total twenty-one included guidelines, twelve were classified as "Recommended", ranging from 56.3% to 84.3%, the others were described as "Recommended with modification", ranging from 35.4% to 68.9%. From the AGREE II analysis carried out, the CPGs included in this survey adopted a punctual methodological rigor but lacked applicative power. The present survey showed that the public, as the primary beneficiary, played a limited role in the development of the twenty-one CPGs. Hence, methodological improvement can better support high-quality CPG development in the future.
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Affiliation(s)
- Demetrio Lamloum
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Antonella Arghittu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20126 Monza, Italy
- IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Marco Dettori
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Guglielmo Campus
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai 600077, India
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26
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Veiga N, Figueiredo R, Correia P, Lopes P, Couto P, Fernandes GVO. Methods of Primary Clinical Prevention of Dental Caries in the Adult Patient: An Integrative Review. Healthcare (Basel) 2023; 11:healthcare11111635. [PMID: 37297776 DOI: 10.3390/healthcare11111635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
AIM Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels. METHODS This review followed the PICO strategy with the research question: "What are the methods of primary prevention of dental caries, in adults, for improving and maintaining oral health integrating clinical and community-based strategies?" Electronic screening was carried out by two independent reviewers in five databases (MedLine/PubMed, SciELO, Web of Science, Cochrane Library, and LILACS) to find relevant publications between 2015-2022. We applied eligibility criteria for selection of the articles. The following MeSH terms were used: "Primary Prevention"; "Adult"; "Oral Health"; "Dental Caries"; "Fluorides, Topical"; "Fluoride Varnishes"; "Pit and Fissure Sealants"; "Preventive Dentistry". Although the term "Prevention strategy" is not a MeSH descriptor, several correlated terms appeared and were used in the search engines: "Preventative Care", "Disease Prevention, Primary", and "Prevention, Primary". The tool provided by the JBI organization (Joanna Briggs Institute) was used to assess the quality of the included studies. RESULTS Nine studies were included. Overall, it was found that the main primary prevention methods applied in dentistry in adults are the application of pit and fissure sealants, topical application of fluoride performed in the dental clinic, use of fluoridated toothpaste, mouthwash with chlorhexidine at home, use of xylitol, the recommendation for regular appointments with the dentist, and the need to inform patients about the saliva buffer capacity and adoption of a non-cariogenic diet. For that purpose, preventive policies should be taken to prevent dental caries. These include three major challenges: providing the adult population with more knowledge regarding their oral health, empowering patients through adopting healthy lifestyles, and developing new preventive strategies and awareness campaigns aimed at the adult population to promote proper oral health habits. CONCLUSIONS A small number of studies were found whose participants were adult patients. There was some consistency regarding primary prevention methods in our studies. However, good quality randomized control studies are still required to define the best intervention strategies for adult caries prevention.
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Affiliation(s)
- Nélio Veiga
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Ricardo Figueiredo
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Patrícia Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Pedro Lopes
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Patrícia Couto
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Gustavo Vicentis Oliveira Fernandes
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
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Sirivichayakul P, Jirarattanasopha V, Phonghanyudh A, Tunlayadechanont P, Khumsub P, Duangthip D. The effectiveness of topical fluoride agents on preventing development of approximal caries in primary teeth: a randomized clinical trial. BMC Oral Health 2023; 23:349. [PMID: 37268914 DOI: 10.1186/s12903-023-03045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/14/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND This 18-month randomized clinical trial aimed to compare the effectiveness of two topical fluoride applications versus placebo control on preventing development of approximal caries in primary teeth. METHODS Preschool children were recruited if they had at least one initial approximal carious lesion at the distal surface of the canines, both approximal surfaces of the first molars, or the mesial surface of the second molars assessed from bitewing radiographs. The participants were randomly allocated into 3 intervention groups: Group 1 (placebo control), Group 2 (5% sodium fluoride [NaF] varnish), and Group 3 (38% silver diamine fluoride [SDF]). All agents were applied semiannually. Two calibrated examiners evaluated the caries development from bitewing radiographs. Caries development was recorded when the baseline sound surface or initial approximal carious lesion surface developed dentin caries (beyond the outer one-third of dentine) at the follow-up examination. The intention-to-treat approach was adopted. The Chi-square test was used to analyze the effectiveness of topical fluoride agents in preventing approximal caries development and the effect of other variables. The multi-level logistic regression analysis was performed to assess the relative effectiveness of topical fluoride agents in preventing approximal caries development at the 18-month follow-up. RESULTS At baseline, 190 participants with 2,685 sound or initial carries at the approximal surfaces were recruited. No differences in participant demographic backgrounds, oral health related habits, or caries experience were observed among the 3 groups (P > 0.05). After 18 months, 155 (82%) participants remained in the study. The rates of developing approximal caries in Groups 1, 2, and 3 were 24.1%, 17.1%, and 27.2%, respectively (P < 0.001, χ2 test). After adjusting for confounding factors and clustering effect, the multilevel logistic regression analysis showed no differences in caries development rates between the 3 groups (P > 0.05). Tooth type and the extent of a carious lesion at baseline were the significant factors for caries development. CONCLUSION At 18-month follow-up, after adjusting for confounding factors and clustering effect, there were no statistically significant differences in preventing of approximal caries development between the semiannual application of 5%NaF, 38%SDF, or placebo. TRIAL REGISTRATION The study was registered in the Thai Clinical Trials Registry under the number TCTR20190315003 on 15/03/2019.
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Affiliation(s)
- Parach Sirivichayakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Varangkanar Jirarattanasopha
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand.
| | - Araya Phonghanyudh
- School of Dentistry, King Mongkut's Institute of Technology Ladkrabang, 1 Chalongkrung St, Ladkrabang, Bangkok, 10520, Thailand
| | - Pitchaya Tunlayadechanont
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Ploychompoo Khumsub
- Dental department, Pakkred hospital, 33 Moo 5 Saphan Nonthaburi - Bang Bua Thong Rd., Pakkret district, Nonthaburi, 11120, Thailand
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Prince Phillip Dental Hospital, 34 Hospital Rd., Sai Ying Pun, Hong Kong SAR, China
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Niemeyer SH, Maniewicz S, Campus G, Tennert C, Yilmaz B, Zekeridou A, Roccuzzo A, Esteves-Oliveira M, Carvalho TS, Wierichs RJ. Design, development and validation of a questionnaire to assess dentists' knowledge and experience in diagnosing, recording, and managing root caries. Clin Oral Investig 2023; 27:2705-2711. [PMID: 36629963 PMCID: PMC10264516 DOI: 10.1007/s00784-022-04842-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The prevalence of root caries is increasing globally, especially in the elderly population, and even though the number of patients with root caries lesions is augmenting, there are still many discrepancies in how dentists manage this condition. The present study aimed to develop and validate a questionnaire to evaluate how dentists diagnose, record and manage root caries lesions, and to verify the validity and reliability of this questionnaire. MATERIALS AND METHODS An expert panel developed a self-administered questionnaire survey with three domains: (1) dentists' knowledge on diagnosis, recording, and managing root caries; (2) information about their current general clinical routines; (3) their demographics. The original English [E] version was translated into three different languages (French [F], German [G], Italian [I]), and subsequently back-translated into English by independent dentists. For the validation, 82 dentists (20-22 for each of the translated versions) accepted to answer the questionnaire at two different time-points (with 1-week interval). The data was quality checked. Construct validity, internal reliability, and intra-class correlation (ICC) were assessed. RESULTS Seventy-seven dentists completed the questionnaire twice [E: 17; F: 19; G: 19; I: 22]. The mean ICC (standard deviation) was 0.98(0.03) for E, 0.90(0.12) for F, 0.98 (0.04) for G, and 0.98 (0.01) for I. Overall, the test-retest reliability was excellent (mean ICC (SD): 0.96 (0.08)). Furthermore, the questionnaire demonstrated good internal reliability (inter-observer reliability; Fleiss kappa: overall:0.27(fair); E:0.30 (fair); F: 0.33(fair); G: 0.33(fair); I: 0.89 (almost perfect)). CONCLUSION The questionnaire was validated and is suitable to be used in the four languages to assess the knowledge of dentists on diagnosing, recording and managing root caries. CLINICAL SIGNIFICANCE The present questionnaire was validated and seems to be a good tool to evaluate how dentists diagnose, record, and manage root caries lesions both in its original (English) and its translated (French, German, and Italian) versions.
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Affiliation(s)
- Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Christian Tennert
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Burak Yilmaz
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, zmk bern, Bern, Switzerland
| | - Alkisti Zekeridou
- Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrea Roccuzzo
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marcella Esteves-Oliveira
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Thiago S Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, zmk bern Freiburgstrasse 7, CH-3010, Bern, Switzerland
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Arduim ADS, Gonçalves DP, Scherer MM, Araújo FBD, Lenzi TL, Casagrande L. Effectiveness of non-operative approaches in active enamel carious lesions: a retrospective longitudinal study. Braz Oral Res 2023; 37:e057. [PMID: 37255077 DOI: 10.1590/1807-3107bor-2023.vol37.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 11/03/2022] [Indexed: 06/01/2023] Open
Abstract
The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00-2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98-0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.
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Affiliation(s)
- Andressa da Silva Arduim
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Debora Plotnik Gonçalves
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Maitê Munhoz Scherer
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Fernando Borba de Araújo
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Tathiane Larissa Lenzi
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Luciano Casagrande
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
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Philip N, Suneja B. The revolutionary evolution in carious lesion management. J Conserv Dent 2023; 26:249-257. [PMID: 37398856 PMCID: PMC10309123 DOI: 10.4103/jcd.jcd_54_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/23/2023] [Accepted: 04/19/2023] [Indexed: 07/04/2023] Open
Abstract
Contemporary paradigms of dental caries management focus on the biological approaches to treating the disease and its principal symptom, the carious lesion. This narrative review traces the evolution of carious lesion management from the operative and invasive approaches of G. V. Black's era to the current period of minimally invasive biological approaches. The paper explains the rationale for adopting biological approaches to dental caries management and lists the five core principles of this management approach. The paper also details the aims, features, and the most recent evidence base for the different biological carious lesion management approaches. Based on current practice guidelines, collated clinical pathways for lesion management are also presented in the paper to aid clinicians in their decision-making. It is hoped that the biological rationale and evidence summarized in this paper will bolster the shift to modern biological carious lesion management approaches among dental practitioners.
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Affiliation(s)
- Nebu Philip
- Paediatric Dentistry, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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31
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Zhou W, Chen H, Weir MD, Oates TW, Zhou X, Wang S, Cheng L, Xu HH. Novel bioactive dental restorations to inhibit secondary caries in enamel and dentin under oral biofilms. J Dent 2023; 133:104497. [PMID: 37011782 DOI: 10.1016/j.jdent.2023.104497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
OBJECTIVE To provide the first review on cutting-edge research on the development of new bioactive restorations to inhibit secondary caries in enamel and dentin under biofilms. State-of-the-art bioactive and therapeutic materials design, structure-property relationships, performance and efficacies in oral biofilm models. DATA, SOURCES AND STUDY SELECTION Researches on development and assessment new secondary caries inhibition restorations via in vitro and in vivo biofilm-based secondary caries models were included. The search of articles was carried out in Web of Science, PubMed, Medline and Scopus. CONCLUSIONS Based on the found articles, novel bioactive materials are divided into different categories according to their remineralization and antibacterial biofunctions. In vitro and in vivo biofilm-based secondary caries models are effective way of evaluating the materials efficacies. However, new intelligent and pH-responsive materials were still urgent need. And the materials evaluation should be performed via more clinical relevant biofilm-based secondary caries models. CLINICAL SIGNIFICANCE Secondary caries is a primary reason for dental restoration failures. Biofilms produce acids, causing demineralization and secondary caries. To inhibit dental caries and improve the health and quality of life for millions of people, it is necessary to summarize the present state of technologies and new advances in dental biomaterials for preventing secondary caries and protecting tooth structures against oral biofilm attacks. In addition, suggestions for future studies are provided.
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London SD, Chamut S, Fontelo P, Iafolla T, Dye BA. Assessment of the Quality of Current American Dental Association Clinical Practice Guidelines. JDR Clin Trans Res 2023; 8:178-187. [PMID: 35369790 PMCID: PMC10029135 DOI: 10.1177/23800844221083563] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The American Dental Association (ADA) defines evidence-based dentistry (EBD) as "an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences." Clinical practice guidelines (CPGs) are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. Therefore, ADA CPGs are the most rigorous examples of EBD to inform clinical practice. CPGs should be of the highest level of quality to ensure the appropriateness and timeliness of clinical recommendations. OBJECTIVES The aim of this study was to measure the methodological rigor and transparency of the ADA CPGs. METHODS Each ADA CPG was appraised by 4 independent assessors using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Quantitative quality scores were obtained for 6 domains and overall quality. In addition, assessors provided a qualitative analysis by providing comments for each item and an appraisal of the full recommendation. RESULTS A quality score of 75% was used as the threshold for high-quality guidelines. Using this metric, 6 of the current 10 current ADA CPGs were considered to be of high quality, 1 was slightly below the quality threshold, and 3 were considered marginal. Even among those evaluated to be high quality in overall assessment, certain domains did not reach the quality threshold of 75%. CONCLUSION Overall, the ADA CPGs collectively provide high-quality guidance for the clinician. While the AGREE appraisal guidelines have been used in CPG development since 2016, there is still room for improvement in certain domains (i.e., stakeholder involvement, rigor of development, applicability, and editorial independence). KNOWLEDGE TRANSFER STATEMENT The results of this study summarize the methodological rigor and transparency of the 10 current ADA clinical practice guidelines. Since adoption of AGREE standards (2016), CPGs have been uniformly of high quality. The quality of older CPGs was somewhat lower but overall deemed acceptable. Thus, ADA CPGs may be used with confidence to inform practitioners of treatment options supported by rigorous evidence-based dentistry standards. However, there is still room for improvement in methodological quality.
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Affiliation(s)
- S D London
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
- Applied Clinical Informatics Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
- Department of Oral Biology and Pathology, Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - S Chamut
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - P Fontelo
- Applied Clinical Informatics Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | - T Iafolla
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - B A Dye
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
- Department of Community Dentistry and Population Health, University of Colorado School of Dental Medicine, Aurora, CO, USA
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Brandon RG, Bangar S, Yansane A, Neumann A, Mullins JM, Kalenderian E, Walji MF, White JM. Development of quality measures to assess tooth decay outcomes from electronic health record data. J Public Health Dent 2023; 83:33-42. [PMID: 36224111 PMCID: PMC10006288 DOI: 10.1111/jphd.12545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/10/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To develop outcomes of care quality measures derived from the dental electronic health record (EHR) to assess the occurrence and timely treatment of tooth decay. METHODS Quality measures were developed to assess whether decay was treated within 6 months and if new decay occurred in patients seen. Using EHR-derived data of the state of each tooth surface, algorithms compared the patient's teeth at different dates to determine if decay was treated or new decay had occurred. Manual chart reviews were conducted at three sites to validate the measures. The measures were implemented and scores were calculated for three sites over four calendar years, 2016 through 2019. RESULTS About 954 charts were manually reviewed for the timely treatment of tooth decay measure, with measure performance of sensitivity 97%, specificity 85%, positive predictive value (PPV) 91%, negative predictive value (NPV) 95%. About 739 charts were reviewed for new decay measure, with sensitivity 94%, specificity 99%, PPV 99%, and NPV 94%. Across all sites and years, 52.8% of patients with decay were fully treated within 6 months of diagnosis (n = 247,959). A total of 23.8% of patients experienced new decay, measured at an annual exam (n = 640,004). CONCLUSION Methods were developed and validated for assessing timely treatment of decay and occurrence of new decay derived from EHR data, creating effective outcome measures. These EHR-based quality measures produce accurate and reliable results that support efforts and advancement in quality assessment, quality improvement, patient care and research.
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Affiliation(s)
- Ryan G Brandon
- Willamette Dental Group and Skourtes Institute, Hillsboro, Oregon, USA
| | - Suhasini Bangar
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Alfa Yansane
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Ana Neumann
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Joanna M Mullins
- Willamette Dental Group and Skourtes Institute, Hillsboro, Oregon, USA
| | | | - Muhammad F Walji
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Joel M White
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California, USA
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Naishlos S, Blumer S, Nissan S, Nissan J, Kharouba J. Comparison of Childhood Caries Levels between Children of Pediatric Dentists and Children of General Dentists: A Cross-Sectional Study. CHILDREN 2023; 10:children10030452. [PMID: 36980010 PMCID: PMC10047690 DOI: 10.3390/children10030452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023]
Abstract
Caries development in children is a prevalent childhood disease. Factors affecting chronic teeth lesions include nutrition, parental involvement, and executing proper dental health attitude. Professional dentists are perceived as role models for the oral health and hygiene of their families. The purposes of the research were 1. To compare caries rates in the children of pediatric dentists and children of general dentists. 2. To compare children’s nutrition habits between pediatric dentists and general dentists. 3. To compare children’s oral health and hygiene between pediatric dentists and general dentists. 4. To compare children’s usage of fluoride-containing products between pediatric dentists and general dentists. A cross-sectional study was conducted by distributing self-reporting questionnaires to pediatric dentists and general dentists via the social media “snowball” platform. The following themes were surveyed: nutrition habits and oral hygiene of the children. The sample consisted of 176 participants. Children of pediatric dentists were found to have fewer cases of caries than children of general dentists (p = 0.018). Nutrition habits did not differ between the two groups. In addition, pediatric dentists reported that their children use more fluoridated toothpaste in comparison with general dentists. Professional training of pediatric dentists contributed to shaping the oral hygiene attitude of their children.
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Affiliation(s)
- Sarit Naishlos
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Sigalit Blumer
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Sagit Nissan
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Joseph Nissan
- Department of Oral-Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Johnny Kharouba
- Department of Paediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-3-6409254
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Oguma H, Matsuda Y, Yoshihara K, Okuyama K, Sakurai M, Saito T, Inoue S, Yoshida Y. Prevention of Root Caries Using Oxalic Acid. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1454. [PMID: 36837083 PMCID: PMC9966124 DOI: 10.3390/ma16041454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/12/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Certain dentin hypersensitivity treatment materials include oxalic acid to coat dentin surfaces with minerals, while certain organic acids possess a remineralization effect. Herein, an organic acid that inhibits the demineralization and coating of root surfaces was evaluated. Specimens were produced using five non-carious extracted bovines. Four different acids were used: oxalic acid (OA), malonic acid (MA), polyacrylic acid (PA), and succinic acid (SA). Each acid was applied to the root surface and washed using distilled water or a remineralization solution, and the surface was observed using scanning electron microscopy (SEM). All the surfaces of each specimen, barring the polished surface, were covered with wax and immersed in an automatic pH cycling system for two weeks. Dentin demineralization was analyzed using transverse microradiography (TMR) before and after pH cycling. SEM analysis demonstrated that the three acid groups demineralized the dentin surface, whereas the OA group generated crystals covering the dentin surface, even in a distilled water environment. TMR analysis revealed that the OA groups showed significantly lower integrated mineral loss compared with the other groups, even in the distilled water environment. The results suggest that OA generates insoluble calcium oxalate crystals on the dentin and suppresses demineralization even under low saliva conditions.
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Affiliation(s)
- Hidetoshi Oguma
- Division of General Dentistry, Hokkaido University Hospital, Sapporo 060-8586, Japan
| | - Yasuhiro Matsuda
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
| | - Kumiko Yoshihara
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Takamatsu 761-0395, Japan
| | - Katsushi Okuyama
- Department of Dental Materials Science, Asahi University School of Dentistry, Mizuho 501-0296, Japan
| | - Masahiko Sakurai
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
| | - Takashi Saito
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu 061-0293, Japan
| | - Satoshi Inoue
- Division of General Dentistry, Hokkaido University Hospital, Sapporo 060-8586, Japan
| | - Yasuhiro Yoshida
- Department of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan
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Cebula M, Göstemeyer G, Krois J, Pitchika V, Paris S, Schwendicke F, Effenberger S. Resin Infiltration of Non-Cavitated Proximal Caries Lesions in Primary and Permanent Teeth: A Systematic Review and Scenario Analysis of Randomized Controlled Trials. J Clin Med 2023; 12:jcm12020727. [PMID: 36675656 PMCID: PMC9864315 DOI: 10.3390/jcm12020727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
The present study aimed to meta-analyze and evaluate the certainty of evidence for resin infiltration of proximal carious lesions in primary and permanent teeth. While resin infiltration has been shown efficacious for caries management, the certainty of evidence remains unclear. The protocol was registered with PROSPERO (CRD42018080895), and PRISMA guidelines have been followed. The databases PubMed, Embase, and Cochrane CENTRAL were systematically screened, complemented by hand searches and cross-referencing. Eleven relevant articles were identified and included, i.e., randomized controlled trials (RCTs) comparing the progression of resin infiltrated proximal caries lesions (combined with non-invasive measures) in primary or permanent teeth with non-invasive measures. Random-effects meta-analyses and trial sequential analyses (TSA) were performed for per-protocol (PP), intention-to-treat (ITT), and best/worst case (BC/WC) scenarios. Six included trials assessed lesions in permanent teeth and five trails assessed lesions in primary teeth. The trials had a high or unclear risk of bias. Risk of caries progression was significantly reduced for infiltrated lesions in the PP, ITT, and BC scenarios in both permanent teeth and primary teeth, but not in the WC scenario. According to the TSA, firm evidence was reached for all of the scenarios except the WC. In conclusion, there is firm evidence for resin infiltration arresting proximal caries lesions in permanent and primary teeth.
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Affiliation(s)
- Marcus Cebula
- Clinical Research Department, DMG Dental Material Gesellschaft mbH, Elbgaustraße 248, 22547 Hamburg, Germany
| | - Gerd Göstemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Vinay Pitchika
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Sebastian Paris
- Department of Restorative, Preventive and Pediatric Dentistry, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Susanne Effenberger
- Clinical Research Department, DMG Dental Material Gesellschaft mbH, Elbgaustraße 248, 22547 Hamburg, Germany
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
- Correspondence:
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Souza TFD, Martins ML, Jural LA, Maciel IP, Magno MB, Coqueiro RDS, Pithon MM, Leal SC, Fonseca-Gonçalves A, Maia LC. Did the Use of Minimum Interventions for Caries Management Change during the COVID-19 Pandemic? A Cross-Sectional Study. Caries Res 2023; 57:459-469. [PMID: 36623490 DOI: 10.1159/000528837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
The aim of this study was to evaluate changes in the frequency of use of minimum intervention (MI) techniques for caries management during the COVID-19 pandemic. A questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of noninvasive, microinvasive, minimally invasive, and mixed interventions, nonaerosol or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test, and the effect size (ES) was calculated. An α = 0.05 was adopted. A total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the noninvasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p < 0.01; ES = 0.11). The frequency of sealants to repair defective restorations was the only microinvasive technique that increased during the pandemic (p < 0.01; ES = 0.03). Among the minimally invasive techniques, the use of atraumatic restorative treatment increased significantly (p < 0.01; ES = 0.06), while the use of air abrasion decreased (p = 0.02; ES = 0.04) during COVID-19 pandemic. Moreover, nonrestorative cavity control (mixed intervention) increased during pandemic period (p < 0.001; ES = 0.11). Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.
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Affiliation(s)
- Tainá Fontes de Souza
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil,
| | - Mariana Leonel Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lucas Alves Jural
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Isadora Passos Maciel
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Matheus Melo Pithon
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Health I, Universidade Estadual Do Sudoeste Da Bahia (UESB), Jequié, Brazil
| | - Soraya Coelho Leal
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, Brazil
| | - Andréa Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Pakdaman A, Gholizadeh N, Kharazifard MJ, Eshrati M. Clinical practice guideline adaptation for risk-based caries management in 18-55 year-old Iranian adults. BMC Oral Health 2023; 23:7. [PMID: 36609271 PMCID: PMC9824988 DOI: 10.1186/s12903-022-02699-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To adapt an evidence-based clinical practice guideline (CPG) for risk-based management of caries in 18-55 year-old Iranian adults. METHODS A multidisciplinary adaptation team reviewed evidence-based guidelines such as the NICE, SIGN, and ADA according to the defined clinical questions. In addition, databases such as the PubMed and Google Scholar were searched and CPGs were screened and appraised using the AGREE II (Appraisal of Guidelines for Research and Evaluation II) tool. Clinical scenarios were developed and their level of evidence, clinical advantage and adaptability were assessed. Following a two-round ranking by experts, the final recommendations were selected using the RAND-UCLA appropriateness method. RESULTS Of 17 CPGs, 5 were selected as the source guidelines for adaptation. To assess the risk of caries in the adult population, reduced Cariogram (without saliva tests) and CAMBRA were suggested as diagnostic tools. In addition, 53 risk-based recommendations on the preventive care (including the use of fluoride toothpaste, fluoride, and chlorhexidine mouthwash, at home and in-office fluoride gel, fluoride varnish, mouth buffering, and sealant), operative intervention threshold, and follow-up interval were adapted for Iranian adults. CONCLUSIONS A guideline was adapted for risk-based management of dental caries in Iranian adults. This helps local dentists in decision making and promoting oral health of adults. Further research is needed to assess the external validity and feasibility of the adapted guideline in the Iranian population.
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Affiliation(s)
- A. Pakdaman
- grid.411705.60000 0001 0166 0922Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - N. Gholizadeh
- grid.411705.60000 0001 0166 0922Oral and Maxillofacial Medicine Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M. J. Kharazifard
- grid.411705.60000 0001 0166 0922Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Eshrati
- grid.411705.60000 0001 0166 0922Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Perspectives on dental health and oral hygiene practice from US adolescents and young adults during the COVID-19 pandemic. PLoS One 2023; 18:e0280533. [PMID: 36656822 PMCID: PMC9851495 DOI: 10.1371/journal.pone.0280533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Adolescence is a critical time for adopting health behaviors which continue through adulthood. There is a lack of data regarding perspectives of US adolescents and young adults on their dental health and oral hygiene practice. METHODS Adolescents and young adults, age 14-24, from MyVoice, a nationwide text message poll of youth. were asked five open-ended questions on the importance of dental health and impact of the COVID-19 pandemic. Responses were qualitatively analyzed using thematic analysis. Chi-square test was used to examine differences in experiences by demographics. RESULTS Of 1,148 participants, 932 responded to at least one question. The mean age was 19 years. Respondents were largely male (49.5%) and non-Hispanic white (62.4%). Most (92%) respondents perceived dental health as important or somewhat important and emphasized overall dental health and hygiene (38.6%) and aesthetics (18.3%). About half (49.2%) of respondents stated they have had at least one cavity since middle school. Just over half (54.8%) reported brushing and flossing to care for their dentition. 58% visited a dentist at least every 6 months, while 38% visited a dentist less frequently or not at all. Being non-cisgender, non-Hispanic black, Hispanic, and receipt of free or reduced lunch was associated with less frequent dental visits. 44% stated COVID-19 impacted their dental health, with many mentioning scheduling difficulties or worsened dental hygiene. CONCLUSIONS Most youth in our study consider dental health important, though their oral hygiene practice may not follow ADA guidelines and self-reported dental caries are high. Dental healthcare among youth has been affected by the COVID-19 pandemic with interruption in regular dental visits and changes in hygiene habits. Re-engagement of adolescents and young adults by dental care providers via greater access to appointments and youth-centered messaging reinforcing hygiene recommendations may help youth improve dental health now and in the future.
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Antimicrobial Efficacy of Silver Diamine Fluoride against Enterococcus faecalis: A Systematic Review of In Vitro Studies. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6544292. [PMID: 36567909 PMCID: PMC9788898 DOI: 10.1155/2022/6544292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/20/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022]
Abstract
Introduction/Objectives. Enterococcus faecalis has been implicated in infections of treated root canals. Current irrigants and intracanal medicaments cannot eliminate E. faecalis completely from the root canal. Silver diamine fluoride (SDF) prevents caries by promoting remineralization and exerting an antibacterial effect. Studies suggest that SDF may possess antibacterial properties against E. faecalis. The purpose of this review is to systematically and critically analyze the literature, focusing on the use of SDF as an intracanal medicament or irrigant, when compared to other antibacterial agents. Data/Sources. The focused question was "Is the antibacterial effect of SDF against E. faecalis better than other intracanal medicaments and irrigants?" Using the keywords ((silver diamine fluoride) AND (Enterococcus faecalis)) AND ((sodium hypochlorite) OR (NaOCl) OR (chlorhexidine) OR (calcium hydroxide) OR (Ca(OH)2)), an electronic search was conducted on the following databases: PubMed/MEDLINE, ISI Web of Science, Scopus, EMBASE, and Google Scholar. The clinical trial registers ClinicalTrials.gov and CONTROL were also searched using the same keywords. General characteristics and outcomes were extracted, and quality of the studies was assessed using the Preferred Reporting Items for Laboratory studies in Endodontology (PRILE) guidelines. Study Selection. Six articles (five in vitro studies and one ex vivo study) were included in this systematic review. In the majority of the studies, SDF had equal or better antibacterial efficacy against E. faecalis compared to calcium hydroxide, sodium hypochlorite, and chlorhexidine. However, the majority of the studies did not fulfill several items in the PRILE criteria and had numerous sources of bias. Conclusions. Within the limitations of the systematic review and the studies reviewed, SDF may be effective against E. faecalis and therefore could be used as an intracanal medicament and/or irrigant to prevent reinfections of the root canals and improve the outcomes of endodontic treatment. However, animal and clinical studies should be carried out to determine the efficacy of SDF in endodontics. Trial Registration. The protocol for this review was registered on PROSPERO. Registration number: CRD42021224741.
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McNutt DE, Wells MH, DeSchepper EJ, Scarbecz M. Dental students and recent dental graduates' perceptions of preparedness in treating pediatric patients. J Dent Educ 2022; 87:548-561. [PMID: 36461151 DOI: 10.1002/jdd.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/29/2022] [Accepted: 10/29/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE/OBJECTIVES To survey potential applicants applying to advanced education in pediatric dental programs and evaluate their preparedness upon graduating from an accredited dental school. METHODS Attendees of a virtual externship of a University program were recruited to participate in a web-based survey. The survey collected demographic data, current levels of confidence with various pediatric clinical procedures, predicted confidence with those procedures, and number of procedures completed. Chi-Square and analysis of variance statistics were performed on resulting data to determine statistical significance. RESULTS Fifty-three participants completed the survey in its entirety (n = 53). Most respondents reported adequate didactic training, mean score of 3.6 (range 0-5) and a moderate to high impact of coronavirus disease 2019 on their overall training with a mean score of 4.9 (range 0-10). Current dental students reported that they are "not confident at all" (<2.0) for 15/24 (63%) of the procedures. Graduates reported "somewhat confident" (<3.0) for 13/24 (54%) of the categories. Both students and graduates report the lowest levels of confidence for managing dental trauma, invasive treatment of young patients (<4 years of age), and patients with special healthcare needs. Dental students self-reported the expectation to feel more confident throughout their matriculation; however, their clinical experience was still reported to be limited. Students did not report reaching the level of "confident" for 75% of the procedures. CONCLUSION Dental students and recent dental graduates alike perceive themselves to be under prepared for practice and do not feel confident in performing pediatric dental procedures. This study can provide dental schools, program directors, recent graduates, and dental students with an understanding of areas where they are under prepared and could offer areas where curricula and clinical experiences could be updated or modified.
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Affiliation(s)
- David E. McNutt
- Private practice McNutt Pediatric Dentistry Nashville Tennessee USA
| | - Martha H. Wells
- Division of Dentistry St. Jude Children's Research Hospital Memphis Tennessee USA
| | - Edward J. DeSchepper
- Department of Restoraive Dentistry, College of Dentistry University of Tennessee Health Science Center Memphis Tennessee USA
| | - Mark Scarbecz
- Department of Bioscience Research, College of Dentistry University of Tennessee Health Science Center Memphis Tennessee USA
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Resin Infiltration of Non-Cavitated Enamel Lesions in Paediatric Dentistry: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121893. [PMID: 36553336 PMCID: PMC9776437 DOI: 10.3390/children9121893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
The resin infiltration (RI) technique was introduced as one of the minimal intervention dentistry strategies in addressing dental caries among the paediatric population. This technique used the low-viscosity resin monomer to infiltrate the non-cavitated carious lesion and other developmental enamel porosities, thus allowing the conservation of the tooth structure. This narrative review aims to explore the value of RI in Paediatric Dentistry. Through our search of the literature, the development of the material, their clinical applications and shortcomings, as well as the innovation that has been carried out to improve the current RI, were discussed. There are number of high-level evidence supporting the use of RI in arresting non-cavitated proximal caries lesions in primary and permanent teeth, but its efficacy in managing anterior white spot lesions is still unclear. Limited penetration depth, not radiopaque and questionable long-term colour and material stability were among the limitation of the material. Various laboratory-based studies have been conducted to improve the current properties of RI. Nevertheless, RI has emerged as one of the important micro-invasive techniques in addressing non-cavitated and anterior white-spot enamel lesions in children and adolescents with great success.
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Spencer P, Ye Q, Misra A, Chandler JR, Cobb CM, Tamerler C. Engineering peptide-polymer hybrids for targeted repair and protection of cervical lesions. FRONTIERS IN DENTAL MEDICINE 2022; 3. [PMID: 37153688 PMCID: PMC10162700 DOI: 10.3389/fdmed.2022.1007753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
By 2060, nearly 100 million people in the U.S. will be over age 65 years. One-third of these older adults will have root caries, and nearly 80% will have dental erosion. These conditions can cause pain and loss of tooth structure that interfere with eating, speaking, sleeping, and quality of life. Current treatments for root caries and dental erosion have produced unreliable results. For example, the glass-ionomer-cement or composite-resin restorations used to treat these lesions have annual failure rates of 44% and 17%, respectively. These limitations and the pressing need to treat these conditions in the aging population are driving a focus on microinvasive strategies, such as sealants and varnishes. Sealants can inhibit caries on coronal surfaces, but they are ineffective for root caries. For healthy, functionally independent elders, chlorhexidine varnish applied every 3 months inhibits root caries, but this bitter-tasting varnish stains the teeth. Fluoride gel inhibits root caries, but requires prescriptions and daily use, which may not be feasible for some older patients. Silver diamine fluoride can both arrest and inhibit root caries but stains the treated tooth surface black. The limitations of current approaches and high prevalence of root caries and dental erosion in the aging population create an urgent need for microinvasive therapies that can: (a) remineralize damaged dentin; (b) inhibit bacterial activity; and (c) provide durable protection for the root surface. Since cavitated and non-cavitated root lesions are difficult to distinguish, optimal approaches will treat both. This review will explore the multi-factorial elements that contribute to root surface lesions and discuss a multi-pronged strategy to both repair and protect root surfaces. The strategy integrates engineered peptides, novel polymer chemistry, multi-scale structure/property characterization and predictive modeling to develop a durable, microinvasive treatment for root surface lesions.
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Zheng FM, Yan IG, Duangthip D, Gao SS, Lo ECM, Chu CH. Silver diamine fluoride therapy for dental care. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:249-257. [PMID: 36097560 PMCID: PMC9463534 DOI: 10.1016/j.jdsr.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 08/05/2022] [Accepted: 08/21/2022] [Indexed: 11/29/2022] Open
Abstract
Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is used to control early childhood caries, arrest root caries, prevent fissure caries and secondary caries, desensitise hypersensitive teeth, remineralise hypomineralised teeth, prevent dental erosion, detect carious tissue during excavation and manage infected root canals. SDF is commonly available as a 38% solution containing 255,000 ppm silver and 44,800 ppm fluoride ions. Silver is an antimicrobial and inhibits cariogenic biofilm. Fluoride promotes remineralisation and inhibits the demineralisation of teeth. SDF also inactivates proteolytic peptidases and inhibits dentine collagen degradation. It arrests caries without affecting dental pulp or causing dental fluorosis. Indirect pulp capping with SDF causes no or mild inflammatory pulpal response. However, direct application of SDF to dental pulp causes pulp necrosis. Furthermore, SDF stains carious lesions black. Patients must be well informed before SDF treatment. SDF therapy is simple, painless, non-invasive, inexpensive, and requires a simple armamentarium and minimal support. Both clinicians and patients generally accept it well. In 2021, the World Health Organization included SDF as an essential medicine that is effective and safe for patients. Moreover, it can be used for caries control during the COVID-19 pandemic because it is non-aerosol-generating and has a low risk of cross-infection.
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Affiliation(s)
| | - Iliana Gehui Yan
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China
| | | | - Sherry Shiqian Gao
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China.,Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361000, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China
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Effectiveness of 38% Silver Diamine Fluoride Application along with Atraumatic Restorative Treatment for Arresting Caries in Permanent Teeth When Compared to Atraumatic Restorative Treatment in Adults-Study Protocol for a Randomized Controlled Trial. Methods Protoc 2022; 5:mps5060087. [PMID: 36412809 PMCID: PMC9680478 DOI: 10.3390/mps5060087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Dental caries in the adult population that require preventive and therapeutic treatment are generally neglected in rural communities. The determination of the effectiveness of the application of 38% silver diamine fluoride (SDF) in arresting caries lesions when combined with atraumatic restorative treatment (ART) is very important, as it serves as a preventive and restorative procedure to regain the function of the permanent dentition. The assessment of optimal SDF application with ART, in comparison with ART alone, in managing cavitated carious lesions in a pragmatic setting, is the need of the hour to recommend optimal dental care, especially in rural settings which have minimal access to comprehensive dental care. METHODS AND ANALYSIS The clinical trial will enrol 220 adults (18-65 years) with cavitated carious lesions attending the Amrita School of Dentistry in the Ernakulam district, India. This study is a randomized, controlled trial with a 1:1 allocation ratio in two parallel groups. Study arm 1 will receive 38% SDF application and ART, and study arm 2 will receive ART only. A digital radiograph will be taken immediately after restoration (baseline) as well as at the end of the 6th month for evaluation of caries arrest. The assessment of the survival of the restoration will be done on the 7th day, 30th day, and at the end of the 6th month. The final analysis would include both the tooth and person levels. ETHICS AND DISSEMINATION This trial adheres to the principles of the Declaration of Helsinki and the guidelines of the Indian Council of Medical Research (ICMR). This study protocol has been approved by the Institutional Review Board. This trial has been registered prospectively with the Clinical Trial Registry of India (Registration No: CTRI/2021/12/038816).
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DaSilva AF, Robinson MA, Shi W, McCauley LK. The Forefront of Dentistry-Promising Tech-Innovations and New Treatments. JDR Clin Trans Res 2022; 7:16S-24S. [PMID: 36121134 PMCID: PMC9793430 DOI: 10.1177/23800844221116850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT This article discusses innovations in technology and treatments that have enormous potential to revolutionize our dental care, including novel concepts in electronic health records, communication between dentists and patients, biologics around diagnosis and treatment, digital dentistry, and, finally, the real-time optimization of information technology. The early implementation and validation of these innovations can drive down their costs and provide better dental and medical services to all members of our society.
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Affiliation(s)
- A F DaSilva
- Learning Health Systems, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - M A Robinson
- University of Alabama at Birmingham School of Dentistry, Birmingham, AL, USA
- University of Alabama at Birmingham School of Education, Birmingham, AL, USA
| | - W Shi
- The Forsyth Institute, Cambridge, MA, USA
| | - L K McCauley
- University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Chan AKY, Tamrakar M, Jiang CM, Tsang YC, Leung KCM, Chu CH. Clinical evidence for professionally applied fluoride therapy to prevent and arrest dental caries in older adults: A systematic review. J Dent 2022; 125:104273. [PMID: 36058347 DOI: 10.1016/j.jdent.2022.104273] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/06/2022] [Accepted: 08/25/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To assess the clinical evidence for professionally applied fluoride therapy to prevent and arrest caries in older adults. DATA/SOURCES Two independent researchers searched the English literature published up to 31st Dec 2021 in five databases (PubMed, Scopus, the Cochrane Library, EMBASE, and Web of Science) for clinical trials with a comparison group on professionally applied fluoride therapy for caries prevention or arrest at older adults aged ≥60 years with any follow-up period. The outcomes were the mean difference in the number of new caries/caries-prevented fraction and caries arrest rate. The Cochrane guidelines were used for the risk of bias assessment. STUDY SELECTION/RESULTS Five hundred and twenty-seven studies were identified, and seven studies were finally included. Five studies were rated as having 'low risk'. The root caries-prevented fraction of 38% silver diamine fluoride (SDF) solution, 5% sodium fluoride (NaF) varnish, and 1.23% acidulated phosphate fluoride (APF) gel were 25-71%, 64%, and 32%, respectively. Meta-analysis indicated a decrease in the number of new root caries by 0.55 (95% CI: 0.32-0.78; p < 0.001) and an overall proportion of arrested root caries of 42% (95% CI: 33% to 49%; p < 0.001) after receiving 38% SDF application at the 24-month follow-up. CONCLUSIONS According to the findings, 5% NaF varnish and 1.23% APF gel prevented root caries, whereas 38% SDF solution prevented and arrested root caries in older adults. More well-designed clinical trials should be conducted to investigate various methods in caries prevention and arrest in older adults. CLINICAL SIGNIFICANCE Preventive measures effective in other age groups may not suit older adults, as caries type and associated risk factors vary. To date, no systematic review has evaluated professionally applied fluoride therapy in older adults. Evidence from clinical trials in older adults could aid clinical practice and public health measures. The International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42022307025.
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Affiliation(s)
- Alice Kit Ying Chan
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Manisha Tamrakar
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chloe Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Yiu Cheung Tsang
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China.
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Jones NA, Bloembergen W, Tenuta LMA, Flannagan SE, Jones GW, Pan LC, Newton M, Clarkson BH, Lahann J, Bloembergen S, González-Cabezas C. Early occlusal caries detection using targeted fluorescent starch nanoparticles. J Dent 2022; 125:104243. [PMID: 35907441 DOI: 10.1016/j.jdent.2022.104243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES We have previously shown fluorescent cationic starch nanoparticles (FCSNs) penetrate enamel surface porosity of active carious lesions, potentially aiding their detection. Here, we evaluate the in vitro diagnostic accuracy of FCSNs in detecting occlusal caries compared to histologic reference standard. METHODS 100 extracted human teeth were selected with sound (50), or either non-cavitated (25) or cavitated (25) lesions. A region of interest (ROI) on the occlusal surface was assessed for fluorescence by two independent examiners, after immersion in FCSN solution, water rinse, and illumination by dental curing lamp viewed through orange UV-filter glasses. ROIs were sectioned and evaluated by histology (Downer Criteria) as a gold standard for caries presence. Cohen's Kappa was determined for inter- and intra-examiner agreement, and sensitivity, specificity, and area under the curve of Receiver Operator Curves (ROCAUC) were calculated. The analysis was repeated for the subset of "early" lesions, defined as being limited to enamel. RESULTS FCSN use resulted in substantial inter-user (k=0.74±0.07), and high intra-user agreement (k=0.80±0.06; 0.94±0.03, by examiner). Sensitivity, specificity and ROCAUC for FCSNs were 88.9%; 94.6%; 0.92±0.06 for all, and 76.9%, 94.6%, and 0.86±0.10 for early lesions. In post hoc analysis, sensitivity seemed to be greater with the FCSN than the expert visual exam, particularly for early lesions. CONCLUSIONS/CLINICAL SIGNIFICANCE FCSNs are a reproducible and accurate novel technology for occlusal caries detection, with high sensitivity and specificity compared to histology. Future clinical validation is necessary. FCSNs can improve early caries detection and shift treatment towards non-invasive approaches, improving oral health.
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Affiliation(s)
- Nathan A Jones
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States.
| | - Wendy Bloembergen
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
| | - Livia M A Tenuta
- University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Susan E Flannagan
- University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Glenn W Jones
- Saba University School of Medicine, Devens, MA, United States
| | - Li-Chi Pan
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
| | - Mariah Newton
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
| | - Brian H Clarkson
- University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Joerg Lahann
- Department of Chemical Engineering and Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
| | - Steven Bloembergen
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
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CHANGES IN PARENTAL SATISFACTION AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PRESCHOOL CHILDREN AFTER RECEIVING ATRAUMATIC RESTORATIVE TREATMENT WITH OR WITHOUT PRIOR SILVER DIAMINE FLUORIDE APPLICATION. J Evid Based Dent Pract 2022; 22:101751. [DOI: 10.1016/j.jebdp.2022.101751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 05/18/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
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MILETIC VESNA. IN VITRO EVIDENCE INDICATES SILVER DIAMINE FLUORIDE PRETREATMENT OF DENTINE MAY REDUCE BOND STRENGTH OF DENTAL ADHESIVES, BUT NOT OF GLASS IONOMER CEMENTS. J Evid Based Dent Pract 2022; 22:101755. [DOI: 10.1016/j.jebdp.2022.101755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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