Prevention strategies for dental caries in the adolescent

Systems mapping of multilevel factors contributing to dental caries in adolescents

Dental caries is a prevalent chronic disease among adolescents. Caries activity increases significantly during adolescence due to an increase in susceptible tooth surfaces, immature permanent tooth enamel, independence in pursuing self-care, and a tendency toward poor diet and oral hygiene. Dental caries in permanent teeth is more prevalent among adolescents in low-income families and racial/ethnic minority groups, and these disparities in adolescent dental caries experience have persisted for decades. Several conceptual and data-driven models have proposed unidirectional mechanisms that contribute to the extant disparities in adolescent dental caries experience. Our objective, using a literature review, is to provide an overview of risk factors contributing to adolescent dental caries. Specifically, we map the interactive relationships of multilevel factors that influence dental caries among adolescents. Such interactive multilevel relationships more closely reflect the complex nature of dental caries experience among the adolescent population. The methods that we use are two-fold: (1) a literature review using PubMed and Cochrane databases to find contributing factors; and (2) the system dynamics approach for mapping feedback mechanisms underlying adolescent dental caries through causal loop diagramming. The results of this study, based on the review of 138 articles, identified individual, family and community-level factors and their interactions contributing to dental caries experience in adolescents. Our results also provide hypotheses about the mechanisms underlying persistence of dental caries among adolescents.

Conclusions

Our findings may contribute to a deeper understanding of the multilevel and interconnected factors that shape the persistence of dental caries experience among adolescents.

An experimental study of the effect of strontium pre-treatment on calcium release from carious and non-carious teeth

The administration of strontium salt is known to be beneficial for bones in preventing calcium loss and osteoporosis. Therefore, we decided to study if strontium treatment affects calcium release from teeth in vitro. Extracted carious as well as non-carious teeth were washed, cleaned, and dried. These were individually immersed in 25 ml of 1% lactic acid at 37 degrees C for 24 h, and the amount of calcium released was measured. The rate of calcium release from these teeth was again determined after their exposure to M/4 strontium chloride for 1 month at 37 degrees C. It was found that: (1) the rate of calcium release from non-carious teeth was significantly higher than carious teeth, possibly because there was more calcium present, (2) the rate of calcium release was almost halved after strontium treatment in both groups of teeth, (3) the Vicker's microhardness of non-carious teeth was higher than those of carious teeth, and (4) strontium treatment did not affect hardness. Strontium treatment may be beneficial in reducing loss of calcium from intact teeth-non-carious as well as carious-and this beneficial effect of strontium is unrelated to change in teeth hardness.