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CIFUENTES-JIMÉNEZ CC, BOLAÑOS-CARMONA MV, ENRICH-ESSVEIN T, GONZÁLEZ-LÓPEZ S, ÁLVAREZ-LLORET P. Evaluation of the remineralizing capacity of silver diamine fluoride on demineralized dentin under pH-cycling conditions. J Appl Oral Sci 2023; 31:e20220306. [PMID: 36995879 PMCID: PMC10065761 DOI: 10.1590/1678-7757-2022-0306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/17/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE (1) to determine the effects of the silver diamine fluoride (SDF) and sodium fluoride (NaF) in demineralized dentin exposed to an acid challenge by pH-cycling, (2) to evaluate the remineralizing capacity of SDF/NaF products based on the physicochemical and mechanical properties of the treated dentin surfaces. METHODOLOGY In total, 57 human molars were evaluated in different stages of the experimental period: sound dentin - negative control (Stage 1), demineralized dentin - positive control (Stage 2), and dentin treated with SDF/NaF products + pH-c (Stage 3). Several commercial products were used for the SDF treatment: Saforide, RivaStar, and Cariestop. The mineral composition and crystalline and morphological characteristics of the dentin samples from each experimental stage were evaluated by infrared spectroscopy (ATR-FTIR), X-ray diffraction, and electron microscopy (SEM-EDX) analytical techniques. Moreover, the mechanical response of the samples was analyzed by means of the three-point bending test. Statistics were estimated for ATR-FTIR variables by Wilcoxon test, while the mechanical data analyses were performed using Kruskal-Wallis and Mann Whitney U tests. RESULTS Regarding the chemical composition, we observed a higher mineral/organic content in the SDF/NaF treated dentin + pH-c groups (Stage 3) than in the positive control groups (Saforide p=0.03; Cariestop p=0.008; RivaStar p=0.013; NaF p=0.04). The XRD results showed that the crystallite size of hydroxyapatite increased in the SDF/NaF treated dentin + pH-c groups (between +63% in RivaStar to +108% in Saforide), regarding the positive control. SEM images showed that after application of the SDF/NaF products a crystalline precipitate formed on the dentin surface and partially filled the dentin tubules. The flexural strength (MPa) values were higher in the dentin treated with SDF/NaF + pH-c (Stage 3) compared to the positive control groups (Saforide p=0.002; Cariestop p=0.04; RivaStar p=0.04; NaF p=0.02). CONCLUSIONS The application of SDF/NaF affected the physicochemical and mechanical properties of demineralized dentin. According to the results, the use of SFD/NaF had a remineralizing effect on the dentin surface even under acid challenge.
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Salem GA, Sharaf RF, El Mansy M. Efficacy of diode laser application versus silver diamine fluoride (SDF) as a modification of Hall technique in primary teeth. Saudi Dent J 2022; 34:723-729. [PMID: 36570583 PMCID: PMC9767833 DOI: 10.1016/j.sdentj.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
Background The Hall technique is a new technique aimed at depriving bacteria of any substrate, thereby limiting the progression of caries. Silver diamine fluoride (SDF) and diode laser are documented to have an antibacterial effect on carious enamel and dentin by eradicating bacteria such as Streptococcus mutans. Aim The current study aimed to increase the success rate of the Hall technique in carious primary molars by eradicating bacteria present in carious lesions using SDF or diode laser in combination with the Hall technique. Materials and methods A total of 159 children aged 4-8 years were randomly divided into three equal groups: Group I, application of the Hall technique; Group II, SDF with Hall technique; Group III, diode laser with Hall technique. Children were recalled at regular intervals over a year. Results: At the end of the follow-up period, Group III showed the highest clinical success rate (94.3 %), followed by Group II (96.2 %), while Group I showed the lowest clinical and radiographic success rates (88.7 % and 86.8 %, respectively); however, these differences were statistically non-significant. Conclusion Treatment of carious lesions using SDF or Diode Laser increased the success rate of the Hall technique in primary teeth.
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Affiliation(s)
- Ghada A. Salem
- Corresponding author at: National Research Centre, Orthodontic and Pediatric Dentistry Department, Oral and Dental Research Institute, Cairo 11728, Egypt. Orcid number 0000-0001-9217-526X.
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Muller-Bolla M, Aïem E, Coulot C, Velly AM, Doméjean S. Restorative thresholds for primary and permanent molars in children: French dentist decisions. Int J Paediatr Dent 2021; 31:299-310. [PMID: 33220074 DOI: 10.1111/ipd.12752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/13/2020] [Accepted: 10/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Worldwide, numerous surveys have investigated practices and knowledge about caries management in adults, but few are available for children. AIM The present cross-sectional survey aimed to assess the restorative thresholds (RTs) in primary and permanent molars in children used by a population of dentists treating children and practicing in France. DESIGN The study population consisted of French dentists treating children (Fr-DTCs) who were registered in the French Society of Pediatric Dentistry (n = 250). A specific questionnaire was developed. Descriptive and statistical analyses were performed. RESULTS Response rate was 80.4% (n = 201). Considering that an appropriate RT is at the stage of a moderate lesion (occlusal: International Caries Detection and Assessment System 4; approximal: lesion involving the external third of dentine), more than 50% of respondents showed a tendency for iatrogenic treatment, except for occlusal carious lesions in primary molars. Inappropriate invasive strategies were more often reported for occlusal lesions in permanent than primary molars. Moreover, for both molar types, these inappropriate RTs were more often chosen for approximal than occlusal lesions. CONCLUSIONS The present survey suggested that Fr-DTCs tend to overtreat in terms of caries management in both primary and permanent molars.
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Affiliation(s)
- Michèle Muller-Bolla
- UFR d'Odontologie de Nice Sophia Antipolis, Université Côte d'Azur, CHUN, Nice, France.,Laboratoire URB2i EA 4662, Paris Descartes, Montrouge, France
| | - Elody Aïem
- UFR d'Odontologie de Nice Sophia Antipolis, Université Côte d'Azur, CHUN, Nice, France.,Laboratoire MICORALIS UPR 7354, Faculté de Chirurgie Dentaire, Université Côte d'Azur, Nice, France
| | - Cyril Coulot
- UFR d'Odontologie de Nice Sophia Antipolis, Université Côte d'Azur, CHUN, Nice, France
| | | | - Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, Univ Clermont Auvergne, UFR d'Odontologie, Clermont-Ferrand, France.,CHU Estaing Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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Featherstone JDB, Crystal YO, Alston P, Chaffee BW, Doméjean S, Rechmann P, Zhan L, Ramos-Gomez F. A Comparison of Four Caries Risk Assessment Methods. FRONTIERS IN ORAL HEALTH 2021; 2:656558. [PMID: 35048004 PMCID: PMC8757708 DOI: 10.3389/froh.2021.656558] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions. Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0-6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups. Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.
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Affiliation(s)
- John D. B. Featherstone
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Yasmi O. Crystal
- Pediatric Dentistry Department, College of Dentistry, New York University, New York, NY, United States
- Comprehensive Pediatric Dentistry, Bound Brook, NJ, United States
| | - Pamela Alston
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin W. Chaffee
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Sophie Doméjean
- Department of Operative Dentistry and Endodontics, UFR d'Odontologie de Clermont-Ferrand, Clermont-Ferrand, France
- EA 4847, Clermont-Ferrand, France
- Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Peter Rechmann
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Ling Zhan
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Francisco Ramos-Gomez
- Section of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
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Sapountzis F, Mahony T, Villarosa AR, George A, Yaacoub A. A retrospective study of the Hall technique for the treatment of carious primary teeth in Sydney, Australia. Clin Exp Dent Res 2021; 7:803-810. [PMID: 33830674 PMCID: PMC8543483 DOI: 10.1002/cre2.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 01/07/2023] Open
Abstract
Objectives The aim of this retrospective study was to evaluate the outcome of preformed metallic crowns (PMC) utilizing the HT in carious primary molars for children treated within public dental clinics across the Sydney region. Materials and Methods A retrospective cohort study was designed, whereby two investigators evaluated 113 primary molars treated with HT PMCs involving 71 participants (aged between 5 and 11 years) after a minimum of 6 months post treatment. The mean time elapsed between crown placement (treatment) and the review was 1.42 years (17 months). The outcome of the HT was assessed by clinical and radiographic criteria. Results One hundred thirteen HT PMCs were reviewed from 71 participants. The overall success rate of PMCs placed utilizing the HT was 99%, with only one case presenting with confirmed failure. Conclusions HT PMCs have an overall high success rate as a treatment option in carious primary molars.
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Affiliation(s)
- Fani Sapountzis
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Tanya Mahony
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Amy R Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), Western Sydney University, Penrith, New South Wales, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Western Sydney University, Penrith, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Albert Yaacoub
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Kingswood, New South Wales, Australia
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Pontes LRA, Lara JS, Novaes TF, Freitas JG, Gimenez T, Moro BLP, Maia HCM, Imparato JCP, Braga MM, Raggio DP, Mendes FM. Negligible therapeutic impact, false-positives, overdiagnosis and lead-time are the reasons why radiographs bring more harm than benefits in the caries diagnosis of preschool children. BMC Oral Health 2021; 21:168. [PMID: 33789655 PMCID: PMC8011211 DOI: 10.1186/s12903-021-01528-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/22/2021] [Indexed: 02/02/2023] Open
Abstract
Background To evaluate the clinical course and interventions required during two years of follow-up of dental surfaces of deciduous molars diagnosed, and consequently treated, by two different strategies: diagnosis made by clinical examination alone or associated with radiographs. Methods This is a secondary analysis of a two-arm randomized clinical trial with parallel groups related to the diagnostic strategy for caries detection in preschool children. 216 children (3–6 years old) were followed-up for two years. All dental surfaces were diagnosed by visual inspection and later, through radiographic assessment. Baseline treatment was made in accordance with the results obtained by visual inspection performed alone or combined with radiographic method, considering the allocated group. Dental surfaces with no restoration needs, or those restored at the beginning of the study were followed-up for two years. The treatment decision was made according to the allocated group. The outcome was the occurrence of failure (a new caries lesion or a restoration replacement) during the follow-up. Results 4383 proximal and occlusal surfaces of deciduous molars in 216 preschool children were diagnosed and treated according to the abovementioned diagnostic strategies and followed-up for 24 months. The assessment of radiographs made change the initial decision reached by visual inspection in about 30% of the surfaces when all types of interventions were considered. However, most disagreements occurred for initial lesions, where radiographs tended to underestimate them. Discordances between methods occurred in less than 5% of all surfaces when considered lesions requiring operative treatment. For discrepancy cases, the placed interventions guided by following the radiographic results did not present less failures against those made following only visual inspection. As a matter of fact, the use of radiographs in the diagnostic strategy for caries detection in children brought more harms than benefits due to the occurrence of false-positives, overdiagnosis and lead-time bias. Conclusions Simultaneous association of visual inspection and radiographic assessment for caries detection in preschool children causes more harms than benefits, and therefore, visual inspection should be conducted alone in the regular clinical practice. Trial registration Clinicaltrials.gov platform: NCT02078453, registered on 5th March 2014. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01528-w.
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Affiliation(s)
- Laura Regina A Pontes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Juan Sebastian Lara
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,Department of Cariology, Operative Dentistry and Dental Public Health, Dental Institute, Indiana University School of Dentistry, 1121 W Michigan St., Indiana, IN, 46202, USA
| | - Tatiane Fernandes Novaes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,Cruzeiro Do Sul University, R. Galvão Bueno, 868, São Paulo, 01506-000, Brazil
| | - Julia Gomes Freitas
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Thais Gimenez
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,School of Dentistry, Ibirapuera University, Av. Interlagos, 1329, São Paulo, 04661-100, Brazil
| | - Bruna Lorena P Moro
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Haline C M Maia
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Daniela P Raggio
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
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Moriyama CM, Novaes TF, Ferreira FR, Moro BLP, Imparato JCP, Diniz MB, Braga MM, Mendes FM. What diagnostic strategy performs better for caries lesion detection on proximal surfaces of adolescents? Clin Oral Investig 2021; 25:3977-3986. [PMID: 33404759 DOI: 10.1007/s00784-020-03728-0] [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: 04/27/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the performance of visual inspection alone and associated to radiographic and laser fluorescence (LF) methods in detecting non-evident caries lesions at adolescents' proximal surfaces. MATERIALS AND METHODS Adolescents (12 to 17 years old) were assessed for the presence of caries lesions through visual inspection, radiographic examination, and LF method (DIAGNOdent pen), at non-cavitated (NC) and cavitated lesion (CAV) thresholds. Temporary separation with orthodontic rubbers followed by direct visual inspection was the reference standard method. Two examiners conducted the examinations, and the first examiner reassessed around 20% of the sample, to evaluate inter- and intra-examiner reproducibility, respectively. Sensitivity, specificity, accuracy, and utility values were calculated for the methods alone and combined with visual inspection using two different strategies: simultaneous and sequential combination. RESULTS A total of 834 proximal surfaces (51 adolescents) were included. Visual inspection presented higher reproducibility values (higher than 0.98). Moreover, visual inspection presented higher sensitivity (around 0.51) than those obtained with other diagnostic strategies (varying from 0.09 to 0.20) at the NC threshold. For CAV, visual inspection presented higher specificity (0.996) than the sequential association with adjunct methods (around 0.97), but with lower sensitivity. Accuracy and utility values for combined strategies were similar or lower than those achieved with the visual inspection performed alone. CONCLUSION Visual inspection alone performs better for detecting caries lesions in premolars and molars of adolescents than other diagnostic strategies. CLINICAL RELEVANCE The best diagnostic strategy for caries detection of proximal caries lesions in adolescents is the visual inspection alone.
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Affiliation(s)
- Caroline M Moriyama
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Metropolitan University of Santos, Av Conselheiro Nebias, 536, Santos, 11045-003, Brazil
| | - Tatiane F Novaes
- School of Dentistry, Cruzeiro do Sul University, R. Galvao Bueno, 868, São Paulo, 01506-000, Brazil
| | - Fernanda R Ferreira
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Bruna Lorena P Moro
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Michele B Diniz
- School of Dentistry, Cruzeiro do Sul University, R. Galvao Bueno, 868, São Paulo, 01506-000, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil. .,Faculdade de Odontologia da Universidade de São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
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Carrouel F, Viennot S, Ottolenghi L, Gaillard C, Bourgeois D. Nanoparticles as Anti-Microbial, Anti-Inflammatory, and Remineralizing Agents in Oral Care Cosmetics: A Review of the Current Situation. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E140. [PMID: 31941021 PMCID: PMC7022934 DOI: 10.3390/nano10010140] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/22/2019] [Accepted: 01/10/2020] [Indexed: 12/29/2022]
Abstract
Many investigations have pointed out widespread use of medical nanosystems in various domains of dentistry such as prevention, prognosis, care, tissue regeneration, and restoration. The progress of oral medicine nanosystems for individual prophylaxis is significant for ensuring bacterial symbiosis and high-quality oral health. Nanomaterials in oral cosmetics are used in toothpaste and other mouthwash to improve oral healthcare performance. These processes cover nanoparticles and nanoparticle-based materials, especially domains of application related to biofilm management in cariology and periodontology. Likewise, nanoparticles have been integrated in diverse cosmetic produces for the care of enamel remineralization and dental hypersensitivity. This review summarizes the indications and applications of several widely employed nanoparticles in oral cosmetics, and describes the potential clinical implementation of nanoparticles as anti-microbial, anti-inflammatory, and remineralizing agents in the prevention of dental caries, hypersensitivity, and periodontitis.
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Affiliation(s)
- Florence Carrouel
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (S.V.); (D.B.)
| | - Stephane Viennot
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (S.V.); (D.B.)
| | - Livia Ottolenghi
- Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Cedric Gaillard
- Institut national de Recherche en Agriculture, Alimentation et Environnement (INRAE), Unité de Recherche 1268 Biopolymères Interactions Assemblages (BIA), 44316 Nantes, France;
| | - Denis Bourgeois
- Laboratory “Systemic Health Care”, University of Lyon, University Claude Bernard Lyon 1, EA4129, 69008 Lyon, France; (S.V.); (D.B.)
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Finucane D. Restorative treatment of primary teeth: an evidence-based narrative review. Aust Dent J 2019; 64 Suppl 1:S22-S36. [PMID: 31144320 DOI: 10.1111/adj.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Various methods, with a variety of materials, exist for restoring carious primary teeth. Successful restoration of primary teeth is dependent on accurate diagnosis, knowledge of the caries process, knowledge of dental materials, and treatment choice. The purpose of this evidence-based review is to present evidence that will help clinicians to make an appropriate diagnosis, from which the optimum treatment plan can be made; to explore the literature regarding restoration of carious primary teeth; and to try and draw conclusions as to which materials and methods can be recommended. This review will primarily deal with the restoration of carious cavities in primary molars. A short discussion on restoration of primary incisors is included, with presentation of what limited evidence there is relating to this.
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Affiliation(s)
- D Finucane
- Hermitage Medical Clinic, Dublin, Ireland.,Faculty of Dentistry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Dublin Dental University Hospital, Dublin, Ireland
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Assessment of the effects of a fluoride dentifrice and GC Tooth Mousse on early caries lesions in primary anterior teeth using quantitative light-induced fluorescence: a randomised clinical trial. Eur Arch Paediatr Dent 2019; 21:85-93. [DOI: 10.1007/s40368-019-00451-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
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Bossù M, Saccucci M, Salucci A, Di Giorgio G, Bruni E, Uccelletti D, Sarto MS, Familiari G, Relucenti M, Polimeni A. Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste. J Nanobiotechnology 2019; 17:17. [PMID: 30683113 PMCID: PMC6346538 DOI: 10.1186/s12951-019-0454-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/10/2019] [Indexed: 12/24/2022] Open
Abstract
Background Dental caries is a recognized worldwide public health problem. Despite being one of the most effective strategies against dental caries, the excessive use of fluorine may result in a potential risk of developing dental fluorosis especially in children under age of six. The purpose of this work is to analyze a fluorine-free toothpaste containing Biomimetic Hydroxyapatite to assess enamel re-mineralizing and repairing properties. Results The study was performed in vitro and in vivo, comparing the hydroxyapatite toothpaste with two others toothpaste containing different fluorine concentrations. The coating effect of the micro-structured Hydroxyapatite nanoparticles reintegrates the enamel with a biomimetic film reproducing the structure and the morphology of the biologic Hydroxyapatite of the enamel. As demonstrated, the coating is due to the deposit of a new layer of apatite, which presents fewer particles than the natural enamel, not based on the chemical—physical changes occurring in fluorinated toothpastes. Moreover, it shows resistance to brushing as a consequence of chemical bonds between the synthetic and natural crystals of the enamel. Conclusions The use of Biomimetic Hydroxyapatite toothpastes has proven to be a valuable prevention measure against dental caries in primary dentition since it prevents the risk of fluorosis.
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Affiliation(s)
- Maurizio Bossù
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161, Rome, Italy
| | - Matteo Saccucci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161, Rome, Italy.
| | - Alessandro Salucci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161, Rome, Italy
| | - Gianni Di Giorgio
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161, Rome, Italy
| | - Erika Bruni
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Daniela Uccelletti
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Maria Sabrina Sarto
- Department of Aerospace, Electrical and Energy Engineering, Sapienza University of Rome, Via Eudossiana 18, 00184, Rome, Italy
| | - Giuseppe Familiari
- Department of Human Anatomy, Histology, Forensic Medicine and Orthopaedics Section of Human Anatomy Electron Microscopy Unit, Laboratory "Pietro M. Motta" Faculty of Pharmacy and Medicine, University of Rome La Sapienza, Via A. Borelli 50, 00161, Rome, Italy
| | - Michela Relucenti
- Department of Human Anatomy, Histology, Forensic Medicine and Orthopaedics Section of Human Anatomy Electron Microscopy Unit, Laboratory "Pietro M. Motta" Faculty of Pharmacy and Medicine, University of Rome La Sapienza, Via A. Borelli 50, 00161, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161, Rome, Italy
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12
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Evans RW. The Monitor Practice Program: implications for dentistry and dental education. Aust Dent J 2019; 64:193-198. [PMID: 30629292 DOI: 10.1111/adj.12676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2019] [Indexed: 11/30/2022]
Abstract
The restorative model of care, known colloquially as drilling and filling, has been challenged on the basis of its inappropriateness. The Caries Management System protocol was developed as an evidence-based strategy for non-surgical treatment of caries lesions and the Monitor Practice Program was designed to test the hypothesis that use of the protocol would reduce risk of dental caries experience. After 7 years, patients attending intervention practices, compared with those attending control practices, needed: 30%-50% fewer restorative interventions; 55% fewer first time restorative interventions; 32% fewer repeat restorative interventions; and were only 23% as likely to be classified as high risk. The outcome was cost-effective and patients attending intervention practices highly valued non-invasive care, and intervention dentists derived professional satisfaction from non-surgical caries management. The implications of the program are that the general public will likely embrace the benefits of non-invasive caries management, as will many current and future dental practitioners. This calls for dental practice reform including: the establishment of a clinical discipline in cariology; cariology curriculum development; revised accreditation regulations for cariology programs in dental schools; advanced training in clinical cariology leading to a specialty; support from the dental profession; and public health advocacy.
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Affiliation(s)
- R W Evans
- Sydney Dental School, The University of Sydney, Sydney, New South Wales, Australia
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13
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Achilleos E, Rahiotis C, Kavvadia K, Vougiouklakis G. Clinical Evaluation of Two Different Prevention Programs in Adults Depending on Their Caries Risk Profile: One-year Results. Oper Dent 2018; 44:127-137. [PMID: 30517071 DOI: 10.2341/17-164-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the management of incipient caries lesions in adults with two preventive protocols. A total of 44 adult patients with high, moderate and low caries risk with 516 incipient caries took part in the study. These patients were assessed for caries with International Caries Detection and Assessment System (ICDAS) criteria and were then divided into three groups depending on their caries risk profile: a high-risk group (group A), a moderate-risk group (group B), and a low-risk group (group C). Participants in each group were further divided randomly into two subgroups. In subgroups A1, B1, and C1, an intensive preventive protocol was applied, while in subgroups A2, B2, and C2, the protocol consisted only of instructions in oral hygiene. The invasive-intensive protocol included the topical application of fluoride, brushing with 5000-ppm fluoride toothpaste, use of amorphous calcium phosphate-casein phosphopeptide, applications of sealants for occlusal lesions (ICDAS code 2), and minimal resin restorations for occlusal lesions (ICDAS code 3). There was no statistically significant difference in the number of lesions (baseline and after one year) in the high-risk and moderate-risk groups that received the intensive protocol (groups A1 and B1), while the control groups were statistically significant different (groups A2 and B2). In the low-risk group, there was no statistically significant difference in the number of lesions (groups C1 and C2). The two different preventive protocols in the high- and moderate-risk groups presented differences in effectiveness, while in the low-risk group, no significant difference was demonstrated.
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Amarasena N, Haag D, Peres KG. A scoping review of caries risk management protocols in Australia and New Zealand. Aust Dent J 2018; 64:19-26. [PMID: 30242843 DOI: 10.1111/adj.12653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2018] [Indexed: 11/27/2022]
Abstract
To identify and map the caries risk management protocols with multiple strategies, which were used in Australia and New Zealand and reported in the existing literature, a scoping review was carried out by electronically searching PubMed, Web of Science, Scopus, Embase and Dentistry and Oral Science. Studies on caries risk management protocols, written in English, limited to Australia and New Zealand and published up to March 2018 were included in the review. There was no restriction on participants' age. Of 257 studies identified, seven were included in the review. These seven studies were reported in Australia and all but six were based on the caries management system (CMS). There were two descriptive studies, one 3-year multicentre cluster randomized controlled trial (RCT), one 2 to 4-year post-RCT follow-up and two cost-effective evaluations based on Markov decision analytic models. While concentrating on assessing individual behavioural risk factors for dental caries, studies indicated that the CMS would be more cost-effective if its protocol was properly adhered to. Future studies on caries risk management protocols are suggested to consider both the individual characteristics and the social context of different population groups in view of enhancing the effectiveness of oral care.
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Affiliation(s)
- N Amarasena
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - D Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,BetterStart Child Health and Development Research Group, School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - K G Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,School of Dentistry and Oral Health, Griffith University, Australia
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15
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Pakdaman A, Montazeri A, Evans RW. Deciduous dentition approximal caries lesion progression and regression following preventive treatment: literature review. Aust Dent J 2018; 63:422-428. [PMID: 30069879 DOI: 10.1111/adj.12646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 11/28/2022]
Abstract
The objective of this review was to investigate rates of caries lesion progression, arrest, and regression in approximal surfaces of deciduous teeth following secondary preventive interventions in order to inform caries management protocols. Studies published in English and other languages from 1960 till February 2017 were searched in electronic databases. Inclusion criteria were: randomized controlled clinical trials and longitudinal studies that involved non-invasive preventive treatment. We excluded: in vivo studies and incidence studies. 805 potential articles were located, of 38 full text reviews, 10 were included. Two types of studies were found; those reporting the mean percentage of lesion progression as progression estimate and those reporting the survival rate of lesions presented as the mean or median survival time in months as survival estimate. Weak evidence suggests it would appear that the most effective secondary preventive intervention was one involving a combination of silver fluoride and stannous fluoride, but this has not been substantiated. To inform treatment protocols better, it is recommended (i) that new well-designed RCTs are conducted to test the effectiveness of different forms of fluoride to arrest lesion progression in deciduous teeth and (ii) to continue ongoing research into the caries preventive effects of approximal surface sealants.
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Affiliation(s)
- A Pakdaman
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - A Montazeri
- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - R W Evans
- Formerly, Population Oral Health, University of Sydney, Sydney, New South Wales, Australia
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16
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Evans RW, Feldens CA, Phantunvanit P. A protocol for early childhood caries diagnosis and risk assessment. Community Dent Oral Epidemiol 2018; 46:518-525. [PMID: 30019771 DOI: 10.1111/cdoe.12405] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 06/19/2018] [Indexed: 12/25/2022]
Abstract
The global Early Childhood Caries (ECC) burden is of concern to the World Health Organisation (WHO), but the quantification of this burden and risk is unclear, partly due to difficulties in accessing young children for population surveys and partly due to diagnostic criteria for ECC experience. The WHO criterion for caries diagnosis is the late stage event of dentine cavitation. Earlier stages of the caries lesion are clinically detectable and should be registered earlier in the life of children and arrested/remineralized before lesions progress to the cavitation stage. A protocol for ECC diagnosis is proposed to guide those engaged in clinical dentistry in their characterization of the ECC lesion. As management of early lesions is a critical step to reduce risk of their progression to later stage lesions, a practical method for assessing ECC risk is proposed also. Risk assessment is very important because it determines (a) urgency for interventions aimed to arrest lesion progression; (b) the frequency of such interventions and (c) the need to enhance the primary prevention of ECC. The guidelines are set out separately for ECC diagnosis for ongoing clinical care and for epidemiologic purposes. Similarly, guidelines are set out for ECC risk assessment and ongoing monitoring.
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17
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Raphael SL, Foster Page LA, Hopcraft MS, Dennison PJ, Widmer RP, Evans RW. A survey of cariology teaching in Australia and New Zealand. BMC MEDICAL EDUCATION 2018; 18:75. [PMID: 29631580 PMCID: PMC5892021 DOI: 10.1186/s12909-018-1176-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The Australian and New Zealand chapter of the Alliance for a Cavity Free Future was launched in 2013 and one of its primary aims was to conduct a survey of the local learning and teaching of cariology in dentistry and oral health therapy programs. METHODS A questionnaire was developed using the framework of the European Organisation for Caries Research (ORCA)/Association of Dental Education in Europe (ADEE) cariology survey conducted in Europe in 2009. The questionnaire was comprised of multiple choice and open-ended questions exploring many aspects of the cariology teaching. The survey was distributed to the cariology curriculum coordinator of each of the 21 programs across Australia and New Zealand via Survey Monkey in January 2015. Simple analysis of results was carried out with frequencies and average numbers of hours collated and open-ended responses collected and compiled into tables. RESULTS Seventeen responses from a total of 21 programs had been received including 7 Dentistry and 10 Oral Health programs. Key findings from the survey were - one quarter of respondents indicated that cariology was identified as a specific discipline with their course and 41% had a cariology curriculum in written format. With regard to lesion detection and caries diagnosis, all of the program coordinators who responded indicated that visual/tactile methods and radiographic interpretation were recommended with ICDAS also being used by over half them. Despite all respondents teaching early caries lesion management centred on prevention and remineralisation, many taught operative intervention at an earlier stage of lesion depth than current evidence supports. Findings showed over 40% of respondents still teach operative intervention for lesions confined to enamel. CONCLUSION Despite modern theoretical concepts of cariology being taught in Australia and New Zealand, they do not appear to be fully translated into clinical teaching at the present time.
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Affiliation(s)
- Sarah L. Raphael
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
| | | | | | | | - Richard P. Widmer
- Department of Dentistry, Children’s Hospital at Westmead, Westmead, Australia
| | - R. Wendell Evans
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
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18
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Watanabe K, Sasabe T, Nakamura A, Eda K, Tanase K, Ikeda H, Ohata N, Minohara Y, Maki K, Watanabe S. Advantage of Introducing Quantitative Light-Induced Fluorescence in School Dental Checkups. Health (London) 2018. [DOI: 10.4236/health.2018.108083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Duangthip D, Chen KJ, Gao SS, Lo ECM, Chu CH. Managing Early Childhood Caries with Atraumatic Restorative Treatment and Topical Silver and Fluoride Agents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1204. [PMID: 28994739 PMCID: PMC5664705 DOI: 10.3390/ijerph14101204] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/02/2017] [Accepted: 10/07/2017] [Indexed: 11/17/2022]
Abstract
Early childhood caries (ECC) is a significant global health problem affecting millions of preschool children worldwide. In general, preschool children from families with 20% of the lowest family incomes suffered about 80% of the ECC. Most, if not all, surveys indicated that the great majority of ECC was left untreated. Untreated caries progresses into the dental pulp, causing pain and infection. It can spread systemically, affecting a child's growth, development and general health. Fundamental caries management is based on the conventional restorative approach. Because preschool children are too young to cope with lengthy dental treatment, they often receive dental treatment under general anaesthesia from a specialist dentist. However, treatment under general anaesthesia poses a life-threatening risk to young children. Moreover, there are few dentists in rural areas, where ECC is prevalent. Hence, conventional dental care is unaffordable, inaccessible or unavailable in many communities. However, studies showed that the atraumatic restorative treatment had a very good success rate in treating dentine caries in young children. Silver diamine fluoride is considered safe and effective in arresting dentine caries in primary teeth. The aim of this paper is to review and discuss updated evidence of these alternative approaches in order to manage cavitated ECC.
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Affiliation(s)
| | - Kitty Jieyi Chen
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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20
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Rirattanapong P, Vongsavan K, Saengsirinavin C, Khumsub P. The efficiency of child formula dentifrices containing different calcium and phosphate compounds on artificial enamel caries. J Int Soc Prev Community Dent 2016; 6:559-567. [PMID: 28032049 PMCID: PMC5184391 DOI: 10.4103/2231-0762.195517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Fluoride toothpaste has been extensively used to prevent dental caries. However, the risk of fluorosis is concerning, especially in young children. Calcium phosphate has been an effective remineralizing agent and is present in commercial dental products, with no risk of fluorosis to users. This in vitro study aimed to compare the effects of different calcium phosphate compounds and fluoride-containing dentifrices on artificial caries in primary teeth. MATERIALS AND METHODS Fifty sound primary incisors were coated with nail varnish, leaving two 1 mm2 windows on the labial surface before immersion in demineralizing solution for 96 hours to produce artificial enamel lesions. Subsequently, one window from each tooth was coated with nail varnish, and all 50 teeth were divided into five groups (n = 10); group A - deionized water; group B - casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (Tooth Mousse); group C - 500 ppm F (Colgate Spiderman®); group D - nonfluoridated toothpaste with triple calcium phosphate (Pureen®); and group E - tricalcium phosphate (TCP). Polarized light microscopy and Image-Pro® Plus software were used to evaluate lesions. RESULTS After a 7-day pH-cycle, mean lesion depths in groups A, B, C, D, and E had increased by 57.52 ± 10.66%, 33.28 ± 10.16%, 17.04 ± 4.76%, 32.51 ± 8.99%, and 21.76 ± 8.15%, respectively. All data were processed by the Statistical Package for the Social Sciences (version 16.0) software package. Comparison of percentage changes using one-way analysis of variance and Fisher's least squares difference tests at a 95% level of confidence demonstrated that group A was significantly different from the other groups (P < 0.001). Lesions in groups B and D had a significant lesion progression when compared with groups C and E. CONCLUSIONS All toothpastes in this study had the potential to delay the demineralization progression of artificial enamel caries in primary teeth. The fluoride 500 ppm and TCP toothpastes were equal in the deceleration of enamel caries progression and better than CPP-ACP paste and TCP toothpaste.
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Affiliation(s)
- Praphasri Rirattanapong
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kadkao Vongsavan
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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21
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van Loveren C, van Palenstein Helderman W. EAPD interim seminar and workshop in Brussels May 9 2015 : Non-invasive caries treatment. Eur Arch Paediatr Dent 2016; 17:33-44. [PMID: 26860292 PMCID: PMC4766220 DOI: 10.1007/s40368-015-0219-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/08/2015] [Indexed: 01/08/2023]
Abstract
Aim This was to collect information for the 9th European Academy of Paediatric Dentistry Interim Seminar and Workshops to discuss the state of art on non-invasive caries therapy to be used if possible to formulate clinical guidelines by European experts in paediatric dentistry Methods Based on systematic reviews and additional papers were assessed for methods to prevent caries initiation and caries progression both in the state of pre-cavitation and cavitation without invasive technologies. Results The use of fluoridated water, careful diligent daily use of fluoride toothpaste, fluoride varnishes, pit and fissure sealants and leak-proof restorative materials without excavation of caries are evidence based for caries prevention and for non-invasive treatment of pre-cavitated and cavitated caries. Other technologies are far less evidenced based and would not logically fit in guidelines for the non-invasive treatment of caries. Recent studies on cavitated lesions in the primary dentition demonstrate that thorough oral hygiene practices may arrest progression. This strategy depends heavily on the strategies in the dental surgery to change behaviour of children. An important aspect is for advice to be tailored at recall intervals to ensure compliance and to timely detect unnecessary and unwanted progression of the lesions. Conclusion Non-invasive therapies have been proven to be effective for caries prevention and the management of pre-cavitated caries lesions. Non-invasive therapies can also be effective to arrest cavitated lesions but the success depends greatly on behavioural changes of patients to brush the lesions.
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Affiliation(s)
- C van Loveren
- Department of Preventive Dentistry, Academic Centre for Dentistry, University of Amsterdam and VU University Amsterdam, ACTA, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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22
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Evans RW, Clark P, Jia N. The Caries Management System: are preventive effects sustained postclinical trial? Community Dent Oral Epidemiol 2015; 44:188-97. [PMID: 26639787 PMCID: PMC5324629 DOI: 10.1111/cdoe.12204] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
Objectives To report, at two and 4 years post‐trial, on the potential legacy of a 3‐year randomized controlled clinical trial (RCT) of the Caries Management System (CMS) at private general dental practices. The CMS was designed to reduce caries risk and need for restorative care. Methods Nineteen dental practices located in city, urban, and rural locations in both fluoridated and nonfluoridated communities participated in the RCT. Eight practices were lost to follow‐up post‐trial; however, baseline mean DMFT balance between CMS and control practices was maintained. At the control practices, caries management following usual practice continued to be delivered. The patient outcome measure was the cumulative increment in the DMFT index score, and the practice outcome measures included the practice‐mean and practice‐median increments of patient DMFT index scores. In covariable analysis (patient‐level unit of analysis), as the patients were clustered by practices, mean DMFT increments were determined through multilevel modeling analysis. Practice‐mean DMFT increments (practice‐level unit of analysis) and practice‐median DMFT increments (also practice level) were determined through general linear modeling analysis of covariance. In addition, a multiple variable logistic regression analysis of caries risk status was conducted. Results The overall 4‐year post‐trial result (years 4–7) for CMS patients was a DMFT increment of 2.44 compared with 3.39 for control patients (P < 0.01), a difference equivalent to 28%. From the clinical trial baseline to the end of the post‐trial follow‐up period, the CMS and control increments were 6.13 and 8.66, respectively, a difference of 29% (P < 0.0001). Over the post‐trial period, the CMS and control practice‐mean DMFT increments were 2.16 and 3.10 (P = 0.055) and the respective increments from baseline to year 7 were 4.38 and 6.55 (P = 0.029), difference of 33%. The practice‐median DMFT increments during the 4‐year post‐trial period for CMS and control practices were 1.25 and 2.36 (P = 0.039), and the respective increments during the period from baseline to year 7 were 2.87 and 5.36 (P < 0.01), difference of 47%. Minimally elevated odds of being high risk were associated with baseline DMFT (OR = 1.17). Patients attending the CMS practices had lower odds of being high risk than those attending control practices (OR = 0.23, 95% CI = 0.06, 0.88). Conclusion In practices where adherence to the CMS protocols was maintained during the 4‐year post‐trial follow‐up period, patients continued to benefit from a reduced risk of caries and, therefore, experienced lower needs for restorative treatment.
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Affiliation(s)
- R Wendell Evans
- Population Oral Health, Sydney Dental School, University of Sydney, Sydney, NSW, Australia
| | - Paula Clark
- Population Oral Health, Sydney Dental School, University of Sydney, Sydney, NSW, Australia
| | - Nan Jia
- Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
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Chaffee BW, Cheng J, Featherstone JDB. Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study. BMC Oral Health 2015; 15:111. [PMID: 26403525 PMCID: PMC4581405 DOI: 10.1186/s12903-015-0097-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 09/16/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Consensus guidelines support non-operative preventives for dental caries management; yet, their use in practice is far from universal. The purpose of this study was to evaluate the effectiveness of non-operative anti-caries agents in caries prevention among high caries risk adults at a university clinic where risk-based caries management is emphasized. METHODS This retrospective observational study drew data from the electronic patient records of non-edentulous adult patients deemed to be at high risk for dental caries during baseline oral evaluations that were completed between July 1, 2007 and December 31, 2012 at a dental university in the United States. We calculated and compared adjusted mean estimates for the number of new decayed or restored teeth (DFT increment) from baseline to the next completed oral evaluation (N = 2,724 patients with follow-up) across three categories of delivery of non-operative anti-caries agents (e.g., high-concentration fluoride toothpaste, chlorhexidine rinse, xylitol products): never, at a single appointment, or at ≥2 appointments ≥4 weeks apart. Estimates were adjusted for patient and provider characteristics, baseline dental status, losses-to-follow-up, and follow-up time. RESULTS Approximately half the patients did not receive any form of non-operative anti-caries agent. Most that received anti-caries agents were given more than one type of product in combination. One-time delivery of anti-caries agents was associated with a similar DFT increment as receiving no such therapy (difference in increment: -0.04; 95% CI: -0.28, 0.21). However, repeated, spaced delivery of anti-caries agents was associated with approximately one decayed or restored tooth prevented over 18 months for every three patients treated (difference in increment: -0.35; 95% CI: -0.65, -0.08). CONCLUSIONS These results lend evidence that repeatedly receiving anti-caries agents can reduce tooth decay among high-risk patients engaged in regular dental care.
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Affiliation(s)
- Benjamin W Chaffee
- Center to Address Disparities in Children's Oral Health, UCSF School of Dentistry, 3333 California Street, Suite 495, San Francisco, CA, 94143-1361, USA.
| | - Jing Cheng
- Center to Address Disparities in Children's Oral Health, UCSF School of Dentistry, 3333 California Street, Suite 495, San Francisco, CA, 94143-1361, USA.
| | - John D B Featherstone
- UCSF School of Dentistry, 513 Parnassus Ave, Room S630, San Francisco, CA, 94143-0430, USA.
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24
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Caries risk assessment in children: how accurate are we? Eur Arch Paediatr Dent 2015; 17:27-32. [DOI: 10.1007/s40368-015-0195-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 06/24/2015] [Indexed: 10/23/2022]
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25
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Masoe AV, Blinkhorn AS, Taylor J, Blinkhorn FA. Factors that influence the preventive care offered to adolescents accessing Public Oral Health Services, NSW, Australia. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2015; 6:101-13. [PMID: 26124689 PMCID: PMC4476312 DOI: 10.2147/ahmt.s84332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Many adolescents are at risk of dental caries and periodontal disease, which may be controlled through health education and clinical preventive interventions provided by oral health and dental therapists (therapists). Senior clinicians (SCs) can influence the focus of dental care in the New South Wales (NSW) Public Oral Health Services as their role is to provide clinical support and advice to therapists, advocate for their communities, and inform Local Health District (LHD) managers of areas for clinical quality improvement. The objective of this study was to record facilitating factors and strategies that are used by SCs to encourage therapists to provide preventive care and advice to adolescent patients. METHODS In-depth, semistructured interviews were undertaken with 16 SCs from all of the 15 NSW LHDs (nine rural and six metropolitan). A framework matrix was used to systematically code data and enable key themes to be identified for analysis. RESULTS All SCs from the 15 NSW Health LHDs participated in the study. Factors influencing SCs' ability to integrate preventive care into clinical practice were: 1) clinical leadership and administrative support, 2) professional support network, 3) clinical and educational resources, 4) the clinician's patient management aptitude, and 5) clinical governance processes. Clinical quality improvement and continuing professional development strategies equipped clinicians to manage and enhance adolescents' confidence toward self-care. CONCLUSION This study shows that SCs have a clear understanding of strategies to enhance the therapist's offer of scientific-based preventive care to adolescents. The problem they face is that currently, success is measured in terms of relief of pain activities, restorations placed, and extraction of teeth, which is an outdated concept. However, to improve clinical models of care will require the overarching administrative authority, NSW Health, to accept that the scientific evidence relating to dental care has changed and that management monitoring information should be incorporated into NSW Health reforms.
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Affiliation(s)
- Angela V Masoe
- School of Health Sciences, Faculty of Health and Medicine, Oral Health, University of Newcastle, Ourimbah, NSW, Australia
| | - Anthony S Blinkhorn
- Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia
| | - Jane Taylor
- School of Health Sciences, Faculty of Health and Medicine, Oral Health, University of Newcastle, Ourimbah, NSW, Australia
| | - Fiona A Blinkhorn
- School of Health Sciences, Faculty of Health and Medicine, Oral Health, University of Newcastle, Ourimbah, NSW, Australia
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26
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Affiliation(s)
- RJM Knevel
- School of Dentistry and Oral Health; La Trobe Rural Health School; La Trobe University; Bendigo Australia
| | - M Gussy
- School of Dentistry and Oral Health; La Trobe Rural Health School; La Trobe University; Bendigo Australia
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Twetman S, Fontana M, Featherstone JDB. Risk assessment - can we achieve consensus? Community Dent Oral Epidemiol 2015; 41:e64-70. [PMID: 24916679 DOI: 10.1111/cdoe.12026] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The object of this conference paper was to review and discuss caries risk assessment in general practice from the questions i) 'Why', ii) 'When', and iii) 'How'. METHOD Narrative review. RESULTS i) Patient caries risk assessment is the basic component in the decision-making process for adequate prevention and management of dental caries and for determination of individual recall intervals. ii) Caries risk assessment should always be performed at a child's first dental visit and then regularly throughout life, and especially when social or medical life events are occurring. iii) There are several risk assessment methods and models available for but the evidence for their validity is limited. Although there is no clearly superior method for predicting future caries, the use of structured protocols combining socioeconomy, behavior, general health, diet, oral hygiene routines, clinical data, and salivary tests or computer-based systems are considered best clinical practice. The accuracy ranges between 60% and 90%, depending on age. Caries risk assessment is more effective in the selection of patients at low risk than those with high caries risk. CONCLUSION As evidence suggests that past caries experience is far from ideal but the most important single risk component for more caries at all ages, any clinical sign of likely active demineralization on smooth, occlusal, and proximal tooth surfaces should be taken as a signal for the implementation of individually designed preventive and disease management measures.
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Affiliation(s)
- Svante Twetman
- Institute of Dentistry, Department of Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Ismail AI, Tellez M, Pitts NB, Ekstrand KR, Ricketts D, Longbottom C, Eggertsson H, Deery C, Fisher J, Young DA, Featherstone JDB, Evans W, Zeller GG, Zero D, Martignon S, Fontana M, Zandona A. Caries management pathways preserve dental tissues and promote oral health. Community Dent Oral Epidemiol 2015; 41:e12-40. [PMID: 24916676 DOI: 10.1111/cdoe.12024] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In May 2012, cariologists, dentists, representatives of dental organizations, manufacturers, and third party payers from several countries, met in Philadelphia, Pennsylvania, to define a common mission; goals and strategic approaches for caries management in the 21th century. The workshop started with an address by Mr. Stanley Bergman, CEO of Henry Schein Inc. which focused on the imperative for change in academia, clinical practice, and public health. For decades, new scientific evidence on caries and how it should be managed have been discussed among experts in the field. However, there has been some limited change, except in some Scandinavian countries, in the models of caries management and reimbursement which have been heavily skewed toward 'drilling and filling'. There is no overall agreement on a caries' case definition or on when to surgically intervene. The participants in the workshop defined a new mission for all caries management approaches, both conventional and new. The mission of each system should be to preserve the tooth structure, and restore only when necessary. This mission marks a pivotal line for judging when to surgically intervene and when to arrest or remineralize early noncavitated lesions. Even when restorative care is necessary, the removal of hard tissues should be lesion-focused and aim to preserve, as much as possible, sound tooth structure. Continuing management of the etiological factors of caries and the use of science-based preventive regimens also will be required to prevent recurrence and re-restoration. These changes have been debated for over a decade. The Caries Management Pathways includes all systems and philosophies, conventional and new, of caries management that can be used or modified to achieve the new mission. The choice of which system to use to achieve the mission of caries management is left to the users and should be based on the science supporting each approach or philosophy, experience, utility, and ease of use. This document also presents a new 'Caries Management Cycle' that should be followed regardless of which approach is adopted for caries prevention, detection, diagnosis, and treatment. To aid success in the adoption of the new mission, a new reimbursement system that third party payers may utilize is proposed (for use by countries other than Scandinavian countries or other countries where such systems already exist). The new reimbursement/incentive model focuses on the mission of preservation of tooth structure and outcomes of caries management. Also described, is a research agenda to revitalize research on the most important and prevalent world-wide human disease. The alliance of major dental organizations and experts that started in Philadelphia will hopefully propel over the next months and years, a change in how caries is managed by dentists all over the world. A new mission has been defined and it is time for all oral health professionals to focus on the promotion of oral health and preservation of sound teeth rather than counting the number of surgical restorative procedures provided.
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Affiliation(s)
- Amid I Ismail
- Korenberg School of Dentistry, Temple University, Philadelphia, PA, USA
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Duangthip D, Jiang M, Chu CH, Lo ECM. Non-surgical treatment of dentin caries in preschool children--systematic review. BMC Oral Health 2015; 15:44. [PMID: 25888484 PMCID: PMC4403709 DOI: 10.1186/s12903-015-0033-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 03/26/2015] [Indexed: 11/10/2022] Open
Abstract
Background Untreated dentin caries in primary teeth is commonly found in preschool children worldwide. Recently, the use of simple non-surgical approaches to manage the situation has been advocated. The aim of the study was to systematically review and evaluate the literature on effectiveness of non-surgical methods in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children. Methods A systematic search of the main electronic databases (Pubmed, Cochrane Collaboration, EMBASE) was conducted to identify peer reviewed papers published in English in the years 1947–2014. Keywords and MeSH terms used in the search were “dental caries”, “primary dentition” and various non-surgical treatments (fluoride, sealant, resin infiltration, xylitol, chlorhexidine, CPP-ACP, ozone, etc.). The inclusion criteria were clinical studies conducted in children under 6 years old, and reported findings on caries arrest or caries progression in primary teeth. Retrieved papers were read by two reviewers independently to assess suitability for inclusion, and the final decision was made by consensus. Quality of the included studies was assessed and data were extracted for analysis. Results The search identified 323 papers for screening. Among these, 290 papers did not satisfy the study inclusion criteria. Consequently, 33 full papers were retrieved and reviewed. Finally, 4 studies were included. Three studies reported that topical applications of silver diammine fluoride (SDF) solution could arrest dentin caries in preschool children. One study supported that having a daily toothbrushing exercise in kindergarten using toothpaste with 1000 ppm fluoride could stabilize the caries situation in young children. Conclusions There is limited evidence to support the effectiveness of SDF applications or daily toothbrushing with fluoride toothpaste in arresting or slowing down the progression of active dentin caries in primary teeth in preschool children. More well-designed randomized controlled trials are required to confirm these findings.
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Affiliation(s)
- Duangporn Duangthip
- Faculty of Dentistry, University of Hong Kong, 3/F, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
| | - Ming Jiang
- Faculty of Dentistry, University of Hong Kong, 3/F, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
| | - Chun Hung Chu
- Faculty of Dentistry, University of Hong Kong, 3/F, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
| | - Edward C M Lo
- Faculty of Dentistry, University of Hong Kong, 3/F, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, SAR, China.
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Masoe AV, Blinkhorn AS, Taylor J, Blinkhorn FA. Preventive and clinical care provided to adolescents attending public oral health services New South Wales, Australia: a retrospective study. BMC Oral Health 2014; 14:142. [PMID: 25432193 PMCID: PMC4266880 DOI: 10.1186/1472-6831-14-142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 11/04/2014] [Indexed: 11/20/2022] Open
Abstract
Background Dental Therapists and Oral Health Therapists (Therapists) working in the New
South Wales (NSW) Public Oral Health Service are charged with providing clinical
dental treatment including preventive care for all children under 18 years of age.
Adolescents in particular are at risk of dental caries and periodontal disease
which may be controlled through health education and clinical preventive
interventions. However, there is a dearth of evidence about the type or the
proportion of clinical time allocated to preventive care. The aim of this study is to record the proportion and type of preventive care
and clinical treatment activities provided by Therapists to adolescents accessing
the NSW Public Oral Health Service. Methods Clinical dental activity data for adolescents was obtained from the NSW Health
electronic Information System for Oral Health (ISOH) for the year 2011. Clinical
activities of Therapists were examined in relation to the provision of different
types of preventive care for adolescents by interrogating state-wide public oral
health data stored on ISOH. Results Therapists were responsible for 79.7 percent of the preventive care and 83.0
percent of the restorative treatment offered to adolescents accessing Public Oral
Health Services over the one year period. Preventive care provided by Therapists
for adolescents varied across Local Health Districts ranging from 32.0 percent to
55.8 percent of their clinical activity. Conclusions Therapists provided the majority of clinical care to adolescents accessing NSW
Public Oral Health Services. The proportion of time spent undertaking prevention
varied widely between Local Health Districts. The reasons for this variation
require further investigation.
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Affiliation(s)
- Angela V Masoe
- Faculty of Health, School of Health Sciences, Oral Health, University of Newcastle, Ourimbah, NSW 2258, Australia.
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Vermaire J, Poorterman J, van Herwijnen L, van Loveren C. A Three-Year Randomized Controlled Trial in 6-Year-Old Children on Caries-Preventive Strategies in a General Dental Practice in the Netherlands. Caries Res 2014; 48:524-33. [DOI: 10.1159/000358342] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 12/31/2013] [Indexed: 11/19/2022] Open
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Frydrych AM, Koong B. Hyposalivation in a 16-year-old girl: a case of salivary gland aplasia. Aust Dent J 2014; 59:125-8. [DOI: 10.1111/adj.12136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2013] [Indexed: 11/29/2022]
Affiliation(s)
- AM Frydrych
- School of Dentistry; The University of Western Australia; Perth Western Australia
| | - B Koong
- School of Dentistry; The University of Western Australia; Perth Western Australia
- Envision Medical Imaging; Wembley Western Australia
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Hallett KB. The application of caries risk assessment in minimum intervention dentistry. Aust Dent J 2013; 58 Suppl 1:26-34. [DOI: 10.1111/adj.12047] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- KB Hallett
- Department of Dentistry; The Royal Children's Hospital; Melbourne; Victoria
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Calache H, Hopcraft MS, Martin JM. Minimum intervention dentistry - a new horizon in public oral health care. Aust Dent J 2013; 58 Suppl 1:17-25. [DOI: 10.1111/adj.12046] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - MS Hopcraft
- Melbourne Dental School; The University of Melbourne; Victoria
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Ismail AI. Preface. Community Dent Oral Epidemiol 2013; 41:e9-e11. [DOI: 10.1111/cdoe.12023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Amid I. Ismail
- Laura H. Carnell Professor and Dean, Kornberg School of Dentistry; Temple University
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Saha S, Tomaro-Duchesneau C, Tabrizian M, Prakash S. Probiotics as oral health biotherapeutics. Expert Opin Biol Ther 2012; 12:1207-20. [PMID: 22690730 DOI: 10.1517/14712598.2012.693474] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Oral health is affected by its resident microorganisms. Three prominent oral disorders are dental caries, gingivitis and periodontitis, with the oral microbiota playing a key role in the initiation/progression of all three. Understanding the microbiota and the diseases they may cause is critical to the development of new therapeutics. This review is focused on probiotics for the prevention and/or treatment of oral diseases. AREAS COVERED This review describes the oral ecosystem and its correlation with oral health/disease. The pathogenesis and current prevention/treatment strategies of periodontal diseases (PD) and dental caries (DC) are depicted. An introduction of probiotics is followed by an analysis of their role in PD and DC, and their potential role(s) in oral health. Finally, a discussion ensues on the future research directions and limitations of probiotics for oral health. EXPERT OPINION An effective oral probiotic formulation should contribute to the prevention/treatment of microbial diseases of the oral cavity. Understanding the oral microbiota's role in oral disease is important for the development of a therapeutic to prevent/treat dental diseases. However, investigations into clinical efficacy, delivery/dose optimization, mechanism(s) of action and other related parameters are yet to be fully explored. Keeping this in mind, investigations into oral probiotic therapies are proving promising.
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Affiliation(s)
- Shyamali Saha
- McGill University, Physiology and Artificial Cells and Organs Research Centre, Departments of Biomedical Engineering, Biomedical Technology and Cell Therapy, Research Laboratory, Faculty of Medicine, 3775 University Street, Montreal, Quebec, H3A 2B4, Canada
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Chong GTF, Evans RW, Dennison PJ. Screening for caries in targeted schools in the Blue Mountains and Hawkesbury districts, New South Wales, Australia: an evaluation of the School Assessment Program. ACTA ACUST UNITED AC 2011; 2:259-67. [PMID: 25426897 DOI: 10.1111/j.2041-1626.2011.00069.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To determine if the school dental screening program in New South Wales, the School Assessment Program, achieved its aim of being the key entry point for high-risk children to receive care. METHODS A secondary analysis was conducted on epidemiological data gathered in 16 primary schools in New South Wales (10 for the School Assessment Program and six for the non-School Assessment Program) in 2003. The validity of the School Assessment Program targeting criteria in identifying high-risk schools was determined. Post-screening treatment outcomes were evaluated from the assessment of treatment ratios. RESULTS There were negligible differences in the caries experience and proportions of high-risk children, irrespective of their School Assessment Program status. Sensitivity and specificity values were approximately 60% and 40%, respectively, using various case definitions of high risk applied to both children and schools. Deciduous dentition treatment ratios for School Assessment Program and non-School Assessment Program children with decayed, missing, and filled teeth (dmft) ≥1 ranged from 0.48 to 0.79 and from 0.47 to 0.73, respectively. Respective permanent dentition treatment ratios for School Assessment Program and non-School Assessment Program children with Decayed, Missing, and Filled Teeth (DMFT) ≥1 were 0.49-0.82 and 0.64-1.08. CONCLUSION The School Assessment Program failed to identify schools with high caries-risk children or confer post-screening caries treatment benefits.
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Arora A, Evans RW, Sivaneswaran S, Sujeer AN, Blinkhorn AS. Parental support for water fluoridation in Lithgow, New South Wales. Aust Dent J 2010; 55:417-22. [PMID: 21133941 DOI: 10.1111/j.1834-7819.2010.01263.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A Arora
- Population Oral Health, Faculty of Dentistry, The University of Sydney.
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