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Amaechi BT, AbdulAzees PA, Mohseni S, Luong MN, Lin CY, Restrepo-Ceron MC, Kataoka Y, Omosebi TO, Kanthaiah K. Caries preventing efficacy of new Isomalt-containing mouthrinse formulations: a microbial study. BDJ Open 2024; 10:51. [PMID: 38890317 PMCID: PMC11189562 DOI: 10.1038/s41405-024-00241-4] [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: 04/13/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES The effectiveness of an Isomalt-containing mouthrinse to prevent caries development was investigated. METHODS Human enamel blocks were randomly assigned to five groups (n = 30/group): De-ionized distilled water (DDW), and mouthrinse containing either (IFC) 1% Isomalt, 225 ppm fluoride, and 0.05% cetylpyridinium chloride (CPC), (IF) 1% Isomalt and 225ppm fluoride, (FC) 225 ppm fluoride and 0.05% CPC or (F) 225 ppm fluoride. During 7-day demineralization in a Microbial Caries Model, mouthrinses were applied once daily for 1 min. Demineralization was assessed using Surface Microhardness testing for percentage change in SMH (%ΔSMH) and Transverse Microradiography for mineral loss (ΔZ). Data analysis (α = 0.05) used paired t-test (Intra-group comparison using SMH) and ANOVA/Tukey's for inter-group comparisons (%ΔSMH and ΔZ). RESULTS With SMH, relative to sound enamel baseline, demineralization was significant (P < 0.001) in all groups, except in IFC. Intergroup comparison with %ΔSMH showed significantly (p < 0.001) greater demineralization in DDW compared to other groups, and in IF, FC, and F compared to IFC (P < 0.001). With ΔZ, relative to DDW, all groups significantly (p < 0.0001) inhibited demineralization at varying percentages. CONCLUSIONS Mouthrinse containing Isomalt, fluoride, and CPC inhibited demineralization amidst cariogenic biofilm; thus, highlighting its potential as a more effective caries control tool than mouthrinse with only fluoride.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, TX, USA.
| | | | - Sahar Mohseni
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, TX, USA
| | - Minh N Luong
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, TX, USA
| | - Chun-Yen Lin
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, TX, USA
- Department of Dentistry, Tri-Service General Hospital, Taipei City, Taiwan, ROC
| | - Maria Camila Restrepo-Ceron
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, TX, USA
- CES University, Medellín, Colombia
| | - Yuko Kataoka
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, TX, USA
| | - Temitope O Omosebi
- Department of Restorative Dentistry, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Kannan Kanthaiah
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, TX, USA
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Pienihäkkinen K, Hietala-Lenkkeri A, Arpalahti I, Söderling E. The effect of xylitol chewing gums and candies on caries occurrence in children: a systematic review with special reference to caries level at study baseline. Eur Arch Paediatr Dent 2024; 25:145-160. [PMID: 38430364 PMCID: PMC11058973 DOI: 10.1007/s40368-024-00875-w] [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: 05/03/2023] [Accepted: 01/24/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE A systematic review of published data was carried out to assess the caries-preventive effects of xylitol chewing gums and candies in children. METHODS Electronic and hand searches were performed to find clinical studies on the effects of xylitol chewing gums and candies on dental caries in children (≤ 18 years). Prospective randomised or controlled clinical trials published before 2023 were included in the review. RESULTS The initial search identified 365 titles to be evaluated. After applying inclusion and exclusion criteria, 15 articles with either fair or low quality were reviewed. Nine articles studied chewing gums, five candies, and one both of them. In the ten evaluated xylitol chewing gum studies xylitol consumption significantly reduced caries occurrence when compared with no treatment or a placebo polyol gum. The effect was clinically significant in studies with high or moderate caries level at study baseline. The results also suggested that the caries-reducing effect of xylitol gums may differ from sorbitol/polyol gums. In five of the six heterogenous xylitol candy studies, no caries-reducing effect was found independent of caries level. In addition to caries level, also the daily xylitol dose was a confounding factor. CONCLUSION The present findings suggest that the caries-reducing effect of adding xylitol chewing gum to the daily diet has been well demonstrated in children and adolescents with high or moderate caries level at study baseline. Xylitol gum use could benefit subjects with active incipient caries lesions on smooth tooth surfaces.
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Affiliation(s)
- K Pienihäkkinen
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - A Hietala-Lenkkeri
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - I Arpalahti
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland
| | - E Söderling
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland.
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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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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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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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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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Cheng L, Zhang L, Yue L, Ling J, Fan M, Yang D, Huang Z, Niu Y, Liu J, Zhao J, Li Y, Guo B, Chen Z, Zhou X. Expert consensus on dental caries management. Int J Oral Sci 2022; 14:17. [PMID: 35361749 PMCID: PMC8971510 DOI: 10.1038/s41368-022-00167-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 02/05/2023] Open
Abstract
Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
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Affiliation(s)
- Lei Cheng
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China
| | - Lu Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong, China
| | - Mingwen Fan
- School of Medicine, Jianghan University, Wuhan, China
| | - Deqin Yang
- College of Stomathology, Chongqing Medical University, Chongqing, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Yumei Niu
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, China
| | - Jianguo Liu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Yanhong Li
- Affiliated Stomatological Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Bin Guo
- Department of Stomatology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China.
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Gowdar I, BinKhames Y, Althani R, Almuthaybiri S, Alabdulmuhsin S, Alatiyyah F. Knowledge of caries risk assessment among dental students in Riyadh Region Saudi Arabia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S327-S330. [PMID: 36110735 PMCID: PMC9469363 DOI: 10.4103/jpbs.jpbs_804_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Caries is a preventable dental disease; further, it is associated with many risk factors. If risk factors are identified and evaluated in time, prevention can be achieved. Aim: Present study attempts to assess the knowledge of caries risk evaluation among dental students in Riyadh using a cross-sectional observational study design. Materials and Methods: The study comprised 390 dental students, interns, from the Riyadh region, Saudi Arabia. Questionnaire was developed to assess knowledge about Caries Risk Assessment (CRA). Questionnaire included ten straight statements with options for acceptance or refusal by marking true or false. Results: About 10.3% of the participants accepted dental caries as transmissible disease. About 69.5% of the participants think White spot lesions as carious lesions. 66.9% predict radiographic approximal lesions are disease indicators. Conclusion: Majority of the participants possessed knowledge about caries risk assessment, although prevention-oriented knowledge needs to be improved because knowledge of caries inducing aspects and risk of occurrence among clinicians help to deliver tailored preventive measures and appropriate execution of treatment.
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Corchuelo-Ojeda J, González Pérez GJ, Casas-Arcila A. Factors Associated With Self-Perception in Oral Health of Pregnant Women. HEALTH EDUCATION & BEHAVIOR 2021; 49:516-524. [PMID: 34955047 PMCID: PMC9149525 DOI: 10.1177/10901981211038903] [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] [Indexed: 11/16/2022]
Abstract
Background Health perception is a subjective predictor of long-term morbidity and
mortality. Few studies address the perception that pregnant women have of
their oral health. Objective The objective of this study was to explore the relationship between
socioeconomic factors and self-assessment of oral health in pregnant women
from Cali, Colombia. Method A cross-sectional study was carried out with a sample of 998 pregnant women,
calculated using the formula to estimate a proportion in finite populations,
with a confidence level of 95%. A questionnaire was applied for
sociodemographic characterization, as well as to enquire about oral health
perception, knowledge, and practices of oral health. Results The mean age of the surveyed mothers was 24.7, with a standard deviation of
6.1, of which 23.6% were adolescents. The perception they had about their
oral health status was considered good by 60.8%. Of the 82.9% who reported
having attended dentistry, more than half perceived good oral health.
Pregnant women with no history of oral problems, with a perception of medium
or high income, and with good oral hygiene practices tend to have a good
perception of their oral health. Conclusion Pregnant women with no history of oral problems, with a perception of medium
or high income, and with good oral hygiene practices tend to have a good
perception of their oral health.
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10
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Amaechi BT, Alshareif DO, Azees PAA, Shehata MA, Lima PP, Abdollahi A, Kalkhorani PS, Evans V, Bagheri A, Okoye LO. Anti-caries evaluation of a nano-hydroxyapatite dental lotion for use after toothbrushing: An in situ study. J Dent 2021; 115:103863. [PMID: 34743963 DOI: 10.1016/j.jdent.2021.103863] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 09/20/2021] [Accepted: 10/22/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The aim of this randomized, double-blind, two-arm crossover in situ study was to investigate whether nano-hydroxyapatite (nanoHAP) dental lotion (Apagard Deep Care) applied immediately after tooth-brushing with nanoHAP toothpaste (Apagard M-plus) enhances the remineralization promotion and the demineralization inhibition efficacies of nanoHAP toothpastes. METHODS 64 sound enamel blocks and 64 blocks bearing artificially-produced initial caries were produced from human permanent molar teeth. During each treatment period, lasting 14 days per arm, two blocks, one sound and one lesion-bearing, were exposed to either 5% nanoHAP-containing or placebo dental lotion after tooth-brushing with 5% nanoHAP toothpaste, via an intra-oral appliance worn by 30 adults in each of the study groups. Baseline and post-test mineral loss were quantified using transverse microradiography (TMR). One-sided t-test of one group mean was used for intragroup comparison, while two-sided t-test of two independent means was used to compare the two dental lotions. RESULTS Pairwise comparison (baseline vs. post-test) indicated significant (p<.001) remineralization by nanoHAP toothpaste in both groups. However, when compared against each other, there was a significantly (p<.001) greater percentage of remineralization with nanoHAP lotion [58.4(±1.8)%] than with placebo lotion [37.7(±2.2)%]. TMR examination showed absolute demineralization inhibition in sound enamel blocks exposed to either lotions. CONCLUSIONS Toothpaste containing 5% nanoHAP effectively remineralized initial caries and inhibited demineralization of healthy enamel; however, the application of a dental lotion containing 5% nanoHAP after brushing resulted in superior remineralization compared to a placebo lotion. CLINICAL SIGNIFICANCE Dental lotion containing 5% nanohydroxyapatite used immediately after toothbrushing with 5% nanohydroxyapatite toothpaste can serve as an adjunct to enhance the clinical benefits of the toothpaste.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
| | - Dina O Alshareif
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Parveez A Abdul Azees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Marina A Shehata
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Patricia P Lima
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Azadeh Abdollahi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Parisa S Kalkhorani
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Veronica Evans
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Ariana Bagheri
- Department of Biology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249, United States
| | - Linda O Okoye
- Faculty of Dentistry, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
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Gupta A, Gallagher JE, Chestnutt IG, Godson J. Formulation and fluoride content of dentifrices: a review of current patterns. Br Dent J 2021:10.1038/s41415-021-3424-y. [PMID: 34552213 DOI: 10.1038/s41415-021-3424-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/07/2020] [Indexed: 11/08/2022]
Abstract
Introduction Consumer oral hygiene products play a key role in improving and maintaining population oral health. The oral personal care market is rapidly diversifying; a growing number of dentifrices marketed a 'natural' and fluoride-free are entering mainstream retailers, which may have implications for the oral health of the population 'with regards to caries risk.Aims To investigate the range of fluoride concentrations, flavour formulations and delivery mechanisms of dentifrices available on the UK market.Methods A cross-sectional survey was used to catalogue dentifrices sold in a range of supermarkets, high-street pharmacy and health chains, and specialist online retailers. In addition, a standard search engine was used to examine dentifrice brands being sold in the UK. The fluoride content was recorded as parts per million (ppm) and the product name data were analysed for key terms using Microsoft Excel. Excluded from the survey were mouthwashes, rinses and non-dentifrice whitening products.Results Five hundred different toothpaste, tooth powder and tablet products from 95 different brands were recorded. Sixty percent of these contained a fluoride concentration of 1,000 ppm or above. Forty-five percent of all products had the recommended adult concentration of at least 1,350 ppm. Almost one-third (31%) contained no fluoride and 4% of products did not specify the absence, presence or concentration of fluoride.Conclusions This study has quantified and confirmed the increasingly diverse range of dentifrices for sale in the UK. A large number of fluoride-free products exist within a growing 'natural' and 'organic market'. The study also gives oral health professionals an insight into the diverse types of products available to consumers in order to appropriately advise patients on caries prevention.
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Affiliation(s)
- Anisha Gupta
- Dental Core Trainee & Academic Clinical Fellow, University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, UK; Honorary Research Fellow, University of Bristol, UK; Dental Core Trainee in Dental Public Health, King´s College Hospital Dental Institute, Bessemer Road, London, SE5 9RS, UK; Honorary Research Associate, King´s College London, UK.
| | - Jennifer E Gallagher
- Newland-Pedley Professor of Oral Health Strategy/Honorary Consultant in Dental Public Health, Dean for International Affairs, Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, Bessemer Road, London, SE5 9RS, UK
| | - Ivor G Chestnutt
- Professor and Honorary Consultant, Dental Public Health, College of Biomedical and Life Sciences, Cardiff University, UK
| | - Jenny Godson
- National Lead for Oral Health Improvement, Public Health England, UK
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Interactions of boron released from surface pre-reacted glass ionomer with enamel/dentin and its effect on pH. Sci Rep 2021; 11:15734. [PMID: 34344982 PMCID: PMC8333262 DOI: 10.1038/s41598-021-95279-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 07/19/2021] [Indexed: 02/07/2023] Open
Abstract
This study investigated the interaction of borate ions released from surface pre-reacted glass ionomer (S-PRG) fillers with the biological apatites of enamel and dentin using solid-state (SS) magic-angle spinning nuclear magnetic resonance (MAS-NMR) spectroscopy analysis. We further evaluated the effect of borate ions on the pH change. Bovine enamel and dentin powder were submerged in S-PRG eluate (with borate ion concentration of 100 mM) for 3 h, then washed with deionized water (DW). The dried enamel and dentin specimens were used for 11B SS-NMR and Fourier transform infrared spectroscopy (FT-IR) analysis. Enamel and dentin blocks were treated with three solutions: DW (control), S-PRG eluent and borate solution (100 mM). The treated samples were submerged in the demineralization solution and the pH was measured using a pH meter daily for 6 days. The surfaces of the enamel and dentin blocks were then observed using field emission scanning electron microscopy (FE-SEM). SS-NMR analysis revealed the presence of adsorbed borate ions in the enamel and dentin samples in a tetra-coordinated form. The pH results demonstrated an increase in pH values in the S-PRG and borate groups. SEM images showed that the surfaces of the control group were demineralized, whereas the surfaces of the S-PRG and borate groups were intact. These results concluded that borate ions could be adsorbed to enamel and dentin in the tetra-coordinated form. Borate ions possess a buffer capacity which may help to protect the tooth structure against acid attacks and promote remineralization.
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Khallaf YS, Hafez S, Shaalan OO. Evaluation of ICCMS versus CAMBRA Caries Risk Assessment Models Acquisition on Treatment Plan in Young Adult Population: A Randomized Clinical Trial. Clin Cosmet Investig Dent 2021; 13:293-304. [PMID: 34290532 PMCID: PMC8289689 DOI: 10.2147/ccide.s318313] [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: 05/06/2021] [Accepted: 06/22/2021] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To evaluate the difference between ICCMS and CAMBRA models on treatment plan of young adults. SETTINGS AND DESIGN A total of 104 young adult patients were randomly divided into two groups, either ICCMS or CAMBRA. PATIENTS AND METHODS Patients were examined according to the criteria of the ICDAS-II and caries risk was analyzed according to CAMBRA and divided into two equal groups according to treatment protocol. Caries incidence was assessed according to ICDAS-II criteria after 6 and 12 months. Statistical analysis used Chi-square test. A value of P ≤ 0.05 was considered statistically significant. Relative risk (RR) was used to determine the clinical significance. RESULTS The current study has revealed no statistically significant difference between both caries risk assessment models tested at baseline (P = 0.317), 6 months (P = 0.164) and 1 year (P = 0.287). Intra-group assessment of CAMBRA group showed a statistically significant difference in ICDAS scores (P = 0.002) after 12 months in high- and moderate-risk groups while low-risk group did not show statistically significant difference in ICDAS scores between different follow-up periods (P = 0.593) and (P = 1.000), respectively. ICCMS groups did not show statistically significant differences in any group along follow-up periods. CONCLUSION ICCMS and CAMBRA were equivalent in preventing new decay. The ICCMS treatment plan is a safe approach and its preventive products are available over the counter. However, it is more complicated than CAMBRA. While CAMBRA is simpler, it is less comprehensive, some of its products are not available over the counter worldwide (e.g. Duraphat 5000 ppm) and some of them may be accompanied by several side effects (e.g. chlorhexidine mouthwash), which may weaken its management protocol.
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Affiliation(s)
- Yomna Sayed Khallaf
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Shereen Hafez
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Omar Osama Shaalan
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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A survey of cariology education in U.S. dental hygiene programs: The need for a core curriculum framework. J Dent Educ 2020; 84:1348-1358. [DOI: 10.1002/jdd.12348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/29/2020] [Accepted: 07/21/2020] [Indexed: 11/07/2022]
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da Silva Tagliaferro EP, da Silva SRC, Rosell FL, Valsecki A, Riley JL, Gilbert GH, Gordan VV. METHODS FOR CARIES PREVENTION IN ADULTS AMONG DENTISTS FROM A BRAZILIAN COMMUNITY: Adult' caries prevention among Brazilian dentists. BRAZILIAN JOURNAL OF ORAL SCIENCES 2020; 19. [PMID: 32461752 DOI: 10.20396/bjos.v19i0.8656224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Little is known about dental practice patterns of caries prevention in adults among Brazilian dentists. OBJECTIVE To quantify procedures used for caries prevention for adult patients among dentists from a Brazilian community. METHODS Dentists (n=197) who reported that at least 10% of their patients are more than 18 years old participated in the first Brazilian study that used a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" from the U.S. National Dental Practice-Based Research Network. A questionnaire about characteristics of their practice and patient population were also completed by the dentists. Generalized linear regression models and a hierarchal clustering procedure were used (p<0.05). RESULTS In-office fluoride application was the preventive method most often reported. The main predictors for recommending some preventive agent were: female dentist (dental sealant; in-office fluoride; non-prescription fluoride) and percentage of patients interested in caries prevention (dental sealant; in-office fluoride; non-prescription fluoride). Other predictors included private practice (dental sealant), percentage of patients 65 years or older (in-office fluoride), graduation from a private dental school (non-prescription fluoride), years since dental school graduation (chlorhexidine rinse) and using a preventive method (recommending sealant/fluoride/chlorhexidine rinse/sugarless, xylitol gum). Cluster analysis showed that dentists in the largest subgroup seldom used any of the preventive agents. CONCLUSION Dentists most often reported in-office fluoride as a method for caries prevention in adults. Some practitioner, practice and patients' characteristics were positively associated with more-frequent use of a preventive agent.
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Affiliation(s)
- Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Silvio Rocha Correa da Silva
- Department of Community Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Fernanda Lopez Rosell
- Department of Community Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Aylton Valsecki
- Department of Community Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Joseph L Riley
- University of Florida College of Dentistry, Director, Pain Clinical Research Unit, UF CTSI, Deputy Director, South Atlantic Region, Dental Practice-based Research Network, Clinical and Translational Research Building (CTRB), Room 2227, 2004 Mowry Road, Box 100404, Gainesville, FL 32610-0404, The United States of America
| | - Gregg H Gilbert
- Department of Clinical & Community Sciences, Room SDB 109, School of Dentistry, University of Alabama at Birmingham, 1720 Second Avenue South, Birmingham, AL 35294-0007, The United States of America
| | - Valeria Veiga Gordan
- Dental Practice-Based Research, University of Florida, College of Dentistry, Room D9-6 P.O. Box 100415, Gainesville, FL 32610-0415, The United States of America
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Staszczyk M, Jurczak A, Magacz M, Kościelniak D, Gregorczyk-Maga I, Jamka-Kasprzyk M, Kępisty M, Kołodziej I, Kukurba-Setkowicz M, Krzyściak W. Effect of Polyols and Selected Dental Materials on the Ability to Create a Cariogenic Biofilm-On Children Caries-Associated Streptococcus Mutans Isolates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103720. [PMID: 32466155 PMCID: PMC7277333 DOI: 10.3390/ijerph17103720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 01/13/2023]
Abstract
Secondary caries is a disease associated with the formation of biofilm on the border of the tooth and dental filling. Its development is strongly influenced by the dietary sweet foods and the type of dental material. The aim of the study was to assess the effect of sweeteners on the ability of clinical Streptococcus mutans strains to form biofilm on dental materials. Strains were isolated from plaque samples from 40 pediatric patients from the 3-6 ICADS II group. The ability to form biofilm was tested on composite and glass ionomer dental materials used for milk teeth filling in the presence of sucrose, xylitol, sorbitol, and erythritol. The bacterial film mass after 12, 24, 48, and 72 h and the number of bacterial colonies significantly decreased (p < 0.01) compared to the initial value for 5% erythritol and sorbitol on examined materials. A greater inhibitory effect was noted for glass ionomers compared to composites. Sucrose and xylitol supported biofilm formation, while erythritol had the best inhibitory effect. The use of fluoride-releasing glass ionomers exerted an effect synergistic to erythritol, i.e., inhibited plaque formation and the amount of cariogenic S. mutans. Selection of proper type of dental material together with replacing sucrose with polyols can significantly decrease risk of secondary caries development. Erithritol in combination with glass ionomer seems to be the most effective in secondary caries prevention.
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Affiliation(s)
- Małgorzata Staszczyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Anna Jurczak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Marcin Magacz
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland;
- Doctoral School of Health and Medical Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Dorota Kościelniak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Iwona Gregorczyk-Maga
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Małgorzata Jamka-Kasprzyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Magdalena Kępisty
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Iwona Kołodziej
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Magdalena Kukurba-Setkowicz
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland;
- Correspondence: ; Tel.: +48-12-620-57-60
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17
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Newton JT, Awojobi O, Nasseripour M, Warburton F, Di Giorgio S, Gallagher JE, Banerjee A. A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum in Dental Caries. JDR Clin Trans Res 2019; 5:214-223. [PMID: 31743654 DOI: 10.1177/2380084419887178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To determine the difference in level of dental caries in adults and children who chew sugar-free gum (SFG), compared with those who do not chew SFG or use alternatives such as lozenges, candies, rinses, tablets, and other nonchewing controls. METHODS Systematic review of published literature. RESULTS Twelve studies of interventions of SFG for dental caries outcomes were included. SFGs were found to significantly reduce caries increment, giving a preventative fraction (PF) of 28% (95% CI, 7% to 48%). Including the 8 trials that used xylitol gum only as the basis of the intervention, the PF was 33% (95% CI, 4% to 61%). No adverse effects were recorded. There was a high level of heterogeneity among the trials included. CONCLUSION The findings of this review provide tentative evidence that chewing SFG reduces caries increment in comparison to nonchewing controls. However, there is a considerable degree of variability in the effect and the trials included were generally of moderate quality. There is a need for future research to explore the acceptability and feasibility of the use of SFG as a public health intervention (PROSPERO 2018 CRD42018094676). KNOWLEDGE TRANSFER STATEMENT The results of this study can be used by clinicians when deciding how best to implement dental caries prevention regimes for their patients. With consideration of cost and patient preference, this information could help to develop national policy directives on caries prevention and dictate the direction of future clinical research.
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Affiliation(s)
- J T Newton
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - O Awojobi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - M Nasseripour
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - F Warburton
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - S Di Giorgio
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - J E Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
| | - A Banerjee
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Dental Hospital, London, UK
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Abstract
The objective of this article is to review evidence-based strategies available for the nonrestorative management of caries lesions, both cavitated and noncavitated. The goal is to help clinicians make appropriate decisions regarding nonrestorative management of caries lesions. In addition, in the decision-making process, clinicians must consider thresholds for restorative and nonrestorative care and strategies for nonrestorative management that are supported by best available evidence. It is important that this information be considered taking into account a provider's clinical expertise and a patient's treatment needs and preferences, in order to maintain health and preserve tooth structure.
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Affiliation(s)
- Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Room 2393, Ann Arbor, MI 48109, USA.
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19
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Weber-Gasparoni K. Examination, Diagnosis, and Treatment Planning of the Infant and Toddler. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00014-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Fontana M, Gonzalez-Cabezas C. Evidence-Based Dentistry Caries Risk Assessment and Disease Management. Dent Clin North Am 2018; 63:119-128. [PMID: 30447787 DOI: 10.1016/j.cden.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The objective of this article was to provide a summary of evidence-based recommendations for the assessment of caries risk and management of dental caries. The goal is to help clinicians manage the caries disease process using personalized interventions supported by the best available evidence, taking into account the clinician's expertise and the patient's needs and preferences, to maintain health and preserve tooth structure.
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Affiliation(s)
- Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Ann Arbor, MI 48109, USA.
| | - Carlos Gonzalez-Cabezas
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Ann Arbor, MI 48109, USA
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Amaechi BT, Kasundra H, Joshi D, Abdollahi A, Azees PAA, Okoye LO. Effectiveness of S-PRG Filler-Containing Toothpaste in Inhibiting Demineralization of Human Tooth Surface. Open Dent J 2018; 12:811-819. [PMID: 30505361 PMCID: PMC6210529 DOI: 10.2174/1874210601812010811] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/23/2018] [Accepted: 10/02/2018] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Using an established pH-cycling caries model, the authors evaluated the effectiveness of toothpastes containing Surface Pre-reacted Glass-ionomer filler (S-PRG) in preventing tooth surface demineralization. MATERIALS AND METHODS 210 tooth blocks were randomly assigned to seven experimental groups (30 blocks/group): no treatment (A), and toothpaste containing either NaF (B), 0 wt% S-PRG (C), 1 wt% S-PRG (D), 5 wt% S-PRG (E), 20 wt% S-PRG (F) or 30 wt% S-PRG (G). Groups were subjected to 14-day demineralization for development of early caries lesions using a pH-cycling caries model. Demineralization was assessed using Quantitative Light-induced Fluorescence (QLF) and Transverse Microradiography (TMR). All pairwise contrasts (between treatments) were tested using Analysis of Variance (ANOVA), and then Tukey's HSD for multiple comparisons. All p-values are considered significant if <0.05. RESULTS With QLF, there was a significant (ANOVA; p<0.001) difference in mean percent fluorescence loss (∆F) observed among the groups. Relative to control, all S-PRG-containing toothpastes significantly (Tukey's; p<0.0001) inhibited demineralization at varying percentages (48.6%, 61.3%, 67.4% and 69.8% reduction with S-PRG 1%, 5%, 20% and 30% respectively). Demineralization reduction was not significant with either NaF (15.6% reduction) or 0% S-PRG (-2.5% reduction i.e. 2.5% more demineralization than the Control) when compared to control group. Mineral loss assessed using TMR followed a similar trend as fluorescence loss. CONCLUSION Toothpaste containing S-PRG filler can serve as an effective caries control tool. S-PRG filler-containing dentifrice to be more effective in preventing tooth demineralization than 1100 ppm fluoride provided as sodium fluoride.
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Affiliation(s)
- Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Hariyali Kasundra
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Deepika Joshi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Azadeh Abdollahi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Parveez A. A. Azees
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Linda O. Okoye
- Department of Restorative Dentistry, Faculty of Dentistry’ College of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
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Abstract
Although there are recommendations to prevent tooth decay by other means, this nonsystematic review finds that fluoride is the key to prevention and control of tooth decay. There are multiple fluoride modalities with effectiveness and safety of fluoride depending on dose and concentration. Prevention of tooth decay occurs at the individual level by fluoride use at home and with professional application and at the community level through fluoridation of water or salt.
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Affiliation(s)
- Howard Pollick
- Dental Public Health Residency Program, Division of Oral Epidemiology and Dental Public Health, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, 707 Parnassus Avenue, Box 0758, San Francisco, CA 94143-0758, USA.
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Marchini L, Recker E, Hartshorn J, Cowen H, Lynch D, Drake D, Blanchette DR, Dawson DV, Kanellis M, Caplan D. Iowa nursing facility oral hygiene (INFOH) intervention: A clinical and microbiological pilot randomized trial. SPECIAL CARE IN DENTISTRY 2018; 38:345-355. [PMID: 30194737 DOI: 10.1111/scd.12327] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/12/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE/AIM The aim of this pilot study was to evaluate feasibility and gather initial data for a definitive study to test the clinical and microbiological effectiveness of a nursing facility (NF) customized oral hygiene protocol, intended to be delivered by dental hygienists and NF personnel. MATERIALS AND METHODS A convenience sample of 8 Eastern Iowa NFs was recruited, and each NF was assigned to one of three intervention groups: (1) control (current oral hygiene practice), (2) educational program only, and (3) educational program plus 1% chlorhexidine varnish monthly application. Demographic information, systemic health data, patient centered data, oral health data, and microbiology samples were collected at baseline and after 6 months. RESULTS Recruitment response rates were 21% for NFs and 23% for residents. A total of 81 residents were examined at baseline and of those, 49 were examined at 6 months (39.5% attrition). There were no statistically or clinically significant differences among the intervention groups at 6 months for any of the recorded clinical or microbiological outcomes. CONCLUSIONS Recruitment and retention posed a significant challenge to this trial, even with a relatively short observation period. Results from this pilot study did not encourage further investigation of this customized oral hygiene protocol.
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Affiliation(s)
- Leonardo Marchini
- Assistant Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Erica Recker
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Jennifer Hartshorn
- Clinical Assistant Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Howard Cowen
- Clinical Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - David Lynch
- Post-Doctoral Fellow, Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - David Drake
- Professor, Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Derek R Blanchette
- Biostatistician, Division of Biostatistics and Computational Biology, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Deborah V Dawson
- Morris Bernstein Professor of Dentistry, Professor of Biostatistics, Iowa Institute for Oral Health Research and the Departments of Pediatric Dentistry & Biostatistics, and the Interdisciplinary Programs in Genetics and in Informatics, University of Iowa, Iowa City, IA, USA
| | - Michael Kanellis
- Associate Dean for Patient Care, Professor, Department of Pediatric Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Daniel Caplan
- Professor and Head, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
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Hujoel PP, Hujoel MLA, Kotsakis GA. Personal oral hygiene and dental caries: A systematic review of randomised controlled trials. Gerodontology 2018; 35:282-289. [PMID: 29766564 DOI: 10.1111/ger.12331] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To conduct a systematic review of randomised trials assessing the association between personal oral hygiene and dental caries in the absence of the confounding effects of fluoride. BACKGROUND Dental caries continues to affect close to 100% of the global population. There is a century-old conflict on whether dental caries is caused by poor oral hygiene or poorly formed teeth (ie, teeth with dental defects). Resolving this conflict is of significant public health importance as these two hypotheses on dental caries aetiology can lead to different prevention strategies. METHODS A systematic search for randomised trials was conducted using predefined criteria in 3 databases. The impact of personal oral hygiene interventions on coronal dental caries incidence was evaluated using random-effects models. RESULTS Three randomised studies involving a total of 743 participants were included. Personal oral hygiene interventions failed to influence the incidence of dental caries (Δ Decayed, Missing and Filled Surfaces (DFMS) = -0.11; 95% confidence interval: (-0.91, 0.69; P-value < .79)) despite meticulous deplaquing of teeth. There was no significant heterogeneity in the trial results (heterogeneity chi-squared = 1.88, P = .39). The findings were robust to sensitivity analyses, including consideration of the results of nonrandomised studies. CONCLUSION Personal oral hygiene in the absence of fluorides has failed to show a benefit in terms of reducing the incidence of dental caries.
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Affiliation(s)
- Philippe Pierre Hujoel
- Department of Oral Health Sciences, School of Dentistry & Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | | | - Georgios A Kotsakis
- Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
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Kossioni AE, Hajto-Bryk J, Maggi S, McKenna G, Petrovic M, Roller-Wirnsberger RE, Schimmel M, Tamulaitienè M, Vanobbergen J, Müller F. An Expert Opinion from the European College of Gerodontology and the European Geriatric Medicine Society: European Policy Recommendations on Oral Health in Older Adults. J Am Geriatr Soc 2017; 66:609-613. [PMID: 29266168 DOI: 10.1111/jgs.15191] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This is an expert opinion paper on oral health policy recommendations for older adults in Europe, with particular focus on frail and care-dependent persons, that the European College of Gerodontology (ECG) and the European Geriatric Medicine Society (EUGMS) Task and Finish Group on Gerodontology has developed. Oral health in older adults is often poor. Common oral diseases such as caries, periodontal disease, denture-related conditions, hyposalivation, and oral pre- and cancerous conditions may lead to tooth loss, pain, local and systemic infection, impaired oral function, and poor quality of life. Although the majority of oral diseases can be prevented or treated, oral problems in older adults remain prevalent and largely underdiagnosed, because frail persons often do not receive routine dental care, due to a number of barriers and misconceptions. These hindrances include person-related issues, lack of professional support, and lack of effective oral health policies. Three major areas for action are identified: education for healthcare providers, health policy action plans, and citizen empowerment and involvement. A list of defined competencies in geriatric oral health for non-dental healthcare providers is suggested, as well as an oral health promotion and disease prevention protocol for residents in institutional settings. Oral health assessment should be incorporated into general health assessments, oral health care should be integrated into public healthcare coverage, and access to dental care should be ensured.
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Affiliation(s)
- Anastassia E Kossioni
- Division of Gerodontology, Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Justyna Hajto-Bryk
- Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Stefania Maggi
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
| | - Gerry McKenna
- Centre for Public Health, Royal Victoria Hospital, Queens University Belfast, Belfast, Northern Ireland
| | - Mirko Petrovic
- Department of Internal Medicine (Geriatrics), Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Martin Schimmel
- Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | | | - Frauke Müller
- Department of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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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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Walsh LJ. Minimal intervention management of the older patient. Br Dent J 2017; 223:151-161. [DOI: 10.1038/sj.bdj.2017.660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 01/08/2023]
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Wang Y, Li J, Sun W, Li H, Cannon RD, Mei L. Effect of non-fluoride agents on the prevention of dental caries in primary dentition: A systematic review. PLoS One 2017; 12:e0182221. [PMID: 28787448 PMCID: PMC5546704 DOI: 10.1371/journal.pone.0182221] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/15/2017] [Indexed: 12/02/2022] Open
Abstract
Objective To assess the effect of non-fluoride agents on the prevention of dental caries in primary dentition. Materials and methods Medline, Web of Science, Embase, Cochrane Library, CBM and CNKI databases were searched to identify all the relevant articles published prior to 16 December 2016. Grey literature was also searched. Randomized controlled human clinical trials in which non-fluoride agents were delivered by any method were considered. Results Of the 1,236 studies screened, 39 full articles were scrutinized and 14 selected for inclusion in the final sample. Five chemical agents, namely arginine, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), chlorhexidine, triclosan and xylitol were investigated in these included studies. The cariostatic effects of non-fluoride agents in vivo were evaluated in comparison with fluoride or placebos in randomized controlled trials. There is evidence that the use of certain doses of xylitol may be effective in arresting dental caries in primary dentition. However, quantitative synthesis could not be carried out because of the clinical and methodological heterogeneity of the included studies. Conclusions A study at low risk of bias indicated that daily use of xylitol wipes is a useful adjunct for caries control in young children, however, this conclusion should be interpreted with caution as this study had a very limited sample size. Chlorhexidine and CPP-ACP may be more effective than a placebo in managing caries in primary dentition, but their effectiveness is borderline when compared with fluoride. Arginine-containing mint confection and 0.3% triclosan varnish were found to reduce caries development in primary teeth but the evidence was at high risk of bias. High quality randomized controlled trials are needed in order to make a conclusive recommendation.
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Affiliation(s)
- Yu Wang
- Department of Preventive Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jialing Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weibin Sun
- Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
- * E-mail: (WS); (HL)
| | - Huang Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
- * E-mail: (WS); (HL)
| | - Richard D. Cannon
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Li Mei
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Affiliation(s)
- Allen Wong
- University of the Pacific- Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA.
| | - Paul E Subar
- University of the Pacific- Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
| | - Douglas A Young
- University of the Pacific- Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
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Lippert F. The effects of fluoride, strontium, theobromine and their combinations on caries lesion rehardening and fluoridation. Arch Oral Biol 2017; 80:217-221. [PMID: 28458181 DOI: 10.1016/j.archoralbio.2017.04.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/17/2017] [Accepted: 04/17/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim was to investigate the effects of fluoride, strontium, theobromine and their combinations on caries lesion rehardening and fluoridation (EFU) under pH cycling conditions. DESIGN Human enamel specimens were demineralized at 37°C for 24h using a pH 5.0 solution containing 50mM lactic acid and 0.2% Carbopol 907 which was 50% saturated with respect to hydroxyapatite. Lesions were assigned to nine treatment groups (n=16) based on Knoop surface microhardness indentation length. TREATMENT aqueous solutions were: placebo, 11.9mM sodium fluoride (F), 23.8mM sodium fluoride (2×F), 1.1mM strontium chloride hexahydrate (Sr), 1.1mM F theobromine, Sr+theobromine, F+Sr, F+theobromine, F+Sr+theobromine. Lesions were pH cycled for 5d (daily protocol: 3×1min-treatment; 2×60min-demineralization; 4×60min & overnight-artificial saliva). Knoop indentation length was measured again and%surface microhardness recovery (%SMHr) calculated. EFU was determined using the acid-etch technique. Data were analysed using ANOVA. RESULTS Model showed fluoride dose-response for both variables (2×F>F>placebo). For%SMHr, F+Sr+/-theobromine resulted in more rehardening than F, however less than 2×F. F+theobromine was similar to F. For EFU, F+Sr was inferior to F, F+theobromine and F+Sr+theobromine which were similar and inferior to 2×F. In absence of fluoride, Sr, theobromine or Sr+theobromine were virtually indistinguishable from placebo and inferior to F. CONCLUSIONS It can be concluded that a) strontium aids rehardening but not EFU and only in presence of fluoride; b) theobromine does not appear to offer any anti-caries benefits in this model; c) there are no synergistic effects between strontium and theobromine in the presence or absence of fluoride.
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Affiliation(s)
- Frank Lippert
- Indiana University School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indianapolis, IN, USA.
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Al-Sudani FYH, Vehkalahti MM, Suominen AL. Association of current employment status with oral health-related behaviors: findings from the Finnish Health 2000 Survey. Eur J Oral Sci 2016; 124:368-76. [DOI: 10.1111/eos.12276] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Fouad Y. H. Al-Sudani
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Miira M. Vehkalahti
- Department of Oral and Maxillofacial Diseases; Faculty of Medicine; University of Helsinki; Helsinki Finland
| | - Anna L. Suominen
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- The Living Environment and Health Unit; National Institute for Health and Welfare (THL); Kuopio Finland
- The Health Monitoring Unit; National Institute for Health and Welfare (THL); Helsinki Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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Gold J. Consumption of Xylitol Gummy Bears May not Provide Additional Caries Prevention for School Children. J Evid Based Dent Pract 2016; 16:70-2. [DOI: 10.1016/j.jebdp.2016.01.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bizhang M, Kaleta-Kragt S, Singh-Hüsgen P, Altenburger MJ, Zimmer S. Effect of 10% fluoride on the remineralization of dentin in situ. J Appl Oral Sci 2016; 23:562-70. [PMID: 26814458 PMCID: PMC4716694 DOI: 10.1590/1678-775720150239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/01/2015] [Indexed: 11/21/2022] Open
Abstract
Objective The purpose of this randomized, cross-over, in situ study was to determine the remineralization of demineralized dentin specimens after the application of a 10% fluoride (F-) or a 1% chlorhexidine-1% thymol (CHX-thymol) varnish. Material and Methods Twelve individuals without current caries activity wore removable appliances in the lower jaw for a period of four weeks. Each appliance contained four human demineralized dentin specimens fixed on the buccal aspects. The dentin specimens were obtained from the cervical regions of extracted human third molars. After demineralization, half the surface of each specimen was covered with a nail varnish to serve as the reference surface. The dentin specimens were randomly assigned to one of the three groups: F-, CHX-thymol, and control (no treatment). Before the first treatment period and between the others, there were washout periods of one week. After each treatment phase, the changes in mineral content (vol% µm) and the lesion depths (µm) of the dentin slabs were determined by transverse microradiography (TMR). Data analysis was accomplished by the Kruskal-Wallis test and the Mann-Whitney U test (p<0.05). Results The medians (25th/75th percentile) of integrated mineral loss were 312.70 (203.0-628.7) for chlorhexidine varnish, 309.5 (109.8-665.8) for fluoride varnish, and -346.9 (-128.7 - -596.0) for the control group. The medians (25th/75th percentile) of lesion depth were 13.6 (5.7-34.5) for chlorhexidine varnish, 16.5 (5.6-38.1) for fluoride varnish, and -14.2 (-4.5- -32.9) for the control group. Use of the 10% F- or 1% CHX-1% thymol varnishes resulted in significantly decreased mineral loss and lesion depth in dentin when compared with the control group. There were no statistically significant differences among the test groups. Conclusions Within the limitations of this study, the results suggest that the effect of the treatment of demineralized dentin with 10% F- or 1% CHX-1% thymol is better than without any treatment.
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Affiliation(s)
- Mozhgan Bizhang
- Department of Operative and Preventive Dentistry, University Witten/Herdecke, Witten, Germany
| | - Sabine Kaleta-Kragt
- Department of Operative and Preventive Dentistry, University Witten/Herdecke, Witten, Germany
| | - Preeti Singh-Hüsgen
- Department of Operative and Preventive Dentistry and Periodontics, Heinrich-Hein University Duesseldorf, Duesseldorf, Germany
| | - Markus Jörg Altenburger
- Department of Operative Dentistry and Periodontology, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, University Witten/Herdecke, Witten, Germany
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Tanaka S, Shinzawa M, Tokumasu H, Seto K, Tanaka S, Kawakami K. Secondhand smoke and incidence of dental caries in deciduous teeth among children in Japan: population based retrospective cohort study. BMJ 2015; 351:h5397. [PMID: 26489750 PMCID: PMC4613892 DOI: 10.1136/bmj.h5397] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STUDY QUESTION Does maternal smoking during pregnancy and exposure of infants to tobacco smoke at age 4 months increase the risk of caries in deciduous teeth? METHODS Population based retrospective cohort study of 76 920 children born between 2004 and 2010 in Kobe City, Japan who received municipal health check-ups at birth, 4, 9, and 18 months, and 3 years and had information on household smoking status at age 4 months and records of dental examinations at age 18 months and 3 years. Smoking during pregnancy and exposure of infants to secondhand smoke at age 4 months was assessed by standardised parent reported questionnaires. The main outcome measure was the incidence of caries in deciduous teeth, defined as at least one decayed, missing, or filled tooth assessed by qualified dentists without radiographs. Cox regression was used to estimate hazard ratios of exposure to secondhand smoke compared with having no smoker in the family after propensity score adjustment for clinical and lifestyle characteristics. STUDY ANSWER AND LIMITATIONS Prevalence of household smoking among the 76 920 children was 55.3% (n=42 525), and 6.8% (n=5268) had evidence of exposure to tobacco smoke. A total of 12 729 incidents of dental caries were observed and most were decayed teeth (3 year follow-up rate 91.9%). The risk of caries at age 3 years was 14.0% (no smoker in family), 20.0% (smoking in household but without evidence of exposure to tobacco smoke), and 27.6% (exposure to tobacco smoke). The propensity score adjusted hazard ratios of the two exposure groups compared with having no smoker in the family were 1.46 (95% confidence interval 1.40 to 1.52) and 2.14 (1.99 to 2.29), respectively. The propensity score adjusted hazard ratio between maternal smoking during pregnancy and having no smoker in the family was 1.10 (0.97 to 1.25). WHAT THIS STUDY ADDS Exposure to tobacco smoke at 4 months of age was associated with an approximately twofold increased risk of caries, and the risk of caries was also increased among those exposed to household smoking, by 1.5-fold, whereas the effect of maternal smoking during pregnancy was not statistically significant. FUNDING, COMPETING INTERESTS, DATA SHARING This study was supported by a grant in aid for scientific research 26860415. The authors have no competing interests or additional data to share.
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Affiliation(s)
- Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Maki Shinzawa
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Hironobu Tokumasu
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Kahori Seto
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Sachiko Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
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Wu AJ. Management of Salivary Hypofunction in Sjögren’s Syndrome. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2015. [DOI: 10.1007/s40674-015-0023-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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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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Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in children and adults. Cochrane Database Syst Rev 2015; 2015:CD010743. [PMID: 25809586 PMCID: PMC9345289 DOI: 10.1002/14651858.cd010743.pub2] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dental caries is a highly prevalent chronic disease which affects the majority of people. It has been postulated that the consumption of xylitol could help to prevent caries. The evidence on the effects of xylitol products is not clear and therefore it is important to summarise the available evidence to determine its effectiveness and safety. OBJECTIVES To assess the effects of different xylitol-containing products for the prevention of dental caries in children and adults. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 14 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 7), MEDLINE via OVID (1946 to 14 August 2014), EMBASE via OVID (1980 to 14 August 2014), CINAHL via EBSCO (1980 to 14 August 2014), Web of Science Conference Proceedings (1990 to 14 August 2014), Proquest Dissertations and Theses (1861 to 14 August 2014). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials assessing the effects of xylitol products on dental caries in children and adults. DATA COLLECTION AND ANALYSIS Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We attempted to contact study authors for missing data or clarification where feasible. For continuous outcomes, we used means and standard deviations to obtain the mean difference and 95% confidence interval (CI). We used the continuous data to calculate prevented fractions (PF) and 95% CIs to summarise the percentage reduction in caries. For dichotomous outcomes, we reported risk ratios (RR) and 95% CIs. As there were less than four studies included in the meta-analysis, we used a fixed-effect model. We planned to use a random-effects model in the event that there were four or more studies in a meta-analysis. MAIN RESULTS We included 10 studies that analysed a total of 5903 participants. One study was assessed as being at low risk of bias, two were assessed as being at unclear risk of bias, with the remaining seven being at high risk of bias.The main finding of the review was that, over 2.5 to 3 years of use, a fluoride toothpaste containing 10% xylitol may reduce caries by 13% when compared to a fluoride-only toothpaste (PF -0.13, 95% CI -0.18 to -0.08, 4216 children analysed, low-quality evidence).The remaining evidence on children, from small single studies with risk of bias issues and great uncertainty associated with the effect estimates, was insufficient to determine a benefit from xylitol products. One study reported that xylitol syrup (8 g per day) reduced caries by 58% (95% CI 33% to 83%, 94 infants analysed, low quality evidence) when compared to a low-dose xylitol syrup (2.67 g per day) consumed for 1 year.The following results had 95% CIs that were compatible with both a reduction and an increase in caries associated with xylitol: xylitol lozenges versus no treatment in children (very low quality body of evidence); xylitol sucking tablets versus no treatment in infants (very low quality body of evidence); xylitol tablets versus control (sorbitol) tablets in infants (very low quality body of evidence); xylitol wipes versus control wipes in infants (low quality body of evidence).There was only one study investigating the effects of xylitol lozenges, when compared to control lozenges, in adults (low quality body of evidence). The effect estimate had a 95% CI that was compatible with both a reduction and an increase in caries associated with xylitol.Four studies reported that there were no adverse effects from any of the interventions. Two studies reported similar rates of adverse effects between study arms. The remaining studies either mentioned adverse effects but did not report any usable data, or did not mention them at all. Adverse effects include sores in the mouth, cramps, bloating, constipation, flatulence, and loose stool or diarrhoea. AUTHORS' CONCLUSIONS We found some low quality evidence to suggest that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste for preventing caries in the permanent teeth of children, and that there are no associated adverse-effects from such toothpastes. The effect estimate should be interpreted with caution due to high risk of bias and the fact that it results from two studies that were carried out by the same authors in the same population. The remaining evidence we found is of low to very low quality and is insufficient to determine whether any other xylitol-containing products can prevent caries in infants, older children, or adults.
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Affiliation(s)
- Philip Riley
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Deborah Moore
- School of Dentistry, The University of ManchesterOxford RoadManchesterUKM13 9PL
| | - Farooq Ahmed
- University of Manchester Dental HospitalOrthodonticsHigher Cambridge StreetManchesterUKM15 6FH
| | - Mohammad O Sharif
- Eastman Dental HospitalSchool of Dentistry256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
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38
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Vale GC, Cury AADB, Arthur RA, Cury JA, Tabchoury CPM. Recolonization of mutans Streptococci after application of chlorhexidine gel. Braz Dent J 2015; 25:485-8. [PMID: 25590193 DOI: 10.1590/0103-6440201300156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 11/24/2014] [Indexed: 11/21/2022] Open
Abstract
Streptococcus mutans is specifically suppressed by intensive treatment with chlorhexidine gel, but the time for recolonization and the effect on other oral bacteria are not totally clear. In this study, recolonization of mutans streptococci was evaluated in nine healthy adult volunteers, who were highly colonized with this microorganism. Stimulated saliva was collected before (baseline) and at 1, 7, 14, 21 and 28 days after application of 1% chlorhexidine gel on volunteers' teeth for two consecutive days. On each day, the gel was applied using disposable trays for 3 x 5 min with intervals of 5 min between each application. Saliva was plated on blood agar to determine total microorganisms (TM); on mitis salivarius agar to determine total streptococci (TS) and on mitis salivarius agar plus bacitracin to determine mutans streptococci (MS). Chlorhexidine was capable of reducing the counts of MS and the proportion of MS with regard to total microorganisms (%MS/TM) (p<0.05), but these values did not differ statistically from baseline (p>0.05) after 14 days for MS and 21 days for %MS/TM. The counts of TM and TS and the proportion of MS to total streptococci did not differ statistically from baseline (p>0.05) after chlorhexidine treatment. The results suggest that the effect of chlorhexidine gel treatment on suppression of mutans streptococci is limited to less than a month in highly colonized individuals.
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Affiliation(s)
| | | | | | - Jaime Aparecido Cury
- Piracicaba Dental School, UNICAMP - University of Campinas, Piracicaba, SP, Brazil
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Affiliation(s)
- Jaana Gold
- A.T. Still University, College of Graduate Health Studies, Department of Public Health, USA; Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, 1329 SW 16th Street, Room 5180, P.O. Box 103628, Gainesville, FL 32610-3628, USA.
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40
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Giacaman R, Contzen M, Yuri J, Muñoz-Sandoval C. Anticaries effect of an antioxidant-rich apple concentrate on enamel in an experimental biofilm-demineralization model. J Appl Microbiol 2014; 117:846-53. [DOI: 10.1111/jam.12561] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/28/2014] [Accepted: 06/02/2014] [Indexed: 12/22/2022]
Affiliation(s)
- R.A. Giacaman
- Cariology Unit; Department of Oral Rehabilitation; University of Talca; Talca Chile
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES); University of Talca; Talca Chile
| | - M.P. Contzen
- Cariology Unit; Department of Oral Rehabilitation; University of Talca; Talca Chile
| | - J.A. Yuri
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES); University of Talca; Talca Chile
- Centro de Pomáceas; Facultad de Ciencias Agrarias; University of Talca; Talca Chile
| | - C. Muñoz-Sandoval
- Cariology Unit; Department of Oral Rehabilitation; University of Talca; Talca Chile
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES); University of Talca; Talca Chile
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Abstract
UNLABELLED Oral adverse drug effects negatively impact oral health, comfort and function. BACKGROUND Patients treated in the oral health care environment take multiple medications, many of which cause oral complications. Dental professionals are challenged with making recommendations to prevent or minimize drug-induced oral disease risks, while reducing symptoms to improve oral health quality of life. METHODS This paper presents a critical analysis of current evidence regarding common oral adverse drug events, and reviews existing clinical practice guidelines based upon findings from published systematic reviews. RESULTS There is a lack of sufficient, high quality evidence to support most recommendations for interventions to relieve signs and symptoms of drug-induced oral adverse events. Existing recommendations are largely based on data obtained from observational studies and case reports, and from randomized controlled clinical trials with significant design flaws and potential reporting bias. Outcome measures, especially those related to symptom relief and long-range benefits, are either insufficient or lacking. CONCLUSIONS Oral adverse drug effects are a common problem, and additional data is needed to support best practices for product recommendations to improve oral health in medicated patients.
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Brown JP, Amaechi BT, Bader JD, Gilbert GH, Makhija SK, Lozano-Pineda J, Leo MC, Chen C, Vollmer WM. Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries-active adults. Community Dent Oral Epidemiol 2013; 42:271-8. [PMID: 24205951 DOI: 10.1111/cdoe.12082] [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] [Received: 02/15/2013] [Accepted: 10/01/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To better understand the effectiveness of xylitol in caries prevention in adults and to attempt improved clinical trial efficiency. METHODS As part of the Xylitol for Adult Caries Trial (X-ACT), non cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 g/day of xylitol, consumed by dissolving in the mouth five 1 g lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21-80, with complete data for four dental examinations, were selected from the 691 randomized into the 3-year trial, conducted at three sites. Acceptable inter- and intra-examiner reliability before and during the trial was quantified using the kappa statistic. RESULTS The mean annualized noncavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically nonsignificant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. CONCLUSIONS There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non cavitated lesion assessment in this full-scale, placebo-controlled, multisite, randomized, double-blinded clinical trial in adults experiencing dental caries did not achieve added trial efficiency or demonstrate practical benefit of xylitol. TRIAL REGISTRATION ClinicalTrials.Gov NCT00393055.
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Affiliation(s)
- John P Brown
- Dental School, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Fontana M, Gonzalez-Cabezas C. Xylitol Lozenges Were Not Effective in Overall Dental Caries Prevention in Adults. J Evid Based Dent Pract 2013; 13:97-9. [DOI: 10.1016/j.jebdp.2013.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Xylitol is a safe dental caries preventive when incorporated into chewing gum or confections used habitually. The goal of this paper is to identify and assess the work on xylitol and other polyols and dental caries since 2008. Xylitol is effective when used by the mother prenatally or after delivery to prevent mutans transmission and subsequent dental caries in the offspring. One new completed trial confirmed that children of mothers who used xylitol lozenges after delivery had less dental caries than a comparison group. A similar study confirmed that the use of xylitol gum by the mother either prevented or postponed MS transmission to the offspring. Xylitol use among schoolchildren delivered via a gummy bear confection reduced S. mutans levels, but a once per day use of xylitol-containing toothpaste did not. Randomized trials, with caries outcomes, assessing xylitol-containing lozenges in adults and xylitol-containing gummy bears in children will release results in the coming year. Other studies are ongoing but are not systematic and will fail to answer important questions about how xylitol, or other polyols, can address the global dental caries problem.
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Affiliation(s)
- P Milgrom
- University of Washington, Box 357475, B-509 Health Sciences, University of Washington, Seattle, WA 98195-7475, USA.
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Fontana M, González-Cabezas C. Are we ready for definitive clinical guidelines on xylitol/polyol use? Adv Dent Res 2013; 24:123-8. [PMID: 22899694 DOI: 10.1177/0022034512449468] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the past decades, numerous studies have looked at the anticaries effects of polyols, particularly xylitol, and a great many studies have focused on xylitol's antimicrobial properties. Researched vehicles have mostly included chewing gums, followed by lozenges/candies, toothpastes, and others (e.g., syrup). Good evidence supports the claims that xylitol is non-cariogenic and has a dose-/frequency-dependent antimicrobial effect on dental plaque/mutans streptococci, and that polyol use is very safe. However, interpretation of caries data has been controversial, due in part to variability in study designs, formulations/dosages tested, and outcomes reported (e.g., many caries studies have a "no gum" control, limiting the interpretation of the polyol's benefit; few studies have compared different polyols side-by-side, or in adults). Even when the level/strength of high-quality anticaries evidence is still limited, most recent systematic reviews have consistently concluded that the habitual use of sucrose-free xylitol or polyol-combination chewing gum/ lozenges is an effective adjunct in coronal caries prevention. Consequently, many health organizations worldwide are supporting this recommendation for at-risk populations. However, most experts agree that well-designed, placebo-controlled randomized clinical trials (RCTs) (focusing on efficacy, feasibility, adherence, dosage, vehicle, synergism with other preventive strategies, and cost) are still needed in target populations worldwide to reach definitive caries-preventive/therapeutic recommendations.
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Affiliation(s)
- M Fontana
- Department of Cariology and Restorative Sciences, University of Michigan School of Dentistry, 1011 North University, Room 2393, Ann Arbor, Michigan 48109, USA.
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Young DA, Featherstone JDB. Caries management by risk assessment. Community Dent Oral Epidemiol 2013; 41:e53-63. [DOI: 10.1111/cdoe.12031] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Douglas A. Young
- Department of Dental Practice; University of the Pacific; San Francisco; CA; USA
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Tellez M, Gomez J, Kaur S, Pretty IA, Ellwood R, Ismail AI. Non-surgical management methods of noncavitated carious lesions. Community Dent Oral Epidemiol 2012; 41:79-96. [DOI: 10.1111/cdoe.12028] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 11/02/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Marisol Tellez
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
| | - Juliana Gomez
- Colgate Palmolive Dental Health Unit; School of Dentistry; University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - Sundeep Kaur
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
| | - Iain A. Pretty
- Colgate Palmolive Dental Health Unit; School of Dentistry; University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - Roger Ellwood
- Colgate Palmolive Dental Health Unit; School of Dentistry; University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - Amid I. Ismail
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
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48
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Hujoel PP. Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis. Nutr Rev 2012; 71:88-97. [PMID: 23356636 DOI: 10.1111/j.1753-4887.2012.00544.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Vitamin D has been used to prevent and treat dental caries. The objective of this study was to conduct a systematic review of controlled clinical trials (CCTs) assessing the impact of vitamin D on dental caries prevention. Random-effects and meta-regression models were used to evaluate overall and subgroup-specific relative-rate estimates. Twenty-four CCTs encompassing 2,827 children met the inclusion criteria. Twenty-two of the 24 CCTs predated modern clinical trial design, some of which nonetheless reported characteristics such as pseudo-randomization (n = 2), blinding (n = 4), or use of placebos (n = 8). The relative-rate estimates of the 24 CCTs exhibited significant heterogeneity (P < 0.0001), and there was evidence of significant publication bias (P < 0.001). The pooled relative-rate estimate of supplemental vitamin D was 0.53 (95% CI, 0.43-0.65). No robust differences were identified between the caries-preventive effects of vitamin D(2) , vitamin D(3) , and ultraviolet radiation (Prob > F = 0.22). The analysis of CCT data identified vitamin D as a promising caries-preventive agent, leading to a low-certainty conclusion that vitamin D may reduce the incidence of caries.
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Affiliation(s)
- Philippe P Hujoel
- Department of Oral Health Sciences, School of Dentistry, Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA.
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49
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Affiliation(s)
- Ayesha Swarn
- School of Dental Medicine, Department of Restorative Dentistry, University of Colorado, Denver, CO, USA
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50
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Teich ST, Demko C, Al-Rawi W, Gutberg T. Assessment of Implementation of a CAMBRA-Based Program in a Dental School Environment. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2013.77.4.tb05489.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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