Microbial Etiology and Prevention of Dental Caries: Exploiting Natural Products to Inhibit Cariogenic Biofilms

[Effects of D-tagatose, Stevia and Sucrose on pH and oral bacterial activity in dentistry students. A randomized controlled trial]

Introduction

Background: stevia and D-tagatose have shown a reduction in total calorie and carbohydrate intake as a substitute for sucrose, demonstrating a stabilizing effect on pH and bacterial proliferation. Objective: to evaluate the effect of D-tagatose, stevia and sucrose on salivary pH and bacterial activity in odontology students. Methodology: a controlled study of parallel and randomized groups with a single blind, whose sample considered three groups subjected to a mouthwash of D-tagatose (n = 10), stevia (n = 10) and sucrose (n = 10). These solutions were administered over 1 minute in a single 6.4 % concentrated dose. Data collection and analysis considered the recording of salivary pH 5 min before exposure to the sweetener, immediately after expulsion of the mouthwash and 15 min later, 30 min, 45 min and 48 hours. The counting of the final number of colony-forming units per mL (CFU/mL) was counted using the salivary samples obtained immediately after exposure of the sweetener together with the sample obtained 30 minutes later, with the cultures performed on agar plates. Results: D-tagatose, stevia and sucrose presented significant differences in total CFU/mL at 30 minutes (p < 0.001), while salivary pH showed significant differences at 48 hours after administration (p < 0.001). Conclusion: D-tagatose, stevia and sucrose present significant differences in total CFU/mL and salivary pH, these findings being a possible indication of a partial inhibitory effect on bacterial metabolism.

Antibacterial Effects of Black Cumin Seed Oil on Oral Microcosm Biofilms

Interest in natural extracts for managing oral biofilms is increasing, with black cumin seed oil (BCSO) demonstrating efficacy against Streptococcus mutans. The effectiveness of antibacterial agents should be evaluated using multi-species oral biofilm models that closely mimic actual conditions. This study aimed to compare the antibacterial effects of BCSO and chlorhexidine gluconate (CHX) on oral microcosm biofilms. Biofilms using human saliva as the inoculum were cultured for 2 days and subsequently treated with 0.5% dimethyl sulfoxide, 0.5% BCSO, or 0.12% CHX once daily for 6 days. Following treatment, the red fluorescence intensity (RatioR/G) of the oral biofilm; biomass, including extracellular polymeric substance (EPS) levels and live bacteria counts; and colony-forming units (CFUs) of aciduric bacteria were evaluated. RatioR/G after BCSO treatment (1.26 ± 0.03) was not significantly different from that after CHX treatment (p = 0.552). The EPS levels were also not significantly different between the two groups (p = 0.743). The live bacteria count was 0.55 times lower in the BCSO-treated group than in the CHX-treated group (p = 0.018). No significant between-group difference was observed in the CFUs of aciduric bacteria (p = 0.935). These results suggest that BCSO exhibits antibacterial effects similar to those of CHX, highlighting its potential as an effective alternative.

Evaluation of riboflavin, nanocurcumin, and hydrogen peroxide under light conditions: Reduction of mature dental biofilms and enamel mineral loss

BACKGROUND

Biofilms are a potential harbor for many microorganisms. The aim of this study was to test the efficacy of riboflavin (Rib), nano-micelle curcumin (NC), and hydrogen peroxide (HP), alone and in combination with the respective light (light-emitting diode (LED) or 980 nm diode laser) on the reduction of Streptococcus mutans and Lactobacillus acidophilus dual-species biofilms and their effect on the enamel mineral loss.

MATERIALS AND METHODS

The biofilms were formed on saliva-coated enamel slabs. Then, the biofilms were treated with antimicrobial photodynamic therapy (PDT) based on LED, Rib, and NC photosensitizers and with HP also based on a 980 nm diode laser (n = 8 per group). A crystal violet assay was performed to determine the reduction of the dual-species biofilms. The enamel slabs were analyzed for calcium and phosphorus content by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX).

RESULTS

While HP-PDT showed a reduction of 37% (p < 0.001), PDT with NC resulted in an even greater reduction of dual-species biofilms (40%, p < 0.001) than HP- and Rib-mediated PDT. In the EDX test, no significant difference was found between the control group and the treatment groups.

CONCLUSIONS

The use of natural photosensitizers such as NC in PDT has an effect that may be potentially important in reducing caries-causing bacteria.

Unravelling the Role of Gut and Oral Microbiota in the Pediatric Population with Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease that results in the destruction of pancreatic β cells, leading to hyperglycaemia and the need for lifelong insulin therapy. Although genetic predisposition and environmental factors are considered key contributors to T1DM, the exact causes of the disease remain partially unclear. Recent evidence has focused on the relationship between the gut, the oral cavity, immune regulation, and systemic inflammation. In individuals with T1DM, changes in the gut and oral microbial composition are commonly observed, indicating that dysbiosis may contribute to immune dysregulation. Gut dysbiosis can influence the immune system through increased intestinal permeability, altered production of short chain fatty acids (SCFAs), and interactions with the mucosal immune system, potentially triggering the autoimmune response. Similarly, oral dysbiosis may contribute to the development of systemic inflammation and thus influence the progression of T1DM. A comprehensive understanding of these relationships is essential for the identification of biomarkers for early diagnosis and monitoring, as well as for the development of therapies aimed at restoring microbial balance. This review presents a synthesis of current research on the connection between T1DM and microbiome dysbiosis, with a focus on the gut and oral microbiomes in pediatric populations. It explores potential mechanisms by which microbial dysbiosis contributes to the pathogenesis of T1DM and examines the potential of microbiome-based therapies, including probiotics, prebiotics, synbiotics, and faecal microbiota transplantation (FMT). This complex relationship highlights the need for longitudinal studies to monitor microbiome changes over time, investigate causal relationships between specific microbial species and T1DM, and develop personalised medicine approaches.

Association between untreated caries and cariogenic bacteria in adolescents in Taiwan

Background/purpose

There is a paucity of research focused on salivary bacteria analyzed through real-time polymerase chain reaction (qPCR) among adolescents. The current study determined the quantity of Streptococcus mutans (SM) and Lactobacillus (LB) in saliva obtained from Taiwanese adolescents and investigated the association between the oral bacteria and untreated dental caries.

Materials and methods

This cross-sectional study recruited Taiwanese students aged 10-18. Saliva was collected using a Salivette kit and then analyzed through qPCR. The relative quantification values of SM and LB were coded based on mean fold ratios, with values > 2 coded as high and other values coded as low. Untreated dental caries was assessed through standard oral examinations. Univariate and multivariate logistic regression models were used to estimate the association between the levels of bacteria in the saliva of the study participants and the presence of untreated caries.

Results

The study involved 421 adolescents. 56 (13.3%) had both SM and LB values of >2 and were coded as having high levels of bacteria, whereas the other 365 (86.7%) students were coded as having low levels. The multivariate logistic regression analysis revealed that adolescents who had high combined salivary SM and LB levels had an odds ratio of having untreated dental caries of 2.05 (95% CI = 1.09, 3.86, P = 0.027) compared with those who had low salivary SM and LB levels.

Conclusion

The results of the present study indicate that salivary SM and LB levels are significantly associated with adolescents having untreated caries.

Early oral colonization of streptococcus mutans and lactobacilli species in infants: Investigating the relationship with maternal and environmental factors, from birth through the sixth month

Objective

To assess the presence of Streptococcus Mutans (S.mutans) and Lactobacillus species (LB) of newborn-mother pairs using the real time polymerase chain reaction (qRT-PCR).

Method

Subjects were selected from the patients followed in the Neonatology Clinic of Akdeniz University's Faculty of Medicine between the years 2017-2018. First samples collected within 48 hours after birth, and second samples were at six months. The samples were analyzed for the presence of S.mutans and LB using qRT-PCR. Mothers' smoking habits, education level, occupation, oral hygiene habits, DMFT scores and dietary history; Babies' delivery type, birth weight, feeding type, oral hygiene practices, feeding habits, bottle usage, pacifier usage, consumption of sugary foods, were also recorded. The effect of factors related to both mothers and infants was examined comparatively.

Results

S.mutans DNA was detectable in 87% and LB DNA was detected in 37% mothers, while it was undetected in 63% mothers at the first sampling. S.mutans was detected in 37% and, while LB was detected in 5% of the newborns in the first 48 hours of their life. At the second sampling, the S.mutans and LB levels in infants have increased, while there has been no significant change in mothers. A significant relationship was found only between the increase in S.mutans in infants and the presence of erupted teeth.

Conclusion

S.mutans and LB were able to colonize on the oral mucosal surfaces of edentulous newborns, with the counts of both bacteria increasing significantly with tooth eruption.

Inhibitory effect of helium cold atmospheric plasma on cariogenic biofilms

This study aimed to determine the effects of low-temperature plasma jet produced in gas helium (LTP-helium) on cariogenic biofilms composedby Streptococcusmutans, Streptococcus sanguinis and Streptococcus gordonii, and also by the combination of Candida albicans, Lactobacillus acidophilus and S. mutans. Biofilms were treated for 1, 3, 5, and 7 minutes. A 0.12% chlorhexidine solution was used as the positive control and sterile physiologic solution was the negative control. Biofilm viability was analyzed by viable cell recovery, scanning electron microscopy, and confocal laser scanning microscopy. All assays were performed intriplicate in three independent experiments. Multispecies biofilms exposed to LTP-helium had a significant reduction in viability when compared to the negative control (p < 0.0001). For biofilm formedby S. mutans, S. sanguinis, and S. gordonii, LTP treatments for 5 and 7 minutes caused similar reduction of morethan 2 log10. Also, a significant reduction in the viability of biofilms formedby C. albicans, L. acidophilus, and S. mutans was detected (p < 0.0001). In conclusion, LTP-helium reduced theviability of cariogenic biofilms with different microbial compositions, which indicates that LTP-helium is a potential tool for developing new protocols for dental caries prevention and treatment.

Antimicrobial Properties of Newer Calcium Silicate-Based Pulp-Capping Agents Against Enterococcus Faecalis and Streptococcus Mutans: An In-Vitro Evaluation

AIM

This study aimed to evaluate the antibacterial activity of calcium silicate-based pulp-capping agents against Enterococcus faecalis and Streptococcus mutans using an agar diffusion test.

METHODS AND MATERIALS

The agar diffusion method was used to evaluate the antibacterial properties of pulp-capping agents. The materials used included Bio-C® Temp (Angelus, Brazil), Dia-Root™ Bio mineral trioxide aggregate (MTA) (Diadent Europe B.V., Almere, Netherlands), Biodentine™ (Septodont, Saint-Maur-des-Fossés, France), and TheraCal LC (Bisco Inc., Schaumburg, IL). Eighteen petri dishes, nine for S. mutans and nine for E. faecalis, were divided into four parts each (one for each agent), for a total sample size of 72. The bacterial suspensions were transferred to the petri dishes using a sterile swab. Four wells with a diameter of 4 mm were then punched in each petri dish. The wells were filled with the pulp-capping agents, which had been mixed according to the manufacturer's instructions, and the petri dishes were incubated. The zone of inhibition was measured at 24 and 48 hours to assess the pulp-capping agents' antimicrobial efficacy against E. faecalis and S. mutans. The readings were tabulated and subjected to statistical analysis.

RESULTS

At 24 hours, the highest zone of inhibition was found in the Biodentine™ group (15.83 ± 0.79 mm), followed by Dia-Root™ Bio MTA (14.5 ± 0.88 mm), TheraCal LC® (12.56 ± 0.53 mm), and the shortest in the Bio-C Temp (9.61 ± 0.70 mm) against S. mutans. Analysis of variance (ANOVA) test showed a high statistical significance. After 48 hours, there was no statistically significant difference in the mean zone of inhibition. At 24 hours, the highest zone of inhibition was found in the Biodentine™ group (20.56 ± 0.73 mm), followed by Dia-Root™ Bio MTA (20.06 ± 1.33 mm), TheraCal LC® (18.22 ± 0.97 mm), and the shortest in the Bio-C Temp (14.11 ± 0.78 mm) against E. faecalis. The ANOVA test indicated no statistically significant difference between the Biodentine™ and the Dia-Root™ Bio MTA groups. After 48 hours, there was no statistically significant difference in the mean zone of inhibition.

CONCLUSIONS

Biodentine™ has higher antibacterial efficacy against S. mutans, while Biodentine™ and Dia-Root™ Bio MTA have comparably high antibacterial activity against S. mutans and E. faecalis at 24 and 48 hours.

Oral Microbiome: A Review of Its Impact on Oral and Systemic Health

PURPOSE OF REVIEW

This review investigates the oral microbiome's composition, functions, influencing factors, connections to oral and systemic diseases, and personalized oral care strategies.

RECENT FINDINGS

The oral microbiome is a complex ecosystem consisting of bacteria, fungi, archaea, and viruses that contribute to oral health. Various factors, such as diet, smoking, alcohol consumption, lifestyle choices, and medical conditions, can affect the balance of the oral microbiome and lead to dysbiosis, which can result in oral health issues like dental caries, gingivitis, periodontitis, oral candidiasis, and halitosis. Importantly, our review explores novel associations between the oral microbiome and systemic diseases including gastrointestinal, cardiovascular, endocrinal, and neurological conditions, autoimmune diseases, and cancer. We comprehensively review the efficacy of interventions like dental probiotics, xylitol, oral rinses, fluoride, essential oils, oil pulling, and peptides in promoting oral health by modulating the oral microbiome.

SUMMARY

This review emphasizes the critical functions of the oral microbiota in dental and overall health, providing insights into the effects of microbial imbalances on various diseases. It underlines the significant connection between the oral microbiota and general health. Furthermore, it explores the advantages of probiotics and other dental care ingredients in promoting oral health and addressing common oral issues, offering a comprehensive strategy for personalized oral care.

Structure equation modeling in oral health research: A review of applications and considerations

This review provides an overview of structure equation modeling (SEM) and its applications in dental research. SEM is a statistical technique that allows researchers to examine the relationships between variables and is useful for analyzing data from a wide range of research designs, including cross-sectional, longitudinal, and experimental studies. The process involves specifying a theoretical model, testing the model with data, and evaluating the model fit. It has been used in dental research to investigate a wide range of topics, including dental diseases, oral health-related quality of life, and dental anxiety. SEM is particularly useful in modeling the relationships between various risk factors and dental diseases and also has the potential to provide a deeper understanding of the multifactorial nature of dental diseases such as periodontitis, dental caries, and oral cancer. Moreover, the insights provided can aid in the development of effective strategies for the prevention and treatment of dental diseases. It is a powerful statistical tool that can be used by dental researchers to gain a better understanding of the intricate interplay of factors that underlie dental diseases and other oral health-related outcomes.

New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.

In Vitro Inhibitory Effect of Silver Diamine Fluoride Combined with Potassium Iodide against Mixed-Species Biofilm Formation on Human Root Dentin

Applying a saturated potassium iodide (KI) solution immediately after silver diamine fluoride (SDF) application may affect the inhibitory effects of SDF on biofilm formation. This study compared the efficacy of 38% SDF with and without KI on preventing mixed-species biofilm formation on human root dentin surfaces and assessed ion incorporation into root dentin. The biofilms, composed of Streptococcus mutans, Lactobacillus rhamnosus, and Actinomyces naeslundii, were grown on specimen surfaces treated with either SDF or SDF + KI. After 24 h, the biofilms were evaluated using scanning electron microscopy, live/dead staining, adenosine triphosphate (ATP) assays, colony-forming unit (CFU) counts, and quantitative polymerase chain reaction. A Mann-Whitney U test was used to compare the results between the groups. Ion incorporation was assessed using an electron probe microanalyzer. The relative ATP content in the SDF + KI group was significantly higher than that in the SDF group (p < 0.05). However, biofilm morphology and the logarithmic reduction in CFUs and bacterial DNA were comparable across the groups. The SDF + KI treatment resulted in less silver and fluoride ion incorporation than that yielded by SDF alone. The inhibitory effects of SDF and SDF + KI on mixed-species biofilm formation were almost equivalent, although KI application affected the ion incorporation.

An In Vitro and In Silico Study of Luteolin-Loaded Zinc Oxide Nanoparticles: Enhancing Bioactivity and Efficacy for Advanced Therapeutic Applications Against Cariogenic Microorganisms

Introduction Recent studies have explored alternative methods to enhance caries prevention and treatment. Luteolin compound has been noted for its antimicrobial properties, while zinc nanoparticles (Zn NPs) are recognized for their potent antibacterial effects. This study investigates the synthesis, characterization, and antimicrobial efficacy of luteolin-loaded Zn oxide NPs (Luteo-ZnONPs) against cariogenic bacteria. By combining the biofilm-targeting capabilities of luteolin with the antimicrobial properties of Zn NPs, we aim to explore a novel approach for dental caries management. Methods Luteo-ZnONPs were synthesized and characterized using ultraviolet-visible (UV-vis) and Fourier transform infrared (FTIR) spectroscopy, confirming their successful formation and stability. Antimicrobial efficacy was assessed through minimum inhibitory concentration (MIC), demonstrating effectiveness against cariogenic bacteria such as Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, and Streptococcus mutans in different concentrations. The agar well plate method was employed to analyze the growth inhibitory effect of Luteo-ZnONPs (50 and 100 µg/ml, respectively). Streptomycin (100 µg/ml) was used as a positive control. The results (zone of inhibition (ZOI) in millimeter, mm) were represented as mean ± standard deviation. One-way analysis of variance (ANOVA) was employed to detect the significance (p < 0.05) between the groups. Cytotoxicity was analyzed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay against MG63 cells, and doxorubicin was used as a positive control. Wilcoxon rank test was used for the statistical method. Gyrase B was downloaded from Protein Data Bank (PDB id: 6F86) and docked against luteolin using Autodock software (version 4.2). The binding score was presented as kcal/mol in table format. Results Characterization results showed that UV-vis spectroscopy revealed characteristic peaks, indicating the successful synthesis and stability of Luteo-ZnONPs. FTIR spectroscopy confirmed the presence of functional groups from luteolin compound interacting with the Zn NPs. It showed effective inhibition against E. coli on 50 µg/ml as 12.45 mm as ZOI and increased with concentration (100 µg/ml as 17.13 mm). It showed minimal ZOI on E. faecalis (8.12, 12.21 on 50 and 100µg/ml, respectively). The cytotoxicity of Luteo-ZnONPs was lesser than doxorubicin on MG63 cells with statistical high significance (p < 0.0014). These results showed that Luteo-ZnONPs had effective antimicrobial nature against Enterococcus family. Thus, gyrase B from E. coli was selected for the molecular docking analysis. The catalytic tunnel in gyrase B (E. coli, PDB: 6F86), influenced by Luteo-ZnONPs, indicated potential for novel, broad-spectrum antimicrobials via selective inhibition at conserved active sites.  Conclusion The agar well plate and MIC confirmed that Luteo-ZnONPs exhibited potent antibacterial activity, especially at higher concentrations compared to streptomycin. One- way ANOVA demonstrated significant differences in antibacterial efficacy between treatments, validating its superior performance. Its strong interaction on in silico level showed the targeted mechanism of action. Luteo-ZnONPs showed lesser toxicity than doxorubicin on MG63 cells. These findings underscore the potential of its broad spectrum antimicrobial nature paving the way for its development into innovative, nontoxic therapeutic solutions.

New Perspectives about Relevant Natural Compounds for Current Dentistry Research

Natural compounds have been used since the earliest civilizations and remain, to this day, a safer alternative for treating various dental problems. These present antimicrobial, anti-inflammatory, antioxidant, analgesic, and antimutagenic effects, making them useful in the prophylactic and curative treatment of various oral diseases such as infections, gingivitis, periodontitis, and even cancer. Due to the high incidence of unpleasant adverse reactions to synthetic compounds, natural products tend to gradually replace conventional treatment, as they can be just as potent and cause fewer, milder adverse effects. Researchers use several methods to measure the effectiveness and safety profile of these compounds, and employing standard techniques also contributes to progress across all medical disciplines.

Production and characterization of the lipopeptide with anti-adhesion for oral biofilm on the surface of titanium for dental implants

Titanium implants are subject to bacterial adhesion and peri-implantitis induction, and biosurfactants bring a new alternative to the fight against infections. This work aimed to produce and characterize the biosurfactant from Bacillus subtilis ATCC 19,659, its anti-adhesion and antimicrobial activity, and cell viability. Anti-adhesion studies were carried out against Streptococcus sanguinis, Staphylococcus aureus, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Proteus mirabilis as the minimum inhibitory concentration and the minimum bactericidal concentration. Cell viability was measured against osteoblast and fibroblast cells. The biosurfactant was classified as lipopeptide, with critical micelle concentration at 40 µg mL- 1, and made the titanium surface less hydrophobic. The anti-adhesion effect was observed for Staphylococcus aureus and Streptococcus sanguinis with 54% growth inhibition and presented a minimum inhibitory concentration of 15.7 µg mL- 1 for Streptococcus sanguinis and Aggregatibacter actinomycetemcomitans. The lipopeptide had no cytotoxic effect and demonstrated high potential application against bacterial biofilms.

Oral processing behavior and dental caries; an insight into a new relationship

INTRODUCTION

Previous evidence suggests an individual variation in the preferred oral processing behavior. Individuals can be classified as firm processing(FPL) or soft processing likers(SPL). FPL(crunchers and chewers) prefer using their teeth while SPL(smooshers and suckers) prefer using the tongue and the palate when processing different food items. Variation in the preferred oral processing behavior has been associated with differences in food texture preference and eating time. Time is one of the factors directly related to the development of dental caries(tooth decay). Oral retention and eating times are associated with greater caries experience. This study aims to explore if a relationship exists between the preferred oral processing behavior and the individual's caries experience.

MATERIALS AND METHODS

This was a cross-sectional, dental center-based study conducted at Jordan University of Science and Technology. Five hundred participants consented to fill out the preferred oral processing behavior(POPB) questionnaire. Anthropometric measurements (including weight, height, and waist circumference) were recorded. A single trained and calibrated dentist registered each participant's caries experience and plaque levels using the DMFS index and plaque index of Silness and Loe.

RESULTS

A total of 351(70.2%) and 149(29.8%) participants were typed as FPL and SPL, respectively. SPL demonstrated higher levels of dental caries experience compared to FPL. The mean DMFS score for SPL was 28.8(±25.43) while for FPL was 18.71(± 18.34). This difference remained significant after adjustment for confounders(P<0.001). SPL exhibited a significantly higher mean score for the "M" component(P <0.001) while no significant difference in the mean score of the "D"(P = 0.076) and "F"(P = 0.272) components was observed when compared to FPL.

CONCLUSION

The current findings provide new insight into a possible relationship between the preferred oral processing behavior and an individual's caries experience. A relationship in which the preferred oral processing behavior can potentially affect and/or be affected by the dental caries experience.

Probiotics for oral health: a critical evaluation of bacterial strains

Oral health is critical for total body health and well-being; however, little improvement in oral health status has occurred in the U.S. over the past 20 years. Tooth decay and gum disease remain highly prevalent, with more than 90% and 50% of adults suffering from these conditions, respectively. To combat this lack of improvement, alternative approaches to dental care are now being suggested. One such alternative therapy is probiotics for oral care. In the oral cavity, probiotic strains have been shown to reduce levels of oral pathogens, inhibit the formation of dental caries, and reduce the levels of bacteria that cause halitosis. However, as the oral care probiotic market expands, many products contain bacterial species and strains with no documented health benefits leading to confusion and mistrust among consumers and clinicians. This confusion is enhanced by the regulatory status of probiotic products which puts the onus of safety and efficacy on the manufacturer rather than a central regulatory body. The overarching goal of this review is to provide consumers and clinicians with documented evidence supporting (or refuting) the health benefits of oral care probiotics marketed for sale in the United States. This includes defining what constitutes an oral care probiotic product and a strain level analysis of candidate probiotics from the genera Streptococcus, Lactobacillus, Bifidobacterium, and Bacillus. Additionally, prebiotics and postbiotics will be discussed. Finally, a set of considerations for consumers and clinicians is provided to empower probiotic product decision making. Together, this review will improve understanding of oral care probiotics marketed in the US for dental professionals and consumers.

Prevalence of dental caries among children in Indonesia: A systematic review and meta-analysis of observational studies

Objective

The prevalence of dental caries among children in Indonesia remains unclear. Therefore, we aimed to provide an updated assessment of this prevalence while also investigating the influence of patient characteristics and methodological factors.

Design

We performed a systematic review and meta-analysis, including searches of PubMed, Cochrane Library, and Embase from inception to August 24, 2023. We included 8840 participants in 27 studies reporting the prevalence of dental caries among Indonesian children.

Results

The overall prevalence of dental caries was 76 % (95 % confidence interval: 71%-81 %). Studies in which decay-missing-filled teeth (DMFT) criteria were used to diagnose dental caries were significantly more prevalent than studies using non-DMFT criteria (78 % vs. 64 %, P < 0.05). No significant moderators were identified for the study subgroup based on study origin (Jakarta vs. non-Jakarta) or comorbidity status (comorbidity vs. no comorbidity). Owing to incomplete reporting of variables, metaregression analysis could not be conducted for continuous variables, such as age and male percentage.

Conclusions

The prevalence of dental caries among Indonesian children remains notably high, showing consistency across Jakarta-based studies and non-Jakarta studies. Initiating dental caries prevention and health promotion campaigns is imperative, focusing on the critical importance of early detection.

Challenges in differential diagnosis and treatment of cervical root resorption vs. root caries

External cervical root resorption may be occasionally mistaken for root caries and vice versa. Radiographical and clinical differential diagnoses of cervical root resorption and root caries are essential for correct treatment planning and a successful treatment outcome. This article reviews the contemporary literature and summarises the prevailing professional consensus pertaining to external cervical root resorption. Clinical diagnostics which help distinguish cervical root resorption from root caries are outlined and treatment approaches of external cervical root resorption are discussed.

Alcohol and Periodontal Disease: A Narrative Review

The scientific literature dealing with alcohol and alcoholic beverages revealed that these drinks possess an adverse impact on periodontal tissues. Additionally, other principal risk factors include tobacco, smoking, poor oral hygiene, etc. It has been observed that among chronic alcoholics, there are further issues, such as mental, social, and physical effects, that promote alcoholism. These people may have weak immunity for defense against pathogenic organisms and bacteria. Thus, chances of gingival bleeding, swollen gums, bad breath, and increased bone loss are there. Different alcoholic beverages in the market cause less salivation; these beverages contain sugars that promote acid production in the oral cavity by pathogens that demineralize the enamel and damage gum and teeth. This chronic alcohol consumption can progress into different types of oral disorders, including cancer, halitosis, and caries, and is also associated with tobacco and smoking. Chronic alcohol consumption can cause alteration of the oral microbiome and increase oral pathogens, which lead to periodontal disease and an environment of inflammation created in the body due to malnutrition, diminished immunity, altered liver condition, brain damage, and gut microbiota alteration. Heavily colored alcoholic beverages produce staining on teeth and, due to less saliva, may cause other toxic effects on the periodontium. Over-dependency on alcohol leads to necrotizing lesions such as necrotizing gingivitis, necrotizing periodontitis, and necrotizing stomatitis. These pathological impairments instigate severe damage to oral structures. Therefore, proper counseling by the attending dental surgeon and related health professionals is urgently required for the patient on the basis that the individual case needs to go away from the regular heavy consumption of alcohol.

Plant-Derived Compounds: A Promising Tool for Dental Caries Prevention

There is a growing shift from the use of conventional pharmaceutical oral care products to the use of herbal extracts and traditional remedies in dental caries prevention. This is attributed to the potential environmental and health implications of contemporary oral products. This comprehensive review aims at the analysis of plant-derived compounds as preventive modalities in dental caries research. It focuses on data collected from 2019 until recently, trying to emphasize current trends in this topic. The research findings suggest that several plant-derived compounds, either aqueous or ethanolic, exhibit notable antibacterial effects against Streptococcus mutans and other bacteria related to dental caries, with some extracts demonstrating an efficacy comparable to that of chlorhexidine. Furthermore, in vivo studies using plant-derived compounds incorporated in food derivatives, such as lollipops, have shown promising results by significantly reducing Streptococcus mutans in high-risk caries children. In vitro studies on plant-derived compounds have revealed bactericidal and bacteriostatic activity against S. mutans, suggesting their potential use as dental caries preventive agents. Medicinal plants, plant-derived phytochemicals, essential oils, and other food compounds have exhibited promising antimicrobial activity against oral pathogens, either by their anti-adhesion activity, the inhibition of extracellular microbial enzymes, or their direct action on microbial species and acid production. However, further research is needed to assess their antimicrobial activity and to evaluate the cytotoxicity and safety profiles of these plant-derived compounds before their widespread clinical use can be recommended.

Comparative Evaluation of Antimicrobial Efficacy of Triple Antibiotic Paste Herbal Combination and Camphorated Monochlorophenol as Intracanal Medicaments against Enterococcus faecalis in Deciduous Molars: An In Vivo Study

Aim

Compare the efficacy of triple antibiotic paste (TAP), herbal extracts, and camphorated monochlorophenol (CMCP) as intracanal medicaments against Enterococcus faecalis (E. faecalis) in deciduous molars.

Materials and methods

A total of 60 samples were collected from canals of first and second molars of 4-10-year-old children, with more than two-thirds root length, and fitting the inclusion criteria. Samples were collected at three intervals-S1 was collected just after access opening, S2 was collected after biomechanical preparation (BMP) and irrigation, and just before placement of medicament. Randomization was done to place the medicaments into three groups: group I-CMCP, group II-TAP, and group III-herbal combination. Sample S3 was taken 48 hours after removal of medicament from the canals. The collected samples were transported via Amies media to the laboratory, where they were anaerobically incubated for 24 hours. Growth of E. Faecalis was observed, and manual counting of the colony-forming unit (CFU) was done. The change in CFU in all samples was calculated, and the results were statistically analyzed.

Results

The results show that there is a change from S1 (TAP = 118.67 ± 122.48, herbal = 109.07 ± 106.43; CMCP = 110.73 ± 120.53) to S2 (TAP = 34.13 ± 63.47; herbal = 27.67 ± 39.39; CMCP = 16.40 ± 26.32) and S3 (TAP = 12.33 ± 24.82; herbal = 4.73 ± 12.78; CMCP = 3.40 ± 7.12). It is seen that there is a significant difference seen from S1 to S2 in all three groups (p ≤ 0.05) using repeated measure analysis of variance (ANOVA) test. This shows that all three medicaments were effective in reducing bacterial counts of E. Faecalis from sample S1 (pre) to S3 (post) significantly after exposure to root canal bacterial flora for 48 hours (2 days). The pairwise comparison of the change in CFU within each group, S1-S3, also shows significant changes. There is a significant decrease in CFU seen from S1 to S2 and S1 to S3 but not from S2 to S3 for all three groups, which was evaluated using the post hoc Bonferroni test. It was also observed that in between the canals, although there was a change from S1 to S3 in terms of the CFU, there was no significant difference in the decrease in the bacterial count when intercanal comparison was made. There was, however, a change that was seen to be significant when values from each canal were compared from S1 to S3.

Conclusion

All three medicaments have successfully shown a decrease in the numbers of E. faecalis, which the study aimed at checking. Although the effect varied intergroups, it was mild, so herbal alternatives could be used instead of antibiotics and CMCP. Also, because the local application is effective in controlling interappointment flare-ups, the medicaments can be successfully given without having to prescribe systemic antibiotics.

How to cite this article

Tawde MM, Lakade L, Patil S, et al. Comparative Evaluation of Antimicrobial Efficacy of Triple Antibiotic Paste Herbal Combination and Camphorated Monochlorophenol as Intracanal Medicaments against Enterococcus faecalis in Deciduous Molars: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(3):243-254.

Comparative evaluation of anti-biofilm and anti- adherence potential of plant extracts against Streptococcus mutans: A therapeutic approach for oral health

Dental caries predominantly attributed to the cariogenic nature of Streptococcus mutans, continue to pose a substantial global challenge to oral health. In response to this challenge, this study aimed to evaluate the effectiveness of leaf extracts (LEs) and essential oils (EOs) derived from different medicinal plants in inhibiting the growth of Streptococcus mutans biofilm. In vitro and in silico approaches were employed to identify active compounds and assess their inhibitory effects on S. mutans. Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) were measured to determine the anti-biofilm and anti-adherence activity against S. mutans. Biofilm viability (CFU/mL) and extracellular polymeric substance (EPS) concentration were quantified. GC-MS analysis was utilized to identify active compounds in the most effective plant extracts exhibiting anti-S. mutans activity. A high-throughput screening focused on the interaction between these compounds and the target enzyme SortaseA (SrtA) using molecular docking was performed. Results indicated that Cymbopogon citratus displayed the highest efficacy in reducing S. mutans biofilm formation and adhesion activity, achieving 90 % inhibition at an MIC value of 12 μg/mL. Among the 12 bioactive compounds identified, trans-Carvyl acetate exhibited the lowest binding energy with SrtA (-6.0 Kcal/mole). Trans-Carvyl acetate also displayed favorable pharmacokinetic properties. This study provides novel insights into the anti-S. mutans properties of C. citratus and suggests its potential as a therapeutic approach for oral health. Further research is needed to explore the combined effect of plant extracts for enhanced protection against dental caries.

Sleep disorders, anxiety and obesity associated with untreated dental caries in children eight to ten years of age

OBJECTIVE

To evaluate the presence of sleep disorders, obesity and anxiety associated with cavitated carious lesions in children aged 8 to 10 years.

MATERIALS AND METHODS

A cross-sectional study was carried out in the Northeast of Brazil. The sample was comprised of 793 schoolchildren randomly selected from public and private schools. Calibrated examiners (Kappa >0.80) performed the clinical examination of dental caries using the International Caries Detection and Assessment System and applied the Revised Children's Manifest Anxiety Scale and the Sleep Disturbance Scale for Children questionnaires. The anthropometric variables evaluated were weight and height. Negative binomial regressions (α ≤ 0.05) were performed. A Directed Acyclic Graph was prepared using DAGitty software (version 3.0), to select the co-variables for the statistical fits.

RESULTS

The prevalence of tooth decay was 52.8%. The mean number of tooth surfaces with cavitated caries was 2.2(2.8), 58.9% of the schoolchildren had some type of sleep disorder, while 20.2% were anxious and 29.1% were obese. Sleep disturbance (RR = 1.38; 95% CI: 1.05-1.83), general anxiety (RR = 1.71; 95% CI: 1.32-2.21), obesity (RR = 1.48; 95% CI: 1.17-1.86) were associated with dental caries in the final model.

CONCLUSION

The presence of carious lesions was higher in children with sleep disorders, anxiety, obesity, and those who experienced dry mouth.

Tubular Nanoclay-Enhanced Calcium Phosphate Mineralization and Assembly to Impart High Stiffness and Antimicrobial Properties

Achieving superior mechanical properties of composite materials in artificially engineered materials is a great challenge due to technical bottlenecks in the size and morphological modulation of inorganic nanominerals. Hence, a "bioprocess-inspired fabrication" is proposed to create multilayered organic-inorganic columnar structures. The sequential assembly of halloysite nanotubes (HNTs), polyelectrolytes (PAAs), and calcium phosphates (CaPs) results in organic-inorganic structures. PAA plays a crucial role in controlling the formation of CaP, guiding it into amorphous particles with smaller nanosizes. The introduction of HNT induces the assembly and maturation of CaP-PAA, leading to the formation of a highly crystalline hydroxyapatite. Poly(vinyl alcohol) was then woven into HNT-encapsulated hydroxyapatite nanorods, resulting in composite materials with basic hierarchical structures across multiple scales. The fabricated composite exhibits exceptional hardness (4.27 ± 0.33 GPa) and flexural strength (101.25 ± 1.72 MPa), surpassing those of most previously developed biological hard tissue materials. Additionally, the composite demonstrates effective antibacterial properties and corrosion resistance, attributed to the dense crystalline phase of CaP. This innovative approach showcases the potential of clay minerals, particularly HNT, in the advancement of biomaterial design. The outstanding mechanical and antimicrobial properties of clay-based composites make them a promising candidate for applications in hard tissue repair, offering versatility in biomedicine and engineering.

Nanotechnology in toothpaste: Fundamentals, trends, and safety

Several studies have revealed that healthcare nanomaterials are widely used in numerous areas of dentistry, including prevention, diagnosis, treatment, and repair. Nanomaterials in dental cosmetics are utilized to enhance the efficacy of toothpaste and other mouthwashes. Nanoparticles are added to toothpastes for a variety of reasons, including dental decay prevention, remineralization, hypersensitivity reduction, brightening, and antibacterial qualities. In this review, the benefits and uses of many common nanomaterials found in toothpaste are outlined. Additionally, the capacity and clinical applications of nanoparticles as anti-bacterial, whitening, hypersensitivity, and remineralizing agents in the treatment of dental problems and periodontitis are discussed.

Unlocking the potential of probiotic administration in caries management: a systematic review

BACKGROUND

The use of prebiotics and/or probiotic bacteria with the potential to modulate the oral ecosystem may play an important role in the prevention and management of dental caries. To assess the evidence of the potential of pre/probiotics both in the prevention and treatment of dental caries, we focused on the PICO question "In individuals with caries, after probiotic administration, is there an improvement in outcomes directly related to caries risk and development?".

METHODS

An extensive systematic search was conducted in electronic databases PubMed, Web of Science, Scopus and Cochrane, to identify articles with relevant data. This systematic review included trials performed in Humans; published in English; including the observation of patients with caries, with clear indication of the probiotic used and measuring the outcomes directly involved with the cariogenic process, including the quantification of bacteria with cariogenic potential. To evaluate the methodological quality of the studies, the critical assessment tool from the Joanna Briggs Institute was used.

RESULTS

Eight hundred and fifty articles, potentially relevant, were identified. Following PRISMA guidelines 14 articles were included in this systematic review. Outcomes such as reduction of cariogenic microorganism counts, salivary pH, buffer capacity, and caries activity were assessed. The probiotic most often referred with beneficial results in dental caries outcomes is Lacticaseibacillus rhamnosus. Regarding the most used administration vehicle, in studies with positive effects on the caries management, probiotic supplemented milk could be considered the best administration vehicle.

CONCLUSIONS

Evidence suggests a beneficial effect of probiotic supplemented milk (Lacticaseibacillus rhamnosus) as an adjuvant for caries prevention and management. However, comparable evidence is scarce and better designed and comparable studies are needed.

Analysis of Spatial and Biochemical Characteristics of In Vitro Cariogenic Biofilms

Background Dental caries is the most common bacterial disease of calcified tissues of teeth. Cariogenic biofilms formed on the tooth surface secrete organic acids and thus result in demineralization. Delving into the depth of biofilms is crucial to understand the pathogenic mechanisms and design improved therapeutic approaches. The aim of the study is to analyze the spatial and biochemical characteristics of cariogenic biofilms. Materials and methods Pulp tissue samples sourced from freshly extracted third molars were incubated with oral cariogenic bacteria namely Streptococcus mutans, Staphylococcus aureus, Escherichia coli, Entamoeba faecalis, and Candida albicans to form the biofilm. Spatial assessment of biofilms was done under FESEM (field emission scanning electron microscope, JSM-IT800, JEOL, Tokyo, Japan). FTIR (Fourier transform infrared spectroscopy, Alpha II, Bruker, Germany) spectra were assessed for chemical molecular interactions in 24- and 48-hour time periods.  Results Morphological assessment with FESEM revealed rapid growth and aggregation within a short time period. FTIR spectra to analyze chemical constituents of biofilm presented with varied peaks of water, amide A, amide I, water, lipids, and phospholipids. Conclusion Further validation with more advanced imaging for an extended time period is vital to derive better conclusive evidence.

Cissus Extracts in Dentistry: A Comprehensive Review on its Untapped Potential

Natural products have received a lot of attention in a variety of medical sectors, including dentistry. Cissus, a flowering plant genus, has long been used for its therapeutic benefits. The purpose of this review is to thoroughly investigate the possibilities of Cissus extracts in dentistry. To that end, we used specific selection criteria for the selection of pertinent scientific articles published in the scientific information databases of PubMed, Web of Science, Google Scholar, Scopus, and ProQuest. We found that the diverse array of bioactive compounds found in varied species of Cissus holds promise for applications ranging from oral wound healing to periodontal health. This review summarizes known studies on antibacterial, anti-inflammatory, and tissue-regenerative characteristics of Cissus extracts, shedding light on their potential significance in modernizing modern dental practices. It exerts that Cissus extracts have the potential to supplement established dentistry therapies by providing all-natural remedies for a variety of oral health conditions.

Non-Cariogenic Effect of Milk and Dairy Products on Oral Health in Children and Adolescents: A Scoping Review

Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this scoping review was to analyze the scientific literature on the non-cariogenic effect of milk and DPs, with a focus on their potential to prevent dental caries in children and adolescents. PubMed, EMBASE, and Web of Science were searched for publications relevant to our topic from January 2013 to 30 September 2023. Thirty-eight studies were included in the qualitative analysis. The included studies highlight the properties of milk and DPs that contribute to enamel remineralization, exhibit antibacterial action, inhibit the growth of cariogenic bacteria, and promote a balanced oral microbiome. With regard to the addition of probiotics (PBs) and fluoride (F) to DPs, the mixed results of the studies analyzed did not allow a clear statement to be made about their non-cariogenic effects. However, several studies show that the addition of PBs can reduce cariogenic bacteria, create a protective barrier against pathogens and support the host's natural defense mechanisms. Further long-term and high-quality studies are needed to understand the impact of milk and its constituents on oral health in order to promote effective caries prevention strategies in children and adolescents.

Green Synthesized Polymeric Iodophors with Thyme as Antimicrobial Agents

Antimicrobial resistance (AMR) is a growing concern for the future of mankind. Common antibiotics fail in the treatment of microbial infections at an alarming rate. Morbidity and mortality rates increase, especially among immune-compromised populations. Medicinal plants and their essential oils, as well as iodine could be potential solutions against resistant pathogens. These natural antimicrobials abate microbial proliferation, especially in synergistic combinations. We performed a simple, one-pot synthesis to prepare our formulation with polyvinylpyrrolidone (PVP)-complexed iodine (I2), Thymus Vulgaris L. (Thyme), and Aloe Barbadensis Miller (AV). SEM/EDS, UV-vis, Raman, FTIR, and XRD analyses verified the purity, composition, and morphology of AV-PVP-Thyme-I2. We investigated the inhibitory action of the bio-formulation AV-PVP-Thyme-I2 against 10 selected reference pathogens on impregnated sterile discs, surgical sutures, cotton gauze bandages, surgical face masks, and KN95 masks. The antimicrobial properties of AV-PVP-Thyme-I2 were studied by disc diffusion methods and compared with those of the antibiotics gentamycin and nystatin. The results confirm AV-PVP-Thyme-I2 as a strong antifungal and antibacterial agent against the majority of the tested microorganisms with excellent results on cotton bandages and face masks. After storing AV-PVP-Thyme-I2 for 18 months, the inhibitory action was augmented compared to the fresh formulation. Consequently, we suggest AV-PVP-Thyme-I2 as an antimicrobial agent against wound infections and a spray-on contact killing agent.

The In Vitro Assessment of Antibacterial and Antioxidant Efficacy in Rosa damascena and Hypericum perforatum Extracts against Pathogenic Strains in the Interplay of Dental Caries, Oral Health, and Food Microbiota

The rising demand for novel antibiotic agents prompts an investigation into natural resources, notably plant-derived compounds. In this study, various extracts (aqueous, ethanolic, aqueous-ethanolic, and enzymatic) of Rosa damascena and Hypericum perforatum were systematically evaluated against bacterial strains isolated from dental lesions (n = 6) and food sources (raw milk and broiler carcass, n = 2). Minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), antibiofilm activity, and time-kill kinetics were assessed across a range of extract concentrations, revealing a dose-responsive effect. Notably, some extracts exhibited superior antibacterial efficacy compared to standard clinical antibiotics, and the time-kill kinetics demonstrated a rapid elimination of bacterial loads within 24 h. The susceptibility pattern proved strain-specific, contingent upon the extract type, yet all tested pathogens exhibited sensitivity. The identified extracts, rich in phenolic and polyphenolic compounds, as well as other antioxidant properties, contributed to their remarkable antibiotic effects. This comprehensive investigation not only highlights the potential of Rosa damascena and Hypericum perforatum extracts as potent antibacterial agents against diverse bacterial strains including caries pathogens, but also underscores their rapid action and dose-dependent efficacy. The findings suggest a promising avenue for harnessing plant-derived compounds in the development of novel antimicrobial strategies against dental caries and other oral inflammations, bridging the gap between natural resources and antibiotic discovery.

Formulation and antibacterial properties of lollipops containing of chitosan- zinc oxide nano particles on planktonic and biofilm forms of Streptococcus mutans and Lactobacillus acidophilus

This study aimed to formulate and characterize the experimental lollipops containing chitosan- zinc oxide nanoparticles (CH-ZnO NPs) and investigate their antimicrobial effects against some cariogenic bacteria. The CH-ZnO NPs were synthesized and characterized by X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR) analysis, and Transmission electron microscope (TEM). Then, four groups were made, including lollipops coated with 2 and 4 ml of CH-ZnO NPs, 0.7 ml CH-ZnO NPs incorporated lollipops, and those with no CH-ZnO NPs. Their antibacterial effectiveness against Streptococcus mutans and Lactobacillus acidophilus was evaluated by direct contact test and tissue culture plate method in planktonic and biofilm phases, respectively. Chlorhexidine mouthrinse (CHX) was used as a positive control group. In the planktonic phase, the antibacterial properties of both groups coated with CH-ZnO NPs were comparable and significantly higher than incorporated ones. There was no significant difference between CHX and the lollipops coated with 4 ml of NPs against S. mutans and CHX and two coated groups against L. acidophilus. None of the experimental lollipops in the biofilm phase could reduce both bacteria counts. The experimental lollipops coated with 2 and 4 ml of CH-ZnO NPs could reveal favorable antimicrobial properties against two cariogenic bacteria in the planktonic phase.

Effectiveness of plant-mediated synthesis of hydroxyapatite nano-particles impregnated in Pistachio oleogum resin on mineral contents of human teeth. An in-situ single-blind controlled study

OBJECTIVES

This study aimed to synthesize and characterize an environmentally friendly nanohydroxyapatite (n-HA) and evaluate its impact on enamel mineral content when incorporated into a Pistachio oleo gum resin (Saqqez) bio-chewing gum for in-situ models. We compared the effects of this green nano-hydroxyapatite (G n-HA) with those of a commercially available synthetic nano-hydroxyapatite (S n-HA).

METHODS

Various analytical techniques were employed including XRD, FESEM, FT-IR, EDX/SEM and TGA/DTA to characterize the crystallinity, size and composition of the G n-HA powder. Three chewing gum groups were formulated: (1) Saqqez gum containing 10% wt G n-HA, (2) Saqqez gum containing 10% wt S n-HA, and (3) pure Saqqez gum. In order to evaluate the impact of these chewing gums on enamel, intraoral appliances were fabricated, each containing six enamel specimens. Participants were instructed to chew the gums while wearing these appliances. The calcium (Ca+2) and phosphorus (P) levels in enamel specimens, both with and without exposure to an acid challenge, were quantified using EDX/SEM. FE-SEM was employed to capture the microstructure of the enamel surface. In terms of the statistical analysis, one-way ANOVA and Tukey's post hoc tests were utilized to compare the data, where the significance level (α) was set at 0.05.

RESULTS

The characterization tests confirmed the successful synthesis of G n-HA. Furthermore, EDX/SEM analysis of the enamel specimens from the intraoral appliance revealed significant variations in calcium (Ca+2) content among the enamel specimens (P = 0.000). The S n-HA group, in particular, exhibited the highest Ca+2 content, while the pure Saqqez group displayed the lowest. Nonetheless, there was no statistically significant differences in phosphorus (P) content observed among the three groups (P = 0.27).

CONCLUSIONS

Saqqez gum can be considered a wholesome natural chewing gum that serves, as a carrier for delivering remineralization agents to the tooth surfaces. This was evident in the groups containing n-HA, exhibiting elevated Ca+2 levels. It's noteworthy that G n-HA demonstrated less efficacy in enamel remineralization compared to S n-HA.

In silico analysis unravels the promising anticariogenic efficacy of fatty acids against dental caries causing Streptococcus mutans

Globally, dental caries is a prevalent oral disease caused by cariogenic bacteria, primarily Streptococcus mutans. It establishes caries either through sucrose-dependent (via glycosyltransferases) or through sucrose-independent (via surface adhesins Antigen I/II) mechanism. Sortase A (srtA) attaches virulence-associated adhesins to host tissues. Because of their importance in the formation of caries, targeting these proteins is decisive in the development of new anticariogenic drugs. High-throughput virtual screening with LIPID MAPS -a fatty acid database was performed. The selected protein-ligand complexes were subjected to molecular dynamics simulation (MDs). The Binding Free Energy of complexes was predicted using MM/PBSA. Further, the drug-likeness and pharmacokinetic properties of ligands were also analyzed. Out of 46,200 FAs scrutinized virtually against the three protein targets (viz., GtfC, Ag I/II and srtA), top 5 FAs for each protein were identified as the best hit based on interaction energies viz., hydrogen bond numbers and hydrophobic interaction. Further, two common FAs (LMFA01050418 and LMFA01040045) that showed high binding affinity against Ag I/II and srtA were selected for MDs analysis. A 100ns MDs unveiled a stable conformation. Results of Rg signified that FAs does not induce significant structural & conformational changes. SASA indicated that the complexes maintain higher thermodynamic stability during MDs. The predicted binding free energy (MM/PBSA) of complexes elucidated their stable binding interaction. ADME analysis suggested the FAs are biologically feasible as therapeutic candidates. Overall, the presented in silico data is the first of its kind in delineating FAs as promising anticaries agents of future.Communicated by Ramaswamy H. Sarma.

The Antibacterial Properties of Polish Honey against Streptococcus mutans-A Causative Agent of Dental Caries

Streptococcus mutans is considered the main pathogen responsible for dental caries, one of the major infectious diseases, affecting more than 4 billion people worldwide. Honey is a natural product with well-known antibacterial potential against several human pathogens. The aim of the study was to evaluate the antibacterial efficacy of Polish honey against S. mutans and analyze the role of some bioactive substances on its antibacterial action. The antibacterial potential of different honey varieties (goldenrod, buckwheat, honeydew, and lime) was analyzed using a microdilution assay. Manuka and artificial honey were used as controls. The content of GOX, hydrogen peroxide, total polyphenols, and antioxidant potential was assayed in honey. The influence of catalase and proteinase K on antibacterial activity as well as antibiofilm action was also determined. The strongest antibacterial activity was observed for buckwheat, honeydew, and manuka honey, which were also characterized by the highest antioxidant activity and polyphenols content. Catalase treatment decreases the antibacterial activity of honey, while proteinase K treatment influences the antibacterial potential of honey slightly less. Obtained results suggest that honey can be a good natural product against S. mutans, and hydrogen peroxide was identified as a crucial contributor to its antimicrobial action.

Examining the Role of Vitamin D in Caries Susceptibility in Children's Deciduous Teeth: A Systematic Review

The global prevalence of dental caries in deciduous teeth remains a significant health concern, affecting almost 70% of children by the age of six in specific regions. This systematic review aspired to methodically investigate the association between vitamin D levels and susceptibility to caries in children's deciduous teeth. A detailed search, guided by the PRISMA and PROSPERO guidelines, was conducted across three prominent electronic databases: PubMed, Web of Science, and Scopus, culminating in August 2023. The search integrated various keywords related to vitamin D and dental caries in primary dentition, yielding an initial pool of 1678 articles. After meticulous scrutiny, seven studies with a total of 7655 participants were deemed suitable for inclusion. The studies represented diverse geographical regions, showcasing varied vitamin D levels and sun exposure. Patient habits like brushing frequency, dental visits, and vitamin consumption also varied across studies. The analysis pinpointed vitamin D deficiency as a potential risk factor in some of the studies, with Odds Ratios (OR) ranging from 0.68 to 2.15. Statistically significant associations between vitamin D deficiency and caries susceptibility were documented in three studies (ORs of 2.15, 1.98, and 1.70). This comprehensive review elucidates the complex relationship between vitamin D levels and dental caries in children's deciduous teeth. While some studies spotlight vitamin D's pivotal role in dental health, inconsistencies across studies and regional differences necessitate more in-depth, globally representative investigations. Ensuring optimal vitamin D levels may play an integral role in dental health strategies. However, it is important to highlight that the roles of these studied factors might differ in deciduous teeth compared to permanent teeth.

Sweet Orange Juice Processing By-Product Extracts: A Caries Management Alternative to Chlorhexidine

Dental caries is one of the most prevalent chronic diseases globally in both children and adults. This study investigated the potential of industrial sweet orange waste extracts (ISOWE) as a substitute for chlorhexidine (CHX) in managing dental caries. First, the cytotoxicity of ISOWE (40, 80, 120 mg/mL) and CHX (0.1 and 0.2%) on buccal epithelial cells was determined. ISOWE exhibited no overall toxicity, whereas CHX strongly affected cell viability. The combination of ISOWE and CHX significantly enhanced cell proliferation compared to CHX alone. Next, the antimicrobial efficacy of ISOWE, CHX, and their combination was assessed against a 7-day complex biofilm model inoculated with oral samples from human volunteers. CHX exhibited indiscriminate antimicrobial action, affecting both pathogenic and health-associated oral microorganisms. ISOWE demonstrated lower antimicrobial efficacy than CHX but showed enhanced efficacy against pathogenic species while preserving the oral microbiome's balance. When applied to a cariogenic biofilm, the combined treatment of ISOWE with 0.1% CHX showed similar efficacy to 0.2% CHX treatment alone. Overall, the findings suggest that ISOWE is a promising natural anti-cariogenic agent with lower toxicity and enhanced selectivity for pathogenic species compared to CHX.

Remineralization Induced by Biomimetic Hydroxyapatite Toothpastes on Human Enamel

This work aimed to compare the effect of four new toothpastes (P1-P4) based on pure and biomimetic substituted nano-hydroxyapatites (HAPs) on remineralization of human enamel. Artificially demineralized enamel slices were daily treated for ten days with different toothpastes according to the experimental design. Tooth enamel surfaces were investigated using atomic force microscope (AFM) images and surface roughness (Ra) determined before and after treatment. The surface roughness of enamel slices was statistically analyzed by one-way ANOVA and Bonferroni's multiple comparison test. X-ray diffraction (XRD) and Fourier transform infrared (FTIR) data revealed the HAP structure with crystal sizes between 28 and 33 nm and crystallinity between 29 and 37%. The average size of HAP particles was found to be between 30 and 40 nm. The Ra values indicated that P3 (HAP-Mg-Zn-Sr-Si) toothpaste was the most effective after 10 days of treatment, leading to the lowest mean roughness. The P3 and P2 (HAP) toothpastes were found to be effective in promoting remineralization. Specifically, their effectiveness can be ranked as follows: P3 = P2 > P4 (HAP-Mg-Zn-Si) > P1 (HAP-Zn), considering both the chemical composition and the size of their constitutive nanoparticles. The proposed toothpastes might be used successfully to treat early tooth decay.

Antibacterial Properties of the Antimicrobial Peptide Gallic Acid-Polyphemusin I (GAPI)

A novel antimicrobial peptide, GAPI, has been developed recently by grafting gallic acid (GA) to polyphemusin I (PI). The objective of this study was to investigate the antibacterial effects of GAPI on common oral pathogens. This laboratory study used minimum inhibitory concentrations and minimum bactericidal concentrations to assess the antimicrobial properties of GAPI against common oral pathogens. Transmission electron microscopy was used to examine the bacterial morphology both before and after GAPI treatment. The results showed that the minimum inhibitory concentration ranged from 20 μM (Lactobacillus rhamnosus) to 320 μM (Porphyromonas gingivalis), whereas the minimum bactericidal concentration ranged from 80 μM (Lactobacillus acidophilus) to 640 μM (Actinomyces naeslundii, Enterococcus faecalis, and Porphyromonas gingivalis). Transmission electron microscopy showed abnormal curvature of cell membranes, irregular cell shapes, leakage of cytoplasmic content, and disruption of cytoplasmic membranes and cell walls. In conclusion, the GAPI antimicrobial peptide is antibacterial to common oral pathogens, with the potential to be used to manage oral infections.

Alleviation of dental caries by use of isolated potential probiotic and its characterization

Streptococcus mutans plays a major role in biofilm formation and pathogenic bacterial adhesion. Here we investigated the abilities of our isolates from diverse conventional sources to characterize the beneficial bacteria for inhibition of S. mutans. Enterobacter cloacae PS-74, a beneficial bacteria isolated from yoghurt, is gram negative, rod shaped, and resistant to acid, bile salt, and amylase. PS-74 cell-free supernatants (CFS) demonstrated highest zone of inhibition of 29 ± 1.7 mm. Further, the minimum inhibitory concentration (MIC) value of CFS PS-74 was recorded to be 10 μL and its minimum bactericidal concentration (MBC) value was found to be 15μL which led to 99.9% log reduction of S. mutans. Moreover, the biofilm formation was reduced by 84.91% at MIC15 of CFS PS-74 which alleviate the dental caries formation by S. mutans. This is the first report on E. cloacae PS-74, which was studied for its probiotic properties to inhibit S. mutans MTCC-890 due to the production of organic acids and employed in oral treatment.

Quorum Sensing in Oral Biofilms: Influence on Host Cells

Quorum sensing molecules (QSMs) in the oral cavity regulate biofilm formation, the acquisition of iron, stress responses, and the expression of virulence factors. However, knowledge of the direct QSM-host interactions in the oral environment is limited, although their understanding could provide greater insight into the cross-kingdom communication occurring during oral disease development. This review aims to explore the literature on oral QSM-host interactions and to highlight areas of advancement in this field. The studies included in this review encompass an array of cell types and oral QSMs, with particular emphasis on immune cells and their relationship to periodontal diseases. It can be inferred from the current literature that QSMs are utilised by host cells to detect bacterial presence and, in the majority of cases, elicit an immune response towards the environmental QSMs. This may provide a base to target QSMs as a novel treatment of oral diseases. However, N-acyl homoserine lactone (AHL) detection methods remain an area for development, through which a greater understanding of the influence of oral QSMs on host cells could be achieved.

3,3'-Diindolylmethane (DIM): A Potential Therapeutic Agent against Cariogenic Streptococcus mutans Biofilm

Indole, a metabolite of the amino acid tryptophan, has been proven to act as a signal molecule in bacteria, acting in different aspects of biofilm formation. The oral biofilm is a type of biofilm that has consequences for human health. It is a complex, three-dimensional structure that develops on the surface of teeth via the attachment of primary microbial colonizers. Many oral infections are caused by an imbalance occurring in the microorganisms naturally found in oral biofilms and are considered major public health concerns. In this study, we test the effect of a natural bis-indole, 3,3'-Diindolylmethane (DIM), in mitigating the pathogenicity of the oral biofilm inhabiting bacterium Streptococcus mutans, a bacterium that is considered to be a principal etiological agent in dental caries. Our study found that DIM was able to attenuate S. mutans biofilm formation by 92%. Additionally, treatment with DIM lowered extracellular polymeric substance (EPS) production and decreased its durability significantly under acidic conditions. Therefore, the anti-biofilm and anti-virulence properties of DIM against S. mutans bacteria in an "oral setting" provides evidence for its usefulness in reducing biofilm formation and potentially for caries attenuation.

Dental Caries in the First Permanent Molar during the Mixed Dentition Stage

Background: The early eruption of the first permanent molar (FPM) favors its exposure to the risk factors for dental caries specific to the mixed dentition stage of dental development. The aim of this study was to assess the prevalence and distribution pattern of FPM dental caries and of the consequences of this pathology - caries with pulp involvement in the FPM and missing FPM (FPM extraction) in a sample of Romanian children during the mixed dentition stage. Objective: To evaluate the effect of asanas in Yoga on the IOP of practicing individuals. Materials and methods: Eighty-seven children aged between five and 13 years, who attended a private dental clinic, were enrolled in the present study. The investigations were carried out as part of the comprehensive dental examinations. Written informed consent was obtained from one of the subjects' parents prior to his/her child's participation in this research. The collected data were statistically analyzed with STATA/MP13 software using the Chi square test. The level of significance was set at p<0.05. Results:The prevalence of FPM dental caries was 60.9%. There were statistically significant differences (p = 0.004) in the number of FPMs affected by dental caries per subject in relation to age. No statistically significant differences regarding the number of FPMs affected by dental caries per subject in relation to gender were found. With respect to the distribution pattern of FPM dental caries by location at tooth level, the mesial surface had the highest prevalence (in 36.8% of all investigated subjects), followed by the occlusal surface (33.3%). The prevalence of caries with pulp involvement in the FPM was 19.5% and children in the 10-11-year age group were the most affected (55.5%). There were statistically significant differences regarding the distribution pattern of caries with pulp involvement in the FPM by age (p = 0.0001). The prevalence of FPM extraction was 6.9% and, according to dental history and examination, loss of FPM was due to caries. Among children with missing FPM, five were older than the age recommended for achieving spontaneous space closure, which indicated the need for immediate intervention. Conclusions:Considering the results of the present study, it can be stated that FPM dental caries represents a highly prevalent pathology during the mixed dentition stage. The findings are relevant and useful for the current clinical dental practice, emphasizing the importance of caries detection and diagnosis in developing a comprehensive dental treatment plan tailored to the specific needs of pediatric patients.

Evaluating the Effect of Sumac Extract on Dentine Micro-Hardness during pH Cycling

Statement of the Problem

Although sumac extract (SE) is reported as a collagen cross linker, the available data regarding its effect on the dentine micro-hardness is quite sparse.

Purpose

Therefore, the aim of this study includes evaluating the effect of different concentrations of SE on dentine micro-hardness comparing to grape seed extract (GSE).

Materials and Method

In this experimental study, the GSE was purchased from available market and convert to 5% solution. Meanwhile the 5, 10, and 20% of SE solutions were prepared experimentally. The base line micro-hardness of 60 samples (30 premolars divided to buccal and lingual segments) was recorded triplicate for each specimen and they were randomly divided into 5 groups (four abovementioned experimental solutions and de-ionized water as negative control). For 35 consecutive days, each sample was twice pH cycled and treated by solutions. Ultimately, the final micro-hardness was recorded triplicate again for each sample and the numerical data was compared with each other using one-way ANOVA and Tukey HSD Post Hoc tests (α=0.05).

Results

The meanSD values of micro-hardness for the groups was recorded as 54.45 13.4, 65.6518.5, 39.572.26, 41.131.66 and 43.794.96 at base line and 10.40.99, 11.85 0.75, 10.161.84, 8.481.16 and 6.311.01 at final stage for control, GSE 5%, SE 5%, SE 10% and SE 20% respectively. There was no significant difference among the micro-hardness of the groups before treatment (p= 0.369). However, after experimental treatment, there was significant difference between the groups (p= 0.024) while in pairwise comparison just two groups (GSE 5% and SE 20%) had significant difference with each other (p= 0.017).

Conclusion

The efficacy of SE was reversely related to its concentration. Moreover, neither GSE nor SE had significant effect on dentine micro-hardness after 35 day pH cycling.

Strictinin: A Key Ingredient of Tea

Strictinin is a relatively tiny ellagitannin, which is found in many plants as a minor constituent. Catechins are known as the major constituents in the young leaves of most tea plants, while strictinin was found as a major constituent in the Pu'er tea plant. In some Pu'er tea varieties, strictinin was identified as the most abundant phenolic compound rather than catechins. In the past decade, strictinin was demonstrated to possess several functional activities, including antiviral, antibacterial, anti-obesity, laxative, anticaries, anti-allergic, antipsoriatic, antihyperuricemia, antidiabetic, and anticancer effects. These functional activities were in accordance with the therapeutic effects empirically perceived for Pu'er tea. Evidently, strictinin is the key ingredient in Pu'er tea that acts as a herbal medicine. In functionally-based applications, an instant powder of Pu'er tea infusion was formulated as an active raw material to be supplemented in food, cosmetics, and beverages; a new type of tea named Bitter Citrus Tzen Tea was developed by combining three teas empirically consumed to expel the cold, and new edible oral care products were designed for caries prevention by supplementation with Pu'er tea extract. More functional activities and practical applications of strictinin are scientifically anticipated in follow-up research.

Dental caries in Rwanda: A scoping review

Background and Aims

Dental caries is an infectious disease affecting virtually all nations, including Rwanda. In Rwanda, the burden of dental caries is an issue of public health concern. To ensure the progressive eradication of the current dental caries burden in Rwanda through an evidence-based approach, it is imperative to have an overview of the scientific research landscape of dental caries in the country. This study-a scoping review-aims to review the available evidence and gaps on dental caries in Rwanda.

Methods

This scoping review was reported based on the Preferred Reporting Items for systematic reviews and meta-analyses extension for Scoping Reviews checklist. A systematic search of 11 databases was done to scoop out all literature relevant to the topic. Based on the review's selection criteria, a total of eight peer-reviewed journal articles were included in the review. The extracted data were collated, summarized, and presented as results.

Results

The analysis of the data extracted from the included articles revealed a high prevalence of dental caries (ranging from 42.42% to 71.5%) in Rwanda. Also, the major pathogens causing dental caries in Rwanda as well as the impact of dental caries on the physical health and quality of life of Rwandans were identified in this review. Furthermore, the reported operative treatment options for dental caries in Rwanda were predominantly nonconservative. Also, no intervention study has been conducted on dental caries in Rwanda.

Conclusion

The findings in this review identify the need for massive public health interventions on dental caries in Rwanda.

Anti-cariogenic Properties of Lactobacillus plantarum in the Utilization of Galacto-Oligosaccharide

Ecological approaches can help to correct oral microbial dysbiosis and drive the advent and persistence of a symbiotic oral microbiome, which benefits long-term dental caries control. The aim of this study was to investigate the impact of the prebiotic Galacto-oligosaccharide (GOS) on the growth of probiotics L. plantarum 14,917 and its effect on the inhibitory ability of L. plantarum 14,917 against the growth of Streptococcus mutans and Candida albicans in an in vitro model. Single-species growth screenings were conducted in TSBYE broth with 1% glucose and 1–5% GOS. Interaction experiments were performed using duo- and multi-species models with inoculation of 10⁵ CFU/mL S. mutans, 10³ CFU/mL C. albicans, and 10⁸ CFU/mL L. plantarum 14,917 under 1%, 5% GOS or 1% glucose. Viable cells and pH changes were measured. Real-time PCR was utilized to assess expression of C. albicans and S. mutans virulence genes. Six replicates were used for each group. Student’s t-test, one-way ANOVA, and Kruskal-Wallis were employed to compare the outcomes of different groups. GOS significantly inhibited the growth of C. albicans and S. mutans in terms of growth quantity and speed when the two strains were grown individually. However, GOS did not affect the growth of L. plantarum 14,917. Moreover, 1% and 5% GOS enhanced the anti-fungal performance of L. plantarum 14,917 in comparison to 1% glucose. GOS as the carbon source resulted in a less acidic environment in the C. albicans and S. mutans duo-species model and multispecies model where L. plantarum 14,917 was added. When GOS was utilized as the carbohydrate substrate, S. mutans and C. albicans had a significant reduction in the expression of the HWP1, ECE1, atpD, and eno genes (p < 0.05). To our knowledge, this is the first study that reported the ability of GOS to neutralize S. mutans-C. albicans high caries of medium pH and to disrupt virulence gene expression. Moreover, as a prebiotic, GOS augmented the inhibitory ability of L. plantarum against C. albicans in vitro. The current study revealed the anti-caries potential of prebiotics GOS and shed light on novel caries prevention strategies from the perspective of prebiotics and probiotics. These findings provide a rationale for future biofilm or clinical studies to elucidate the effect of GOS on modulating oral microbiota and caries control.

Potential Oral Health Benefits of Ginseng and Its Extracts

This review discusses the effects of ginseng and its extracts in the treatment of dental caries, periodontal diseases, endodontic diseases, oral cancers, oral mucosal diseases, and some other dental associations. In the meantime, bioavailability and safety application of ginseng products are discussed. All of the articles reviewed were from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and VIP Chinese Science and Technology Periodicals Full-Text Database through November 2022, including full-text English or non-English publications. Ginseng and its extracts were shown to have beneficial effects on oral diseases, and further studies are needed to understand the mechanisms and confirm the effects in humans.

Nanoencapsulation of Grapefruit Seed Extract and Cinnamon Oil for Oral Health: Preparation, In Vitro, and Clinical Antimicrobial Activities

This study aimed to formulate mucoadhesive antimicrobial nanoparticles using natural antimicrobials and biopolymers for oral health and verify their antimicrobial activity in clinical studies. A combination of grapefruit seed extract and cinnamon oil (GCN) and chitosan/carrageenan (CS/CR) were selected as synergistic antimicrobial combinations and mucoadhesive wall materials for nanoparticles, respectively. GCN nanoparticles (NPs; size = 357 nm and polydispersity index = 0.188) prepared by ionic gelation between CS and CR exhibited synergistic antimicrobial activity between grapefruit seed extract and cinnamon oil and significantly higher antimicrobial activity against Streptococcus mutans and sobrinus than free GCN in a time-kill assay. The clinical antibacterial activity of GCN was significantly increased and sustained by nanoencapsulation in the mouth-rinse test and GCN NP-treated drinking yogurt. These results suggest that GCN-loaded CS/CR nanoencapsulation is a promising technique that can inhibit oral bacteria with or without the presence of other food ingredients.