Explore the vast range of titles available.

\"Introduces the reader to what a cavity is, how to prevent them, and what happens when you get one\"-- Provided by publisher.

ObjectivesThis study evaluated and compared the effect of silver diamine fluoride (SDF) and silver-modified atraumatic restorative treatment (SMART) sealants for the treatment of initial carious lesions of permanent molars affected by molar incisor hypomineralization (MIH).MethodsOne hundred and twelve hypomineralized permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF and SMART sealant groups (n = 56 teeth/group) in a split-mouth fashion. Hypersensitivity, formation of caries, and enamel breakdown were evaluated in both groups. Hypersensitivity was assessed by Schiff Cold Air Sensitivity Scale (SCASS), and clinical assessments of SMART sealants were performed according to modified USPHS criteria at 1, 6, and 12 months. The data were analyzed statistically using Fisher’s exact test, Kaplan–Meier analysis, Mann–Whitney U test, and Friedman test.ResultsTwenty-six hypomineralized molars with marked baseline hypersensitivity showed significantly lower SCASS scores at all evaluation periods (p < 0.001). There was no significant difference in hypersensitivity scores between the groups at the repeated applications of SDF at 1, 6, and 12 months. The cumulative survival rates of SMART sealants on occlusal and palatal surfaces were 88.7% and 58.8%, respectively.ConclusionsIn hypomineralized molars, both SDF and SMART sealants showed favorable short-term prevention against dental caries while providing effective desensitization. Marginal discoloration was the most common side effect of the SMART sealants as a result of SDF application.Clinical SignificanceBoth SDF and SMART sealants showed similar short-term effectiveness as non-aerosol procedures in arresting enamel caries and reducing hypersensitivity in hypomineralized molars.Trial registrationClinical Trials Registration Number: NCT03862014.

This randomized, parallel, controlled trial assessed the effect of fluoride varnish, ozone and octenidine on white spot lesions (WSLs) and caries during orthodontic treatment. Patients were enrolled between 1st September 2017 and 31st August 2020 at initiation of orthodontic treatment in Department of Interdisciplinary Dentistry Pomeranian Medical University in Szczecin, Poland. All participants were randomly assigned to four study and one control groups using number random generator. However, investigators were not blinded due to the nature of the study. Groups I, II, III, IV had professional cleaning and varnishing (5% NaF) every 4 weeks. Groups II and IV had in-office ozone therapy before varnishing, groups III and IV received domestic octenidine mouthrinse. Group K had no professional hygienic or prophylactic procedures. WSLs were assessed at T0 and then every 4 weeks (T1–T4) and caries—at T0 and T4. The specific objective was to assess the influence of fluoride varnish, ozone and octenidine on the incidence of white spot lesions and caries during orthodontic treatment. The primary outcome of this report was the highest number of WSLs in group K and the lowest percentage of patients with WSLs in group IV. Each group comprised 30 randomized participants; they were all analyzed. No WSLs were found at T0, but they were stated in all groups at T4. The numbers of patients with WSLs significantly increased between T0-T4 in groups I and K. Group IV had the lowest percentage of patients with WSLs in T1-T4. WSLs in group IV were found no earlier than at T2. Group K had the highest percentage of WSLs at T4: 26%. At T0 all the groups had DMFs above 0 with a significant increase at T4. No side effects of the introduced prophylaxis were observed in any group. Caries is an important problem of fixed orthodontic treatment. Even an extremely intensive prophylaxis could not completely prevent WSLs and caries. Simultaneous application of fluoride varnish, ozone gas exposure and octenidine appears to have a beneficial effect in limiting the development of WSLs. Trial registration: NCT04992481.

Dental caries is one of the most common preventable diseases among Indigenous children. The study aimed to estimate the efficacy of an Early Childhood Caries (ECC) intervention among Aboriginal Australian children over 9 years, and to explore potential risk factors associated with dental caries among Indigenous Australian children. Data were from a randomized controlled trial conducted in South Australia, Australia. Four hundred and forty-eight women pregnant with an Aboriginal child were randomly allocated to either an immediate (II) or delayed (DI) intervention group between January 2011 and May 2012. The immediate intervention comprised (1) provision of dental care to mothers during pregnancy; (2) application of fluoride varnish to teeth of children at ages 6, 12; and 18 months; (3) motivational interviewing delivered in conjunction with; and (4) anticipatory guidance. Mothers/children in the DI group received the same intervention commencing at child aged 2 years. Follow-ups occurred when children were aged 2-, 3-, 5-, 7- and 9-years. In this analysis, outcomes were severity of caries experience: mean dmft/DMFT at child aged 9 years. Dependent variables included mothers' baseline and seven years follow-up characteristics (age, education level, source of income, residential location, smoking and alcohol status) and children's birth and feeding, and dental behaviours characteristics (sex, gestation, birth weight, breastfeeding status and sweet food consumption, and frequency of tooth brushing). Multivariable log-Poisson regression models with robust standard error estimation were applied as a statistical model to estimate multivariable relationships of dental caries and other covariates. Risk ratios (RRs) with their 95%CI were calculated. Sensitivity analyses were conducted by using the inverse-probability-of censoring weighting (IPCW) to overcome the loss-follow-up issues. Data were available for 367 (II = 180 and DI = 187) children at age 9 years. The mean dmft was 3.41 (95% CI: 2.95-3.87) and DMFT was 0.31(95%CI: 0.22-0.41). In multivariable modelling, mean dmft was higher (RR = 1.13, 95% CI: 1.01-1.26) among DI children than II children, but there were no significant differences in the permanent dentition. Risk factors for caries severity in both the primary and permanent dentition included lower mothers' education level (<12 years level: dmft; RR = 1.56, 95% CI:1.31-1.86; and 'Trade or TAFT: DMFT: RR =3.40, 95%CI: 1.16-9.98). Other risk factors for dental caries experience in the primary dentition included preterm birth, low birth weight, child not breastfed and sugar consumption more than 10%, and in permanent dentition was self-rated 'fair/poor' or 'Good' children's oral health, compared with self-rated 'Excellent/very good' oral health. The present study suggests that, within this cohort, initiating an early childhood caries intervention during pregnancy and infancy may be associated with lower caries experience in the primary dentition by age 9 years compared to a later start. Low maternal education level was associated with caries severity in both primary and permanent dentitions. Sugar consumption, a modifiable risk factor, greater than 10% was an important contributor to dental caries in primary teeth.

Silver diamine fluoride (SDF) can effectively prevent and control dental caries, the world’s most pervasive noncommunicable disease. This study estimated the transition probabilities for caries in children receiving SDF. The CariedAway study was a community-based cluster-randomized trial of SDF, glass ionomer sealants, and atraumatic restorations conducted in 48 primary schools enrolling predominately low-income minority children in New York, USA. For enrolled children receiving SDF, probabilities were computed for transitions between healthy (sound), diseased (carious), and disease-controlled (arrested) states for 6-year molars using multistate Markov models. Subject-level transition probabilities over one- and two-year periods were then calculated by aggregating states of all 6-year molars and first and second bicuspids. Tooth state progression was treated as a relapsing-remitting condition. A total of 7418 children were enrolled in CariedAway, of which 1352 received SDF and completed at least three study observations. Among eligible participants, the baseline prevalence of untreated decay was 29% and the prevalence of preexisting dental sealants was 8%. The probability of transitioning between sound and carious states in 6-year molars ranged from 0.0022 to 0.0074. At the subject-level, the sound to carious transition probabilities were 0.07 and 0.12 after one and two years, respectively. Once in a fully arrested state, the probability of remaining arrested was 0.72 and 0.60 after 1 and 2 years. While the overall probabilities of teeth remaining in disease-free or arrested states was high after receiving SDF, multiple applications might be needed for consistent caries control.

Resin infiltration is an innovative approach to arrest progression of caries lesions. The aim of this randomized split-mouth placebo-controlled clinical trial was to assess whether resin infiltration of proximal lesions is more effective than non-operative measures alone with respect to the inhibition of caries progression. In 22 young adults, 29 pairs of interproximal lesions with radiological extension into the inner half of enamel or the outer third of dentin were randomly allocated to two treatment groups. In the test group, lesions were infiltrated (Icon, pre-product; DMG). A placebo treatment was performed in the control group. All participants received instructions for diet, flossing, and fluoridation. The primary outcome after 18 months was radiographic lesion progression (assessed by digital subtraction radiography). No unwanted effects could be observed. In the effect group, 2/27 lesions (7%) and in the control group 10/27 lesions (37%) showed progression (p = 0.021; McNemar). Infiltration of interproximal caries lesions is efficacious in reducing lesion progression.

ECC is a significant therapeutic and social problem and a global burden on public health. The aim of this clinical trial was to test whether a 2-week daily consumption of chewing tablets containing thermally inactivated L. salivarius reduces the 12-month caries increment compared to the control group. The investigation was a single-center, randomized, controlled open-label, blinded end-point evaluation trial in two parallel groups. At baseline, 140 generally healthy children between 3 and 6 years of age with or without ECC were randomly assigned to the probiotic test group (n = 70) or to the treatment as the usual control group (n = 70). The primary outcome measure was the 1-year increment in caries incidence and prevalence. Secondary endpoints assessed were the initial, cavitated and obvious dentinal caries increment as well as the measurement of dental plaque accumulation, as an indicator of the ECC risk. Data were collected through the clinical assessment of the children’s caries (dmft and ICDAS II) and oral hygiene status (DI-S of OHI-S index). Caries incidence and prevalence were statistically significantly lower in the probiotic group versus the control group (p < 0.001 and p = 0.0075). The initial and final mean OHI-S scores in the probiotic group did not show any significant differences. In conclusion, the regular short-term intake of probiotics may reduce caries development. Our findings suggest that self-administered probiotic therapy may provide a good complement to increase the effectiveness of individual preventive home care in preschool children. This is the first clinical study evaluating the effect of a short-term probiotic intervention on reducing early childhood caries with 12 months of follow-up.

Objectives A multicentric randomized, 3-year prospective study was conducted to determine for how long Biodentine, a new biocompatible dentine substitute, can remain as a posterior restoration. Materials and methods First, Biodentine was compared to the composite Z100®, to evaluate whether and for how long it could be used as a posterior restoration according to selected United States Public Health Service (USPHS)’ criteria (mean ± SD). Second, when abrasion occurred, Biodentine was evaluated as a dentine substitute combined with Z100®. Results A total of 397 cases were included. This interim analysis was conducted on 212 cases that were seen for the 1-year recall. On the day of restoration placement, both materials obtained good scores for material handling, anatomic form (0.12 ± 0.33), marginal adaptation (0.01 ± 0.10) and interproximal contact (0.11 ± 0.39). During the follow-up, both materials scored well in surface roughness (≤1) without secondary decay and post-operative pain. Biodentine kept acceptable surface properties regarding anatomic form score (≤1), marginal adaptation score (≤2) and interproximal contact score (≤1) for up to 6 months after placement. Resistance to marginal discoloration was superior with Biodentine compared to Z100®. When Biodentine was retained as a dentine substitute after pulp vitality control, it was covered systematically with the composite Z100®. This procedure yielded restorations that were clinically sound and symptom free. Conclusions Biodentine is able to restore posterior teeth for up to 6 months. When subsequently covered with Z100®, it is a convenient, efficient and well tolerated dentine substitute. Clinical relevance Biodentine as a dentine substitute can be used under a composite for posterior restorations.

Dental sealants, an evidence-based clinical practice, can arrest occlusal non-cavitated carious lesions (NCCLs); however, U.S. oral health providers rarely provide this treatment. To increase providers’ adoption of the practice, clinic leaders need to identify implementation strategies to deploy. Using a stepped wedge design across 16 cluster-randomized dental clinics, we examined whether small-group deliberative engagement enabled 680 oral health providers and staff to endorse implementation strategies and to increase placement of dental sealants on occlusal NCCLs. Participants deliberated about two barriers and eight implementation strategies. Sealant placement for occlusal NCCLs was extracted from the electronic health record. After deliberating, 49% of participants endorsed the first barrier and 37% endorsed the second barrier. Of those, 26% indicated a strategy was needed for the first barrier and 28% indicated a strategy was needed for the second. Consistent with this perceived lack of need for strategies, leaders did not deploy implementation strategies. Compared with the non-intervention period (98 clinic-months), in the intervention period (101 clinic-months), providers did not increase placement of sealants on occlusal NCCLs. Deliberative engagement may help clinic leaders efficiently evaluate support for implementation strategies, but future research is needed to determine how to increase guideline adoption. Trial Registration: This project is registered at ClinicalTrials.gov with ID NCT04682730. The trial was first registered on 18/12/2020. https://clinicaltrials.gov/ct2/show/NCT04682730.