Caries experience in relation to oral hygiene, salivary cariogenic microflora, buffer capacity and secretion rate in 6-year olds and 12 year olds in Riga

OBJECTIVE: The aim was to assess possible relationship between oral hygiene, salivary cariogenic microflora, buffer capacity, secretion rate and caries experience in 6 year olds and 12 year olds in Riga, and to evaluate these variables in relation to caries risk. MATERIALS AND METHODS: 50 children aged 6 and 71 children aged 12 were examined clinically and by bitewing X-ray for caries diagnosis. Green-Vermillion oral hygiene index, stimulated salivary flow rate and buffer capacity were estimated (CRT-buffer; Ivoclar, Vivadent, Liechtenstein). Salivary mutans streptococci (MS) and lactobacilli (LB) (CRT-bacteria; Vivadent) were determined only for children with dmft/DMFT>4: 60% at age of 6, 54,9% at age of 12. All data were statistically analyzed using frequency tables, Pearson chi2test and ANOVA analysis. RESULTS: Mean DMFT was 0.12 in 6 year olds, and 4.6 in 12 year olds. Mean Green-Vermillion index was 0.75 in 6 year olds and 0.99 in 12 year olds. Caries experience and Green-Vermillion index were associated only in 6 year olds (p=0.024). Salivary MS was associated with Green-Vermillion index only in 12 year olds (p=0.086). Salivary MS and caries experience were associated only in 12 year olds (p=0.010). Salivary LB was associated with stimulated saliva's secretion rate only in 12 year olds (p=0.027). Salivary cariogenic microflora level and buffer capacity were associated in 6 year olds (p for MS=0.010; p for LB=0.052). Same association was observed only between salivary MS and buffer capacity in 12 year olds (p=0.081). Stimulated saliva's secretion rate and buffer capacity were associated only in 12 year olds (p=0.004). CONCLUSIONS: Information of caries risk factors should be used to work effectively on caries reduction in 6 year olds and 12 year olds in Riga.publishersversionPeer reviewe

Comparative analysis of CRT Buffer, GC saliva check buffer tests and laboratory titration to evaluate saliva buffering capacity

OBJECTIVE. The purpose of this study is to evaluate the ability of two commercial strip tests and laboratory titration to detect saliva buffer capacity. MATERIALS AND METHODS. Sixty-four patients were examined. Stimulated saliva was collected and buffer capacity was determined with two different chair-side strip tests in addition to immediate transportation to the laboratory to check the buffering ability by titrating with 0.005 M HCl and measuring pH by digital pH/Ion meter, used as a gold standart. The correlation were analyzed using the Spearman Rank Correlation Test, Cohen's Kappa coefficient and Pearson's Correlation test, p < 0.01. Sensitivity and specificity were used to measure precision of these tests. RESULTS. The response rate was 80%. High buffer capacity was found in 23.4% of cases, medium in 62.5%, and low in 14.1%. The Spearman Rank Correlation coefficient between the titration method and CRT Buffer test was 0.685 and the GC Saliva Check Buffer was 0.837. The Kappa coefficient for the CRT Buffer test was 0.508, while the coefficient for the GC Saliva Check Buffer was 0.752. The Pearson Correlation for the GC Saliva Check was 0.675. The difference is found in the buffer capacity at initial pH and at pH value 3. CONCLUSIONS. Both colorimetric tests correlate with the acid titration method in laboratory and are usable for saliva buffer capacity detection in dental offices. Buffer capacity detected in laboratory at different pH values can provide more information regarding caries risk.publishersversionPeer reviewe

Evidence based toothpaste classification, according to certain characteristics of their chemical composition

Toothpastes are daily oral care products, the chemical composition of which is constantly changing due to manufacturer's competition. It becomes more and more difficult for dentists to recommend the best toothpaste and for patients to choose one. The objective of this paper was to draw out recommendations based on the best evidence available and to propose a new classification of toothpastes. Publications were searched in PubMed database (published between 1991-2011, limited to English language articles in dental journals). Recommendations for toothpaste choice and usage were developed from the best evidence available.publishersversionPeer reviewe

Effect of COVID-19 on Coverage of Dental Services in Latvia

Publisher Copyright: © The Authors This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).This study aimed to describe the impact of the COVID-19 pandemic and related public health decisions on dental services. A retrospective study was conducted using secondary data on dental services (2019–2021). Data were obtained from the Latvian National Health Service and the Centre for Disease Prevention and Control and analysed using descriptive statistics and data visualisation methods. In the first wave of COVID-19, the frequency of routine dental services decreased by 81.6% at the patient level, which coincided with the restrictions imposed as public health measures. The amount of regular dental manipulations returned to its previous level immediately after lifting restrictions. Still, they decreased to a more moderate extent (not exceeding 25% decline) with the beginning of the second wave. We observed a decrease in all manipulations, regardless of their aerosol-generating risk, and no increase in preventive manipulations that could be performed without any physical contact. We conclude that the most significant decrease in the availability of services was directly linked to existing public health measures. It seems that these measures allowed time to adapt the clinics to the new sanitary requirements, further ensuring continuity of service provision.Peer reviewe

Inadequacy of Self-Implemented Preventive Measures to Control Caries Increment due to Poor Dietary Habits in 6 and 12 Years Old Children in Riga, Latvia

Aim. This study investigated whether the self-implemented preventive measures practiced among the 6 and 12 years olds in Riga, Latvia can control the caries increment due to poor dietary habits among this age groups. Material and methods. Caries examination was performed on Thirty-eight 6 and thirty-nine 12 years olds by visual and bitewing radiographic examination at baseline and after 3 years. All participants and/or their parents completed dietary habits questionnaires. The data was analyzed using t-test, chi-square test, ANOVA and frequency tables, Wilcoxon and Fisher’s tests (α=0.05). Results. The mean (SD) values of caries experience at baseline/3-year period in 6- vs.12- year olds were as follows. DMFS: 0.72 (1.02)/3.13 (3.13) (p=0.0000) vs. 6.79 (5.14)/14.79 (9.86) (p=0.0000); dmfs: 11.26(8.71)/7.74 (4.86) (p=0.078) vs. 3.57 (2.03)/1.5 (0.71) (p=0.317). The statistical significance was reported only for the consumption of soft drinks (p=0.032) and sugared tea (p=0.018) for the 6 years olds, and for sugared tea (p=0.017) and number of teaspoons of sugar added to tea (p=0.0095) for the 12-years olds. There was positive caries increment in all the 6 and 12 years olds that reported significant increase in consumption of soft drinks and sugared tea, and increase daily number of teaspoons of sugar used in tea. Conclusions. The present study demonstrated high cariogenic diet among the children in Riga, which is associated with increased caries experience that the currently practiced self-implemented oral hygiene measures was not capable of controlling.publishersversionPeer reviewe

Caries Increment and Oral Hygiene Changes in 6-and 12-Year-Old Children in Riga, Latvia : A 3-Year Follow-Up Report Using ICDAS II and RADKE Criteria

Publisher Copyright: © 2019 Dental Investigation Society.Objectives: The purpose of this study was to investigate the caries increment and oral hygiene changes over a 3-year period and also compare the sensitivity and specificity of Radke's caries assessment method to ICDAS II among 6-and 12-year-old children in Riga, Latvia. Materials and Methods: Thirty-eight 6 and thirty-nine 12-year-old children were examined visually and with bitewing (BW) radiographs for dental caries at baseline and after a 3-year period. Decayed, missing, and filled surfaces (dmfs/DMFS) in all teeth were scored by one calibrated examiner using the Radke's caries scoring criteria. Oral hygiene level was determined using Green-Vermillion index (G-V ind.) at baseline and after 3 years. ICDAS II was used to assess all children only at the 3rd-year time point. The parents of the 6-and 12-year-old children responded to a questionnaire on oral hygiene at baseline and at the 3-year mark. Statistical Analysis: The data were analyzed using t-test, Chi-square test, Wilcoxon test (α= 0.05), and sensitivity and specificity tests. Results: The mean (SD) values of G-V ind. and caries experience at baseline/3-year period in 6-versus 12-year-old children were as follows. G-V ind.: 1.14(0.80)/1.48(0.89) [p = 0.4768] versus 0.99(0.45)/1.45(1.22) [p = 0.0337]. DMFS: 0.72(1.02)/3.13(3.13) [p = 0.0000] versus 6.79(5.14)/14.79(9.86)[p = 0.0000]; dmfs: 11.26(8.71)/7.74 (4.86) [p = 0.0780] versus 3.57 (2.03)/1.5(0.71)[p = 0.3173].The sensitivity and specificity of Radke to ICDAS II of caries-affected surfaces was: in proximal surfaces-0.57 and 0.98, on occlusal surfaces-0.83 and 0.98, on buccal/lingual surfaces-0.43 and 0.99. Conclusions: The result of the present study suggests that the increased caries experience over a 3-year period among the 6-and 12-year-old children in Riga may be due to the concurrent decreased level of oral hygiene, suggesting that ICDAS II instead of Radke's criteria should be used to detect and monitor dental caries.publishersversionPeer reviewe

The Effect of MI Varnish™ on Caries Increment and Dietary Habits among 6- and 12-Year-Old Children in Riga, Latvia : A 3-Year Randomized Controlled Trial

Funding Information: Recruitment was facilitated by exempting volunteers from the two-year wait time required for their regular, complete (including radiographic examination) dental check-up financially supported by the government. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/ CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-yearold children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia.publishersversionPeer reviewe

COVID-19 as an opportunity for minimally-invasive dentistry : a national cross-sectional survey

Funding Information: IM acknowledges financial support from Post-doctoral-Research-Aid-Programme (European Regional Development Fund; 1.1.1.2/VIAA/3/19/543, Contract No 9.-14.5/27). All authors were part-time financed by the project of National Research Program “Impact of COVID-19 on health care system and public health in Latvia; ways in preparing health sector for future epidemics” (Project Nr. VPP-COVID-2020/1-0011). SEU acknowledges financial support from the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreement No. 857287. Publisher Copyright: © 2022, The Author(s).BACKGROUND: During the COVID19 pandemic, the Latvian government issued first absolute restrictions (elective treatments prohibited, only emergency care) and later relative restrictions (preference for non-aerosol-generating procedures (AGP) and emergency care) on dental care. This study aims to assess the impact of these restrictions on the decision made by Latvian dentists about caries treatment. METHODS: A Survey-based cross-sectional study was used. A minimum sample size of 174 dentists was estimated for national representativeness (N = 1524). The questionnaire was developed by experts and sent three times via email to Latvian dentists from July to September 2020 and was also delivered in printed form at two national conferences in September and October 2020. Descriptive statistics were calculated. RESULTS: We received 373 completed questionnaires, with a total response rate of 24.5%. Under the recommendation to reduce AGP for the treatment of uncomplicated caries, 10% of the dentists stated that they would stop attending, 54% would only attend emergencies, and 36% would attend as usual. Under prohibition, the percentages are 15%, 74%, and 11%, respectively. Regarding the type of treatment, more than 75% would opt to proceed with selective caries removal for both primary and permanent teeth and 10% for extraction. CONCLUSION: Latvian dentists are willing to treat patients with caries during the pandemic and state that they prefer to use non- or minimally invasive and less aerosol-generating methods for caries treatment.publishersversionPeer reviewe

Oral Microbiome Traits of Type 1 Diabetes and Phenylketonuria Patients in Latvia

Funding Information: The study was funded by Riga Stradins University Internal scientific budgets. Publisher Copyright: © 2023 by the authors.Some metabolic disorder treatments require patients to follow a specific diet or to consume supplements that, over time, can lead to oral microbiome alterations. Well-known disorders requiring such treatment are phenylketonuria (PKU), an inborn error of amino acid metabolism, and type 1 diabetes (T1D), a metabolic disorder that requires a specific diet regimen. Therefore, the aim of this study was to investigate the oral health and microbiome characteristics that might contribute to caries activity and periodontal disease risk in PKU and T1D patients. In this cross-sectional study, 45 PKU patients, 24 T1D patients, and 61 healthy individuals between the ages of 12 and 53 years were examined. Their anamnestic data and dental status were assessed by one dentist. Microbial communities were detected from saliva-isolated DNA using 16S rRNA gene V3–V4 sequencing on Illumina MiSeq sequencing platform. Results revealed that the PKU patient group displayed the highest number of extracted teeth (on average 1.34), carious teeth (on average 4.95), and carious activity (44.44% of individuals) compared to the T1D and CTRL groups. The lowest numbers of filled teeth (on average 5.33) and extracted teeth (on average 0.63) per individual were observed in T1D patients. Gingivitis appeared more often in the T1D group; however, possible risk of periodontal disease was seen in both the T1D and PKU patient groups. The highest number of differentially abundant genera was detected in the PKU group (n = 20), with enrichment of Actinomyces (padj = 4.17 × 10−22), Capnocytophaga (padj = 8.53 × 10−8), and Porphyromonas (padj = 1.18 × 10−5) compared to the CTRL group. In conclusion, the dental and periodontal health of PKU patients was found to be significantly inferior compared to T1D patients and healthy controls. T1D patients showed early signs of periodontal disease. Several genera that correlate with periodontal disease development were found in both groups, thus suggesting that T1D and PKU patients should seek early and regular dental advice and be educated about proper oral hygiene practices.Peer reviewe

Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries: a randomised clinical trial

Knowledge gaps exist regarding optimal silver diammine fluoride (SDF) regimens and the efficacy of new products for arresting dental caries in young children. We evaluated the effectiveness of 38%-SDF (SDI-RivaStar), Tiefenfluorid (TF) comparing with Placebo (P), all in conjunction with behavioural modification (BM), in preventing major complications (endodontic/extractions/pain)—a patient-centred outcome—due to early childhood caries over 12 months in children under 71-months. A six-arm, patient/parent-blinded, superiority, placebo-controlled randomised control trial at the university clinic in Riga, Latvia, from 1/9/20-31/8/22 (Protocol registration ISRCTN17005348). The trial tested six protocols, using three compounds (P/SDF/TF) under two regimes: annual and biannual (P1/P2/TF1/TF2/SDF1/SDF2) for major complications. Secondary outcomes included minor complications and parental satisfaction. All groups received BM. 373/427 randomised children (87.3%) completed the study. SDF2 had a significantly lower rate and risk of major (21.5%, OR = 0.28, 95%CI [0.11, 0.72], p 0.05). SDF biannual application with BM effectively prevented major complications of early childhood caries and was well accepted by children and their parents. Trial registration number: ISRCTN17005348, principal investigator: Ilze Maldupa, registration date: 30/06/2021. Clinical trial registration number: ISRCTN registry: ISRCTN17005348, https://doi.org/10.1186/ISRCTN17005348, registration date: 30/06/2021