Risk Indicators for Noncavitated and Cavitated Carious Lesions in Preschool Children

Objective: The aim of this study was to evaluate the risk indicators associated with noncavitated and cavitated lesions in preschool children. Methods: The cross-sectional study included 3- to 4-year-old healthy children (N = 741) recruited in a randomised controlled clinical trial. After obtaining written informed consent, parents completed a questionnaire about their child's sociodemographic background and oral health–related behaviours and parents' oral health–related knowledge and attitude. Caries and plaque were evaluated using International Caries Detection and Assessment System-II and Visible Plaque Index (VPI), respectively. Children were grouped according to their oral health status as being caries-free (CF), having only noncavitated lesions (NC), or having cavitated lesions (CL). The least absolute shrinkage and selection operator (LASSO) sparse multinomial regression was used to study the variables using 1 standard error above the minimum criterion set at P < .05. Results: The prevalence of children with NC and CL was 29.1% and 49.4%, respectively, with a prevalence of early childhood caries being 78.5%. The proportion of children who brushed twice or more than twice a day was highest in CF (71.7%), followed by NC (58.3%), and was least in CL (57.7%). A higher percentage of CL children (56.2%) had twice or more than twice the frequency of between-meal snacking than CF (41.7%) and NC (41.1%) (P < .001) children. The variables included with non-zero coefficients in the model were mean parental oral health knowledge, attitude score, and children's mean VPI score, and all were significant for CL; however, in NC, only VPI score was found to be significant. Conclusions: Poor oral hygiene is the risk indicator associated with the presence of NC in preschool children, whilst poor oral hygiene and poor parental oral health knowledge and attitude are associated with the presence of cavitated lesions

Is Mutans Streptococci count a risk predictor of Early Childhood Caries? A systematic review and meta-analysis

Abstract Background The review aims to determine the risk predictability of mutans streptococci in the development of carious lesions in children with primary dentition. Methods Longitudinal observational studies with at least 6 months follow-up and evaluating mutans streptococci presence in caries-free children under 6 years of age for the development of any cavitated or non-cavitated carious lesion. Six databases and grey literature were searched without any restrictions. Risk of bias was evaluated using the New Castle Ottawa scale for longitudinal studies, and the certainty of the evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation using GRADEpro software. Meta-analysis was performed using a random effect (DerSimonian and Laird, DL) model, and heterogeneity was evaluated using tau-squared, I2 statistics and prediction interval. Sensitivity analysis was performed to assess the relationship between the mutans streptococci presence at baseline and the caries development, according to the sample and methods used for the microbiological assessment and the length of follow-up of the studies. Publication bias was checked by funnel plot using a random effect (DerSimonian and Laird, DL) model. Results Twelve studies met the inclusion criteria and were included in the review. Four studies received a maximum of 9 stars, and among the remaining eight studies, six received 8 stars and the rest two studies were assigned 7 stars in the risk of bias scale. After pooling the results quantitatively, odds ratio (OR) was found to be 4.13 (95% CI: 3.33, 5.12), suggesting that children with mutans streptococci had 4 times higher odds of developing caries later (p < 0.001). Four studies were pooled to compare future caries experience among children with and without mutans streptococci at baseline, obtaining standardized mean difference (SMD) of 0.85 (95% CI: 0.33, 1.37), indicating a large effect (p < 0.001). Certainty of evidence was found to be moderate, and no publication bias was reported by the funnel plot criteria of symmetry. Conclusions Presence of mutans streptococci in a preschool child is a risk predictor for future caries experience. Early identification of children with increased caries-risk may facilitate in implementation of appropriate preventive strategies

Supporting data for thesis titled "Are calcium- and phosphate-containing fluoride varnishes more effective than the conventional fluoride varnish in preventing early childhood caries?"

This data contains supporting resources for the thesis titled "Are calcium- and phosphate-containing fluoride varnishes more effective than the conventional fluoride varnish in preventing early childhood caries?" The thesis is pivoted on a randomised clinical trial that started to recruit children in 2019.  The baseline characteristics of the study participants is published in International Dental Journal (Article title: Risk indicators for non-cavitated and cavitated carious lesions in preschool children- Manchanda et al., 2023). The follow-up data of this two-year randomised trial is under consideration for publication in a refereed journal at the time of publishing this data. The first dataset associated with these publications was generated utilizing the demographic characteristics of the study population, knowledge attitude and practices regarding oral health,  and clinical parameters (including visile plaque index and dental caries) at the level of teeth. A subset of the above population was randomly sampled from the above dataset and saliva and plaque were collected to evaluate the quantity of S.mutans and L. fermentum using the qRT-PCR technique. The baseline characteristics of that subset with the microbiological counts in saliva and plaque samples are published (Article title: Manchanda S, Cheung BPK, Lee GHM, Lo ECM, Yiu CKY. Quantitative analysis of salivary and biofilm bacteria associated with cavitated and non-cavitated carious lesions in pre-school children. Arch Oral Biol. 2023;146:105607. doi: 10.1016/j.archoralbio.2022.105607.). At the time of this data publishing, the two-year follow-up of this subset is under peer review regarding the effect of three study varnishes in altering the microbiological counts.</p