Six months of high-dose xylitol in high-risk caries subjects—a 2-year randomised, clinical trial

Objectives The hypothesis was that the daily use of a high dose of a xylitol chewing gum for 6 months would reduce the increment of decayed permanent first molar surfaces (ΔD6S) in high-risk schoolchildren after 2 years. Methods In this randomised, clinical trial, 204 schoolchildren with a high caries risk were assigned to two experimental groups, xylitol and non-xylitol. Caries status, salivary mutans streptococci, and lactobacilli were re-evaluated 2 years later in 74 xylitol-treated and 83 non-xylitol-treated schoolchildren. Differences in mean ∆D6S between groups registered at baseline and at follow-up were evaluated using the nonparametric Mann–Whitney U test. Results Outcome was the development of detectable carious lesions initial (D1–D2) and manifest (D3) in the permanent first molars. In the xylitol group, the difference in proportion of children with decayed first permanent molars at baseline and follow-up was 1.43 % for manifest lesion and 2.86 % for initial lesions; while in the non-xylitol group was 10.26 % (p < 0.01) and 16.66 % (p < 0.01), respectively. A statistically significant difference regarding means was also observed in the non-xylitol group: the ∆D6S for manifest lesion was 0.18 (p = 0.03) and 0.67 (p = 0.02) for initial lesion. Conclusion The use of a chewing gum containing a high dose of xylitol for a period of 6 months has been shown to produce a long-term effect on caries development in high caries-risk children. Clinical relevance A school-based preventive programme based on 6 months’ administration of a high dose of xylitol via chewing gum proved to be efficacious in controlling caries increment in high-risk children

Changing trend of caries from 1989 to 2004 among 12-year old Sardinian children

Background. During the past decades, the prevalence of caries disease in the population of Western industrialized countries has decreased markedly. In children also, a reduction of dental caries experience has been reported by many authors. The aim of this paper was to evaluate the trend of dental caries prevalence in 12-year-old children living in the city of Sassari, (Italy), by five cross-sectional studies conducted in 1989, 1992, 1995, 1998 and 2004. Methods. In all cohorts, dental caries (DMFT and SiC Index according to WHO indications), was measured. For each variable measured (DMFT and sub-indices, SiC Index), differences in proportions among the five cohorts during the fifteen years were tested using χ2-square test. Results. The mean DMFT index decreased from 4.3 ± 3.1 in 1989 to 0.8 ± 1.5 in 2004. The prevalence of untreated caries (DT) had a notable decrease between 1992 and 1995, increased slightly between 1995 and 1998 and had the greatest decrease in 2004. The number of filled teeth remains low. The percentage of caries-free children increased from 10% to 64%, whereas the percentage of untreated caries changed from 44% in 1989 to 62% in 2004. SiC Index decreased from 7.8 in 1989 to 3.9 in 2004. Conclusion. On the basis of the results of DMFT and SiC Index, caries experience has been reduced. The vigilance and the promotion of a higher standard of personal oral hygiene and dental check-ups are necessary to obtain an improvement of oral status in the future adult population and to reach the new WHO global goals

Caries risk assessment using different Cariogram models. A comparative study about concordance in different populations-Adults and children.

This methodological survey aimed to verify whether there is concordance among several Cariogram different risk models at different thresholds, comparing both children and adult populations and how each risk/protective factor weight on the overall caries risk profile. Three groups' data (two in children and one in adults) were obtained from previous studies, while a fourth, in young adults, was ad hoc enrolled. Different caries risk levels were assessed: a) three risk categories with two different thresholds as: "low risk"  =  61-100% or 81-100% chance to avoid caries, "moderate risk"  =  41-60% or 21-80% and "high risk"  =  0-40% or 0-20%, named model 1 and 2; b) four risk categories with two different thresholds as: "low risk"  =  61-100% or 76-100%, "moderate/low risk" = 41-60% or 51-75%; "moderate/high risk" = 21-40% or 26-50% and "high risk" = 0-20% or 0-25%, model 3 and 4; c) five risk categories as: "very low risk"  =  81-100%; "low risk"  =  61-80% "moderate risk" = 41-60%; "high risk" = 21-40% and "very high risk" = 0-20%, model 5. Concordance of the different Cariogram risk categories among the four groups was calculated using Cohen's kappa. The weight of the association between all Cariogram models toward the Cariogram risk variables was evaluated by ordinal logistic regression models. Considering Cariogram model 1 and 2, Cohen's Kappa values ranged from 0.40 (SE = 0.07) for the young adult group to 0.71 (SE = 0.05) for the adult one. Cohen's Kappa values ranged from 0.14 (SE = 0.03 p<0.01) for the adult group to 0.62 (SE = 0.02) for the two groups of children in models 3 and 4. Statistically significant associations were found for all Cariogram risk variables excepting Fluoride program in models 4 and 5 and the overall risk on children's samples. Caries experience showed a quite variable weight in the different models in both adult groups. In the regression analyses, adult groups' convergence was not always achievable since variations in associations between caries risk and different risk variables were narrower compared to other samples. Significant differences in caries risk stratification using different thresholds stands out from data analysis; consequently, risk assessments need to be carefully considered due to the risk of misleadingly choosing preventive and research actions

Effect of a daily dose of <i>Lactobacillus brevis</i> CD2 lozenges in high caries risk schoolchildren

Objectives A double-blind, randomised, placebo-controlled clinical trial was performed to validate the hypothesis that the use of lozenges containing Lactobacillus brevis CD2 (Inersan®, CD Investments srl) may reduce plaque pH, salivary mutans streptococci (ms) and bleeding on probing, during a 6-week period, in a sample of high caries risk schoolchildren. Methods A total of 191 children (aged 6–8 years), presenting two to three carious lesions and a salivary ms concentration of ≥105 CFU/ml, were enrolled and divided into two groups, an L. brevis CD2 lozenge group and a no L. brevis lozenge group, and examined at baseline (t0), after 3 weeks (t1), after 6 weeks of lozenge use (t2) and 2 weeks after the cessation of lozenge use (t3). Plaque pH was assessed using the microtouch technique following a sucrose challenge. The area under the curve (AUC5.7 and AUC6.2) was recorded. Salivary ms were counted, and bleeding on probing was assessed. Results At t0, the plaque-pH and ms concentration values were similar in both groups. Mean areas (AUC5.7 and AUC6.2) were significantly greater in the control group at t1, t2 and t3. L. brevis CD2 lozenges significantly reduced salivary ms concentrations and bleeding. The subjects from the test group showed a statistically significant decrease (p=0.01)in salivary ms concentration. At t2, a statistically significantly lower bleeding value was recorded in the test group compared with the control group (p=0.02). Conclusions Six weeks’ use of lozenges containing L. brevis CD2 had a beneficial effect on some important variables related to oral health, including a reduction in plaque acidogenicity, salivary ms and bleeding on probing.</br

World Caf\ue9 at Summer School of WHO Collaborating Centre for Epidemiology and Community Dentistry

Objectives of the study: This study is a qualitative evaluation of a teaching method. The 2015 Summer School organized by the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan took place in Sardinia. The educational objectives of the first day included: make an informal conversation with other members of the summer school; create an interesting exchange of ideas and experiences also between new, \u201chabitue\u301\u201d and beginners with senior professionals of this event; make a group for the works in the next days. Considering the different professional roles, age and context of origin, the purpose of the Pedagogists was to create a positive, relaxed but intimate atmosphere using the pleasure of \u201cinformal\u201d conversation, through a creative and practical method: The World Cafe\u300. Materials &amp; methods: The Pedagogists\u2019 first task focused on: caring of the location and the physical setup of the table, creating relevant questions to the concerns of the group, establishing the rules, managing the process to encourage participants to have a non- formal learning experience consequently improving thinking, speaking and listening skills. Finally the participants answered self-administered questionnaire to write about their emotions and cognitive processes that went out during the World Cafe\u300. Results: The analysis of the questionnaires was carried out with Interpretative Phenomenological Analysis (IPA), The interpretative steps identified two emerging themes: \u201cdifferent vs peer\u201d and \u201cdiscovering vs practicing\u201d. Conclusions: The World Cafe\u301 experience improves learning by connection; thinking and learning become dynamic processes instead of learning outcomes

Does a social/behavioural gradient in dental health exist among adults? A cross-sectional study

Objective To explore the potential presence of a social/behavioural gradient in dental health among Italian adults using a cross-sectional study. Methods Caries indices were recorded among 480 subjects (52.9% men, 47.1% women) who also completed a structured self-administered social and behavioural questionnaire. A social/behavioural gradient was generated as the sum of the worst circumstances recorded on the questionnaire (cariogenic diet, smoking, lowest occupational profile, brushing teeth < twice daily, lowest educational level, uneven dental examination attendance). Results Caries figures (DMFT) and the number of filled sound teeth (FS-T) were statistically significantly linked to the social/behavioural gradient (DMFT: χ(2)(9) = 20.17 p = 0.02, Z = 0.02 p = 0.99; FS-T: χ(2)(9) = 25.68 p < 0.01, Z = -4.31 p < 0.01). DMFT was statistically significantly associated with gender and with social and behavioural variables. FS-T was higher in women (p = 0.03) and was linked to smoking ( p < 0.01). Conclusions The proposed social/behavioural gradient demonstrated how subjects reporting the worst circumstances on the questionnaire exhibited the worst dental health. The use of the gradient demonstrates that health promotion and prevention cannot be compartmentalized

Is Orthodontic Treatment with Microperforations Worth It? A Scoping Review

Malformations of teeth and dental arches can produce functional modifications intermingled with esthetic alterations. Children’s rehabilitation may be long, requiring multiple interventions. One of the main challenges of contemporary orthodontics is to reduce treatment time by accelerating orthodontic tooth movements. Among the currently used methods, micro-osteoperforations (MOPs) are flapless, minimally invasive perforations that induce a local trauma to the bone, increase healing capacity, and accelerate dental movements. The use of MOPs in orthodontics is spreading but there are no definite and recognized protocols for their application. This scoping review collected the available evidence in the effect of MOPs during orthodontic therapy as compared to current treatments, to summarize the evidence. The guidelines proposed by PRISMA-ScR were followed: original clinical studies carried out from 2010 to 2021 were retrieved by medical databases combining the terms “micro-osteoperforations” and “accelerated orthodontic tooth movement”. From a total of 965 articles, nine were finally selected. The studies' aims, designs, methods, measurements, outcomes, and main findings were very heterogenous, with a duration ranging from 4 weeks to 7 months. This included only Class I malocclusion to any malocclusion. It assessed the effects of MOPs coupled with a variety of orthodontic mechanics on either the retraction of maxillary canines, the distalization of maxillary molars, or the modifications on premolar roots. Mostly, variations in the number, location, and timing of MOPs impeded a global assessment. Overall, most of the studies (six out of nine) reported moderately useful effects of MOPs, one was negative, and only two found significant advantages of MOPs over conventional treatment. The review synthesized the available evidence about MOP applications in orthodontics and identified some important gaps in knowledge that could be starting points for a systematic review of the literature. In conclusion, even if MOPs can accelerate tooth movements, the variety of aims and methods of the published research prevents suggestion of their widespread use

Incidental Finding in Pre-Orthodontic Treatment Radiographs of an Aural Foreign Body: A Case Report

The presence of foreign bodies in the external auditory canal of young patients may cause, if left untreated, severe permanent damage to the adjacent anatomical structures, and infections. A 10‐year‐old patient with an intellectual disability underwent orthodontic evaluation. An aural radiopaque finding was visible in the lateral cephalogram and in the orthopantomography. The patient’s mother reported that her son never showed any ear discomfort, except for a mild hearing impairment that was never investigated. The patient was referred to an ear, nose and throat (ENT) specialist that removed the foreign body located in the left external auditory meatus. The careful evaluation of dental radiographs, including pre‐orthodontic and interim orthodontic radiographs, may help to identify silent incidental findings that may otherwise lead to severe complications if left untreated

Performance of two potentiometric fluoride determination methods in hard dental tissue

A comparison between two ion selective electrode (ISE) potentiometric methods is reported for determining the amount of fluoride in hard dental tissue after placement of fluoride-releasing dental restorations. The two methods are: (1) the direct method involving linear calibration (LC), and (2) a spiking method involving multiple standard additions (MA). Results showed that measurements performed by the LC method underestimate the amount of fluoride released by up to 30%. Recovery tests demonstrated that the use of MA and blank correction procedures is useful for an accurate and sensitive ISE determination of fluoride in hard dental tissues

Dental care protocol based on visual supports for children with autism spectrum disorders

Background : Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments. Material and Methods : 83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in or der to undergo: an oral examination (stage 1), a professional oral hygiene session (stage 2), sealants (stage 3), and, if necessary, a restorative treatment (stage 4). Each stage came after a visual training, performed by a psychologist (stage 1) and by parents at home (stages 2, 3 and 4). Association between acceptance rates at each stage and gender, intellectual level, verbal fluency and cooperation grade was tested with chi-square test if appropriate. Results: Seventy-seven (92.8%) subjects overcame both stage 1 and 2. Six (7.2%) refused stage 3 and among the 44 subjects who need restorative treatments, only three refused it. The acceptance rate at each stage was statistically significant associated to the verbal fluency ( p =0.02; p =0.04; p =0.01, respectively for stage 1, 3 and 4). In stage 2 all subjects accepted to move to the next stage. The verbal/intellectual/cooperation dummy variable was statistically associated to the acceptance rate ( p <0.01). Conclusions: The use of visual supports has shown to be able to facilitate children with ASDs to undergo dental treatments even in non-verbal children with a low intellectual level, underlining that behavioural approach should be used as the first strategy to treat patients with ASDs in dental setting