The relationships between prevalence of caries, percentage with active caries, and caries severity

The specification of the relationships between prevalence of caries, percentage of children with active caries, and caries severity improves our understanding of the distribution and extent of caries as well as providing a method of predicting one from another. Using recent Australian data these relationships were investigated and specified. A catalytic equation best fitted the relationship between prevalence of caries and caries severity. A mixed-multiplicative equation best fitted the relationship between percentage with active caries and caries severity. The specifications of these relationships appeared sensitive to changes in the distribution and extent of caries over time. However, the magnitude of the changes occurring differs between the three measures. This may have contributed to the late recognition of the changing pattern of caries and may have implications for the delivery of dental services.     

Saliva, caries and diagnostics

During the last decades the proportion of children without tooth decay and dental restorations has strongly increased. Yet, some patients show rampant caries or a sudden progression of decay into the dentin. In order to intervene adequately in such cases, it is of importance to determine first of all the underlying causes. Indicators have been developed to predict the progression of caries. By determining the amount of fluoride in the dental plaque one gets insight into the fluoride regime of the patient. One may also determine numbers of caries-pathogenic bacteria in saliva samples, as can now be done with commercially available kits for S. mutans and lactobacilli. The buffering capacity of saliva can also be determined. Although none of these tests have a high predictive value, they are useful in explaining sudden changes in caries activity and to formulate preventive schemes.     

Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia

OBJECTIVES: The objective of this study was to determine the prevalence of dental erosion in preschool children in Jeddah, Saudi Arabia, and to relate this to caries and rampant caries in the same children. METHODS: A sample of 987 children (2-5 years) was drawn from 17 kindergartens. Clinical examinations were carried out under standardised conditions by a trained and calibrated examiner (M.Al-M.). Measurement of erosion was confined to primary maxillary incisors and used a scoring system and criteria based on those used in the UK National Survey of Child Dental Health. Caries was diagnosed using BASCD criteria. Rampant caries was defined as caries affecting the smooth surfaces of two or more maxillary incisors. RESULTS: Of the 987 children, 309 (31%) had evidence of erosion. For 186 children this was confined to enamel but for 123 it involved dentine and/or pulp. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). The mean dmft for the 987 children was 4.80 (+/-4.87). Of the 384 children who had caries but not rampant caries, 141 (37%) had erosion, a significantly higher proportion than the 72 (27%) out of 267 who were clinically caries free (SND=2.61, P<0.01). Of the 336 with rampant caries, 96 (29%) also had evidence of erosion. CONCLUSIONS: The level of erosion was similar to that seen in children of an equivalent age in the UK. Caries was a risk factor for erosion in this group of children.     

A longitudinal study of early childhood caries risk,dental caries,and life style

The objectives of this longitudinal study were to assess children's caries risk and mean number of decayed teeth and determine their life style factors that influence their caries activity. A total of 283 children were selected based on the following criteria: they had 1.5, 2.5, and 3.5-year-old oral examinations, participated in Cariostat microbial sampling and the mother of a child filled out the questionnaires. Caries experiences of children were 2.1% for the 1.5-year-old, 8.1% for the 2.5-year-old, and 14.8% for 3.5-year-old period, respectively. Caries risk at the 1.5-year-old period showed significant differences (P<0.001) for mean number of decayed teeth when children were at the 2.5-, and 3.5-year-old period. A significant difference (P<0.01) was also seen for caries risk at the 2.5-year-old period. Regarding children's lifestyle factors at the 1.5-year-old period, pre-chewing food and breastfeeding produced significant caries susceptibility in both 2.5- and 3.5-year-old period. Additionally, children's life styles were analyzed to have an impact on caries only at the 2.5-year-old period. For children's life style at the 2.5-year-old period, increased frequency of snack, irregular snack time, and brushing without assistance by the mother put 3.5-year-old children at high risk of developing caries. A caries activity test could predict 2.5-, and 3.5-year-old children's caries risk based on the 1.5-year-old test result. Some children's life styles at an early age showed a higher risk of developing caries at a later age.     

Xylitol, sweeteners, and dental caries

The purpose of this report was to provide an overview of xylitol and other polyol sweeteners and dental caries for clinicians and to discuss current applications for dental practice and potential community-based public health interventions. Xylitol, like other polyol sweeteners, is a naturally occurring sugar alcohol. Studies suggest polyols are noncariogenic. Furthermore, studies indicate that xylitol can decrease mutans streptococci levels in plaque and saliva and can reduce dental caries in young children, mothers, and in children via their mothers. Food products containing xylitol are now available and have the potential to be widely accessible to consumers to help control rampant decay. Determining whether products contain adequate xylitol amounts for practical use towards prevention is challenging, however, because xylitol content is not clearly labeled. Sufficient evidence exists to support the use of xylitol to reduce caries. Clinicians and dental associations should push for clear recommendations of efficacious dose and frequency of xylitol use and for clear labeling of xylitol content in products to help consumers choose appropriately.     

Carisolv,a change in the perception of caries treatment--a chemo-mechanical removal of caries

This paper reviews the chemo-mechanical method (Carisolv) for caries removal. The mechanism of action and some treatment choices are described. Modern dentistry aims to preserve tooth structure by minimal invasive procedures. Chemo-mechanical removal of caries is a new method with the advantage of selective removal of severely demineralized dentin. This enhances the caries diagnostic ability of the clinician. Ensuring chair side caries diagnosis and removal, based on a biological principle, helps to preserve as much healthy tissue as possible. This method is most comfortable for the patient. On the other hand treatment time is prolonged. In most cases, the method has to be used in combination with a conventional bur. Caries lesions in which removal of enamel or a restoration is needed cannot be treated exclusively by the chemo-mechanical method. However, the chemo-mechanical caries treatment can be used as the first choice of treatment in specific cases in the prosthodontic and pediatric field.     

A clinical, microbiologic, and radiographic study of deep caries lesions after incomplete caries removal.

OBJECTIVE: Clinical, radiographic, and microbiologic changes in deep caries lesions were assessed after incomplete carious dentin removal and tooth sealing. METHOD AND MATERIALS: Thirty-two teeth with deep caries lesions were studied. Treatment consisted of incomplete excavation of the demineralized dentin, application of calcium hydroxide, and sealing for a 6- to 7-month period. The color and consistency of the dentin were clinically assessed. Differences in radiographic density were assessed by digital image subtraction. Microbiologic samples were obtained from the demineralized dentin before the temporary sealing and after the experimental period. The samples were cultivated on blood agar under aerobic and anaerobic conditions, in Mitis Salivarius agar, and Rogosa selective Lactobacillus agar. RESULTS: Two cases were lost during the study; one presented pulpal necrosis. In the other case, there was pulpal exposure during removal of provisional sealing. In all teeth, the initial demineralized dentin was soft and wet; one lesion was yellow, 21 were light brown, and eight were dark brown. After treatment, the dentin was dry, and 80.00% of specimens were hard, 16.67% were leathery, and 3.33% remained soft. The dentin was light brown in five teeth and dark brown in 25. There was a statistically significant mean difference in radiographic density (pixel intensity), 88.77 +/- 7.02 in the control areas and 94.66 +/- 6.75 in the test areas. The counts of anaerobic and aerobic bacteria, lactobacilli, and Streptococci mutans had decreased significantly by the end of treatment. CONCLUSION: Incomplete removal of carious dentin and subsequent tooth sealing resulted in the arrest of the lesions, suggesting that complete dentinal caries lesion removal is not essential to the control of caries lesions.     

食物·糖·营养素与龋病龋病学研究百年回顾和展望之一

本文回顾了百年来龋病学研究中关于食物、营养素与龋病发病关系的主要成就。在食物方面,加工精细的食物虽然可口,但却丢失了许多有利于牙颌健康的物理性能和营养成分。在食物中,除糖以外,还未发现其他在龋病发病中起关键或重要作用的物质。糖,特别是蔗糖,在龋病发病中起到非常重要的作用。日常生活中,每天多次摄取糖食的危害性最大。因此,少次少量摄取糖食对维护牙齿健康是很重要而有益的。     

Associations between caries activity,salivary buffer tests and caries increment in Mongolian children

The aim of the study was to evaluate caries increment in combination with a caries activity test (CAT21 Test) and a salivary buffer test (CAT21 Buf Test)—to predict future caries activity in Mongolian preschool children living in Ulaanbaatar City. The effectiveness of combining both tests and deft (decayed, extracted, filled teeth) means was also investigated. The caries prevalence in subjects was 94%, and deft mean value was 6.8. The caries increment after one year was 2.3 teeth. From the distribution of CAT21 Test scores a low risk was found in 38.6% and high risk in 61.4% of the examined children. From the CAT21 Buf Test scores, the high risk (lower buffer capacity) was found in 79.8% of the examined children. When the combination CAT21 Test and CAT21 Buf Test scores were divided into four groups (low-low/lowhigh/ high-low/high-high), the mean def-teeth showed a significant difference among the four groups (ANOVA P < 0.001). One year after the caries increment was evaluated in combination with the CAT21 Test scores and CAT21 Buf Test scores, the low-low risk group showed the lowest mean def-teeth. On the other hand, the high-high risk group showed the highest mean def-tooth (ANOVA P < 0.05). Based on these results, the CAT21 Test and CAT21 Buf Test are useful for clinical application of preschool children in predicting future caries activity. Furthermore, when the CAT21 Test and the CAT21 Buf Test were combined, a higher correlation was shown with the caries status.     

Milk, flavoured milk products and caries

The consumption of flavoured milk increased by 50% between 1992 and 1999 and dental health educators need to know if these and other sugar and fruit juice sweetened milk products, such as fruit yoghurts, are acceptable as snack items. Available evidence suggests that their cariogenicity is negligible to low and consumed in moderation they are a preferable alternative to similarly sweetened soft drinks.     

Eating patterns, diet and dental caries

There is new evidence showing that excessive sugar consumption increases the risk of caries, even if the correlation between sugar intake and dental health has weakened due to exposure to fluoride. Moreover, there are still patient groups whose fluoride exposure seems to be insufficient to tolerate the generally increased level of sugar intake. CLINICAL RELEVANCE: Patients with high caries risk and/or insufficient fluoride exposure need personal advice and recommendations related to the use of sugars, sweets, sweet juices and soft drinks, even today. Patients with increased risk of obesity may also benefit from dietary recommendations conducted by dental professionals.     

Tuftelin, mutans streptococci, and dental caries susceptibility

The purpose of this study was to identify genetic factors that contribute to dental caries susceptibility, either alone or in combination with environmental factors. Dental examinations were performed and buccal swab samples collected from 3- to 5-year-old children with at least 4 surfaces of decay, or with no evidence of decay. SNP assays for each of 6 candidate genes were performed for all cases and controls. Chi-square analysis and regression analysis were used for the evaluation of individual gene effects, environmental effects, and gene-environment interactions. There were no significant associations between single candidate genes and caries susceptibility. Levels of S. mutans were positively and Lactobacilli were negatively associated with caries. Regression analysis revealed a significant interaction between tuftelin and S. mutans, with 26.8% of the variation in dmfs explained by the interaction. Future research will focus on the identification of these additional factors and the development of functional assays so that these interactions can be better understood.     

Secondary caries: prevalence,characteristics, and approach

The objectives of this cross-sectional survey were to determine the prevalence of secondary caries (SC) in general population, to identify patient- and mat