OBJECTIVE: This study aimed to assess the accuracy of ultra-low dose (ULD) cone-beam computed tomography (CBCT) for detection of proximal caries.
METHODS: This in vitro study evaluated 104 molar and premolar teeth. The teeth were mounted in dry skulls and underwent CBCT with four protocols of high-resolution (HR), normal (NORM), ULD-HR, and ULD-NORM; 78 CBCT images were scored by three observers for presence and penetration depth of caries twice with a 2-week interval using a 5-point Likert scale. The teeth were then sectioned and observed under a stereomicroscope (gold standard). The four protocols were compared with each other and with the gold standard. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated and compared by the Chi-square test (alpha = 0.05).
RESULTS: The interobserver agreement ranged from 0.5233 to 0.6034 for ULD-NORM, 0.5380 to 0.6279 for NORM, 0.5856 to 0.6300 for ULD-HR, and 0.6614 to 0.7707 for HR images. The intra-observer agreement ranged from 0.6027 to 0.8812 for ULD-HR, 0.7083 to 0.7556 for HR, 0.6076 to 0.9452 for ULD-NORM, and 0.7012 to 0.9221 for NORM images. Comparison of AUC revealed no significant difference between NORM and ULD-NORM (P > 0.05), or HR and ULD-HR (P > 0.05). The highest AUC belonged to HR (0.8529) and the lowest to NORM (0.7774).
CONCLUSIONS: Considering the significant reduction in radiation dose in ULD CBCT and its acceptable diagnostic accuracy for detection of proximal caries, this protocol may be used for detection of proximal carious lesions and assessment of their depth.

BACKGROUND: Early childhood caries (ECC) remain a serious oral health problem on a global scale. Risk-based caries management (RBCM) implemented in some parts of the world has been effective in preventing ECC. However, there is a lack of prospective research on the application of RBCM among Chinese children, and little is known about its effectiveness. The purpose of this study was to evaluate the effectiveness of RBCM in preventing caries among children aged 3-5 years in Wanzhou District, Chongqing Municipality, China.
METHODS: Three- to five-year-old children from four kindergartens in Wanzhou were randomly selected for baseline dental examination and caries risk assessment (CRA) and randomly assigned to the experimental group (EG) or the control group (CG) according to the kindergarten. The EG received caries prevention measures of different intensities based on the child\'s caries risk level. The CG received full-mouth fluoride twice a year according to standard prevention, regardless of their caries risk. One year later, another dental examination and CRA were conducted, to observe changes in the decayed, missing, and filled teeth (dmft) index and caries risk, and to analyze potential factors that may affect the incidence of new caries.
RESULTS: Complete data were collected from 291 children (EG, N = 140, 84.8%; CG, N = 181, 83.4%). A total of 25.7% of the EG and 50.3% of the CG children developed new caries, with newly added dmft scores of 0.54 ± 1.12 and 1.32 ± 1.72, respectively (P < 0.05). Multivariate logistic regression indicated that children living in rural areas, assigned to the CG, and rated as high-risk at baseline were more likely to develop new caries (P < 0.05). The proportion of children with an increased caries risk in the EG was significantly lower than that in the CG (P < 0.05).
CONCLUSIONS: RBCM effectively prevented new caries in 3- to 5-year-old Wanzhou children and reduced the proportion of children at increased risk of caries. It is an effective approach for preventing ECC.
BACKGROUND: This trial was registered in the Chinese Clinical Trials Register. The registration number was ChiCTR230067551 (11/01/2023).

To investigate the in vivo and in situ effect of different types of lasers in prevention of enamel demineralization in high caries risk cases (around orthodontic brackets, around restoration and in caries susceptible pits and fissures). PubMed was searched using the following keyword sequence; (Laser therapy OR laser irradiation OR laser application) AND (enamel caries prevention OR enamel demineralization OR enamel remineralization OR early enamel caries OR early-enamel caries OR enamel resistance OR enamel decalcification OR white spot lesions WSLs OR incipient lesion OR enamel decay OR enamel Dissolution OR enamel microhardness) AND (clinical trial OR Randomized clinical trial OR In situ study). The latest literature search was ended by \"30 January 2023\". PubMed was used as a primary data base for study selection. Scopus, EBSCO, and Google scholar are checked in our study after results of systematic search on PubMed. Only duplicates were found. Two meta-analyses were carried out. The first, clinical meta-analysis on incidence of white spot lesions (WSLs) following CO2 laser irradiation of enamel. The second meta-analysis on ex-vivo/in situ effect of CO2 laser on microhardness of enamel. In each meta-analysis three studies were included. Risk of bias was assessed. The search identified eight studies (four ex-vivo and four clinical trials). Regarding the clinical meta-analysis, the overall standardized mean difference was 0.21 [ 95% confidence interval (CI): 0.15-0.30, p < 0.00001]. This indicates that the incidence of new WSLs in patients who received low power CO2 laser treatment was highly significantly lower than placebo groups. The heterogeneity was considerable (I2 = 71%). In the second meta-analysis, the overall standardized mean difference was 49.55 [ 95% confidence interval (CI): 37.74, 61.37, p < 0.00001]. This indicates that microhardness of enamel receiving low power (0.4-5 W) CO2 laser irradiation is highly significantly lower than control untreated enamel. The heterogeneity was substantial (I2 = 48%). Within the limitations of this study, Low level laser therapy concept with CO2 laser seems to be effective in preventing enamel caries.Prospero registration number: CRD42023437379.

OBJECTIVE: The objective of this study was to determine the prevalence of early childhood caries in children with severe acute malnutrition (SAM) and also the hierarchy of association if any with malnutrition, anemia, and other risk factors with ECC using machine learning algorithms.
METHODS: A hospital-based preventive and interventional study was conducted on SAM children (age = 2 to <6 years) who were admitted to the malnutrition treatment unit (MTU). An oral examination for early childhood caries status was done using the deft index. The anthropometric measurements and blood examination reports were recorded. Oral health education and preventive dental treatments were given to the admitted children. Three machine learning algorithms (Random Tree, CART, and Neural Network) were applied to assess the relationship between early childhood caries, malnutrition, anemia, and the risk factors.
RESULTS: The Random Tree model showed that age was the most significant factor in predicting ECC with predictor importance of 98.75%, followed by maternal education (29.20%), hemoglobin level (16.67%), frequency of snack intake (9.17%), deft score (8.75%), consumption of snacks (7.1%), breastfeeding (6.25%), severe acute malnutrition (5.42%), frequency of sugar intake (3.75%), and religion at the minimum predictor importance of 2.08%.
CONCLUSIONS: Anemia and malnutrition play a significant role in the prediction, hence in the causation of ECC. Pediatricians should also keep in mind that anemia and malnutrition have a negative impact on children\'s dental health. Hence, Pediatricians and Pediatric dentist should work together in treating this health problem.

BACKGROUND: In cariology studies, mitis-salivarius-bacitracin (MSB) agar has been commonly considered as the selective medium for Streptococcusmutans growth. The present study was the part of a funded project (a noninferiority randomized controlled trial) which compared the efficacy of a plant extract-based mouth rinse with that of a fluoride mouth rinse on the S.mutans counts of the children.
OBJECTIVE: This study aimed to identify the frequency of detection of S.mutans and nonstreptococcal bacterial species from the dental plaque of caries active children using a combined technique of anaerobic culture and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry.
METHODS: Caries-active children (8-12 years old) were enrolled from a pediatric dental outpatient department at a tertiary care hospital. From each participant, dental plaque samples were collected from carious surfaces under sterilized conditions and then subjected to anaerobic culture. After 48 h of incubation, the bacterial colonies were isolated by sub-culture and identified by the MALDI-TOF.
RESULTS: In all, 13 different bacterial species were isolated from the MSB agar medium. Other than S.mutans species, colonies of bacterial species such as Veillonelladispar,Streptococcusanginosus, Veillonellaparvula, and Streptococcusgordonii were also frequently observed from the medium.
CONCLUSIONS: The study concluded that several bacterial strains, both streptococcal and nonstreptococcal, could be isolated from the MSB agar medium; hence, this medium should no longer be considered selective medium for the culture of S.mutans in clinical and epidemiological studies.

BACKGROUND: One of the essential components for successful caries management is caries risk assessment (CRA). Among CRA tools (CRATs) published in the literature: Caries management by risk assessment (CAMBRA) 123 and American Academy of Pediatric Dentistry (AAPD) CRATs are specifically designed for infants and toddlers.
OBJECTIVE: The aim of this study is to compare readily available internationally accepted CRAT for infants and toddlers and check the usability of these tools in assigning caries risk among the Indian population.
METHODS: The study was conducted at Baby Oral Health Promotion Clinic, Department of Pediatrics, Tertiary Care Hospital using a cross-sectional study design.
METHODS: Data were collected using CAMBRA 123 and AAPD CRATs from 379 children aged 0-6 years. The caries risk of the children was recorded with each CRAT and a comparison was made between the two tools used.
METHODS: The percentage of agreement and Cohen\'s kappa coefficient were used to know the agreement between the CAMBRA 123 and AAPD CRATs using the SPSS statistical tool. The significance level was set at 5% (α = 0.05).
RESULTS: For children aged <2 years, the study showed slight agreement between the CAMBRA 123 and AAPD, whereas, for children more than 2 years, there was a fair agreement between the two methods which was statistically significant. This indicates that the agreement between the two methods is still not perfectly established, and AAPD CRA assigns a higher risk category than CAMBRA 123.
CONCLUSIONS: CAMBRA 123 is a promising user-friendly quantitative method for CRA in clinical practice. Since there is ambiguity in assessing the caries risk in children <2 years, there is a need to establish a CRAT that can be used exclusively for children below 2 years.

The oral cavity harbors complex communities comprising bacteria, archaea, fungi, protozoa, and viruses. The oral microbiota is establish at birth and develops further during childhood, with early life factors such as birth mode, feeding practices, and oral hygiene, reported to influence this development and the susceptibility to caries. We here analyzed the oral bacterial composition in saliva of 260 Swedish children at two, three and five years of age using 16S rRNA gene profiling to examine its relation to environmental factors and caries development at five years of age. We were able to assign the salivary bacterial community in each child at each time point to one of seven distinct clusters. We observed an individual dynamic in the development of the oral microbiota related to early life factors, such as being first born, born by C-section, maternal perinatal antibiotics use, with a distinct transition between three and five years of age. Different bacterial signatures depending on age were related to increased caries risk, while Peptococcus consistently linked to reduced risk of caries development.

BACKGROUND: The aim of this study was to analyse the risk factors that affect oral health in adults and to evaluate the success of different machine learning algorithms in predicting these risk factors.
METHODS: This study included 2000 patients aged 18 years and older who were admitted to the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gaziantep University, between September and December 2023. In this study, patients completed a 30-item questionnaire designed to assess the factors that affect the decayed, missing, and filled teeth (DMFT). Clinical and radiological examinations were performed, and DMFT scores were calculated after completion of the questionnaire. The obtained data were randomly divided into a 75% training group and a 25% test group. The preprocessed dataset was analysed using various machine learning algorithms, including naive Bayes, logistic regression, support vector machine, decision tree, random forest and Multilayer Perceptron algorithms. Pearson\'s correlation test was also conducted to assess the correlation between participants\' DMFT scores and oral health risk factors. The performance of each algorithm was evaluated to determine the most appropriate algorithm, and model performance was assessed using accuracy, precision, recall and F1 score on the test dataset.
RESULTS: A statistically significant difference was found between various factors and DMFT-based risk groups (p < 0.05), including age, sex, body mass index, tooth brushing frequency, socioeconomic status, employment status, education level, marital status, hypertension, diabetes status, renal disease status, consumption of sugary snacks, dry mouth status and screen time. When considering machine learning algorithms for risk group assessments, the Multilayer Perceptron model demonstrated the highest level of success, achieving an accuracy of 95.8%, an F1-score of 96%, and precision and recall rates of 96%.
CONCLUSIONS: Caries risk assessment using a simple questionnaire can identify individuals at risk of dental caries, determine the key risk factors, provide information to help reduce the risk of dental caries over time and ensure follow-up. In addition, it is extremely important to apply effective preventive treatments and to prevent the general health problems that are caused by the deterioration of oral health. The results of this study show the potential of machine learning algorithms for predicting caries risk groups, and these algorithms are promising for future studies.

OBJECTIVE: To study the structural characteristics of oral microorganisms in children with caries by 16S rRNA high-throughput sequencing technology.
METHODS: Thirty healthy children aged 3-5 years were enrolled as subjects. According to the index of dmfs, they were divided into caries-free (CF) group (15) and early childhood caries (ECC) group(15). To compare the differences in bacterial community structure, samples of saliva and dental plaque were collected, and high-throughput sequencing was conducted using the Illumina Miseq sequencing platform. Bioinformatics analysis was used to analyze the difference of microbial community structure and diversity with SPSS 23.0 software package.
RESULTS: Microbial diversity in ECC group was significantly lower than CF group. At phylum level, Actinobateria was more abundant in saliva samples of ECC group, while Firmicutes was more abundant in plaque samples of CF group. At genus level, the abundance of Lautropia of CF group was higher in saliva samples while Cardiobacterium, Gemella and Granulicatella were abundant in plaque samples. The abundance of Rothia of ECC group was higher in saliva samples and Corynebacterium was abundant of ECC group in plaque samples.
CONCLUSIONS: There are significant differences in the species and composition of microbial community in saliva and plaque of children with or without caries. Specific microorganisms are related to the occurrence of ECC, and screening specific microorganisms is helpful for early prediction and prevention of ECC.

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) and minor complications (OR = 0.16 (95%CI [0.05, 0.50], p = 0.002). Overall satisfaction was 96% (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.