JDR Clinical & Translational Research最新文献

{"title":"Opioid Prescribing by US Dentists and Dental Specialists after Continuing Education.","authors":"D E Polk, A Carrasco-Labra, N H Shah, N Mukhopadhyay, K J Suda","doi":"10.1177/23800844261433880","DOIUrl":"https://doi.org/10.1177/23800844261433880","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine whether dental providers wrote fewer prescriptions for opioid-containing medications and more prescriptions for non-opioid analgesics after taking a continuing education course that targeted both knowledge about an American Dental Association-endorsed guideline on the management of acute dental pain and challenges in shared decision-making.</p><p><strong>Methods: </strong>The implementation strategy comprised a prerecorded 1-h video continuing education course and supplementary materials that were previously shown to increase knowledge about shared decision-making. Using propensity score matching, we matched 420 dentists and dental specialists who took the continuing education course to 4,200 providers who had not. We used regression analyses to compare learners with their propensity score-matched controls on their change in opioid prescribing and change in non-opioid analgesic prescribing from the 6 mo before to the 6 mo after course completion.</p><p><strong>Results: </strong>Providers who took the continuing education course decreased the number of opioid prescriptions they wrote by 0.60 prescriptions more than providers who did not take the continuing education course (B = -0.60; 95% confidence interval [CI] -1.07, -0.13; t = -2.50; P < 0.01). Among providers who decreased their prescribing by 3 or more prescriptions, a greater percentage took the continuing education course. There was no difference in non-opioid analgesic prescribing between providers who took the continuing education course and providers who did not (B = -0.10; 95% CI -0.87 0.68; t = -0.25, ns).</p><p><strong>Conclusion: </strong>Equipping dental providers with skills in shared decision-making to use in conversations with patients about approaches to acute pain management may enable them to decrease the number of opioid prescriptions they write more than providers who are not exposed to these skills.Knowledge Transfer Statement:The results of this study can be used by groups and organizations seeking to improve dental providers' adherence to the guideline on managing acute dental pain following simple and surgical tooth extraction or toothache.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261433880"},"PeriodicalIF":2.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary Biological Responses to Nonsurgical Periodontal Treatment in Type 2 Diabetics.","authors":"J L Ebersole, S S Kirakodu, X Zhang, D Dawson, C S Miller","doi":"10.1177/23800844261437825","DOIUrl":"https://doi.org/10.1177/23800844261437825","url":null,"abstract":"<p><strong>Background: </strong>This investigation evaluated the predictive capacity of the oral microbiome and host salivary biomarkers on treatment outcomes for periodontitis in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>Two patient cohorts were enrolled: T2DM without periodontitis (DWoP; n = 32) and T2DM with periodontitis (DWP; n = 29). Whole saliva was collected at baseline and 4 to 7 wk posttreatment (i.e., DWoP, supragingival prophylaxis; DWP, scaling and root planing). The oral microbiome (operational taxonomic units; OTUs) and targeted salivary biomarkers were assessed in pre- and posttreatment saliva.</p><p><strong>Results: </strong>Most OTUs (57%-68%) and salivary biomarkers (43%-55%) decreased after treatment in both groups. Supragingival prophylaxis in the DWoP patients altered a limited number of taxa (V. dispar, P. denticola, Rothia, Neisseria), showing substantial increases in the microbiome, whereas predominantly gram-negative OTUs decreased. In the DWP, decreases were observed following therapy for Bacillota, Bacteroidetes, and Proteobacteria, again representing primarily gram-negative taxa. Microbe-host response biomarker correlations increased posttherapy in DWoP and decreased in DWP samples. Importantly, poor response (PR) to therapy was independent of HbA1c levels but associated with higher pretreatment levels of multiple bacterial genera (i.e., Alloprevotella, Campylobacter, Corynebacterium, Fusobacterium, and Leptotrichia) and elevated levels of interleukin (IL)-1b, IL-6, matrix metalloprotease-8 (MMP-8), adiponectin, and resistin. After therapy, PR was characterized by increases in Lachnospiraceae, Prevotella, and a lack of effects on Leptotrichia, Alloprevotella, Porphyromonas, and Stomatobaculum.</p><p><strong>Conclusions: </strong>Poor clinical response to therapy was characterized by (1) less microbiome diversity and elevated levels of specific bacteria and salivary analytes pretherapy and (2) posttherapy elevations in multiple taxa and sustained levels of IL-1b and MMP-8 in both groups of PR patients. These findings support that a panel of salivary features could enhance our prediction and earlier decisions on response to therapy at the biological level, thus opening the door for more precise patient-level management.Knowledge Transfer Statement:These findings contribute to a pathway for understanding oral health using biological measures as a standard for better decisions in oral health care. Specifically, microbiome and host response parameters provided important insights with predictive value and differential biological presentation related to response to therapy. While these measures do not dictate disease causation, they appear to reflect the periodontal environment, hallmarks of disease, and response to therapy.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261437825"},"PeriodicalIF":2.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative Effectiveness of School-Based versus Clinic-Based Fluoride Varnish Application.","authors":"P-Y Lin, J Wang, D-Y Hsu, P-Y Lin, L-Y Chi","doi":"10.1177/23800844261435921","DOIUrl":"https://doi.org/10.1177/23800844261435921","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the relative effectiveness of school-based versus clinic-based fluoride varnish (FV) application within a single program in Taiwan.</p><p><strong>Methods: </strong>Data for the phase 1 study (population-based analysis) were extracted from Taiwan's National Health Insurance Research Database (NHIRB). The phase 1 cohort included 347,544 children born in 2015 or 2016 who received FV application services at school, in a dental clinic, or in both settings. FV services were recorded using specific codes: 88 and 89 for school-based FV application and 81 and 87 for clinic-based FV application. During follow-up, primary molars were assessed for caries-related treatments. The phase 2 (fieldwork) cohort included 1,479 children examined for early childhood caries (ECC). Their data were linked to the NHIRB to obtain corresponding data on the FV application. In both phases, logistic regression was performed to determine the associations of application setting with the odds of caries-related treatments and ECC.</p><p><strong>Results: </strong>The odds of the following treatments were significantly higher with school-based FV application than with clinic-based FV application (all <u>P</u>s < 0.0001): dental restoration (odds ratio [OR] = 1.09; 95% confidence interval [CI], 1.06-1.11), endodontic treatment (OR = 1.21; 95% CI, 1.16-1.26), and tooth extraction (OR = 1.33; 95% CI, 1.25-1.42). This difference was particularly prominent in moderately and highly urbanized areas. Furthermore, the risk of ECC was higher with school-based FV application (OR = 1.52; 95% CI, 1.10-2.11; <u>P</u> < 0.05) than with school-based FV application. However, after covariate adjustment, both groups had similar risk estimates (OR = 1.03; 95% CI, 0.71-1.50).</p><p><strong>Conclusions: </strong>Clinic-based FV application significantly reduces the likelihood of caries-related treatments for primary molars. Future studies should consider our findings when evaluating the effectiveness of FV application.Knowledge Transfer Statement:Compared with school-based FV application, clinic-based FV application significantly reduced the likelihood of caries-related treatments, particularly among children residing in urban areas. For children who received only school-based FV application services, dentists may recommend additional clinic-based FV application services. Our findings may guide future studies aimed at evaluating the effectiveness of FV application.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261435921"},"PeriodicalIF":2.2,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Provider Experiences with AI Radiograph Annotation: A Qualitative Case Study.","authors":"K L Schroeder, L Slashcheva, L J Heaton, H J Cheung, B Prosa, N Ferrian, J Grantz, D Jacobi, M Helgeson, E P Tranby","doi":"10.1177/23800844261429908","DOIUrl":"https://doi.org/10.1177/23800844261429908","url":null,"abstract":"<p><strong>Introduction: </strong>The use of artificial intelligence (AI) tools to aid in dental diagnosis, treatment planning, and education is rapidly growing in oral health care. One type of artificial intelligence (AI) tool is radiographic annotation software that identifies and highlights anomalies on dental radiographs that may be indicative of oral disease.</p><p><strong>Objectives: </strong>The aim of this study was to explore challenges and facilitators that contributed to oral health professionals accepting and using an AI radiograph annotation software in a large US oral health care organization.</p><p><strong>Methods: </strong>A qualitative collective case study design was used to gain insight into dental providers' experiences using AI radiograph annotation software. Semi-structured interviews were conducted from November 8, 2024, to December 15, 2024, through an online platform. Study participants were from 5 Apple Tree Dental clinics located in Little Falls, Madelia, Mounds View, Rochester, and Fairmont, Minnesota. Abductive coding was conducted to create themes related to the interviewees' experiences with the AI software.</p><p><strong>Results: </strong>Study participants included dentists (<u>n</u> = 6), dental hygienists (<u>n</u> = 2), and dental therapists (<u>n</u> = 3). The themes identified were providers' first impressions, current beliefs, utilization, diagnostic confidence, treatment plan alignment, person-centered care, unexpected benefits, and challenges related to the AI annotation software. Providers gained understanding over time that the AI software is a tool to assist with decision-making and is not capable of replacing critical thinking skills needed for patient-centered care.</p><p><strong>Conclusion: </strong>These study findings provide insights for oral health care delivery organizations on how best to support oral health professionals faced with implementing AI software protocols.Knowledge Transfer Statement:This study explored how dental AI radiograph annotation software could enhance diagnostic confidence, support treatment planning, and improve patient education. While adoption by the participants in this study varied, they found the tool valuable for engaging patients and identifying early signs of disease. This supports the need for structured onboarding, ongoing training, and peer support to optimize AI integration. Embracing such technologies could promote earlier intervention, more personalized care, and improved oral health outcomes across diverse populations.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261429908"},"PeriodicalIF":2.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Value-Based Oral Health Care: A Scoping Review.","authors":"R Bentley, C Liu, H Khalil","doi":"10.1177/23800844261435909","DOIUrl":"https://doi.org/10.1177/23800844261435909","url":null,"abstract":"<p><strong>Introduction: </strong>This review presents a scoping review exploring the characteristics of value-based oral health care (VBOHC) and the potential to transform the delivery of dental services. VBOHC represents a shift from the traditional fee-for-service model, which prioritises service volume, to a system focused on improving patient outcomes, enhancing preventive care, and optimising cost-efficiency.</p><p><strong>Objectives: </strong>To identify and synthesise the defining characteristics of VBOHC and assess the potential to enhance patient outcomes, cost-efficiency, and care delivery in dental systems.</p><p><strong>Methods: </strong>Following methodology per the Joanna Briggs Institute and guidance per PRISMA-ScR reporting (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews), a scoping review was undertaken to include literature discussing VBOHC across various health care settings. Searches were undertaken in 6 relevant databases. Peer-reviewed quantitative and qualitative studies published in English were included and thematically analysed. A total of 50 studies were included after 185 studies were screened.</p><p><strong>Results: </strong>This research identifies several defining characteristics of VBOHC, including prevention and early intervention, patient-centred care, shared decision making, and outcome-based compensation. The scoping review highlights how VBOHC emphasises preventive care to reduce the incidence of severe dental conditions, particularly benefiting vulnerable populations with limited access to regular care. By encouraging proactive engagement with oral health, VBOHC improves long-term patient outcomes while reducing health care costs. Additionally, VBOHC promotes shared decision making, fostering a collaborative relationship between providers and patients, which enhances patient satisfaction and adherence to treatment plans. For providers, the transition to VBOHC requires significant operational and cultural changes, including adopting new workflows focused on outcomes, incorporating digital health technologies, embracing team-based care models, and integrating dental services into broader health care systems.</p><p><strong>Conclusion: </strong>This review concludes that VBOHC is characterised by patient empowerment and a patient-centred whole system approach. However, successful implementation requires addressing the challenges associated with transitioning from the fee-for-service model, particularly through provider support, infrastructure investments, and policy reforms.Knowledge Transfer Statement:The findings of this scoping review can inform policy makers, dental professionals, and health service planners seeking to implement value-based oral health care models. By understanding the core characteristics, this evidence can support more sustainable, equitable, and efficient dental care delivery across a range of health care settings.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261435909"},"PeriodicalIF":2.2,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translational Research to Maximize the Impact of e-Oral Health.","authors":"Y Liu, J Xiao, E Emami, T Madden, A Rodrigues, M El Tantawi, H Lee","doi":"10.1177/23800844261435499","DOIUrl":"https://doi.org/10.1177/23800844261435499","url":null,"abstract":"<p><p>The rapid development of digital technologies is reshaping oral health research and care delivery. However, the translation of these innovations into routine clinical and public health application remains limited. This special communication, jointly developed by the International Association for Dental Research's Clinical and Translational Science Network and e-Oral Health Network, explores how principles of translational science can be intentionally aligned with e-oral health research to strengthen the impact of digital innovation on oral health outcomes. Drawing on established translational models, this perspective outlines how coordinated bidirectional research approaches can support the progression of digital oral health interventions from early development to sustainable real-world use. Contemporary e-oral health approaches, including virtual care delivery, intelligent decision support systems, mobile and connected technologies, and advanced digital diagnostics, offer new opportunities to enhance disease prevention, clinical decision making, patient engagement, and population-level surveillance. Evidence to date suggests that these approaches can improve diagnostic performance, expand access to care, and support behavior change. Nevertheless, widespread adoption has been hindered by economic, regulatory, ethical, and workforce-related challenges, creating digital inequities. To overcome these barriers, we introduce an integrated translational research framework for e-oral health based on 3 core pillars: 1) technology and capabilities, 2) workforce capacity and training, and 3) real-world patient care, supported by enabling factors including industry and partnerships, policy and governance, and a strong ethics and regulation foundation. By embedding translational research principles into e-oral health development and implementation, this framework seeks to promote methodological rigor, reproducibility, scalability, and equity. Strategic integration of translational science and e-oral health research has the potential to accelerate the uptake of effective digital solutions and contribute to improving oral health outcomes across diverse populations and health systems worldwide.Knowledge Transfer Statement:This special communication, developed by the International Association for Dental Research's Clinical and Translational Science Network and e-Oral Health Network, explores how translational science frameworks can accelerate integration of digital oral health technologies into practice. Translational science provides structured methods to move innovations from development to implementation, while e-oral health encompasses digital technologies such as teledentistry and artificial intelligence for oral health care delivery. Applying translational principles to e-oral health research can enhance rigor and accelerate evidence-based adoption of digital solutions that improve access and outcomes globally.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261435499"},"PeriodicalIF":2.2,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whose Responsibility Is It? A Community-Level Situational Analysis of Oral Health Care in Amsterdam.","authors":"S Begovic, M W van der Linden, K Rosing, L E de Almeida, M Lorenz, S Listl, M H van der Veen","doi":"10.1177/23800844251332227","DOIUrl":"10.1177/23800844251332227","url":null,"abstract":"<p><strong>Background: </strong>DELIVER (DELiberative ImproVEment of oRal care quality) is a multinational project funded under the EU's Horizon Europe program that aims to improve the quality of oral health care at the practice, community, national, and international levels. It is important to understand the current situation of oral health care quality to make improvements possible. This study aimed to map oral health care priorities among stakeholders in Amsterdam, the Netherlands, and to describe how these stakeholders interacted to improve the quality of oral health care at the community level.</p><p><strong>Methods: </strong>A situational analysis approach was used to collate data from desk research and semi-structured interviews with key informants. Interview transcripts were analyzed and grouped into main themes and subthemes using inductive coding. A situational map, a social worlds/arenas map, and a positional map were constructed to represent the community-level situation of quality improvement of oral health care.</p><p><strong>Results: </strong>Interviews were conducted with 10 professional stakeholders (5 social/welfare workers, 3 health care professionals, 1 public health professional, and 1 municipality policy maker). Stakeholders described prioritizing at least basic oral health care and stated that it should be accessible for everyone. Other priorities included a need for simplified access to oral health care and strengthened social support. While stakeholders agreed that people should not rely on emergency funds and volunteers, they felt that it was unclear which organizations or individuals were responsible for determining access to oral health care. This led social/welfare organizations to feel a sense of responsibility and offer informal care solutions.</p><p><strong>Conclusion: </strong>There was consensus among stakeholders about the need for social support and simplified access to oral health care for citizens. Stakeholders also emphasized the lack of clarity about who was responsible for oral health care and quality improvement at the community level, which highlighted the urgent need for improved governance, allocating responsibilities for oral health care quality improvement to all parties operating at the community level.Knowledge Transfer Statement:This study mapped the current practice of oral health care quality in Amsterdam, the Netherlands, through a situational analysis as a crucial starting point for enhancing quality improvement of oral health care at the community level. It underscored the need for clarity about responsibilities and provided insights for oral health care providers, social and welfare workers, policy makers, and researchers that could support research and policy formulation targeted at underserved populations, involving multiple stakeholders.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"181-194"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Medical Necessity of Orthodontic Care: A Qualitative Study.","authors":"D Richmond, H Benzian, J Daskalogiannakis, A Holden, C Quiñonez","doi":"10.1177/23800844251355270","DOIUrl":"10.1177/23800844251355270","url":null,"abstract":"<p><strong>Introduction: </strong>As global momentum builds for universal health coverage (UHC), it is unclear whether orthodontic care should be included in UHC packages. The concept of medically necessary orthodontic care (MNOC) and its criteria thus have far-reaching implications for priority setting and resource allocation in public and private oral health care programs.</p><p><strong>Objective: </strong>To identify factors that contribute to the determination of MNOC based on perspectives from leaders of dental professional organizations, academics, clinicians, funders, patient advocates, and patients from 7 countries: Canada, United States, Germany, Greece, United Kingdom, Switzerland, and Australia.</p><p><strong>Methods: </strong>A qualitative description design was used with semi-structured virtual interviews conducted via Zoom from November 2021 to August 2022. Interviews were transcribed verbatim, coded, and analyzed for themes.</p><p><strong>Results: </strong>Sixteen interviews were conducted. Participants described their concept of MNOC through 4 interrelated categories: (1) dental factors including dental health, the goals of treatment, and methods of needs assessment; (2) medical factors including the meaning of medical necessity, systemic health considerations, and treatment of craniofacial anomalies; (3) psychosocial factors including societal standards of beauty, social functioning, and mental health; and (4) funding factors including resource allocation considerations and the goals of funding.</p><p><strong>Conclusion: </strong>The diversity of factors identified highlights the complex interplay between the dental profession, funders of care, society, and individual patients in understanding MNOC. Given this complexity, MNOC is arguably not amenable to a concise definition or list of criteria. Instead, a decision-making process that incorporates key actor perspectives can enhance transparency, fairness, and accountability in priority setting and resource allocation as related to MNOC and medically necessary oral health care more broadly. This approach would ensure coverage for those with demonstrated need in the context of health, well-being, and quality of life.Knowledge Transfer Statement:This study provides critical insights into the dental, medical, psychosocial, and funding factors that influence the meaning of medically necessary orthodontic care (MNOC) from the perspectives of key actors in 7 high-income countries. The findings reveal that MNOC cannot be defined by a simple set of criteria. Instead, determinations of MNOC should be made through a decision-making process that incorporates a wide array of viewpoints. This approach ensures transparent and fair resource allocation, improving access to essential orthodontic services, thereby enhancing patient health and well-being.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"159-167"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water Fluoridation and Dental Caries Prevention Globally: A Systematic Review and Meta-Analysis.","authors":"C F D Nascimento, L A D S Gindri, M N de Oliveira, L R Paranhos, F N Hugo","doi":"10.1177/23800844251342804","DOIUrl":"10.1177/23800844251342804","url":null,"abstract":"<p><p>Fluoridation of community water supplies constitutes one of the most effective public health interventions for preventing dental caries. In recent years, questions have been raised about its effectiveness and safety. This study aims to systematically review and summarize the existing evidence on community water fluoridation (CWF) and dental caries in permanent and deciduous teeth. Five databases and 3 gray databases were searched for relevant studies. Paired reviewers independently screened the studies, extracted data, and assessed their methodological quality. Standard mean differences (SMDs) for dmf(s)/DMFT(S) (decayed, missing, and filled teeth/surface) and odds ratios (ORs) for caries prevalence were measured between exposure or not to CFW for deciduous and permanent teeth. Subgroup analysis was performed to explore whether the study design, continent, or decade of publication changed the point estimates. Seventy-four studies were included in the qualitative analysis: 57 cross-sectional, 13 before-and-after, and 4 cohort studies. Thirty-two studies provided sufficient data for meta-analyses. The overall SMD of DMFT and dmf in those exposed to CWF compared with unexposed were -0.32 (95% confidence interval [CI]: -0.48 to -0.17, <i>I</i>² = 96%, <i>P</i> < 0.01) and -0.30 (95% CI: -0.39 to -0.21, <i>I</i>² = 88%, <i>P</i> < 0.01), respectively. The prevalence of caries was smaller in those exposed to CWF for both the permanent (OR = 0.52, 95% CI: 0.43 to 0.63) and deciduous (OR = 0.60, 95% CI: 0.48 to 0.76) dentitions. Study design, continent, or decade of publication satisfactorily explained the heterogeneity between studies. Communities where water was fluoridated experienced less caries and differences expressed in terms of SMD and prevalence (OR) where of high magnitude, both in children and in adults. The results of the meta-analyses revealed significant differences in caries experience and prevalence in favor of CWF, which represents an effective and comprehensive public health intervention for caries prevention, especially in the primary dentition.Knowledge Transfer Statement:Based on the published literature, the results of this study show that fluoridation of community water supplies is still an effective public health intervention to prevent dental caries, both in children and adults, despite the widespread availability of fluoride-containing dental products, especially toothpaste. This result adds to the existing evidence to support its incorporation into public oral health policies.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"107-116"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arginine Dentifrices and Childhood Caries Prevention: A Randomized Clinical Trial.","authors":"W Yin, Z Zhou, R-Z Huang, G Sun, Y Zhong, Z Yang, Y Li, Y Zhang, P Zhang, D Hu, L R Mateo, G Gao, S Lim, A I Ismail, J Zimmerman, B Garcia-Godoy, M Ryan, Y-P Zhang","doi":"10.1177/23800844251361471","DOIUrl":"10.1177/23800844251361471","url":null,"abstract":"<p><strong>Background: </strong>Dental caries remains a significant oral health burden globally. Scientific evidence has demonstrated the dose-dependent anticaries action of fluoride; however, more effective, comprehensive, and alternative prevention strategies are required.</p><p><strong>Methods: </strong>A 2-y, phase 3, randomized controlled trial based on a double-blind, 3-arm, parallel-group design was conducted from April 15, 2019, through March 12, 2022 across 3 centers in China. Six thousand children aged 10 to 14 y with ≥2 active caries lesions were assigned 1 of 3 study dentifrices: 8.0% arginine, 1.5% arginine, and 0.32% sodium fluoride (NaF). The primary efficacy outcomes were incremental DMFS (decayed, missing, and filled surfaces) and DMFT (decayed, missing, and filled teeth) caries indices scores after 2 y of product use. The secondary efficacy outcomes were the incremental caries indices scores after 1 y and 6 mo of product use. Noninferiority was achieved if the 95% CI of the mean difference in scores was below the noninferiority margin of 0.2545 after 2 y, 1 y, and 6 mo of product use.</p><p><strong>Results: </strong>After 2 y, the 8.0% arginine-containing dentifrice demonstrated a statistically significant reduction of 26.0% in DMFS scores (-0.16; 95% CI, -0.22 to -0.10; P < .001) and 25.3% in DMFT scores (-0.17; 95% CI, -0.24 to -0.11; P < .001) versus control. No statistical difference was measured between the 1.5% arginine-containing dentifrice and control in DMFS (-0.01; 95% CI, -0.07 to 0.05; P = .819) and DMFT (-0.01; 95% CI, -0.07 to 0.05; P = .739).</p><p><strong>Conclusions: </strong>Dentifrice containing 8.0% arginine showed a statistically significant reduction in caries incidence versus the NaF control, while the 1.5% arginine dentifrice showed equivalence to the NaF control regarding caries reduction. This clinical study confirms that arginine dentifrices are effective alternatives to fluoride in providing anticaries protection.Knowledge Transfer Statement:This study demonstrates that arginine is an efficacious anticaries agent at the examined doses of 1.5% and 8%. Clinicians and consumers can consider this a new caries preventive agent providing choice to people seeking fluoride-free alternatives. Policy makers could leverage these findings to guide oral health initiatives and inform regulations on dentifrice composition, promoting broader access to effective caries prevention methods.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"204-214"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}