Caries Research最新文献

{"title":"Age-specific dental caries clusters and perceived oral health over 20 years: a novel approach to DMFT index data.","authors":"Pedro Henrique Duarte Franca de Castro, Maria Augusta Bessa Rebelo, Mario Vianna Vettore","doi":"10.1159/cre/abuag018","DOIUrl":"https://doi.org/10.1159/cre/abuag018","url":null,"abstract":"<p><strong>Introduction: </strong>The use of dental caries indices in oral health surveys, such as the decayed, missing and filled teeth (DMFT) index, may mask heterogeneity in both disease severity and its distribution. This study aimed to identify age-specific clusters of dental caries across a 20-year period in Brazil, assess their temporal trends and examine their associations with perceived oral health.</p><p><strong>Methods: </strong>Secondary data from three Brazilian National Oral Health Survey (SB Brasil) conducted in 2003 (N = 70,119), 2010 (N = 29,681), and 2023 (N = 33,229) were analysed across four age groups: children (12 years), adolescents (15-19 years), adults (35-44 years), and older adults (65-74 years). Latent Profile Analysis (LPA) was applied to DMFT components to identify dental caries clusters. Multivariable ordinal and logistic regression models examined associations between caries cluster, self-rated oral health (SROH) and oral health-related quality of life (OHRQoL).</p><p><strong>Results: </strong>LPA identified five caries clusters in children, seven in adolescents, seven in adults, and four in older adults. The low-caries-experience cluster increased consistently across children, adolescents and adults over time. Severe untreated caries clusters declined in children and adolescents, and severe tooth loss clusters decreased in adults and older adults. Worse caries clusters were consistently associated with poorer SROH and OHRQoL across all age groups and survey years. These associations were generally stronger than those observed for DMFT and DMFT components. In older adults, dental caries clusters showed greater discriminatory capacity than DMFT components.</p><p><strong>Conclusion: </strong>The relationship between dental caries and perceived oral health is dynamic, age-dependent, and cluster-specific. LPA of DMFT components captured clinically meaningful heterogeneity beyond DMFT index and its components, offering a more nuanced understanding of caries severity and its impact on subjective oral health. These findings offer preliminary evidence supporting the complementary use of cluster-based approaches within dental caries indices for oral health surveillance.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning for Predicting Dental Caries Presence and Severity: An Age-Cohort Perspective from a Nationally Representative Survey in Brazil.","authors":"Jessye Melgarejo do Amaral Giordani, Orlando Luiz do Amaral Junior, Maria Laura Braccini Fagundes, Juliana Balbinot Hilgert, Fernando Neves Hugo","doi":"10.1159/cre/abuag004","DOIUrl":"10.1159/cre/abuag004","url":null,"abstract":"<p><strong>Introduction: </strong>Although preventable, dental caries remains a global public health challenge due to its multifactorial nature and the deep influence of socio-structural determinants. This study evaluates the performance of artificial intelligence (AI) models as decision-support frameworks for population-level risk stratification, screening, and public health planning.</p><p><strong>Methods: </strong>We analyzed a representative sample (N = 23,726) from the SB Brasil 2023 national survey, stratified into three age cohorts: children (12 years), adolescents (15-19 years), and adults (35-44 years). Eleven predictors, encompassing socioeconomic (wealth score via PCA, household density, race, water access), psychosocial (self-rated oral health status), behavioral, and clinical domains, were used to predict caries presence (≥1 untreated decayed tooth) and severity (DMFT index regression). To account for overdispersion and the high frequency of zero counts, we utilized advanced count-based regressions, including Zero-Inflated Negative Binomial (ZINB) and Negative Binomial models. Performance was assessed using AUC, mean absolute error (MAE), and decision curve analysis (DCA) via 5-fold cross-validation.</p><p><strong>Results: </strong>Caries prevalence increased progressively with age (36.8-52.7%). The non-clinical triage models demonstrated significant net benefit in DCA across all groups, effectively identifying high-risk individuals for prioritization without requiring clinical examination. For severity prediction, the ZINB model identified structural signals of inequity, particularly in late adolescence (15-19 years), where socio-structural determinants explained a meaningful proportion of clinical variance (R2 = 0.1010; MAE = 2.79). Across all stages, SHAP analysis reinforced that wealth score and household density are the primary structural predictors of caries risk.</p><p><strong>Conclusion: </strong>AI provides a feasible framework for population-level risk stratification and public health planning. The findings suggest that AI-driven frameworks should be utilized for managerial triage and resource allocation, enabling proportional universalism by identifying high-risk clusters through structural determinants rather than individual-level clinical diagnostics.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13695527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of ICDAS for root caries: comparison with histological reference standards.","authors":"Margarita Usuga-Vacca, Jaime E Castellanos, Masatoshi Ando, E Angeles Martinez-Mier, Mario G Saavedra, Stefania Martignon","doi":"10.1159/cre/abuag017","DOIUrl":"https://doi.org/10.1159/cre/abuag017","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence regarding the performance of visual test for root caries severity assessment is still limited. This in vitro diagnostic performance study evaluated visual test with ICDAS (International Caries Detection and Assessment System) root criteria against three histological reference standards -stereomicroscopy (SM), polarised-light microscopy (PLM), and micro-computed tomography (micro-CT).</p><p><strong>Methods: </strong>A total of 125 extracted permanent teeth were classified with the visual test using ICDAS root criteria. Histological evaluation was performed using SM and PLM. In addition, in a subsample of 22 teeth was assessed further using micro-CT. Discriminative power, global and categorised performance (confidence interval with a 95% confidence level) and agreement (Cohen's Kappa and percentage), and indicators of validity and diagnostic utility (sensitivity, specificity, positive and negative predictive values - PPV and NPV, likelihood ratios - LR+ and LR-) were stablished.</p><p><strong>Results: </strong>Compared with histological reference standards, the visual-tactile test showed moderate to high diagnostic performance for root caries for sensitivity (≥ 0.73), specificity (≥ 0.90), and predictive values (PPV ≥ 0.71, NPV ≥ 0.91). Overall likelihood ratios supported moderate confirmatory value (LR+ = 7.43-9.39) and rule-out ability (LR- = 0.26-0.30) after visual-tactile classification. Agreement between the visual test and the histological references was substantial (weighted kappa ≥ 0.88), with moderate discriminative power (0.63-0.68). Complete observed agreement was found for the sound category. Performance was high for initial caries (≥90% for sensitivity, specificity, and predictive values; LR+ ≥10; discriminative power ≥0.82), whereas extensive lesions showed good rule-out ability but lower confirmatory value.</p><p><strong>Conclusion: </strong>The visual-tactile test showed substantial agreement against histological reference standards, moderate to high diagnostic performance, and moderate discriminative power. The test showed complete observed agreement for sound surfaces and high performance for identifying initial caries, whereas extensive lesions showed good rule-out ability but lower confirmatory value. These findings support the visual-tactile ICDAS root caries criteria as useful for the detection and assessment of root caries lesions.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Based Clinical Decision Support Systems for Secondary Caries Detection and Staging on Bitewings: A Multi-Algorithm Comparison.","authors":"Eduardo Trota Chaves, Johannes Teunis Domburg, Vitor Henrique Digmayer Romero, Niels van Nistelrooij, Shankeeth Vinayahalingam, Dilek Sezen-Hulsmans, Fausto Medeiros Mendes, Marie-Charlotte Huysmans, Maximiliano Sergio Cenci, Giana Silveira Lima","doi":"10.1159/cre/abuag016","DOIUrl":"10.1159/cre/abuag016","url":null,"abstract":"<p><strong>Introduction: </strong>Radiographic detection of caries lesions adjacent to restorations is challenging because of the limitations of two-dimensional imaging and difficulties distinguishing true lesions from restorative or anatomical radiolucencies. Artificial intelligence (AI)-based clinical decision support systems have been introduced to assist radiographic interpretation; however, different AI tools may yield variable diagnostic outputs, and their comparative performance remains unclear. We aimed to compare the diagnostic performance of commercial and experimental AI algorithms for detecting and staging secondary caries lesions on bitewings.</p><p><strong>Methods: </strong>This cross-sectional diagnostic accuracy study included 200 anonymized bitewings comprising 885 restored tooth surfaces. A consensus-based reference standard classified each restored surface as non-carious, secondary caries, or indeterminate. Secondary caries lesions were further staged as enamel-stage or dentin-stage. Five commercial AI systems (Second Opinion®, CranioCatch, Diagnocat, DIO Inteligência, and Align™ X-ray Insights) and three experimental systems based on Mask R-CNN and Mask DINO architectures were tested. Diagnostic performance was assessed using sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (95% confidence intervals). Comparisons were performed using generalized estimating equations adjusted for clustered data.</p><p><strong>Results: </strong>Specificity was high across all systems (0.957-0.986), whereas sensitivity was moderate (0.327-0.487), reflecting missed detections of secondary caries lesions, particularly dentin-stage lesions. Accuracy ranged from 0.882 to 0.917, with no significant differences among the evaluated systems (p ≥ 0.05). Similar patterns were observed in the additional analysis restricted to dentin-stage lesions. Misclassifications between non-carious and secondary caries surfaces were frequently associated with radiographic overlap, restoration-related radiolucencies, and cervical artifacts.</p><p><strong>Conclusion: </strong>Artificial intelligence algorithms, regardless of architecture or commercial status, showed similar diagnostic capabilities and a conservative diagnostic profile, favoring specificity over sensitivity. Improvements in dataset diversity, reference-standard quality, and model explainability may further enhance the reliability of AI-assisted secondary caries detection.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and enablers influencing the implementation of minimally invasive caries management: a systematic review and behavioural analysis.","authors":"Heather Lundbeck, Waraf Al-Yaseen, Anwen L Cope, Ivor G Chestnutt, Glesni Guest-Rowlands, Daniela Prócida Raggio, Constance Hardwick, Rachael Pattinson, Zoe Marshman, Nicola P Innes","doi":"10.1159/cre/abuag015","DOIUrl":"https://doi.org/10.1159/cre/abuag015","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally Invasive Dentistry (MID) aims to preserve tooth structure and maintain pulp vitality. Despite MID being incorporated into clinical guidelines, an evidence-practice gap persists. This systematic review aimed to synthesise the barriers and enablers influencing the implementation of MID for the management of carious lesions.</p><p><strong>Method: </strong>This PROSPERO registered mixed methods systematic review (CRD42022342877) followed PRISMA guidelines. MEDLINE, EMBASE, Scopus, CENTRAL, the Cochrane Library, JBI, and ProQuest were searched from 01/01/1970 to 18/05/2025. Eligible studies were primary quantitative, qualitative, or mixed methods studies examining barriers and enablers to MID implementation, with no restrictions on language, participants, or setting. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT), with moderate or high-quality studies included. A narrative synthesis was undertaken with findings mapped to the Capability, Opportunity, Motivation-Behaviour (COM-B) model and Theoretical Domains Framework (TDF). No funding sought.</p><p><strong>Results: </strong>From 13,086 records, 87 studies from 26 countries were included, comprising 5,100 child patients, 934 adult patients, 1,131 parents, 159 mixed patient groups, 15,145 practitioners, 172 educators, and 1,644 students. Perspectives were reported from practitioners (n=34), patients (n=49), and the education sector (n=6). The most frequently studied approaches were atraumatic restorative treatment (n=23), silver diamine fluoride (n=23) and the Hall Technique (n=18). Eight themes were identified: practitioner-related, patient-related, evidence, outcomes, financial, social, procedural, and organisational factors. These were sub-categorised into 27 subthemes representing key barriers and enablers, many of which operated as both depending on context. All COM-B components and TDF domains were represented with beliefs about consequences (n=26), environmental context and resources (n=19), social influences (n=17), reinforcement (n=14), and knowledge (n=11) being the most common. One study evaluated an intervention to support MID implementation, targeting practitioner knowledge. A limitation of this review is that it reports frequencies of barriers and enablers without assessing their relative importance.</p><p><strong>Conclusion: </strong>Implementation of MID is influenced by multiple interacting behavioural determinants spanning all COM-B factors and TDF domains, with substantial overlap across MID approaches, suggesting that unified, multifaceted implementation strategies may be appropriate. The limited evidence on how best to support MID implementation highlights an important priority for future research.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caries Experience in Children and Adolescents with Thalassemia: A Systematic Review and Meta-analysis.","authors":"Biswadeep Roychowdhury, Sagar Jalihal, Anil V Ankola, Roopali M Sankeshwari, David Albert Coutinho, Karthiga Sakthi, Dorothy Dutta, Varkey Nadakkavukaran Santhosh","doi":"10.1159/cre/abuag014","DOIUrl":"https://doi.org/10.1159/cre/abuag014","url":null,"abstract":"<p><p>Introduction Thalassemia creates a distinct and compounding oral risk environment, characterized by transfusion-related salivary gland dysfunction, thalassemia-driven craniofacial remodeling, polypharmacy, and constrained access to preventive dental care, that may substantially elevate dental caries susceptibility. Yet the true magnitude of this burden across global populations has remained unquantified. This review aimed to synthesize evidence on caries experience, assessed using the Decayed, Missing, and Filled Teeth indices for permanent (DMFT) and primary dentition (dmft), in children and adolescents with thalassemia compared with healthy controls. Methods This PRISMA 2020 compliant systematic review and meta-analysis was prospectively registered with PROSPERO (CRD42024603110). Five databases were searched from January 2000 to January 2026 for cross-sectional and case-control studies in individuals aged ≤18 years with any thalassemia type. Risk of bias was appraised using the Newcastle-Ottawa Scale and JBI Checklist. Pooled mean differences (MD) with 95% confidence intervals (CIs) were derived using random-effects models, and certainty of evidence was graded using GRADE. Results 22 studies from 12 countries were included; most involved transfusion-dependent children and adolescents with β-thalassemia major and 13 contributed quantitative data. Children with thalassemia had significantly higher caries experience in both permanent dentition (10 studies; n = 1,646; MD = 1.41, 95% CI: 0.36 - 2.45) and primary dentition (6 studies; n = 1,256; MD = 1.59, 95% CI: 0.39 - 2.79). However, heterogeneity was very high across both outcomes, publication bias was substantial, with trim-and-fill adjustment rendering the permanent dentition estimate non-significant and GRADE certainty was rated very low. Conclusion Unadjusted analyses indicated higher mean DMFT and dmft among children and adolescents with thalassemia; however, prediction intervals crossed zero, and substantial heterogeneity and possible reporting bias, including small-study effects, limit confidence in the stability of the observed effect. The certainty of evidence was very low, precluding a stable estimate of the magnitude of the association. Most evidence concerned transfusion-dependent children and adolescents with β-thalassemia major, limiting the generalizability of findings to other forms of thalassemia. Preventive dental care remains justified on clinical and mechanistic grounds, despite the uncertainty in the quantitative evidence.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluoride Content and Its Potential Availability in Dentifrice Tablets Available on the Dutch market: A Laboratory Assessment.","authors":"Rob A M Exterkate, Bastiaan P Krom, Catherine M C Volgenant","doi":"10.1159/cre/abuag013","DOIUrl":"10.1159/cre/abuag013","url":null,"abstract":"<p><strong>Introduction: </strong>Dentifrice tablets are increasingly presented as a more sustainable alternative to regular toothpastes, yet evidence regarding their efficacy is still limited. This study aimed to evaluate the quality of dentifrice tablets available on the Dutch market with respect to their total fluoride content and their potentially available fluoride.</p><p><strong>Methods: </strong>Twenty types of dentifrice tablets were analyzed using two different techniques: an ion-selective electrode and gas-liquid chromatography. Prior to analysis, two criteria were defined: (1) total content of fluoride should be >80% of the content that the manufacturer claimed and (2) the potentially available fluoride content should be ≥80% of the measured total fluoride content.</p><p><strong>Results: </strong>Nine of the twenty tablets met both criteria. Moreover, most tablets had a lower weight than the amount of toothpaste recommended by the Dutch Ivory Cross. This variation in quality, combined with the relatively lower mass of dentifrice tablets raises concerns regarding the reliability of dentifrice tablets for caries prevention.</p><p><strong>Conclusion: </strong>Although these tablets were purchased on the Dutch market, the results of this study suggest that dentifrice tablets in general may lack sufficient quality control.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13713049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Critical Review of the Validity and Reliability of Caries Detection Methods for Non-Cavitated Lesions.","authors":"Saranya Murukutla, Amid Ismail","doi":"10.1159/cre/abuag012","DOIUrl":"10.1159/cre/abuag012","url":null,"abstract":"<p><strong>Background: </strong>Dental caries is the most prevalent chronic disease that affects people of all ages. Early detection of dental caries is crucial to prevent irreversible dental tissue damage, infection, and tooth loss, yet traditional detection methods face challenges in reliably identifying non-cavitated lesions. The review aimed to determine the validity and reliability of epidemiological and clinical diagnostic methods used to detect non-cavitated caries.</p><p><strong>Summary: </strong>Twenty in vivo studies from 1997 to 2025 were analyzed, focusing on clinical-visual examination, radiographs, tactile examination, and fiber-optic transillumination (FOTI), along with new adjunctive technologies, such as LumiCare, CALCIVIS, and BlueCheck. Diagnostic validity among the studies was assessed using reference standards, including histological validation, operative intervention involving fissure opening, and, in some studies, clinical-visual examination. Of the 20 included studies, 18 evaluated conventional diagnostic methods, with only two assessing tactile examination, and one evaluating FOTI. Only one study evaluated newer adjunctive technologies, including LumiCare and CALCIVIS. Visual examination with International Caries Detection and Assessment System (ICDAS) showed high sensitivity for enamel caries (up to 98%), while radiographs demonstrated greater specificity, particularly for dentinal lesions. Approximal detection with either visual or radiograph examinations showed variable sensitivity but consistently high specificity. Visual methods demonstrated moderate-to-high reliability (≥0.85), whereas radiographic reliability varied widely (0.08-1.00). Evidence for FOTI and tactile examination was limited, and the validity of FOTI remains underexplored. Despite limited available evidence, LumiCare and CALCIVIS reported high sensitivity (91-92%) and specificity (98-100%) for early caries detection.</p><p><strong>Key messages: </strong>Overall, detailed visual examination demonstrated higher sensitivity, while radiographs offer greater specificity, highlighting the need for combined diagnostic approaches based on lesion type and location. Evidence for LumiCare and CALCIVIS is limited, with a need for further clinical validation.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does detection of active initial caries lesions in primary teeth improve clinical outcomes? CARDEC-02 randomized controlled trial of diagnostic-treatment strategies guided by different caries thresholds.","authors":"Mariana Minatel Braga, Isabela Floriano, Raiza Dias Freitas, Elizabeth Souza Rocha, Tamara Kerber Tedesco, Gabriela Manco Machado, Renata Antonangelo Gomes, Thais Gomes Machado, Laura Regina Antunes Pontes, José Carlos Pettorossi Imparato, Daniela Prócida Raggio, Fausto Medeiros Mendes","doi":"10.1159/cre/abuag011","DOIUrl":"https://doi.org/10.1159/cre/abuag011","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection of caries lesions has been encouraged to prevent their progression. However, because the progression rate is relatively low, detecting initial lesions in the caries diagnosis strategy may be considered overdiagnosis, since one can expend additional unnecessary treatment with no relevant benefits for children. Thus, this study aimed to assess the impact on children's clinical outcomes of guiding dental treatment based on detecting active initial caries lesions versus ignoring initial caries lesions when assessing dental surfaces in primary teeth.</p><p><strong>Methods: </strong>A randomized controlled diagnostic-treatment trial was designed with 3- to 6-year-old participants and a 2-year follow-up. Caries management interventions were defined based on two different diagnostic thresholds (diagnostic-treatment strategies) considering all caries lesions (including active initial caries) (ALL) or only advanced lesions (ADV). The primary outcome was the number of surfaces needing new operative interventions after two years. Secondary outcomes comprised the type of treatment performed at baseline, the number of new caries lesions after follow-up, the need for restoration replacement, endodontic treatment, or tooth extraction, and oral-health-related quality of life and parental satisfaction with the treatment. An intention-to-treat analysis was conducted, and negative binomial regression was used for comparisons.</p><p><strong>Results: </strong>Of the 260 participants included, 222 were followed up (14.6% attrition rate). No difference was observed between groups for the primary outcome (p=0.827). For the secondary outcomes, children allocated to the ALL group had more non-operative procedures and a higher number of sessions with professional fluoride application. For other secondary outcomes, the groups did not differ.</p><p><strong>Conclusion: </strong>Detecting active initial caries lesions and guiding dental treatment focused on these lesions does not decrease the new operative interventions in primary teeth compared to when these initial lesions are ignored.</p><p><strong>Trial registration: </strong>NCT02473107. Registered June 16, 2015.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Parents' Multiple Perceived Beliefs on Dental Service Utilization among Chinese Children.","authors":"Lujin Zhang, Ruyu Sun, Tingzhong Yang, Ying Ying, Xinxin Ying, Weifang Zhang","doi":"10.1159/cre/abuag007","DOIUrl":"10.1159/cre/abuag007","url":null,"abstract":"<p><strong>Introduction: </strong>Caries-preventive dental services are essential during the mixed dentition stage, yet utilization disparities persist in China despite universal coverage. This study examined the independent influence of parental health beliefs, conceptualized within a five-construct operationalization of the Health Belief Model (HBM), on preventive dental service utilization after adjusting for socioeconomic position (SEP).</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 1,254 parent-child dyads (second-grade schoolchildren, predominantly aged 7-8 years) within a government-funded, free oral health program. Preventive service utilization was measured via a parent-reported composite index of three services (regular dental check-ups, pit-and-fissure sealants, and fluoride varnish; total score range 3-15). Parental beliefs were assessed using a 23-item HBM questionnaire covering five constructs (Cronbach's α = 0.835-0.931). Data were analyzed using a saturated structural path model.</p><p><strong>Results: </strong>The model explained 15.4% of the variance in utilization. After adjusting for SEP (β = 0.287, p < 0.001), perceived benefits (β = 0.131, p < 0.001) and perceived susceptibility (β = 0.115, p < 0.001) were positively associated with service use, and self-efficacy showed a modest positive association (β = 0.075, p = 0.016). Perceived barriers demonstrated a negative association (β = -0.118, p < 0.001). Perceived severity was not significant (β = -0.033, p = 0.340).</p><p><strong>Conclusion: </strong>Preventive dental service utilization reflects both the structural context indexed by SEP and value-based motivation. Interventions should complement financial support with strategies targeting practical access constraints and strengthening prevention-oriented health communication, rather than relying solely on fear-based messaging.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}