Caries Research最新文献

{"title":"Accuracy Assessment of Human and AI-Assisted Bitewing Radiography and NIRI-Based Methods for Interproximal Caries Detection: A Histological Validation.","authors":"Nicole Rodrigues, Francisco Martinez-Rus, Alicia Miguel-Calvo, Guillermo Pradíes, Maria Paz Salido","doi":"10.1159/000546644","DOIUrl":"https://doi.org/10.1159/000546644","url":null,"abstract":"<p><strong>Introduction: </strong>This study compared the diagnostic accuracy of interproximal caries detection using intraoral bitewing radiographs, assessed by both human operators and an artificial intelligence (AI) program, a near-infrared imaging (NIRI) system with operator-conducted assessment, and histological evaluation as the reference.</p><p><strong>Methods: </strong>100 posterior teeth with or without caries were mounted on 10 typodonts. Initially, 180 surfaces were examined, but eight were excluded for different reasons. Therefore, 171 proximal surfaces were analyzed. NIRI imaging was performed using the iTero Element 5D®, and radiographs were analyzed by operators and an artificial intelligence program, Denti.AI. Results were compared with histology, assessing sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV, NPV), F1-Score, areas under receiver operating characteristic curves (AUC), and the Fleiss Kappa coefficient (k).</p><p><strong>Results: </strong>The statistical analysis results for each diagnostic test were as follows: examiners radiographic assessment (Se=52%, Sp=84.6%, PPV=71.6%, NPV=70.3%, F1-Score=60%, AUC=0.684, k=0.459); NIRI (Se=37%, Sp=98.9%, PPV=96.4%, NPV=67.8%, F1-Score=52%, AUC=0.673, k=0.475); AI-guided radiographic assessment (Se=13.7%, Sp=95.9%, PPV=71%, NPV=59.8%, F1-Score=23%, AUC=0.548). McNemar's test showed a p<0.05 for all diagnostic tests.</p><p><strong>Conclusion: </strong>Both the operator-conducted NIRI system and examiners radiographic assessment demonstrated superior detection capabilities compared to the artificial intelligence program. Among these methods, the examiners radiographic assessment yielded the best results, followed by the NIRI system, demonstrating its potential for clinical use.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-23"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198316","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":"Maternal Psychological Wellbeing and Caries Experience in 3-year-old offspring: Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.","authors":"Wen Cheng, Chin-Ying Stephen Hsu, Carolina Un Lam, Johan Gunnar Eriksson, Helen Chen, Shiao-Yng Chan, Yung Seng Lee, Mary Foong-Fong Chong, Kok Hian Tan, Michael Meaney, Yap Seng Chong, Rosalind J Wright, Aderonke A Akinkugbe","doi":"10.1159/000546070","DOIUrl":"https://doi.org/10.1159/000546070","url":null,"abstract":"<p><strong>Introduction: </strong>Dental caries is a biofilm-mediated, multifactorial disease of the dental hard tissues. Maternal psychosocial and behavioral factors can affect a child's risk for many chronic childhood conditions including dental caries. We examined the relationship between maternal psychological wellbeing during and after pregnancy on caries experience in 3-year-old offspring.</p><p><strong>Methods: </strong>Using data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study (N=667), maternal psychological wellbeing including depressive symptoms [Edinburg Postnatal Depression scale (EPDS), anxiety symptoms [State Trait Anxiety Inventory (STAI)], and sleep quality were measured. Offspring dental caries experience was defined as having at least one decayed, missing, and filled teeth or surface (dmft ≥1 vs.0 /dmfs ≥1 vs. 0). We estimated associations between maternal psychological wellbeing in the pre- and post-natal periods with offspring dental caries experience using logistic regression models adjusted for several maternal and child demographic and socioeconomic factors.</p><p><strong>Results: </strong>The mean maternal age at delivery was 31 (SD: 5.1) years with ethnic distribution of 55% Chinese, 28% Malay, and 17% Indian; 8.6% of mothers had a prenatal EPDS score ≥15 indicating probable depression and 44% of the children had dmft ≥1. Children of mothers with high prenatal EPDS scores (≥15) had 1.57 times (95% CI: 0.85 - 2.93) the adjusted odds of dental caries experience as compared to children of mothers with prenatal EPDS score <15, although this association was not statistically significant. Moreover, children of mothers with consistently high/changing EPDS and STAI scores in the pre- and postnatal periods had adjusted odds of caries experience of 1.65 (95% CI: 1.01 - 2.72) and 1.24 (95% CI: 0.89 - 1.74), respectively when compared to children whose mothers had consistently low EPDS and STAI scores, though only EPDS association was statistically significant. Associations with poor sleep quality followed a similar direction, although not statistically significant.</p><p><strong>Conclusion: </strong>While the current findings did not consistently demonstrate statistically significant associations, they suggest a potential role of maternal psychological wellbeing during and after pregnancy on children's oral health status. These observations point to a need for further research to validate our findings and the addition of maternal psychological wellbeing status as a preventive measure to promote offspring oral health.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198334","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":"Influence of social mobility on untreated dental caries at age 4: Intergenerational and Intragenerational analysis.","authors":"Sarah Arangurem Karam, Francine Dos Santos Costa, Marcos Britto Correa, Bernardo Horta, Helen Gonçalves, Andréa Dâmaso Bertoldi, Flávio Fernando Demarco","doi":"10.1159/000546513","DOIUrl":"https://doi.org/10.1159/000546513","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to describe the prevalence of untreated dental caries in early childhood based on intergenerational socioeconomic data; and to evaluate the association between intragenerational socioeconomic mobility data and untreated dental caries in children aged 4.</p><p><strong>Methods: </strong>Longitudinal study. Data from three birth cohorts in Pelotas (1982, 1993, and 2015) were used. Data from three generations participating in these cohorts were evaluated. Untreated dental caries in childhood (2015 cohort) was considered the dependent variable. Family income and schooling were independent variables. The social mobility variable was categorized considering income and level of schooling data in the mothers' generation. Poisson regression was performed to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI).</p><p><strong>Results: </strong>286 pairs of children and mothers/grandmothers were evaluated for the intergenerational sample (1982 and 1993 cohorts), and 3,633 mothers and children for the intragenerational sample (2015 cohort). In the intergenerational analysis, there was a reduction of about 10 percentage points in the prevalence of untreated caries in children from families that experienced upward/downward income mobility compared to children whose generations remained with lower income. In the intragenerational analysis, children belonging to the ascending/descending economic mobility groups had twice the prevalence of untreated dental caries compared to those always with higher salaries ([RP 2.04;95%CI 1.52-2.71] [PR 2.07;95%CI 1.56-2.74), respectively).</p><p><strong>Conclusion: </strong>Findings demonstrate an association between untreated dental caries in children and family socioeconomic status, including their mothers' income/education mobility. Thus, intervening in early childhood socioeconomic conditions is needed to improve children's oral health.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149316","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":"72nd ORCA Congress Abstracts.","authors":"","doi":"10.1159/000546564","DOIUrl":"https://doi.org/10.1159/000546564","url":null,"abstract":"<p><p>N/A.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":"59 3","pages":"1-143"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141504","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 Moderating Effect of Oral Health Literacy on the Relationship Between Socioeconomic Conditions and Untreated Dental Caries in Pregnant Women.","authors":"Gabriela de Araujo, Mateus Zilch Scheuermann, Jessica Klöckner Knorst, Thiago Machado Ardenghi, Bruno Emmanuelli","doi":"10.1159/000546293","DOIUrl":"https://doi.org/10.1159/000546293","url":null,"abstract":"<p><strong>Introduction: </strong>Dental caries is highly prevalent among pregnant women, and investigating potential modifying factors is particularly relevant for this population. This study aimed to evaluate the moderating effect of oral health literacy (OHL) on the relationship between socioeconomic conditions and dental caries in pregnant women.</p><p><strong>Methods: </strong>This cross-sectional study was performed with pregnant women attending the public health service in Santa Maria, a municipality in Southern Brazil. The Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) instrument was used to evaluate OHL. The presence of dental caries was measured using the Decayed, Missing, or Filled Teeth (DMFT) index. Socioeconomic conditions were assessed based on family income and education level. The moderating effect of OHL on the relationship between income, education, and caries (D component of DMFT) was tested using multilevel Poisson regression analyses. The results are presented as Prevalence Ratio (PR).</p><p><strong>Results: </strong>A total of 520 pregnant women were examined (response rate of 93%). Pregnant women with low educational level and low OHL exhibited a 69% higher prevalence of dental caries compared to those with higher education and high OHL. Similarly, among those with high income, pregnant with low OHL had a 57% higher prevalence of untreated dental caries than their counterparts with both high income and high OHL.</p><p><strong>Conclusion: </strong>Our findings indicate that low OHL modifies the association between socioeconomic conditions and dental caries among pregnant women. Low OHL appears to function as an aggravating factor, potentially exacerbating oral health outcomes in this population.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-14"},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118976","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":"Initial caries lesions in preschool children are not a risk factor for caries in adolescents.","authors":"Bruna Brondani, Jessica Klöckner Knorst, Bruno Emmanuelli, Thiago Machado Ardenghi, Fausto Medeiros Mendes","doi":"10.1159/000546347","DOIUrl":"https://doi.org/10.1159/000546347","url":null,"abstract":"<p><p>Caries experience in primary teeth has been highlighted as the most important single risk factor for caries development in the subsequent permanent teeth, but at cavitated stages. This 10-year cohort study aimed to evaluate whether children with only initial caries lesions in the primary teeth could also have a higher risk for caries incidence in permanent teeth. We evaluated Brazilian preschoolers aged 1 to 5 years in 2010 (T1) and re-evaluated them 2 (T2), 7 (T3), and 10 (T4) years later. Dental caries in primary and permanent teeth was assessed through the International Caries Detection and Assessment System (ICDAS). For the primary dentition (T1 and T2), the participants were categorized according to caries severity in the first two assessments into children with (i) no caries, (ii) only initial caries lesions (ICDAS scores 1 and 2), (iii) at least one moderate lesion (ICDAS scores 3 and 4), and (iv) extensive caries lesions (ICDAS scores 5 and 6). We also created a dichotomous variable considering only extensive lesions. Demographic and socioeconomic data were also collected. For the permanent dentition (T3 and T4), the participants were re-evaluated for extensive caries lesions after 7 and 10 years of follow-up. The outcome variables were the number of decayed, extracted, and filled surfaces of permanent teeth (D3MFS) and the occurrence of any extensive lesion (caries incidence) after 10 years. Associations were evaluated through negative binomial and Poisson regression analyses, respectively. Incidence rate ratios (IRR) and Relative Risks, along with 95% confidence intervals (95%CI), were derived. At the baseline, 639 children were included, and 429 were reassessed after 10 years (67.2% of retention rate). Children with only initial or moderate caries lesions did not have a higher risk of caries in permanent teeth. By contrast, children with extensive caries lesions were more likely to develop caries in the permanent dentition than children without caries (IRR, 95% CI = 2.90, 1.98 to 4.23). This higher risk was more clearly demonstrated when the caries experience was used as a dichotomous variable (IRR, 95% IC = 4.02, 2.38 to 6.78). In conclusion, children with only initial caries lesions do not have a higher risk of developing dental caries in the permanent dentition by adolescence.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-20"},"PeriodicalIF":2.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118972","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":"Dental practitioners' thresholds for restorative intervention in carious lesions: a survey based systematic review update.","authors":"Heather J Lundbeck, Vinay Pitchika, Paul Wilson, Daniela P Raggio, Jennifer Galloway, Waraf Al-Yaseen, Arindam Dutta, Rhiannon Jones, Shannu Bhatia, Glesni Guest-Rowlands, Kathryn Rowles, Falk Schwendicke, Nicola Innes","doi":"10.1159/000546194","DOIUrl":"https://doi.org/10.1159/000546194","url":null,"abstract":"<p><strong>Introduction: </strong>Despite evidence supporting the clinical and cost-effectiveness of Minimally Invasive Dentistry (MID), its adoption by the dental profession has been slow. A systematic review in 2016 found the majority of dentists intervene invasively earlier than necessary. The aim was to update this review of the assessment of dental practitioners' thresholds for providing restorative treatment for carious lesions given changes in evidence, teaching and guidelines since 2016. The primary outcome was dental practitioners' restorative thresholds (the extent of the lesion when they would decide to intervene restoratively). Secondary outcomes were changes over time; caries risk; regional differences and primary/permanent dentition.</p><p><strong>Methods: </strong>This updated review replicated the methodology for the initial review, following the PRISMA 2020 guideline (PROSPERO; CRD42023431906). EMBASE, Medline (via PubMed) and Web of Science databases were searched (2016 to 2023) for observational studies reporting on dental clinicians' thresholds for restorative interventions in adults and children without language, time or quality restrictions. Screening, data extraction and risk of bias assessment (Modified Newcastle-Ottawa Scale) were carried out independently and in duplicate. Meta-analyses were performed using a random effects model. No funding sought.</p><p><strong>Results: </strong>Overall, 47 publications (30 from original publication and 17 from updated search) met the inclusion criteria and 65 datasets were included in the meta-analyses; 19 for occlusal lesions (16 pre-2016 and 3 post-2016; n=11,946) and 46 for proximal lesions (38 pre-2016 and 8 post 2016; n=20,428). The meta-analyses found that for occlusal lesions confined to enamel, there were fewer practitioners intervening invasively: 5% (95% confidence interval [CI]; 1-20%) post-2016, compared with 15% (95% CI; 9-23%) pre-2016. The opposite was found for proximal lesions with increased intervention levels, 27% (95% CI; 18-40%) for lesions confined to enamel post-2016, compared with 19% (95% CI; 12-29%) pre-2016, and for lesions extending up to the enamel-dentine junction 61% (95% CI; 36-81%) post-2016, compared with 39% (95%CI; 29-51%) pre-2016. There was variance between regions but too few studies to draw conclusions on individual regions.</p><p><strong>Conclusion: </strong>There was suggestion of less invasive treatment of occlusal lesions over time, however this was not evident for proximal lesions.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-26"},"PeriodicalIF":2.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964084","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":"Split-Spectrum Optical Attenuation Coefficient Method for Caries Detection.","authors":"Jian Liu, Linghui Kong, Han Su, Yao Yu, Zhenhe Ma","doi":"10.1159/000546320","DOIUrl":"https://doi.org/10.1159/000546320","url":null,"abstract":"<p><strong>Introduction: </strong>Cavities that are difficult to detect through visual inspection pose risks to dental health. To address this, we propose a detection method using the Split Spectrum Optical Attenuation Coefficient (OAC), capitalizing on the wavelength-dependent properties of carious dental structures.</p><p><strong>Methods: </strong>The complete OCT spectrum is divided into four spectral segments, each independently reconstructed and analyzed for OAC. OAC values are then compared across segments to differentiate between healthy and carious tissue. Experiments were conducted on ex vivo human teeth, with carious areas marked by dental professionals. The accuracy of the proposed method was evaluated and compared with the full-spectrum OAC method.</p><p><strong>Results: </strong>For healthy enamel, OAC values ranged from 0.2 to 0.4 mm⁻¹, remaining consistent across spectral bands. In carious enamel, OAC increased significantly (0.5-2.5 mm⁻¹), with a 60% rise in short-wave versus long-wave OAC. Healthy dentin showed OAC values from 0.3 to 0.7 mm⁻¹, whereas carious dentin reached 0.8-1.2 mm⁻¹, with a 50% increase in short-wave OAC compared to long-wave. The average false positive rate of the method proposed in this paper is 0.9%, significantly lower than the 1.8% of the traditional OAC method (t-test, n=16, p=0.013). The average false negative rates of both methods are around 1%, with no significant difference.</p><p><strong>Conclusion: </strong>Findings indicate that the split-spectrum OAC method can effectively identify caries, with higher accuracy and specificity compared to the traditional OAC method.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-22"},"PeriodicalIF":2.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954751","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":"Effect of early life income and sugars intake on child oral health - marginal structural modelling using a birth cohort study.","authors":"Diep H Ha, Lucinda Bell, Gemma Devenish-Coleman, Sam Leary, Jane E Scott, William Murray Thomson, Andrew John Spencer, David J Manton, Loc G Do","doi":"10.1159/000546215","DOIUrl":"https://doi.org/10.1159/000546215","url":null,"abstract":"<p><strong>Introduction: </strong>Determinants of oral health are formed early and influenced by variations in socioeconomic status (SES). It is unclear whether early-life SES influences child oral health directly, or indirectly through determinants such as intake of free sugars. This study applied the marginal structural modelling approach to household income at birth and free sugar intake to investigate pathways those determinants influence child oral health.</p><p><strong>Methods: </strong>We used data collected in SMILE, a population-based birth cohort study of Australian mother/newborn dyads, who have been followed-up prospectively since birth with questionnaires and clinical assessment. Area- and individual-level factors collected at childbirth were background confounders. Household income at childbirth (Low/Medium/High) and free sugar intake at age two years (Low/Medium/High) were used as primary exposure and mediator to investigate pathways through which SES at childbirth influences oral health. By applying the causal inference approach and using marginal structural modelling, we estimated the controlled direct effect of household income and the direct effect and mediating effect of intake of free sugars on dental caries experience. We developed a causal directed acyclic graph to guide the analysis. The baseline confounders were balanced using a stabilised inverse probabilities of treatment weight, mimicking randomisation.</p><p><strong>Results: </strong>Low household income at childbirth was associated with 1.65 (95%CI: 1.01, 3.02) times higher accumulated dental caries experience by age five years than in children born to high-income households. High intake of free sugars had strong direct effects on both the prevalence (1.55 (95%CI: 1.03, 2.32)) and cumulative experience (2.64 (95%CI: 1.36, 5.15)) of dental caries by age five years. Proportions of effects of income were mediated by intake of free sugars.</p><p><strong>Conclusion: </strong>Socioeconomic variations at birth and immediate determinants such as intake of sugars, directly and indirectly, influence oral health. Timely and appropriate addressing of those variations may limit inequity in oral health.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-20"},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980608","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":"Cavity-management effectiveness and feasibility of SDF solution and NaF varnish in children: One-year follow-up non-inferiority RCT.","authors":"Stefania Martignon, Margarita Usuga-Vacca, Andrea Cortes, Sofía Jácome-Liévano, Natalia Fortich-Mesa, Emilia María Ochoa, Roquelina Pianeta, Vivi Hoyos-Hoyos, Edgar O Beltrán","doi":"10.1159/000544953","DOIUrl":"https://doi.org/10.1159/000544953","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of caries experience among 5-year-old children in Colombia remains high (62%). The National Health System supports the use of NaF varnish (FV) from age one. Considering the inclusion of SDF solution (SDF) by the WHO and the FDI to control caries burden by 2030, the aim of this non-inferiority randomised controlled trial (RCT) was to compare after one year the effectiveness and feasibility of biannual applications of SDF or FV for the control of cavities in young children from Bogotá and Cartagena, Colombia.</p><p><strong>Methods: </strong>This non-inferiority RCT included 752 3-4 year-old medically healthy children from Bogotá and Cartagena. Participants in each city were randomised to receive either SDF (38%) or FV (5%) biannually.</p><p><strong>Primary outcome: </strong>cavity (d) prevention effect.</p><p><strong>Secondary outcomes: </strong>active-cavity (active-d) arresting effect, feasibility (study adherence, received-treatment fidelity), dental-care parental satisfaction/acceptance, child-procedure behaviour and pain, and adverse effects. Data were analysed using t-tests, Chi-square tests, and generalised-estimating-equation (GEE) (0.05 statistical significance).</p><p><strong>Results: </strong>611 children (75.1%) completed the one-year follow-up. At baseline, overall prevalence of caries experience (dmf) was of 32% (prevalence of d: 27%), increasing to over 75% when including Initial and Moderate caries lesions (assessed without air-drying, Epi) (ICDAS-merged Epi dmf). Corresponding mean number of tooth surfaces with ICDAS-merged Epi dmf was >5.9, of which cavities/d: >1.1. Most reported a high daily intake of free sugars (FV: 82.8%; SDF: 79.9%), and use of fluoridated toothpaste was not generalised (FV: 60.3%; SDF: 57.8%). After one year, mean number of new-cavity tooth surfaces showed no inferiority for SDF vs. FV (FV: 0.61±1.86; SDF: 0.40±1.13, p=0.22). Arresting active cavities was achieved in 49.4% (FV) and 72.2% (SDF) of children (p>0.05). Feasibility was high: study adherence (FV: 76.1%; SDF: 74.0%); received-treatment fidelity (FV: 92.9%; SDF: 91.4%) (p>0.05). Most parents were satisfied-very-satisfied (FV: 93.2%; SDF: 96.0%) (p>0.05). Only one case of adverse effects appeared after the first fluoride application (SDF) and resolved uneventfully.</p><p><strong>Conclusion: </strong>After one year, a biannual application of SDF versus FV was not inferior in preventing new cavities, with high feasibility in community settings. This study supports the use of these fluoride therapies for young children in similar socioeconomic contexts, recommending increasing fluoridated toothpaste affordability and including behaviour change strategies to improve oral-health practices.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-21"},"PeriodicalIF":2.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965173","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}