Caries Research最新文献

{"title":"Diffuse Reflectance Spectroscopy for Caries Detection and Discrimination of Restorative Materials: An In Vitro Diagnostic Accuracy Study.","authors":"Jindřich Charvát, Aleš Procházka, Lucie Himmlová, Tomáš Kučera, Lenka Vavřičková","doi":"10.1159/cre/abuag010","DOIUrl":"10.1159/cre/abuag010","url":null,"abstract":"<p><strong>Introduction: </strong>Diffuse reflectance spectroscopy (DRS) is a proposed optical adjunct for caries detection, but its diagnostic accuracy against histology has not been validated alongside its ability to discriminate restorative materials. We aimed to validate DRS in vitro for both tasks.</p><p><strong>Methods: </strong>This in vitro study comprised two arms. In part 1, 200 occlusal regions of interest from 100 extracted teeth were assessed by DRS (350-1,730 nm) and by two independent examiners using the International Caries Detection and Assessment System (ICDAS), with histological scoring as the reference standard. In part 2, four freshly prepared restorative materials (45 sites each: a self-adhesive resin cement, two resin composites, a resin-modified glass-ionomer) were compared with 37 sound-enamel sites from a separate cohort (one site per tooth). Spectra were classified by partial least squares discriminant analysis (PLS-DA) with specimen-grouped 10-fold cross-validation (sites from a specimen kept in one fold, preventing leakage).</p><p><strong>Results: </strong>DRS reached 80.5% exact agreement with histology (quadratically weighted κ = 0.916, 95% CI: 0.890-0.939) versus 54.0-57.5% for the visual examiners. At the any-caries threshold (histological score ≥D1), DRS achieved sensitivity 90.8% (95% CI: 84.3-94.8) and specificity 95.0% (87.8-98.0), with four false-positive classifications of sound surfaces against 25 and 23 for ICDAS examiners. The DRS AUC (0.946) exceeded both examiners (0.908 and 0.914), reaching significance against one (DeLong test, p = 0.027). Sensitivity for dentin-level caries was low (37.5%). PLS-DA discriminated the five classes (four materials plus sound enamel) with overall accuracy 99.5% (95% CI: 97.4-99.9).</p><p><strong>Conclusion: </strong>In vitro, DRS showed markedly higher specificity than visual ICDAS scoring for occlusal caries and discriminated four freshly prepared restorative materials from sound enamel. Its low sensitivity for dentin-level lesions and the controlled laboratory conditions warrant cautious interpretation pending in vivo validation.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929188","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":"Human-AI Collaboration in Proximal Early Caries Lesion Detection: Potential Benefits for Novices and Potential Risks for Experts.","authors":"Ricardo E Gonzalez-Valenzuela, Quoc T D Vu, Pascal Mettes, Bruno G Loos, Henk Marquering, Erwin Berkhout","doi":"10.1159/cre/abuag009","DOIUrl":"10.1159/cre/abuag009","url":null,"abstract":"<p><strong>Introduction: </strong>Early-stage proximal caries detection on bitewing radiographs is challenging and hampered by inter-observer variability. This study aimed to assess how artificial intelligence (AI) support influences radiographic detection and staging of proximal early caries lesions, confidence, and assessment time across observer experience levels.</p><p><strong>Methods: </strong>Eighteen observers (dental students, general dentists, and dental radiologists) evaluated 369 proximal surfaces on 25 bitewing radiographs in two sessions: first unaided, then aided with AI-annotated caries lesion regions. Observers assigned lesion stages and provided self-reported (SR) confidence ratings. Radiographic detection and staging accuracy relative to an expert consensus reference standard was assessed using cumulative link mixed models. Ordinal agreement and binary detection metrics were computed for each observer group.</p><p><strong>Results: </strong>The AI-based tool had divergent effects across the different groups of observers. Dental students showed a statistically significant improvement in radiographic detection and staging accuracy relative to the reference standard (p = 0.039). General dentists and dental radiologists showed no statistically significant change in radiographic detection and staging accuracy when using AI support (p = 0.28 and p = 0.15, respectively). SR confidence increased when the AI-based tool was used for all groups.</p><p><strong>Conclusion: </strong>AI support induced a shift in observers' detections toward the AI-based tool's performance pattern, with its effect on radiographic detection and staging accuracy varying across observer groups and no statistically significant change observed in more experienced observers. AI generally increased the SR confidence of the clinicians.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929110","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":"Silver-Modified Atraumatic Restorative Treatment in Geriatric Dentistry: Rationale and Evidence Gaps for Root Caries Management.","authors":"Soraya León, Cecilia Muñoz-Sandoval, Angela Martínez, Paulo Gallardo, Rodrigo A Giacaman","doi":"10.1159/cre/abuag006","DOIUrl":"10.1159/cre/abuag006","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Population ageing has resulted in a growing number of older adults retaining natural dentition, with a consequent rise in the prevalence of root caries lesions (RCLs). These lesions are strongly associated with gingival recession, hyposalivation, multimorbidity, polypharmacy, and functional dependence, all of which can limit tolerance to conventional restorative care and compromise long-term restoration survival. Minimal intervention dentistry has, therefore, gained increasing relevance in geriatric practice. Silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) are established minimally invasive approaches, while silver-modified atraumatic restorative treatment (SMART) integrates both strategies. However, its role in managing geriatric RCLs remains insufficiently defined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;This review critically examines the biological rationale, current evidence, clinical indications, limitations, and knowledge gaps associated with SMART for root caries management in older adults. Clinical evidence supports SDF as a non-restorative option for arresting active RCLs in older populations. Because SDF alone is less invasive than SMART, it should be preferred when lesion arrest is the principal treatment objective and the lesion remains cleansable, asymptomatic, and functionally acceptable. A restorative intervention may be indicated for selected cavitated lesions when loss of anatomical contour results in persistent plaque-retentive morphology, impaired cleansability or function, or structural rehabilitation needs. However, evidence evaluating SMART derives predominantly from paediatric and laboratory studies, and its comparative effectiveness over SDF alone, ART, or other restorative approaches has not been demonstrated in older adults. The combination of SDF and high-viscosity glass-ionomer cement is, therefore, supported by mechanistic plausibility rather than geriatric clinical evidence. Important uncertainties remain regarding appropriate case selection, treatment sequencing, long-term restoration survival, subgingival performance, retreatment needs, cost-effectiveness, and patient-reported outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;SDF is supported by clinical evidence for arresting active RCLs in older adults and is less invasive than SMART. Many non-cavitated, shallow, or cleansable RCLs do not require restoration and may be managed using non-restorative strategies. Restoration should be considered only when an independent restorative indication exists, including persistent plaque-retentive cavitation, impaired cleansability or function, loss of anatomical contour, or structural rehabilitation needs. No clinical evidence currently demonstrates that SMART is superior to SDF alone, ART, or other restorative approaches for RCLs in older adults. SMART should, therefore, be regarded as a biologically plausible but unproven option for selected cavitated lesions, pending geriatri","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911041","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 for Detecting Secondary Caries: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy.","authors":"Akshat Sachdeva, Yata Prashanth Kumar, Amrita Chawla, Vijay Kumar, Sidhartha Sharma, Ashish Dutt Upadhyay, Vasudev Ballal, Ajay Logani","doi":"10.1159/cre/abuag008","DOIUrl":"10.1159/cre/abuag008","url":null,"abstract":"<p><strong>Introduction: </strong>Secondary caries (SC) is one of the untoward consequences of dental restorations, which, if detected in a timely manner, can decrease the expense of frequent reinterventions. The aim of this systematic review is to assess the diagnostic accuracy of artificial intelligence (AI) in the detection of SC.</p><p><strong>Methods: </strong>The protocol was registered in PROSPERO (CRD420251014888). PubMed, EBSCOhost, Scopus, Embase, IEEE Xplore, and Web of Science databases were searched up to 11th June 2026. Data extraction focused on different AI models used, dataset characteristics, and diagnostic performance metrics. Risk of bias assessment was done using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. A bivariate random-effects model was used to pool sensitivity and specificity. Heterogeneity, threshold effect, and publication bias were evaluated.</p><p><strong>Results: </strong>After screening 116 articles, nine studies fulfilled the inclusion criteria and were included in the review. The pooled sensitivity and specificity of AI for SC detection were 76.83% (95% CI: 51.70-91.13) and 84.43% (95% CI: 29.06-98.63), respectively. The hierarchical summary receiver operating characteristic analysis yielded an area under the curve of 0.85 (95% CI: 0.81-0.88) and heterogeneity of 59.47%, indicating moderate diagnostic ability. Three studies demonstrated a high risk of bias in the index test domain and 1 in the patient selection domain.</p><p><strong>Conclusion: </strong>Pooled results suggest that AI demonstrated reasonable diagnostic accuracy for detecting SC. However, given the limited and heterogeneous evidence base, its clinical use remains promising yet insufficiently validated.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905121","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":"Socioeconomic Inequalities in Untreated Root Caries in Adults and Older Adults in two National Cross-Sectional Samples.","authors":"Luiz Alexandre Chisini, Luana Carla Salvi, Jaqueline Barbieri Machado, Marcus Cristian Muniz Conde, Francine Dos Santos Costa, Flávio Fernando Demarco","doi":"10.1159/cre/abuag005","DOIUrl":"10.1159/cre/abuag005","url":null,"abstract":"<p><strong>Introduction: </strong>Ageing and tooth retention expand root caries susceptibility. This study aimed to evaluate socioeconomic inequalities in untreated root caries.</p><p><strong>Methods: </strong>Cross-sectional data from the 2010 and 2023 Brazilian National Oral Health Surveys (SB Brasil) were analysed, including dentate adults (35-44 years) and older adults (65-74 years). Untreated root caries was assessed according to WHO criteria. Socioeconomic inequalities were evaluated using educational attainment, household income, household assets, and a latent socioeconomic position (SEP) indicator estimated through generalized structural equation modelling. Absolute and relative inequalities were quantified using the Slope Index of Inequality (SII) and Concentration Index (CIX), respectively.</p><p><strong>Results: </strong>Overall, 28,318 dentate participants were included (13,220 in 2010 and 15,098 in 2023). Between survey years, edentulism declined from 20.2% to 11.5%. Prevalence of root caries increased from 16.0% (95% CI: 14.2-17.9) in 2010 to 22.0% (95% CI: 19.2-25.2) in 2023, particularly among older adults (22.4-26.8%). Negative SII and CIX values indicated that root caries remained concentrated among socioeconomically disadvantaged groups. Among adults, absolute inequalities widened over time, increasing from -17.6 to -21.7 p.p. according to SEP. Among older adults, SEP inequalities that were not consistently observed in 2010 became statistically significant across all indicators in 2023, reaching -23.8 percentage points (SII) and -15.4 (CIX).</p><p><strong>Conclusion: </strong>Untreated root caries prevalence increased in Brazil between 2010 and 2023 despite substantial gains in tooth retention. Socioeconomic inequalities persisted and intensified over time, suggesting that the ongoing epidemiological transition in oral health has expanded the population susceptible to root caries without equitable improvements across social groups.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839189","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":"Evidence-Based Caries Management in Latin American Dental Schools: A COM-B Implementation Science Baseline Study.","authors":"Stefania Martignon, Angie Sanabria, Viviana Avila, Ninoska Abreu-Placeres, Vicente Aránguiz, Fabiana Carletto-Körber, Rodrigo A Giacaman, Claudia Polanco, Amaury Pozos-Guillén, Magdalena San-Martín, Aldo Squassi, Mario G Saavedra, Margarita Úsuga-Vacca, Edgar O Beltrán, Sofía Jácome-Liévano, Andrea Cortes","doi":"10.1159/000553589","DOIUrl":"10.1159/000553589","url":null,"abstract":"<p><strong>Introduction: </strong>Adopting core cariology curricula into dental schools remains an international challenge in dental education and clinical practice. For the first time, implementation science is supporting this adoption process. Therefore, as part of the exploration phase of the Latin-American-Cariology-Curriculum-Framework implementation, this baseline Capability, Opportunity, Motivation-Behaviour (COM-B) study assessed how best-practice caries risk/lesions diagnosis and management behaviours are being performed across regional dental schools.</p><p><strong>Methods: </strong>We administered an adapted, previously validated COM-B model caries-care best-practice questionnaire to 1,317 participants (806 final-year students and 511 clinical educators) across eight Latin American dental schools. The 56-item instrument evaluated self-reported behaviours regarding caries diagnosis and management (5-point Likert-response scale). Descriptive statistics, Welch's ANOVA, and multiple linear regression models -applied to ordinal Likert-frequency ratings treated as approximately continuous with heteroskedasticity-consistent robust standard errors (HC3), were performed.</p><p><strong>Results: </strong>The overall response rate was 71.1% (students: 74.8%, educators: 65.4%). Respondents reported performing these behaviours \"most of the time,\" with averages (mean ± SD) ranging from 4.0 ± 1.0 - 4.3 ± 0.9. The most frequently reported behaviours were related to caries management, particularly \"Advising on reducing free-sugar intake\" and \"Implementing oral hygiene behaviour change strategies\" (both 4.5 ± 0.7). The least frequent behaviour was \"Monitoring/watching initial inactive caries lesions\" (3.7 ± 1.2). Only one dental school showed overall behaviour-frequency values below \"most of the time.\" Within the COM-B model, capability showed the strongest association with diagnostic behaviours, whereas opportunity-resources showed the strongest association with management behaviours.</p><p><strong>Conclusion: </strong>Clinical educators and final-year students from Latin American dental schools reported high baseline engagement in evidence-based caries diagnosis and management. Capability and opportunity were the COM-B components most strongly associated with these behaviours. As part of a regional implementation-science study, these findings serve as a case study of a global implementation challenge: translating evidence-based cariology principles into dental education and clinical practice.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.5,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788345","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":"Adverse Childhood Experiences and Untreated Dental Caries in Adulthood: Exploring Mediation by Educational Level, Depression Symptoms, and Oral Health-Related Behaviors.","authors":"Letícia R M Sartori, Sarah R Baker, Joseph Murray, Flávio F Demarco, Marcos B Corrêa","doi":"10.1159/000552010","DOIUrl":"10.1159/000552010","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse childhood experiences (ACEs) are relevant predictors for poor oral health in adulthood; however, the relationship with untreated dental caries remains unclear, as well as the underlying pathways. Therefore, the aim was to assess whether educational level, depressive symptoms, and oral health variables in adulthood mediate the association between exposure to ACEs and the number of decayed teeth in adulthood.</p><p><strong>Methods: </strong>Using data from the 2015 Pelotas (Brazil) Birth Cohort Study, this observational study examined mothers' ACE scores (any occurrence and frequency-based) up to age 18 as exposures. The outcome was the maternal number of decayed teeth. Education, depressive symptoms, dental appointments in the past 12 months, and flossing were evaluated as potential mediators. Descriptive statistics and bivariate association tests were used, and mediation was tested using structural equation modeling (α = 5%).</p><p><strong>Results: </strong>A total of 2,480 women were included. Considering exposure at least once, 13.4% reported no ACE and 24.9% reported 5+, regardless of frequency. When applying the frequency-based scoring, 7.1% scored 5+. The mean number of decayed teeth observed was 1.02 (SD = 1.97). A bivariate association was found between the ACE's frequency-based score and the number of decayed teeth. Structural equation modeling indicated that education was the critical mediator between frequency-based ACEs and decayed teeth, accounting for 90% of the association directly and an additional 8.3% due to its effects on teeth flossing.</p><p><strong>Conclusion: </strong>These findings highlight the mediating role of education in the association between frequency-based ACEs and untreated dental caries, underscoring its importance for interventions in the chain of risk.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788421","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":"Self-Reported Preferences for Selective Caries Removal: A Survey Study among Swedish Dentists.","authors":"Elin Campana Wadman, Rashelle Chamoun, Lena Karlsson, Franziska Hetrodt","doi":"10.1159/cre/abuag003","DOIUrl":"10.1159/cre/abuag003","url":null,"abstract":"<p><p><p>Introduction: Selective caries removal (SE) involves intentionally leaving some decayed dentine in deep lesions to maintain pulp vitality and avoid overtreatment. In Sweden, clinical practice has traditionally emphasized stepwise caries removal (SW). However, recently published national guidelines accord equal importance to SE. The present study aimed to investigate the therapeutic approaches reported by general Swedish dentists in the management of deep carious lesions in permanent teeth, the patient- and practitioner-related factors influencing the preference for SE, and the materials employed during the procedure.</p><p><strong>Methods: </strong>An electronic questionnaire was distributed to 200 randomly selected public dental clinics and 150 private dental clinics across Sweden. Additionally, it was shared via professional newsletters and social media platforms.</p><p><strong>Results: </strong>A total of 447 practitioners from all 21 counties in Sweden completed the questionnaire, whose data were included in the analysis. Their collective responses showed that, for an asymptomatic deep caries lesion, less invasive excavation strategies, such as SE and SW, were preferred by 91.3% of dentists, whereas 6.7% favored nonselective removal and 2% chose other approaches. Of note, 85% of the surveyed individuals had previously performed SE on permanent teeth. Dentists aged 36 years or older were significantly less likely to perform SE compared to the control group aged 25 years or younger (p < 0.01). Additionally, dentists working in public dental clinics (odds ratio [OR] = 0.59, p = 0.015) were significantly less likely to perform SE compared to practitioners working in private dental clinics. When performing SE, 58.4% of surveyed dentists preferred composite restorations without any cavity liner closest to the pulp.</p><p><strong>Conclusion: </strong>The majority of surveyed dentists opt for less invasive treatment methods for caries management. SE emerged as the most widely used technique, particularly among younger age-groups and in private practice.</p>.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1"},"PeriodicalIF":2.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788508","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":"Adverse Childhood Experiences and Oral Health in Adulthood.","authors":"Laura Ylitervo, Anu-Helmi Halt, Mika Niemelä, Anna Pelkonen, Marja-Liisa Laitala","doi":"10.1159/000553332","DOIUrl":"10.1159/000553332","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse childhood experiences (ACEs), i.e., child abuse or challenging circumstances in the family, are associated with various negative health outcomes in adulthood, such as cancer and heart disease, and there is some evidence for an association with oral health. We aimed to investigate whether there was an association between ACEs and adulthood caries experience, periodontal health, erosive tooth wear, and related behavior among the participants from the Northern Finland Birth Cohort 1,986 (NFBC1986).</p><p><strong>Methods: </strong>The study population consisted of 1,690 cohort members who participated in a clinical dental examination at the age of 33-35 years. Calibrated dentists performed clinical examinations including caries experience (ICDAS converted to DMFS-score), periodontal status (pocket depth and bleeding on probing), and erosive tooth wear (Basic Erosive Wear Examination-score). Family dysfunction data were collected objectively from cohort follow-up studies at ages 15-16 and 33-35, and national health care registers, and analyzed as Sample 1 (family dysfunction). Child abuse data were collected at ages 20-26 by a specific self-report questionnaire (Trauma and Distress Scale); data from 244 participants (of the 1,690 cohort members) were available and constituted Sample 2 (child abuse). Bivariate and multivariate tests were conducted to examine the association between ACEs, caries experience, bleeding on probing, periodontal pocket depth, erosive tooth wear, smoking, toothbrushing and frequency of snacks.</p><p><strong>Results: </strong>In Sample 1, participants with one or more family dysfunction factors had more caries experience (DMFS = 19.4) than those with no family dysfunction (DMFS = 16.6) and were more often smokers (26.1% vs. 28.8%). In Sample 2, physical abuse was associated with increased bleeding on probing (43.9% vs. 38.8%), smoking (26.0% vs. 33.3%), insufficient toothbrushing (19.5% vs. 33.3%) and increased frequency of snacks (14.3 vs. 14.7).</p><p><strong>Conclusion: </strong>The results suggest that ACEs are associated with higher levels of dental caries, higher risk for periodontal disease and more harmful oral health behavior in adulthood.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788349","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":"How Artificial Intelligence Reshapes Clinical Decision Thresholds in Cariology: A Qualitative Study of Dentists.","authors":"Nevra Karamüftüoğlu, Şafak Etike, Bilge Ersöz, Cenkhan Bal","doi":"10.1159/000552728","DOIUrl":"10.1159/000552728","url":null,"abstract":"<p><strong>Introduction: </strong>Dental caries management requires iterative clinical reasoning, yet treatment thresholds and intervention pathways vary considerably among dentists despite established evidence-based frameworks. This study aimed to examine how dentists integrate AI-supported diagnostic outputs into clinical reasoning in cariology, and how socio-technical conditions shape this process.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 20 dentists from diverse specialties and practice settings in Türkiye. Interviews were developed and analyzed using the COM-B model and theoretical domain framework to identify capability-, opportunity-, and motivation-related determinants of AI adoption.</p><p><strong>Results: </strong>Reflexive thematic analysis revealed three interrelated patterns: (1) AI as a cognitive partner enhancing diagnostic confidence and preventive orientation; (2) structural and economic barriers limiting equitable access and shaping reliance on algorithmic outputs; and (3) ethical and professional concerns, including trust, liability, and surveillance, influencing the extent to which AI recommendations are accepted or resisted.</p><p><strong>Conclusion: </strong>Rather than directly shifting diagnostic thresholds, AI integration appears to reconfigure the socio-technical conditions under which clinical judgments are formed. Understanding these contextual determinants is essential for responsible and equitable AI implementation in cariology.</p>","PeriodicalId":9620,"journal":{"name":"Caries Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788376","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}