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Objective: Dental caries is one of the most prevalent chronic non-communicable diseases worldwide. There is a lack of evidence, especially in adult populations, documenting caries disease progression considering lesion severity, activity and tooth surface-level characteristics. The study aimed to investigate the extent to which primary active caries lesions in adults affect caries lesions progression compared with inactive caries lesions over a 2-year follow-up period, considering their severity, surface and tooth type., Methods: A prospective study data set from a cohort of workers in a factory in Belarus were used. Participants aged 18-64 years with 20 or more natural teeth were included in the study. The participants were clinically examined twice within an interval of 2 years and completed a self-reported questionnaire. One calibrated examiner evaluated caries lesions using the International Caries Detection and Assessment System (ICDAS) and the Nyvad system. The primary outcome was caries lesions' progression. The lesion was classified as 'progressed' if it turned to a more advanced severity stage, was restored or missing/extracted due to caries. A multilevel Poisson regression was used to estimate the association between baseline caries lesions' characteristics and caries lesion progression., Results: Out of 495 participants, 322 people completed clinical examinations at baseline and 2 years later, with an attrition rate of 35%. The prevalence of active DS1-6 and DS5-6 lesions at the baseline was 83.8% and 64.8%, respectively. In 2 years, 24% of active non-cavitated and 31% of active micro-cavitated/shadowed caries lesions progressed, while 15% of inactive caries lesions, non- or micro-cavitated/shadowed, progressed. The adjusted rate ratio (RR) for ICDAS 3 + 4 caries lesions progression was 1.41 (CI 95% 1.16, 1.70) than ICDAS 1 + 2 lesions. The RR for ICDAS 1 + 2 , active and ICDAS 3 + 4 , active lesions was 1.78 (CI 95%, 1.40, 2.27) and 1.97 (CI 95%, 1.53, 2.55), respectively than ICDAS 1 + 2 , inactive lesions. The RR for caries lesions progression on proximal surfaces and on pits and fissures was 1.57 (CI 95%, 1.30, 1.89) and 1.37 (CI 95%, 1.11, 1.67), respectively than smooth surface lesions., Conclusion: In caries active adults over 2 years, most non- and micro-cavitated/shadowed active and inactive caries lesions did not progress. Among caries lesions that showed progression, more severe lesions were more likely to progress than less severe lesions; active lesions were more likely to progress than inactive lesions. Pit and fissure caries lesions and proximal lesions were more likely to progress than smooth surface lesions., (© 2024 The Author(s). Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Background: Early detection of caries is essential for applying non-surgical treatment procedures and preventing the formation of cavitated lesions leading to unnecessary removal of tooth structure. Understanding dentists' preferences for caries detection tools can inform stakeholders about their strategies and knowledge of contemporary, evidence-based caries management approaches. However, there is a lack of research exploring the detection methods of caries commonly used by dentists in Ontario, Canada. The objective of this study was to investigate the methods of caries detection and diagnosis preferred by dentists in Ontario., Methods: A 21-item self-reported survey was mailed to one thousand Ontario dental practices in the Winter of 2022. Descriptive and bivariate data analysis were performed to determine the associations between: demographics and professional practice characteristics (explanatory variables), and methods for detecting and diagnosing dental caries (outcome variables) using SPSS Statistics 29.0., Results: A total of 325 dentists (33%) responded to the survey, with 274 answering all of the questions completely. The highest proportion of respondents were 35-44 years of age (32.8%) and male (53.4%). More than half of the respondents reported using a dental explorer to assess primary occlusal caries (57.6%), secondary caries (57.1%), and cervical caries (57.5%). Likewise, 57.9% of the participants reported using dental radiographs to diagnose proximal caries. Among additional caries detection tools, digital radiography (89.8%) and traditional radiography (84.7%) were the most used methods/modalities, while cone beam computed tomography was the least (12.8%). Most study participants did not use any caries classification system (77.7%) or caries risk assessment tool (85.3%)., Conclusions: Participants preferred conventional methods for caries detection, instead of contemporary visual-tactile caries lesions classification and/or caries risk assessment systems. These findings indicate a need for continuing dental education programs tailored to evidence-based caries management approaches., (© 2024. The Author(s).)

Purpose/objectives: Evidence-based caries management (EBCM) has developed into an internationally recognized tool for integration of comprehensive non-surgical caries treatment in dental education. However, uptake of the EBCM approach remains uneven across Canadian dental schools. Our project sought to understand how dental instructors perceive the challenges and solutions to the integration of the EBCM approach in undergraduate clinical education., Methods: Using a qualitative descriptive design, we recruited a purposeful sample of clinical instructors supervising undergraduate dental students in caries-related dental care. Semi-structured, online interviews focused on the main characteristics of EBCM. Interviews were analyzed using the awareness, desire, knowledge, ability, and reinforcement (ADKAR) change management model to understand challenges with EBCM implementation in undergraduate education. The analysis process started with verbatim transcription; then, transcripts were coded deductively based on the interview guide and the ADKAR model domains, and inductively to generate emergent codes. Finally, thematic analysis was used to develop themes and subthemes., Results: We interviewed 11 dental instructors with a wide range of clinical experience. Our results show that participants had sufficient awareness regarding the need for the EBCM approach and portrayed a strong desire to participate in bringing curricular changes. Knowledge and ability of participants depended on their training, experience, and involvement in continuing education courses. A lack of standardized caries management practices, less chairside time, and poor remuneration for instructors were major barriers in EBCM clinical implementation. Potential solutions suggested included providing continuing education courses, credits for students for non-surgical caries management, and remunerating instructors for implementation., Conclusions: In conclusion, most participants were aware of the need for a substantive change toward EBCM and demonstrated the desire to participate and improve its implementation. Our analysis showed that to facilitate full integration of the EBCM approach into the undergraduate dental clinics, organizational focus needs to be placed on the individual's knowledge and ability, with tailored efforts toward reinforcement., (© 2023 The Authors. Journal of Dental Education published by Wiley Periodicals LLC on behalf of American Dental Education Association.)

Despite the efforts that have been made in dental education and clinical practice to adopt the evidence-informed, risk-based, nonsurgical caries management approach, the surgical treatment approach continues to prevail. There is an urgent need to understand resistance to such a paradigm shift and establish a coordinated evidence-based Cariology teaching approach in Canadian dental schools so trainees are equipped to implement caries management in their practice. To work towards this goal, a two-day interinstitutional symposium was organized in Montreal, QC, bringing together clinical and research experts in cariology and dental education from all 10 Canadian dental schools to develop a consensus on an evidence-informed Core Cariology Curriculum, and strategies for its implementation. Through consensus, participants produced the Core Cariology Curriculum for Canadian dental schools and articulated the challenges and solutions for its implementation. Future work will include working collaboratively on the curriculum integration and evaluation., (© 2020 American Dental Education Association.)

Background: This scoping review addressed the question 'what do we know about stress-related changes in saliva and dental caries in general population?', Methods: The review was conducted using electronic searches via Embase, MEDLINE, PsycINFO, CINAHL and WoS. All published human studies with both observational and experimental designs were included. Two reviewers independently reviewed eligible articles and extracted the data. The studies' quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool., Results: Our search identified 232 reports, of which six were included in this review. All six studies were conducted in children and used salivary cortisol as stress marker. The studies varied by design, types of stressors, children's caries experience, methods of saliva collection. Four studies reported a positive association between saliva cortisol levels and caries (p < 0.05) while the other two reported no association (p > 0.05). The quality of the included studies was weak to moderate., Conclusions: There is lack of evidence about an association between stress-related changes in saliva and caries. Well-designed longitudinal studies with rigorous measurement technics for stress, saliva and dental caries are necessary. This will help to generate new insights into the multifactorial etiology of caries and provide evidence for a rational method for its control.

The aim of this study was to document cariology education across Canadian dental schools. Ten faculty members who supervise cariology education at each of the ten Canadian dental schools were invited to participate in the study in 2016. An adapted version of the European Organization for Caries Research-Association for Dental Education in Europe cariology curriculum group questionnaire was used. Representatives of all ten dental schools completed the questionnaire, for a 100% response rate. In four schools, cariology and restorative dentistry were taught by the same department. Five schools had didactic/laboratory courses focusing primarily on cariology as well as a specific written curriculum. Six schools provided cariology-related hands-on workshops/laboratories before students started working with patients. In teaching cariology, seven institutions included dental hard tissues defects. The following caries detection methods were addressed didactically in cariology education: visual (10/10 total schools), tactile (9/10), International Caries Detection and Assessment System criteria (6/10), caries activity assessment (9/10), radiographic (10/10), and other detection tools (8/10). Seven schools charted activity of carious lesions in clinic. Only one school used the concept of caries risk assessment regularly in clinic. Clinical cariology teaching was carried out mostly by private dentists hired as clinical instructors (7/10) and faculty members involved in didactic cariology education (9/10). Calibration of faculty members for caries detection criteria was reported by only one school. The main concern reported by all institutions was the difficulty of implementing didactic instruction on cariology into clinical training. This study found that contemporary cariology concepts are in the process of being implemented in didactic education across Canadian dental schools, but all schools lacked appropriate integration of cariology education into clinical training. These findings suggest a need for harmonization of evidence-based cariology education in Canada.

Unlabelled: The aim of this study was to evaluate the reproducibility and differences in diagnostic outcomes by practicing dental clinicians previously inexperienced in using the Nyvad criteria and the ICDAS II criteria with the Lesion Activity Assessment system (ICDAS II + LAA). Four volunteer dentists were randomly allocated to one of two groups. Both groups of dentists examined the same voluntary sample (n = 140) of caries active young adults using Nyvad and ICDAS II + LAA criteria in different sequences. The first group used the Nyvad criteria during period 1, followed by ICDAS II + LAA during period 2; the second group did the examinations in the opposite sequence. Before the period 1 and 2 examinations, dentists from both groups were trained with the Nyvad or ICDAS II + LAA criteria, depending on the group to which they were assigned. Intra-examiner agreement for lesion severity was high for both diagnostic instruments (weighted kappa 0.62-0.80). For lesion activity the intra-examiner unweighted kappa values ranged from 0.31 to 0.61 for ICDAS II + LAA and from 0.36 to 0.51 for Nyvad. The mean number of active non-cavitated caries lesions was significantly higher for ICDAS II + LAA (6.14 ± 5.4) than for Nyvad (3.90 ± 3.9) (p < 0.001). Active cavitated/dentinal caries lesions were significantly higher for ICDAS II + LAA (4.14 ± 4.1) than for Nyvad (2.13 ± 3.1) (p < 0.001). Both the Nyvad and ICDAS II + LAA diagnostic criteria showed high reproducibility for lesion severity assessment. The mean number of active caries lesions among high caries risk subjects was significantly higher using the ICDAS II + LAA criteria, which may subsequently lead to more caries treatment., Trial Registration: ISRCTN65592532.