40 results on '"Crystal YO"'
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2. Perturbation of endoplasmic reticulum proteostasis triggers tissue injury in the thyroid gland
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Xiaohan Zhang, Crystal Young, Xiao-Hui Liao, Samuel Refetoff, Mauricio Torres, Yaron Tomer, Mihaela Stefan-Lifshitz, Hao Zhang, Dennis Larkin, Deyu Fang, Ling Qi, and Peter Arvan
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Cell biology ,Medicine - Abstract
Defects in endoplasmic reticulum (ER) proteostasis have been linked to diseases in multiple organ systems. Here we examined the impact of perturbation of ER proteostasis in mice bearing thyrocyte-specific knockout of either HRD1 (to disable ER-associated protein degradation [ERAD]) or ATG7 (to disable autophagy) in the absence or presence of heterozygous expression of misfolded mutant thyroglobulin (the most highly expressed thyroid gene product, synthesized in the ER). Misfolding-inducing thyroglobulin mutations are common in humans but are said to yield only autosomal-recessive disease — perhaps because misfolded thyroglobulin protein might undergo disposal by ERAD or ER macroautophagy. We find that as single defects, neither ERAD, nor autophagy, nor heterozygous thyroglobulin misfolding altered circulating thyroxine levels, and neither defective ERAD nor defective autophagy caused any gross morphological change in an otherwise WT thyroid gland. However, heterozygous expression of misfolded thyroglobulin itself triggered significant ER stress and individual thyrocyte death while maintaining integrity of the surrounding thyroid epithelium. In this context, deficiency of ERAD (but not autophagy) resulted in patchy whole-follicle death with follicular collapse and degeneration, accompanied by infiltration of bone marrow–derived macrophages. Perturbation of thyrocyte ER proteostasis is thus a risk factor for both cell death and follicular demise.
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- 2023
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3. Defective Thyroglobulin: Cell Biology of Disease
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Xiaohan Zhang, Crystal Young, Yoshiaki Morishita, Kookjoo Kim, Omer O. Kabil, Oliver B. Clarke, Bruno Di Jeso, and Peter Arvan
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endoplasmic reticulum ,ER stress ,secretory pathway ,hormonogenesis ,cell death ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
The primary functional units of the thyroid gland are follicles of various sizes comprised of a monolayer of epithelial cells (thyrocytes) surrounding an apical extracellular cavity known as the follicle lumen. In the normal thyroid gland, the follicle lumen is filled with secreted protein (referred to as colloid), comprised nearly exclusively of thyroglobulin with a half-life ranging from days to weeks. At the cellular boundary of the follicle lumen, secreted thyroglobulin becomes iodinated, resulting from the coordinated activities of enzymes localized to the thyrocyte apical plasma membrane. Thyroglobulin appearance in evolution is essentially synchronous with the appearance of the follicular architecture of the vertebrate thyroid gland. Thyroglobulin is the most highly expressed thyroid gene and represents the most abundantly expressed thyroid protein. Wildtype thyroglobulin protein is a large and complex glycoprotein that folds in the endoplasmic reticulum, leading to homodimerization and export via the classical secretory pathway to the follicle lumen. However, of the hundreds of human thyroglobulin genetic variants, most exhibit increased susceptibility to misfolding with defective export from the endoplasmic reticulum, triggering hypothyroidism as well as thyroidal endoplasmic reticulum stress. The human disease of hypothyroidism with defective thyroglobulin (either homozygous, or compound heterozygous) can be experimentally modeled in thyrocyte cell culture, or in whole animals, such as mice that are readily amenable to genetic manipulation. From a combination of approaches, it can be demonstrated that in the setting of thyroglobulin misfolding, thyrocytes under chronic continuous ER stress exhibit increased susceptibility to cell death, with interesting cell biological and pathophysiological consequences.
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- 2022
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4. Economic evaluation alongside the Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial (E-PROSPECT): study protocol
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Katie Ross, Dimitra Fleming, John Marshall, Najib Ayas, François Lellouche, Justin Lys, Ryan Zarychanski, Timothy Karachi, Deborah J Cook, Marie-Claude Tremblay, Jeremy Grushka, Dan Deckelbaum, Kosar Khwaja, Tarek Razek, Donald Griesdale, John Muscedere, David Maslove, Roupen Hatzakorzian, Patrick Archambault, Feng Xie, François Lauzier, Heather Smith, David Williamson, Emmanuel Charbonney, John Granton, Alyson Takaoka, Kwadwo Kyeremanteng, Miranda Hunt, Ian Ball, Victoria McCredie, Michaël Chasse, Jennifer LY Tsang, Jordi Mancebo, Peter Dodek, Emilie Belley-Cote, Neala Hoad, Melissa Shears, Mark Soth, Tracy Campbell, Geeta Mehta, Daniel Chen, Shane English, Maureen Meade, John Kim, Jie Meng, Richard Johnston, Jennie Johnstone, Norman Dewhurst, Panagiota Giannakouros, Laura García, John Ma, Dev Jayaraman, Pierre Cardinal, Vincent Issac Lau, John C Marshall, John Basmaji, Deborah Cook, Erick Duan, France Clarke, Mary Copland, Marnie Jakab, Nicole Zytaruk, Christa Connolly, Denise Davis, Catherine Eaton, Tracy Gallinas, Jean Lee-Yoo, Connie Lukinuk, Leia Musielak, Nancy Pavunkovic, Joy Pelayo, Kaitlyn Phillips, Catherine Pracsovics, Julia Raimondo, Vida Stankus, Christine Wallace, Angela Wright, Crystal Young, Katrina Fimiani, Lori Hand, Harjot Jagdey, Lisa Klotz, Alexana Sabev, Nevena Savija, Deanne Cosentino, Diane Lourenco, Julie Misina, Gita Sobhi, Mashari Alghuroba, Alia Khaled, Lauren Locco, Tina Millen, Ryan Vaisler, Maya Biljan, Brittany Marriott, Jan Frieich, Jennifer Hodder, Imrana Khalid, Julie Lee, Yoon Lee, Pragma Roy, Kurtis Salway, Gyan Sandhu, Marlene Santos, Orla Smith, Melissa Wang, Ann Dowbenka, Ann Kosinski, Terri Norrie, Ranjit Parhar, Laura Parsons, Johanna Proceviat, Gitana Ramonas, Mae Yuen, Maria Agda, Victoria Alcuaz, Betty Jean Ashley, Kelsey Brewer, Janice Palmer, Glen Brown, Mara Pavan, Stephen Lapinsky, Laveena Munshi, Maedean Brown, Brittany Giacomino, Alan Kraguljac, Sumesh Shah, Erik Tamberg, Laura Vergeer, Doret Cheng, Gagan Grewal, Anew Han, Holly Leung, Ioanna Mantas, Hilary Roigues, Anew Wyllie, Alexis Turgeon, Danny Barriault, David Bellemare, Anick Boivin, Sarah-Judith Breton, Eve Cloutier, Marjorie Daigle, Charles Delisle-Thibeault, Stéphanie Grenier, Gabrielle Guilbault, Caroline Léger, Catherine Ouellet, Élisabeth Gagne, Julie Gaueau, Claire Grégoire, Véronique Labbé, Ariane Laprise-Rochette, Caroline Ouellet, Mélanie Samson, Marie-David Simoneau, Virginie Turcotte, Tuong-Vi Tran, Lauralyn McIntyre, Joe Pagilarello, Gianni D’Egidio, Mike Hartwick, Jonathon Hooper, Gwynne Jones, Dal Kubelik, Hilary Meggison, Sherissa Microys, Dave Neiliovitz, Guiseppe Pagliarello, Rakesh Patel, Jo Po, Peter Reardon, Erin Rosenberg, Aimee Sarti, Anew Seely, Shelley Acres, Brigette Gomes, Heather Langlois, Liane Leclair, Sydney Miezitis, Kaitlyn Montroy, Rebecca Porteous, Shawna Reddie, Amanda Van Beinum, Allyshia Van Tol, Irene Watpool, Wendy Aikens, Marianne Cox, Anne-Marie Dugal, Susan Fetzer, Kathy Fraser, Jennifer Kuhn, Rob MacLeod, Susanne Richard, Dawn Rose, Sherry Weir, Bill Henderson, Mypinder Sekhon, Denise Foster, Suzie Logie, Judy Yip, Margaret Herridge, s Alberto Goffi, Eyal Golan, Elizabeth Wilcox, Jaimie Archer, Paulina Farias, Brooke Fraser, Cheryl Geen-Smith, Barbara Kosky, Anea Matte, Christina Pugliese, Priscila Robles, Lia Stenyk, Cristian Urrea, Karolina Walczak, Kyung Ae, Jane Ascroft, Fatima Haji, Rajvinder Kaur, Jane Lui, Sophia Mateo, Nga Pham, Tam Pham, Matthew Suen, Jennifer Teng, Gordon Wood, Daniel Ovakim, Fiona Auld, Gayle Camey, Ralph Fleming, Jennifer Good, Mandeep Manhas, Karin Boyd, Jane Dheere, Priscilia Robles, Muhammad Walid, Jill Westlund, Yoan Lamarche, Soazig Leguillan, Karim Serri, Colin Verdant, Yanick Beaulieu, Patrick Bellemare, Philippe Bernard, Marc Giasson, Véronique Brunette, Alexanos Cavayas, Émilie Lévesque, Halina Labikova, Julia Lainer Palacios, Marie-Ève Langlois, Virginie Williams, Thuy Anh Nguyen, Valérie Phaneuf, Frédérick D’Aragon, Charles St-Arnaud, Hector Quiroz, Virginie Bolduc, Elaine Carbonneau, Joannie Marchand, Marie-Hélène Masse, Sylvie Cloutier, Marianne Guay, Line Morin, Jessie Nicolson, Isabelle Paquette, Patricia Roy, France Théberge, Arnold S Kristof, Peter Goldberg, Sheldon Magder, Jason Shahin, Salman Qureshi, Josie Campisi, Vasilica Botan, Anissa Capilnean, Alyssa Corey, Annick Gagné, Jasmine Mian, Kathleen Normandin, Ash Gursahaney, David Hornstein, Robert Salasidis, Patrizia Zanelli, Norine Alam, Tonia Doerksen, Ariane Lessard, Gilbert Matte, Marie-France Robert, Martin Girard, Pierre Aslanian, Sylvain Belisle, François-Martin Carrier, Ané Denault, Jean-Gilles Guimond, Antoine Halwagi, Paul Hébert, Christopher Kolan, Nicholas Robillard, Fatna Benettaib, Dounia Boumahni, Casey Bourdeau Caporuscio, Marie-Ève Cantin, Virginy Côté-Gravel, Ali Ghamraoui, Martine Lebrasseur, Lancelot Legene Courville, Stéphanie Lorio, Maria Trinidad Maid, Nicole Poitras, Romain Rigal, Maya Salame, Valérie Tran, Katie Bacon, Nathalie Boueau, Cecilia Carvajal, Lyne Gauthier, Julie Genon, Karine Jean, Louise Laforest, Antonietta Lembo, Sothun Lim, Jennifer Morrissette, France Pagé, Lucie Pelletier, Marie-Christine Roigue, Jim Kutsiogiannis, Raiyan Chowdhury, Jon Davidow, Curt Johnston, Kim Macala, Sam Marcushamer, Darren Markland, Doug Matheson, Damian Paton-Gay, David Zygun, Nadine Grant, Tayne Hewer, Pat Thompson, Maggie Ge, Janny Hall, Sharon Matenchuk, Osama Loubani, Rick Hall, Robert Green, Diana Gillis, Lisa Julien, Laura Lee Magennis, Tamara Mitterer, Joanna Arsenault, Kim Bruce-Payne, Patti Gallant, Gord Boyd, Christine D’Arsigny, John Over, Jason Erb, Chris Parker, Stephanie Sibley, Tracy Boyd, Ilinca Georgescu, Danielle Muscedere, Cathy Baker, Jennifer Engel, Jennifer Fleming, Lisa Roderick, Shelley Silk, Marcy Spencer, Michelle Tryon, Marcus Blouw, Kendiss Olafson, Bojan Paunovic, Oliver Gutieror, Nicole Marten, Sherri Lynn Wingfield, Marnie Boyle, Halyna Ferens, Debbie Hrabi, Beata Kozak, Chantal MacDonald, Julie Muise, Eileen Campbell, Susie Imerovski, Athena Ovsenek, Rebecca Rondinelli, Teresa Longfield, Amy Moyer, Faith Norris, Janice Sumpton, Karina Teterycz, Brenda Reeve, Karen Bento, Megan Davis, Will Dechert, Krista Gallo, Barbara Longo, Courtney Mullen, Elysia Skrzypek, Laurenne Wierenga, Wesam Abuzaiter, Lynda Amorim, Rosemarie Bauer, Rachel Damota, Thoa Ho, Nicole Macdougall, Mary Thornewell, Lara Pe, Jennifer Visocchi, Auey Bhairo, Halyna Ferenes, Debra Kubin, Dawn-Lee McLaughlin, Maria Valente, Steve Reynolds, Suzette Willems, Tina Sekhon, Sebastien Trop, Alexana Binnie, Ronald Heslegrave, Kim Sharman, Zaynab Panchbhaya, Rakhi Goel, Kim Kozluk, Julianne Labelle, Hina Marsonia, Cecillia Scott, Dave Nagpal, Tracey Bentall, Jessica Sturt-Smith, Michelle Alexander, Tammy Ellis, Mindy Muylaert, Cindy Paczkowski, Wendy Sligl, Sean Bagshaw, Nadia Baig, Lorena McCoshen, Katrina Alexanopoulos, Sherri Bain, Michelle Brandt, Cathy Constable, Kari Douglas, Shaleen Maharaj, Sabrina Travers, Tom Stelfox, Philippe Couillard, Christopher Doig, Ken Parhar, Joshua Booth, Cassidy Codan, Stacy Ruddell, Candice Cameron, Rhonda Edison, Anne Martin, Breanna Mina, Dan Niven, Luc Berthiaume, Jonathan Gaudet, Gina Fleming, Mercedes Carmargo, Beverly Hoekstra, Rita Caporuscio, Rachel Kressner Falvo, Carmelina Maxwell, Karmen Plantic, François Marquis, Han Tin Wang, Francis Toupin, Stephane Ahern, Brian Laufer, Marc Brosseau, Pauline Dul, Johanne Harvey, Lotthida Inthanavong, Danae Tassy, Helen Assayag, Maude Bachand, Marysa Betournay, Karine Daoust, Kristine Goyette, Marceline Quach, Paul Hosek, Bill Plaxton, Catherine Armstrong, Rhonda Barber, William Dechert, Janelle Ellis, Kayla Fisk, Melissa Gabnouri, Emilie Gordon, Rebecca Haegens, Lisa Halford, Brooklynn Hillis, Rebecca Jesso, Jenn McLaren, Elliot McMillan, Mariska Pelkmans, Matthew Rekman, Sylvia Sinkovitis, Monica Truong, Michelle White, Noah Bates, Susan Bryden-Cromwell, Lisa Cha, Colleen Cameron, Aminah Deen, Sheri DiGiovanni, Anders Foss, Esther Lee, Heidi MacGregor, Esther Galbraith, Robyn McArthur, Julie McGregor, Keith Miller, Sharon Morris, Shelley Parker, Candice Smith, Joanna Stoglow, Jennifer Tung, Melissa Vos, Neill Adhikari, Ane Amaral, Ane Carlos, Brian Cuthbertson, Rob Fowler, Damon Scales, Navjot Kaur, Nicole Marinoff, Adic Perez, Jane Wang, Katrina Hatzifilalithis, John Iazzetta, Chrys Kolos, Ingrid Quinton, Paul Lysecki, Joseph Berlingieri, Sameer Shaikh, Steven Skitch, Hala Basheer, Kathy Bruder, Jane Cheng, Kaiser Qureshi, Celeste Thibault, Ying Tung Sia, Mathieu Simon, Pierre-Alexane Bouchard, Patricia Lizotte, Nathalie Chateauvert, Thérèse Grenier, Jean-François Bellemare, Simon Bordeleau, Christine Ouin, Benoît Duhaime, Ann Laberge, Philippe Lachance, Mélanie Constantin, Estel Deblois, Maude Dionne, Lise Lavoie, Isabelle Michel, Alexane Pépin, Sanine Poulin, Sarah Anctil, Amélie Chouinard, Louis-Étienne Marchand, Robin Roy, Roigo Cartin-Ceba, Richard Oeckler, Brenda Anderson, Lavonne Liedl, Laurie Meade, Sueanne Weist, Anna Bartoo, Debbie Bauer, Vince Brickley, Shaun Bridges, Greg Brunn, Jennifer Eickstaedt, Jill Randolph, Sandy Showalter, Melissa Wendling, Robert Taylor, Margaret Cytron, Kim Fowler, Katie Krause, Jackie O’Brien, Marianne Tow, Kaitlin Stassi, Abdulaziz Al-Dawood, Haytham Tlayjeh, Alaaeldien Ghanem, Ahmad Hassanien, Mohamed Hegazy, Ashraf El Sharkawi, Felwa Bin Humaid, Hala Alanizi, Nadyah Alanizy, Njoud Al Bogami, Mohammed Muhaidib, Jawaher Gramish, Randa Alsomali, Nora Devera, and Marjane Villafranca
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Medicine - Abstract
Introduction Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in the intensive care unit (ICU). Probiotics are defined as live microorganisms that may confer health benefits when ingested. Prior randomised trials suggest that probiotics may prevent infections such as VAP and Clostridioides difficile–associated diarrhoea (CDAD). PROSPECT (Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial) is a multicentre, double-blinded, randomised controlled trial comparing the efficacy of the probiotic Lactobacillus rhamnosus GG with usual care versus usual care without probiotics in preventing VAP and other clinically important outcomes in critically ill patients admitted to the ICU.Methods and analysis The objective of E-PROSPECT is to determine the incremental cost-effectiveness of L. rhamnosus GG plus usual care versus usual care without probiotics in critically ill patients. E-PROSPECT will be performed from the public healthcare payer’s perspective over a time horizon from ICU admission to hospital discharge.We will determine probabilities of in-ICU and in-hospital events from all patients alongside PROSPECT. We will retrieve unit costs for each resource use item using jurisdiction-specific public databases, supplemented by individual site unit costs if such databases are unavailable. Direct costs will include medications, personnel costs, radiology/laboratory testing, operative/non-operative procedures and per-day hospital ‘hoteling’ costs not otherwise encompassed. The primary outcome is the incremental cost per VAP prevented between the two treatment groups. Other clinical events such as CDAD, antibiotic-associated diarrhoea and in-hospital mortality will be included as secondary outcomes. We will perform pre-specified subgroup analyses (medical/surgical/trauma; age; frailty status; antibiotic use; prevalent vs no prevalent pneumonia) and probabilistic sensitivity analyses for VAP, then generate confidence intervals using the non-parametric bootstrapping approach.Ethics and dissemination Study approval for E-PROSPECT was granted by the Hamilton Integrated Research Ethics Board of McMaster University on 29 July 2019. Informed consent was obtained from the patient or substitute decision-maker in PROSPECT. The findings of this study will be published in peer-reviewed journals.Trial registration number NCT01782755; Pre-results.
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- 2020
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5. Caries risk assessment, prevention, and management in pediatric dental care.
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Ramos-Gomez F, Crystal YO, Ng MW, Tinanoff N, and Featherstone JD
- Abstract
The recent increase in the prevalence of dental caries among young children has highlighted the need for a new approach to prevent caries in children at a younger age. New disease prevention management models call for children to have their first visit to the dentist at age 1 or when their first tooth erupts. This article addresses early childhood caries risk assessment, prevention, and management strategies in young children using the concept of the 'dental home' and a simple six-step protocol to conduct an effective and comprehensive infant oral care visit. Age-specific anticipatory guidance recommendations-including early parental education, timely intervention, and/or referral-have been included for counseling parents during early childhood dental visits. [ABSTRACT FROM AUTHOR]
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- 2010
6. Effectiveness of buccal administration of dexmedetomidine and ketamine combination in paediatric dental sedation: A randomized controlled clinical trial.
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El-Rouby SH, Crystal YO, Elshafie AM, Wahba NA, and El-Tekeya MM
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Background: Pain and anxiety can be considerable obstacles while treating paediatric dental patients. Moderate sedation is needed to treat uncooperative patients., Aim: This study aimed to compare the effectiveness of buccal administration of dexmedetomidine-ketamine combination versus dexmedetomidine., Design: Fifty-six uncooperative children were randomly assigned into two groups: Group I received buccal dexmedetomidine (2 μg/kg) and ketamine (2 mg/kg) (DEX-KET), whereas Group II received buccal dexmedetomidine (4 μg/kg) (DEX). The effects of drugs were evaluated based on changes in vital signs, onset and duration of sedation, sedation level, analgesia, ease of treatment and procedural adverse effects., Results: There were no significant differences in vital signs or sedation onset between the two groups. DEX-KET group showed shorter recovery time than DEX group (p < .0001). There were no statistically significant differences between both groups regarding sedation level at optimum sedation and during operative procedure (p = .064, p = .069 respectively). The ease of treatment was significantly better in DEX-KET group than in DEX group (p = .048). Procedural side effects and analgesic effects of the sedative drugs were comparable between both groups., Conclusion: The combination of dexmedetomidine and ketamine delivered buccally provided a better method of delivering care to uncooperative children with more rapid recovery than dexmedetomidine., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)
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- 2024
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7. A scoping review of the links between early childhood caries and clean water and sanitation: the Sustainable Development Goal 6.
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Crystal YO, Luo YL, Duangthip D, Tantawi ME, Benzian H, Schroth RJ, Feldens CA, Virtanen JI, Al-Batayneh OB, Diaz ACM, Vukovic A, Pavlic V, Mfolo T, Daryanavard HA, Gaffar BO, Shamala A, and Foláyan MO
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- Humans, Child, Preschool, Water Supply, Sanitation, Dental Caries prevention & control, Dental Caries epidemiology, Sustainable Development
- Abstract
Introduction: The United Nation's Sustainable Development Goal (SDG) 6 calls for universal access to clean water, sanitation and hygiene (WASH), which are crucial elements of health and well-being and fundamental for a life in dignity. Early childhood caries (ECC) is a preventable disease affecting health and quality of life of millions of young children worldwide. This scoping review aims to explore the connection between ECC and access to clean water and sanitation., Methods: This scoping review, registered on the Open Science Framework and following PRISMA-ScR guidelines, conducted a thorough search in databases (PubMed, Web of Science, Embase, Google Scholar, SciELO) and websites (via Google) in November 2023. The search, without date limitations, targeted studies in English and Spanish linking ECC to SDG6. Exclusions were made for studies solely focusing on ECC without a direct connection to clean water and sanitation. Descriptive statistics summarized the retrieved papers., Results: The initial search yielded 303 articles. After removing duplicates, 264 articles remained for title and abstract screening after which 244 were excluded and one report was added through citation searching. The 21 remaining articles underwent full text review. There were no studies on a direct association between access to clean water and sanitation and the prevalence of ECC. There were nine studies that showed indirect associations between ECC and access to clean water and sanitation through the links of: water and sanitation access as a marker for poverty (n = 1), water consumption as a feeding practice (n = 4), and the effectiveness of water fluoridation (n = 4). These were used to develop a conceptual model., Conclusions: While it is conceivable that a direct link exists between ECC and access to clean water and sanitation, the available body of research only offers evidence of indirect associations. The exploration of potential pathways connecting water access to ECC warrants further investigation in future research., (© 2024. The Author(s).)
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- 2024
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8. Recommendations on Topical Fluoride Usage for Caries Management in East Asia.
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Zheng FM, Adiatman M, Chu CH, Crystal YO, Featherstone JD, Hoang TH, Kim BI, Ogawa H, Pitiphat W, Kadir RA, Wong ML, and Zheng S
- Abstract
Dental caries is a widespread oral health issue in Asia, affecting an estimated 30% to 90% of children and adults. Many caries cases remain untreated, resulting in pain and infection. In response, the Asian Academy of Preventive Dentistry (AAPD) emphasises comprehensive caries management and organised a fluoride workshop at the 15th International Conference of the AAPD in 2023. The AAPD invited a group of experts to form a fluoride working group to review existing literature and develop fluoride recommendations for stakeholders across Asian countries and regions. The working group assessed caries risk and identified commonly used topical fluoride products for home care, professional, and community settings in Asia. The working group concluded that fluoride is a safe and highly effective strategy to reduce caries prevalence and incidence. The working group provided key recommendations based on successful regional caries management practices: (1) use topical fluoride for prevention and control of dental caries; (2) encourage the use of fluoride toothpaste with a concentration of at least 1,000 ppm for effective caries reduction; (3) advise a 0.05% fluoride mouth rinse as soon as children can spit it out to prevent early childhood caries; (4) deliver professionally administered fluoride, such as 5% sodium fluoride varnish, 2% fluoride gel, or 1.23% acidulated phosphate fluoride preparations, to decrease dental caries in at-risk individuals; and (5) apply 38% silver diamine fluoride to arrest cavitated caries. These recommendations aim to help practitioners, health care providers, and parents/caregivers make informed decisions about fluoride use as part of comprehensive oral health care in the region., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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9. Parental perceptions and acceptance of silver diamine fluoride staining in Italy.
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Cappiello MC, Lardani L, Fitzgibbon R, Gatto MR, Crystal YO, Guinot Jimeno F, Piana G, and Bagattoni S
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Background: Parental perceptions of staining due to silver diamine fluoride (SDF) could affect its utilization in paediatric dentistry. This study represents the second part of a wider project focused on SDF esthetic acceptability among Italian parents., Aim: To evaluate parental acceptance of SDF staining in Italy and to assess whether the parent's level of acceptance depends on location, child's behavior, or demographic background., Design: A cross-sectional study was conducted among Italian parents of children attending two university dental clinics. We used a validated Italian version of the questionnaire "Parental Perceptions of Silver Diamine Fluoride Dental Color Changes.", Results: Two hundred and thirty-four parents took part in the survey. Of parents, 65.4% considered the staining on posterior teeth esthetically "acceptable" or "somewhat acceptable," and 19.3% on anterior teeth (p = .001). In a scenario of positive cooperation, 48.5% of parents were "somewhat likely" or "very likely" to choose SDF to treat posterior teeth, and 17.6% on anterior teeth (p = .001). Level of acceptance increased as the difficulty the child would experience to receive conventional treatment increased., Conclusion: Staining on posterior teeth is more acceptable to parents than staining on anterior teeth. Level of acceptance on anterior teeth increases when sedation or general anesthesia is the alternative for the child., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)
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- 2024
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10. Use of Vital Pulp Therapies in Primary Teeth 2024.
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Coll JA, Dhar V, Chen CY, Crystal YO, Guelmann M, Marghalani AA, AlShamali S, Xu Z, Glickman GN, and Wedeward R
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- Humans, Dental Pulp, Calcium, Dental Cements, Glass Ionomer Cements, Tooth, Deciduous, Dental Care, Pulpotomy, Calcium Compounds, Silicates
- Abstract
Purpose: The purpose of this study was to present an evidence-based guideline for primary teeth with deep caries or trauma requiring vital pulp therapies (VPT). Methods: A systematic review/meta-analysis on vital primary teeth resulting from trauma or caries was conducted using GRADE to assess the certainty of evidence for clinical recommendations. A decision tree was provided for choosing VPTs. Results: No articles on trauma VPT were found. For VPT in primary teeth with deep caries, indirect pulp treatment (IPT) or pulpotomy using the calcium silicate cement (mineral trioxide aggregate [MTA] or Biodentine
® ) show increased success over using direct pulp capping (DPC) and other pulpotomies. Different liners do not affect IPT success (high certainty) or DPC capping agents' success (very low certainty) after 24 months. It is strongly recommended, with high certainty from 24-month data, that calcium silicate cement pulpotomy is preferred over formocresol, ferric sulfate, zinc oxide eugenol pulpotomy, and other pulpotomies. Using selective caries removal and IPT for deep caries is strongly recommended with moderate certainty over complete and stepwise removal. Statistically, this results in significantly fewer pulp exposures. No caries removal and Hall technique crown may be used when indicated (moderate certainty at 24 months). For vital primary incisors with deep caries, pulpotomy was significantly better statistically than pulpectomy. Teeth diagnosed with/without reversible pulpitis pain showed comparable success after 12 months of treatment by IPT or calcium silicate cement pulpotomy. The following had little or no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; anterior or posterior teeth. Conclusions: Indirect pulp treatment or calcium silicate cement pulpotomy is likely to increase vital pulp therapy success over other VPTs such as direct pulp capping and other pulpotomies after 24 months (moderate certainty).- Published
- 2024
11. Primary Tooth Vital Pulp Treatment Interventions: Systematic Review and Meta-Analyses.
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Coll JA, Dhar V, Chen CY, Crystal YO, Guelmann M, Marghalani AA, AlShamali S, Xu Z, Glickman G, and Wedeward R
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- Humans, Dental Care, Dental Cements, Zinc Oxide-Eugenol Cement, Dental Pulp Capping, Pulpotomy methods, Glass Ionomer Cements, Tooth, Deciduous, Oxides therapeutic use, Drug Combinations, Treatment Outcome, Aluminum Compounds therapeutic use, Calcium Compounds therapeutic use, Silicates therapeutic use
- Abstract
Purpose: to update the 2016 systematic review evidence for vital pulp therapy (VPT) for primary teeth affected by caries or trauma. Methods: The population, intervention, comparison, outcomes, and study (PICOS) design inclusion/exclusion was used for multiple databases. Risk of bias, meta-analyses using RevMan, and certainty of evidence was created. Results: A total of 299 studies were included; no trauma was found. Indirect pulp treatment (IPT) resulted in 97 percent success. Two calcium silicate cement (CSC) pulpotomies' success using mineral trioxide aggregate (MTA) and Biodentine
® were 94 percent and 90 percent, respectively, greater than for direct pulp capping (DPC; 86 percent) and other pulpotomies (moderate certainty). The success of IPT versus pulpotomy at 24 months showed no significant difference (P=0.31). Different liners or capping agents did not affect the success of IPT (P=0.79) or DPC at 24 months (P=0.24). The two CSC pulpotomies were not significantly different based on 24-month success (P=0.34). The formocresol pulpotomy success at 24 months was significantly lower than for MTA (P=0.02). Ferric sulfate had a significant lower success at 24 months than MTA pulpotomy (69 percent versus 92 percent; P=0.03). Zinc oxide eugenol, as a singular pulpotomy, had low success (65 percent). Selective/stepwise caries removal did significantly better at avoiding pulp exposures than complete excavation (P<0.001). Complete, selective, and no caries removal (Hall technique [HT], steel crown placement with no caries removal) had no significant difference in pulp vitality success for deep caries at 24 months (P=0.29). For deep caries affecting vital incisors, pulpotomy had significantly greater success than pulpectomy (P=0.002). The following had no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; and anterior or posterior teeth. Conclusions: Vital pulp therapy success of indirect pulp treatment or two calcium silicate cement pulpotomies demonstrated improved success over direct pulp capping and other pulpotomies based on 24-month evidence with moderate certainty. The Hall technique did not significantly reduce pulp vitality success versus caries removal.- Published
- 2023
12. Effects of LED curing light on silver diamine fluoride penetration into dentin.
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Crystal YO, Rabieh S, Janal MN, Cerezal G, Hu B, and Bromage TG
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- Humans, Fluorides, Topical, Silver Compounds, Water pharmacology, Dentin, Dental Caries drug therapy
- Abstract
This ex-vivo study investigated the effect of a light-emitting diode (LED) curing light on the depth of penetration of Silver Diamine Fluoride (SDF) into carious lesions. Twenty-four primary teeth with untreated caries lesions were allocated into groups and treated within 5 min after extraction: (1) n = 6 treated for 1 min with one drop of SDF followed by 10 sec rinse with tap water, (2) n = 6 treated for 10 sec with one drop of SDF and exposed to LED light for 20 sec (30 sec total SDF exposure) followed by 10 sec rinse with tap water, (3) n = 6 treated for 10 sec with one drop of SDF followed by a 10 sec rinse with tap water, (4) n = 3 untreated, and (5) n = 3 untreated but exposed to LED light for 20 sec. Samples were prepared, embedded, sectioned and silver penetration was measured using backscattered electron imaging in the scanning electron microscope and energy-dispersive X-ray spectroscopy analysis. Results were expressed as the average relative depth of penetration (%) = Ag depth/lesion depth × 100 from 5 sites in each lesion. Group means were compared using mixed model analysis. Mean ± standard deviation (SD) penetration was: 86.4 ± 20.7% in Group 1, 94.3 ± 13.7% in Group 2, and 26.7 ± 13.9% in Group 3. Groups 1 and 2 were statistically similar and different from Group 3 ( p < 0.001). Groups 4 and 5 had no silver present. Use of LED light for 20 sec after 10 sec SDF application appears to facilitate silver penetration, similar to a 1 min SDF application. Clinical studies are needed to define the role of silver penetration in sustained caries arrest., Competing Interests: The authors declare no conflict of interest., (©2023 The Author(s). Published by MRE Press.)
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- 2023
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13. A scoping review on the association of early childhood caries and maternal gender inequality.
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Sun IG, Duangthip D, Kwok CH, Chu CH, Crystal YO, Schroth RJ, Feldens CA, Virtanen JI, Al-Batayneh OB, Gaffar B, Mfolo T, El Tantawi M, Mohebbi SZ, Daryanavard H, and Folayan MO
- Subjects
- Child, Preschool, Humans, Gender Equity, Family, Databases, Factual, Dental Caries Susceptibility, Dental Caries epidemiology, Dental Caries etiology, Dental Caries prevention & control
- Abstract
Aim: The objective of this scoping review is to present current evidence regarding the association between early childhood caries (ECC) and maternal-related gender inequality., Methods: Two independent reviewers performed a comprehensive literature search using three databases: EMBASE, PubMed, and Web of Science. Literature published in English from 2012 to 2022 was included in the search and was restricted to only primary research by using the following key terms: "dental caries", "tooth decay", "gender", "sex", "preschool", "toddler," and "infant". The included studies were limited to those reporting an association between ECC and maternal aspects related to gender inequality. Titles and abstracts were screened, and irrelevant publications were excluded. The full text of the remaining papers was retrieved and used to perform the review. The critical appraisal of selected studies was guided by the Joanna Briggs Institute (JBI) Critical Appraisal Tools., Results: Among 1,103 studies from the three databases, 425 articles were identified based on publication years between 2012 and 2022. After full-text screening, five articles were included in the qualitative analysis for this review. No published study was found regarding a direct association between ECC and maternal gender inequality at the level of individuals. Five included studies reported on the association between ECC and potential maternal-gender-related inequality factors, including the mother's education level (n = 4), employment status (n = 1), and age (n = 1). Regarding the quality of the included studies, out of five, two studies met all JBI criteria, while three partially met the criteria., Conclusions: Based on the findings of this scoping review, evidence demonstrating an association between gender inequality and ECC is currently limited., (© 2023. The Author(s).)
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- 2023
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14. Editorial: Frontiers in oral health: Highlights in preventive dentistry 2021/2.
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Crystal YO, Campus G, and Cunha-Cruz J
- Abstract
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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- 2023
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15. Clinical need and scientific evidence base for a precise early childhood caries classification.
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Crystal YO, Keels MA, Silva MJ, and Divaris K
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- Child, Preschool, Humans, Risk Factors, Dental Caries, Dental Caries Susceptibility
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- 2022
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16. Editorial: Oral Health and Policy for Patients With Special Health Care Needs.
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Duangthip D, Crystal YO, and Chu CH
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Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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- 2021
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17. In vitro rehardening and staining effects of silver diamine fluoride with and without mucin on early enamel caries lesions.
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Sorkhdini P, Crystal YO, Tang Q, and Lippert F
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- Cariostatic Agents, Dental Caries Susceptibility, Fluorides, Topical, Humans, Quaternary Ammonium Compounds, Silver Compounds, Sodium Fluoride, Staining and Labeling, Dental Caries drug therapy, Dental Caries prevention & control, Mucins
- Abstract
Purpose: To evaluate the rehardening ability of SDF and its individual components, silver, and fluoride ions, on early enamel caries lesions using artificial saliva with and without mucin., Methods: Early caries lesions were created in human permanent enamel specimens. The specimens (n=36 per group) were then treated with a single application of: SDF (38%), SDF followed by application of potassium iodide (SDF+KI), potassium fluoride (KF); fluoride control, 44,800 ppm (F), silver nitrate (AgNO3); silver control, 253,900 ppm (Ag), or deionized water (DIW). Immediately, the specimens were subjected to 4 days of continuous remineralization with or without mucin (n=18 per subgroup). Changes in Vickers surface microhardness from lesion baseline (ΔVHN) were calculated. Data were analyzed using two-way (intervention vs. rehardening models) ANOVA., Results: In both rehardening models (with or without mucin), SDF (ΔVHN data; mean ± standard deviation; with/without mucin: 26± 19/3± 11) was significantly less effective in rehardening promotion than SDF+KI (37± 12/39± 16) and KF (40± 17/41± 29; P≤ 0.0332). Compared to AgNO3 (9± 9/18± 15) and DIW (3± 7/12± 9), SDF was more effective in the presence of mucin (P≤ 0.001) but not in its absence, similar to DIW (P= 0.1117); less effective vs. AgNO3 (P= 0.0061). The presence of mucin significantly increased the rehardening ability of SDF (P< 0.0001). However, mucin did not affect the extent of rehardening in the other groups (P≥ 0.082). SDF+KI and KF were superior in their ability in rehardening promotion than AgNO3 and DIW in both rehardening models (P< 0.0001). In both rehardening models, ΔL* values from baseline to post-rehardening show that applying KI after SDF significantly lessened the dark staining caused by SDF (P< 0.0001). Under the present in vitro conditions, SDF does not appear to enhance surface rehardening of early enamel caries lesions. The co-presence of mucin during rehardening enhanced the efficacy of SDF which warrants further investigation., Clinical Significance: Silver diamine fluoride + potassium iodide may be a viable option in rehardening of early enamel caries lesions., Competing Interests: The authors declared no potential conflicts of interest. This work was supported by the Indiana University School of Dentistry Department of Cariology, Operative Dentistry and Dental Public Health and by the Oral Health Research Institute Remineralization Research Program. The authors are indebted to Elevate Oral Care LLC, Florida, USA for providing SDF (Advantage Arrest) free of charge., (Copyright©American Journal of Dentistry.)
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- 2021
18. Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control.
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Gao SS, Amarquaye G, Arrow P, Bansal K, Bedi R, Campus G, Chen KJ, Chibinski ACR, Chinzorig T, Crystal YO, Duangthip D, Ferri ML, Folayan MO, Garidkhuu A, Hamama HH, Jirarattanasopha V, Kemoli A, Leal SC, Leelataweewud P, Mathur VP, Mfolo T, Momoi Y, Potgieter N, Tezvergil-Mutluay A, Lo ECM, and Chu CH
- Abstract
Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Gao, Amarquaye, Arrow, Bansal, Bedi, Campus, Chen, Chibinski, Chinzorig, Crystal, Duangthip, Ferri, Folayan, Garidkhuu, Hamama, Jirarattanasopha, Kemoli, Leal, Leelataweewud, Mathur, Mfolo, Momoi, Potgieter, Tezvergil-Mutluay, Lo and Chu.)
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- 2021
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19. Predicting Treatment Nonresponse in Hispanic/Latino Children Receiving Silver Diamine Fluoride for Caries Arrest: A Pilot Study Using Machine Learning.
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Ruff RR, Paul B, Sierra MA, Xu F, Li X, Crystal YO, and Saxena D
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Objectives: Silver diamine fluoride (SDF) is a nonsurgical therapy for the arrest and prevention of dental caries with demonstrated clinical efficacy. Approximately 20% of children receiving SDF fail to respond to treatment. The objective of this study was to develop a predictive model of treatment non-response using machine learning. Methods: An observational pilot study ( N = 20) consisting of children with and without active decay and who did and did not respond to silver diamine fluoride provided salivary samples and plaque from infected and contralateral sites. 16S rRNA genes from samples were amplified and sequenced on an Illumina Miseq and analyzed using QIIME. The association between operational taxonomic units and treatment non-response was assessed using lasso regression and artificial neural networks. Results: Bivariate group comparisons of bacterial abundance indicate a number of genera were significantly different between non-responders and those who responded to SDF therapy. No differences were found between non-responders and caries-active subjects. Prevotella pallens and Veillonella denticariosi were retained in full lasso models and combined with clinical variables in a six-input multilayer perceptron. Discussion: The acidogenic and acid-tolerant nature of retained bacterial species may overcome the antimicrobial effects of SDF. Further research to validate the model in larger external samples is needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Ruff, Paul, Sierra, Xu, Li, Crystal and Saxena.)
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- 2021
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20. Oral Health Policies to Tackle the Burden of Early Childhood Caries: A Review of 14 Countries/Regions.
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Chen J, Duangthip D, Gao SS, Huang F, Anthonappa R, Oliveira BH, Turton B, Durward C, El Tantawi M, Attia D, Heima M, Muthu MS, Maharani DA, Folayan MO, Phantumvanit P, Sitthisettapong T, Innes N, Crystal YO, Ramos-Gomez F, Medina AC, Lo ECM, and Chu CH
- Abstract
Aim: Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions. Method: Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country. Results: The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to population ratio was reported by Nigeria at 1:48,400, whereas the highest ratio was in Brazil (1:600). Out of 14, three (21%) countries namely India, Venezuela and Cambodia had no national oral health policies addressing ECC and four (29%) countries (Cambodia, China, India, Venezuela) had no publicly funded dental care program for 0-5-year-old children. Water fluoridation is available in four countries/regions (Australia, Brazil, Hong Kong, USA). Conclusion: ECC remains a global health challenge and dental workforce is limited. National/regional programs to tackle ECC are not yet prioritized in many countries/regions. Evidence to support demonstration projects is limited. Further research on the cost-effectiveness of interventions strategies is required for policymakers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Chen, Duangthip, Gao, Huang, Anthonappa, Oliveira, Turton, Durward, El Tantawi, Attia, Heima, Muthu, Maharani, Folayan, Phantumvanit, Sitthisettapong, Innes, Crystal, Ramos-Gomez, Medina, Lo and Chu.)
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- 2021
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21. A Comparison of Four Caries Risk Assessment Methods.
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Featherstone JDB, Crystal YO, Alston P, Chaffee BW, Doméjean S, Rechmann P, Zhan L, and Ramos-Gomez F
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Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions. Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0-6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups. Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2003, 2007, 2010, 2011, 2019, 2020, 2021 The Regents of The University of California.)
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- 2021
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22. Evidence-Based Caries Management for All Ages-Practical Guidelines.
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Featherstone JDB, Crystal YO, Alston P, Chaffee BW, Doméjean S, Rechmann P, Zhan L, and Ramos-Gomez F
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Introduction: The purpose of the present paper is to provide step-by-step guidelines for dental healthcare providers to manage dental caries based upon caries risk assessment (CRA) for ages 0-6 years and 6 years through adult. The manuscript reviews and updates the CAMBRA (caries management by risk assessment) system which includes CRA and caries management recommendations that are guided by the assessed risk level. Caries Risk Assessment: CAMBRA CRA tools (CRAs) have been evaluated in several clinical outcomes studies and clinical trials. Updated CAMBRA CRAs for ages 0-6 years and 6 years through adult are provided. These CRAs have been refined by the addition of a quantitative method that will aid the health care provider in determining the caries risk of individuals. Caries Management Based Upon Risk Assessment: Guidelines for individualized patient care are provided based upon the caries risk status, results of clinical exams and responses of the patient to questions in the CRA. These guidelines are based upon successful outcomes documented in several clinical outcomes studies and clinical trials. The paper includes a review of successful caries management procedures for children and adults as previously published, with additional emphasis on correct use of silver diamine fluoride (SDF) for children. The caries management plan for each individual is based upon reducing the caries risk factors and enhancing the protective factors with the additional aid of behavior modification. Beneficially altering the caries balance is coupled with minimal intervention restorative dentistry, if appropriate. These methods are appropriate for the management of dental caries in all patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2003, 2007, 2010, 2011, 2019, 2020, 2021 The Regents of The University of California.)
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- 2021
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23. Microbial population shift and metabolic characterization of silver diamine fluoride treatment failure on dental caries.
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Paul B, Sierra MA, Xu F, Crystal YO, Li X, Saxena D, and Ruff RR
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- Carnobacteriaceae genetics, Carnobacteriaceae isolation & purification, Child, Cross-Sectional Studies, DNA, Bacterial chemistry, DNA, Bacterial metabolism, Dental Caries pathology, Dental Plaque microbiology, Discriminant Analysis, Fluorides, Topical therapeutic use, Humans, Leptotrichia genetics, Leptotrichia isolation & purification, Pilot Projects, Principal Component Analysis, Saliva microbiology, Sequence Analysis, DNA, Treatment Failure, Dental Caries drug therapy, Microbiota, Quaternary Ammonium Compounds therapeutic use, Silver Compounds therapeutic use
- Abstract
The objective of this pilot study was to describe the microbial profiles present in the plaque and saliva of children who continued to develop new carious lesions following treatment with silver diamine fluoride ("nonresponders") compared to caries active, caries-free, and children immediately receiving SDF treatment for untreated caries in order to identify potential microbial differences that may relate to a re-incidence of caries. Saliva and plaque samples from infected and contralateral sites were obtained from twenty children who were either caries free, had active carious lesions, were caries active and received SDF treatment immediately before sampling, or had previously received SDF treatment and developed new caries. In total, 8,057,899 Illumina-generated sequence reads from 60 samples were obtained. Reads were processed using the Quantitative Insights Into Microbial Ecology pipeline. Group differences were assessed using Analysis of Variance Models and Tukey Honest Significant Differences. To identify significant taxa between treatment groups, Linear discriminant analysis Effect Size (LefSe) and Analysis of Differential Abundance Taking Sample Variation Into Account were used. Differential abundant analysis indicated that members of the Lachnospiraceae family were significantly enriched in non-responders and the genus Tannerella and species Granulicatella adiances were also highly abundant in this group. LefSe analysis between non-responders and SDF-treated groups revealed that genera Leptotrichia and Granulicatella were enriched in non-responders. We observed the highest abundance of phosphotransferase system and lowest abundance of lipopolysaccharide synthesis in non-responders. The microbiome in dental biofilms is responsible for initiation and progression of dental caries. SDF has been shown to be effective in arresting the progression carious lesions, in part due to its antimicrobial properties. Findings suggest that the differential abundance of select microbiota and specific pathway functioning in individuals that present with recurrent decay after SDF treatment may contribute to a potential failure of silver diamine fluoride to arrest dental caries. However, the short duration of sample collection following SDF application and the small sample size emphasize the need for further data and additional analysis., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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24. The effect of silver diamine fluoride in preventing in vitro primary coronal caries under pH-cycling conditions.
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Sorkhdini P, Crystal YO, Tang Q, and Lippert F
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- Humans, Hydrogen-Ion Concentration, In Vitro Techniques, Sodium Fluoride pharmacology, Cariostatic Agents pharmacology, Dental Caries prevention & control, Fluorides, Topical pharmacology, Quaternary Ammonium Compounds pharmacology, Silver Compounds pharmacology
- Abstract
Objectives: This study investigated the ability of SDF, and its individual components, silver (Ag
+ ) and fluoride (F- ) ions, in preventing enamel demineralization under pH-cycling conditions in the presence or absence of twice-daily fluoride application., Design: Polished human enamel specimens were assigned to five treatment groups (n = 36 per group): SDF (38 %); SDF followed by application of a saturated solution of potassium iodide (SDF + KI); silver nitrate (AgNO3 ; silver control, 253,900 ppm Ag); potassium fluoride (KF; fluoride control, 44,800 ppm F); deionized water. Treatments were applied once. Specimens in each treatment group were divided into two subgroups (n = 18). During the subsequent 7-day pH-cycling phase, specimens were treated twice daily with either 275 ppm fluoride as sodium fluoride or deionized water, immediately before and after a 3-h cariogenic challenge with exposure to artificial saliva at all other times. Changes in color, Vickers surface microhardness (SMH), transverse microradiography (TMR) was calculated. Data were analyzed using two-way ANOVA., Results: In both models, SDF, SDF + KI and KF were superior in inhibiting demineralization compared to AgNO3 and deionized water (p < 0.0001). There was no statistically significant difference between SDF, SDF + KI and KF with twice daily fluoride treatments (p > 0.8). However, KF was more effective in preventing demineralization than SDF and SDF + KI in the absence of fluoride treatments (p = 0.0002). KI did not affect the ability of SDF to prevent demineralization (p > 0.4)., Conclusion: SDF and SDF + KI appears to be an effective option in preventing primary coronal caries., (Copyright © 2020 Elsevier Ltd. All rights reserved.)- Published
- 2021
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25. Teaching and utilization of silver diamine fluoride and Hall-style crowns in US pediatric dentistry residency programs.
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Crystal YO, Janal MN, Yim S, and Nelson T
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- Cariostatic Agents therapeutic use, Child, Crowns, Fluorides, Topical therapeutic use, Humans, Pediatric Dentistry, Quaternary Ammonium Compounds, Silver Compounds, Dental Caries prevention & control, Internship and Residency
- Abstract
Background: Nonsurgical caries management, particularly silver diamine fluoride (SDF) and Hall-style crowns, present alternative options for populations that have barriers to traditional treatment. The authors aimed to assess changes in the teaching and utilization of these modalities in pediatric dental residency programs., Methods: The authors e-mailed a 29-question electronic survey regarding the utilization and teaching of nonsurgical caries management agents to US pediatric dentistry residency program directors. Data were compared with results from a similar survey conducted in 2015 to analyze trends, report protocols, barriers for utilization, and possible reasons for changes., Results: Respondents from 82 programs completed the surveys (89% response rate). Although only 26% of respondents reported using SDF in 2015, 100% reported its utilization in 2020 (P < .001). The Hall-style crown technique is taught didactically in 90% of programs, and 69.5% of respondents use it at least sporadically in their clinics. Long wait times for the operating room (4 weeks-14 months) and sedation (1 week-12 months) motivate increased utilization of SDF, interim therapeutic restorations, and Hall-style crowns. Guidelines supporting off-label utilization of SDF have also resulted in its increased utilization., Conclusions: US pediatric residency programs have universally adopted SDF for caries arrest in the primary dentition, and this trend seems to extend to other nonsurgical caries management agents. These changes are likely driven by diverse barriers to delivery of traditional restorative care., Practical Implications: The rapid increases in teaching and utilization of minimal intervention techniques provide clinicians with more options for caries management in patients with barriers to traditional treatment., (Copyright © 2020 American Dental Association. Published by Elsevier Inc. All rights reserved.)
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- 2020
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26. Use of Non-Vital Pulp Therapies in Primary Teeth.
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Coll JA, Dhar V, Vargas K, Chen CY, Crystal YO, AlShamali S, and Marghalani AA
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- Child, Humans, Pulpectomy, Zinc Oxide-Eugenol Cement therapeutic use, Root Resorption therapy, Tooth, Deciduous
- Abstract
Purpose: To present an evidence-based guideline for non-vital pulp therapies due to deep caries or trauma in primary teeth. Methods: The authors, working with the American Academy of Pediatric Dentistry, conducted a systematic review/meta-analysis for studies on non-vital primary teeth resulting from trauma or caries and used the GRADE approach to assess level of certainty of evidence for clinical recommendations. Results: GRADE was assessed from high to very low. Comparing teeth with/without root resorption, pulpectomy success was better (P<0.001) in those without preoperative root resorption. Zinc oxide plus iodoform plus calcium hydroxide ([ZO/iodoform/CH]; Endoflas TM ) and zinc oxide and eugenol (ZOE) pulpectomy success did not differ from iodoform (iodoform plus calcium hydroxide; Vitapex
TM , MetapexTM ) (P=0.55) after 18-months; however, ZO/iodoform/CH and ZOE success rates remained near 90 percent while iodoform was 71 percent or less. Network analysis ratings showed ZO/iodoform/CH and ZOE better than iodoform. Lesion sterilization tissue repair (LSTR) was better (P<0.001) than pulpectomy in teeth with preoperative root resorption, but pulpectomy results were better (P=0.09) if roots were intact. Rotary instrumentation of root canals was significantly faster (P<0.001) than manual, but the quality of fill did not differ (P=0.09) and both had comparable success. Network analysis ranked ZO/iodoform/CH the best, ZOE second, and iodoform lowest at 18 months. Success rates were not impacted by method of obturation or root length determination, type of tooth, number of visits, irrigants, smear layer removal, or timing/type of final restoration. Conclusions: Pulpectomy 18-month success rates supported ZO/iodoform/CH and ZOE pulpectomy over iodoform. LSTR had limited indication for teeth with resorbed roots and requires close monitoring.- Published
- 2020
27. Effectiveness of in vitro primary coronal caries prevention with silver diamine fluoride - Chemical vs biofilm models.
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Sorkhdini P, Gregory RL, Crystal YO, Tang Q, and Lippert F
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- Biofilms, Cariostatic Agents, Fluorides, Topical, Humans, Quaternary Ammonium Compounds pharmacology, Silver Compounds, Dental Caries prevention & control, Tooth Demineralization prevention & control
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Objectives: The main goal of this study was to investigate the effectiveness of SDF and its individual components, silver (Ag
+ ) and fluoride (F- ) ions, in preventing enamel demineralization using biofilm and chemical models., Methodes: Polished human enamel specimens were assigned to five treatment groups (n = 18 per group): SDF (38 %); SDF followed by application of a saturated solution of potassium iodide (SDF + KI); silver nitrate (AgNO3 ; silver control, 253,900 ppm Ag+ ); potassium fluoride (KF; fluoride control, 44,800 ppm F); deionized water (DIW). Treatments were applied once to sound enamel. In the biofilm model, specimens were demineralized by aerobic overnight incubation using cariogenic bacteria isolated from human saliva in brain heart infusion supplemented with 0.2 % sucrose for three days. In the chemical model, enamel specimens were immersed in a demineralizing solution containing 0.1 M lactic acid, 4.1 mM CaCl2 , 8.0 mM KH2 PO4 , 0.2 % Carbopol 907, pH adjusted to 5.0 for five days. Vickers surface microhardness was used to determine the extent of enamel demineralization. Data were analyzed using one-way ANOVA., Results: In the chemical model, there was no statistically significant difference between SDF and SDF + KI in preventing coronal caries (p < 0.0001). In the biofilm model, SDF + KI was significantly less effective in preventing demineralization than SDF (p < 0.0001). In both models, SDF and SDF + KI were superior in their ability to prevent caries lesion formation than AgNO3 and DIW., Conclusion: KI application after SDF treatment appears to impair SDF's ability to prevent biofilm-mediated but not chemically induced demineralization., Clinical Significance: SDF may be a viable option in preventing primary coronal caries., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)- Published
- 2020
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28. A Systematic Review and Meta-Analysis of Nonvital Pulp Therapy for Primary Teeth.
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Coll JA, Vargas K, Marghalani AA, Chen CY, AlShamali S, Dhar V, and Crystal YO
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- Calcium Hydroxide, Humans, Pulpectomy, Tooth, Deciduous, Zinc Oxide-Eugenol Cement, Dental Caries, Root Canal Filling Materials, Root Resorption
- Abstract
Purpose: The purpose of this systematic review and meta-analysis was to assess success rates for nonvital treatment in primary teeth for caries/trauma. Methods: Databases were searched between 1960 and 2020 for randomized controlled trials, cohorts, case series, and in vitro studies. The primary outcome was overall success (clinical and radiographic) for pulpectomy and lesion sterilization tissue repair (LSTR). Included articles were independently determined, agreed upon, data extraction assessed, risk of bias, meta-analyses, and assignment of quality of evidence (GRADE). Results: Comparing teeth with and without root resorption, pulpectomy success was better (P<0.001) in teeth without preoperative root resorption. Success with pulpectomies performed with zinc oxide eugenol [ZOE] and with Endoflas (ZOE plus iodoform plus calcium hydroxide) did not differ from that observed using Vitapex or Metapex (iodoform plus calcium hydroxide; P ≥ 0.50) after 18 months; however, Endoflas and ZOE success rates remained near 90 percent versus 71 percent or less for iodoform. Network analysis ratings showed Endoflas and ZOE performed better than iodoform alone. Also, LSTR performed better (P<0.001) than pulpectomies in teeth with preoperative root resorption, but pulpectomy results were superior (P=0.09) if roots were intact. Rotary instrumentation of root canals was significantly faster (P<0.001) than manual instrumentation. Success rates were not impacted by method of obturation or root length determination, type of tooth, number of visits, irrigants, smear layer removal, or timing/type of final restoration. Conclusions: Eighteen-month success rates support Endloflas and zinc oxide eugenol pulpectomies over iodoform pulpectomies. Lesion sterilization tissue repair had limited indication for teeth with resorbed roots.
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- 2020
29. Quality Appraisal of Child Oral Health-Related Quality of Life Measures: A Scoping Review.
- Author
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Yang C, Crystal YO, Ruff RR, Veitz-Keenan A, McGowan RC, and Niederman R
- Subjects
- Adolescent, Child, Child, Preschool, Family, Humans, Oral Health, Dental Caries, Quality of Life
- Abstract
Background: Children's oral health-related quality of life (COHQoL) measures are well known and widely used. However, rigorous systematic reviews of these measures and analyses of their quality are in absence., Objectives: To systematically review and quantitatively assess the quality of COHQoL measures through a scoping review., Data Sources: Systematic literature search of PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE (Excerpta Medica database), HaPI (Health and Psychosocial Instruments), and DOSS (Dentistry and Oral Sciences Source)., Study Eligibility: The measure's focus was COHQoL; the child age ranged from 5 to 14 years; the publication was either a research article or a systematic review and related to caries; and it was written in English or had an English abstract. Two authors independently selected the studies. Disagreements were reconciled by group discussions with a third author., Appraisal: The International Society for Quality of Life Research minimum standards for patient-reported outcome measures were used for quality appraisal., Synthesis: Descriptive analysis., Results: We identified 18 measures. Their quality scores ranged from 9.5 to 15.0 on a scale of 16. The quality appeared to bear no relationship to the citation and use of these measures. However, elements of these measures might be more useful than others, depending on the age-specific use and primary quality concerns., Limitations: Some of the information on the minimum standards of the 18 measures cannot be found in the existing literature. Measures published without English abstract were not searched., Conclusions: The quality of these measures is suboptimal. Researchers and practitioners in this field should exercise caution when choosing and using these measures. Efforts at improving the quality of the COHQoL measures, such as refining existing ones or developing new measures, are warranted., Knowledge Transfer Statement: Researchers, clinician scientists, and clinicians can use the results of this study when deciding which oral health-related quality of life measure they wish to use in children.
- Published
- 2020
- Full Text
- View/download PDF
30. Silver and fluoride content and short-term stability of 38% silver diamine fluoride.
- Author
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Crystal YO, Rabieh S, Janal MN, Rasamimari S, and Bromage TG
- Subjects
- Cariostatic Agents, Child, Child, Preschool, Fluorides, Topical, Humans, Quaternary Ammonium Compounds, Silver Compounds, Dental Caries, Fluorides
- Abstract
Background: As silver diamine fluoride (SDF) gains popularity for caries arrest, the authors aimed to investigate the content of fluoride and silver in 38% SDF produced for the US market and its short-term stability., Methods: Five samples of 38% SDF were evaluated when the bottle was first opened, and at 7 and 28 days. Fluoride concentrations were determined with a fluoride ion-selective electrode, and silver concentrations were determined with a simultaneous inductively coupled plasma mass spectrometer. pH was measured with a pH probe. Weight and volume of individual drops were measured., Results: At day 0, 40% of individual measured values were above the expected fluoride concentration, and at day 28, 93% were above the expected fluoride concentration (P = .005). At day 0, 19% of individual measured values were below the lowest expected silver concentration, and at day 28, 93% were below (P < .001). Acidity (pH 10) was consistent over the 3 periods. Mean (standard deviation) weight of a drop was 40 (4.0) milligrams, and mean (standard deviation) volume was 32.55 (1.89) microliters, 30% more than the reported value of 25 μL., Conclusion: Over 28 days, the product pH is stable, whereas the fluoride content tends to increase and the silver content tends to decrease. Drops were larger than expected when dispensed from the bottle., Practical Implications: Drops are larger than expected, so each delivers higher than expected quantities of silver and fluoride. Clinicians should exercise caution when using this product on young children, replace the cap immediately, and use as soon as dispensed., (Copyright © 2019 American Dental Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
31. Evidence-Based Dentistry Update on Silver Diamine Fluoride.
- Author
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Crystal YO and Niederman R
- Subjects
- Aged, Anti-Bacterial Agents therapeutic use, Child, Fluorides, Topical adverse effects, Fluorides, Topical therapeutic use, Humans, Patient Satisfaction, Pediatric Dentistry, Quaternary Ammonium Compounds adverse effects, Root Caries prevention & control, Silver Compounds adverse effects, Tooth Remineralization, Tooth, Deciduous, Cariostatic Agents therapeutic use, Dental Caries prevention & control, Evidence-Based Dentistry, Quaternary Ammonium Compounds therapeutic use, Silver Compounds therapeutic use
- Abstract
This article reviews current evidence on the effectiveness of silver diamine fluoride (SDF) as a caries arresting and preventive agent. It provides clinical recommendations around SDF's appropriate use as part of a comprehensive caries management program. Systematic reviews confirm that SDF is effective for caries arrest on cavitated lesions in primary teeth and root caries in the elderly. It may also prevent new lesions. Application is easy, noninvasive, affordable, and safe. Although it stains the lesions dark as it arrests them, it provides clinicians with an additional tool for caries management when esthetics are not a primary concern., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
32. Silver Diamine Fluoride is Effective in Arresting Caries Lesions in Primary Teeth.
- Author
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Crystal YO and Chaffee BW
- Subjects
- Humans, Brazil, Cariostatic Agents, Fluorides, Topical, Quaternary Ammonium Compounds, Silver Compounds, Meta-Analysis as Topic, Systematic Reviews as Topic, Dental Caries, Tooth, Deciduous
- Abstract
Article Title and Bibliographic Information: Silver diamine fluoride has efficacy in controlling caries progression in primary teeth: A systematic review and meta-analysis. Chibinski AC, Wambier LM, Feltrin J, Dourado Loguercio A, Stadler Wambier D, Reis A. Caries Res 2017;51:527-41., Source of Funding: This study was partially supported by the National Council for Scientific and Technological Development of Brazil under grants 304105/2013-9 and 305588/2014-1 TYPE OF STUDY/DESIGN: Systematic review with meta-analysis., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
33. Use of Silver Diamine Fluoride for Dental Caries Management in Children and Adolescents, Including Those with Special Health Care Needs.
- Author
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Crystal YO, Marghalani AA, Ureles SD, Wright JT, Sulyanto R, Divaris K, Fontana M, and Graham L
- Subjects
- Adolescent, Child, Fluorides, Topical, Humans, Silver Compounds, Dental Caries drug therapy, Quaternary Ammonium Compounds therapeutic use
- Abstract
Background: This manuscript presents evidence-based guidance on the use of 38 percent silver diamine fluoride (SDF) for dental caries management in children and adolescents, including those with special health care needs. A guideline workgroup formed by the American Academy of Pediatric Dentistry developed guidance and an evidence-based recommendation regarding the application of 38 percent SDF to arrest cavitated caries lesions in primary teeth., Types of Studies Reviewed: The basis of the guideline's recommendation is evidence from an existing systematic review "Clinical trials of silver diamine fluoride in arresting caries among children: A systematic review." (JDR Clin Transl Res 2016;1[3]:201-10). A systematic search was conducted in PubMed®/MEDLINE, Embase®, Cochrane Central Register of Controlled Trials, and gray literature databases to identify randomized controlled trials and systematic reviews reporting on the effect of silver diamine fluoride and address peripheral issues such as adverse effects and cost. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of the evidence and the evidence-to-decision framework was employed to formulate a recommendation., Results: The panel made a conditional recommendation regarding the use of 38 percent SDF for the arrest of cavitated caries lesions in primary teeth as part of a comprehensive caries management program. After taking into consideration the low cost of the treatment and the disease burden of caries, panel members were confident that the benefits of SDF application in the target populations outweigh its possible undesirable effects. Per GRADE, this is a conditional recommendation based on low-quality evidence. Conclusions and practical implications: The guideline intends to inform the clinical practices involving the application of 38 percent SDF to enhance dental caries management outcomes in children and adolescents, including those with special health care needs. These recommended practices are based upon the best available evidence to-date. A 38 percent SDF protocol is included in Appendix II.
- Published
- 2017
34. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions.
- Author
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Dhar V, Marghalani AA, Crystal YO, Kumar A, Ritwik P, Tulunoglu O, and Graham L
- Subjects
- Child, Humans, Dental Caries therapy, Dental Pulp Capping, Pulpotomy, Tooth, Deciduous
- Abstract
Purpose: This manuscript presents evidence-based guidance on the use of vital pulp therapies for treatment of deep caries lesions in children. A guideline panel convened by the American Academy of Pediatric Dentistry formulated evidence-based recommendations on three vital pulp therapies: indirect pulp treatment (IPT; also known as indirect pulp cap), direct pulp cap (DPC), and pulpotomy., Methods: The basis of the guideline's recommendations was evidence from "Primary Tooth Vital Pulp Therapy: A Systematic Review and Meta-Analysis." (Pediatr Dent 2017;15;39[1]:16-23.) A systematic search was conducted in PubMed®/MEDLINE, Embase®, Cochrane Central Register of Controlled Trials, and trial databases to identify randomized controlled trials and systematic reviews addressing peripheral issues of vital pulp therapies such as patient preferences of treatment and impact of cost. Quality of the evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation approach; the evidence-to-decision framework was used to formulate a recommendation., Results: The panel was unable to make a recommendation on superiority of any particular type of vital pulp therapy owing to lack of studies directly comparing these interventions. The panel recommends use of mineral trioxide aggregate (MTA) and formocresol in pulpotomy treatments; these are recommendations based on moderate-quality evidence at 24 months. The panel made weak recommendations regarding choice of medicament in both IPT (moderate-quality evidence [24 months], low quality evidence [48 months]) and DPC (very-low quality evidence [24 months]). Success of both treatments was independent of type of medicament used. The panel also recommends use of ferric sulfate (low-quality evidence), lasers (low-quality evidence), sodium hypochlorite (very low-quality evidence), and tricalcium silicate (very low-quality evidence) in pulpotomies; these are weak recommendations based on low-quality evidence. The panel recommended against the use of calcium hydroxide as pulpotomy medicament in primary teeth with deep caries lesions. Conclusions and practical implications: The guideline intends to inform the clinical practices with evidence-based recommendations on vital pulp therapies in primary teeth with deep caries lesions. These recommendations are based upon the best available evidence to-date.
- Published
- 2017
35. Parental perceptions and acceptance of silver diamine fluoride staining.
- Author
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Crystal YO, Janal MN, Hamilton DS, and Niederman R
- Subjects
- Adult, Female, Fluorides, Topical, Humans, Male, Middle Aged, New York City, Silver Compounds, Surveys and Questionnaires, Tooth, Deciduous, Cariostatic Agents adverse effects, Dental Caries prevention & control, Parents psychology, Quaternary Ammonium Compounds adverse effects, Tooth Discoloration chemically induced
- Abstract
Background: The caries arrest that can be achieved by using silver diamine fluoride (SDF) offers a minimally invasive and inexpensive alternative to traditional restorative caries treatment. The authors evaluated how the dentinal staining that is associated with SDF influences the acceptance of this treatment among parents of young children in the New York City metropolitan area., Methods: The authors invited the parents of children who had experienced dental caries and who had appointments at the New York University Pediatric Dentistry Clinic and at several private clinics in New Jersey to participate in a Web-based survey designed to assess parents' demographics, perceptions of photographs of SDF-treated carious teeth, and acceptability of treatment in different behavior management scenarios., Results: Ninety-eight mothers and 22 fathers from diverse backgrounds participated. Most parents (67.5%) judged SDF staining on the posterior teeth to be esthetically tolerable, but only 29.7% of parents made this same judgment about anterior teeth (P < .001). In the absence of their child having behavioral barriers to conventional restorations, 53.6% of parents reported that they were likely to choose SDF to treat their child's posterior teeth, but only 26.9% of parents were likely to choose SDF to treat their child's anterior teeth. As the number of children's behavioral barriers increased, so did the parents' level of acceptance. In extreme cases, in which parents had to decide whether their children should undergo general anesthesia during treatment, parents' acceptance rate of SDF as a treatment method increased to 68.5% on posterior teeth and to 60.3% on anterior teeth. Parents' acceptance of the treatment also varied according to their socioeconomic status., Conclusions: Staining on posterior teeth was more acceptable than staining on anterior teeth. Although staining on anterior teeth was undesirable, most parents preferred this option to advanced behavioral techniques such as sedation or general anesthesia., Practical Implications: Clinicians need to understand parental sensitivities regarding the staining effect of SDF to plan adequately for the use of SDF as a method of caries management in pediatric patients., (Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
36. Silver Diamine Fluoride Treatment Considerations in Children's Caries Management.
- Author
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Crystal YO and Niederman R
- Subjects
- Administration, Topical, Child, Fluorides, Topical therapeutic use, Humans, Randomized Controlled Trials as Topic, Risk Factors, Silver Compounds, Tooth, Deciduous, Dental Caries prevention & control, Quaternary Ammonium Compounds therapeutic use
- Abstract
By arresting and preventing caries, silver diamine fluoride (SDF) offers an alternate care path for patients for whom traditional restorative treatment is not immediately available. Current data from controlled clinical trials encompassing more than 3,900 children indicate that biannual application of SDF reduces progression of current caries and risk of subsequent caries. The purpose of this paper was to highlight the best evidence from systematic reviews and clinical trials for clinicians to consider the benefits, risks, and limitations as they implement silver diamine fluoride therapy on young children.
- Published
- 2016
37. Silver Diamine Fluoride in Pediatric Dentistry Training Programs: Survey of Graduate Program Directors.
- Author
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Nelson T, Scott JM, Crystal YO, Berg JH, and Milgrom P
- Subjects
- Child, Cross-Sectional Studies, Curriculum, Fluorides, Topical, Humans, Silver Compounds, Surveys and Questionnaires, United States, Cariostatic Agents administration & dosage, Dental Caries prevention & control, Internship and Residency, Pediatric Dentistry education, Quaternary Ammonium Compounds administration & dosage
- Abstract
Purpose: The purpose of this study was to investigate practice, teaching, and perceived barriers to the use of silver diamine fluoride and other caries control agents in U.S. pediatric dentistry residency programs., Methods: A 14-question survey regarding use and teaching of caries control agents was sent via email to residency program directors in 2015. Survey participants responded, using a web-based survey tool, by completing a paper and pencil survey instrument, or by interview., Results: Surveys were completed by 74 directors or associate directors (87 percent adjusted response rate). More than a quarter (25.7 percent) reported use of silver diamine fluoride, with 68.9 percent expecting to increase use. The use of silver diamine fluoride was not associated with region or program type. Programs reported commonly used caries control agents of fluoride varnish (100 percent), acidulated phosphate fluoride foam (48.6 percent), silver nitrate (9.5 percent), and povidone iodine (1.3 percent). Most felt silver diamine fluoride should be used only with high-risk patients (89.2 percent), and the majority agreed it could be used in primary and permanent teeth. The most frequently reported barrier to use of silver diamine fluoride was parental acceptance (91.8 percent)., Conclusions: Silver diamine fluoride is being rapidly adopted in graduate pediatric dentistry training programs, with the majority expecting to incorporate it into their teaching clinics and curricula.
- Published
- 2016
38. Minimal intervention dentistry: part 3. Paediatric dental care--prevention and management protocols using caries risk assessment for infants and young children.
- Author
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Ramos-Gomez FJ, Crystal YO, Domejean S, and Featherstone JD
- Subjects
- Child, Child, Preschool, Female, Humans, Infant, Male, Oral Health education, Pregnancy, Prenatal Care methods, Risk Assessment, Dental Caries prevention & control, Pediatric Dentistry methods
- Abstract
Recent increases in caries prevalence in young children throughout the world highlight the need for a simple but effective infant oral care programme. This programme needs to include a medical disease prevention management model with an early establishment of a dental home and a treatment approach based on individual patient risk. This article presents an updated approach with practical forms and tools based on the principles of caries management by risk assessment, CAMBRA. This method will aid the general practitioner to develop and maintain a comprehensive protocol adequate for infant and young children oral care visits. Perinatal oral health is vitally important in preventing early childhood caries (ECC) in young children. Providing dental treatment to expectant mothers and their young children in a 'dual parallel track' is an effective innovative strategy and an efficient practice builder. It promotes prevention rather than intervention, and this may be the best way to achieve long-lasting oral health for young patients. General dental practice can adopt easy protocols that will promote early preventive visits and anticipatory guidance/counselling rather than waiting for the need for restorative treatment.
- Published
- 2012
- Full Text
- View/download PDF
39. Pediatric dental care: prevention and management protocols based on caries risk assessment.
- Author
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Ramos-Gomez FJ, Crystal YO, Ng MW, Crall JJ, and Featherstone JD
- Subjects
- California epidemiology, Cariostatic Agents administration & dosage, Child, Child, Preschool, Clinical Protocols, Counseling, Dental Caries epidemiology, Female, Fluorides, Topical administration & dosage, Humans, Infant, Patient Positioning, Physical Examination, Pregnancy, Risk Assessment, Toothbrushing, Dental Care for Children methods, Dental Caries prevention & control, Perinatal Care
- Abstract
Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model. This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment in an effort to stimulate greater adoption of infant oral care programs among clinicians and early establishment of dental homes for young children. [corrected]
- Published
- 2010
40. Gender and racial issues that affect delivery of care are we prepared for the future changes?
- Author
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Crystal YO
- Subjects
- Child, Child, Preschool, Cultural Diversity, Culture, Dentist-Patient Relations, Dentists, Dentists, Women, Female, Forecasting, Health Behavior, Humans, Male, Minority Groups, Pediatric Dentistry trends, Socioeconomic Factors, United States, Delivery of Health Care trends, Dental Care for Children trends, Racial Groups, Sex
- Published
- 2003
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