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This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the individual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia., info:eu-repo/semantics/published

Objective: This study aimed to investigate possible early childhood caries (ECC) risk indicators in preschoolers who applied for examination/treatment at the Government University Pediatric Dentistry Clinic, Istanbul, Turkey. Material and Methods: Children aged 36-71 months and their mothers who applied for examination/treatment and consented were enrolled in this cross-sectional survey during a 3-month period. Mother-child pairs were examined intraorally, and caries experience was recorded using (dmft/DMFT) an index. A structured questionnaire inquiring oral hygiene habits and diet history of the children was employed to interview the mothers. Categorical data from children with no clinical caries (NC), ECC, Severe ECC (S-ECC) were compared using Chi-square test and correlation of caries experience in mother-child pairs and were tested with Spearman rho. Statistical significance was set p

Candida albicans, a major opportunistic fungal pathogen, is frequently found together with Streptococcus mutans in dental biofilms associated with severe childhood caries (tooth decay), a prevalent pediatric oral disease. However, the impact of this cross-kingdom relationship on C. albicans remains largely uncharacterized. Here, we employed a novel quantitative proteomics approach in conjunction with transcriptomic profiling to unravel molecular pathways of C. albicans when cocultured with S. mutans in mixed biofilms., Candida albicans, a major opportunistic fungal pathogen, is frequently found together with Streptococcus mutans in dental biofilms associated with severe childhood caries (tooth decay), a prevalent pediatric oral disease. However, the impact of this cross-kingdom relationship on C. albicans remains largely uncharacterized. Here, we employed a novel quantitative proteomics approach in conjunction with transcriptomic profiling to unravel molecular pathways of C. albicans when cocultured with S. mutans in mixed biofilms. RNA sequencing and iTRAQ (isobaric tags for relative and absolute quantitation)-based quantitative proteomics revealed that C. albicans genes and proteins associated with carbohydrate metabolism were significantly enhanced, including sugar transport, aerobic respiration, pyruvate breakdown, and the glyoxylate cycle. Other C. albicans genes and proteins directly and indirectly related to cell morphogenesis and cell wall components such as mannan and glucan were also upregulated, indicating enhanced fungal activity in mixed-species biofilm. Further analyses revealed that S. mutans-derived exoenzyme glucosyltransferase B (GtfB), which binds to the fungal cell surface to promote coadhesion, can break down sucrose into glucose and fructose that can be readily metabolized by C. albicans, enhancing growth and acid production. Altogether, we identified key pathways used by C. albicans in the mixed biofilm, indicating an active fungal role in the sugar metabolism and environmental acidification (key virulence traits associated with caries onset) when interacting with S. mutans, and a new cross-feeding mechanism mediated by GtfB that enhances C. albicans carbohydrate utilization. In addition, we demonstrate that comprehensive transcriptomics and quantitative proteomics can be powerful tools to study microbial contributions which remain underexplored in cross-kingdom biofilms.

SummaryMicrobiota-based prediction of chronic infections is promising yet not well established. Early childhood caries (ECC) is the most common infection in children. Here we simultaneously tracked microbiota development at plaque and saliva in 50 4-year-old preschoolers for 2 years; children either stayed healthy, transitioned into cariogenesis, or experienced caries exacerbation. Caries onset delayed microbiota development, which is otherwise correlated with aging in healthy children. Both plaque and saliva microbiota are more correlated with changes in ECC severity (dmfs) during onset than progression. By distinguishing between aging- and disease-associated taxa and exploiting the distinct microbiota dynamics between onset and progression, we developed a model, Microbial Indicators of Caries, to diagnose ECC from healthy samples with 70% accuracy and predict, with 81% accuracy, future ECC onsets for samples clinically perceived as healthy. Thus, caries onset in apparently healthy teeth can be predicted using microbiota, when appropriately de-trended for age.

Objectives The aim of this cross-sectional study was to investigate the relationship between parental and family-related factors and childhood dental caries in a sample of 5- to 6-year-old children of Dutch, Moroccan and Turkish origin. Furthermore, the relationship of parental and family-related factors with social class and ethnicity was examined. Methods The study sample included 92 parent-child dyads (46 cases and 46 controls), which were recruited from a large paediatric dental centre in The Hague, the Netherlands. Cases were children with four or more decayed, missing or filled teeth, and controls were caries free. Validated questionnaires were used to collect data on sociodemographic characteristics, oral health behaviours, parents' dental self-efficacy and locus of control (LoC), parenting practices and family functioning. Parenting practices were also assessed using structured video observations of parent-child interactions. Results Parents of controls had a more internal LoC, and they were more likely to show positive (observed) parenting in terms of positive involvement, encouragement and problem-solving, compared to cases (P < 0.05). Lower social class was significantly associated with a lower dental self-efficacy, a more external LoC and poorer parenting practices. Furthermore, LoC was more external in Moroccan and Turkish parents, compared to Dutch parents. Conclusion Parents' internal LoC and observed positive parenting practices on the dimensions positive involvement, encouragement and problem-solving were important indicators of dental health in children of Dutch, Moroccan and Turkish origin. Findings suggest that these parental factors are potential mediators of socioeconomic inequalities in children's dental health. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Background The majority of young children receive no early dental examination while attending primary health care for routine check-ups. Our aim was to study primary care nurses’ knowledge of oral health care (OHC) and their attitudes toward delivering OHC, as well as to assess their willingness to obtain OHC information. Methods We conducted a cross-sectional survey of all primary-care nurses working in the public health centres of Tehran city. An anonymous self-administered questionnaire queried their knowledge in paediatric-, general and medicine-related areas of dentistry, providing knowledge scores for three domains. The nurses’ attitudes toward OHC and their willingness to obtain OHC information underwent evaluation with statements utilizing a five-point Likert scale. Altogether 680 nurses took part in the survey. The Chi-square test, t-test, one-way ANOVA and logistic regression model served for statistical analyses. Result The mean score for the paediatric dentistry domain (3.6, SD: 1.5) was lower than for the medical (4.4, SD: 2.3) and dental domains (5.8, SD: 1.5). Obtaining higher scores in the paediatric (OR = 1.2) and dental (OR = 1.3) domains, and a greater willingness to receive OHC information (OR = 5.3), were associated with a positive attitude toward OHC. Nurses with a lower education (OR = 1.9) and better oral health behaviour (OR = 1.1) as well as those working in a non-affluent region (OR = 1.6) had a more positive attitude toward OHC. Conclusion Primary care nurses’ low level of knowledge in OHC and their positive attitude and willingness to obtain more information point to the need for appropriate OHC training and encouragement for the nurses to promote oral health and prevent dental diseases.