Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.
Child ; Child, Preschool ; Consensus ; Dental Caries/prevention & control* ; Dental Caries Susceptibility ; Humans ; Oral Health

Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
Consensus ; Dental Care ; Dental Caries/prevention & control* ; Humans ; Prevalence

Dental caries is one of the most common oral diseases around the world. Dental plaque attached to the surfaces of teeth is the main biological factor leading to caries. Although fluoride is still one of the most commonly used methods to prevent caries, with the change of epidemiological characteristics of caries and the update of the understanding of caries etiology, it is necessary to use other ecological methods such as antimicrobial peptides, arginine, probiotics and natural products, etc. to enhance the effect of fluoride in preventing dental caries. The present article reviews the research progress on the ecological approaches for caries prevention in recent years.
Arginine ; Dental Caries/prevention & control* ; Fluorides/therapeutic use* ; Humans ; Mouth Diseases/complications*

OBJECTIVES: To investigate caries status and its impact factors in preschool children in plateau and to provide reference for caries prevention in highlands. METHODS: Examination of caries was performed on 1 597 children aged 3-5 years old in 11 kindergartens in Changdu, Xizang, in accordance with the 4th National Oral Health Survey standards and methods. Their parents were surveyed with the questionnaire regarding oral hygiene habit and consciousness about oral health and related factors. All the data were collected and analyzed. RESULTS: The prevalence of caries among children aged 3-5 years old in Changdu was 52.85%, with dmft index of 2.44. The caries rate and dmft of children aged 3 years old were lower than those of children aged 4 and 5 years old ( CONCLUSIONS The prevalence of ca-ries in children aged 3-5 years old in Changdu increases with aging. Good oral hygiene and eating habits and regular oral examination can reduce the rate of caries.
Child, Preschool ; Cross-Sectional Studies ; DMF Index ; Dental Caries/prevention & control* ; Dental Caries Susceptibility ; Female ; Humans ; Male ; Oral Health ; Oral Hygiene ; Prevalence

Caries of children under 3 years old has such characteristics as early onset, multiple tooth involvement and rapid development. It may affect the mastication and digestive functions of the children, as well as oral and systemic development, and may become a risk factor for systemic diseases. In order to standardize the prevention and treatment of the caries of the infants and toddlers, to fully utilize the existing medical resources to prevent caries, to reduce the incidence rate and to increase the treatment rate, and to improve the oral health statuses of the infants and toddlers in China, the Society of Pediatric Dentistry and the Society of Preventive Dentistry of the Chinese Stomatological Association convened experts of pediatric dentistry and preventive dentistry from 19 universities and hospitals to conduct profound discussions on this topic, and finally developed the present guideline on diagnosis, prevention, clinical practice and effect evaluation for caries of children under 3 years old suitable to China's conditions.
Child, Preschool ; China ; Dental Caries/prevention & control* ; Dental Caries Susceptibility ; Humans ; Infant ; Pediatric Dentistry ; Preventive Dentistry

Glucosyltransferases (Gtfs) play critical roles in the etiology and pathogenesis of Streptococcus mutans (S. mutans)- mediated dental caries including early childhood caries. Gtfs enhance the biofilm formation and promotes colonization of cariogenic bacteria by generating biofilm extracellular polysaccharides (EPSs), the key virulence property in the cariogenic process. Therefore, Gtfs have become an appealing target for effective therapeutic interventions that inhibit cariogenic biofilms. Importantly, targeting Gtfs selectively impairs the S. mutans virulence without affecting S. mutans existence or the existence of other species in the oral cavity. Over the past decade, numerous Gtfs inhibitory molecules have been identified, mainly including natural and synthetic compounds and their derivatives, antibodies, and metal ions. These therapeutic agents exert their inhibitory role in inhibiting the expression gtf genes and the activities and secretion of Gtfs enzymes with a wide range of sensitivity and effectiveness. Understanding molecular mechanisms of inhibiting Gtfs will contribute to instructing drug combination strategies, which is more effective for inhibiting Gtfs than one drug or class of drugs. This review highlights our current understanding of Gtfs activities and their potential utility, and discusses challenges and opportunities for future exploration of Gtfs as a therapeutic target.
Biofilms ; Dental Caries/prevention & control* ; Glucosyltransferases/antagonists & inhibitors* ; Humans ; Streptococcus mutans/enzymology*

OBJECTIVE: To compare the anti-caries effect and safety of Er:YAG laser combined with fluoride and methylene blue-photodynamic therapy (MB-PDT). METHODS: A total of 28 rat dental caries models were established and randomly divided into seven groups: photodynamic therapy (PDT) group, laser combined with fluoride group, laser group, sodium fluoride group, and 0.9% saline control group. Spectrophotometric optical density was used to reflect the growth of Streptococcus mutans. Laser-induced fluorescence diagnostic (LF) instrument was utilized to detect the demineralization degree of dental caries. Histopathological sections were employed to observe the damage of dental pulp and buccal mucosa. RESULTS: The optical density (OD) value of the PDT and combination groups was significantly lower than that of other treatment groups (P<0.05). An increase in LF value and demineralization occurred in varying degrees with different treatment methods. Histopathological observation showed that pulp and buccal mucosa injury was more obvious in the combination group of 70 mw·cm⁻² and Er:YAG laser group compared with other groups. CONCLUSIONS Under the same parameters, the combined group and PDT have good germicidal efficacy, but PDT has fewer adverse reactions and less damage. It is an effective and safe method for caries prevention.
Cariostatic Agents ; Dental Caries/prevention & control* ; Fluorides ; Humans ; Laser Therapy ; Lasers, Solid-State ; Methylene Blue ; Photochemotherapy

INTRODUCTION: Dental caries, which is prevalent in Singapore preschoolers, is a disease that has a major impact on children's health and places a high cost on the society and health services. Oral health programmes for young children implemented in some parts of the world have been shown to be effective in the prevention of dental caries. We aimed to examine the clinical efficacy of a two-year oral health programme for infants and toddlers in Singapore. METHODS: 90 children and their caregivers participated in the programme, and 64 children, who were 24 months older than the intervention group at the initial visit, were recruited as controls in a quasi-experimental study design. We evaluated the presence of severe early childhood caries (SECC) and dmfs in the control group at the initial visit and in the intervention group after the completion of the two-year programme. RESULTS: Some children in the intervention (7.8%) and control (31.3%) groups (p < 0.001) had SECC (difference 23.5%, 95% confidence interval 11%-36%). A higher percentage of children in the intervention group had dmfs = 0 and habits associated with low risk for caries. The odds of SECC in the control group were three times higher than that for the intervention group, and the effect was significant (p = 0.037) after adjustment for other significant risk factors. CONCLUSION The preventive oral health programme in Singapore was successful in reducing SECC among infants and toddlers when targeted behaviour modifications were implemented.
Caregivers ; Child, Preschool ; Dental Caries ; prevention & control ; Dentistry ; methods ; Female ; Health Care Costs ; Health Promotion ; Humans ; Infant ; Male ; Oral Health ; Pediatrics ; Program Evaluation ; Regression Analysis ; Research Design ; Risk Factors ; Singapore

OBJECTIVE: To evaluate the clinical effect of fluoride releasing flowable resin used in treatment of early enamel caries of children compared with conventional sealant. METHODS: Seventy-six patients, including fifty-two couples of permanent first molars and thirty couples of premolars were selected for this trial. Both sides of all the molars and premolars were diagnosed as early enamel caries based on International Caries Detection and Assessment System (ICDAS) dental caries diagnostic criteria. Using the contralateral control, the teeth were randomly divided into two groups. Molars/premolars in the experimental group were sealed with a fluoride releasing flowable resin; the contralateral molars/premolars were sealed with a conventional fissure sealant as a control group. The retention rate and progress of caries were evaluated at the end of 3, 6, 12 and 24 months. RESULTS: There was no fissure sealant loss or caries progression in both groups 3 and 6 months after sealing the premolars by fluoride releasing flowable resin or conventional fissure sealants. At the end of 12 and 24 months, only one case of fissure sealant loss was observed in conventional fissure sealant group. There was no statistical significance between the two premolar groups. In the first molar group, fluoride releasing flowable resin showed 100%, 98.08%, 90.38% and 88.46% complete retention at the end of 3, 6, 12 and 24 months, respectively. The conventional fissure sealant retention rates were 96.15%, 92.31%, 76.92% and 73.08% at the corresponding time points. The data at the end of 24 months showed that fluoride releasing flowable resin had significantly higher retention rate than the conventional fissure sealant group (P<0.05). The incidence of caries progression at the end of 6, 12 and 24 months were 1.92%, 5.77% and 7.69%, respectively, in the fluoride releasing flowable resin group. In the conventional fissure sealant group, the incidence was 5.77%, 19.23% and 25.00%, respectively. At the end of 12 and 24 months, more significant decrease of caries progress incidence was observed in the fluoride releasing flowable resin group than in the control group, and there was statistical difference between the two groups (P<0.05). CONCLUSION Compared with conventional fissure sealant, using fluoride releasing flowable resin as a fissure sealant in children enamel caries of permanent molars can improve the sealant preservation rate and effectively prevent enamel caries progress.
Child ; Dental Caries/prevention & control* ; Dental Enamel ; Fluorides ; Humans ; Molar ; Pit and Fissure Sealants

This study aimed to investigate the factors influencing the decision on whether to receive regular oral check-ups among the national health insurance beneficiaries with income and aged over 20 years in Korea. This was a cross-sectional study, using the data from the 2014 6th Korea National Health and Nutrition Examination Survey (KNHANES VI-2), conducted by the Korea Centers for Disease Control and Prevention. The final sample included 2,843 subjects who participated in the health examination survey and oral check-ups. The IBM SPSS Statistics ver. 20.0 was used for the statistical analysis, based on the complex sampling design. The Rao-Scott chi-square test was used to verify the difference in the distribution of independent variables with regard to oral check-ups. The binary logistic regression analysis was used to determine the influencing factors. The ratio of beneficiaries who received oral check-ups was less than half of those who received medical examinations. The Rao-Scott chi-square test, revealed significant differences in the age group (p<0.05) of the predisposing factors, toothache within a year (p<0.001), untreated dental caries (p<0.001) of the need factors, personal income level (p<0.001), educational level (p<0.001), type of medical insurance (p<0.001), and private health insurance (p<0.01) of the enabling factors. In the binary logistic regression analysis, factors influencing oral check-ups were age group, personal income level, educational level, toothache within a year, and untreated dental caries. These findings show a variety of factors influencing the utilization of regular oral check-ups.
Causality ; Centers for Disease Control and Prevention (U.S.) ; Cross-Sectional Studies ; Dental Care ; Dental Caries ; Health Surveys ; Humans ; Insurance ; Insurance, Health ; Korea* ; Logistic Models ; National Health Programs ; Nutrition Surveys* ; Odds Ratio ; Toothache