Dental and Dental Hygiene Students' Knowledge and Capacity to Discriminate the Developmental Defects of Enamel: A Self-Submitted Questionnaire Survey.

Background: A prompt and accurate diagnosis of developmental defects of enamel (DDE) is mandatory for proper treatment management. This cross-sectional survey, designed and carried out using anonymous self-administered questionnaires, aimed to assess dental and dental hygiene students' knowledge and their capability to identify different enamel development defects. Methods: The questionnaire consisted of twenty-eight closed-ended questions. Two different samples of undergraduate students were selected and enrolled: a group of dental hygiene (GDH) students and a group of dental (GD) students. A multivariate logistic regression was performed by adopting the correct answers as explanatory variables to assess the difference between the two groups. Results: Overall, 301 completed questionnaires were analyzed: 157 from the GDH and 144 from the GD. The dental student group showed better knowledge than the GDH of enamel hypomineralization and hypoplasia (p = 0.03 for both). A quarter (25.25%) of the total sample correctly identified the period of development of dental fluorosis with a statistically significant difference between the groups (p < 0.01). Amelogenesis imperfecta (AI) was identified as a genetic disease by 64.45% of the sample, with a better performance from the GD (p = 0.01), while no statistical differences were found between the groups regarding molar incisor hypomineralization. Multivariate analysis showed that AI (OR = 0.40, [0.23;0.69], p < 0.01) and caries lesion (OR = 0.58, [0.34;0.94], p = 0.03) were better recognized by the GD. Conclusions: Disparities exist in the knowledge and management of DDE among dental and dental hygiene students in Italy; however, significant knowledge gaps were found in both groups. Education on the diagnosis and treatment of DDE during the training for dental and dental hygiene students needs to be strongly implemented.

Caries risk assessment using different Cariogram models. A comparative study about concordance in different populations-Adults and children.

This methodological survey aimed to verify whether there is concordance among several Cariogram different risk models at different thresholds, comparing both children and adult populations and how each risk/protective factor weight on the overall caries risk profile. Three groups' data (two in children and one in adults) were obtained from previous studies, while a fourth, in young adults, was ad hoc enrolled. Different caries risk levels were assessed: a) three risk categories with two different thresholds as: "low risk" = 61-100% or 81-100% chance to avoid caries, "moderate risk" = 41-60% or 21-80% and "high risk" = 0-40% or 0-20%, named model 1 and 2; b) four risk categories with two different thresholds as: "low risk" = 61-100% or 76-100%, "moderate/low risk" = 41-60% or 51-75%; "moderate/high risk" = 21-40% or 26-50% and "high risk" = 0-20% or 0-25%, model 3 and 4; c) five risk categories as: "very low risk" = 81-100%; "low risk" = 61-80% "moderate risk" = 41-60%; "high risk" = 21-40% and "very high risk" = 0-20%, model 5. Concordance of the different Cariogram risk categories among the four groups was calculated using Cohen's kappa. The weight of the association between all Cariogram models toward the Cariogram risk variables was evaluated by ordinal logistic regression models. Considering Cariogram model 1 and 2, Cohen's Kappa values ranged from 0.40 (SE = 0.07) for the young adult group to 0.71 (SE = 0.05) for the adult one. Cohen's Kappa values ranged from 0.14 (SE = 0.03 p<0.01) for the adult group to 0.62 (SE = 0.02) for the two groups of children in models 3 and 4. Statistically significant associations were found for all Cariogram risk variables excepting Fluoride program in models 4 and 5 and the overall risk on children's samples. Caries experience showed a quite variable weight in the different models in both adult groups. In the regression analyses, adult groups' convergence was not always achievable since variations in associations between caries risk and different risk variables were narrower compared to other samples. Significant differences in caries risk stratification using different thresholds stands out from data analysis; consequently, risk assessments need to be carefully considered due to the risk of misleadingly choosing preventive and research actions.

Long-term caries prevention of dental sealants and fluoride varnish in children with autism spectrum disorders: a retrospective cohort study.

The aim was to compare two strategies for caries prevention in children with Autism Spectrum Disorders (ASDs). Participants were retrospectively retrieved and divided in two groups. Group one had first permanent molars treated with fluoride varnishes, FA group (n = 92, 9.43 ± 2.44 years) whilst the second, with dental sealant plus fluoride varnishes, FA + S group (n = 140, 7.77 ± 2.57 years). Logistic and multivariate analysis were run to evaluate the caries incidence, the retention rate of sealants, and background factors associated with caries risk over a period of at least 11 years. Survival rates from dental caries were statistically significantly higher in the FA + S group compared to the FA group (LogRank test p < 0.01). Dental sealant plus fluoride varnish played as a protective factor towards the development of caries (HR = 0.25 95%CI = 0.00/0.55 and HR = 0.34 95%CI = 0.00/0.66 in the upper right and left first molars; HR = 0.32 95%CI = 0.00/0.66 and HR = 0.26 95%CI = 0.00/0.58 in the lower right and left first molars). Dental sealants retention rate was high, ranging between 58.02% and 64.29%. No baseline variable was statistically significantly associated to the risk of caries development. Combined dental sealant and fluoride varnish application was more effective in reducing caries risk in first permanent molars of ASDs children than fluoride varnish alone. This preventive strategy should be therefore routinely applied in high caries risk patients as ASDs children.

COVID-19 pandemic and dental hygienists in Italy: a questionnaire survey.

OBJECTIVE: This online cross-sectional survey assesses the signs/symptoms, the protective measures taken and the awareness and risk perception regarding COVID-19 among Italian dental hygienists. All Italian dental hygienists were invited to participate. The ad hoc online questionnaire was divided into four domains: personal data, protective measures (-before patient arrival; -in the waiting room; -in the operating room) and PPE, awareness and risk perception. RESULTS: Two-thousand-seven-hundred-ninety-eight subjects participated. Only 0.25% of the sample was positive to the virus. Sense of fatigue (8.19%), headache (7.81%) and sore throat (7.32%) were the most common symptoms. A statistically significant trend across the areas with a different prevalence of COVID-19 was observed related to the number of signs/symptoms (areas z = 6.38 p < 0.01). Overall, 90.55% of the sample used protective glasses or visor, 90.10% disposable gloves and 82.80% surgical mask. Regarding the confidence to avoid the infection, a statistically significant difference was found among dental hygienists belonging to the 3 years-professional-experiences groups who worked in the high COVID-19 prevalence area. The findings of this survey show that Italian dental hygienists have modified their working habits according to the professional risk related to the current pandemic and they seem correctly prepared to face the risk of a SARS-CoV-2 infection.

Are standardized caries risk assessment models effective in assessing actual caries status and future caries increment? A systematic review.

BACKGROUND: Assessing caries risk is an essential element in the planning of preventive and therapeutic strategies. Different caries risk assessment (CRA) models have been proposed for the identification of individuals running a risk of future caries. This systematic review was designed to evaluate whether standardized caries risk assessment (CRA) models are able to evaluate the risk according to the actual caries status and/or the future caries increment. METHODS: Randomized clinical trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, reporting caries risk assessment using standardized models (Cariogram, CAMBRA, PreViser, NUS-CRA and CAT) in patients of any age related to caries data recorded by DMFT/S or ICDAS indices, were included. PubMed, Scopus and Embase were searched from 2000 to 2016. A search string was developed. All the papers meeting the inclusion criteria were subjected to a quality assessment. RESULTS: One thousand three-undred ninety-two papers were identified and 32 were included. In all but one, the Cariogram was used both as sole model or in conjunction with other models. All the papers on children (n = 16) and adults (n = 12) found a statistically significant association between the risk levels and the actual caries status and/or the future caries increment. Nineteen papers, all using the Cariogram except one, were classified as being of good quality. Three of four papers comprising children and adults found a positive association. For seven of the included papers, Cariogram sensibility and specificity were calculated; sensibility ranged from low (41.0) to fairly low (75.0), while specificity was higher, ranging from 65.8 to 88.0. Wide 95% confidence intervals for both parameters were found, indicating that the reliability of the model differed in different caries risk levels. CONCLUSIONS: The scientific evidence relating to standardized CRA models is still limited; even if Cariogram was tested in children and adults in few studies of good quality, no sufficient evidence is available to affirm the method is effective in caries assessment and prediction. New options of diagnosis, prognosis and therapy are now available to dentists but the validity of standardized CRA models still remains limited.