The Effect of Dental Treatment under General Anesthesia on Quality of Life and Growth and Blood Chemistry Parameters in Uncooperative Pediatric Patients with Compromised Oral Health: A Pilot Study.

BACKGROUND: The effect of untreated dental caries and their treatment under general anesthesia (GA) on the quality of life, growth, and blood chemistry parameters in uncooperative pediatric patients has not been extensively elucidated. The aims are to evaluate the impact of dental treatment under GA on oral health-related quality of life (OHRQoL) in uncooperative pediatric patients with severe dental caries and to assess the effect of dental treatment under GA on children's weight (Wt), height (Ht), Body Mass Index (BMI), and blood chemistry parameters. METHODS: Forty-three uncooperative children aged 3-14 years were selected. OHRQoL, through ECOHIS (Early Childhood Oral Health Impact Scale) and COHRQoL (Child Oral Health-Related Quality of Life) questionnaires, Wt, Ht, BMI, and blood chemistry parameters were measured at baseline and eight months after dental treatment under GA. RESULTS: At follow up, the reductions in the ECHOIS and the COHRQoL components were statistically significant (p < 0.0001), there was significant improvement in the anthropometric measures: 76.5% of children increased the percentile curves for weight, 68.6% for height, and 51.4% for BMI; for the blood chemistry parameters: ferritin improved in 68.6% of the samples, PCR in 65.7%, ESR in 68.6%, Vitamin D in 68.6%, and IGF-1 in 65.7%. CONCLUSIONS: Oral health status significantly influences OHRQoL, growth, and blood chemistry parameters in uncooperative pediatric patients.

COVID-19 Disease in Children: What Dentists Should Know and Do to Prevent Viral Spread. The Italian Point of View.

Coronavirus disease 2019 (COVID-19) has spread rapidly across the globe, becoming a major public health challenge not for China only, but also for countries around the world. Despite worldwide efforts to contain viral spread, the outbreak has not been stopped yet. Among healthcare personnel, dentists seem to be at elevated risk of exposure to COVID-19. This risk is even more serious in pediatric dentistry, since affected children, frequently, present an asymptomatic, mild or moderate clinical viral infection and, therefore, they may play a major role in community-based COVID-19 transmission. To date, despite no universal guidelines are available for dental procedures in pediatric dentistry during COVID-19 outbreak, routine dental practice should be postponed and only severe dental emergencies must be treated. In the case of a dental emergency, involving a pediatric patient, dentists should be aware of which recommended management protocol can be adopted during the practice to protect patient health, to safeguard their-self and to prevent viral transmission. The aim of this paper is to provide clinical recommendations, presenting a needed tool for dentists to allow a valid and safe how-to-do protocol. Pediatric dentists should keep a high level of awareness to help patients, minimize risk and prevent viral spread.

Socioeconomic Factors and Oral Health-Related Behaviours Associated with Dental Caries in Preschool Children from Central Italy (Province of Ascoli Piceno).

BACKGROUND: Dental caries is a serious oral health concern with high prevalence in preschool children. AIM: To assess the association among oral health-related behaviors, socioeconomic factors, and dental caries in Italian preschool children. DESIGN: 513 preschool children from 3 to 6 years of age, enrolled in nursery schools in central Italy, represent the population of the present study. The children underwent dental clinical examination and were divided on the basis of their caries experience in the primary dentition ("Yes" or "No"). Nonparametric analysis and univariate and multivariate logistic regression models were applied to evaluate the contribution of oral health-related behaviors and socioeconomic factors to the caries experience in the primary dentition. RESULTS: 419 children were caries free, and 94 children had caries experience in the primary dentition, corresponding to the 18.4% of participants. Different oral health-related behaviors and socioeconomic factors resulted to be associated with caries development. In particular, the mother's foreign nationality results in a strong predictive factor. CONCLUSIONS: The multivariate logistic model revealed factors significantly affecting caries experience in the primary dentition, which were the mother's nationality, the number of dental visits in a year, and the personal impression by the mother.

Relationship Between Social and Behavioural Factors and Caries Experience in Schoolchildren in Italy.

PURPOSE: The aims of this study were to: 1) determine the oral health status of Campanian (Italy) 5- and 12-year-old schoolchildren; 2) establish an oral health baseline prior to introducing promotion and prevention strategies and appropriate healthcare for specific groups; 3) provide the starting point for monitoring changes over time according to the World Health Organization 2020 global goals for oral health. MATERIALS AND METHODS: A cross-sectional observational study was performed on schoolchildren from public schools. 828 children were clinically evaluated, recording DMFT, dmft and SiC (Significant Caries Index). A questionnaire investigating demographic and oral health behaviour was completed by parents. RESULTS: 56.6% of the 5-year-old children were caries free (deciduous dentition) and the mean dmft value was 1.44 ± 2.13. In 12-year-old children, caries prevalence was 35.8%. The mean DMFT value was 1.17 ± 1.96, while the SiC was 3.42 ± 1.97. There were significant relationships between dmft/DMFT (caries experience) and family income level (p < 0.001), mother's educational level (p < 0.001) and history of recent dental visits (p < 0.01). CONCLUSION: Information drawn from this study can be helpful to describe future and specific dental prevention programmes in order to reduce caries incidence and promote better oral health in the Campania region of Italy.

Screening and Scoring of Antimicrobial and Biological Activities of Italian Vulnerary Plants against Major Oral Pathogenic Bacteria.

This study aims to evaluate the activity of Italian vulnerary plants against the most important oral pathogenic bacteria. This estimate was accomplished through a fivefold process: (a) a review of ethnobotanical and microbiological data concerning the Italian vulnerary plants; (b) the development of a scoring system to rank the plants; (c) the comparative assessment of microbiological properties; (d) the assessment of potential cytotoxic effects on keratinocyte-like cells and gingival fibroblasts in culture by XTT cell viability assay; (e) clinical evaluation of the most suitable plant extract as antibacterial agent in a home-made mouthwash. The study assays hexane (H), ethanol (E), and water (W) extracts from 72 plants. The agar diffusion method was used to evaluate the activity against Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, and Actinomyces viscosus. Twenty-two plants showed appreciable activity. The extracts showing the strongest antibacterial power were those from Cotinus coggygria Scop., Equisetum hyemale L., Helichrysum litoreum Guss, Juniperus communis L., and Phyllitis scolopendrium (L.) Newman subsp. scolopendrium. The potential cytotoxic effect of these extracts was assessed. On the basis of these observations, a mouth-rinse containing the ethanolic extract of H. litoreum has been tested in vivo, resulting in reduction of the salivary concentration of S. mutans.

In vivo remineralising effect of GC tooth mousse on early dental enamel lesions: SEM analysis.

OBJECTIVE: Casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP) exhibit anticariogenic potential in laboratory, animal and human experiments. The remineralising potential of synthetic CPPs on early enamel caries was investigated. DESIGN: In vivo study. SETTING: University of Naples 'Federico II', School of Dentistry, Department of Paediatric Dentistry, 2010, Italy. PARTICIPANTS: 40 volunteers (age range 10-16 years) were recruited and divided in two groups of 20 (Group A and B). INTERVENTIONS: In Group A subjects two demineralised enamel specimens were placed on the buccal surfaces of the first molars and subjects were instructed to apply a commercial product containing CPPs (GC Tooth Mousse) only on the right-sided specimen and a placebo mousse on the left, for 1 month. In Group B subjects two enamel specimens were similarly placed into the mouth and used as controls. RESULTS: SEM analysis revealed a diffuse and homogeneous mineral coating, reducing the surface alterations only in the demineralised specimens treated with synthetic CPPs into the mouth. CONCLUSIONS: Results demonstrate that CPPs are able to promote remineralisation of early enamel lesions.

Antimicrobial properties of green tea extract against cariogenic microflora: an in vivo study.

The aim of the present study was to test in vivo the effectiveness of an experimental green tea extract in reducing levels of mutans streptococci and lactobacilli in saliva by means of selective culture medium. Sixty-six healthy patients ranging in age from 12 to 18 years were recruited and randomly divided into two groups: Group A (n=33) and group B (n=33). Group A subjects were asked to rinse their mouths with 40 mL of an experimental green tea extract, for 1 minute, three times a day for a week, whereas Group B subjects were asked to rinse with 40 mL of a placebo mouth rinse. Saliva samples were obtained at baseline, 4 days, and 7 days. The counts of mutans streptococci and lactobacilli were investigated by chair-side kits. Data were statistically processed. A regression binary logistic analysis was done. The statistical significance level was established at P<.05. The experimental group showed a statistically significant reduction in colony counts of mutans streptococci and lactobacilli relative to the control group. These findings showed the efficacy of a green tea extract against cariogenic oral flora, opening a promising avenue of clinical applications in the preparation of specific and natural anticariogenic remedies.

Plant polyphenols and their anti-cariogenic properties: a review.

Polyphenols constitute one of the most common groups of substances in plants. Polyphenolic compounds have been reported to have a wide range of biological activities, many of which are related to their conventional antioxidant action; however, increasing scientific knowledge has highlighted their potential activity in preventing oral disease, including the prevention of tooth decay. The aim of this review is to show the emerging findings on the anti-cariogenic properties of polyphenols, which have been obtained from several in vitro studies investigating the effects of these bioactive molecules against Streptococcus mutans, as well as in vivo studies. The analysis of the literature supports the anti-bacterial role of polyphenols on cariogenic streptococci, suggesting (1) a direct effect against S. mutans; (2) an interaction with microbial membrane proteins inhibiting the adherence of bacterial cells to the tooth surface; and (3) the inhibition of glucosyl transferase and amylase. However, more studies, particularly in vivo and in situ, are necessary to establish conclusive evidence for the effectiveness and the clinical applications of these compounds in the prevention of dental caries. It is essential to better determine the nature and distribution of these compounds in our diet and to identify which of the hundreds of existing polyphenols are likely to provide the greatest effects.

Anti-cariogenic effects of polyphenols from plant stimulant beverages (cocoa, coffee, tea).

Polyphenols occurring in cocoa, coffee and tea can have a role in the prevention of cariogenic processes, due to their antibacterial action. Cocoa polyphenol pentamers significantly reduce biofilm formation and acid production by Streptococcus mutans and S. sanguinis. In the same way, trigonelline, caffeine and chlorogenic acid occurring in green and roasted coffee interfere with S. mutans adsorption to saliva-coated hydroxyapatite beads. Studies carried out on green, oolong and black tea indicate that tea polyphenols exert an anti-caries effect via an anti-microbial mode-of-action, and galloyl esters of (-)-epicatechin, (-)-epigallocatechin and (-)-gallocatechin show increasing antibacterial activities. The anti-cariogenic effects against alpha-haemolytic streptococci showed by polyphenols from cocoa, coffee, and tea suggest further studies to a possible application of these beverages in the prevention of pathogenesis of dental caries.