Impact of Motivational Interviewing on Parental Risk-Related Behaviors and Knowledge of Early Childhood Caries: A Systematic Review.

BACKGROUND: Behavior is important in dental disease etiology, so behavioral interventions are needed for prevention and treatment. Motivational interviewing (MI) has been proposed as a potentially useful behavioral intervention for prevention of early childhood caries. METHODS: Studies have evaluated the effectiveness of MI on reduction of the risk-related behaviors for early childhood caries (ECC) compared to dental health education (DHE) The aim of this systematic review was to assess the scientific evidence on MI applied to change parental risk-related behaviors. The potentially eligible studies involved the assessment of caries-related behaviors in caregivers receiving MI. Electronic search of English published literature was performed in February 2020 in the Scopus, Cochrane, PubMed, and Embase databases. Assessment of risk of bias was done by the Cochrane risk of bias tool. RESULTS: Of 329 articles retrieved initially, seven were eligible for inclusion in this review. Four studies evaluated the behavior of tooth brushing and four studies assessed the cariogenic feeding practice, while only one study investigated the behavior of checking teeth for pre-cavities. Moreover, two studies examined dental attendance for varnish fluoride use and oral health-related knowledge. It was not possible to perform a meta-analysis. CONCLUSIONS: Generally, results support the application of MI to improve the "dental attendance behavior for fluoride use" and participants' knowledge. However, the results were inconclusive for other behaviors. We need further and better designed interventions to completely evaluate the impact of MI on specific ECC-related behaviors.

Make proper surfaces for immobilization of enzymes: Immobilization of lipase and α-amylase on modified Na-sepiolite.

This paper has focused on making suitable carriers for the immobilization of α-amylase from Bacillus subtilis and lipase from Candida rugosa via adsorption on modified Na-sepiolite (SEP). Two modified carriers were prepared by changing the nature of SEP with cetrimonium bromide surfactant at concentrations below the CMC of the surfactant, to produce SEP with monolayer surfactant (MSEP) with hydrophobic properties and above the CMC of the surfactant to produce SEP with bilayer surfactant (BSEP) with hydrophilic properties. The enzymatic activity of immobilized lipase on MSEP (MSEPL) and immobilized α-amylase on BSEP (BSEPA) was successfully tested in the hydrolysis of olive oil and starch. The support modification and immobilization process were characterized by BET, XRD, and SEM techniques. The results demonstrated that the specific activity of MSEPL and BSEPA was 1.74 and 2.28 U/mg, respectively. The remained activity of MSEPL (56.7%) and BSEPA (40.4%) after their incubation at 60 °C for 4 h was much higher than that of free enzymes. The residual activity of MSEPL and BSEPA was 77.4% and 66.7%, after 30 days of storage at 4 °C. The MSEPL and BSEPA also showed good reusability, and their relative activities were 54.0% and 44.2% after ten cycles.

Persica Chewing Gum Effects on Saliva Fluoride Concentration and Flow Rate: A Triple-Blind Randomized Clinical Trial.

CONTEXT: Dental caries is a prevalent disease worldwide. Salvadora persica or Miswak could be a source of fluoride and has caries preventive effects. AIMS: The aim of this study was to compare saliva fluoride concentration and flow rate after using Persica and sodium fluoride chewing gums. SETTINGS AND DESIGN: In a triple-blind crossover randomized trial, 44 healthy volunteers (21-25 year old) were recruited according to the inclusion criteria and were randomly allocated into two groups (22 each). PARTICIPANTS AND METHODS: This study was performed within two sets of trial with a 10-day washout period. Participants (subjects) were followed a running period and matched for trial confounders. Saliva samples were collected under controlled conditions at similar time (11 am) within baseline, 5, 10, 20, and 45 min intervals preceded by 5-min chewing of Persica or sodium fluoride chewing gum. Saliva samples were analyzed for fluoride ion using hexamethyldisiloxane diffusion method. STATISTICAL ANALYSIS USED: Saliva flow rate (ml/min) and mean fluoride concentration (ppm) during different time periods in two types of gum were compared using ANOVA-repeated measures (P < 0.05). RESULTS: The difference in total means of stimulated saliva flow rates between two Persica and sodium fluoride gum intervention groups was statistically significant (P = 0.048); however, difference of fluoride concentrations was not statistically significant (P = 0.244). CONCLUSIONS: Chewing Persica containing gum released fluoride ions in saliva and increased saliva flow rate comparable with sodium fluoride chewing gum use as a gold standard.

Development of Caries Risk Assessment Tool for Iranian Preschoolers: A Primary Validation Study.

BACKGROUND: The aim of the present study was to develop a dental caries risk assessment tool for Iranian preschoolers. METHODS: In a validation and cross-sectional study, a random sample of 150 preschool children was involved. This study was conducted in three phases: questionnaire design (expert panel and peer evaluation), questionnaire testing (pilot evaluation and field testing), and validation study. The initial assessments include interview, dental examination, and laboratory investigations. Validity and reliability indices, content validity index (CVI), content validity ratio (CVR), impact score, and test-retest and Cronbach's alpha were measured. Decayed, missing, filled teeth (dmft) scores were calculated according to the WHO guidelines. RESULTS: The Iranian version of caries risk assessment (CRA) questionnaire contained 17 items. Cronbach's alpha coefficient (0.86) indicated a suitable internal consistency. The mean scores for the CVI and the CVR were 0.87 and 0.78, respectively. The prevalence rate of dental caries in the study group was 69.3%, and the mean dmft was 4.57 (range 0-19). CONCLUSIONS: The Persian version of CRA questionnaire was adapted to the Iranian population. The findings demonstrated overall acceptable validity and also reliability in the application of test-retest. The results of the present study provide initial evidence that the designed CRA form could be a useful tool for CRA in the Iranian preschoolers.

Assessment of available and stable fluoride in four widely-used toothpastes in the Iranian market.

OBJECTIVE: Presence of available and stable fluoride in a dentifrice formulation is a major requirement for an anti-caries effect. Although the available fluoride concentration in Iranian dentifrices has been reported in previous studies, there is little information on its stability; which is dependent upon dentifrice formulation. This study was done to assess the fluoride ion concentration and stability in four widely used dentifrices in Iran. MATERIALS AND METHODS: In this analytical study, three samples of each brand of dentifrice (Nasim, Pooneh, Crest, and Signal) were purchased. Total fluoride (TF) and total soluble fluoride (TSF) concentrations were determined by ion specific electrodes. Data about TF were analyzed by one-way analysis of variance (ANOVA). Kruskal-Wallis and Mann-Whitney tests were used for nonparametric data (TSF). RESULTS: All dentifrices had more than 1000 ppm of fluoride ions. TSF in Crest was significantly higher than in other dentifrices (P<0.0001) and was over the maximum permitted dose. CONCLUSION: The TF concentration in Iranian toothpastes was sufficient to prevent caries.

Salivary Streptococcus mutans and Lactobacilli levels following probiotic cheese consumption in adults: A double blind randomized clinical trial(*).

BACKGROUND: The beneficial effects of Lactobacillus species have been reported but the role of these species including Lactobacillus casei (L. casei) on oral health is not well documented. The purpose of this study was to evaluate the effects of conventional or probiotic cheese containing L.casei on salivary Streptococcus mutans (SM) and Lactobacilli levels. METHODS: In this double-blind controlled trial (IRCT201009144745N1), 60 adults were randomly allocated in 2 parallel blocks. SM and Lactobacilli count assessment were performed three times. Subjects consumed either cheese containing L. casei (1×10(6)Cfu/g) (probiotic block, n=29) or cheese without any probiotic (control block, n=31) twice daily for two weeks. Bacterial levels changes were compared using Wilcoxon and Mann-Whitney Tests. Logistic regression compared changes in number of subjects with lowest and highest SM or Lactobacilli levels. RESULTS: Statistically significant (p = 0.001) reduction of salivary SM was found in probiotic group. SM levels reduction was not significant between placebo and trial groups (p = 0.46, 62% in probiotic vs. 32% in placebo group). Lacto-bacilli count changes during trial were not statistically significant inter and intra blocks (p = 0.12). Probiotic intervention was significantly effective in high levels (> 10(5)cfu/ml) of SM (Odds Ratio 11.6, 95% CI 1.56-86.17, p = 0.017). CONCLUSIONS: Probiotic cheese containing L. casei was not effective in salivary SM levels reduction comparing to conventional cheese. Adding L. casei to cheese could be useful in decreasing SM counts in adults 18-37 years old with highest level of SM.

Recharge pattern of contemporary glass ionomer restoratives.

BACKGROUND: As glass ionomers have the ability to reload fluoride from outside sources, the aim was to compare the recharge pattern of six glass ionomer cements after exposure to fluoride. MATERIALS AND METHODS: Fuji VII, Fuji IX, Riva Pink, Riva Bleach, Ketac Fil and Fuji IX Extra were investigated. The fluoride-containing materials used were tooth paste and mouth wash (Colgate). Specimens of each material (n=15) were immersed separately in deionized water for 59 days. Then the samples of each material were divided into three groups of five each. Two groups were recharged for 2, 20 and 60 min daily during three consecutive weekly intervals and then no treatment for one week. The third group was used as control. Fluoride release measurements (µg/cm(2)/day) were made in every 24 h. One-way and repeated measures analysis of variance tests were used. RESULTS: Tooth paste recharged materials showed higher level of recharge. On day 1, the difference of fluoride release from different treatment groups of different materials except for Fuji IX Extra were not significant (P>0.05). On days 7 and 14, the differences observed were significant (P<0.05) for all materials except for Fuji VII (tooth paste versus mouth wash) and Trial Fuji IX (mouth wash versus control) and on day 14 for Rvia Pink (mouth wash versus control). On days 21 and 28, the differences observed were significant for all the materials (P<0.05) except for Riva Pink (toothpaste versus mouth wash), Riva Bleach, Ketac Fil and Trial FujiI X (mouth wash versus control) on day 28. CONCLUSION: A time tabled schedule of application of fluoride-containing materials could help to achieve high fluoride release.

Plaque pH Changes Following Consumption of Two Types of Plain and Bulky Bread.

BACKGROUND: Consistency, backing process and content differences could influence cariogenic potential of foods. The aim was to compare plaque pH changes following consumption of two types of bread with different physical characteristics. METHODS: In this clinical trial, interproximal plaque pH of 10 volunteers with high risk of dental caries (saliva Streptococcus mutans > 10(5), high dental caries experience, and average DMFT =6.10 ± 1.56) was measured. Plain traditionally backed "Sangak bread" and soft bulky "Baguette bread" and %10 sucrose solution were tested in a cross over designed experiment. Baseline plaque pH was recorded and followed by 1, 5, 10, 15, 20, and 30 minutes intervals. Data was analyzed using ANOVA and Tukey test (α = 0.05). RESULTS: Sucrose solution caused the most pronounced pH and ΔpH drop from 7.15 ± 0.33 at baseline to 6.78 ± 0.29. Means plaque pH of 10% sucrose solution and Baguette were not statistically different at 1, 20 and 30 minutes (P > 0.05). Mean plaque pH of Sangak and Baguette showed significant differences at 0, 1, 20 and30 minutes (P <60; 0.05). Sucrose solution caused a dramatic plaque pH drop during first 10 minutes and then within 30 minutes returned to baseline pH. For two bread samples within first 10 minutes, pH increased and then started to decrease during tenth to fifteenth minutes. CONCLUSION: During all experiment phases, the mean pH of Baguette with less consistency and carbohydrate content and higher rate of starch gelatination was lower compared to Sangak.

Association of cardiometabolic risk factors and dental caries in a population-based sample of youths.

BACKGROUND: Cardiovascular disease (CVD) risk factors begin from early life and track onto adulthood. Oral and dental diseases share some risk factors with CVD, therefore by finding a clear relation between dental diseases and cardiometabolic risk factors; we can then predict the potential risk of one based on the presence of the other. This study aimed to compare the prevalence of dental caries between two groups of age-matched adolescents with and without CVD risk factors. METHODS: In this case-control study, the decayed, missing and filled surfaces (DMFS), based on the criteria of the World Health Organization, were compared in two groups of equal number (n = 61 in each group) of population-based sample of adolescents with and without CVD risk factors who were matched for sex and age group. RESULTS: The study participants had a median age 13 y 5 mo, age range 11 y 7 mo to 16 y 1 mo, with male-to-female proportion of 49/51. We found significant difference between the mean values of DMFS, body mass index, waist and hip circumferences, as well as serum lipid profile in the case and control groups. Significant correlations were documented for DMFS with TC (r = 0.54, p = 0.02), LDL-C (r = 0.55, p = 0.01) and TG (r = 0.52, p = 0.04) in the case group; with LDL-C (r = 0.47, p = 0.03) in the whole study participants and with TC in control s(r = 0.45, p = 0.04). CONCLUSIONS: Given the significant associations between dental caries and CVD risk factors among adolescents, more attention should be paid to oral health, as one of the topics to be taken into account in primordial/primary prevention of cardiometabolic disorders.