Caries experience between primary teeth at 3-5 years of age and future caries in the permanent first molars.

BACKGROUND/PURPOSE: Past caries experience remains the most powerful predictor of future caries. This study was aimed at exploring the possible relationship between the caries statuses at 3-5 and 8-10 years of age and examining the predictive power of caries experience at 3-5 years of age for the caries pattern at 8-10 years of age. MATERIALS AND METHODS: A total of 76 children (43 boys and 33 girls) were included in this study from 2012 to 2018. The first caries examination, performed in 2012, was completed when participants underwent dental rehabilitation under general anesthesia at 3-5 years of age. Tooth decay was recorded based on the International Caries Detection and Assessment System criteria. The caries examination was repeated in the clinic in 2018 when the participants were 8-10 years old. Associations between the permanent and primary teeth were analyzed using the Mann-Whitney U test. The receiver operating characteristic curve analysis was performed to determine the predictive accuracy of the primary dentition. RESULTS: A significant dmfs score of the primary second molar was found between groups of free dentin caries and dentin caries of the permanent first molars (p = 0.002). The calculated areas under the receiver operating characteristic curve for the dmfs score of the primary second molar was 0.74. CONCLUSION: Caries in the primary second molars is a clinically useful predictor at 3-5 years of age for future dentin caries development on surfaces of the first permanent molars in the following 5 years.

Dental plaque pH in predicting caries relapse after general anaesthesia - an exploratory study.

OBJECTIVES: Numerous caries risk assessment tools have been proposed in the literature, with few validated in preschool children especially those receiving oral rehabilitation under general anaesthesia (GA). Past caries experience, the best predictor thus far, may not be a reliable indicator after effective clinical intervention. Hence, this longitudinal study was aimed to explore the potential role of plaque pH in predicting future caries incidence after GA among preschool children. METHODS: Oral examination, plaque pH measurements and questionnaire survey were performed, among pre-schoolers indicated for GA, at baseline (n = 92), 6-month (6M; n = 83), 12-month (12M; n = 79) and 24-month (24M; n = 66) recall visits after GA. Multivariable logistic regression and receiver-operating characteristic analysis were performed to evaluate the predictive value of models with plaque pH and past caries experience. RESULTS: Individuals with low resting plaque pH at 6M and 12M were shown to be at high risk of 1-year caries incidence at 12M [relative risk (RR) 1.41, 95% confidence interval (CI) 1.09-1.48] and 24M (RR 1.61, 95% CI 1.22-1.73) recall visit, respectively. Moreover, plaque pH demonstrated a statistically significant predictive value in the 12M and 24M models (12M/24M: 85%/77%) compared with past caries experience, which was not a significant predictor in both models (both P > 0.05). CONCLUSIONS: Plaque pH may be a promising prognostic and predictive marker for early identification of high-risk children undergoing oral rehabilitation under GA.

Risk assessment models to predict caries recurrence after oral rehabilitation under general anaesthesia: a pilot study.

OBJECTIVES: Oral rehabilitation under general anaesthesia (GA), commonly employed to treat high caries-risk children, has been associated with high economic and individual/family burden, besides high post-GA caries recurrence rates. As there is no caries prediction model available for paediatric GA patients, this study was performed to build caries risk assessment/prediction models using pre-GA data and to explore mid-term prognostic factors for early identification of high-risk children prone to caries relapse post-GA oral rehabilitation. METHODS: Ninety-two children were identified and recruited with parental consent before oral rehabilitation under GA. Biopsychosocial data collection at baseline and the 6-month follow-up were conducted using questionnaire (Q), microbiological assessment (M) and clinical examination (C). RESULTS: The prediction models constructed using data collected from Q, Q + M and Q + M + C demonstrated an accuracy of 72%, 78% and 82%, respectively. Furthermore, of the 83 (90.2%) patients recalled 6 months after GA intervention, recurrent caries was identified in 54.2%, together with reduced bacterial counts, lower plaque index and increased percentage of children toothbrushing for themselves (all P < 0.05). Additionally, meal-time and toothbrushing duration were shown, through bivariate analyses, to be significant prognostic determinants for caries recurrence (both P < 0.05). CONCLUSIONS: Risk assessment/prediction models built using pre-GA data may be promising in identifying high-risk children prone to post-GA caries recurrence, although future internal and external validation of predictive models is warranted.

Effects of Lactobacillus casei Shirota intake on caries risk in children.

BACKGROUND/PURPOSE: Yakult is a well-known probiotic beverage consisting of a single live bacterial species, Lactobacillus casei Shirota. However, the potential cariogenic/cariostatic effects of Yakult intake among children have not been studied yet. Hence, this study aimed to investigate the clinical effects of short-term Yakult intake on oral biofilm acidogenicity, cariogenic bacterial counts, and caries risk in children. MATERIALS AND METHODS: Eighteen children, 7-11 years of age, consumed standard Yakult daily for 7 days. Prior to and after intervention, functional oral biofilm acidogenicity characterized by the Stephan curve, Lactobacillus and Streptococcus mutans counts, and caries risk were determined. RESULTS: Probiotic intervention demonstrated significant increase in minimum pH from 4.88 to 5.14 (P = 0.02), 18.2% reduction in area under the Stephen curve [area under the curve (AUC)], and 29.3% decrease in pH recovery time, although these two differences were not statistically significant. No difference was observed in S. mutans and Lactobacillus counts or caries risk after intervention (all P > 0.05). However, on subgroup analysis using "reduction of AUC" to separate "responders" from the "nonresponders", the significant cariostatic effects on oral biofilm acidogenicity, among "responders", were revealed by an increase in minimum pH (P = 0.005) and a reduction in pH recovery time (P = 0.003). CONCLUSION: There may be a potential cariostatic effect of short-term Yakult intake in reducing functional biofilm acidogenicity in children with certain oral biofilm and risk profile. Further studies may be needed to validate this probiotic effect. Quality risk assessment may be critical prior to prescribing/recommending Yakult as an adjunct caries-preventive treatment for children.