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Untreated dental caries in Chinese pre-school children is common. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. Three hundred seventy-five children, aged 3-5 years, with carious upper anterior teeth were divided into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). Sodium fluoride varnish (22,600 ppm F) was applied every three months to the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. Three hundred eight children were followed for 30 months. The respective mean numbers of arrested carious tooth surfaces in the five groups were 2.5, 2.8, 1.5, 1.5, and 1.3 (p < 0.001). Silver diamine fluoride was found to be effective in arresting dentin caries in primary anterior teeth in pre-school children.

This concise review presents two Cochrane Reviews undertaken to determine: (1) the relative effectiveness of fluoride toothpastes of different concentrations in preventing dental caries in children and adolescents; and (2) the relationship between the use of topical fluorides in young children and their risk of developing dental fluorosis. To determine the relative effectiveness of fluoride toothpastes of different concentrations, we undertook a network meta-analysis utilizing both direct and indirect comparisons from randomized controlled trials (RCTs). The review examining fluorosis included evidence from experimental and observational studies. The findings of the reviews confirm the benefits of using fluoride toothpaste, when compared with placebo, in preventing caries in children and adolescents, but only significantly for fluoride concentrations of 1000 ppm and above. The relative caries-preventive effects of fluoride toothpastes of different concentrations increase with higher fluoride concentration. However, there is weak, unreliable evidence that starting the use of fluoride toothpaste in children under 12 months of age may be associated with an increased risk of fluorosis. The decision of what fluoride levels to use for children under 6 years should be balanced between the risk of developing dental caries and that of mild fluorosis.

Background/Aims: Root caries among elderly communities is of growing public health concern globally. This controlled clinical trial investigated the effectiveness of silver diamine fluoride and oral health education in preventing and arresting root caries. Methods: Two hundred sixty-six elderly subjects who had at least 5 teeth with exposed root surfaces and did not have serious life-threatening medical diseases were allocated to 3 groups according to a computer-generated random list: group 1 (the control group) received oral hygiene instructions (OHI) annually; group 2 received OHI and silver diamine fluoride (SDF) application annually, and group 3 was given OHI and SDF application annually, plus an oral health education (OHE) programme every 6 months. Results: Two hundred twenty-seven elderly subjects were followed for 24 months. The mean numbers of new root caries surfaces in groups 1, 2 and 3 were 1.33, 1.00 and 0.70, respectively (ANOVA, p < 0.05). Group 3 had fewer root surfaces with new caries than group 1 (Scheffé multiple-comparison test, p < 0.05). The mean numbers of arrested root caries surfaces in groups 1, 2 and 3 were 0.04, 0.28 and 0.33, respectively (ANOVA, p < 0.01). Group 3 and group 2 had a greater number of active root caries surfaces which became arrested than group 1 (Scheffé multiple-comparison test, p < 0.05). Conclusion: Annual application of SDF together with biannual OHE was effective in preventing new root caries and arresting root caries among community-dwelling elderly subjects.

Dental caries (tooth decay) is an infectious disease. Its etiology is not fully understood from the microbiological perspective. This study characterizes the diversity of microbial flora in the saliva of children with and without dental caries. Children (3–4 years old) with caries (n = 20) and without caries (n = 20) were recruited. Unstimulated saliva (2 mL) was collected from each child and the total microbial genomic DNA was extracted. DNA amplicons of the V3-V4 hypervariable region of the bacterial 16S rRNA gene were generated and subjected to Illumina Miseq sequencing. A total of 17 phyla, 26 classes, 40 orders, 80 families, 151 genera, and 310 bacterial species were represented in the saliva samples. There was no significant difference in the microbiome diversity between caries-affected and caries-free children (p > 0.05). The relative abundance of several species (Rothia dentocariosa, Actinomyces graevenitzii, Veillonella sp. oral taxon 780, Prevotella salivae, and Streptococcus mutans) was higher in the caries-affected group than in the caries-free group (p < 0.05). Fusobacterium periodonticum and Leptotrichia sp. oral clone FP036 were more abundant in caries-free children than in caries-affected children (p < 0.05). The salivary microbiome profiles of caries-free and caries-affected children were similar. Salivary counts of certain bacteria such as R. dentocariosa and F. periodonticum may be useful for screening/assessing children’s risk of developing caries.

BackgroundThis study aimed to assess the dental caries and erosion status of 12-year-old Hong Kong children and study the determinants of dental caries and dental erosion of these children.MethodsThe survey was performed from 2011 to 2012 with ethics approval. Stratified random sampling was adopted to select 12-year-old children in 7 primary schools in Hong Kong. The participating parents were asked to complete a self-administered questionnaire concerning their children’s diet and oral health habits. The children were examined for caries status with WHO criteria by 3 calibrated examiners. Detection of dental erosion followed Basic Erosive Wear Examination (BEWE) criteria.ResultsA total of 704 children were recruited and 600 (316 boys, 53%) participated in the survey. There were 124 children (21%) with caries experience (DMFT > 0) and their DMFT was 0.34 ± 0.76. About half of their decay was unfilled (DT = 0.16 ± 0.52) The DMFT of girls and boys were 0.45 ± 0.89 and 0.23 ± 0.61, respectively (p = 0.001). Girls also had a higher DT (0.21 ± 0.62 compared with 0.11 ± 0.41, p = 0.013) and FT than boys (0.23 ± 0.63 compared with 0.12 ± 0.44, p = 0.016). Most children (75%) had at least some sign of erosion (BEWE > 0), but no severe erosion (BEWE = 3). Logistic regression showed girls who consumed soft drinks and took vitamin C supplements had higher caries risk. Dental erosion was more severe among the children who had caries experience and consumed fruit juice.ConclusionsThe 12-year-old Hong Kong children had low caries experience, and almost half of the decay was left untreated. Although severe erosion was not found, many children had early signs of erosion.

Human-in-the-loop (HITL) AI may enable an ideal symbiosis of human experts and AI models, harnessing the advantages of both while at the same time overcoming their respective limitations. The purpose of this study was to investigate a novel collective intelligence technology designed to amplify the diagnostic accuracy of networked human groups by forming real-time systems modeled on biological swarms. Using small groups of radiologists, the swarm-based technology was applied to the diagnosis of pneumonia on chest radiographs and compared against human experts alone, as well as two state-of-the-art deep learning AI models. Our work demonstrates that both the swarm-based technology and deep-learning technology achieved superior diagnostic accuracy than the human experts alone. Our work further demonstrates that when used in combination, the swarm-based technology and deep-learning technology outperformed either method alone. The superior diagnostic accuracy of the combined HITL AI solution compared to radiologists and AI alone has broad implications for the surging clinical AI deployment and implementation strategies in future practice.

BackgroundFor many years, topical use of fluorides has gained greater popularity than systemic use of fluorides. A possible adverse effect associated with the use of topical fluoride is the development of dental fluorosis due to the ingestion of excessive fluoride by young children with developing teeth. ObjectivesTo describe the relationship between the use of topical fluorides in young children and the risk of developing dental fluorosis. Search strategyElectronic search of the Cochrane Oral Health Group Trials Register, CENTRAL, MEDLINE, EMBASE, BIOSIS, Dissertation Abstracts and LILACS/BBO. Reference lists from relevant articles were searched. Date of the most recent searches: 9th March 09. Selection criteriaRandomised controlled trials (RCTs), quasi-RCTs, cohort studies, case-control studies and cross-sectional surveys, in which fluoride toothpastes, mouthrinses, gels, foams, paint-on solutions, and varnishes were compared to an alternative fluoride treatment, placebo or no intervention group. Children under the age of 6 years at the time topical fluorides were used. Data collection and analysisData from all included studies were extracted by two review authors. Risk ratios for controlled, prospective studies and odds ratios for case-control studies or cross-sectional surveys were extracted or calculated. Where both adjusted and unadjusted risk ratios or odds ratios were presented, the adjusted value was included in the meta-analysis. Main results25 studies were included: 2 RCTs, 1 cohort study, 6 case-control studies and 16 cross-sectional surveys. Only one RCT was judged to be at low risk of bias. The other RCT and all observational studies were judged to be at moderate to high risk of bias. Studies were included in four intervention/exposure comparisons. A statistically significant reduction in fluorosis was found if brushing of a child's teeth with fluoride toothpaste commenced after the age of 12 months odds ratio 0.70 (random-effects: 95% confidence interval 1 Topical fluoride as a cause of dental fluorosis in children (Review)