Prevalence of Health Problems Targeted by the National School-Based Screening Program among Primary School Students in Saudi Arabia, 2019

The Saudi Ministry of Health (MOH) established a National School-Based Screening Program (NSBSP) for health screening of schoolchildren. Students from specific grades were systematically screened for several health problems, including obesity, visual and auditory problems, dental cavities, scoliosis, and attention-deficit/hyperactivity disorder (ADHD). This cross-sectional study aimed to determine the prevalence of these health problems among primary school students based on secondary data obtained from the NSBSP. We included 444,259 screened school children from the first and fourth grades of 50% of the selected schools (both private and public) across the Kingdom of Saudi Arabia (KSA) during the academic year 2018–2019. Among them, the most prevalent health problems identified were dental cavities (38.7%), eye refractory errors (10.9%), and overweight and obesity (10.5%); the less prevalent problems included ADHD (2.81%), auditory problems (0.6%), and scoliosis (0.48%). A greater prevalence of most health problems was observed in girls more than boys. The NSBSP successfully aided the detection of health conditions with high and low prevalence among primary school students in the KSA, and thus, the identification of health problems of specific concern. Implementation of effective school health services for the prevention, early detection, diagnosis, and treatment of these health problems are imperative.

The largest and earliest known sample of dental caries in an extinct mammal (Mammalia, Euarchonta, Microsyops latidens) and its ecological implications

Dental cavities or caries is a common disease among modern humans, affecting almost every adult. Caries frequency has been used to study dietary change in humans over time, based on an inferred tie between the incidence of caries and a carbohydrate-rich diet. However, the disease is not unique to our species. Among non-human primates, there is also variation in caries frequency associated with diet, suggesting that this metric may provide a mechanism for studying diet in broader contexts, and across geological time. To date, very few studies have examined caries among fossil mammals, and none have done so among Eocene mammals. Here, we present our analysis of the largest sample to date of fossil caries in a single extinct mammal species, Microsyops latidens, a stem primate from the early Eocene, which is known from over a thousand specimens from the Southern Bighorn Basin of Wyoming (n = 1030). Our results show that Microsyops latidens is characterized by a high prevalence of dental caries (7.48% of individuals), with notable variation through time, reaching 17.24% of individuals from a particular interval. This interval is also associated with a change in overall dental form, as quantified by dental topographic analysis, which measures functional aspects of the chewing surface of teeth. These observations suggest that this species experienced a shift in their diet to include more fruit or other sugar rich-foods for a short period. Our analysis, therefore, suggests that the diet of M. latidens fluctuated over time, as well as providing a framework for assessing caries in other fossil taxa.

Prevalence of Health Problems Targeted by the National School-based Screening Program among Primary School Students in Saudi Arabia, 2019

The Ministry of Health (MOH) in the Kingdom of Saudi Arabia (KSA) established a National School-based Screening Program (NSBSP) for health screening of school-going children. Students from specific grades were systematically screened for several health problems including obesity, visual and auditory problems, dental cavities, scoliosis, and attention-deficit/hyperactivity disorder (ADHD). This cross-sectional study aimed to determine the prevalence of these health problems among primary school students based on secondary data obtained from the NSBSP. We included 444,259 screened school children from the 1st and 4th grades of 50% of the selected schools (both private and public) across the KSA during the academic year 2018-2019. Among them, the most prevalent health problems identified were dental cavities (38.7%), eye refractory errors (10.9%), and overweight and obesity (10.5%); the less prevalent problems included ADHD (2.81%), auditory problems (0.6%), and scoliosis (0.48%). A greater prevalence of most health problems was observed in girls than boys. The NSBSP successfully aided the detection of health conditions with high and low prevalence among primary school students in the KSA, and thus, identification of health problems of specific concern. Implementation of effective school health services for the prevention, early detection, diagnosis, and treatment of these health problems is imperative.

Positioning on the Use of Polyols as Table Sweeteners

Polyols are poorly digestible carbohydrates present in small amounts in some fruits and vegetables. Xylitol and erythritol are used as table sweeteners. These compounds are widely used in the food industry due to their low-calorie content. Erythritol is the only noncaloric polyol. Xylitol is the sweetest of the polyols, being the only one with sweetness equivalent to sucrose, but with one third of its calories. Clinical studies have shown reductions in the number of plaques, in counts of Streptococcus mutans, and in the number of dental cavities in individuals receiving erythritol and xylitol. Xylitol is also capable of reducing the growth and adherence to the oropharynx of bacteria that cause acute otitis media, such as Streptococcus pneumoniae, and several studies have shown that it reduces the risk of this bacterial infection in children. In addition to these effects, polyols can also have beneficial effects on metabolism. Both erythritol and xylitol have been approved by the European Union for use as sweeteners for several years, and replacing sugar with polyols decreases caloric intake, which can reduce body weight and blood glucose in individuals with obesity and type 2 diabetes mellitus. The safety of polyols is recognized by the Food and Drug Administration (FDA), who classifies them as compounds generally recognized as safe (GRAS). Thus, based on available scientific data, the daily consumption of both substances is associated with several benefits and does not represent any risk to human health.

Scale-dependent tipping points of bacterial colonization resistance

Bacteria are efficient colonizers of a wide range of secluded micro-habitats, such as soil pores, skin follicles, dental cavities or crypts in gut-like environments. Although numerous factors promoting or obstructing stable colonization have been identified, we currently lack systematic approaches to explore how population stability and resilience depend on the scale of the micro-habitat. Using a microfluidic device to grow bacteria in crypt-like incubation chambers of systematically varied lengths, we found that the incubation scale can sensitively tune bacterial colonization success and resistance against invaders. Small crypts are un-colonizable, intermediately sized crypts can stably support dilute populations, while beyond a second critical lengthscale, populations phase-separate into a dilute and a jammed region. We demonstrate that the jammed state confers extreme colonization resistance, even if the resident strain is suppressed by an antibiotic. Combined with a flexible biophysical model, we show that scale acts as an environmental filter that can be tuned via the competition between growth and collective cell motion. More broadly, our observations underscore that scale can profoundly bias experimental outcomes in microbial ecology. Systematic, flow-adjustable lengthscale variations may serve as a promising strategy to elucidate further scale-sensitive tipping points and to rationally modulate the stability and resilience of microbial colonizers.

Scardovia wiggsiae and Streptococcus sobrinus Prevalence among Orthodontic and Non-Orthodontic Patients

Background: Dental cavities or caries have been identified as among the most prevalent of preventable oral conditions. However, studies are discovering new information regarding the incidence and prevalence of several cariogenic organisms, including Streptococcus mutans (SM), the recently discovered Scardovia wiggsiae (SW), as well as Streptococcus sobrinus (SS). These studies have revealed varying prevalence among different populations, such as those undergoing orthodontic treatment. Based upon this information, the main goal of the current study was to assess the prevalence of specific cariogenic organisms (SS and SW) within saliva samples originally obtained from a dental school-based clinic. Methods: The protocol for this retrospective study of DNA isolated from previously collected saliva samples was reviewed and approved by the Institutional Review Board (IRB) as exempt research. In brief, clinical DNA samples were screened for SS and SW using quantitative polymerase chain reaction (qPCR). Demographic and subgroup (Orthodontic, non-Orthodontic) analysis was also performed. Results: This study found that pediatric (12-17 year old patient) samples were much more likely to harbor either SW or SS compared with adult (>18 year old patient) samples. In addition, this study found many more SW-positive samples among pediatric orthodontic patients compared with either adult or pediatric non-Orthodontic patients, which may suggest this population may be at higher risk for SW-related caries or other negative oral health outcomes. Finally, this study found these microbial populations to be strongly linked within the same patient samples. Conclusions: This study has demonstrated that prevalence of SW and SS may be more highly associated with specific population subgroups, including SS observed in non-orthodontic patients and SW found among pediatric orthodontic patients. These results also differ from previous evidence, which found only minor and partially overlapping prevalence of these and other oral microbes. The results of this current study may suggest that SS and SW may be more strongly correlated within similar oral microbial communities and their presence may be directly or indirectly linked through one or more behavioral, microbial or other factors – although more research will be needed to determine these mechanisms.

Detection of Inflammatory and Homeostasis Biomarkers after Selective Removal of Carious Dentin—An In Vivo Feasibility Study

Deep carious dentin lesions induce an immune reaction within the pulp-dentin complex, leading to the release of cytokines, which might be suitable biomarkers in pulp diagnostics. This in vivo feasibility study determines the concentration of different cytokines after selective removal of carious infected dentin (SCR). In our methodology, paired samples are obtained from 21 patients—each of them with two deep carious lesions at posterior teeth without clinical symptoms. After SCR, lesions are randomly assigned to treatment strategy: Group 1 (11 patients): Carious dentin is covered either with BiodentineTM (n = 11) or gutta-percha (n = 11) before using the adhesive OptibondTM FL. Group 2 (10 patients): The adhesives ClearfilTM SE Protect Bond (n = 10) or ClearfilTM SE Bond 2 (n = 10) are directly applied. Prepared cavities are rinsed with phosphate buffered saline containing 0.05% Tween 20 (10X) for five minutes immediately after SCR (visit 1) and eight weeks later (visit 2). Rinsing liquid is regained. Concentrations of IL-1β, IL-6, IL-10, C-reactive protein (CRP), TNF-α, IFN-γ, TIMP-1, -2, and MMP-7, -8, -9 are assessed by customized multiplex assays, evaluated with fluorescence analyzer. Non-parametric statistical analysis (Wilcoxon, Mann–Whitney U Test, p < 0.05) is performed (SPSS 25). Our results show that concentrations of CRP, IL-1β, IL-6, TIMP-1, -2, and MMPs were detectable. Median concentrations of CRP, IL-1β und IL-6 were significantly higher in visit 1 (304.9, 107.4, 3.8 pg/mL), compared to visit 2 (67.8, 2.3, 0.0 pg/mL; pi < 0.001). The study revealed that the non-invasive determination of cytokines from prepared dental cavities is possible.

Resistência à compressão de compósitos de preenchimento único

A new class of composite resins called single fill resins (Bulk-Fill) was proposed to simplify restorative procedures. They allow filling dental cavities in layers of approximately 4mm. This study aims to compare the compression strength of single fill composites with different polymerization times. Four Bulk-Fill composites were used Filtek Bulk-Fill, Filtek Bulk-Fill Flow, Tetric N-Ceram Bulk-Fill, and Tetric N-Flow Bulk-Fill, and also a conventional composite Filtek Z350 XT as a control group. One hundred cylinders were manufactured in a matrix with 4.7mm diameter and 4mm height for Bulk-Fill compounds, and 2mm height for the control group. Half of the specimens of each material was photopolymerized for 10 seconds and the other half for 20 seconds (n = 10). The samples were stored in distilled water for 48 hours at 37°C and subjected to compression testing in a universal test machine. Variance analysis was performed with t-test of multiple comparisons between groups and student t-test for the different polymerization times with significance index p=0.05. The results did not show statistically significant difference in relation to polymerization time. However, there was a statistically significant difference between the control and Filtek Bulk-Fill Flow groups, which presented higher strenght to compression than the Filltek Bulk-Fill, Tetric N-Ceram Bulk-Fill, and Tetric N-Flow Bulk-Fill groups. The type of resin can influence its resistance to fracture. The polymerization time did not have any influence in the materials strength.

Deliberate Practice Makes Perfect: Improving Therapist Effectiveness

Psychotherapy works. The results of numerous studies show that those individuals treated are better off than those not treated or on waitlists with an average effect size of .8 (Duncan et al., 2008). To put it in perspective, the effects of psychotherapy are equal to those found for coronary artery bypass surgery and 4 times greater than fluoride in the prevention dental cavities. Yet, three persistent problems plague the psychotherapy field: 1) clients drop out of therapy at alarming rates – almost half of clients decide not to continue and prematurely terminate; 2) not only do therapists not notice when clients are at risk for dropping out, they also do not detect when things are getting worse (approximately 10% of clients get worse after starting therapy); and 3) a small percentage of clients (10%) accounts for the largest amount of expenditures (Minami, 2008). This last finding may be the result of therapists not realizing when things are not working or getting worse and instead of changing course, doing more of what is not working, over and over again. Along these lines, most therapists do not have an accurate sense of their helpfulness and on average, overrate their effectiveness by 65% (Chow, 2014). Given the issues with retention, coupled with the self-assessment bias among therapists, it’s not surprising that psychotherapy outcomes have not appreciably improved over the past 40 years.

Effect of Low and High Viscosity Composites on Temperature Rise of Premolars Restored through the Bulk-Fill and the Incremental Layering Techniques

Background: Deep dental cavities can be restored through a single step according to the bulk-fill technique. Due to the great amount of resin to be cured, a main concern is the temperature rise occurring in the pulp chamber, potentially higher than that developed through the incremental layering technique. Temperature rise of bulk-fill composites have been evaluated. Methods: Bulk-fill composites, differing in material composition and viscosity, were used. Maximum temperature and temperature rate occurring in the composites were measured. Mesio-occlusal-distal cavities of human premolars were restored through the bulk-fill or the incremental layering techniques, and peak temperature and temperature rate occurring in the dentin, 1 mm below the cavity floor, were evaluated. Results: Temperature peak and temperature rise of flowable composites were significantly higher (p < 0.05) than packable composites. For both the techniques, higher temperature peaks were recorded in the dentin for flowable composites. Peak temperatures higher than 42 °C were recorded for the incremental layering technique considering flowable composites. Conclusions: For all the composites, the light curing modality of 1000 mW/cm2 for 20 s can be considered safe if the bulk-fill technique is performed. Instead, for the incremental layering technique, potentially dangerous temperature peaks have been recorded for flowable composites.