Fluorosis is a worldwide public health problem. One of the factors related to it is the type of water consumed, such as groundwater. High fluoride concentration in groundwater may be explained by contamination from local industries. Since fluoride and arsenic are the main pollutants of groundwater, some studies correlate groundwater consumption with high prevalence of fluorosis. Aim: The aim of this study was to conduct a systematic review to determine whether children’s risk of fluorosis is related to drinking groundwater. Materials and Method: The protocol for this systematic review was registered at the National Institute of Health Research Database (CRD42021227298). A comprehensive search was conducted to identify potentially relevant studies by exploring a range of electronic databases (Medline via PubMed, Scopus, Cochrane Library, Science Direct, Web of Science Core Collection, Medline via Ovid, Lilacs, Embase, and grey literature). Results: A total 2189 articles were found. After reading titles and abstracts, 63 were selected for screening, and the final data was extracted from 15 articles. Conclusion: A relationship was identified between drinking fluoridated water from wells and the prevalence of fluorosis in individuals up to 18 years old. This is the first study to assess the issue systematically worldwide.

Background and Objectives: Dental caries is still a dramatic public health problem. The effectiveness of an alternative technique using acidulated phosphate fluoride (APF) gel pH 3.5 was evaluated and compared with conventional treatments in reducing dental caries incidence. Materials and Methods: A double-blind randomized controlled trial was conducted, involving 180 children aged 4–11 years. Three groups were formed: NaF varnish (NaFV), APF in tray (APFt), and APF in toothbrush (APFtbru). Clinical examinations were performed using standardized criteria and the ICDAS Index was assessed. The Caries Treatment Needs Index (CTNI) was calculated. Dental examinations were conducted at baseline, 12 months, and 24 months. Results: At baseline, 16,719 dental surfaces were included, with 15,434 surfaces being sound. After 24 months, the Kaplan–Meier analysis showed significant differences between the APFtbru group and the other two groups (p = 0.03). Cox regression analysis revealed that the surfaces treated with NaF varnish had the lowest survival rates (HR = 0.51 95%CI = 0.33/0.81). Occlusal surfaces had the lowest cumulative survival, while other tooth surfaces showed similar performance. Conclusions: The alternative technique of APF gel application with a toothbrush resulted in maintaining dental health over 24 months. This technique can be cost-effective and may offer advantages over traditional fluoride varnish application.

Aim: To prepare a consensus document of the cariology contents and competences included in the curriculum for the dentistry degree at Argentine dental faculties/schools. Materials and Method: Planning the process in stages: Stage 1- Diagnosis of the situation (Google Form) and invitation to participate extended to the 20 academic units (AU) that offer dentistry degrees. Stage 2- Assessment process of Content (C) and Competences (I) agreements in the five domains: D1 Basic Sciences, D2 Risk and diagnosis of dental caries, D3 Decision-making for non-invasive treatments, D4 Decision-making for invasive treatment, and D5 Evidence-based cariology at community level. Stage 3- Consensus. Stages 2 and 3 were held in Workshop format in virtual mode (W). Results: Stage 1- Of the total 20 Google forms sent to the AU, 13 responses were received: 7 from National Universities and 6 from Private Universities. All participants agreed to be part of the consensus. Stage 2- W: 20 representatives from 10 AU participated. It began with a contextualizing conference, after which the representatives were divided into 5 groups to assess the agreements of each D. Stage 3- The Cariology Curriculum document was organized into 5 Domains, and 23 C and 31 I of clinical application were defined for teaching cariology. The contents and competences for each domain were agreed upon. The final document was sent to all W participants for their approval and dissemination in each AU involved. Conclusion: Cariology contents were defined for dentistry students at Universities in the Argentine Republic.

Introduction: Excessive fluoride exposure during enamel development is a major risk factor for dental fluorosis, particularly in populations relying on groundwater sources with naturally elevated fluoride concentrations. Rural regions with limited access to centralized water systems may present heterogeneous exposure patterns influenced by environmental and socioeconomic factors. Aim: This study aimed to evaluate fluoride concentration in drinking water and the prevalence of dental fluorosis in schoolchildren from La Rioja, Argentina. Method: A cross-sectional ecological study was conducted including 469 schoolchildren aged 6–12 years from San Blas de los Sauces and Arauco. Only children born and continuously residing in the study area were included. Dental fluorosis was assessed using the Thylstrup and Fejerskov (T-F) index by calibrated examiners (Kappa > 0.8). Fluoride concentration was determined in 82 georeferenced groundwater samples using an ion-selective electrode. Spatial analysis included Moran's I and Local Indicators of Spatial Association (LISA). Associations between fluorosis severity and locality were evaluated using chi-square tests with Monte Carlo simulation. Results: The overall prevalence of dental fluorosis was 46.3% (95% CI: 40.8–49.9), with moderate fluorosis as the most frequent category. A significant association between locality and fluorosis severity was observed ( p < 0.0001; Cramér's V = 0.23), with marked spatial heterogeneity. Fluoride concentrations varied across localities, with several exceeding the 1.5 mg/L threshold. Spatial analysis revealed significant clustering of high fluoride concentrations (Moran's I = 0.16; p = 0.006) and localized hotspots. Discussion: Although areas with higher fluoride concentrations and higher fluorosis severity were spatial overlapped, this was therefore interpreted as a descriptive pattern of co-occurrence, not as evidence of causality. A high prevalence of dental fluorosis with significant spatial variability was identified in the study area. The absence of a direct association between fluoride levels and fluorosis severity suggests a complex exposure pattern influenced by multiple factors. Conclusion: The integration of epidemiological, environmental, and spatial data provides a useful framework for identifying high-risk areas and supporting targeted public health interventions in regions with decentralized water systems.

Fluoridated dentifrices are the most widely used formulations for caries prevention and control. However, there is great concern regarding legislation on the use of fluoride formulations in early childhood from the standpoint of avoiding increased risk of fluorosis while at the same time achieving a concentration that ensures anticaries activity. AIM: The aim of this study was to evaluate the stability of fluoride concentration in the main children’s toothpaste brands marketed in Argentina. Materials and Method: Twenty different brands of children’s toothpaste were evaluated by analyzing the concentration of total fluoride (TF), total soluble fluoride (TSF) and ionic fluoride (IF) in two or three samples of each brand. Each sample was analyzed in duplicate using an ion-specific electrode calibrated with fluoride standards, and the results were expressed in ppm (μg F/g). Results: TF was found to be lower than stated by the manufacturer in 85% of the brands analyzed. TF concentration found in fluoride toothpastes ranged from 651.5 to 1090.4 μg/ml F-, while TSF ranged from 504.2 to 915.5 μg/ml F, and IF from 298.6 to 838.2 μg/ml F-. Conclusions: The formulation and fluoride content in children’s toothpastes marketed in Argentina vary greatly according to brand. In all the samples, TF concentration was lower than 1500 ppm F-, and TSF concentration was lower than 1000 ppm F-, the minimum amount necessary to ensure anticaries effect. This indicates the need for improved formulations and regulations.

Background:In 2020, CariesCare International (CCI) -derived from ICCMS- was plannedto be tested for caries-control effectiveness in children by means of a multicenter randomized clinical trial (RCT). Nevertheless, due to the pandemic, RCTs proved unfeasible and aerosol-generating procedures (AGP) were associated with a spread of COVID-19. Consequently, the study design required to be modified to a single-interventional study and CCI had to be adapted excluding AGP and reducing on-site consultation (CCI-adapted). Objective: This 12-month multicenter single-group interventional study aimed at assessing the effect of a pandemic CCI-adapted protocol on caries control in children. Methods: Twenty-one Latin American and European centers with n³20 3-8-year-old children per center were invited to participate; 17 obtained IRB and signed written informed consents. Trained examiners assessed at baseline (T0) and 1-year follow-up (T1y) (blind to the intervention): CCI-caries risk, oral-health-related practices; dmf/DMFS with ICDAS-merged-Epi visual caries severity and activity criteria; dental sepsis and toothache. Individual- and tooth-surface-level personalized care plan was then performed by dental practitioners previously trained in CCI-adapted. After 5 months, parents’ and dentists’ dental-care-process acceptance (Treatment Evaluation Inventory) was assessed. The one-year caries-control effect of CCI-adapted was assessed in terms of tooth-surface and individual-level caries-progression control; oral-health behavior improvement, and caries-care system acceptability. Results: Sixteen centers finished the study (94.1%; Latin America: n=13; Europe: n=3), with 337 children (78.6%;mean age of 5.5±1.6 years). There was a T0 to T1y significant decrease (p<0.05) in the mean number of tooth surfaces with caries lesions (7.7±9.1 to 2.8±4.6), with active caries lesions (6.8±8.8 to 0.8±2.2), and a tooth-surface caries-progression control of 99.3%. In the majority of children there was a significant (p<0.05) control of: caries progression (79.5%), high-caries risk (86.6%), and non-adequate oral-health behavior (72.7%). There was a very high (parents) and a high-very high (dentists) acceptability of CCI. Conclusion: Given the challenge of the pandemic, this single-group interventional CCI-adapted study showed one-year control of caries progression, caries risk, and high parents’ and dentists’ CCI acceptance. Trial registration:Retrospectively‐registered‐ClinicalTrials.gov NCT04666597 07/12/2020 (Protocol version 2): https://register.clinicaltrials. gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h