Early childhood caries (ECC) significantly impacts the physical and mental health of children. Saliva stands as a critical model for investigating the pathogenesis of caries disease since it reflects both host and microbial dynamics. However, the specific contributions of salivary host factors to ECC have not been fully understood. In this study, we monitored a prospective cohort of 3-4 year-old healthy children for 12 months, who either stayed caries-free or developed caries. Deep quantitative proteomics analysis of saliva was conducted at both recruitment and end point of the cohort to investigate the molecular mechanisms underlying ECC etiology and identify potential biomarkers for caries prediction. Proteomics analysis identified a total of 2873 proteins and revealed involvement of immune response, dental structure repair, and regeneration, as well as interactions with microorganisms during caries pathogenesis. Characteristic salivary proteins were identified in caries-susceptible children prior to caries development. An ECC prediction panel of proteins keratin 3 (KRT3) and mucin 21 (MUC21) was established and further validated through another independent cohort. This study illuminated the role of the complex salivary microenvironment in caries etiology and offered a prognostic tool for early ECC prediction, thus facilitating the precise prevention and control of ECC to ultimately reduce its incidence.

Caries is the most prevalent chronic disease affecting oral health in preschool children. In this 12-month prospective cohort study of 3–4-year-olds, we investigated the community-level bacterial–fungal interkingdom interactome and its role in cariogenic microenvironments, using 16S rRNA gene (bacterial) sequencing and ITS2 gene (fungal) sequencing of unstimulated saliva. Longitudinal analysis identified 19 key bacterial and fungal species that were associated with both caries progression and clinical features. Salivary bacteria Desulfovibrio, Bacteroides heparinolyticus, Alloprevotella, Anaerobiospirillum, and fungus Candida tropicalis not only showed altered abundances during caries development but also correlated with severity of caries, establishing diagnostic microbial signatures for caries prediction. The salivary mycobiome exhibited highly active and complex intra-network interactions in the caries-active state, suggesting that fungal networks may drive the broader community-wide microbiota interaction network in the caries state. Metabolic profiling further revealed distinct pathway shifts before and after caries onset. The findings demonstrate that caries progression follows ecological succession governed by cross-domain interactions. This study highlighted the fungal network’s important role in driving dysbiosis, advancing the current understanding of early childhood caries beyond bacterial-centric models, and also highlighted fungi not only as modulators but as active contributors to cariogenesis, which could guide future antimicrobial strategies.

Background: As a dental simulator, the Simodont Dental Trainer (SDT) is widely used in preclinical dental training in many dental schools. This study aimed to compare and evaluate the effectiveness of SDT training versus the traditional operation training based on head-simulator (HS) in enhancing undergraduate students’ dental operative skills. Furthermore, the study intends to investigate the optimal sequence for integrating SDT training with the traditional training curriculum in order to optimize the overall course design.. Methods: Eighty-two undergraduate dental students were recruited and randomized into two groups. Group A initially practiced on the SDT and group B practiced on the KaVo head-simulator (HS) first. Subsequently, both groups practiced again on the HS system. The two groups then exchanged training systems for practice, and underwent test on the HS system. A questionnaire was administered to all the students when the training sequences were completed. Results: Both the short-term teaching effectiveness of virtual training and the impact of training sequence on students’ long-term performance varied depending on the specific dental operation. Students encountered varying levels of technical difficulty across the two training systems, even when practicing the same procedure. Virtual training is generally acknowledged by students, yet more than half of them perceived real-world head-simulator-based practice more beneficial for improving operational proficiency. Conclusion: The SDT serves as a useful supplement to traditional preclinical dental training, providing students with a platform to refine their technical skills efficiently. However, obvious difference in the sensory experiences is notable between the virtual reality and real-world training systems. SDT may be particularly beneficial for procedures requiring distinct tactile feedback. The widespread acceptance of virtual training by undergraduate dental students highlights virtual reality’s promise in dental education, though systematic integration and training curriculum design still require continuous exploration and refinement.