This paper aims to provide a systematic review of the caries-prevention effect of probiotics in human. The hypothesis was that the administration of probiotic strains might play a role in caries lesion prevention and in the control of caries-related risk factors. The main relevant databases (Medline, Embase) were searched. Quality of the Randomized Clinical Trials (RCTs) was classified using the “Consolidated Standards of Reporting Trials” (CONSORT) checklist and the Impact Factor (IF) value of each journal was recorded. Sixty-six papers were identified, and 23 fulfilled the inclusion criteria. Only three studies had caries lesion development as outcome, all the others reported caries risk factors as interim evaluation. Using the CONSORT Score, the papers were coded as 4 excellent, 9 good and 10 poor. The mean IF value recorded was 1.438. Probiotics may play a role as antagonistic agent on mutans streptococci (MS), acidogenic/aciduric bacteria that contributes to the caries process. In two-thirds of the selected papers, probiotics have demonstrated the capacity to reduce MS counts in saliva and/or plaque in short-term. The effect of probiotics on the development of caries lesion seems encouraging, but to date, RCTs on this topic are insufficient to provide scientific clinical evidence.

This survey assessed the symptoms/signs, protective measures, awareness, and perception levels regarding COVID-19 among dentists in Lombardy, Italy. Moreover, an analysis of the answers gathered in areas with different prevalence of the disease was carried out. All Lombardy’s dentists were sent an online ad hoc questionnaire. The questionnaire was divided into four domains: personal data, precautionary measures (before patient arrival; in the waiting room; in the operating room), awareness, and perception. Three thousand five hundred ninety-nine questionnaires were analyzed. Five hundred two (14.43%) participants had suffered one or more symptoms referable to COVID-19. Thirty-one subjects were positive to the virus SARS-CoV-2 and 16 subjects developed the disease. Only a small number of dentists (n = 72, 2.00%) were confident of avoiding infection; dentists working in low COVID-19 prevalence areas were more confident than those working in the Milan area and high prevalence area (61.24%, 61.23%, and 64.29%, p < 0.01 respectively). The level of awareness was statistically significantly higher (p < 0.01) in the Milan area (71.82%) than in the other areas. This survey demonstrated that dentists in the COVID-19 highest prevalence area, albeit reported to have more symptoms/signs than the rest of the sample, were the ones who adopted several precautionary measures less frequently and were the more confident of avoiding infection.

Assessing caries risk is an essential element in the planning of preventive and therapeutic strategies. Different caries risk assessment (CRA) models have been proposed for the identification of individuals running a risk of future caries. This systematic review was designed to evaluate whether standardized caries risk assessment (CRA) models are able to evaluate the risk according to the actual caries status and/or the future caries increment. Randomized clinical trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, reporting caries risk assessment using standardized models (Cariogram, CAMBRA, PreViser, NUS-CRA and CAT) in patients of any age related to caries data recorded by DMFT/S or ICDAS indices, were included. PubMed, Scopus and Embase were searched from 2000 to 2016. A search string was developed. All the papers meeting the inclusion criteria were subjected to a quality assessment. One thousand three-undred ninety-two papers were identified and 32 were included. In all but one, the Cariogram was used both as sole model or in conjunction with other models. All the papers on children (n = 16) and adults (n = 12) found a statistically significant association between the risk levels and the actual caries status and/or the future caries increment. Nineteen papers, all using the Cariogram except one, were classified as being of good quality. Three of four papers comprising children and adults found a positive association. For seven of the included papers, Cariogram sensibility and specificity were calculated; sensibility ranged from low (41.0) to fairly low (75.0), while specificity was higher, ranging from 65.8 to 88.0. Wide 95% confidence intervals for both parameters were found, indicating that the reliability of the model differed in different caries risk levels. The scientific evidence relating to standardized CRA models is still limited; even if Cariogram was tested in children and adults in few studies of good quality, no sufficient evidence is available to affirm the method is effective in caries assessment and prediction. New options of diagnosis, prognosis and therapy are now available to dentists but the validity of standardized CRA models still remains limited.

The association between vitamins and oral health have recently been discussed, yielding increased attention from medical and dental perspectives. The present review aimed to systematically evaluate and appraise the most recently scientific papers investigating the role of vitamins in the prevention and treatment of the main oral diseases as hard dental pathological processes and gum/periodontal disease. Randomized controlled trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, reporting associations between vitamins and oral diseases or the use of vitamins to prevent or treat oral diseases in patients of any age were included. PubMed, Embase and Scopus were searched to November 2019 using an ad hoc prepared search string. All the papers meeting the inclusion criteria were subjected to a quality assessment. The search identified 1597 papers; 741 were selected after removing duplicates. A total of 334 articles were excluded after title and abstract evaluation; 407 were assessed and 73 papers were full-text assessed; other 14 papers were discharged after full text evaluation, leaving finally 58 papers included. In general, there is weak evidence supporting the association between vitamins and both gingival/periodontal disease and hard dental pathological processes.

Background: Several maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated. Methods: Italian toddlers (n = 2395) aged 24–30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers’ caries data and mothers’ questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy). Results: Caries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate–high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p < 0.01). No moderate and high caries severity levels were observed in an exclusively breastfed children. High caries severity levels were significantly associated with sweet beverages (p < 0.04) and SES (p < 0.01). Toddlers whose mothers smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p < 0.01) respect to those whose mothers did not smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p < 0.01). Conclusions: Higher caries severity levels were observed in toddlers fed with infant formula and exposed to smoke during pregnancy living in area with a low mean housing price per square meter.

A systematic review and meta-analysis were carried out to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in cavitated primary molars. A search for randomized and non-randomized trials with follow-up > 6 months was performed using PubMed, Scopus and Embase. The Cochrane risk of bias tools were used for the quality assessment. The success rate and odds ratios were chosen to calculate the effect size for the meta-analysis. A total of 792 papers were identified and 9 were selected. A high variability regarding SDF application protocol was found; otherwise, caries arrest was always recorded using visual/tactile methods. Two studies were judged at low risk of bias, six at moderate risk and one at high risk. Data from five studies were aggregated for meta-analysis. Heterogeneity was found moderate (I² = 35.69%, p = 0.18). SDF application was found to be overall effective (fixed effect model) in arresting caries progression (ES = 0.35, p < 0.01). In a total of 622 arrested lesions, out of 1205 considered, the caries arrest rate was 51.62% ± 27.40% (Confidence = 1.55) using SDF ≥ 38% applied annually or biannually. In conclusion, when applied to active cavitated caries lesions in primary molars, SDF appears to be effective in arresting dental caries progression, especially if applied biannually.