BackgroundAlthough most clinical guidelines throughout the world indicate that clinicians take two bitewings for detecting caries lesions in primary molars of all children, evidence for this recommendation is essentially based on cross-sectional studies performed in laboratory settings or using convenience samples. The benefits and impact of performing radiographs on diagnosis and treatment decision of caries lesions in primary teeth, mainly considering relevant outcomes for patients, have not been evaluated yet. Thus, the aim of this randomized clinical trial will be to evaluate the impact of performing radiographic examination adjunct to the visual inspection for detecting and making treatment decision regarding caries lesions in primary teeth compared with visual inspection performed alone. We will consider different outcomes related to children's health and welfare.Methods/DesignTo reach this objective, 250 children ages 3 to 6 years who sought dental treatment in our dental school will be randomly allocated in two groups according to the diagnostic strategy used for caries detection: visual inspection performed alone or visual inspection associated to radiographic examination. Two trained and calibrated examiners will carry out the examinations and elaborate the treatment decision plan. Then, children will be treated and followed up for 2 years, with evaluations after 12 and 24 months after the inclusion of children in the study. Children will also return after 6 and 18 months to reinforce the preventive orientations. Primary outcome will be the number of dental surfaces in need of dental treatment at the follow-up. Secondary outcomes will be the components of the primary outcome separately, as well as, proportion of false-positive results, the oral health-related quality of life, cost-efficacy, cost-adjusted life years, and number of new lesions in the first permanent molars.DiscussionOur working hypothesis is that radiographic examination would actually exert little influence on patient-centered outcomes, and visual inspection would be enough as diagnostic strategy for caries detection in primary teeth.Trial registrationNCT02078453. Registered 4 March 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1196-5) contains supplementary material, which is available to authorized users.

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BackgroundThe responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) has varied greatly across studies; hence, we hypothesized that this discrepancy could be related to the complexity of dental treatment received. Thus, we aimed to evaluate the responsiveness of the ECOHIS to changes in oral health-related quality of life (OHRQoL) following dental treatments of varying complexity in preschool children.MethodsPreschool children aged 3 to 6 years were selected; their parents responded to the ECOHIS at baseline. The parents responded to the ECOHIS again and a global transition question 30 days after the children were treated. The type of treatment received by the children was categorized according to complexity, as follows: 1) non-operative treatment only, 2) restorative treatment, and 3) endodontic treatment and/or tooth extraction. Change scores and effect sizes (ES) were calculated for total scores, as well as considering the different treatment types and global transition question responses.ResultsOf the 152 children who completed the study, the ECOHIS yielded large ES for total scores (0.89). The children showed increasing ES values associated with better perception of improvement, assessed by the global transition question. The magnitude of ES after treatment was related to treatment complexity (0.53, 0.92 and 1.43, for children who received non-operative treatment only, restorative treatment, and endodontic treatment and/or tooth extraction, respectively).ConclusionsParents whose children required more complex dental treatment are more likely to perceive treatment-related changes to OHRQoL assessed with the ECOHIS.Electronic supplementary materialThe online version of this article (doi: 10.1186/s12955-017-0756-z) contains supplementary material, which is available to authorized users.

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Abstract. It has been speculated that the red fluorescence emitted by dental plaque could be related to its cariogenicity. To test this hypothesis, we designed this crossover in situ study, with two experimental phases of 14 days each. Seventeen volunteers, wearing a palatal appliance with bovine enamel blocks, were instructed to drip a 20% sucrose solution (experimental group) or purified water (control group) onto the enamel blocks eight times daily. The specimens were removed after 4, 7, 10, and 14 days, and the red fluorescence of dental plaque formed on the enamel blocks was assessed using a quantitative light-induced fluorescence device. After the plaque removal, surface and cross-sectional microhardness tests were performed to assess the mineral loss. The comparisons were made by a multilevel linear regression analysis. We observed a significant increase in the red fluorescence of the dental plaque after longer periods of formation, but this trend was verified in both groups. The mineral loss assessed by the microhardness techniques, contrariwise, showed a significant increase only in the experimental group. In conclusion, the red fluorescence emitted by the dental plaque indicates a mature biofilm, but this fact is not necessarily associated with its cariogenicity. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.