Andrea Zandona

• Doctor of Philosophy
• Executive Associate Dean at The Ohio State University

Early childhood caries (ECC) is the most common noncommunicable childhood disease—an important health problem with known environmental and social/behavioral influences lacking consensus genetic risk loci. To address this knowledge gap, we conducted a genome-wide association study of ECC in a multiancestry population of U.S. preschool-age children (...

Background: To comparethe cariogenic diets of children and parental OHL levels between American and Brazilian families. Methods: Participating in this cross-sectional study were the parents/guardians of 946 children aged 2 to 5, Brazilian parents of children. There were 672 Brazilian parents of Brazilian children (BB), 203 American parents of Ameri...

Parental behavior towards their children's oral health is strongly influenced by parent's Oral Health Literacy (OHL) level. This study evaluated the impact of parental OHL on preschool children's utilization of dental services. A cross-sectional study was conducted with parents of 419 children aged 3 to 5 years who answered a self-administered ques...

Early caries diagnosis is crucial to treatment decisions in dentistry and requires identification of lesion activity: whether a carious lesion is active (progressively demineralizing) or arrested (progressively remineralizing). This study aimed to identify microtomographic (micro-CT) differences between active and arrested smooth surface enamel les...

Objective: This cross-sectional study assessed the implementation of documenting a baseline caries risk assessment (CRA) of patients seen by predoctoral dental students and its association with the presence of caries risk management (CRM) treatment. Methods: A convenience sample of 10,000 electronic axiUm patient records at Tufts University Scho...

Streptococcus mutans has been implicated as the primary pathogen in childhood caries (tooth decay). While the role of polymicrobial communities is appreciated, it remains unclear whether other microorganisms are active contributors or interact with pathogens. Here, we integrate multi-omics of supragingival biofilm (dental plaque) from 416 preschool...

Microbiome studies are revealing complex microbiota in biofilm-mediated human diseases commonly linked with specific bacterial pathogens. Streptococcus mutans has been implicated as the primary pathogen in childhood dental caries (tooth decay). While the role of polymicrobial communities is appreciated, it remains unclear whether other microorganis...

Reliable clinical assessment of dental students is challenging. Longitudinal qualitative assessment of student progression and competency should allow for opportunities for identification of students achieving early competency as well as for those needing additional experience. Furthermore, ongoing assessment is critical to assure that students are...

This study aimed to assess the effect of silver diamine fluoride (SDF) on natural carious dentin microhardness and the correlation between tactile sensation, fluorescence, and microhardness on carious dentin. Permanent carious teeth scored ICDAS 4–6 were longitudinally sectioned into tooth slabs exposing carious dentin on one side and sound dentin...

The importance of visual aids in communicating clinical examination findings or proposed treatments in dentistry cannot be overstated. Similarly, communicating dental research results with tooth surface-level precision is impractical without visual representations. Here, we present the development, deployment, and two real-life applications of a we...

Manufacturer instructions for 38% silver diamine fluoride (SDF) are limited to current FDA clearance for tooth desensitization. There is a need for instructions to provide best-practice recommendations for off-label use of SDF for caries prevention and arrest. Methods: The authors considered existing clinical approaches to the use of 38% SDF at p...

A challenging and crucial component to clinical caries diagnosis is diagnosing the activity of early lesions because it may have a significant impact on treatment decisions. This study aims to utilize microtomographic (micro-CT) scans of the enamel smooth surface layer to serve as a reference standard for future ex vivo caries activity assessment v...

Purpose: Diet is a well-established, modifiable factor influencing dental caries risk. However, evidence regarding its association with distinct clinical patterns of dental caries is lacking. The purpose of this study was to identify the association of child nutrition patterns with two distinct clinical presentations (subtypes) of childhood dental...

Objective In this cross‐sectional study in a large community‐based sample of preschool‐age children, we sought to identify distinct clusters of modifiable early childhood oral health‐related behaviours (OHBs) and quantify their association with clinical and parent‐reported measures of early childhood oral health. Methods We relied upon a questionn...

Dental caries is characterized by a dysbiotic shift at the biofilm–tooth surface interface, yet comprehensive biochemical characterizations of the biofilm are scant. We used metabolomics to identify biochemical features of the supragingival biofilm associated with early childhood caries (ECC) prevalence and severity. The study’s analytical sample c...

Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals’ susceptibility or genomic risk factors. The genome-wide association study (GWAS) of ECC (“ZOE 2.0”) is a com...

Objectives: To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. Methods: Based on two systematic reviews, a consensus conference followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. Results: Managing an individual’s caries risk us...

For an ORCA/EFCD consensus, this review systematically assessed available evidence regarding interventions performed and materials used to manage dentin carious lesions in primary teeth. A search for systematic reviews (SRs) and randomized clinical trials (RCTs) with a follow-up of at least 12 months after intervention was performed in PubMed, LILA...

The purpose of this study was to determine if the degree of fluorescence detected by fluorescence-aided caries excavation (FACE) correlates with dentin bacterial microbiome diversity, as assessed by 16S rRNA gene amplicon sequencing, and with traditional tactile dentin caries assessment. Unidentified human teeth were obtained from a dental facility...

The effect of preventive oral habits is largely unexplored in older individuals. The purpose of this study was to evaluate the associations between home use of flossing and prevalence of periodontal disease and caries in older adults. Five-year incident tooth loss was also evaluated. Data on 686 individuals ≥65 y-old from the Piedmont 65+ Dental St...

Background The mesial surface of the first permanent molar is the most caries susceptible proximal surface of the permanent dentition in children under the age of 12. Aim The aim of this study was to determine the association between caries progression on the mesial surface of the first permanent molar (T6M) and caries on the distal surface of the...

This in vitro study aimed to compare the performance of a light-emitting diode (LED) device (Midwest Caries I.D.: MID), International Caries Detection and Assessment System (ICDAS) visual criteria, and fluorescence-based devices (DIAGNOdent: LF; DIAGNOdent pen: LFpen; and Quantitative Light-induced Fluorescence: QLF) in detecting occlusal caries in...

Epidemiological investigations of early childhood oral health rely upon the collection of high-quality clinical measures of health and disease. However, ascertainment of valid and accurate clinical measures presents unique challenges among young, preschool-age children. The paper presents a clinical research protocol for the conduct of oral epidemi...

Oral health and disease are known to be influenced by complex interactions between environmental (e.g., social and behavioral) factors and innate susceptibility. Although the exact contribution of genomics and other layers of “omics” to oral health is an area of active research, it is well established that the susceptibility to dental caries, perio...

Silver diamine fluoride (SDF), a low-cost topical agent used in many countries to arrest dental caries, was cleared as a desensitizing agent by the Food & Drug Administration for the U.S. market in 2014. The aim of this study was to survey U.S. dental schools regarding their teaching of SDF. Email invitations were sent to all accredited U.S. predoc...

Fig. S1. Results of the saliva sample collection process among the 346 preschool‐age children participating in the ZOE study. Fig. S2. Quantitation of DNA purified from saliva samples among the 213 preschool‐age children that donated a sample for the ZOE GWAS study. Fig. S3. Quantile‐Quantile (QQ) plot of GWAS results of ECC among the 212 prescho...

The purpose of this study was to evaluate the associations between interdental cleaning behavior and the prevalence of caries and periodontal disease and numbers of missing teeth, with data from the National Health and Nutrition Examination Survey (2011 to 2012 and 2013 to 2014). Analysis included the following parameters: interproximal clinical at...

Objective: A genetic component in early childhood caries (ECC) is theorized, but no genome-wide investigations of ECC have been conducted. This pilot study is part of a long-term research program aimed to: (1) determine the proportion of ECC variance attributable to the human genome and (2) identify ECC-associated genetic loci. Methods: The stud...

Objectives: To determine the sensitivity and specificity of DEXIS CariVu TM (DCV), a near-infrared based caries detection device, on interproximal lesions compared to ICDAS and digital bitewings radiography (DBR). Methods: This clinical study, conducted in Santo Domingo, Dominican Republic, included healthy 15-21 year-olds with moderate-to-high car...

This study aimed to evaluate the ability of quantitative light-induced fluorescence (QLF) to assess caries lesion activity using visual examination (VE) as the gold standard. Twenty-four visible white spot lesions on buccal surfaces were examined from 23 children, ages 9 to 14 years. At baseline, the surface was hydrated with water, and thereafter,...

Objectives: The aim of this study was to determine if the use of certain image enhancements and dual observers had an effect on the detection of caries, dentin extension, and cavitation. Study design: Seven observers viewed unenhanced and enhanced images taken on photostimulable phosphor plates (PSP) and Schick 33 sensors and were asked to deter...

Transcription or recording of lectures has been in use for many years, and with the availability of high-fidelity recording, the practice is now ubiquitous in higher education. Since technology has permeated education and today's tech-savvy students have expectations for on-demand learning, dental schools are motivated to record lectures, albeit wi...

Among various preventive approaches, non-invasive phototherapy/photodynamic therapy is one of the methods used to control oral biofilm. Studies indicate that light at specific wavelengths has a potent antibacterial effect. The objective of this study was to determine the effectiveness of violet-blue light at 380–440 nm to inhibit biofilm formation...

To evaluate the in vitro performance of the International Caries Detection and Assessment System (ICDAS) visual examination, bitewing radiography (BW), and the DIAGNOdent 2190, a pen-type laser fluorescence device (LFpen), in detecting caries around amalgam restorations on approximal surfaces. Approximal surfaces (N=136) of permanent posterior teet...

This retrospective clinical study determined the association of caries activity and orange/red fluorescence on quantitative light-induced fluorescence (QLF) images of surfaces that progressed to cavitation, as determined by clinical visual examination. A random sample of QLF images from 565 children (5-13 years) previously enrolled in a longitudina...

Purpose: Secondary caries is the major reason for replacement of restorations in operative dentistry. New detection methods and technology have the potential to improve the accuracy for diagnosis of secondary carious lesions. This in vitro study evaluated the performance of the ICDAS (International Caries Detection and Assessment System) visual cr...

Caries lesions that develop around restorations (CARS) are the main reason for restoration replacement. The aim of this study was to assess whether surfaces that developed CARS and progressed to cavitation have a different fluorescent profile than surfaces that have restorations and no associated lesions. Quantitative light-induced fluorescence (QL...

This chapter describes the conceptual basis and uses of caries risk assessment (CRA) and provides an overview of important considerations for assessing children's risk for dental disease. The chapter also reviews current caries-risk assessment tools (CATs) and highlights implementation and policy issues regarding various uses of CRA. It provides an...

56th ORCA Congress: July 1-4, 2009, Budapest, Hungary: Session 5 Repeatability of ICDAS from Clinical Studies H. Eggertsson, S.R. Saemundsson, G.J. Eckert, S. Nelson, A.G. Ferreira Zandona, M.R. Fontana, D.T. Zero The aim was to address two fundamental questions regarding ICDAS criteria: (1) What are reasonable goals for clinical calibration of exa...