Dental caries is defined as a chronic, multifactorial disease characterized by the demineralization of dental hard tissues resulting from the acid production by oral microbial communities metabolizing dietary sugars. The ingestion of sugars is a pivotal ecological factor in the progression of caries, with mechanisms that extend beyond merely providing substrates for cariogenic bacteria. This review explores the influence of sugars on the metabolism, adhesion, biofilm formation, and interspecies interactions of oral microorganisms, with a particular focus on species such as Streptococcus mutans, Lactobacilli, Actinomyces, and Candida albicans. The disruption of the oral microbiome balance by these sugars initiates and promotes the process of caries. The review comprehensively summarizes contemporary public health strategies for caries prevention based on microbial ecological theories, including the limitations of sugar intake, fluoride application, probiotics, and ecological management, assessing their effectiveness and challenges. The objective of this study is to establish a theoretical framework and practical guidelines for the precise prevention of dental caries.

The application of modified phosphogypsum (MPG) as a soil amendment has emerged as a promising strategy for its large-scale utilization, yet the potential environmental risk of fluoride (F[-]) release during this process has been largely overlooked. This study systematically demonstrated that MPG-amended soils pose a persistent F[-] leaching hazard, with leachate contents reaching up to 3.0 mg L[-1], which was three times the Class III limit of Chinese Groundwater Quality Standards. To address this risk, Nocardia sp. X10 was isolated and its efficient F[-] immobilization mechanisms were elucidated. Direct quantification of extracellular polymeric substances (EPS) embedded within the biominerals (30.7-67.7 mg L[-1]) provided evidence that EPS served as nucleation templates for fluorine-containing minerals. Comprehensive characterization identified the biominerals as a co-precipitated assemblage of Ca5(PO4)3F, CaF2, and CaCO3, intimately associated with EPS. Quantitative analysis of contributions revealed that microbially mediated mineralization dominated F[-] immobilization. Calcium (Ca[2+]) and phosphate (PO4[3-]) acted as essential mineral precursors, with F[-] immobilization efficiency increasing from 8.6% (F[-] alone) to 67.9% and 77.1% (Supplement Ca[2+] and PO4[3-] successively). Soil column validation confirmed that strain X10 achieved superior F[-] immobilization (65.7%) compared to chemical passivators (57.2% and 61.8%), consistently maintaining leachate F[-] below regulatory limits. The findings will help reveal the potential environmental risks and the biological immobilization mechanisms involved in the resource utilization of industrial by-products.

Sodium-ion batteries are promising energy storage devices due to abundant sodium, inherent safety, and low cost, but irreversible sodium loss during initial cycles limits their reversible capacity and long-term stability. Cathode sodium-supplemented additives offer a simple and fabrication-compatible strategy. Herein, an organic sodium-supplemented additive, sodium squarate (Na2C4O4, NCO), is introduced into the high-capacity Prussian white (PW) cathodes to achieve efficient sodium compensation. During the first charge, NCO undergoes decomposition, releasing additional Na+ ions to compensate for irreversible sodium consumption associated with SEI formation and other interfacial side reactions. Meanwhile, the generated CO2 participates in interfacial reactions, leading to the formation of a carbonate-rich cathode-electrolyte interphase (CEI) on the PW cathode, while its diffusion toward the anode promotes the construction of a robust SEI enriched with carbonate species and sodium fluoride (NaF) on the hard-carbon anode. As a result, the PW-10% NCO||HC full cell delivers an enhanced discharge capacity of 100 mAh g-1, compared to 53 mAh g-1 for the pristine PW||HC full cell. Moreover, a multilayer pouch cell obtained a capacity retention of 80.1% after 100 cycles. Overall, this work highlights NCO as an effective cathode sodium-supplemented additive and provides insights into the interfacial regulation for sodium-ion full cells.

Silver diamine fluoride (SDF) is a key preservation-based intervention in pediatric dentistry. It can arrest many cavitated lesions, reduce treatment burden, and expand access for children who cannot receive conventional restorative care. This viewpoint article offers a reasoned, heuristic framework for calibrating SDF guidance to the strength of the underlying evidence. It does not present a systematic review or formal policy standards. Foundational trials support the clinical usefulness of 38% SDF. The 2017 AAPD guidelines provided conditional recommendations based on low-quality evidence. The current challenge is no longer whether to endorse SDF but how to calibrate guidance on its implementation. Later studies addressing intervals and implementation often have open-label designs, small samples, single centers, or overlapping data sources. Mechanistic and microbiome studies support biological plausibility, but policy should not treat them as definitive evidence. We propose a hypothesis-generating framework that separates claims about the existence of an effect (for which there is stronger directional support) from claims about its optimal conditions (which remain more uncertain), highlights dataset overlap, and matches recommendation strength to study quality. The framework supplements GRADE and provides illustrative upgrade pathways. The goal is to preserve SDF access while making guidelines more transparent, credible, and precise.

An updated understanding of the U.S. oral health care system is essential for addressing the burden of oral disease, high dental expenditures, and persistent inequities in access. This narrative review synthesizes current evidence on the prevalence of major oral diseases, dental care delivery, financing, dental workforce, and public health initiatives, and highlights the challenges and future opportunities in the U.S. A comprehensive search of PubMed, Google Scholar, and reports from U.S. federal agencies and professional organizations was conducted between September 2025 and March 2026. Following the latest National Health and Nutrition Examination Survey, untreated caries remains widespread, affecting 11% of children (ages 2-5), 10% of adolescents (ages 12-19), 21% of adults (ages 35-49), and 12% of older adults (ages 65-74). Periodontal diseases are common, with 42% of adults aged 30 years or older having periodontitis. Oral cancer incidence stands at 11.5 per 100,000 and increases sharply with advancing age. Edentulism among older adults (ages 65-74) was approximately 11%. The U.S. dental workforce includes over 200,000 dentists, yet shortages affect rural and low-income areas, with 62 million Americans living in Dental Health Professional Shortage Areas. Dental care is primarily delivered through private practices, supplemented by community health centers. Financing relies mostly on private insurance and out-of-pocket payments, while the coverage of public programs like Medicaid varies across states, and Medicare generally excludes routine dental care for older adults. Water fluoridation remains widespread, yet ongoing debates highlight persistent challenges. School-based dental sealants and topical fluoride programs are widely recognized as cost-effective and scalable, offering substantial benefits at the population level. Nevertheless, community-based preventive measures are often hindered by resource constraints, inequitable access, and in some cases political conflicts. In summary, oral diseases remain prevalent in the U.S. Limited public coverage, workforce shortages in rural or underserved areas, and uneven access to dental care highlight the need for systemic reforms to improve oral health equity. These findings point to the importance of strengthening dental public health research and coordinated policy action to reduce structural barriers and expand access to dental care.

Ameloblasts are specialized epithelial cells responsible for enamel formation, a process that requires tightly coordinated matrix secretion, proteolytic turnover, and hydroxyapatite crystal growth. Although genetically regulated, amelogenesis is susceptible to environmental modulation by agents such as fluoride and amoxicillin. Calcium and vitamin D supplementation have been proposed as potential protective factors against fluoride-induced enamel alterations. This study investigated whether combined exposure to fluoride and amoxicillin impairs ameloblast viability and enamel formation, and whether vitamin D and calcium supplementation can mitigate these effects. Using a rat incisor model, enamel structure, ameloblast apoptosis, and matrix protein dynamics were evaluated through ultrastructural analysis, histology, immunohistochemistry, TUNEL assay, and proteomic profiling. Fluoride exposure, particularly when combined with amoxicillin, resulted in disorganization of enamel prisms and increased apoptotic activity in ameloblasts, as evidenced by caspase-3 and TUNEL labeling, especially during the early maturation stage. Immunohistochemistry revealed reduced KLK4 levels within ameloblasts, whereas proteomic analysis demonstrated increased KLK4 abundance in the enamel matrix, suggesting altered intracellular trafficking and impaired proteolytic turnover. Additionally, the abundance of AMBN, AMTN, and ODAM, proteins essential for enamel crystal nucleation and maturation, was reduced in treated groups. Vitamin D and calcium supplementation neither significantly restored enamel organization nor normalized matrix protein alterations under the experimental conditions tested. Overall, these results indicate that fluoride exposure, particularly when combined with amoxicillin administration, disrupts ameloblast homeostasis, matrix proteolysis, and enamel prism organization, resulting in structurally compromised enamel, with no beneficial effects from vitamin D and calcium supplementation.

The aim of the present study was to determine the effects of high dietary fluoride intake on performance, egg quality, serum biochemical parameters, bone tissue, mineral accumulation, and the expression of selected mineralisation-related genes in laying hens, and to evaluate whether these effects could be alleviated by dietary activated charcoal supplementation. A total of 180 Hy-Line Brown laying hens were allocated to six groups: a control group and experimental groups receiving diets supplemented with sodium fluoride (1200 mg/kg), activated charcoal (0.35% or 0.70%), or combinations of these additives. Performance parameters and egg quality traits were recorded throughout the experimental period, while serum biochemical parameters were analysed at the end of the experiment. Tibial bone samples were evaluated by histological and histomorphometric methods, and calcium and phosphorus concentrations were determined in tibial bone and eggshell samples. In addition, mRNA expression levels of the mineralisation-related genes Oc-116, Opg, and Rankl were analysed in uterine and sternal tissues. Dietary sodium fluoride supplementation reduced feed intake and egg production, impaired eggshell quality, induced histological and histomorphometric alterations in the tibia, and increased calcium and phosphorus accumulation in bone tissue, accompanied by upregulation of Oc-116 and Rankl mRNA expression. The effects of activated charcoal were dose-dependent and non-linear. Supplementation with 0.35% activated charcoal partially restored feed intake, egg production, and feed conversion ratio, limited histological deterioration in bone, and attenuated the fluoride-induced shift in the Rankl/Opg axis. In contrast, 0.70% activated charcoal suppressed eggshell calcium content and Oc-116 expression while increasing Opg and Rankl levels. These findings indicate that activated charcoal may serve as a supportive dietary additive under high-dose fluoride exposure, with 0.35% emerging as the more favourable inclusion level, whereas higher doses may adversely affect mineral bioavailability and eggshell formation.