Research Excellence & Impact

Why does caries, despite being preventable, remain the most prevalent human disease? We address the overuse-underuse paradox: low-value care is overused while high-value care is underused.

We have conducted randomized clinical trials examining non- and minimally-invasive approaches for caries in children. The IEVA project represents our current flagship evidence transfer study, implementing evidence-based pediatric caries management strategies in Latvian clinical practice.

Key Studies:

• Randomized clinical trial comparing topical fluoride treatments for caries effectiveness and patient satisfaction - RCT showing biannual silver diamine fluoride reduces major complications versus placebo

• Global systematic review and meta-analysis of early childhood caries prevalence using WHO diagnostic criteria - Global meta-analysis establishing 48% early childhood caries prevalence (230+ citations)

• Case-control studies identifying caries risk indicators in pediatric populations - revealed high caries burden in 12-year-old Latvian children with 71.9% prevalence

• Benefit-cost analysis of noninvasive early childhood caries interventions among Latvian children - Economic analysis demonstrating cost-effectiveness of preventive approaches

• Qualitative study exploring parental perspectives on minimally invasive caries management in Latvia - Qualitative study revealing parents value complete treatment information and choice

• Therapeutic sealing of approximal caries - With Prof. Gomez, we proposed sealants for proximal lesions, the histhological evaluation and the first clinical protocol. Systematic reviews of clinical studies confirm its effectiveness in arresting these lesions.

• Prolonged effect of a mother-child caries preventive program on dental caries in the permanent 1st molars in 9 to 10-year-old children - Long-term evaluation 4 years post-program showing 70% caries-free children (vs. 33% controls), 87% caries-free molars (vs. 61%), and mean DFS of 0.52 (vs. 1.57; all p<0.001)

Human decision-making requires technological support. We develop AI applications for caries management.

Key Studies:

• Deep learning models for caries detection with systematic accuracy evaluation - Deep learning for caries detection (68%-99% accuracy across 42 studies)

• Federated learning approaches for tooth segmentation on panoramic radiographs - Federated learning for collaborative AI training without data sharing

• Core outcome measures for dental computer vision studies (DentalCOMS) - DentalCOMS: standardized evaluation framework for dental AI

• Publicly available dental image datasets for AI development - Public datasets inventory revealing critical data scarcity (only 16 datasets)

We address technical development, ethics, and implementation challenges through book chapters and guidelines.

Clinical evidence and technological innovation require systematic implementation to achieve population health impact. 

Policy Impact

Local - National Caries treatment

• The Fluoride Use Guidelines for Latvia establish national standards for caries prevention. Establish national caries prevention standards, influencing clinical practice and public health policy.

• SPKC Oral Epidemiology Survey (2022-2023): Surveyed 3,943 adolescents establishing national baseline data (only 14% of 12-year-olds caries-free, D3MFT exceeding European averages). Principal Investigators: Maldupa & Uribe. Informs Ministry of Health policy development, resource allocation, and evidence for fluoride standards and sugar reduction initiatives.

• Sugar Taxation Policy Brief (2025) "Impact of Sugar Consumption on Physical and Mental Health" study (RSU Institute of Public Health, co-investigator: Maldupa). Evidence incorporated into Ministry of Health Action Plan 2025-2029. Sugar taxation identified as priority intervention. Status: Legislative consideration for 2026 budget.

Global - Artificial Intelligence in Dentistry

• The FDI World Dental Federation White Paper on Artificial Intelligence for Dentistry establishes worldwide regulatory standards and ethical principles for AI in dentistry.

Implementation Research

Research that stays in journals changes nothing. We measure how evidence reaches clinicians, what barriers exist, and whether interventions work outside controlled trials.

• Benefit-cost analysis of noninvasive early childhood caries interventions - demonstrated economic viability of preventive strategies in Latvia

• National surveys of dental practice patterns during COVID-19 - revealed dentists' willingness to adopt minimally invasive approaches during pandemic restrictions

• Assessment of teledentistry acceptance and implementation barriers - developed comprehensive survey tool for evaluating teledentistry adoption factors

• Educational integration of AI tools in dental curricula - identified need for dental-specific AI guidelines in education

Education

First article in Spanish about evidence-based dentistry 1999

Firs article in Latvian about evidence-based dentistry

European guidelines for IT implementation in dental curriculum

Artificial intelligence for oral and dental healthcare: Core education curriculum

Meta-Research & Quality Improvement

Research quality determines evidence reliability and public trust in research. Our meta-research examines publication practices, data availability, and transparency.

• Analysis of research transparency in 59 clinical medicine disciplines - revealed poor compliance with FAIR principles in COVID-19 research

• Development of AI research evaluation criteria for editors and reviewers - provided practical guidance for peer review of dental AI studies

• Assessment of ChatGPT usage in dental research publications - quantified AI tool usage showing 4.8-fold increase in signaling words post-ChatGPT

• Protocols for evaluating dental AI research quality - found only 7% of dental articles shared data and none adhered to all transparency practices