Visual Inspection and Toothbrush Care: A Mother-Baby Paired Cross-Sectional Study

ABSTRACT Objective To evaluate the physical conditions and presence of residues of toothbrushes used by mothers and their babies and mothers' knowledge about toothbrush care. Material and Methods This was a cross-sectional study comprising a convenience sample represented by 60 mother-baby pairs. The mothers answered a questionnaire to evaluate their knowledge of toothbrush care. A calibrated dentist performed a visual inspection of the toothbrushes. Statistical analysis was performed using the chi-square and Fisher's exact tests, with a significance level of 5%. Results It was found that 82% of the mothers had never received instructions regarding the care of toothbrushes after use (p=0.024). Most of them believed that their toothbrushes (70%) and their children's toothbrushes (88%) were in good condition to use (p=0.043). However, most mother's toothbrushes presented an unacceptable deformity of the bristles (65%) and the presence of residues (60%). In addition, babies' toothbrushes also presented unacceptable deformities of the bristles (52%) and residues (55%). There was an association between the lack of instructions received by the mother and the presence of deformity and residues on the mother's toothbrush bristles (p=0.037 and p=0.003, respectively). Conclusion Most mothers had never received instructions regarding toothbrush care, which is reflected in the condition of their and their baby's toothbrushes, which presented unacceptable physical conditions concerning deformation and presence of residues.

Halitosis: Principios básicos sobre su origen y tratamiento Revisión narrativa / Halitosis: Basic Principles About its Origin and Treatment Narrative Review

RESUMEN Halitosis es la presencia de un olor desagradable que emana de la cavidad oral. La etiología de este mal olor es multifactorial, existiendo causas no orales, orales y extraorales. Los compuestos volátiles sulfurados (CVS): sulfuro de hidrógeno y metilmercaptano son los elementos prominentes del mal olor. Intraoralmente, existe una correlación significativa entre las concentraciones de CVS y bacterias periodontopatogénicas. En pacientes sin enfermedad periodontal el mal olor se origina principalmente de la cobertura del dorso de la lengua por lo que la limpieza o raspado de ésta es un método efectivo para prevenir o disminuir la halitosis. Existen múltiples opciones químicas para el abordaje del mal aliento que dependerán del origen y grado de severidad. Este artículo revisa el origen y los tratamientos tanto mecánicos como químicos que se tienen disponibles.

ABSTRACT Halitosis is the presence of an unpleasant smell that emanates from the oral cavity. The etiology of halitosis is multifactorial, existing non oral, oral and extraoral causes. The volatile sulphur compounds (VSC): hydrogen sulfide and methyl mercaptan are the prominent elements of malodour. Intraorally there is a significant correlation between VSC concentrations and periodontopathogenic bacteria. In patients with no gum disease the halitosis is originated mainly in the dorsal surface of the tongue, so cleaning or brushing it is an effective method to prevent or decrease halitosis. There are multiple chemical options for the treatment of the malodour that will depend on the origin and severity of it. This article reviews the origin and mechanical and chemical treatments that are available.

O esportista e a prevalência de trauma bucomaxilofacial: conhecimento e uso de protetor bucal, hábitos e respiração na prática esportiva / The athlete and the prevalence of maxillofacial trauma: knowledge and use of mouth guard, habits and breathing in sports practice

O trauma buco maxilo facial (TBMF) relacionado à prática esportiva tem aumentado nos últimos anos, portanto é fundamental investigar os esportes de maior ocorrência, a saúde bucal dos atletas e a adoção de medidas preventivas. O objetivo neste estudo foi verificar a prevalência de trauma buco-maxilo-facial (BMF) em atletas; a relação com a modalidade esportiva praticada, bem como conhecimento e uso de protetores bucais, hábitos de higiene bucal, hábitos sociais e de hidratação. Trata-se de um estudo transversal, descritivo, envolvendo 647 atletas praticantes de diferentes esportes em um município do Brasil. Os participantes responderam a um questionário que abordava como desfecho primário a ocorrência de trauma na região da cabeça e pescoço durante atividades esportivas e o conhecimento e uso de protetores bucais. As seguintes variáveis também foram investigadas: esporte praticado, região afetada, escovação, uso do fio dental, consumo de refrigerantes, bebidas alcoólicas, tabagismo, hidratação e a respiração durante a prática esportiva. Do total, 148 atletas (22,87%) sofreram TBMF e os esportes de maior ocorrência foram o basquetebol e o futebol. Houve associação significativa entre ocorrência de TBMF e desconhecimento sobre protetores bucais (p=0,0042) e modalidade esportiva (p<0,0001). A boca foi o local mais acometido (30,40%), a cotovelada foi a principal causa (32,54%). O protetor bucal era conhecido por 538 atletas (83,15%), no entanto, apenas 169 (26,12%) utilizavam, sendo 13 (7,69%) deles personalizados. Verificou-se que 313 atletas (48,53%) respiravam pela boca durante a prática esportiva, 381 (58,89%) não ingeriam refrigerantes, 618 (95,52%) não fumavam e 98 (15,15%) consumiam bebidas alcoólicas ao menos duas vezes por semana. A maioria dos atletas (n=554; 85,63%) ingeria apenas água, enquanto 138 (21,33%) consumiam energéticos durante o exercício. O fio dental não era usado por 212 (32,77%) atletas e 606 (93,67%) escovavam os dentes 2 a 3 vezes ao dia. A maioria dos atletas conhecia os protetores bucais, no entanto, poucos faziam uso. Grande parte dos atletas apresentava respiração bucal durante a prática esportiva e embora todos realizassem a escovação dentária, uma parcela considerável não fazia uso de fio dental. O consumo de refrigerante, bebidas alcoólicas e cigarros foi baixo(AU)

Buccomaxillofacial trauma (TBMF) related to sports practice has increased in recent years, so it is essential to investigate the sports with the highest occurrence of TBMF, the oral health of athletes and the adoption of preventive measures. The aim of this study was to verify the prevalence of buccomaxillofacial trauma (BMF) in athletes; the relationship with the sport practiced, as well as knowledge and use of mouthguards, oral hygiene habits, social habits and hydration. This is a cross-sectional, descriptive study, involving 647 athletes practicing different sports in a municipality in Brazil. Participants answered a questionnaire that addressed the occurrence of trauma in the head and neck during sports activities and the knowledge and use of mouthguards as the primary outcome. The following variables were also investigated: sport practiced, affected region, brushing, flossing, consumption of soft drinks, alcoholic beverages, smoking, hydration and breathing during sports practice. Of the total, 148 athletes (22.87%) suffered TBMF and the most frequent sports were basketball and football. There was a significant association between the occurrence of TBMF and lack of knowledge about mouthguards (p=0.0042) and sports (p <0.0001). The mouth was the most affected site (30.40%), the elbow was the main cause (32.54%). The mouthguard was known by 538 athletes (83.15%), however, only 169 (26.12%) used it, 13 (7.69%) of whom were personalized. It was found that 313 athletes (48.53%) breathed through the mouth during sports, 381 (58.89%) did not drink soft drinks, 618 (95.52%) did not smoke and 98 (15.15%) consumed drinks alcoholic at least twice a week. Most athletes (n = 554; 85.63%) drank only water, while 138 (21.33%) consumed energy drinks during exercise. The dental floss was not used by 212 (32.77%) athletes and 606 (93.67%) brushed their teeth 2 to 3 times a day. Most athletes knew about mouthguards, however, few used them. Most of the athletes had mouth breathing during sports practice and although all of them performed tooth brushing, a considerable portion did not use dental floss. The consumption of soft drinks, alcoholic beverages and cigarettes was low(AU)

Electric toothbrush for biofilm control in individuals with Down syndrome: a crossover randomized clinical trial

Abstract Poor oral hygiene seems to be the norm in children and teenagers with Down Syndrome (DS). Advances in design and types of toothbrushes may improve biofilm control. This randomized, single-blind, crossover clinical trial evaluated the effectiveness of electric toothbrushes regarding mechanical control of biofilm in children and teenagers with DS and their cooperation. Twenty-nine participants with DS, aged 6 to 14 years, used both types of toothbrushes: electric (ET) and manual (MT). The order of use of the different types of toothbrushes was randomly defined, including a 7-day period with each type with 7-day washout period in between. The Turesky-Quigley-Hein biofilm index was used before and after brushing to assess the effectiveness of the technique. Frankl's behavioral scale was used during toothbrushing to assess the participants' cooperation. Paired T-test, Mann Whitney, Chi-square, and Fisher's Exact tests were applied, with a significance level of 5%. The quantity of dental biofilm was significantly reduced after both brushing techniques (p < 0.001). However, no significant difference was found in total biofilm (ET: 0.73 ± 0.36; MT: 0.73 ± 0.34; p = 0.985) or % biofilm reduction (ET: 72.22%; MT: 70.96%; p = 0.762) after brushing between techniques or in % biofilm reduction between toothbrushes of age groups (6 -9 years, p = 0.919; 10-14 years, p = 0.671). Participants showed similar cooperation level with the two types of toothbrush (p = 1.000). The use of electric or manual toothbrush had no effect on the quantity of dental biofilm removed in children and teenagers with DS, nor did it influence their cooperation during the procedure.

Characterization of Enamel After the Use of Oral Hygiene Auxiliaries with Whiteners / Caracterización del esmalte después del uso de auxiliares de higiene bucal con blanqueadores

ABSTRACT The purpose of this study was to evaluate the effect of the use of the combined auxiliaries of oral hygiene with whitening agents on the micro-hardness and micro-morphology of dental enamel. Materials and Methods. 40 human incisors were used and sectioned to obtain 4x4mm samples and divided into four study groups. Group 1: Electric brushing with Toothpaste (BTP); Group 2: Electric brushing with Toothpaste+mouthwash (BTP+MW); Group 3: Electric brushing with Toothpaste+whitening pen (BTP+WP); Group 4: Electric brushing with Toothpaste+mouth wash+whitening pen (BTP+MW+WP). Samples were submitted toVickers micro-hardness test and visualized using scanning electron microscopy (SEM). Results. All groups, with the exception of group 1, showed a decrease in micro- hardness values after applying the treatments (p<0.05). Likewise, when comparing the values after the treatments between the groups, significant statistical differences were found in all of comparisons except for those of groups 2 and 4. SEM images showed changes in the morphology in all the study groups with the exception of group 1. Conclusion. Significant changes such as decrease in micro-hardness as well as in the topography of the enamel surface such as elevations, craters, porosities and etching patterns were founded after the use of the combination of auxiliaries of oral hygiene with whitening agents.

RESUMEN El propósito de este estudio fue evaluar el efecto del uso de los auxiliares de higiene oral combinados con agentes blanqueadores sobre la microdureza y la micro-morfología del esmalte dental. Materiales y métodos. Se utilizaron 40 incisivos humanos y se seccionaron para obtener muestras de 4x4 mm los cuales se dividieron en cuatro grupos de estudio. Grupo 1: cepillado eléctrico con pasta de dientes (BTP); Grupo 2: cepillado eléctrico con pasta dental+enjuague bucal (BTP+MW); Grupo 3: cepillado eléctrico con pasta dental+pluma blanqueadora (BTP+WP); Grupo 4: cepillado eléctrico con pasta dental+enjuague bucal+pluma blanqueadora (BTP+MW+WP). Las muestras fueron analizadas por medio de microdurezaVickers y microscopía electronica de barrido (SEM). Resultados. Todos los grupos, con la excepción del grupo 1, mostraron una disminución en los valores de microdureza después de aplicar los tratamientos (p<0.05). Del mismo modo, al comparar los valores después de los tratamientos entre los grupos, se encontraron diferencias estadísticamente significativas en todas las comparaciones, excepto en las de los grupos 2 y 4. Las imágenes de SEM nos muestran cambios en la morfología en todos los grupos de estudio con la excepción del grupo 1 Conclusión. Cambios significativos como la disminución de la microdureza y los cambios en la topografía de la superficie del esmalte, como elevaciones, cráteres, porosidades y patrones de grabado, se encontraron después del uso de la combinación de auxiliares de la higiene oral con agentes blanqueadores.

Efficacy of Two Different Toothbrushes on Plaque Control: A Randomized Clinical Study

Objective: This parallel, randomized, examiner-blind clinical trial aimed to evaluate the efficacy of two different toothbrushes (manual and sonic) on plaque control in adolescents. Material and Methods: This study enrolled 56 volunteers, randomly allocated to two different groups: group A (n = 28) for the manual toothbrush (Curaprox 5460 Ultra Soft®) and group B (n = 28) for the sonic toothbrush (Edel White®). Mean age was 17.2 ± 1.1 years. A calibrated periodontist performed a periodontal evaluation to assess the presence of plaque with the Turesky Modification of the Quigley Hein Plaque Index (PI) and the gingival inflammation with the Silness & Löe Gingival Index (GI). Adolescents received instructions about the mechanical control of plaque at baseline (T0), with a reexamination after 3 months (T1) and 6 months (T2). Non-parametric Mann Whitney test was used to compare the differences between the two toothbrush groups and the Friedman test was used for the comparisons between times. Results: There has been PI reduction concerning the study times (T0, T1 and T2, p<0.05), but not between the groups A and B (p>0.05). As for GI there has been no significant difference between the groups and between the study times (p>0.05). Conclusion: Both toothbrushes were efficient in the control of supragingival plaque (visible biofilm).

Desenvolvimento de mantenedor de abertura bucal para auxílio na higienização oral de pessoas com necessidades especiais / Development of mouth opening maintainer to assist in oral hygiene of people with special needs

A realidade cotidiana de uma pessoa com necessidades especiais (PNE) e de seus responsáveis ou cuidadores é cercada de desafios impostos pelos diferentes impedimentos ou restrições apresentadas. A dificuldade de se executar uma higienização oral adequada, muitas vezes por causa dos comprometimentos motores do PNE, impedem a abertura e manutenção da boca em posição colaborativa para os movimentos escovatórios provocando agravamento do quadro de saúde bucal. A pesquisa desenvolve um novo produto acessório e inovador chamado de dedeira rígida que proporciona a abertura e estabilização da boca em posição aberta de forma segura, confortável e facilitada, possibilitando as práticas de higienização oral da PNE pelos seus responsáveis. Os testes em voluntária com paralisia cerebral, realizados com o uso do protótipo da dedeira, prototipado em material ABS Plus (copolímero de acrilonitrila butadieno estireno), provaram sua efetividade e eficiência, proporcionando adequadamente a escovação dental com o uso da escova dental e pasta. Os objetivos da proposta foram não só alcançados, viabilizando a introdução, movimentação da escova livremente na boca e visualização do interior da cavidade bucal, como também se mostrou possível sua abrangência de utilização por outros profissionais da saúde, como cirurgião dentista e enfermeiros. A aceitação da paciente voluntária foi total, bem como de sua responsável, que pode perceber as facilitações de utilidade e segurança que a dedeira proporciona. As dificuldades encontradas estão relacionadas na troca da dedeira para o dedo da outra mão do operador, quando da necessidade de se escovar o outro lado da arcada dental, sendo necessário treinamento dos movimentos com a escova com a mão contrária à de costume. A pesquisa concluiu que foi de fato atendido, em forma e função, os objetivos propostos de proporcionar a higienização do PNE com a utilização da dedeira, porém pode ser aprimorada nos quesitos de refino de design e pesquisa de materiais aplicáveis para um processo de produção em escala industrial(AU)

The daily reality of a person with special needs and their guardians or caregivers is surrounded by challenges imposed by the different impediments or restrictions presented. The difficulty of performing adequate oral hygiene, often due to the motor impairment, prevents the opening and maintenance of the mouth in a collaborative position for the brush movements causing worsening of oral health. The research develops a new and innovative accessory product called rigid finger that provides the opening and stabilization of the mouth in an open position safely, comfortably and easily, enabling the oral hygiene practices by their guardians in a person with special needs. The tests in volunteers with cerebral palsy, performed using the prototype of the rigid finger, prototyped in ABS Plus material (acrylonitrile butadiene styrene copolymer), proved its effectiveness and efficiency, providing adequate brushing with the use of toothbrush and paste. The objectives of the proposal were not only achieved, enabling the introduction, movement of the brush freely in the mouth and visualization of the interior of the oral cavity, but it was also possible its use by other health professionals such as dental surgeon and nurses. The acceptance of the volunteer patient was complete, as well as that of her guardian, who can perceive the facilitations of usefulness and safety that the rigid finger provides. The difficulties found are related to the exchange the rigid finger to the other hand of the operator, when the need to brush the other side of the dental arch is necessary and training the movements with the brush with the opposite hand to the usual. The research concluded that the proposed objectives of providing cleanliness of the person with special needs with the use of the finger were indeed fulfilled, in form and function, but can be improved in the design refining and material research requirements applicable to a production process underway industrial scale(AU)

Saúde bucal: dos hábitos e conhecimento de higiene ao comportamento e acesso a serviços odontológicos de universitários brasileiros e estrangeiros / Oral health: from the hygiene habits and knowledge to the behavior and access to dental services of Brazilian and foreing university students

Objetivo: o estudo objetivou investigar os hábitos, o conhecimento sobre higiene oral e o comportamento em saúde bucal bem como o acesso aos serviços odontológicos de estudantes brasileiros e principalmente estudantes africanos, recém-ingressos à universidade.Sujeitos e método: trata-se de estudo exploratório, descritivo,transversal e quantitativo, conduzido em universidade pública brasileira. Após assinatura do termo e consentimento livre e esclarecido, foi aplicado um questionário aos acadêmicos. Os dados foram tabuladose analisados. Resultados: entre os brasileiros, 90%escovavam os dentes no mínimo 3 vezes ao dia, 50%não utilizavam fio dental, 55% não faziam uso de colutório,e 80% higienizavam a língua. Entre os estrangeiros,55% escovavam 2 vezes ao dia, 85% não usavamfio dental, 80% não utilizavam colutório, e 65%higienizavam a língua. Todos os brasileiros conheciam fio dental e colutório, enquanto que 70% dos acadêmicos estrangeiros sabiam o que era fio dental, e 60%desconheciam o que era colutório. Observou-se uma associação entre ser estudante estrangeiro e não utilizar fio dental. Dos participantes, 95% dos brasileiros e 50%dos estrangeiros já tinham buscado atendimento odontológico.Sobre a autopercepção de higiene bucal, 95%dos brasileiros e 60% dos estrangeiros consideravam-na boa. Constatou-se ainda uma relação entre ser acadêmico recém-ingresso e ter uma boa percepção de higiene oral sem utilizar fio dental. Conclusão: concluiu-se que há diferenças entre hábitos, conhecimento e comportamento em saúde bucal de acadêmicos de acordo com anacionalidade. A pesquisa contribuiu para caracterização,comparação e relação de importantes variáveis em saúde bucal nos contextos universitário e étnico. (AU)

Objective: the study aimed to investigate the oral hygiene habits and knowledge, and the oral health behavior, as well as the access to dental services of Brazilian and international students recently admitted to the university. Subjects and method: this is an exploratory, descriptive, cross-sectional, and quantitative study conducted in a Brazilian public university. After signing the Informed Consent Form, a questionnaire was applied to the students. The data were tabulated and analyzed. Results: among the Brazilian students, 90% brushed their teeth at least 3 times a day, 50% did not use dental floss, 55% did not use mouthwash, and 80% cleaned their tongue. Among the international students, 55% brushed their teeth 2 times a day, 85% did not use dental floss, 80% did not use mouthwash, and 65% cleaned their tongue. All Brazilians were aware of dental floss and mouthwash, while 70% of international students knew dental floss and 60% were unaware of the mouthwash. There was an association between being an international student and not using dental floss. From the participants, 95% of Brazilians and 50% of international students had already sought dental care. Regarding oral hygiene self-perception, 95% of Brazilians and 60% of international students considered it satisfactory. Additionally, being a newly enrolled student and having a good perception of oral hygiene were associated with not using dental floss. Conclusion: it was concluded that there are differences between oral health habits, knowledge, and behavior of students according to nationality. The research contributed to the characterization, comparison, and association of major oral health variables in the university and ethnic context. (AU)

O uso do fio dental reduz a ocorrência de sangramento gengival? / Does dental flossing reduce the occurrence of gingival bleeding?

Objetivos: tendo em vista a relevância da prevenção à gengivite, e consequentemente à periodontite, e a falta de consenso na literatura sobre a efetividade do fio dental como medida protetora ao sangramento gengival, este artigo buscou revisar a literatura objetivando responder a seguinte pergunta: "O uso do fio dental é efetivo para prevenir o sangramento gengival?". Material e métodos: revisões sistemáticas foram buscadas na base de dados Pubmed, sem limite de data e de linguagem. Resultados: duas revisões foram encontradas, e seus resultados foram sumarizados. Conclusão: a literatura científica sugere que o uso do fio dental associado à escovação é adequado para o controle do biofilme, e consequentemente, do sangramento gengival. Entretanto, essa evidência apresenta inúmeras limitações, e seus resultados precisam ser confirmados. Assim, são necessários mais estudos que demonstrem claramente o efeito do fio dental sobre o sangramento gengival.

Objectives: given the relevance of gingivitis prevention, and consequently periodontitis, and the lack of consensus in the literature on the effectiveness of dental floss as a protective measure of gingival bleeding, this article aimed to revise the literature in order to answer the following question: Is flossing effective in preventing gum bleeding? Material and methods: systematic reviews were searched on Pubmed database, with no limits for date and language. Results: two reviews were found, and their results were summarized. Conclusion: the scientific literature suggests that flossing associated with brushing is adequate for biofilm control, and consequently, for preventing gingival bleeding. However, this evidence has relevant limitations, therefore, these results need to be carefully considered. Thus, further studies are needed to clearly demonstrate the effect of dental floss on prevention of gingival bleeding.

Relationship Between Stress Level, Fatigue Symptoms, and Sleep Quality with Oral Health Behavior among Preclinical Student Faculty of Pharmacy, Indonesia

Objective: To determine the association of the stress level, fatigue symptoms, and sleep quality with oral health behavior of preclinical pharmacy students. Material and Methods: Observational analytic study surveyed the students of the Faculty of Pharmacy of Hasanuddin University. From the total 205 sample of pharmacy students, 77 students drawn from the 2017 year of study, 68 students from the 2016 year of study, and 60 students from the 2015 year of study. The study consisted of 4 questionnaires, which are Perceived Stress Scale, Fatigue Assessment Scale, Karolinska Sleep Questionnaire and questions that assess oral health behaviors reported per individual. Data were collected and analyzed statistically using Chi-square test and Fisher's exact test. The level of significance was set at 5%. Results: The percentage of oral health behaviors in terms of the frequency of tooth brushing, use of dental floss, use of tongue cleaner and use of mouthwash increase as the year of study. In contrast to the percentage of stress level, awakening difficulties symptoms, sleep disturbance symptoms, daytime sleepiness symptoms and fatigue symptoms tended to decrease according to the year of study. Significant associations found among students who are under stress with the frequency of dental floss (p<0.05). However, no significant association was found between the fatigue symptoms, awakening difficulties symptoms, sleep disturbance symptoms, and daytime sleepiness symptoms with oral health behavior (p>0.05). Conclusion: There is an association between stress levels with the use of dental floss.

Levantamento transversal da relação do índice de placa com o grau de escolaridade, idade e frequência do uso do fio dental e escova em pacientes de 31 a 69 anos de idade / The relationship of plaque index, educational degree, age, and frequency of dental fl oss in patients from 31 to 69 years-old ­ a cross-sectional study

Objetivo: estudar o índice de placa e a sua correlação com a técnica de higiene empregada, com o grau de escolaridade, idade, frequência e o conhecimento sobre a higiene oral. Material e métodos: em uma amostra da população da cidadede Divinópolis/MG, foi aplicado um questionário específico sobre os hábitos de higiene oral. O exame clínico foi realizado com sonda milimetrada, e a placa evidenciada pelo corante. Todos os pacientes foram divididos em quatro faixas etárias e receberam reforço na higiene oral. As possíveis associações entre os critérios foram investigadas com o teste Qui-quadrado. Resultados: 216 pacientes (86 homens, 130 mulheres) foram incluídos. No total, 5.853 dentes e 23.412 faces foram analisados. O nível de placa variou de 54,29% (60-69 anos) a 60,10% (40-49 anos), e as faces interproximais foram as mais coradas (83,27%). Um total de 140 pacientes não tinha realizado tratamento periodontal prévio; dos 76 pacientes com tratamento prévio, 34 não haviam sido instruídos sobre a higiene oral. Metade dos pacientes relatou usar a escova dental três vezes ao dia; 1/3 dos pacientes usavam o fio dental duas vezes e estavam no ensino médio. Conclusão: 1) há necessidade de uma campanha maciça sobre a importância da escova dental e do fio dental, e como usá-los; 2) os menores índices de placa estão nos indivíduos de grau superior; 3) as faces proximais coradas confirmam a falta de uso do fio dental, principalmente nos pacientes que foram submetidos ao tratamento periodontal, por ausência de informação profissional.

Objective: to study the plaque index and possible correlations with oral hygiene, educational levels, age, and frequency of dental flossing. Material and methods: a patient sample from Divinopolis/MG received an appropriate questionnaire survey regarding their oral hygiene habits. The clinical exam was made with a periodontal probe and a disclosing agent. All patients were divided according to 4 age conditions and receive further oral instructions. Possible associations were investigated with the Chi-square method. Results: 216 patients (86 men, 130 women) were included. Overall, 5,852 teeth and 23,412 surfaces were examined. Plaque levels varied from 54.29% (60-69 years) to 60.10% (40-49 years), being most prevalent at the proximal surfaces (83.27%). 140 patients did not have previous periodontal treatment; from 76 patients under active periodontal treatment, 34 had no oral hygiene instructions. Half of the patients reported the use of toothbrushing 3 times a day; 1/3 of patients reported flossing twice a day. Conclusion: 1) a massive campaign is needed to underscore the importance of oral hygiene and dental floss, 2) the lowest plaque scores were observed in people with higher education, 3) the proximal surfaces confirmed the lack of dental floss, particularly in patients under periodontal treatment due to the lack of professional information.

Effectiveness of a single-tuft toothbrush for control of newly formed dental biofilm

Aim: To compare the effectiveness of a single-tuft toothbrush (STB) with conventional toothbrushes (CT) to control dental biofilm neoformation in the dentogingival area. Methods: For this cross-sectional prospective blind study, 20 periodontally healthy subjects were selected and randomly divided into 4 groups: STB; CT; CHX - chlorhexidine mouthwash (positive control) and PS - placebo mouthwash (negative control). The subjects were instructed to use only the assigned care method for 72 h with a 7-day washout period between experiments. The evaluated parameters were visible and disclosed plaque indices (PI and DPI), gingival bleeding index (GBI) at baseline (T-0) and at the end of each experimental period (T-72). Results: Data analysis demonstrated that at T-0 no difference was observed for any of the parameters (p>0.05); after 72 h, CT, STB and CHX showed equivalente effectiveness at controlling biofilm. When the PI data were analyzed, between T-0 and T-72, STB was similar to CT and CHX (p<0.05), whereas for DPI, STB was significantly superior to the other methods. Except for PS, all methods yielded similar results for GBI (p<0.05). Conclusions: The tested STB was effective at controlling short-term dental biofilm neoformation on the dentogingival area (au)

Diamino fluoreto de prata - uma nova proposta para o tratamento não operatório de lesões proximais em molares decíduos: estudo clínico randomizado / Silver diamine fluoride - a new proposal for the non-operative treatment for approximal caries lesions in primary molars: randomized clinical trial

Este ensaio clínico randomizado, cego e controlado com placebo teve como objetivo principal avaliar a eficácia do diamino fluoreto de prata (DFP) a 30% no tratamento não operatório de lesões de cárie em superfícies proximais de molares decíduos e compará-la a eficácia do infiltrante resinoso e a do controle do biofilme interproximal pelo uso do fio dental. Além disso, também avaliou a custo-eficácia e o desconforto dos tratamentos e a satisfação dos participantes quanto ao tratamento recebido. Para isso, foram selecionadas 141 crianças entre 3 e 10 anos de idade, que apresentavam pelo menos uma superfície proximal com lesão de cárie clinicamente em esmalte. A alocação dos participantes foi aleatória, de acordo com o tratamento: DFP a 30%, infiltrante resinoso de cárie e orientação para o uso diário do fio dental (controle). Todos os participantes receberam o tratamento ativo para os quais foram alocados e também o placebo dos tratamentos realizados nos outros grupos. Os custos dos materiais utilizados nos tratamentos foram registrados. Ao final da consulta de tratamento, foi aplicada aos participantes a Escala Facial de Wong-Baker para avaliação do desconforto. Os responsáveis pelos participantes, que concluíram o seguimento da pesquisa, responderam a um questionário de satisfação sobre o tratamento recebido. As crianças foram examinadas após 1 mês para avaliação de higiene bucal e também de presença de biofilme nas superfícies tratadas

Análises de regressão foram realizadas para verificar se os grupos de tratamento influenciaram os desfechos testados após 12 e 24 meses de seguimento (análise por protocolo - Poisson multinível e análise de sobrevida). Valores pontuais de custo-eficácia dos tratamentos foram calculados e, para comparar a custo-eficácia da implementação do uso do DFP em relação às outras opções testadas foi utilizada a razão de custo-eficácia incremental. Análises de regressão de Poisson foram utilizadas para verificar a associação entre o desconforto e variáveis explicativas. A satisfação dos participantes e seus responsáveis foi explorada descritivamente. Um total de 316 superfícies proximais foram incluídas, sendo a maioria classificada como escore 2 do ICDAS (Sistema Internacional de Detecção e Avaliação de Cárie) associadas à ausência de imagem radiográfica (46,8%). As perdas de seguimento foram de 15% e 24% aos 12 e 24 meses, respectivamente. Não houve associação entre o grupo de tratamento e a progressão das lesões aos 12 e 24 meses, tanta pela análise por protocolo como pela análise de sobrevida. A taxa de progressão clínica das lesões para cavidade em dentina foi de 2,5% aos 12 meses e de 5,6% aos 24 meses

This randomized, blinded and placebo-controlled clinical trial aimed to evaluate the efficacy of 30% silver diamine fluoride (SDF) as a non-operative treatment of the approximal surfaces of primary molars and to compare it with the efficacy of resin infiltration and the mechanical control of the interproximal biofilm by flossing. We also evaluated the cost-efficacy and the discomfort of the treatments as well as the parent's satisfaction regarding treatments. One hundred forty-one, 3-to-10-year-old, children were included. They must present at least one caries lesion clinically into enamel sited on an approximal surface of primary molar. Participants were randomly allocated to the following groups according to active treatment to be received: 30% SDF, caries resin infiltration, flossing orientation (control). All participants received the active treatment, in which they were allocated and they also received the placebo treatment corresponding to the other groups. Costs of materials used in the treatment were registered. In the end of treatment session, the Wong-Baker faces scale was applied to evaluate participants' reported discomfort. Children were examined after 1 month to evaluation of the oral hygiene and the presence of the biofilm on the treated surfaces. After 6, 12 and 24 months, visual and tactile examinations were performed to verify the lesions progression. Radiography was taken at 12- and 24-month follow-ups. To evaluate the efficacy of non-operative treatments, two outcomes were considered: (I) any clinical progression and (II) progression to cavity into dentine

The radiographic progression was used as a secondary outcome and to evaluate with clinical standard of lesions progression. Regression analyses were used to verify if the treatment influenced on these outcomes after 12 and 24 months (per-protocol analyses - multilevel Poisson and survival analysis). Cost-efficacy ratios were calculated for the treatments. To compare the cost-efficacy of implementing the use of DFP versus other options tested, the incremental cost-efficacy ratio was used. Poisson regression analyses were used to verify the association between discomfort and explanatory variables. The parents' satisfaction about the treatments were explored descriptively. A total of 316 approximal surfaces were included. The majority of them were classified as ICDAS (International Caries Detection and Assessment System) score 2 associated with absence of radiographic image. The dropout in the study was 15% and 24% at 12-month and 24-month follow-up, respectively. There was no association between treatment groups and lesions progression at 12 and 24 months, both for the per-protocol analysis and by survival analysis. The rate of clinical lesions progression to cavity into dentine was 2.5% at 12 months and 5.6% at 24 months. Lesions without initial radiographic image did not progress into the middle of the dentine or more. Baseline clinical condition of caries lesions was associated with lesions progression in all analyses. The caries risk was also associated to caries progression in 24-month analyses and in the survival analyses

Avaliação da percepção pessoal em relação à condição de halitose e confirmação clínica / Personal perception of assessment for the condition of halitosis and clinical confirmation

Introdução: A halitose é uma condição em que o hálito se apresenta de forma desagradável, acometendo milhares de pessoas e causando impacto negativo para as mesmas. Objetivo: A presente pesquisa em campo buscou avaliar a percepção pessoal em relação à condição de halitose por meio de aplicação de questionário específico e confirmação clínica. Material e método: A amostra foi composta por 59 indivíduos entre 20 e 60 anos de idade, usuários de Unidades Básicas de Saúde de Araraquara, que foram selecionados de forma aleatória. A metodologia empregada constituiu-se de: i) Assinatura do Termo de Consentimento Livre e Esclarecido; ii) Aplicação de questionário especialmente elaborado para esta pesquisa; iii) Confirmação clínica, com a aplicação do teste com halímetro (Tanita Breath Alert CHC-212S). Após o experimento, todos receberam folhetos informativos com dados gerais sobre halitose. Os resultados obtidos foram agrupados em tabelas de contingência, construídas pelo Microsoft Excel, sendo então analisados pelo teste do Qui-quadrado. Resultado e conclusão: Após análises, conclui-se que as pessoas perderam a capacidade de perceber o próprio hálito quando tinham halitose; não tiveram condições de se autoavaliarem de forma eficaz; os fatores de riscos que influenciaram na halitose foram: idade superior aos 40 anos, uso de alguns tipos de medicamentos, algumas patologias, frequência de visita ao Dentista e falhas em procedimentos de higiene bucal, tais como escovação dentária, uso do fio dental, limpeza da língua e limpeza de próteses. Os outros fatores pesquisados não se mostraram estatisticamente suficientes para estabelecerem relação de influência na halitose.

Introduction: Halitosis is a condition characterized by unpleasant breath,affecting thousands of people and causing a negative impact on them. Objective: The aim of this study was to evaluate self-perception of halitosis condition by applying a specific questionnaire and having clinical evaluation. Material and method: The sample was composed by 59 randomly selected voluntaries between the ages of 20 and 60 years old who were users of Basic Health Units of Araraquara. The methodologies applied were: 1. Signature of informed consent; 2. Application of standardized questionnaire specially designed for this research; 3. Clinical confirmation through halimeter (Tanita Breath Alert CHC-212S). After the experimental phase, all the volunteers received a document with general information about halitosis (causes and treatment). The results were grouped in Microsoft Excel tables and analyzed by Chi-square test. Result and conclusion: After the analyses, it was concluded that people had lost the ability to perceive their own breath when they had halitosis and they are unable to evaluate themselves effectively; the risky factors that influenced the halitosis were: people over the age of 40, the use some types of drugs, some diseases, frequency of visit to the dentist and poor oral hygiene including bad-technique procedures such as teeth brushing, flossing, tongue cleaning and dentures cleaning. Other factors studied were not statistically sufficient to influence halitosis.

Avaliação longitudinal da clorexidina associada ao full-mouth desinfection mucosite peri-implantar / Longitudinal evaluation of chlorhexidine associated with full-mouth peri-implant mucositis desinfection

A mucosite peri-implantar é uma inflamação da mucosa ao redor do implante em resposta ao acúmulo do biofilme. Existem diversos protocolos para o tratamento da mucosite peri-implantar, mas ainda não existem evidências consistentes para escolha de um protocolo. Em virtude disso, esta pesquisa objetiva verificar a eficácia longitudinal do uso da clorexidina a 0,12% como um adjuvante à terapia full-mouth desinfection da mucosite peri-implantar. Trinta e oito pacientes previamente diagnosticados com mucosite peri-implantar foram distribuídos aleatoriamente em dois grupos. Todos os pacientes receberam o tratamento não-cirúrgico associado (teste, n = 22) ou não (controle, n = 16) a clorexidina a 0,12% além de instrução de higiene bucal individualizada. Os pacientes foram avaliados no baseline, 3, 6, 12 e 18 meses quanto aos índices de placa visível e sangramento gengival, profundidade de sondagem e sangramento à sondagem. Os dados foram analisados estatisticamente pelos testes de Friedman, Wilcoxon, Mann-Whitney, Correlação de Spearman e Qui-quadrado, utilizando um a de 5%. A análise intragrupo mostrou que ambos os tratamentos propostos foram eficazes na redução dos índices de placa visível e sangramento gengival, profundidade de sondagem e sangramento à sondagem (p<0,05). No entanto, nenhum dos grupos alcançou resultados superiores em retação ao outro. Conclui-se que a terapia mecânica por si só é eficaz na redução dos parâmetros clínicos analisados e que, como os grupos tornaram-se iguais pelo fato do efeito da clorexidina não mais existir, a terapia de suporte peri- implantar fora eficiente em reduzir os índices de placa visível e sangramento gengival, profundidade de sondagem e sangramento à sondagem ao final do estudo. (AU)

The peri-implant mucositis is an inflammation of the mucosa around the implant in response to the accumulation of biofilm. There are many protocols for the treatment of peri-implant mucositis, but are not consistent evidence for selecting a protocol. As a result, this research has evaluated the longitudinal effectiveness of use of chlorhexidine 0.12% as an adjunct to full-mouth desinfection therapy peri-implant mucositis. Thirty-eight patients previously diagnosed with peri-implant mucositis were randomized into two groups. All patients received non-surgical treatment associated (test, n = 22) or not (control, n = 16) to 0.12% chlorhexidine plus individualized oral hygiene instruction. Patients were evaluated at baseline, 3, 6, 12 and 18 months as the visible plaque index, gingival bleeding, probing depth and bleeding on probing. Data were statistically analyzed by Friedman, Wilcoxon and Mann-Whitney test, Spearman correlation and chi-square test, using a a 5%. The intra-group analysis showed that both the treatments were effective in reducing visible plaque indices, gingival bleeding, probing depths and bleeding on probing (p <0.05). However, none of the groups achieved superior results relative to each other. It was concluded that the mechanical therapy alone is effective in reducing the clinical parameters analyzed and, as groups become equal because the effect of chlorhexidine not exist, supportive therapy peri-implant was effective in reducing the visible plaque index, gingival bleeding, probing depth and bleeding on probing at the end of the study. (AU)

Avaliação da prática de higiene bucal em pacientes ortodônticos / Evaluation of oral hygiene in orthodontic patients

Objetivo: identificar as condições de higiene bucal, principalmente em relação ao uso do fio dental, em pacientes submetidos ao tratamento ortodôntico fixo. Material e métodos: um questionário sobre as atuais práticas de higiene bucal foi respondido por 200 indivíduos entre 11 e 25 anos de idade, sendo 100 do sexo feminino e 100 do sexo masculino, em fase ativa de tratamento ortodôntico fixo. Resultados: os resultados avaliados pela estatística, por meio de teste de comparação entre as faixas etárias, correlação, associação e distribuição de frequência, revelaram que a maioria dos pacientes (66%) escova os dentes duas vezes ao dia; utiliza escovas de dente convencionais (100%), ao invés de escova elétrica, e apenas 35,55% utiliza rotineiramente fio dental.

Objective: this study analyzed the oral hygiene status, especially concerning the use of dental floss, in patients submitted to fixed orthodontic treatment. Material and methods: a questionnaire on the current oral hygiene practices was responded by 200 individuals aged 11 to 25 years, being 100 females and 100 males, in active stage of fixed orthodontic treatment. Results: the results were statistically analyzed by comparison between age ranges, correlation, association and frequency distribution, and revealed that; there is positive correlation between age and frequency of toothbrushing; there is association between age and use of dental floss. Conclusions: analysis of the oral hygiene practice of orthodontic patients revealed that most patients (66%) brush their teeth twice a day; use conventional toothbrushes (100%) rather than electric toothbrushes and only 35.55% make routine use of dental floss.

Influence of time, toothpaste and saliva in the retention of Streptococcus mutans and Streptococcus sanguinis on different toothbrushes

Objectives: The intraoral transmission of cariogenic and periodontopathogenic species seems to be facilitated by contaminated toothbrushes and other oral hygiene devices. The aim of this investigation was to analyze the in vitro retention and survival rate of Streptococcus mutans and Streptococcus sanguinis on different toothbrushes. The impacts of human saliva and antimicrobial toothpaste on these parameters were further evaluated. Material and Methods: Part I: Four toothbrushes (Colgate 360°, Curaprox CS5460 ultra soft, elmex InterX, Trisa Flexible Head3) were contaminated by S. mutans DSM 20523 or S. sanguinis DSM 20068 suspensions for three minutes. Bacteria were removed from the toothbrushes after either three minutes (T0) or 24 hours (T24) of dry storage and grown on Columbia blood agar plates for the quantification of colony-forming units (CFUs). Part II: The effects of saliva from a caries-active or a caries-inactive person and of toothpaste containing 0.12% chlorhexidine digluconate were also tested. Results: Part I: After three minutes of dry storage, approximately one percent of the bacteria were still detectable on the toothbrushes. After 24 hours, S. sanguinis exhibited a more pronounced decrease in viable cell numbers compared with S. mutans but the differences were not significant (Kruskal-Wallis test, p>0.05). Part II: The addition of human saliva from a caries-active or caries-inactive person slightly increased the retention of both streptococcal species at T0. The use of toothpaste had no influence on the amount of viable streptococci at T0, but it reduced the microbial load after 24 hours of storage. There were only slight nonsignificant differences (p>0.05) between the four toothbrushes. Conclusions: In vitro bacterial retention and survival of S. sanguinis and S. mutans on different toothbrushes occurred. Within the limitations of this study, the use of human saliva or an antimicrobial toothpaste ...

Avaliação do consumo e custo de produtos de higiene bucal para população de um município no Nordestebrasileiro / Evaluation of the consumption and cost of oral hygiene products for the population of a small town in Northeast Brazil

Objetivo: Avaliar a relação entre o custo e o consumo de produtos de higiene bucal para população deum município do Nordeste do Brasil. Materiais e Métodos: Trata-se de um estudo transversal, realizado emduas fases: na primeira com uma entrevista sobre os hábitos de higiene bucal e a partir dos resultados obtidosfoi realizada uma consulta de preços dos produtos nos estabelecimentos comerciais. A seleção da amostra (n =422) foi realizada por conglomerados. Os dados foram avaliados por analises estatísticas descritiva e analítica.Resultados: A maioria dos participantes foi do sexo feminino (55%), faixa etária de 18-30 anos (59,7%), rendamédia familiar de 3-5 salários mínimos (34,3%). Em relação aos produtos que utilizam para realizar higienebucal, (36,7%) relataram a utilização e a associação de escova dental, dentifrício, e fio dental. As variáveisidade, nível de escolaridade e renda apresentaram associação positiva e estatisticamente significativa com avariável produtos de higiene bucal. Conclusão: O uso de produtos de higiene bucal apresenta uma associaçãosignificativa com a idade, anos de estudo e renda familiar média. Os custos dos produtos podem servir comouma barreira de acesso ao consumo e a uso pela população.

Social determinants and use of dental floss by 35-44-year-old adults / Determinantes sociais e o uso de fio dental por adultos de 35 a 44 anos de idade

Objective: To analyze social, economic and demographic variables associated with the use of dental floss by 35-44-year-old adults living in the district of Embu, 2008. Methods: A cross-sectional type study in which an inquiry was applied and oral conditions were examined. The sample delineation was conglomeration probabilistic in two stages of random selection (censor sectors and eligible homes). The dependent variable was the use of dental floss in daily oral hygiene practices. The independent variables were social economic and demographic conditions, access to health services, habits and presence of caries and periodontal diseases. EPIINFO 06 and STATA 10 programs were used for Poisson regression analysis with adjustment for conglomeration sample.Results: Of persons interviewed 52.1% stated that they did not use dental floss. In the multivariate model there was an association of non use of dental floss for men (PR=1,61 p=0,00), with those who declared having smoking habit (PR=1.24 p=0.04); with family income equal to or less than one minimum salary (PR=1.62 p=0.00); who had up to 8 years of schooling (PR=1.42 p=0.01); who did not receive information from the dentist about cleaning the teeth and gums (PR=1.27 p=0.02), and who presented severe periodontal diseases with clinical attachment loss >3.5mm (PR=1.05 p=0.00). Conclusion: The research showed that the lack of dental floss use is a socially related behavior. Therefore, fair social policies is needed in order to minimize social inequalities, and ensure adult oral health educational programs.

Objetivo: Analisar as variáveis sócio econômicas e demográficas associadas ao uso do fio dental em adultos de 35 a 44 anos no município de Embu, 2008. Métodos: Estudo do tipo transversal no qual foi aplicado um inquérito e realizado um exame das condições bucais. O delineamento da amostra foi probabilístico por conglomerado em dois estágios de sorteio (setores censitários e domicílios elegíveis). A variável dependente foi o uso do fio dental nas práticas diárias de higiene bucal. As variáveis independentes: condições sócio demográficas, sócio econômicas, acesso aos serviços, hábitos, presença de cárie dentária e doença periodontal. Empregou-se o programa EPIINFO 06 e o STATA 10, foi usado o modelo de regressão de Poisson com ajuste para amostragem complexas. Resultados: A percentagem de pessoas relatando que não utilizavam o fio dental foi de 52,1%. No modelo de análise multivariável demonstrou que houve associação para o não uso do fio dental entre os homens (RP=1,61 p=0,00), que relataram o hábito de fumar (RP=1,24 p=0,04), com renda familiar menor ou igual a um salário mínimo (RP=1,62 p=0,00), que apresentavam até 8 anos de estudo (RP=1,42 p=0,01), que não receberam informação do cirurgião-dentista sobre higiene bucal (RP=1,27 p=0,02), e apresentam perda de inserção periodontal superior a 3,5mm (RP=1,05 p=0,00). Conclusão: A pesquisa demonstrou que não usar o fio dental de maneira regular é um comportamento socialmente determinado, verifica-se a necessidade de elaboração de políticas socialmente mais justas que minimizem as iniquidades sociais, com ações de educação de saúde bucal voltadas para adultos

Condição de saúde bucal, comportamentos, autopercepção e impactos associados em estudantes universitários moradores de residências estudantis / Oral health status, behaviours, self-perception and associated impacts among university students living in student residences

Introdução: Na perspectiva dos projetos de Universidade Saudável, uma estratégia importante é a avaliação da condição de saúde dos estudantes universitários. No Brasil, um dos grupos vulneráveis é o que reside em moradias estudantis institucionais. Objetivo: Este estudo transversal investiga a condição de saúde bucal, os comportamentos, a autopercepção e os impactos associados em moradores de residências estudantis em uma universidade pública. Material e método: A amostra foi constituída de 68 residentes das quatro Casas de Estudantes Universitários da Universidade Federal de Goiás (UFG), em Goiânia. Os dados foram coletados por meio de exame clínico bucal e entrevista. Resultado: A condição bucal mais prevalente foi a cárie, sendo que 74,6% dos estudantes necessitavam de tratamento para essa condição. A pior condição periodontal observada foi a presença de cálculo (50,8%). A maioria dos estudantes informou que escovava os dentes três vezes ao dia, usava fio dental e necessitava de tratamento odontológico. Dor de dente nos seis meses anteriores à pesquisa foi relatada por 33,8% da amostra; sangramento gengival ao escovar, por 41,2%, e 19,1% afirmaram procurar o serviço odontológico da universidade. O relato de consumo de açúcares entre as refeições foi muito alto e quase 18% fumavam. Mais da metade dos estudantes (51,4%) relatou estar indiferente ou insatisfeita em relação à sua boca e aos seus dentes. O maior impacto da condição bucal foi a dificuldade para comer ou beber, e 19,1% relataram ter faltado à aula em razão de problemas bucais. Conclusão: Os estudantes apresentaram alto percentual de necessidades de tratamento para cárie, bons hábitos de higiene bucal e autopercepção da sua saúde bucal com características negativas.

Introduction: In regard to Healthy University projects, an important strategy is the assessment of university students? health status. In Brazil, a vulnerable group is the one living in university student residences. Objective: This descriptive cross-sectional study aims to investigate the oral health status, behaviors, self-perception and its associated impacts among public university students living in student residences. Material and method: The study population consisted of 68 students who live in four university residences from the Federal University of Goiás in the city of Goiânia. Data were collected through oral clinical examination and interviews. Result: The most prevalent buccal condition was dental caries, and 74.6% of the students had treatment needs for this condition. The worst periodontal condition observed was dental calculus (50.8%). Most of the students reported that they brush their teeth three times a day, use dental floss and need for dental treatment. Dental pain in the last six months was reported by 33.8%, gingival bleeding by 41.2%, and 19.1% had sought the university dental service for treatment. Sugar consumption between meals was very high and almost 18% were smokers. More than half of the students (51.4%) reported being indifferent or dissatisfied with their mouth and teeth. The greatest oral health impact was difficulty for eating or drinking, and 19.1% reported to have missed classes due to oral disorders. Conclusion: Students presented high percentage of treatment needs for caries, good oral hygiene habits, and negative self-perception of their oral health condition.