Directiva sanitaria para el manejo de la atención estomatológica a la persona con discapacidad / Health directive for the management of dental care for people with disabilities

La presente publicación describe los criterios técnicos de referencia y contrarreferencia para la atención integral oportuna y de calidad de las personas con discapacidad., así como las actividades y procedimientos del personal que brinda atención estomatológica para disminuir el riesgo de complicaciones y aparición de nuevos casos por enfermedades estomatológicas

Self-reported oral hygiene habits and gingival bleeding in women with breast cancer: evidence from an observational and prospective study / Hábitos de higiene oral e sangramento gengival autorrelatados em mulheres com câncer de mama: evidência de um estudo observacional e prospectivo

Objectives: to describe and examine oral hygiene habits and self-reported gingival bleeding in women with breast cancer undergoing chemotherapy. Methods: in an observational and prospective study, 140 women were evaluated during chemotherapy between 2017 and 2019. Results and Conclusion: more than 40% of participants reported gingival bleeding at some point during chemotherapy. Flossing was unsatisfactory at baseline and in the intermediate cycle as well as did not affect self-reported gingival bleeding. The amount of tooth brushing per day was a predictor of self-reported gingival bleeding at the end of chemotherapy.

Objetivos: descrever e examinar os hábitos de higiene bucal e o autorrelato de sangramento gengival em mulheres com câncer de mama em quimioterapia. Métodos: em um estudo observacional prospectivo, foram avaliadas 140 mulheres ao longo da quimioterapia, entre 2017 e 2019. Resultados e Conclusão: mais de 40% das participantes relataram sangramento gengival em algum momento da quimioterapia. O uso de fio dental foi insatisfatório no baseline e ciclo intermediário, bem como não afetou o autorrelato de sangramento gengival. A quantidade de escovação dentária por dia foi um preditor para o autorrelato de sangramento gengival ao fim da quimioterapia.

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.

La higiene oral y los efectos de la terapia periodontal mecánica / Oral hygiene and effects of mechanical periodontal therapy

Introducción: Las enfermedades periodontales junto con la caries dental son las patologías más frecuentes que afectan los dientes y tejidos circundantes. El principal agente etiológico es el acúmulo de biopelícula dental bacteriana ya sea en las fosas y fisuras de los dientes como en el surco gingival. Objetivo: La presente revisión narrativa tuvo por objetivo sintetizar los resultados de la terapia mecánica sobre la higiene oral al ser indicadas en pacientes con diagnóstico de periodontitis. Material y Métodos: Se realizó un estudio descriptivo que se basó en una revisión crítica de las publicaciones relacionadas a la terapia periodontal mecánica en las bases de datos: Scopus, SciELO (Scientific Electronic Library Online), MEDLINE (Pubmed), ScienceDirect así como el buscador Google académico. En cada base de datos se realizó una búsqueda libre de la información con un límite de 10 años de antigüedad de las fuentes de información para analizar tanto fuentes antiguas como actuales. Resultados: De una búsqueda inicial de 678 artículos se incluyeron 52 estudios que compararon técnicas de higiene oral, así como revisiones sistemáticas que sintetizaron el efecto de la terapia mecánica periodontal. Conclusiones: El tratamiento periodontal debe ser considerado la terapia inicial para la periodontitis, debe incluir instrucción en técnicas de higiene para el control de la biopelícula dental y el debridamiento mecánico de las zonas afectadas. No se ha demostrado que una técnica de cepillado manual específica sea superior a otras, por tanto, se debería aplicar aquella que mejor pueda manejar el paciente. No se encontró evidencia que demuestre que el uso del hilo dental disminuya eficientemente los índices de biopelícula dental y parámetros gingivales debido a la dificultad por parte del paciente para emplear adecuadamente la técnica(AU)

Introduction: Periodontal diseases together with dental caries are the most frequent pathologies affecting the teeth and surrounding tissues. The main etiological agent is the accumulation of bacterial dental biofilm in the pits and fissures of the teeth and the gingival sulcus. Objective: The present narrative review aimed to synthesize the results of mechanical therapy on oral hygiene when it is indicated in patients with the diagnosis of periodontitis. Material and methods: A descriptive study was conducted. It was based on a critical review of some articles related to mechanical periodontal therapy published in databases such as Scopus, SciELO (Scientific Electronic Library Online), PubMed/ MEDLINE and ScienceDirect. Google search engine was also used. A free search for information was carried out in each database. An age limit of 10 years was established for the analysis of both old and current sources. Results: The initial search included 678 articles. Of these, 52 studies that compared oral hygiene techniques as well as systematic reviews that synthesized the effect of mechanical periodontal therapy were included. Conclusions: Periodontal treatment should be considered as the initial therapy for the treatment of periodontitis. It should include oral hygiene instructions for the control of dental biofilm and mechanical debridement of the affected areas. A specific manual brushing technique has not been proven to bebetter than others; therefore, the one that can best be performed by the patient should be used. There was no proven evidence that effective flossing reduces dental biofilm indexes and gingival parameters due to the patient difficulty to adequately perform the technique(AU)

The effect of dental plaque level and self-performed oral hygiene on periodontal status: a cross-sectional study in Brazilian Indigenous / O efeito do nível da placa dentária e da higiene bucal autorrealizada no estado periodontal: um estudo transversal em indígenas brasileiros

Objective: This study evaluated the associations of periodontal status with dental plaque index and frequency of toothbrushing and flossing in Kiriri Brazilian Indigenous people. Methods: Gingival bleeding, periodontal clinical attachment level, and dental plaque index were clinically evaluated in 204 adult Brazilian indigenous. They were categorized as healthy, gingivitis, or periodontitis. Sociodemographic data and oral hygiene habits were registered. Bivariate and logistic regression analyses were performed (p≤0.05). Results: Gingivitis [odds ratio (OR): 2.83; 95% confidence interval (CI), 1.52­5.25; p=0.001] and periodontitis (OR: 6.88; 95%CI, 1.44­32.78; p=0.02) were associated with plaque index level, but not with toothbrushing or flossing frequency (p ≥0.55). Conclusion: Gingivitis and periodontitis were associated with higher plaque index, but not with the frequency of toothbrushing and flossing. To enhance this population's periodontal health, a prevention program focused on improving the quality of self-performed oral hygiene should be planned and implemented.

Objetivo: avaliar as associações do estado periodontal com o índice de placa dentária, a frequência de escovação e o uso do fio dental em Indígenas Brasileiros Kiriri. Métodos: sangramento gengival, nível de inserção clínica periodontal e índice de placa dentária foram avaliados, clinicamente, em 204 indígenas brasileiros adultos. Eles foram classificados como saudáveis, com gengivite ou periodontite. Dados sociodemográficos e hábitos de higiene bucal foram registrados. Foram realizadas análises bivariadas e de regressão logística (p≤0,05). Resultados: gengivite [Odds Ratio (OR): 2,83; Intervalo de confiança de 95% (IC), 1,52-5,25; p = 0,001] e periodontite (OR: 6,88; IC 95%, 1,44­32,78; p = 0,02) foram associados ao nível de índice de placa, mas não à frequência de escovação ou uso do fio dental (p ≥0,55). Conclusão: gengivite e periodontite foram associados a maior índice de placa, mas não com frequência de escovação e uso do fio dental. Para melhorar a saúde periodontal dessa população, um programa de prevenção com foco na melhoria da qualidade da higiene bucal autorrealizada deve ser planejado e implantado.

Cepillos interdentales, de la teoría a la práctica. Revisión de literatura e indicaciones clínicas / Interdental toothbrushes, from theory to practice: a review of the literature and clinical indications

Los cepillos interproximales son una herramienta de higiene interdental que tiene variadas indicaciones y múltiples beneficios. Pacientes con enfermedad periodontal, con papilas que no llenan el espacio interdentario, portadores de aparatología ortodóncica, prótesis fija o de implantes entre otros casos, pueden beneficiarse con su utilización. El presente artículo tiene como objetivo dar una orientación de su uso clínico basado en la evidencia científica disponible. Los resultados apoyan su utilización en combinación con el hilo dental para la prevención y tratamiento de las enfermedades bucales más prevalentes, con un efecto marcado sobre el control del biofilm y la inflamación gingival (AU)

Interproximal brushes are an interdental hygiene tool with diverse indications that have, multiple benefits. Among other uses, they are indicated in patients with periodontal disease, with papillae that do not fill the interdental space, patients with orthodontic appliances, fixed prosthesis or implant-supported prosthesis. The aim of this article is provide guidance on their clinical use based on the available evidence. The results support their use in combination with dental floss for preventing and treating the most prevalent oral diseases, with a significant effect on biofilm control and gingival inflammation (AU)

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.

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.

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)

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).

Cepillos interdentales, de la teoría a la práctica. Revisión de literatura e indicaciones clínicas. / Interdental brushes, from theory to practice: literature review and clinical indications

Los cepillos interproximales son una herramienta de higiene interdental que tiene variadas indicaciones y múltiples beneficios. Pacientes con enfermedad periodontal, con papilas que no llenan el espacio interdentario, portadores de aparatología ortodóncica, prótesis fija o de implantes entre otros casos, pueden beneficiarse con su utilización. El presente artículo tiene como objetivo dar una orientación de su uso clínico basado en la evidencia científica disponible. Los resultados apoyan su utilización en combinación con el hilo dental para la prevención y tratamiento de las enfermedades bucales más prevalentes, con un efecto marcado sobre el control del biofilm y la inflamación gingival.

Interproximal brushes are an interdental hygiene tool with diverse indications that have multiple benefits. Among other uses, they are indicated in patients with periodontal disease, with papillae that do not fill the interdental space, patients with orthodontic appliances, fixed prosthesis or implant.supported prosthesis. The aim of this article is to provide guidance on their clinical use based on the available evidence. The results support their use in combination with dental floss for preventing and treating the most prevalent oral diseases, with a significant effect on biofilm control and gingival inflammation.

Effect of environmental and socioeconomic factors on the use of dental floss among children: a hierarchical approach

Abstract The aim of this study was to evaluate the association of environmental and socioeconomic characteristics with the use of dental floss in preschool children. This cross-sectional study was conducted with a sample of 402 preschool children aged 1-5 years, from Santa Cruz do Sul, a Southern city in Brazil. Mothers answered questions about environmental, demographic, and socioeconomic characteristics. Behavior variables as use of dental floss (study outcome) and dental attendance were also evaluated. Poisson regression analysis with robust variance through a hierarchical approach was used to investigate the association of explanatory variables for use of dental floss. Prevalence ratio (PR) and 95% confidence intervals (95%CI) were estimated. The mean sample age was 3.32 years (standard deviation [SD] 1.10). Of the included children, 291 (73.12%) did not use dental floss. The environmental model indicated that children who attended daycare (PR 2.53; 95%CI 1.39-4.60) and those whose parents were members of volunteer networks (RP 1.58; 95%CI 1.02-2.46) were more likely to use dental floss. Children from families with higher income (PR 1.55; 95%CI 1.07-2.24) and maternal schooling (PR 2.21; 95%CI 1.31-3.74) presented a higher prevalence of dental floss use. Older children and those who attended dental services were also related to higher dental floss use. Our findings suggest that children who live in a supporting environment and those with a higher socioeconomic status are more likely to use dental floss.

Pobreza y salud bucal en comunidades afrodescendientes vulnerables / Poverty and oral health in vulnerable Afro-descendants communities

Objetivo: Determinar la relación entre pobreza y salud bucal en comunidades afrodescendientes vulnerables. Métodos: Estudio realizado en 240 adultos residentes en Tierra Baja, Manzanillo y Boquilla de Cartagena, Colombia. La selección fue a conveniencia en visita domiciliaria. El estudio conto con una etapa descriptiva y una analítica. En la primera etapa descriptiva se indagó por variables sociodemográficas, presencia de pobreza, condiciones de salud bucal, hábitos de higiene oral y otros nocivos. En la segunda, analítica de corte transversal, se clasificó la pobreza en objetiva, subjetiva y general, como variables independientes en tanto que la condición de salud bucal y hábitos bucales las dependientes. La valoración clínica de la población estuvo a cargo de examinadores entrenados. Los datos se analizaron a partir de frecuencias y proporciones y odds ratio por regresión logística bivariada. Resultados: De los participantes 76,7 por ciento se percibieron pobres y 89,2 por ciento contaban con sus necesidades básicas insatisfechas (pobreza objetiva); el 65,8 por ciento se clasificaron con pobreza general. Se encontraron asociaciones entre la pobreza objetiva y subjetiva y la condición de salud bucal inadecuada (odd ratio: 2,17 y 1,8 respectivamente) y entre hogares con pobreza general y frecuencia del cepillado (odd ratio: 2,18), recambio del cepillo de dientes (odd ratio: 2,3) y hábito del bruxismo (odd ratio: 2,4). Conclusiones: La pobreza ejerce influencia desfavorable en la salud bucal en comunidades afrodescendientes vulnerables. Se demuestra la necesidad de una intervención efectiva en el entorno social(AU)

Objective: To determine the relationship between oral health and the presence of poverty in african descent of Tierra Baja, Manzanillo and Boquilla, Cartagena, Colombia. Methods: Study conducted in 240 adults selected convenience in the home visit. The first descriptive stage asses sociodemographic variables, presence of poverty, oral health condition, oral health habits and other nocuous. In the second analytical stage of cross-section, the poverty classified as objective, subjective and general were the independent variables while the oral health condition and oral habits were the dependent variables. There was calibration of examiners, for clinical assessment. The data were analyzed from frequencies and proportions and odds ratio by bivariate logistic regression. Results: 76,7 percent of participants perceived poor and 89,2 percent had their Dissatisfied Basic Needs (objective poverty); 65,8 percent were classified as general poor people. There were associations between objective and subjective poverty and inadequate oral health condition (OR: 2.17 and 1.8 respectively) and among households with general poverty and frequency of brushing (OR: 2.18), toothbrush replacement (OR: 2,3) and habit of bruxism (OR: 2,4). Conclusions: Poverty has an adverse influence in oral health in vulnerable Afro-descendants communities. It is demonstrated the necessity of effective interventions in the social environment(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.

Guía de práctica clínica para la prevención, diagnóstico y tratamiento de la caries dental en niñas y niños: Guía técnica / Clinical practice guide for the prevention, diagnosis and treatment of dental caries in girls and boys: Technical guide

La presente publicación describe los criterios técnicos, basados en la mejor evidencia disponible, para la prevención, diagnóstico y tratamiento de la caries dental en niños y niñas. Estos criterios serán utilizados en todos los niveles de atención en salud del sector público

Salud bucodental relacionada a la calidad de vida: revisión crítica de los instrumentos de medición / Oral health related quality of life: a critical review of measuring instruments

Un creciente reconocimiento de la importancia de la calidad de vida en odontología ha llevado al desarrollo de varios instrumentos para medir su relación con la salud bucodental. Saber por qué y de qué manera la salud bucodental afecta la calidad de vida de las personas es relevante para la práctica, la investigación y la enseñanza en odontología. El objetivo de esta revisión bibliográfica fue actualizar los conocimientos sobre las características generales y sicométricas de los instrumentos para medir la calidad de vida relacionada a la salud bucodental que surgieron posterior a la publicación en 1997 de los resultados de la conferencia "Measuring oral health and quality of life”. Se realizó una búsqueda bibliográfica para identificar publicaciones aparecidas de enero de 1998 a junio del 2011, utilizando las bases de datos MEDLINE y GOOGLE académico. Se establecieron criterios específicos, basados en marcos de referencia internacionales, para la inclusión, la recolección y el análisis de las propiedades generales y sicométricas de los instrumentos. Se identificaron 233 artículos de los cuales 10 cumplían con todos los criterios predeterminados y finalmente quedaron 9 porque uno de ellos se encontraba repetido. Todas las publicaciones fueron encontradas en lengua inglesa. Todos los instrumentos fueron multidimensionales, presentaron propiedades sicométricas adecuadas y la mayoría de ellos tomó como base a otros instrumentos de medición previos y a la clasificación de deficiencias y discapacidades. Se concluye que es necesario avanzar en la medición de salud bucodental relacionada a la calidad de vida para el contexto y las características de la población de América Latina ya que sólo se cuenta con publicaciones anglosajonas.

There is growing recognition of the importance of oral health-related quality of life.This has given rise to the development of various instruments to measure therelationship between quality of life and oral health. Understanding why and how oralhealth affects quality of life is highly relevant to the research, teaching and practice ofprofessional dentistry. The objective of this literature review was to update theknowledge about the general and psychometric characteristics of instruments tomeasure quality of life related to oral health that emerged after the publication in 1997of the results of the conference "Measuring oral health and quality of life”. We conducted a literature review using MEDLINE and GOOGLE Scholar databases to identifypublications that appeared between January, 1998 and June, 2011. We used commoninternational frames of reference to establish specific search criteria for the inclusion,collection, and analysis of the general and psychometric properties of the instruments.We identified 233 articles, ten of which met all the established criteria. Ultimately wereduced this number to nine because one of the articles was a duplicate. All identifiedarticles were in English. All instruments identified through the literature review weremultidimensional and had adequate psychometrtic properties. The majority ofinstruments was based on prior measurement tools and the classification of impairmentsand disabilities. We conclude that to advance the measurement of oral health-relatedquality of life, the specific context and characteristics of the Latin American populationshould be taken into account. So far, this topic has only been addressed in Englishlanguage publications.

Eficácia de diferentes tipos de escovas dentais na remoção do biofilme bucal / Effectiveness of different types of dental brushes in removal of oral biofilm

Devido ao fato de o método mais indicado para remoção do biofilme bucal ser o mecânico, com a utilização da escova dental, buscou-se verificar as características das escovas dentais mais eficazes. Foram avaliadas as seguintes características: relação entre cabo haste e cabeça, com o intuito de verificar angulações, formato e tipo das cerdas, considerando tamanho e disposição dos tufos, bem como comparar a eficácia das escovas manuais e elétricas. O estudo foi realizado com 28 crianças em uma escola municipal da cidade de Umuarama-PR. Foram utilizados quatro tipos de escovas: escova de haste reta com cerdas regulares; escova de haste angulada com cerdas regulares; escova de haste angulada com cerdas irregulares e escova elétrica. Foram realizados a evidenciação do biofilme e o Índice de Higiene Oral Simplificado (IHOS) antes e após a escovação. Os diferentes tipos de escovas foram avaliados de acordo com a diferença entre o percentual de biofilme antes e após a escovação, bem como em relação à redução da classificação do IHOS. Nas diferentes análises, a escova de haste reta apresentou os melhores resultados. Em contrapartida, a escova elétrica apresentou resultados menos satisfatórios. Pode-se concluir que todas as escovas dentárias apresentaram potencial de redução do biofilme dentário, independentemente das características de sua haste, cerdas ou manuseio (manual ou elétrico). Contudo, os melhores resultados foram atribuídos à escova que apresenta a haste reta, que também possui cerdas regulares.

Since the most effective method for the removal of oral biofilm is the mechanical one, with the use of a toothbrush, this study aimed to check the characteristics of the most effective toothbrushes. The following characteristics were analyzed: handle and head ratio, tuft layout, as well as a comparison between manual and electric toothbrushes. This work was conducted with 28 children in a public school in the city of Umuarama/PR. Four types of brushes were used: straight shank brush with regular bristles; angled stem with regular bristles; angled stem with irregular bristles; and electric toothbrush. The disclosure of oral biofilm and the Simplified Oral Hygiene Index (SOHI) before and after brushing were analyzed. The different kinds of brushes were evaluated according to the difference between the percentage of biofilm before and after brushing, as well as the reduction of SOHI. Straight shank brushes showed the best results in different analysis. On the other hand, the electric toothbrush brought the less satisfactory results. It was possible to conclude that all toothbrushes have shown potential for biofilm reduction, regardless of the characteristics of their handles, bristles or usage (manual or electric). However, the best results were attributed to the straight shank brush with regular bristles.