Uncovering a pseudoscience: an analysis of 'biological dentistry' Instagram posts.

OBJECTIVE: This infodemiology study aimed to analyze characteristics of English-language Instagram posts on 'Biological Dentistry'. MATERIALS AND METHODS: Using CrowdTangle, we analyzed 500 'Biological Dentistry' posts published on Instagram from May 2017 to May 2022. Two researchers assessed each post for facticity, motivation, author's profile, sentiment, and interaction metrics. Statistical analysis was employed to compare interaction metrics between dichotomized categories of posts' characteristics and determine predictors of misinformation and user engagement. RESULTS: Over half of the posts (58.4%) were from health-related authors, and a considerable number contained misinformation (68.2%) or were financially motivated (52%). Sentiment was mostly negative or neutral (59.8%). Misinformation was associated with financial motivation (OR = 2.12) and health-related authors (OR = 5.56), while non-health-related authors' posts associated with higher engagement (OR = 1.98). Reliable content, non-health-related authorship, and positive sentiment were associated with increased user interaction. CONCLUSION: Misinformation about 'Biological Dentistry' on Instagram is mainly spread by financially incentivized health-related authors. Yet, non-health-related authors' posts resonate more with audiences, highlighting a nuanced relationship between content facticity, authorship, and engagement.

Unveiling deception: Characterizing false amber necklace messages on Facebook.

BACKGROUND: Messages promoting the benefits of amber necklaces for children are common on social media, despite their health risks. AIM: This study characterized Facebook posts with false content about the efficacy of amber necklaces in teething. DESIGN: A sample of 500 English-language Facebook posts was analyzed by two investigators to determine the motivations, author's profile, and sentiments of posts. Latent Dirichlet Allocation topic modeling was used to identify salient terms and topics. An intertopic distance map was created to calculate the topic similarity. These data were analyzed using descriptive analysis, the Mann-Whitney U test, Cramer's V test, and multiple logistic regression models, regarding the time since initial posting and interaction metrics. RESULTS: Most posts were made by business profiles and expressed positive sentiments, with social, psychological, and financial motivations. The posts were categorized into the topics "giveaway," "healing features," and "sales." Overperforming scores and total interaction increased with time since the initial posting. Posts with links had higher overperforming scores. CONCLUSION: The findings suggest that Facebook posts about the efficacy of amber necklaces in teething are motivated by financial interests, using psychological and social mechanisms to achieve greater interaction with their target audience.

Practical training using BEWE aimed at improving the diagnosis ability of erosive tooth wear for dental students-A randomized trial.

INTRODUCTION: Erosive tooth wear (ETW) has been gaining attention due to its high prevalence. However, ETW clinical diagnosis is difficult and may go unnoticed by many professionals. The present study aimed to develop, implement and evaluate a theoretical-practical training using active methodologies in the development of undergraduate students' skills for the diagnosis of ETW compared to the traditional teaching method. MATERIALS AND METHODS: This randomized controlled study involved two parallel groups: control group (n = 22), with learning based only on theoretical content and test group (n = 24), learning by theoretical-practical activity mediated by monitors/tutors. The theoretical class covered the current concepts of ETW, aetiology, diagnosis, use of the BEWE index, prevention and treatment. The practical training included exercises and discussions based on the diagnosis using BEWE scores of a collection of images and extracted teeth. To evaluate the efficacy of the teaching-learning methods, a theoretical multiple-choice questionnaire and a practical test using images and extracted teeth were applied. The outcome was the number of correct answers. Groups were compared by Mann-Whitney (theoretical knowledge) and T tests (practical ability in diagnosis) (p < .05). RESULTS: There was no significant difference between groups in the theoretical evaluation (p = .866). The test group showed higher ability to diagnose ETW lesions compared to the control group in the practical tests (p = .001). The performance of ETW diagnosis was similar when images were used in comparison to extracted teeth (p = .570). CONCLUSION: The practical activity associated with theoretical classes can be a promising strategy to improve the development of undergraduate students' skills in the diagnosis of ETW.

Digital surveillance: The interest in mouthwash-related information.

BACKGROUND: The comprehension of the interests of Internet users regarding their health-related searches may reveal the community's demands about oral health. The study aimed to characterize the interests of Google users related to mouthwash in Australia, Brazil, Chile, Japan, Mexico, Russia, the United Kingdom, the United States, Saudi Arabia and South Africa applying the Google Trends. METHODS: This longitudinal retrospective study analysed the mouthwash-related interest of Google users from January 2004 to December 2020. The monthly variation of relative search volume (RSV) and the main queries related were determined using Google Trends. Autoregressive integrated moving average (ARIMA) forecasting models were built to establish the predictive RSV values for mouthwash for additional 12 months. Auto-correlation plots and a general additive model (GAM) were used to diagnose trends and seasonality in RSV curves. In addition, the influence of social isolation related to the outbreak of COVID-19 were analysed. RESULTS: The RSVs curves showed a considerable increase in searches related to mouthwash to AUS, BRA, JAP, MEX, GBR and USA (RSV > 25), while the growth was slight to CHI, KSA, RSA and RUS (RSV < 25) over the years, without influence of monthly seasonality. All countries showed a significant increase in mouthwash interest after the outbreak of COVID-19, except for KSA and RUS. The mouthwash-related searches were associated to specific brands or chemical compositions, treatments, whitening agents, homemade mouthwash and indications for the 'best mouthwash'. CONCLUSIONS: In general, there was an increasing interest of Google users in mouthwash-related topics between 2004 and 2020. In addition, in most countries, there was an expansion in searches during the social isolation of the COVID-19 pandemics.

Reacting, Sharing, and Commenting: How Many Facebook Users Are Engaging with Posts Related to Dental Caries That Contain Misinformation?

Recent studies have been concerned about the vast amount of misinformation detected on social media that directly hampers the prevention and control of chronic diseases. Based on these facts, the aim of this study was to identify and characterize misinformation about dental caries-related content found on Facebook, regarding the predictive factors of user interaction with posts. Then, CrowdTangle retrieved 2,436 posts published in English, ordered by the total interaction of the highest users. A total of 1,936 posts were selected for inclusion and exclusion criteria to select a sample of 500 posts. Subsequently, two independent investigators characterized the posts by their time of publication, author's profile, motivation, the aim of content, content facticity, and sentiment. The statistical analysis was performed using Mann-Whitney U and χ2 tests and multiple logistic regression models to determine differences and associations between dichotomized characteristics. p values <0.05 were considered significant. In general, posts were predominantly originated from the USA (74.8%), related to business profiles (89%), presented preventive content (58.6%), and noncommercial motivation (91.6%). Furthermore, misinformation was detected in 40.8% of the posts and was positively associated with positive sentiment (OR = 3.43), business profile (OR = 2.22), and treatment of dental caries (OR = 1.60). While the total interaction was only positively associated with misinformation (OR = 1.44), the overperforming score was associated with posts from the business profile (OR = 5.67), older publications (OR = 1.57), and positive sentiment (OR = 0.66). In conclusion, misinformation was the unique predictive factor of increased user interaction with dental caries-related posts on Facebook. However, it did not predict the performance of the diffusion of posts such as business profiles, older publications, and negative/neutral sentiment. Therefore, it is essential to promote the development of specific policies toward good quality information on social media, which includes the production of adequate materials, the increase of the critical sense of consuming health content, and information filtering mediated by digital solutions.

Analysis of Fluoride-Free Content on Twitter: Topic Modeling Study.

BACKGROUND: Although social media has the potential to spread misinformation, it can also be a valuable tool for elucidating the social factors that contribute to the onset of negative beliefs. As a result, data mining has become a widely used technique in infodemiology and infoveillance research to combat misinformation effects. On the other hand, there is a lack of studies that specifically aim to investigate misinformation about fluoride on Twitter. Web-based individual concerns on the side effects of fluoridated oral care products and tap water stimulate the emergence and propagation of convictions that boost antifluoridation activism. In this sense, a previous content analysis-driven study demonstrated that the term fluoride-free was frequently associated with antifluoridation interests. OBJECTIVE: This study aimed to analyze "fluoride-free" tweets regarding their topics and frequency of publication over time. METHODS: A total of 21,169 tweets published in English between May 2016 and May 2022 that included the keyword "fluoride-free" were retrieved by the Twitter application programming interface. Latent Dirichlet allocation (LDA) topic modeling was applied to identify the salient terms and topics. The similarity between topics was calculated through an intertopic distance map. Moreover, an investigator manually assessed a sample of tweets depicting each of the most representative word groups that determined specific issues. Lastly, additional data visualization was performed regarding the total count of each topic of fluoride-free record and its relevance over time, using Elastic Stack software. RESULTS: We identified 3 issues by applying the LDA topic modeling: "healthy lifestyle" (topic 1), "consumption of natural/organic oral care products" (topic 2), and "recommendations for using fluoride-free products/measures" (topic 3). Topic 1 was related to users' concerns about leading a healthier lifestyle and the potential impacts of fluoride consumption, including its hypothetical toxicity. Complementarily, topic 2 was associated with users' personal interests and perceptions of consuming natural and organic fluoride-free oral care products, whereas topic 3 was linked to users' recommendations for using fluoride-free products (eg, switching from fluoridated toothpaste to fluoride-free alternatives) and measures (eg, consuming unfluoridated bottled water instead of fluoridated tap water), comprising the propaganda of dental products. Additionally, the count of tweets on fluoride-free content decreased between 2016 and 2019 but increased again from 2020 onward. CONCLUSIONS: Public concerns toward a healthy lifestyle, including the adoption of natural and organic cosmetics, seem to be the main motivation of the recent increase of "fluoride-free" tweets, which can be boosted by the propagation of fluoride falsehoods on the web. Therefore, public health authorities, health professionals, and legislators should be aware of the spread of fluoride-free content on social media to create and implement strategies against their potential health damage for the population.

eHEALS as a predictive factor of digital health information seeking behavior among Brazilian undergraduate students.

This study aimed to perform the cross-cultural adaptation and validation of the eHealth Literacy Scale (eHEALS) for Brazilian Portuguese. The cross-cultural adaptation was conducted through conceptual equivalence, verbatim translation, semantic, item and operational equivalence, and back-translation. Subsequently, 521 undergraduate students answered the adapted version of the eHEALS, the General Perceived Self-Efficacy Scale (GSES), the Oral Health Impact Profile-14 (OHIP-14) and sociodemographic and health-related questions. Statistical analysis was performed to determine the dimensionality, internal consistency, stability and concurrent/convergent/discriminant/predictive validities of the eHEALS (p < 0.05). The adequacy of sample size was confirmed by a non-identity correlation matrix (Bartlett's test of sphericity, p < 0.001), without influence of multicollinearity (determinant = 0.026). The confirmatory factor analysis identified four factors in agreement to the constructs namely as online searching self-efficacy, awareness of available sources, information usage ability, and critical analysis of useful information. The eHEALS displayed an excellent internal consistency (Cronbach's alpha = 0.88), a good stability (ICC = 0.71, 95% CI: 0.49-0.84), and it was significantly correlated with GSES (concurrent validity). Higher eHEALS scores were identified among (i) white and (ii) younger students, (iii) from health sciences courses, (iv) with more years of graduation, (v) who their fathers were working in specialized functions (discriminant validity), and (vi) among those who were frequently interested in digital health information (convergent validity). The students with higher eHealth literacy levels were more likely to seek health information in the last 24 h (predictive validity). In conclusion, the eHEALS demonstrated adequate psychometric properties to be applied for the Brazilian population.

The eHealth Literacy Scale (eHEALS) is a self-fulfilling tool designed to determine individuals' levels of electronic health literacy. It helps to determine how people deal with electronic health-related information, being useful to identify potential difficulties of accessing, evaluating and using online health information, with potential to support the planning of educational interventions. This study aimed to adapt and validate the eHealth Literacy Scale (eHEALS) for being applied to Brazilian Portuguese native speakers. Five hundred twenty-one undergraduate students answered the adapted version of the eHEALS, the General Perceived Self-Efficacy Scale (GSES), the Oral Health Impact Profile-14 (OHIP-14), and sociodemographic and health-related questions. The tool showed sufficient consistency and stability, with the detection of higher eHEALS scores among white and younger people who reported a frequent interest for seeking digital health information, students from health sciences courses, those with more years of graduation, and who their fathers were working in specialized functions. Also, the students with higher eHealth literacy scores were more likely to seek health information in the last 24 h. In conclusion, the eHEALS demonstrated being adequate to be applied for the Brazilian population.

Digital surveillance: The interests in toothache-related information after the outbreak of COVID-19.

OBJECTIVES: The aim of this ecological study was to analyze the relationship of social restriction measures and people's interest in searching toothache-related information on the Internet. MATERIALS AND METHODS: The following indicators Stringency Index (SI), Years Lived with Disability (YLDs) for untreated caries in permanent teeth, Google market share, Internet penetration, and relative search volume (RSV) for the Topic "Toothache" in Google Trends were determined for 21 countries with available data, from April 2018 to May 2020. Statistical analysis was performed using Mann-Whitney U test, t-Student test, Pearson's Chi-square test, and Spearman and Pearson's cross-correlation tests (α = 0.05). RESULTS: Relative search volume values increased significantly after restriction measures in all countries, except for Japan. Higher RSV values were found among 11 countries that presented a cross-correlation between RSV and SI with r≥│0.6│. The most common queries were linked to the treatment and self-resolution of toothache, with a sudden increase of searches that combined the symptom with COVID-19. CONCLUSIONS: The interests in toothache-related digital information were associated with social restriction measures. These results allow the identification of dental demands of distinct populations, contributing to the planning of specific public health policies during and after the pandemic period.

Characterization of False or Misleading Fluoride Content on Instagram: Infodemiology Study.

BACKGROUND: Online false or misleading oral health-related content has been propagated on social media to deceive people against fluoride's economic and health benefits to prevent dental caries. OBJECTIVE: The aim of this study was to characterize the false or misleading fluoride-related content on Instagram. METHODS: A total of 3863 posts ranked by users' total interaction and published between August 2016 and August 2021 were retrieved by CrowdTangle, of which 641 were screened to obtain 500 final posts. Subsequently, two independent investigators analyzed posts qualitatively to define their authors' interests, profile characteristics, content type, and sentiment. Latent Dirichlet allocation analysis topic modeling was then applied to find salient terms and topics related to false or misleading content, and their similarity was calculated through an intertopic distance map. Data were evaluated by descriptive analysis, the Mann-Whitney U test, the Cramer V test, and multiple logistic regression models. RESULTS: Most of the posts were categorized as misinformation and political misinformation. The overperforming score was positively associated with older messages (odds ratio [OR]=3.293, P<.001) and professional/political misinformation (OR=1.944, P=.05). In this context, time from publication, negative/neutral sentiment, author's profile linked to business/dental office/news agency, and social and political interests were related to the increment of performance of messages. Although political misinformation with negative/neutral sentiments was typically published by regular users, misinformation was linked to positive commercial posts. Overall messages focused on improving oral health habits, side effects, dentifrice containing natural ingredients, and fluoride-free products propaganda. CONCLUSIONS: False or misleading fluoride-related content found on Instagram was predominantly produced by regular users motivated by social, psychological, and/or financial interests. However, higher engagement and spreading metrics were associated with political misinformation. Most of the posts were related to the toxicity of fluoridated water and products frequently motivated by financial interests.

Digital Volumetric Monitoring of Palate Growth in Children With Cleft Lip and Palate.

ABSTRACT: This study aimed to evaluate longitudinally the volume of the dental arches in children with unilateral cleft lip and palate before and after the rehabilitative plastic surgeries. This is a longitudinal retrospective study was composed by 102 digitized dental casts of children with unilateral complete cleft lip (G1) and cleft lip and palate (G2). The palate volume was evaluated at 3 periods: preoperative (T1), postoperative 1 (T2), and postoperative 2 (T3). The intra- and inter-examiner reliability was analyzed by Wilcoxon test/Dahlberg formula and interclass correlation coefficient, respectively. The intragroup comparison was analyzed by Wilcoxon test and Friedman test followed by post-hoc Dunn test. Mann-Whitney test was applied for the intergroup comparison (α = 5%). G1 had a significant growth at T2 (P = 0.031). G2 demonstrated a positive development at T2, but decreased at T3 (P = 0.003). The intergroup analysis revealed that G2 showed a greater volume at T1 and T2 (P < 0.0001 and P = 0.0024, respectively). T2-T1 exhibited no statistically significant difference (P = 0.262). In conclusion, there was a volumetric increase in the dental arches after cheiloplasty followed by a reduction after palatoplasty. Further investigations are necessary to validate the preliminary results of the present study.

A sugarcane cystatin (CaneCPI-5) alters microcosm biofilm formation and reduces dental caries.

The antimicrobial and anticaries effects of CaneCPI-5 were evaluated. Ninety bovine enamel samples were treated for 60 s with either phosphate-buffered-saline (PBS), 0.12% chlorhexidine (CHX), 0.05 mg ml-1 CaneCPI-5, 0.1 mg ml-1 CaneCPI-5 or 0.5 mg ml-1 CaneCPI-5. They were incubated with inoculum (human saliva + McBain's saliva) for the first 8 h. From then until the end of the experiment, the enamel was exposed to McBain saliva with sucrose and, once a day, for 5 days, they were treated with the solutions. At the end of the experimental period, resazurin and viable plate count assays were performed. Enamel demineralization was also measured. All concentrations of CaneCPI-5 and CHX significantly reduced the activity of biofilms compared with PBS. For viable plate counts, all treatments similarly reduced the lactobacilli and total streptococci; for the mutans streptococci, 0.05 mg ml-1 CaneCPI-5 performed better than CHX. All CaneCPI-5 concentrations significantly reduced the integrated mineral loss. This study represents the first step regarding the use of CaneCPI-5 within the concept of acquired enamel pellicle and biofilm engineering to prevent dental caries.

In vitro effect of curcumin-mediated antimicrobial photodynamic therapy on fibroblasts: viability and cell signaling for apoptosis.

Although it was demonstrated that curcumin-mediated antimicrobial photodynamic therapy (aPDT) is effective for reducing the viability of microbial cells and the vitality of oral biofilms, the cytotoxicity of this therapeutic approach for host cells has not been yet elucidated. Hence, the aim of this study was to evaluate the cytotoxicity and apoptotic effects of curcumin-mediated aPDT on mouse fibroblasts. Cells were treated with 0.6 or 6 µmol.L-1 curcumin combined with 0.075 or 7.5 J.cm-2 LED at 455 nm. Cytotoxicity was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and crystal violet (CV) assays, while quantitative reverse transcriptase-PCR (qRT-PCR) was used to assess the expression of Bax, Bad, Bcl-2, VDAC-1, cytochrome C, and Fas-L genes for apoptosis. The differences between groups were detected by Kruskal-Wallis and post hoc Dunn's tests for MTT and CV assays and by ANOVA and post hoc Tukey test for qRT-PCR (P < 0.05). The effect of 0.6 µmol.L-1 curcumin plus 0.075 J.cm-2 LED (minimum parameter) did not differ statistically from control group; however, the combination of 0.6 µmol.L-1 curcumin plus 7.5 J.cm-2 LED reduced viable cells in 34%, while the combinations of 6 µmol.L-1 curcumin plus 0.075 and 7.5 J.cm-2 LED reduced viable cells in 47% and 99%, respectively. aPDT increased significantly the relative expression of Bax/Bcl-2, cytochrome C, VDAC-1, and Fas-L genes, without influence on the ratio Bad/Bcl-2. Therefore, curcumin-mediated aPDT activated Bcl-2 apoptosis signaling pathways in mouse fibroblasts regarding present conditions, reducing the viability of cells with the increase of curcumin concentrations and light energies.

A Biobank of Stem Cells of Human Exfoliated Deciduous Teeth: Overview of Applications and Developments in Brazil.

A biobank is an organized collection of biological human material and its associated information stored for research according to regulations under institutional responsibility, without commercial purposes, being a mandatory and strategical activity for research, regenerative medicine, and innovation. Stem cells have largely been employed in research and frequently stored in biobanks, which have been used as an essential source of biological materials. Stem cells of human exfoliated deciduous teeth (SHED) are stem cells which have a high multipotency and can be easily obtained. Besides, this extremely accessible tissue has advantages with respect to storage, as the SHED obtained in childhood can be used in later life, which implies the necessity for the creation and regulation of biobanks. The proper planning for the creation of a biobank includes knowledge of the material types to be stored, requirements regarding handling and storage conditions, storage time, and room for the number of samples. Thus, this study aimed to establish an overview of the development of a SHED biobank. Ethical and legal standardization, current applications, specific orientations, and challenges for the implementation of a SHED biobank were discussed. Through this overview, we hope to encourage further studies to use SHED biobanks.

Characterization of polymicrobial biofilms obtained from saliva or carious lesions in dentin.

This study aimed to compare the formation of polymicrobial biofilms using carious dentin or saliva as inoculum for application in in vitro microbiological studies on caries research. For biofilm growth, combined samples of infected dentin or saliva from three donors were used. The biofilms were grown on glass coverslips, under a regimen of intermittent exposure (6 h day-1) to 1% sucrose for 4 days. Total bacterial loads, as well as specific aciduric bacteria and mutans streptococci loads were quantified and correlated with biofilm acidogenicity and susceptibility to chlorhexidine. The data were evaluated using the Student's-t, Mann Whitney and Kruskal-Wallis tests. The two biofilms showed similar microbial loads (total bacteria, aciduric bacteria and mutans streptococci) on day 4, and high acidogenicity after 48 h and were susceptible to chlorhexidine at different time intervals. In conclusion, both dentin and saliva can be used as an inoculum in in vitro studies of processes related to biofilm formation.

Photobiomodulation effect on angiogenic proteins produced and released by dental pulp cells.

OBJECTIVE: To verify the photobiomodulation effect on angiogenic proteins produced and released by dental human pulpal fibroblasts (HPFs). MATERIAL AND METHODS: HPFs were irradiated with 660-nm low-level laser at fluences of 2.5 J/cm2 and 3.7 J/cm2. The control group was not irradiated. MTT, crystal violet, and ELISA assays respectively verified viability, proliferation, and angiogenic protein (supernatant/lysate) at 6 h, 12 h, and 24 h after photobiomodulation. Capillary-like structure formation assay verified functional role. Two-way ANOVA/Tukey's test and ANOVA/Bonferroni's multiple comparisons test respectively verified cell viability/proliferation and intragroup and intergroup comparisons of protein synthesis (p < 0.05). RESULTS: Irradiated and non-irradiated HPFs showed statistically similar cell viability and proliferation pattern. Intragroup comparisons showed similar patterns of protein synthesis for all groups: VEGF-A, VEGF-C, and vascular endothelial growth factor receptor 1 (VEGFR1) increased significantly in the supernatant, while FGF-2 and VEGF-A increased significantly in the lysate. The lower fluence significantly increased BMP-9 (6 h) in the supernatant and VEGFR1 (6 h and 12 h) and VEGF-D (24 h) in the lysate, while the higher fluence significantly increased BMP-9 (6 h) in the supernatant and VEGFR1 (12 h) in the lysate. Regardless of the time, both fluences statistically downregulated placental growth factor (PLGF) and PDGF secretion. Both fluences statistically decreased VEGF-A secretion (24 h) and PLGF production (6 h). CONCLUSION: Photobiomodulation produced stimulatory effects on angiogenic protein secretion by pulp fibroblasts. In terms of photobiomodulation, over time, both fluences significantly increased the secretion of VEGF-A, VEGF-C, and VEGFR1 and significantly upregulated BMP-9 (6 h) in the supernatant; for capillary-like structure formation, the fluence of 2.5 J/cm2 was better than the fluence of 3.7 J/cm2. CLINICAL RELEVANCE: This study results addressed effective photobiomodulation parameters tailored for pulp angiogenesis.

Parental perspectives on early childhood caries: A qualitative study.

BACKGROUND: Early childhood caries (ECC) affects about 621 million children worldwide, causing chronic pain, infections, sleeping disorders, and tooth extraction. AIM: To determine perspectives of parents and caregivers of preschoolers regarding ECC. DESIGN: Three focus groups were conducted with attendees of the Clinics of Paediatric Dentistry from the Bauru School of Dentistry. The meetings were video- and audio-recorded, and the contents were transcribed verbatim. Then, textual passages were examined and coded using the software NVivo 12 Plus. RESULTS: The participants associated the presence of dental caries lesions with negative consequences for children, such as problems for permanent dentition, discrimination, and psychological damages. Although regular oral hygiene and healthy diet were recognized as important factors for the prevention of ECC, specific doubts about feeding, toothpaste usage, oral hygiene, and dental eruption were detected among parents. Additionally, they declared that their children brush teeth alone, intake fermentable carbohydrates frequently, and sleep during breastfeeding without dental plaque removal, because uncooperativeness, permissiveness, and convenience. CONCLUSIONS: Based on these results, parents and caregivers understand the unfavourable effects of ECC on children's quality of life; however, their attitudes against the disease seemed to be inaccurate, influenced by their daily routines, doubts, and beliefs.

Are the Internet users concerned about molar incisor hypomineralization? An infoveillance study.

BACKGROUND: Molar incisor hypomineralization (MIH) is a developmental enamel defect characterized by well-demarcated discolorations frequently detected in molars, causing pain and esthetic alterations. AIM: To assess the interests of Google users on MIH-related information. DESIGN: Digital data were collected in Google Trends through two search strategies, 'molar incisor hypomineralization' (topic) and 'MIH' (search term), between January 2004 and November 2018. ARIMA models were applied to analyze trends of curves and to predict the activity of Google users during 12 months. Autocorrelation and partial autocorrelation (ACF/PACF) plots were used to detect trends in the variation of relative search volume (RSV) related to search strategies over time. The most popular queries were analyzed qualitatively, whereas geographical heat maps were retrieved to determine search volumes according to countries (P < .05). RESULTS: Gradual increasing trends were detected, with forecasts indicating similar levels of RSVs to the period between December 2017 and November 2018. Most popular queries and topics were associated with MIH diagnosis, being retrieved predominantly in European countries. CONCLUSIONS: The activity of Google users related to this condition is maintained low, with a reduced intensification over time, suggesting that the awareness on MIH is probably confined to dentists and affected people worldwide.

Could orthodontic fixed appliances and excess weight affect gingival health in adolescents?

INTRODUCTION: The aim of this study was to evaluate the impact of being overweight or obese while wearing orthodontic fixed appliances on the prevalence of gingivitis in adolescents. METHODS: A total of 334 adolescents, aged between 12 and 18 years, were recruited from 3 public schools in Cuiabá, Brazil. Participants were divided in dichotomized categories of body mass index (BMI) (under and normal weight or overweight and obesity) and fixed orthodontic appliance usage (yes or no). Gingival inflammation was evaluated by Löe & Silness index. Socioeconomic status was determined by the criteria of the Brazilian Association of Research Companies, and sugar consumption was assessed by a questionnaire of dietary habits. The statistical analysis was performed with P <0.05 considered significant. RESULTS: In a multivariate linear regression model, gingivitis was directly related to BMI (%) variation and orthodontic appliance use. In addition, excess weight seemed to be 2 times more relevant in predicting gingivitis than orthodontic fixed appliance usage. A strong positive correlation was observed between BMI (%) variation and gingival index (ρ = 0.97, P <0.001). CONCLUSIONS: Orthodontic fixed appliance usage and excess weight were associated with increased gingivitis in adolescents; BMI (%) variation was the most significant predictor of gingival inflammation.

Digital behavior surveillance: Monitoring dental caries and toothache interests of Google users from developing countries.

OBJECTIVE: To determine the differences between the levels of interest of South American Google users on information related to dental caries and toothache over time. MATERIALS AND METHODS: The monthly variation of Relative Search Volume (RSV) for both queries was obtained in Google Trends between 2004 and 2017. The association between RSVs, Internet penetration, and disability-adjusted life-years (DALYs) for dental caries in permanent teeth were tested by distinct regression models. Forecasting ARIMA models were developed to analyze trends and predict the interests until December 2018. RESULTS: In general, toothache-related searches presented an uptrend associated positively with Internet penetration and negatively with DALYs, whereas dental caries-related searches presented a downtrend associated negatively with Internet penetration and positively with DALYs. The seasonality affected only dental caries curves, with the highest rates observed in the first trimester and the lowest rates in June, July, and December. CONCLUSION: The levels of interests of South American Google users in seeking dental caries and toothache information appear to have a direct connection with the burden of untreated dental caries lesions and Internet penetration. The no association between dental caries- and toothache-related interests reinforces the unfamiliarity of most people about the relationship of dental pain with the final stages of chronic oral diseases.

Could a chelant improve the effect of curcumin-mediated photodynamic antimicrobial chemotherapy against dental intact biofilms?

To our knowledge, there is still no evidence in relation to the combination of curcumin with chelants to improve the effects of antimicrobial photodynamic therapy (aPDT) on complex dental caries biofilms. Therefore, the aim of this study was to evaluate the antimicrobial effect of curcumin-ethylenediaminetetraacetic acid (EDTA)-mediated aPDT on the vitality of intact biofilms of dentin caries microcosms. Biofilms were grown on glass slabs in McBain medium plus 1% sucrose in microaerophily at 37 °C for 5 days. Then, biofilms were treated with associations of 600 µmol L-1 curcumin combined or not with 1% EDTA and 37.5 or 75 J cm-2 LED (455 nm). The vitality was determined by a confocal laser scanning microscopy (CLSM) after staining biofilms with a mixture of 2.5 g L-1 fluorescein diacetate and 0.25 g L-1 ethidium bromide. Statistical analysis was conducted by Kruskal-Wallis and post hoc Dunn's test (P < 0.05). Three treatments were able to reduce the vitality of overall biofilms: curcumin + 75 J cm-2 LED, curcumin-EDTA + 37.5 J cm-2 LED, and curcumin-EDTA + 75 J cm-2 LED. Also, the vitality of inner layers of biofilms was significantly reduced only after the combination of aPDT with EDTA. Therefore, the association of curcumin and EDTA improved the antimicrobial effect of aPDT on dentin caries microcosms, considering the application of lower light densities and deeper layers of biofilms.