The influence of breastfeeding and pacifier use on the association between preterm birth and primary-dentition malocclusion: A population-based birth cohort study.

INTRODUCTION: Little is known about the influence of biological characteristics on the occurrence of malocclusion. This study aimed to investigate the association between preterm birth and primary-dentition malocclusion and how breastfeeding and the use of pacifiers are related to this association. METHODS: A representative sample (n = 1129) of children from the 2004 Pelotas, Brazil birth cohort study underwent a dental examination at age 5 years. Malocclusions were diagnosed according to the World Health Organization criteria, and the outcome was considered as the presence of moderate or severe malocclusion (MSM). Questionnaires including the children's oral health information were completed by the mothers. Data on socioeconomic status, breastfeeding, and preterm birth were obtained from previous follow-ups. Poisson regression analysis was conducted, followed by an interaction test. RESULTS: The prevalence of MSM was 26.3% (95% confidence interval [CI], 23.6%-29.1%) in the total sample, 24.1% (95% CI, 21.5%-26.9%) in full-term births, and 42.2% (95% CI, 39.1%-45.3%) in preterm births. After adjustment, the prevalence of MSM was 42% higher in preterm births. Breastfeeding duration and pacifier use up to age 4 years modified the effect of gestational age on MSM. CONCLUSIONS: Preterm birth is associated with the development of MSM. Breastfeeding reduces the effect of preterm birth on MSM, and pacifier use strengthens this association. Dentists should be aware that preterm birth may be a risk factor for malocclusion in primary dentition. The findings reinforce the benefits of breastfeeding on occlusal development and the negative consequences of pacifier use.

Does dental trauma in the primary dentition increases the likelihood of trauma in the permanent dentition? A longitudinal study.

OBJECTIVES: The aim of this longitudinal study was to assess the likelihood of children suffering traumatic dental injuries in the permanent dentition subsequent to traumatic dental injuries in their primary dentition. MATERIALS AND METHODS: A longitudinal study was conducted in Pelotas, Brazil. Children were assessed in 2007, when they were aged 2-5 years, and in 2013, at which time, they were aged 8-11 years. Data collection included interviews with parents and clinical oral examination for dental trauma and occlusion. The classification proposed by Andreasen and Andreasen was used, and crown discoloration and fistula were added to this criterion in order to assess pulp involvement. Child/parent report was used to aid in the diagnosis of both treated and untreated injuries. As a limitation, no radiographs were taken. Descriptive, univariate, and multivariate logistic regression analyses were performed. RESULTS: A total of 110 children were included. Dental trauma frequency in the primary dentition was 38.2% and that in the permanent dentition was 30.9%. In the multivariate analyses, children with dental trauma in the primary dentition showed a higher likelihood of suffering dental trauma in the permanent dentition [odds ratio (OR) 2.97, 95% confidence interval (CI) 1.01-8.91, P = 0.05]. CONCLUSIONS: Individuals with previous trauma in the primary dentition are prone to further trauma in the permanent dentition. The history of dental trauma may be used to predict dental trauma in the permanent dentition and to establish preventive measures. CLINICAL RELEVANCE: Behavioral characteristics may be related to the risk of a child suffering injuries. The results suggested that some children are accident-prone.

Traumatic intrusion of permanent teeth: 10 years follow-up of 2 cases.

Intrusive luxation is a kind of traumatic injury characterized by an axial displacement of the tooth toward the alveolar bone. Its main causes are bicycle accidents, sports/recreational activities, and falls or collisions. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. In order to decide which treatment to follow, the degree of root formation, the patient's age, and intrusion severity should be taken into consideration. This study aimed to report a 10-year follow-up of two patients that suffered permanent incisor (PI) traumatic injury who had a similar root development (incomplete rooting) but different results. In the first case, the treatment of choice was follow-up. The patient showed gingival alteration and root resorption of tooth 21. Calcium hydroxide therapy and root canal filling were performed twice because of not attending callback. After finishing the endodontic treatment, follow-up visits showed no abnormalities. In the second case, the treatment of choice was watch and wait to the teeth 11 and 21. After 7 months spontaneous eruption of both teeth was detected. Radiographic examination showed atypical root formation and almost completely pulp canal obliteration, 8 years later. In the follow-up, visit after 10 years was observed complete crow and pulp canal obliteration. It was concluded that PI intrusion treatments are good intervention alternatives, as they proved to be successful after a 10-year follow-up period.

Traumatic dental injuries in primary dentition: epidemiological study among preschool children in South Brazil.

AIM: To estimate the prevalence of traumatic injury in primary dentition among children aged 12-71 months old, as well as to evaluate the distribution of traumatic injuries, type of trauma and associated factors. MATERIAL AND METHODS: After the research project approval by the Ethics Research Committee, a cross-sectional study was carried out including 571 preschool children--both from public and private schools--in the city of Pelotas, Southern Brazil. Data were collected by means of anterior teeth examination, and by the administration of a structured questionnaire to parents. The classification proposed by Andreasen & Andreasen was used, and crown discoloration and fistula were added to this criterion. RESULTS AND CONCLUSIONS: The prevalence of dental trauma was 36.6% (95% CI 32.7-40.5), with no significant differences between boys and girls. Trauma were more frequent among older children (P = 0.001). No associations were found for maternal schooling, income and type of school. The most frequent trauma was enamel fracture, and the most affected tooth was number 61. A significant statistical association was observed between the presence of dental trauma during clinical examination and parental report of trauma occurrence. The percentage of parents who looked for dental treatment was higher among children from private schools (P = 0.001). The most frequent place of occurrence was home, and the most frequently reported etiology was child's own-height fall. CONCLUSIONS: Dental trauma in primary teeth is characterized as an accident that occurs due to the children's development stage, even when they are cared for by mothers of higher schooling and income. Parents should search for assistance right after trauma occurrence to minimize sequelae.

Pacifier use modifies the association between breastfeeding and malocclusion: a cross-sectional study.

This study aimed to evaluate the influence of breastfeeding and pacifier use on the occlusal status of preschool children. A cross-sectional study was conducted with children (n = 489) aged 2-5 years in private and public schools in Pelotas, South Brazil. Mothers answered a questionnaire on demographic, socioeconomic and behavioral variables, including breastfeeding and non-nutritive sucking habits. Malocclusion was classified as normal/mild and moderate/severe, according to WHO criteria. The association between breastfeeding and pacifier use with malocclusion was tested using multivariate logistic regression. The prevalence of malocclusion was 37.83% (95%CI 33.52-42.14), and 57.87% of the children used a pacifier. A total of 46.01% of the sample was exclusively breastfed for 6 months, and 24.74% were never breastfed. Malocclusion was associated with pacifier use, and with both non-exclusively breastfed and never breastfed. After adjustments for demographic and socioeconomic variables, the children who used a pacifier and were never breastfed (OR = 19.08; 95%CI 8.54-42.63), or who used a pacifier and were not exclusively breastfed (OR = 13.74; 95%CI 6.11-30.92), showed worse occlusal conditions, compared with the children who were exclusively breastfed and never used a pacifier. Pacifier use modifies the relationship between breastfeeding and occlusal status.

Longevity of posterior restorations in primary teeth: results from a paediatric dental clinic.

OBJECTIVES: The aim of this retrospective study was to evaluate the longevity of restorations in the posterior primary teeth of children attending to a public paediatric dental clinic and to test the factors associated with failures. METHODS: Patient records of 329 children (162 boys and 166 girls) were used for collecting and analyzing data. A total of 565 restorations in primary teeth were included in the study. All children enrolled in the study were classified as high caries risk. The longevity of restorations from their placement until failure (up to 4 years of follow-up) was assessed using the Kaplan-Meier survival curves with log-rank test. Multivariate Cox regression analysis with shared frailty (p<0.05) was used to assess the factors associated with failures. RESULTS: Up to 4 years of follow-up, the annual failure rates were 9.5% for composite fillings, 12.2% for light-cured glass ionomer restorations, and 12.9% for conventional glass ionomer restorations with statistical difference between the materials (p=0.014). Glass ionomer restorations had a higher risk of failure over time compared with composites (HR 1.86, 95% CI 1.17-2.97). In crude analysis, Class II restorations showed lower survival rate than Class I restorations (p=0.031) but lost significance after adjustments. CONCLUSIONS: Our findings suggested that the material influenced the survival rate of primary posterior restorations, with composite presenting the best performance. CLINICAL SIGNIFICANCE: Differences were observed between restorative materials with different properties in primary teeth up to 4 years of follow-up. This study provides valuable information regarding the primary teeth posterior restoration longevity in a paediatric population with restorations performed under daily life clinical environment.

An investigation of the presence of specific anaerobic species in necrotic primary teeth.

Different microbial identification methods have shown that the microbial community profiles in endodontic infections are diverse and assorted. The aim of this study was to evaluate the frequency of selected endodontic pathogens in the pulp chambers (PCs) and root canals (RCs) of infected primary teeth using PCR methods. Paired PC and RC samples were collected from 15 subjects and analyzed by PCR for the presence of Filifactor alocis, Fusobacterium nucleatum, Parvimonas micra, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Prevotella tannerae, Tanerella forsythia, Treponema denticola, and Treponema socranskii. The frequency of each species was determined in the PC and RC of each case. The species most frequently detected in PCs were P. nigrescens (86.7%), P. gingivalis (73.3%), and F. alocis (73.3%). Of the PC samples, 13.3% contained P. micra and T. denticola, and 6.7% contained T. forsythia. The species most frequently detected in RCs were P. gingivalis (100%) and P. nigrescens (93.3%). P. tannerae, P. micra, and T. denticola were found in 40% of the RC samples; T. forsythia was found in 26.7% of the RC samples. The "red complex", which comprises P. gingivalis, T. denticola, and T. forsythia, was not found in the PC of any tooth but was found in 30% of the RC samples. The detection of P. nigrescens in the PC was statistically associated with the presence of P. nigrescens in the RC (p = 0.04). The results suggest high heterogeneity among the samples, even among those from the same subject.

Efficacy of 1.23% APF gel applications on incipient carious lesions: a double-blind randomized clinical trial.

The aim of this double-blind randomized clinical trial was to evaluate the efficacy of 1.23% APF gel application on the arrest of active incipient carious lesions in children. Sixty 7- to 12-year-old children, with active incipient lesions were included in the study. Children were divided randomly into 2 groups: 1.23% APF gel and placebo gel applications. Each group received 8 weekly applications of treatment. The lesions were re-evaluated at the 4th and 8th appointments. Poisson regression analysis was used to estimate relative risks of the presence of active white spot lesions. Groups showed similar results (PR = 1.67; CI 95% 0.69-3.98). The persistence of at least 1 active lesion was associated with a higher number of lesions in the baseline (PR = 2.67; CI 95% 1.19-6.03), but not with sugar intake (PR = 1.06; CI 95% 0.56-2.86) and previous exposure to fluoride dentifrice (PR = 1.26; CI 95% 0.49-2.29). The trial demonstrates the equivalence of the treatments. The use of the APF gel showed no additional benefits in this sample of children exposed to fluoridated water and dentifrice. The professional dental plaque removal in both groups may also account for the resulting equivalence of the treatments.

Pacifier use modifies the association between breastfeeding and malocclusion: a cross-sectional study

Abstract This study aimed to evaluate the influence of breastfeeding and pacifier use on the occlusal status of preschool children. A cross-sectional study was conducted with children (n = 489) aged 2-5 years in private and public schools in Pelotas, South Brazil. Mothers answered a questionnaire on demographic, socioeconomic and behavioral variables, including breastfeeding and non-nutritive sucking habits. Malocclusion was classified as normal/mild and moderate/severe, according to WHO criteria. The association between breastfeeding and pacifier use with malocclusion was tested using multivariate logistic regression. The prevalence of malocclusion was 37.83% (95%CI 33.52-42.14), and 57.87% of the children used a pacifier. A total of 46.01% of the sample was exclusively breastfed for 6 months, and 24.74% were never breastfed. Malocclusion was associated with pacifier use, and with both non-exclusively breastfed and never breastfed. After adjustments for demographic and socioeconomic variables, the children who used a pacifier and were never breastfed (OR = 19.08; 95%CI 8.54-42.63), or who used a pacifier and were not exclusively breastfed (OR = 13.74; 95%CI 6.11-30.92), showed worse occlusal conditions, compared with the children who were exclusively breastfed and never used a pacifier. Pacifier use modifies the relationship between breastfeeding and occlusal status.

Dental emergencies in a university pediatric dentistry clinic: a retrospective study.

A significant number of children visit a dentist for the first time due to emergency situations. However, little is known regarding the prevalence, etiology, and treatment provided for children at emergency dental visits. This study aimed to evaluate the profile of children attending a dental school emergency clinic, the reasons for seeking dental care, and the treatment provided. Records of 270 patients who attended an emergency clinic during 2010 were analyzed, and 253 were selected. Demographic, diagnostic, and procedural information was collected. The mean child age was 7.8 years. For 208 children (82%), pain was the main reason for the emergency visit. Nearly 79% of the visits were due to caries, and the most frequently required treatment was endodontic intervention (31.22%). Of the decayed teeth, 61.70% were primary posterior teeth and 31.9% permanent posterior teeth. Pain caused by dental decay was the most frequent chief complaint. A large number of children were brought to the dentist with complaints that had started long before, for which over-the-counter medications had been used.

Dental trauma occurrence and occlusal characteristics in Brazilian preschool children.

PURPOSE: The purpose of this study was to analyze the association between dental trauma and occlusal traits in the primary dentition. METHODS: Five hundred and one 24- to 71-month-old children, attending both private and public schools in Pelotas, Rio Grande do Sul, Brazil, were included. Clinical examinations were performed at each school. Occurrence of dental trauma was assessed using the Andreasen and Andreasen classification. Occlusal characteristics used in this study were: overjet; open bite; overbite; anterior crossbite; crowding and rotated teeth occurrence; and canine class. The occlusion type was classified according to the World Health Organization. A questionnaire was sent to parents to obtain socioeconomic data. Descriptive statistics were used, as well as chi-square tests (for heterogeneity or linear trend; P ≤ .05) and Fisher's exact test. RESULTS: The prevalence of dental trauma was 40% (95% confidence interval=35-44). Of all children examined, 20% showed normal occlusion, 42% mild malocclusion, and 38% moderate/severe malocclusion. Dental trauma was associated with overjet ≥ 3 mm (P=.02), overbite ≥ 3 mm (P=.01), and canine class (P=.04). Children bearing mild or moderate/severe malocclusion presented greater dental trauma (P<.01). CONCLUSION: The findings of this study emphasize the importance of preventing dental trauma, especially in children presenting increased overjet, overbite, or canine Class II.

Epidemiology of malocclusions in primary dentition and associated factors

This study aimed to evaluate malocclusion occurrence in children with complete primary dentition, describing the most frequent one and verifying potential associations with demographic, socioeconomic, and behavioral variables. Subjects and method: 502 children with complete primary dentition from primary schools in the city of Pelotas, RS, Brazil, were examined. Data was collected based on questionnaires distributed to the mothers, as well as on physical examinations of the oral cavity. The children with malocclusion presented at least one of the following changes: anterior open bite, deep overbite, posterior crossbite, and overjet. Chi-square tests for heterogeneity and linear trend were used to verify associations with demographic, socioeconomic, and behavioral variables. Results: the occurrence of malocclusions in the population studied was 67.5%. From them, 33.6% presented anterior open bite, 22.3% presented deep overbite, 9.8% presented posterior crossbite, and overjet was present in 1.8%. The most frequent malocclusion was anterior open bite, which was directly associated with the use of pacifier (p<0.001), duration of use (p<0.001), and frequency use (p<0.001). There was also an inverse association with children's age (p=0.007) and maternal level of education (p=0.016). An association was found between the number of children and anterior open bite (p=0.039). Conclusion: the population studied presented high prevalence of malocclusions, and anterior open bite was the most frequent one, which was associated with the use of pacifier, as well as the duration and frequency of use.

Efficacy of 1.23% APF gel applications on incipient carious lesions: a double-blind randomized clinical trial

The aim of this double-blind randomized clinical trial was to evaluate the efficacy of 1.23% APF gel application on the arrest of active incipient carious lesions in children. Sixty 7- to 12-year-old children, with active incipient lesions were included in the study. Children were divided randomly into 2 groups: 1.23% APF gel and placebo gel applications. Each group received 8 weekly applications of treatment. The lesions were re-evaluated at the 4th and 8th appointments. Poisson regression analysis was used to estimate relative risks of the presence of active white spot lesions. Groups showed similar results (PR = 1.67; CI 95% 0.69–3.98). The persistence of at least 1 active lesion was associated with a higher number of lesions in the baseline (PR = 2.67; CI 95% 1.19–6.03), but not with sugar intake (PR = 1.06; CI 95% 0.56–2.86) and previous exposure to fluoride dentifrice (PR = 1.26; CI 95% 0.49–2.29). The trial demonstrates the equivalence of the treatments. The use of the APF gel showed no additional benefits in this sample of children exposed to fluoridated water and dentifrice. The professional dental plaque removal in both groups may also account for the resulting equivalence of the treatments.

An investigation of the presence of specific anaerobic species in necrotic primary teeth

Different microbial identification methods have shown that the microbial community profiles in endodontic infections are diverse and assorted. The aim of this study was to evaluate the frequency of selected endodontic pathogens in the pulp chambers (PCs) and root canals (RCs) of infected primary teeth using PCR methods. Paired PC and RC samples were collected from 15 subjects and analyzed by PCR for the presence of Filifactor alocis, Fusobacterium nucleatum, Parvimonas micra, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Prevotella tannerae, Tanerella forsythia, Treponema denticola, and Treponema socranskii. The frequency of each species was determined in the PC and RC of each case. The species most frequently detected in PCs were P. nigrescens (86.7%), P. gingivalis (73.3%), and F. alocis (73.3%). Of the PC samples, 13.3% contained P. micra and T. denticola, and 6.7% contained T. forsythia. The species most frequently detected in RCs were P. gingivalis (100%) and P. nigrescens (93.3%). P. tannerae, P. micra, and T. denticola were found in 40% of the RC samples; T. forsythia was found in 26.7% of the RC samples. The “red complex”, which comprises P. gingivalis, T. denticola, and T. forsythia, was not found in the PC of any tooth but was found in 30% of the RC samples. The detection of P. nigrescens in the PC was statistically associated with the presence of P. nigrescens in the RC (p = 0.04). The results suggest high heterogeneity among the samples, even among those from the same subject.

Efetividade de uma estratégia educacional em saúde bucal aplicada a crianças deficientes visuais / Effectiveness of an educational strategy on oral health of visually impaired children

Objetivo: o objetivo deste estudo foi avaliar a efetividade de uma estratégia educacional em saúde bucal direcionada a crianças deficientes visuais, matriculadas em uma escola da cidade de Pelotas - RS. Métodos: a estratégia foi empregada semanalmente, durante um mês. Utilizaram-se material lúdico-pedagógico, orientação através do tato e escovação supervisionada. A higiene bucal e o estado de saúde gengival dos 15 alunos com idades entre 7 e 16 anos foram avaliados através do índice de placa (IP) e índice de sangramento gengival (ISG), antes da intervenção, trinta e noventa dias após. Para avaliar a percepção, atitude e conhecimento quanto à saúde bucal, foi aplicado um questionário semiestruturado às crianças e aos seus cuidadores. Os dados foram analisados por meio de estatística descritiva e teste T pareado. Resultados: após trinta dias, houve redução significativa do IP e ISG (p = 0,001), 80% reduziram o IP e 100%, o ISG. Após noventa dias, houve um aumento do ISG e do IP, porém sem diferença estatisticamente significativa, quando comparado ao exame de trinta dias. Conclusão: a proposta educativa e preventiva utilizada neste estudo pode ser efetiva se pautada nos sentidos remanescentes destes pacientes, devendo ser regular e contínua.

Dental emergencies in a university pediatric dentistry clinic: a retrospective study

A significant number of children visit a dentist for the first time due to emergency situations. However, little is known regarding the prevalence, etiology, and treatment provided for children at emergency dental visits. This study aimed to evaluate the profile of children attending a dental school emergency clinic, the reasons for seeking dental care, and the treatment provided. Records of 270 patients who attended an emergency clinic during 2010 were analyzed, and 253 were selected. Demographic, diagnostic, and procedural information was collected. The mean child age was 7.8 years. For 208 children (82%), pain was the main reason for the emergency visit. Nearly 79% of the visits were due to caries, and the most frequently required treatment was endodontic intervention (31.22%). Of the decayed teeth, 61.70% were primary posterior teeth and 31.9% permanent posterior teeth. Pain caused by dental decay was the most frequent chief complaint. A large number of children were brought to the dentist with complaints that had started long before, for which over-the-counter medications had been used.

Adaptação transcultural de instrumentos para mensurar ansiedade e comportamento em clínica odontológica infantil / Cross-cultural adaptation of instruments to assess anxiety and behavior in children's dental treatment

O artigo traz uma adaptação dos instrumentos Dental Anxiety Scale (DAS) e da Behavior Rating Scale para utilização no Brasil. A adaptação transcultural desses instrumentos constou das seguintes etapas: tradução dos instrumentos originais para o português, retrotradução, avaliação do comitê, adaptação cultural, validação de face e validação de conteúdo, originando, respectivamente, a Versão Brasileira da Escala de Ansiedade de Norman Corah e a Versão Brasileira da Escala de Padrão Comportamental de Venhan. Estas duas escalas foram consideradas válidas, confiáveis e facilmente integráveis em atividades clínicas e de pesquisa, podendo ser utilizadas em conjunto numa avaliação de relação entre ansiedade dos pais e comportamento das crianças.

Integração entre pediatria e odontopediatria: uma abordagem transdisciplinar na saúde bucal infantil / Integration between pediatrics and pediatric dentistry:a transdisciplinary approach to children’s oral health

Introdução: Embora os levantamentos epidemiológicos venham demonstrando redução significativa, ainda é possível observar, entre a população infantil, alta prevalência da doença cárie, a qual é responsável pelo desenvolvimento de morbidades além do comprometimento da saúde sistêmica da criança. O objetivo deste estudo foi avaliar a conduta dos pediatras relacionada à saúde bucal infantil e a viabilidade de integração entre a pediatria e a odontopediatria. Métodos: Foi aplicado um questionário semiestruturado, previamente submetido a teste-piloto, aos pediatras da cidade de Pelotas, RS. Todos os profissionais foram registrados, obtendo-se uma taxa de resposta de 81,25% (n=53). Através de análise bivariada, foi realizado teste qui-quadrado, com nível de significância de p<0,05. Resultados: Observou-se associação significativa entre o tempo de atuação do profissional e o conhecimento sobre saúde bucal (p=0,024) e o interesse em receber maiores informações (p<0,001). Entre os participantes, 82,69% responderam incorretamente alguma das questões e 88,67% desejavam receber maiores orientações. Os assuntos de maior interesse foram sobre cárie, flúor, oclusão, técnicas de higiene e idade da primeira consulta odontológica. Um Guia de Orientação para Saúde Bucal da Criança, baseado nos resultados da pesquisa, foi distribuído aos pediatras. Conclusões: Detectou-se que os profissionais com formação acadêmica mais recente apresentaram um conhecimento e conduta mais adequados quando comparados aos demais, sendo possível inferir que existe a necessidade de métodos de educação continuada. Os pediatras concordam com a importância da condição bucal para o desenvolvimento de uma boa saúde sistêmica, sentem-se parcialmente responsáveis nesta questão e avalizam o desenvolvimento de ações integradas com a odontopediatria para execução de medidas promotoras de saúde bucal.

Introduction: Although epidemiological surveys have been showing a significant reduction, there still is a high prevalence of dental caries among children. Dental caries are responsible for the development of morbidities as well as impairment of the systemic health. The aim of this study was to evaluate pediatricians’ approach to children’s oral health and the feasibility of integrating pediatrics with pediatric dentistry. Methods: We applied a semi-structured, previously piloted questionnaire to pediatricians in the city of Pelotas, RS. All of the physicians were included, and we obtained a response rate of 81.25% (n = 53). Through bivariate analysis, a chi-square test was performed with a significance level of p <0.05. Results: There was a significant association between time working as a physician and knowledge about oral health (p = 0.024) and an interest in receiving more information (p <0.001). Among participants 82.69% answered some questions incorrectly, and 88.67% wanted to receive further guidance. The subjects that raised most interest were caries, fluorine, occlusion, oral hygiene techniques, and age at the first dental visit. A Guideline for Children’s Oral Health based on the results of the survey was distributed to pediatricians. Conclusions: More recently graduated physicians were found to show a more appropriate knowledge and approach as compared to the others, and it is possible to infer that there is a need for methods of continuing education. Pediatricians agree on the importance of oral health conditions for the development of good systemic health, feel partially responsible for this issue, and endorse the development of integrated actions with pediatric dentistry in order to implement measures to promote oral health.

Tratamento endodôntico de dentes decíduos / Root canal therapy of primary teeth

Muitas vezes, para a manutenção da dentição decídua em condições saudáveis, faz-se necessária a terapia pulpar. Este trabalho propõe-se avaliar, clinicamente, a resposta do organismo ao tratamento endodôntico, avaliando a pasta Guedes-Pinto acrescida de óxido de zinco como material de obturação, em molares decíduos, de crianças de 3 a 8 anos. Os resultados parciais mostraram a regressão dos sinais e sintomas; a manutenção dos dentes decíduos na cavidade bucal até o momento da esfoliação; dentes sucessores normais. Radiograficamente, observou-se a absorção da pasta, mas que geralmente foi lenta quando a mesma encontrava-se em maior quantidade nos canais radiculares, ou seja, na porção cervical dos canais amplos. Em todos os casos em que havia rarefação óssea intrarradicular inicial, houve neoformação óssea. Concluiu-se que este tratamento mostrou-se eficaz, mas que o acréscimo de óxido de zinco na proporção utilizada trouxe alguma dificuldade para a absorção da pasta

Avaliação de um programa de promoção de saúde bucal para crianças / Evaluation of a program of oral health promotion for children

A saúde bucal da população brasileira é precária, por isto são necessários programas de promoção de saúde bucal. Estes programas, quando aplicados à pré-escolares, podem possibilitar a mudança precoce de maus hábitos e, conseqüentemente, dentição permanente e gengiva saudáveis. A boa relação do paciente com o cirurgião-dentista é fator determinante da motivação e obtenção de benefícios. Vinte e três crianças, de 4 a 5 anos, pertencentes a uma creche, foram avaliadas quanto à relação com o cirurgião-dentista, à condição da gengiva (sangramento ou não à escovação) e ao estado dos dentes. Os procedimentos necessários foram planejados e realizados. As crianças receberam orientações de escovação a cada duas semanas. O grupo controle foi composto por 25 crianças. Os resultados foram submetidos ao teste c² e ao teste exato de Fisher. Comparando o exame inicial com o exame final, houve aumento do número de cavidades de cárie nos grupos experimental e controle e não houve diferença significante entre estes grupos. Quanto à condição da gengiva, houve melhora significante no grupo experimental e não houve diferença significante no grupo controle. Quanto à relação da criança com o cirurgião-dentista, houve melhora no grupo experimental, porém a diferença não foi estatisticamente significante (p = 0,05). Assim este programa foi eficaz para melhorar o estado da gengiva e a relação da criança com o cirurgião-dentista, além de promover a adequação do meio bucal através de procedimentos realizados, mas não reduziu o incremento de cárie.