Early Childhood Caries: Epidemiology, Severity and Sociobehavioural Determinants.

PURPOSE: To investigate the association between sociobehavioural variables and the pattern and severity of early childhood caries in Brazilian infants and toddlers ages 0-3 years. MATERIALS AND METHODS: This was a cross-sectional study with 768 children who attended 58 public nursery schools. Five previously calibrated teams (Kappa = 0.842) performed oral examinations, using the decayed, missing, filled teeth (dmft) index according to the WHO methodology. A pretested, self-administered questionnaire was given to the subjects' parents or guardians to obtain sociobehavioural information. RESULTS: Caries was observed in 134 of the 768 (17%) children. Caries and rampant caries were significantly more prevalent in low-income families (p = 0.0121) and the incidence of caries was associated with access to dental services (p < 0.05). The percentages of children who were caries free in the age groups of 0-11 months, 12-23 months, 24-35 months and 36-47 months were 100%, 96%, 88% and 76%, respectively. CONCLUSION: Programmes for prevention and oral health education should be instituted, preferably during the first year of life, especially for those in the most socioeconomically deprived groups.

Desmame precoce: falta de conhecimento ou de acompanhamento? / Early weaning: lack of knowledge or lack of follow up?

Objetivo: Verificar conhecimentos de mulheres e orientações recebidas por elas sobre aleitamento materno, durante a gestação e após o nascimento dos bebês, e as influências destes sobre a prática da amamentação. Métodos: Trata-se de um estudo longitudinal, com acompanhamento de 84 pares de mães e bebês, da gestação ao sexto mês de vida dos bebês. Na primeira fase da pesquisa foram realizadas entrevistas domiciliares e em Unidades Básicas de Saúde com as gestantes, para obtenção de suas intenções e conhecimentos sobre a prática do aleitamento materno. Na segunda fase foi realizado acompanhamento das mães e bebês, do primeiro ao sexto mês de idade, para registro das dificuldades na amamentação e motivos de desmame. Resultados: No primeiro mês de vida, 94,3% (82) dos bebês foram amamentados, destes, apenas 49,4% (43) receberam leite materno exclusivamente. Ao final do sexto mês, 43,7% (38) dos bebês já tinham sido desmamados. Nenhuma mãe amamentava exclusivamente seu bebê ao sexto mês de vida. Durante a gravidez, 60,7% (51) das mães não receberam orientações sobre o aleitamento, e 83,4% (70) das mães receberam orientações sobre aleitamento após o nascimento das crianças. A maioria das mães (76,2%) tinha conhecimento do período ideal de amamentação. Um total de 73 (86,9%) mães acreditava que o aleitamento era benéfico ao bebê, mas somente 41 (48,8%) destas amamentaram. Somente 11 (13,1%) mulheres do estudo foram acompanhadas pela equipe do sistema público de saúde durante a lactação. Conclusão: Apesar da maioria das gestantes terem sido orientadas e possuírem conhecimento sobre o aleitamento materno, houve desmame precoce. Orientar é importante, entretanto, o apoio e o acompanhamento das mães são fundamentais para que se tenha sucesso na prática da amamentação...

Objective: To assess the knowledge of women and the instructions received on breastfeeding during pregnancy and after childbirth, and their influence on breastfeeding practice.Method: This study was a longitudinal investigation following 84 pairs of mothers and babies from pregnancy through the sixth month of baby?s life. In the first phase of the research, interviews were made with the pregnant women at home and at Basic Health Units to collect information about their intentions and knowledge of breastfeeding. In the second phase of the research, mothers and babies were followed up from the first to sixth month of baby?s life to record the difficulties of breastfeeding and reasons for weaning.Results: In the first month, 94.3% (82) of the babies were breastfed, but only 49.4% (43) were breastfed exclusively. At the end of the sixth month of life, 43.7% (38) of the babies had already been weaned. No mother breastfed exclusively her baby within the sixth month. During pregnancy, 60.7% (51) of the mothers had no instructions about breastfeeding and 83.4% (70) of the mothers received instructions on breastfeeding after childbirth. Most mothers (76.2%) knew about the ideal breastfeeding period. Seventy-three (86.9%) mothers believed that breastfeeding was beneficial for the baby, but only 41 (48.8%) of them really breastfed. Only 11 (13.1%) mothers were followed up by the public health system team during lactation.Conclusion: Although most women had been instructed during pregnancy or after childbirth and had knowledge of breastfeeding, early weaning occurred. Advising is important, but the support and follow up of the mothers are of utmost importance for a successful breastfeeding practice...

Socio-behavioral factors influence prevalence and severity of dental caries in children with primary dentition

The aim of this study was to analyze the influence of socio-behavioral variables on the prevalence and severity of dental caries in 4- to 6-year-old children. A cross-sectional study was performed on a sample of 1993 children enrolled in 58 public preschools from Araçatuba City, São Paulo State, Brazil, during 2010. The exams were made using the decayed, missing, and filled teeth index (World Health Organization methodology) and detection criteria for non-cavitated lesions. A tested, self-administered questionnaire was sent to parents to obtain information about their socio-behavioral characteristics. Standardization was performed to verify concordance among examiners (kappa = 0.84). The prevalence of cavitated caries lesions was 41.2% (821), and the prevalence of both, cavitated and non-cavitated caries lesions, was 43.9% (875). The means ± standard deviations of the decayed, missing, and filled teeth index for children aged 4, 5, and 6 years were 1.18 ± 2.45, 1.65 ± 2.67, and 1.73 ± 2.77, respectively. Caries were significantly more prevalent in children from families with low incomes and low educational levels. The presence of dental caries was associated with access to dental services (p < 0.05). The associations between both, cavitated and non-cavitated dental caries lesions, and the frequency of oral hygiene were statistically significant. The prevalence of dental caries in preschoolers was strongly associated with factors related to the children's parents. Therefore, information about parents' socio-economic status, behaviors, and attitudes in relation to oral health should be considered when planning prevention and educational programs for the oral health of preschool children.

Socio-behavioral factors influence prevalence and severity of dental caries in children with primary dentition.

The aim of this study was to analyze the influence of socio-behavioral variables on the prevalence and severity of dental caries in 4- to 6-year-old children. A cross-sectional study was performed on a sample of 1993 children enrolled in 58 public preschools from Araçatuba City, São Paulo State, Brazil, during 2010. The exams were made using the decayed, missing, and filled teeth index (World Health Organization methodology) and detection criteria for non-cavitated lesions. A tested, self-administered questionnaire was sent to parents to obtain information about their socio-behavioral characteristics. Standardization was performed to verify concordance among examiners (kappa = 0.84). The prevalence of cavitated caries lesions was 41.2% (821), and the prevalence of both, cavitated and non-cavitated caries lesions, was 43.9% (875). The means ± standard deviations of the decayed, missing, and filled teeth index for children aged 4, 5, and 6 years were 1.18 ± 2.45, 1.65 ± 2.67, and 1.73 ± 2.77, respectively. Caries were significantly more prevalent in children from families with low incomes and low educational levels. The presence of dental caries was associated with access to dental services (p < 0.05). The associations between both, cavitated and non-cavitated dental caries lesions, and the frequency of oral hygiene were statistically significant. The prevalence of dental caries in preschoolers was strongly associated with factors related to the children's parents. Therefore, information about parents' socio-economic status, behaviors, and attitudes in relation to oral health should be considered when planning prevention and educational programs for the oral health of preschool children.

Determinantes sóciocomportamentais da cárie precoce da infância, em bebês e crianças de 0 a 6 anos de idade / Socio-behavioral determinants of early childhood caries in infants and children of the 0-6 years of ages

Introdução: Poucos estudos traçam um perfil epidemiológico da cárie em bebês e pré-escolares. Considerando a importância do diagnóstico precoce, da identificação dos fatores de risco para prevenção e tratamento dessa doença, estudos com a população infantil são essenciais. Objetivos: Analisar a influência de variáveis sóciocomportamentais na prevalência e severidade da cárie precoce da infância, em bebês de 0 a 3 anos de idade e em crianças de 4 a 6 anos. Método: Realizou-se um estudo transversal, com amostras de 768 bebês e 1993 crianças, matriculados em 58 escolas públicas do município de Araçatuba, São Paulo, Brasil, no ano de 2010. Cinco equipes, previamente calibradas (Kappa = 0.842), realizaram os exames bucais, utilizando o índice ceod (Metodologia da Organização Mundial da Saúde) e critérios de detecção de lesões não cavitadas. Um questionário testado, autoaplicável, foi utilizado para obter informações sóciocomportamentais. Os dados foram analisados utilizando-se os testes Qui-quadrado e Exato de Fisher, ao nível de significância de 5%. Resultados: A prevalência de cárie foi de 17.36% (133) no grupo de bebês e de 41.20% (821) entre as crianças. Cárie Rampante foi observada em 11.06% (85) dos bebês e em 16.20% (323) das crianças. O ceod médio encontrado no grupo de bebês foi de 0.53 e entre as crianças foi de 1.53. O componente cariado foi o maior responsável pelo valor do índice ceod, com um percentual de 89.73% entre os bebês e de 83.33% entre as crianças. A experiência de cárie foi significantemente mais prevalente em bebês e crianças de famílias de baixa renda (p<0.05) e baixo nível educacional (p<0.05). A associação entre cárie e frequência de higienização foi significante apenas quando incluídas as lesões não cavitadas e somente no grupo de crianças (p<0.05). Conclusão: A prevalência de cárie, esteve fortemente associada a fatores relacionados aos pais dos bebês e das crianças, significando que informações sobre status sócioeconômico dos pais...

Background: Few studies have traced the epidemiological profile of caries in babies and preschoolers. Considering the importance of early diagnosis, research identifying risk factors for this population, so as to better prevent and treat this disease, is essential. Objectives: To analyze the influence of sociobehavioral variables in the prevalence and severity of early childhood caries in babies from 0 to 3 years of age and in children 4 to 6 years. Method: We conducted a cross-sectional study, with samples from 768 infants and 1993 children enrolled in 58 public schools in Brazil, in 2010. Five teams, previously calibrated (Kappa = 0.842), performed the oral examinations, using the dmft (Methodology of the World Health Organization criteria) and detection of non-cavitated lesions. A tested questionnaire, self-administered, was used to obtain information about sociobehavioral. Data were analyzed using the chi-square and Fisher’s exact, the significance level of 5%. Results: The prevalence of dental caries was 17.36% (133) in the group of infants and 41.20% (821) among children. Rampant caries was observed in 11.06% (85) of infants and 16.20% (323) of children. The mean dmft found in the group of babies was between 0.5339 and 1.5344 were children. The decay component was largely responsible for the value of the dmft, with a percentage of 89.73% among infants and 83.33% among children. Caries was significantly more prevalent in infants and children from low-income families (p <0.05) and low educational level (p <0.05). The association between caries and frequency of cleaning was statistically significant only when included non-cavitated lesions and only in the group of children (p <0.05). Conclusion: The prevalence of caries between the groups, was strongly associated with factors related to parents of infants and children, meaning that information on socioeconomic status of parents, the same behavior and attitudes regarding oral health should be considered in...

A influência da queiloplastia realizada em tempo único e em dois tempos cirúrgicos no padrão oclusal de crianças com fissura bilateral completa de lábio e palato / Influence of lip repair performed in one and two surgical times on the dental pattern of children with bilateral cleft lip and palate

OBJETIVO: analisar a influência da queiloplastia realizada em tempo único e em dois tempos cirúrgicos no padrão oclusal de cirnaças com fissuras bilateral completa de lábio e palato. METODOLOGIA: a relação oclusal, de acordo com o índice Bauru, para a fissura bilateral completa de lábio e palato, foi estudada em uma amostra de 91 crianças nos estágios de dentadura decídua e mista. As crianças apresentavam fissura bilateral completa de lábio e palato e encontravam-se distribuídas na faixa etária compreendida entre 4 anos e 3 meses e 11 anos no momento do exame oclusal. Todas as crianças foram operadas na infância, no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC-USP), obedecendo dois protocolos de queiloplastia primária: 53 crianças foram submetidas à queiloplastia em tempo único (G1) e 38 crianças foram submetidas à queiloplastia em dois tempos cirúrgicos (G2). RESULTADOS E CONCLUSÕES: o padrão oclusal, mensurado com base numa escala de 1 a 5, de acordo com o índice Bauru para fissura bilateral completa de lábio e palato, obteve média de 2,28 e 2,51 para a queiloplastia realizada em tempo único e em dois tempos cirúrgicos, respectivamente. Os resultados permitem concluir que as cirurgias plásticas primárias comprometem a oclusão na dentadura decídua e mista, independentemente do número de etapas para a realização da queiloplastia.

AIM: To analyse the influence of lip repair performed in one and two surgical times on the dental pattern of children with bilateral cleft lip and palate. METHODS: The occlusal relationship of 91 children in the primary and mixed dentition with bilateral cleft lip and palate (BCLP) and aged 4 years and 4 months to 21 years was assessed according the Bauru yardstick. All children had BCLP and were operated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, on the basis of two surgical protocols. Of the total sample, 53 children were operated in one surgical time and 38 were operated in two surgical times. RESULTS AND CONCLUSIONS: The findings show that the primary repairing surgeries compromise the occlusion in the primary and mixed dentition regardless of the lip repair techniques evaluated in this study. The lip repair in one or two surgical times does not have influenced the inter-arch relationship.