Microbiota of dental caries in primary teeth of a Costa Rican Child population / Microbiota de la caries dental en piezas primarias de una población infantil costarricense

Abstract The objective of this research was to identify bacteria present in the microbiota of dentinal carious lesions in primary molars of some Costa Rican pediatric patients. Data were collected from 15 children aged between 4 and 8 years old who attended the Pediatric Dentistry Clinic at the Faculty of Dentistry from the University of Costa Rica (UCR). The inclusion criteria were: infants between 4 and 8 years old who presented cavitated carious lesions in primary teeth, who were actively attended by students at the Faculty of Dentistry from the UCR, and whose parents or legal guardians signed the informed consent to participate in this research. Samples were taken using a sterile spoon, placed in storage vials, and subjected to various conventional and molecular microbial identification techniques, such as Gram stain identification, catalase tests, oxidase, TSI, API 20E, API STAPH, and VITEK 2. Of the 60 bacterial strains subjected to Gram staining, the following was obtained: 28 Gram-positive bacteria and 32 Gram-negative bacteria. The main isolated organisms were species of Staphylococcus epidermidis, Pasteurella pneumotropica/Mannheimia haemolytica, Pantoea spp, and Streptococcus mutans.

Resumen El objetivo de esta investigación fue identificar las bacterias presentes en la microbiota de lesiones cariosas dentinales en molares primarias de pacientes pediátricos costarricenses. Las muestras fueron recolectadas de 15 niños entre los 4 y 8 años que fueron atendidos en la Clínica de Odontopediatría en la Facultad de Odontología de la Universidad de Costa Rica (UCR). Los criterios de inclusión fueron: pacientes entre los 4 y los 8 años de edad que presentaran lesiones cariosas cavitadas en dientes primarios, que se encuentraran activos para su atención por estudiantes de la Facultad de Odontología de la UCR, y que los padres o encargados legales firmaran el consentimiento informado para participar en esta investigación. Las muestras se tomaron utilizando una cuchareta estéril, colocándolas en viales de almacenamiento y fueron sometidas a diversas técnicas de identificación microbiana convencionales y moleculares tales como: identificación por Tinción de Gram, pruebas catalasa, oxidasa, TSI, API 20E, API STAPH y VITEK. De las 60 cepas bacterianas sometidas a tinción de Gram se obtuvo: 28 bacterias Gram Positivas y 32 bacterias Gram Negativas. Los principales organismos aislados fueron: especies de Staphylococcus epidermidis, Pasteurella pneumotropica/ Mannheimia haemolytica, Pantoea spp y Streptococcus mutans.

Which Dental Procedures Lead to Greater Distress During Children's Dental Treatment? A Cohort Study

ABSTRACT Objective: To assess children's self-reported distress during dental procedures and investigate risk factors. Material and Methods: A total of 163 children (3-10 years old) were included from a clinical trial on diagnostic strategies for evaluating restorations in primary teeth. Treatment plans were elaborated based on the clinical examination performed at the baseline of the study. Dentists performed 742 dental procedures, and an external evaluator collected children's self-reported distress through the Wong Backer Facial Scale (WBFS) and dentists' opinions about children's behavior during the treatment. Kruskal-Wallis Test was performed to compare the distress and the dentists' perception of the different dental procedures, and multilevel ordered logistic regression analysis was conducted to the evaluate association between explanatory variables and the outcomes. Results: More complex procedures caused more distress in children (p=0.017), with a 5.5 times higher risk than simple operative treatments. Similarly, dentists reported children's worse behavior (p<0.001). Older children (older than 7 years) reported less distress than younger children (OR 0.52; CI 0.30-0.87; p=0.014). Patients reported greater distress in the first consultations, reducing the chance of higher scores by 16% in the next interventions. Conclusion: Children experience higher levels of distress during their first treatment appointments. More complex operative procedures and the child's age below 7 years were risk factors associated with greater distress during dental treatment.

Cárie dentária em molares decíduos, doenças comuns na infância e condição socioeconômica: estudo representativo de escolares brasileiros / Dental caries in deciduous molars, common childhood diseases and socioeconomic status: a representative study of brazilian schoolchildren

Objetivo: verificar a experiência de cárie em molares decíduos e a sua associação com doenças comuns na infância, uso de medicamentos, condições socioeconômicas. Materiais e Métodos: foi realizado um estudo transversal representativo com uma amostra de 1181 crianças entre 8 e 9 anos, de ambos os sexos. O exame clínico foi realizado em ambiente escolar por uma dentista calibrada para diagnóstico de cárie dentária através do índice de dentes cariados, extraídos ou com extração indicada e obturados (Índice ceo-d). Os responsáveis responderam questionários sobre a história médica da criança e condições socioeconômicas. O projeto foi aprovado pelo Comitê de Ética em Pesquisa Local. Os dados foram analisados através da Regressão de Poisson, sendo que as variáveis com p<0,20 foram introduzidas em um modelo multivariado e hierárquico (p<0,05). Razão de Prevalência (RP) e Intervalo de Confiança (IC) de 95% foram calculados. Resultados: a maioria das crianças apresenta cárie em molares decíduos (54,6%). Doenças comuns na infância e uso medicamentos não apresentaram associação estatisticamente significativa com cárie dentária (p>0,05). Estudantes de escolas públicas tiveram uma prevalência 27% maior de (IC95%=1,05-1,59) experiência de cárie em molares decíduos quando comparados aos estudantes de escolas particulares. Menor escolaridade materna também se mostrou associada à experiência de cárie em molares decíduos, sendo que crianças cujas mães tinham até 4 anos de estudo tinham uma prevalência 60% maior de cárie dentária (IC95%:1,19-2,16). Conclusão: a maioria das crianças apresentou experiência de cárie em molares decíduos, mas esta condição não foi associada com doenças e medicamentos utilizados até os 4 anos de idade. Entretanto, crianças de escola pública e cujas mães possuíam menor escolaridade apresentaram maior experiência de cárie.

Objective: to verify the caries experience in deciduous molars and its association with common childhood diseases, medication use, socioeconomic conditions. Materials and Methods: a representative cross-sectional study was carried out with a sample of 1181 children between 8 and 9 years old, of both sexes. The clinical examination was performed in a school environment by a dentist calibrated for the diagnosis of dental caries through the index of decayed teeth, extracted or with the indicated and filled samples (ceo-d index). Those responsible for the child answered about the child's medical history and socioeconomic conditions. The project was approved by the Research Ethics Committee Local. The data were analyzed using an analysis model, and as p<0.20, varied with variables were evaluated in a model and hierarchical. Prevalence Ratio (PR) and 95% Confidence Interval (CI) were calculations. Results: 54.6% of the children had caries experience in the deciduous molars. Common childhood diseases and medication use were not significantly associated with dental caries (p>0.05). Public school students had a prevalence of 27% of students (95%CI=1.05-1.59) of caries experience in deciduous molars when compared to school students. Lower maternal schooling was also associated with caries experience in deciduous molars, with mothers with up to 4 years of schooling having a 60% higher probability of having children with dental caries (95%CI:1.19-2.16). Conclusion: most children had caries experience in deciduous molars, but it was not associated with diseases and medications used between 0 and 4 years old. However, school children and whose mothers had less schooling had a greater experience of caries.

Métodos de diagnóstico molecular en la práctica odontológica / Molecular diagnostic methods in dental practice

El diagnóstico molecular, mediante la aplicación de técnicas molecu- lares, ha permitido estudiar microorganismos presentes en el inicio y progresión de la caries dental, enfermedad periodontal, y en los fracasos endodónticos. Las técnicas moleculares permiten la detección y cuan- tificación del material genético del ácido desoxirribonucleico (DNA), ácido ribonucleico (RNA) o proteínas, lo que posibilita el estudio del genoma completo o secuencias de DNA específicas. Estas técnicas surgen como una necesidad de detectar microorganismos de difícil o lento crecimiento en cultivos; la técnica más utilizada es la reacción en cadena de la polimerasa (PCR) que permite la amplificación de peque- ños segmentos de material genético al utilizar cebadores, por lo que es un método económico, preciso, sensible y rápido para la detección de microorganismos. El presente artículo de revisión bibliográfica servirá para informar sobre los avances de las técnicas moleculares utilizadas para el diagnóstico en la práctica odontológica (AU)

Molecular diagnosis, through the application of molecular techniques, has made it possible to study microorganisms present in the onset and progression of dental caries, periodontal disease, and endodontic failures. Molecular techniques allow the detection and quantification of the genetic material of deoxyribonucleic acid (DNA), ribonucleic acid (RNA) or proteins, allowing the study of the complete genome or specific DNA sequences, they arise as a need to detect difficult or slow growing microorganisms in cultures. The most widely used technique is the polymerase chain reaction (PCR) that allows the amplification of small segments of genetic material using primers, it is an economical, precise, sensitive and fast method for the detection of microorganisms. This bibliographic review article will serve to report on the advances in molecular techniques used for diagnosis in dental practice (AU)

Factores asociados con la caries de infancia temprana severa en niños peruanos / Factors associated to severe early childhood caries in Peruvian children

Introducción: La caries de infancia temprana severa es un problema de salud pública que afecta a los niños que la padecen y a sus familias. Objetivo: Determinar la asociación de variables sociodemográficas, de higiene y alimentación con la caries de infancia temprana severa en niños peruanos. Métodos: Se realizó un estudio observacional, analítico, de casos y controles, de octubre a diciembre del 2019. La muestra estuvo compuesta por 264 niños de 2-5 años de edad y sus acompañantes (100 del grupo sin caries y 164 del grupo con caries de infancia temprana severa) que asistieron al Departamento de Odontopediatría del Instituto Nacional de Salud del Niño en Lima, Perú. Se realizó una entrevista estructurada directa, con preguntas cerradas sobre variables sociodemográficas, de higiene, de alimentación y una evaluación clínica, utilizando el índice cpo-s. Se utilizaron las pruebas estadísticas de chi cuadrado, Kruskal-Wallis y el modelo de regresión logística binaria. Resultados: De las variables sociodemográficas, experiencia dental negativa y seguro de salud, tuvieron un valor p < 0,05. Igual resultado tuvo el uso de una pasta dental fluorada, alimentación por biberón, tiempo de alimentación por biberón y edad de inicio del cepillado dental. En el modelo de regresión logística binaria solo las variables uso de pasta dental fluorada (OR = 0,578; 95 por ciento IC: 0,495-0,674) y edad de inicio del cepillado dental (OR = 0,924; 95 por ciento IC: 0,850-0,938) tuvieron un p < 0,05. Conclusiones: Las variables edad de inicio del cepillado dental y uso de una pasta dental fluorada están asociadas con la aparición de caries de infancia temprana severa en niños peruanos. Las variables sociodemográficas y de alimentación no están asociadas(AU)

Introduction: Severe early childhood caries is a public health problem affecting sufferers and their families. Objective: Determine the association of sociodemographic, hygiene and food intake variables to severe early childhood caries in Peruvian children. Methods: An observational analytical case-control study was conducted from October to December 2019. The study sample was 264 children aged 2-5 years (100 from the group without caries and 164 from the group with severe early childhood caries) and their companions, who attended the Children's Dental Care Department at the National Children's Health Institute in Lima, Peru. Direct structured interviews were held based on closed-ended questions about sociodemographic, hygiene and food intake variables, and a clinical evaluation was performed using the cpo-s index. Use was made of the chi-square statistical test, the Kruskal-Wallis test and the binary logistic regression model. Results: Among the sociodemographic variables considered, a negative dental care experience and health insurance obtained a value of p < 0.05. The same result was obtained by use of fluoride toothpaste, bottle feeding, bottle feeding time and age at tooth brushing start. In the binary logistic regression model only the variables use of fluoride toothpaste (OR = 0.578; 95 por ciento CI: 0.495-0.674) and age at tooth brushing start (OR = 0.924; 95 por ciento CI: 0.850-0.938) obtained a value of p < 0.05. Conclusions: The variables age at tooth brushing start and use of fluoride toothpaste are associated to the appearance of severe early childhood caries in Peruvian children. Sociodemographic and food intake variables are not associated(AU)

O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática / Is the treatment of non-cavitated dental caries lesion effective? A systematic review

Os métodos contemporâneos de diagnóstico e tratamento de cárie preconizam uma distinção entre lesões cavitadas e não cavitadas, ativas e inativas e, quando possível, intervenções minimamente invasivas. A pergunta de pesquisa desta revisão sistemática foi: O tratamento de lesões não cavitadas de cárie é efetivo em impedir o aparecimento de cavidade dentária, restauração, dor de dente ou perda de dente, em indivíduos com dentes decíduos ou permanentes?. Foi feita uma busca bibliográfica nas principais bases de dados até o ano de 2020. Duas revisoras selecionaram os estudos e extraíram os dados independentemente. Nos casos em que houve discordância, uma terceira revisora foi consultada e a disputa foi resolvida por consenso. A análise de risco de viés foi executada utilizando-se a ferramenta RoB2 e avaliação de certeza da evidência utilizando o sistema GRADE. Foram obtidos 4.108 títulos, e após a remoção dos títulos duplicados e da aplicação dos critérios de exclusão, selecionou-se 19 estudos. Nenhum estudo apresentou o risco para o indivíduo de desenvolver pelo menos um evento relacionado aos desfechos de interesse, por isso não foi possível realizar metanálise de risco. Dez estudos apresentaram os resultados em número médio de lesões cavitadas em dentina ou restauradas por indivíduo, permitindo que fossem feitas metanálises de diferenças nas médias. Várias combinações foram feitas, uma vez que alguns estudos apresentavam mais de uma intervenção a ser comparada com placebo ou higiene bucal. Os resultados das metanálises foram semelhantes, com a estimativa pontual da diferença na média variando entre -0,22 e -0,27 nas diversas metanálises executadas. Ou seja, em média, por indivíduo, houve entre menos 0,22 e menos 0,27 dente com cavidade de cárie em dentina (ou com restauração) no grupo que recebeu tratamento em comparação com o grupo que recebeu o placebo ou nenhum tratamento. O Índice de Higgins (I2) nos diz a proporção da variabilidade nas estimativas de efeito que pode ser atribuída à heterogeneidade entre os estudos e não ao acaso. Com base neste índice, a heterogeneidade foi substancial em todas as metanálises, variando entre 69% e 76%. Conclusão: nenhum estudo avaliou a efetividade do tratamento não invasivo de lesões não cavitadas (mancha branca) em evitar dor ou perda de dente. Poucos estudos avaliaram a efetividade do tratamento em evitar cavidades ou restaurações. Dentre esses poucos estudos, o tratamento teve um efeito relativamente modesto. O risco de viés nos estudos incluídos foi, de uma forma geral, alto ou moderado e a certeza da evidência foi baixa. Pesquisas sobre cárie dentária devem incluir desfechos verdadeiros para que seja possível conhecer a efetividade das diferentes intervenções precoces em evitar cavidades em dentina, restaurações, dor e perda de dentes.

Contemporary methods of diagnosing and treating caries advocate a distinction between cavitated and non-cavitated, active and inactive lesions and, when possible, minimally invasive interventions. The research question of this systematic review was: Is the treatment of non-cavitated caries lesions effective in preventing the appearance of dental cavity, restoration, toothache or tooth loss, in individuals with deciduous or permanent teeth?. A bibliographic search was carried out in the main databases until the year 2020. Two reviewers independently selected the studies and extracted the data. In cases where there was disagreement, a third reviewer was consulted and the dispute was resolved by consensus. Bias risk analysis was performed using the RoB2 tool and evidence certainty assessment using the GRADE system. A total of 4,108 titles were obtained, which after removing duplicate titles and applying the exclusion criteria, 19 studies were selected. No study presented the risk for the individual of developing at least one event related to the outcomes of interest, so it was not possible to perform a risk meta-analysis. Ten studies presented the results in terms of the average number of cavitated or restored dentin lesions per individual, allowing meta-analyses of differences in averages to be performed. Various combinations were made, as some studies had more than one intervention to be compared with placebo or oral hygiene. The results of the meta-analyses were similar, with the point estimate of the difference in the mean varying between -0.22 and -0.27 in the various meta-analyses performed. That is, on average, per individual, there were between 0.22 and 0.27 fewer teeth with dentin (or filled) carious cavity in the group that received treatment compared to the group that received the placebo or no treatment. The Higgins Index (I2) tells us the proportion of variability in effect estimates that can be attributed to heterogeneity across studies rather than chance. Based on this index, heterogeneity was substantial in all meta-analyses, ranging from 69% to 76%. Conclusion: no study has evaluated the effectiveness of non-invasive treatment of non-cavitated lesions (white spot) in preventing pain or tooth loss. Few studies have evaluated the effectiveness of the treatment in preventing cavities or restorations. Among these few studies, treatment had a relatively modest effect. The risk of bias in the included studies was generally high or moderate and the certainty of evidence was low. Research on dental caries must include true outcomes so that it is possible to know the effectiveness of different early interventions in preventing dentin cavities, restorations, pain and tooth loss.

Efficacy of Resin Infiltration and Fluoride Casein Phosphopeptide Amorphous Calcium Phosphate Varnish on Non-cavitated Active White Spot Lesions in Children: A Randomized Clinical Trial

Abstract Objective: To compare the efficacy of resin infiltration and fluoride casein phosphopeptide amorphous calcium phosphate varnish on non-cavitated active white spot lesions in 5-8 years old children. Material and Methods: 60 non-cavitated active white spot lesions in 60 patients with ICDAS II score 2 from both genders in the age range of 5 to 8 years were taken. Thirty lesions were treated by resin infiltration (Group 1) and 30 by Fluoride CPP-ACP varnish (Group 2). Resin infiltration was performed on the same day, while Fluoride CPP-ACP varnish was applied once a week for 4 weeks. The follow-up was done at 3, 6 months, and 12 months. Results: At 3, 6, and 12 months change in mean ICDAS II Score in group 1 was 1.5±0.5,1.13±0.73 and 0.9±0.88, respectively, while in group 2, it was observed to be 0.30±0.59, 0.4±0.89 and 0.06±0.82, respectively (p<0.001). Conclusion: Resin infiltration was more successful than Fluoride CCP-ACP varnish in active non-cavitated white spot lesions (AU).

Decisions about the diagnostic and treatment criteria of dental caries among a group of dental students, faculty staff and dentists within the city of Medellin, Colombia / Decisiones sobre los criterios de diagnóstico y tratamiento de la caries dental entre un grupo de estudiantes de odontología, profesores y odontólogos de la ciudad de Medellín, Colombia

Objective: To analyze the criteria for diagnosis and treatment decision-making in relation to dental caries in different participants (teachers of dentistry, dental students at dental schools, and dentists practicing at public oral health services) in the city of Medellin (Colombia). Material and Methods: A cross-sectional study was applied in the period September 2015-december 2016 by means of an international validated questionnaire in 340 participants (dental teachers: 69, dental students: 193, dentists: 78). The survey addressed several topics related to detection and restorative threshold, preferences of preparation type, restorative materials used and opinions about diagnosis and treatment for dental caries. A descriptive analysis was carried out and Chi square tests were applied to observe statistically significant differences between the study variables.Results: 340 participants were surveyed among teachers who teach cariology, health care dentists, and undergraduate final-year students. Most participants were women (70%). The age mean was higher for DDSs (46 ± 9 years). On average, practicing dentists and dental teachers had a work experience of 21 ± 9 years. In case of treatment decisions, the majority of the surveyed would use immediate operative restorative treatment for advanced carious lesions (inner one-third of the dentin for approximal and grade 5 for occlusal). In addition, respondents reported different cavities diagnosis for clinical occlusal cases and some significant statistically differences were found for restorative treatment decisions and type of materials according to the type of participant. Conclusion: Criteria for diagnosis and treatment of dental caries differed among the student, dentist and dental teachers with variety in diagnosis and treatment concepts. However, a conservative tendency for restorative treatment decisions was observed. Strategies for incorporating non-restorative and minimal measures in professional practice should be considered in curricula of universities.

Objetivo: Analizar los criterios para la toma de decisiones diagnósticas y terapéuticas en relación a la caries dental en diferentes participantes (docentes, estudiantes de odontología de las facultades de odontología y odontólogos de los servicios públicos de salud bucal) de la ciudad de Medellín (Colombia). Material y Métodos: Se aplicó un estudio transversal en el período septiembre 2015 - diciembre 2016 mediante cuestionario internacional validado en 340 participantes (profesores de odontología: 69, estudiantes de odontología: 193, odontólogos: 78). La encuesta abordó varios temas relacionados con la detección y el umbral de restauración, las preferencias del tipo de preparación, los materiales de restauración utilizados y las opiniones sobre el diagnóstico y el tratamiento de la caries dental. Se realizó un análisis descriptivo y se aplicaron pruebas de Chi cuadrado para observar diferencias estadísticamente significativas entre las variables de estudio. Resultados: Se encuestó a 340 participantes entre profesores que imparten clases de cariología, odontólogos y estudiantes de último año de pregrado. La mayoría de los participantes eran mujeres (70%). La edad media fue mayor para los odontólogos (46 ± 9 años). En promedio, los odontólogos y los profesores de odontología tenían una experiencia laboral de 21 ± 9 años. En caso de decisiones de tratamiento, la mayoría de los encuestados utilizaría tratamiento restaurador quirúrgico inmediato para lesiones cariosas avanzadas (tercio interno de la dentina para proximal y grado 5 para oclusal). Además, los encuestados informaron diferentes diagnósticos de caries para los casos clínicos oclusales y se encontraron algunas diferencias estadísticamente significativas para las decisiones de tratamiento restaurativo y el tipo de materiales según el tipo de participante. Conclusion: Los criterios para el diagnóstico y tratamiento de la caries dental fueron diferentes entre los estudiantes, odontólogos y profesores de odontología con variedad en los conceptos de diagnóstico y tratamiento. Sin embargo, se observó una tendencia conservadora para las decisiones de tratamiento restaurativo. Las estrategias para incorporar medidas mínimas y no restaurativas en la práctica profesional deben ser consideradas en los planes de estudio de las universidades.

Avaliação do estado nutricional em relação à presença de cárie dentária em crianças de 4 a 6 anos do município de Cajamar - São Paulo / Evaluation of the nutritional status in relation to the presence of dental caries in children aged 4 to 6 years in the city of Cajamar - São Paulo

Este artigo tem como objetivo avaliar o estado nutricional em relação à presença de cáries dentárias em crianças de 4 a 6 anos de idade, do município de Cajamar, São Paulo. Trata-se de estudo transversal com crianças entre 4 a 6 anos (n=1642), acompanhadas pelo Programa Saúde na Escola (PSE) do Município de Cajamar, São Paulo. A classificação do estado nutricional foi baseada no Índice de Massa Corporal (IMC) e a avaliação das condições bucais, por meio do índice ceo-d e critério para Risco de Cárie. A análise do estado nutricional, faixa etária e sexo conforme o número de cáries, foi feita por meio dos testes Mann-Whitney U e Kruskal-Wallis (p<0,05). Observou-se maior prevalência de meninos entre 4 a 6 anos. Em todas as faixas etárias a prevalência de excesso de peso foi de aproximadamente 30% e eutrofia em torno de 70%. 65% (n=1068) das crianças não apresentavam risco de cárie (A) e 28,8% (n=475), alto risco (D, E e F). Das 1162 crianças sem cáries, 0,2% eram magras (n=2), 67,2% (n=781) eutróficas e 32,7% (n=380) possuíam excesso de peso. A frequência de 1 a 5 cáries maior entre meninas e de 6 ou mais cáries, entre meninos. Segundo estado nutricional, o número médio do número de cáries foi de 2,17 para magreza, 0,93 para eutrofia e 0,65 para excesso de peso (p<0,010). Conclui-se que houve diferença entre número cáries e estado nutricional, na qual crianças com déficit nutricional apresentavam maior número de cáries dentárias comparadas às eutróficas ou com excesso de peso, sugerindo-se a inclusão do estado nutricional na avaliação odontológica.

This article aims at evaluating the nutritional status in relation to the presence of dental caries in children aged 4 to 6 years in the city of Cajamar, in the state of São Paulo. It is a cross-sectional study with children aged 4 to 6 years (n=1642) accompanied by the School Health Program of the City of Cajamar, São Paulo. The nutritional status classification was based on the Body Mass Index (BMI) and the evaluation of oral conditions, through the ceo-d index, and criteria for risk for caries. The analysis of the nutritional status, age, and sex according to the number of caries was made through the Mann-Whitney U and Kruskal-Wallis tests (p<0.05). A higher prevalence was observed among boys aged 4 to 6 years. In all age groups, there was a prevalence of 30% of overweight children, and eutrophy of approximately 70%. A total of 65% (n=1068) of the children presented no risk of caries (A), whereas 28.8% (n=475) showed high risk (D, E, and F). Among the 1162 children with no caries, 0.2% were thin (n=2); 67.2% (n=781) eutrophic; and 32.7% (n=380) were overweight. Girls presented a higher frequency of 1 to 5 caries while boys presented frequency of having 6 or more caries. According to the nutritional status, the average number of caries was 2.17 for thin individuals; 0.93 for eutrophic individuals; and 0.65 for overweight individuals (p<0.010). It could be concluded that there was a difference between the number of caries and the nutritional status, in which children with nutritional deficit presented a higher number of dental caries when compared to eutrophic or overweight ones, suggesting the inclusion of the nutritional status in the dental evaluation.

¿Cómo Intervenir el Proceso de Caries en Adultos? Adaptación del Consenso de ORCA/EFCD/DGZ / How to Intervene the Caries Process in Adults? Adaptation of the ORCA/EFCD/DGZ Consensus

RESUMEN: El manejo terapéutico de lesiones de caries primarias y secundarias concentra gran parte del quehacer de los dentistas en el mundo. Recientes cambios en la concepción de la enfermedad de caries llevaron a un panel de expertos de la Organización Europea para la Investigación en Caries (ORCA), la Federación Europea de Odontología Conservadora (EFCD) y la Federación Alemana de Odontología Conservadora (DGZ) a analizar la evidencia y consensuar recomendaciones sobre manejo de caries en adultos. Mediante una reunión en Berlín, Alemania en 2019 y con metodología e-Delphi, los expertos analizaron la evidencia y propusieron recomendaciones clínicas. El propósito de este artículo es presentar una adaptación idiomática de las principales recomendaciones, que incluyen terapias no invasivas (higiene, uso de fluoruros y control de dieta), terapias microinvasiva (sellantes e infiltrantes), terapias necesariamente invasivas y la reparación de restauraciones. Todas las recomendaciones se basan en un enfoque mínimamente invasivo, con un adecuado manejo restaurador. Los dentistas de países hispanoparlantes podrán encontrar recomendaciones basadas en evidencia, provenientes de un consenso de expertos a nivel global, que orienten sus decisiones clínicas, apoyándose en los principios de la odontología de mínima intervención.

ABSTRACT: Therapeutic management of primary and secondary caries lesions concentrates much of the work of dentists throughout the world. Recent changes in caries disease conception and therapeutic management led a panel of experts from the European Organisation for Caries Research (ORCA), the European Federation for Conservative Dentistry (EFCD) and the German Federation for Conservative Dentistry (DGZ) to analyze the evidence and reach consensus on recommendations for caries management in adults. Through a meeting held in Berlin, Germany in 2019 and using an e-Delphi methodology, the experts analyzed the evidence and proposed clinical recommendations. The purpose of this article is to present an idiomatic adaptation to Spanish of the main recommendations, which include non-invasive therapies (hygiene, use of fluoride and diet control), microinvasive therapies (sealants and infiltrants), invasive therapies and repair of restorations. All recommendations are based on a minimally invasive dentistry approach, with a technically adequate restorative management. Spanish-speaking dentists may use these consensus recommendations to guide their clinical decisions, based on the most recent evidence and experts opinions, under the principles of minimal intervention dentistry.

Consecuencias Clínicas de las Lesiones Cariosas no Tratadas y su Impacto en la Calidad de Vida de Preescolares Peruanos / Clinical consequences of untreated carious lesions and their impact on the quality of life of peruvian preschoolers

La caries dental no tratada tiene repercusiones en la salud de los niños que la padecen, también repercute en el bienestar familiar; más aún, existe mayor probabilidad de presentar consecuencias clínicas, lo que agravaría la condición de salud. El objetivo del estudio fue investigar el impacto de las lesiones cariosas extensas en dentina y las consecuencias clínicas de lesiones cariosas no tratadas en la calidad de vida de preescolares peruanos. Un total de 150 niños, de 3 a 5 años, fueron evaluados usando ICDAS y pufa. También se evaluó la historia de extracción dental y se registró la presencia de dolor dental. El impacto de la salud oral en la calidad de vida fue evaluado mediante la versión peruana del ECOHIS (P-ECOHIS). Se utilizó el modelo de regresión logística binaria para analizar la asociación entre la prevalencia de lesiones cariosas extensas en dentina, pufa, historia de extracción y dolor dental con la puntuación del P- ECOHIS. La media del puntaje total del P-ECOHIS fue de 19,98 ± 6,9, la prevalencia de las lesiones cariosas no tratadas y lesiones cariosas extensas en dentina fue de 90 % y 71 %, respectivamente. El 77 % de los dientes cariados no tratados desarrollaron una infección oral. El dolor dental tuvo una asociación estadísticamente significativa con el puntaje del P- ECOHIS (p<0,05) (OR=3,76; 95 % IC: 1,61 - 8,80). Los niños que presentaron compromiso pulpar (OR=2,44; 95 % IC: 1,12 - 5,30) y presencia de fistula (OR=4,39; 95 % IC: 1,72 - 11,24) tuvieron altas probabilidades de tener altos puntajes en el P- ECOHIS (p<0,05). Las lesiones cariosas extensas en dentina no impactan en la calidad de vida de los preescolares peruanos, como si impacta negativamente, el compromiso pulpar y la presencia de fistula como consecuencias clínicas de lesiones cariosas no tratadas.

Untreated dental caries has repercussions on the health of children who suffer from it, it also affects family well-being; Furthermore, there is a greater probability of presenting clinical consequences, which would aggravate the health condition. The objective of the study was to investigate the impact of extensive carious lesions on dentin and the clinical consequences of untreated carious lesions on the quality of life of Peruvian preschoolers. A total of 150 children, 3 to 5 years old, were evaluated using ICDAS and PUFA. The dental extraction history was also evaluated and the presence of den- tal pain was recorded. The impact of oral health on quality of life was evaluated using the Peruvian version of ECOHIS (P- ECOHIS). The binary logistic regression model was used to analyze the association between the prevalence of extensive carious lesions in dentin, PUFA, extraction history and dental pain with the P-ECOHIS score. The mean total P-ECOHIS score was 19.98 ± 6.9, the prevalence of untreated carious lesions and extensive carious lesions in dentin was 90 % and 71 %, respectively. 77 % of untreated carious teeth developed an oral infection. Dental pain had a statistically significant association with the P-ECOHIS score (p <0.05) (OR = 3.76; 95 % CI: 1.61 - 8.80). Children who had pulp involvement (OR = 2.44; 95 % CI: 1.12 - 5.30) and the presence of fistula (OR = 4.39; 95 % CI: 1.72 - 11.24) were highly likely to have high scores on the P- ECOHIS (p <0.05). Extensive carious lesions in dentin do not impact the quality of life of Peruvian preschoolers, as it does negatively impact, pulpal involvement and the presence of fistula as clinical consequences of untreated carious lesions.

Salivary biochemical indices related to early childhood caries / 华西口腔医学杂志

OBJECTIVES@#This study aimed to compare the salivary biochemical indices between caries-free individuals and those with early childhood caries (ECC), and construct a saliva-based caries diagnostic model by analyzing the correlation between salivary biochemical indices and caries severity.@*METHODS@#A total of 120 children aged 4-6 years were selected and divided into two groups: individuals with ECC (C group, @*RESULTS@#The NO@*CONCLUSIONS@#Salivary biochemical indices can contribute to the diagnosis and risk assessment of ECC.

Methods for Caries Prevention in Children Reported by Dentists from a Brazilian Community

ABSTRACT Objective: To describe the dental practice patterns related to caries prevention in children aged 6-18 years and associated factors. Material and Methods: Dentists (n=162) from Araraquara, Brazil, completed two paper questionnaires: (1) one about characteristics of their practice and their patient population; and (2) a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" Questionnaire from the National Dental Practice-Based Research Network. Regression analyses were used for data analysis (p<0.05). Results: Dentists reported using in-office fluoride (IOF) and dental sealants (DS) in 74.2% and 45.1% of their pediatric patients, respectively. Regression analysis showed that female dentists (p=0.035 for DS; p=0.044 for IOF; p=0.011 for non-prescription fluoride rinse), those with advanced degrees (p=0.032 for prescription of fluoride), those who graduated from a private dental school (p=0.018 for chlorhexidine rinse), those who provided caries prevention regimens (p<0.001 for DS; p=0.004 for IOF; p=0.013 for non-prescription fluoride rinse), those with a greater percentage of patients interested in a caries prevention regimen (p=0.007 for non-prescription fluoride rinse), those working in a private practice model (p=0.047 for prescription of fluoride) were more likely to recommend some type of preventive methods to their pediatric patients. Conclusion: Dentists reported recommending IOF to most of their pediatric patients. Certain dentists', practices', and patients' characteristics were associated to some caries prevention regimens recommended by dentists.

Comparison of Detection Rate of Root Canal Orifices of Maxillary First Molar Using Various Techniques: An in-vivo Study

ABSTRACT Objective: To compare the detection rate of root canal orifices of maxillary first molar by various techniques in the Indian population. Material and Methods: A total of 50 maxillary 1st molar cases were selected and sequentially divided into four groups: Group I: Naked eye; Group II: Surgical loupe; Group III: Surgical operating microscope; and Group IV: Fluorescein sodium dye. After access opening, the number of root canal orifices was detected in all cases with these methods. Results: By naked eye and surgical loupe, a total of 171 root canal orifices were detected, by a surgical operating microscope, 176, and by fluorescein sodium dye, 177 root canal orifices were detected. The detection rate of root canal orifices is as follows: Group I (96.61%) = Group II (96.61%) < Group III (99.44%) < Group IV (100%) and detection rate of MB-2 canal orifices Group I (40%) = Group II (40%) < Group III (50%) < Group IV (52%). No significant difference in the number of canal orifices detected could be seen for any of the comparisons. No significant difference was observed between the naked eye and surgical loupe techniques. Although the surgical operating microscope detected more root canal orifices, it did not have a significantly higher detection than the other two techniques. Conclusion: No significant difference was seen among various methods. However, the use of a surgical operating microscope and fluorescein sodium dye increased the detection rate of root canal orifices.

Dental Status of Firefighters of Rio de Janeiro State and Comparison with Brazilian Oral Health Surveys

ABSTRACT Objective: This cross-sectional study aimed to assess clinical dental status in military firefighters of Rio de Janeiro State and compare data with Brazilian National and Regional oral health surveys. Material and Methods: A sample of 926 military firefighters was examined using the visible biofilm index, the DMFT index and the Community Periodontal Index (CPI). Clinical exams were performed by 15 trained dentists. The Kruskal-Wallis test and Mann-Whitney test with Bonferroni correction were used. Results: Higher biofilm accumulation was associated with increased age. The mean DMFT index for the whole sample of this study was 12.74 (±7.03), and the 'filled' component was the most prevalent (69.9%), whereas the 'decayed' and 'missing' components were, respectively, 8.4% and 21.7%. There was a higher prevalence of periodontal diseases with increasing age, ranging from 57.1% in firefighters of 34 years or less to 70.5% in the ones between 35 and 44 years old and 75.4% in participants at age 45 years or older. Clinical dental status of the military firefighters who belonged to the age group 35-44 was better than the one observed for the Brazilian population at the same age range. However, pathological conditions that can be solved with health promotion strategies associated with dental procedures of low complexity still persist. Conclusion: These results suggest that the availability of dental health care services itself does not represent the most effective approach to the oral health problems found in the studied population.

Associação entre problemas para dormir e condições orais em escolares / Association between trouble sleeping and oral conditions among schoolchildren

ABSTRACT Objective: To investigate the prevalence of self-reported trouble sleeping due to dental problems and its association with oral conditions in schoolchildren. Methods: This is a cross-sectional study carried out with a representative sample of 1,589 schoolchildren aged 8-10 years enrolled in public schools from Florianópolis, Santa Catarina, Brazil. Non-clinical data included a questionnaire about socioeconomic indicators answered by parents/guardians. Children were questioned about whether they had trouble sleeping due to dental problems and about previous history of toothache. Clinical oral examinations were performed to evaluate dental caries - Decayed, Missing, and Filled Teeth Index (DMFT/dmft index) and its clinical consequences [PUFA/pufa index: considering the presence of pulpal involvement (P/p); ulceration of tissues due to tooth fragments from decayed crowns (U/u); fistula (F/f); and abscesses (A/a), and traumatic dental injuries (TDI)]. We conducted a descriptive analysis and used adjusted logistic regression models (p<0.05; 95%CI). Results: The prevalence of trouble sleeping due to dental problems was 28%. Children with untreated dental caries (OR 1.32; 95%CI 1.05-1.67) and clinical consequences from the PUFA/pufa index (OR 1.89; 95%CI 1.45-2.46) had higher chances of reporting trouble sleeping due to dental problems. Conclusions: Approximately one-third of the children declared having trouble sleeping due to dental problems. Untreated dental caries and its clinical consequences were associated with self-reported trouble sleeping due to dental problems in schoolchildren.

RESUMO Objetivo: Investigar a prevalência de problemas para dormir por motivos dentários autorrelatado e sua associação com condições orais adversas em escolares. Métodos: Estudo transversal com amostra representativa de 1589 escolares de 8 a 10 anos matriculados em escolas públicas de Florianópolis, Brasil. Os dados não clínicos incluíram um questionário sobre indicadores socioeconômicos respondidos pelos pais/cuidadores. As crianças foram questionadas se tinham problemas para dormir por motivos dentários e sobre episódios anteriores de dor de dente. Foram realizados exames clínicos orais para avaliar: cárie dentária - Índice de Dentes Cariados, Perdidos e Obturados (índice CPO-D/ceo-d) - e suas consequências clínicas (índice PUFA/pufa - presença de envolvimento pulpar (P/p); ulceração (U/u); fístula (F/f); e abscessos (A/a) e traumatismo dental (TD). Foram realizados análise descritiva e modelos ajustados de regressão logística (p<0,05; IC95%). Resultados: A prevalência de problemas para dormir por motivos dentários foi de 28%. Crianças com cárie dentária não tratada (OR 1,32; IC95% 1,05-1,67) e presença de índice PUFA/pufa (OR 1,89; IC95% 1,45-2,46) apresentaram maiores chances de relatar problemas para dormir devido a razões dentárias. Conclusões: Aproximadamente, um terço das crianças apresentou problemas para dormir devido a razões dentárias. Cárie dentária não tratada e suas consequências clínicas foram associadas a problemas autorrelatados para dormir por motivos dentários em escolares.

Association between self-assessment and clinical oral health status in adults, Paraguay / Asociación entre la autoevaluación y el estado clínico de salud oral en adultos, Paraguay

Introduction: Oral health can be defined as the absence of pathologies and disorders that affect the stomatognathic system. Objetives: This study aimed to determine the characteristics of self-assessment oral health status, in the clinical experience of dental caries, periodontal status, periodontal fixation loss and to investigate the association between self-reported and clinical oral health status among Paraguayans adults during early 2017. Material and Methods: The design is cross-sectional. Two dentists carried out the oral examinations following the recommendations of the World Health Organization (WHO). Results: There were 333 adult participants with a mean age of 35 ± 13 years. Most (77.2%) of the participants were female. Missing teeth (5.32±6), filled teeth (3.56±4), and decayed teeth (2.55±3) were also detected. Almost half (48.0%) of participants had dental calculus, while 5.8% had a periodontal pocket and 48.6% periodontal fixation loss. The self-perception of oral health was poor in 12.3% of participants, fair in 29.8%, normal in 31.8%, good in 16.2%, and excellent in 9.9%. Oral health self-assessment was positive in 58.0% and negative in 42.0%. A statistically significant difference was found when comparing the DMFT index according to self-perception of oral health, the score being higher in those who had negative self-perception; obtaining similar results in the decayed component. Conclusion: Negative oral health self-perception was associated with a high DMFT index, of this, the decayed component was the only one that presented statistically significant differences.

Introducción: La salud bucodental puede ser definida como la ausencia de patologías y trastornos que afectan el sistema estomatognático. Objetivos: Este estudio tuvo como objetivo determinar las características de la autoevaluación del estado de salud bucal, en la experiencia clínica de la caries dental, el estado periodontal, la fijación de la pérdida periodontal e investigar la asociación entre el estado de salud bucal autoinformado y clínico entre los adultos paraguayos a principios de 2017. Material y Métodos: El diseño es transversal. Dos odontólogos fueron calibrados para el examen bucal, siguiendo las recomendaciones de la Organización Mundial de la Salud (OMS). Resultados: Participaron 333 sujetos, el promedio de edad fue de 34.93 (DE=12.64) años, 77.2% eran mujeres. El 21.1% de las piezas dentarias estaban perdidas, el 12.2% obturadas y el 9.2% cariadas. El 48.0% presentó cálculo dental, 5.8% el bolsa periodontal y el 48.6% pérdida de fijación. La autopercepción de salud bucal fue para el 12.3% pobre, el 29.8% regular, el 31.8% normal, el 16.2% buena y el 9.9% excelente. Tuvieron una autoevaluación de su salud oral positiva el 58.0% y negativa el 42.0%. Se encontró diferencia estadísticamente significativa al comparar el DMFT index según la autopercepción de salud oral, siendo mayor el puntaje en los negativos; obteniéndose resultados similares con el componente cariado. Conclusión: La autopercepción de salud oral negativa se asoció con un elevado DMFT index, de este, el componente cariado fue el único que presentó diferencias estadísticamente significativas.

Programa de Salud Bucodental en escolares de la Comunidad del Bajo Boulogne / Oral Health Program in children from Bajo Boulogne Community

Las afecciones bucodentales constituyen un problema de salud pública por su alta prevalencia y su fuerte impacto individual y colectivo en términos de dolor, malestar y discapacidad social y funcional. El Centro de Medicina Familiar y Comunitaria San Pantaleón, ubicado en la provincia de Buenos Aires, brinda asistencia sanitaria gratuita a la comunidad. Un relevamiento documentó que el 97% de los concurrentes presentaba caries y no se lavaban los dientes por falta de cepillo y pasta dental. Se decidió llevar adelante un programa de promoción de la salud bucodental. El objetivo fue evaluar su implementación; que incluyó: a) rastreo de caries y problemas odontológicos; b) coordinación interinstitucional; c) entrega de cepillos y pasta dental; d) intervención educativa; e) extensión comunitaria. Participaron en forma irregular 120 niñas, niños y adolescentes entre 5 y 18 años del Centro de Apoyo Escolar Fundación Bajo Boulogne. Se realizaron dos encuentros educativos y entrega de cepillos y pasta dental. En la revisión odontológica inicial sobre 60 participantes se detectaron caries en 43 (71,6%), que fueron derivados para tratamiento odontológico, pero concurrieron solo 26 (60,4%). El conocimiento sobre salud bucodental mostró cambios entre los más pequeños luego de las intervenciones educativas. Se logró implementar el programa, cumplimentando las actividades propuestas. Pero surgieron barreras que dificultaron la cobertura. En cuanto a la eficacia de la intervención educativa, no se logró mostrar cambios en el conocimiento. Se consiguió la detección oportuna, la incorporación de hábitos como el cepillado dentro de la institución educativa, la articulación para mejorar el acceso a la atención y la vinculación entre los diferentes actores comunitarios. (AU)

Oral disorders are a public health problem due to their high prevalence and their strong individual and collective impact in terms of pain, discomfort, and social and functional disability. The San Pantaleón Family and Community Medicine Center, located in the province of Buenos Aires, provides free healthcare to the community. A survey documented that 97% of those present had cavities and did not brush their teeth due to a lack of brush and toothpaste. It was decided to carry out an oral health promotion program. The objective was to evaluate its implementation; which included: a) tracking of caries and dental problems; b) inter-institutional coordination; c) delivery of brushes and toothpaste; d) educational intervention; e) community extension. 120 girls and boys and adolescents between 5 and 18 years of age from the Bajo Boulogne Foundation School Support Center irregularly participated. Two educational meetings were held, handing out brushes and toothpaste. In the initial dental review of 60 participants, caries was detected in 43 (71.6%), who were referred for dental treatment, with only 26 (60.4%) concurring. Oral health knowledge showed changes among the youngest after educational interventions. It was possible to implement the program, completing the proposed activities. Barriers arose that made coverage difficult. Regarding the effectiveness of the educational intervention, it was not possible to show changes in knowledge. Timely detection was achieved, the incorporation of habits such as brushing within the educational institution, articulation to improve access to care and the link between the different community actors. (AU)

Frecuencia de patologías pulpares en niños asistentes a la Facultad de Odontología, UNAH, Tegucigalpa, Honduras / Pulp pathologies frequency in children who attended UNAH Dental School, Tegucigalpa, Honduras

Según la Organización Mundial dela Salud (OMS), entre el 60 y 90% de la población infantil presenta lesiones cariosas concavitación. Las patologías pulpares son consecuencia de la evolución de la caries o traumatismo dental, manifestándose con dolor, inflamación o infección, que obliga a los pacientesa acudir de forma urgente a la consulta odontológica con cuadros de pulpitis reversible, irreversible o necrosis pulpar. Dependiendo dela gravedad de la patología, esta puede intervenirse mediante terapias curativas y cuando ha alcanzado un nivel muy avanzado, laúnica opción es la exodoncia, dejando secuelas a corto, mediano y largo plazo en el niño. Objetivo: Analizar las diferentes patologías pulpares en molares de ciduos de pacientes infantiles entre 5 y 9 años que acuden a la clínica de Odontopediatría de la Facultad de Odontología de la Universidad Nacional Autónoma de Honduras (UNAH) durante 2016-2018.Pacientes y métodos: Estudio descriptivo, retrospectivo y cuantitativo.Se recolectaron historias clínicas de niños entre 5 y 9 años que acudieron entre 2014 -2016 con una muestra de 310 expedientes de un universo de1605. Resultados: Predominaron las patologías pulpares en el género masculino (54.2%). La caries dental fue la etiología más registrada (77.34%),predominó la pulpitis reversible (9.3%), el órgano dentario más afectado, en el sistema de nomenclatura FDI, (Federation Dentaire Internationale), fue el primer molar deciduo inferior izquierdo (7,4). El tratamiento más realizado fue pulpotomía (15.2%). Conclusión: en la población infantil la caries dental no tratada evolucionó en su mayoría apulpitis reversible...(AU)