A defined-multispecies microbial model for studying enamel caries development.

The aims of this study were to describe and validate an in vitro multispecies microbial biofilm model for caries development by evaluating the effects of varying medium concentration of sucrose (0.5 and 1.0%) and fluoride (0.4, 0.8 and 1.0 ppm F) in study 1, and calcium (1.0 and 2.0 mM Ca) in study 2. Defined-multispecies biofilms, formed by Lactobacillus casei, Streptococcus mutans, S. salivarius and S. sanguinis, were grown on the surface of salivary-pellicle-coated enamel slabs, with known baseline surface hardness; growth medium was changed daily. Counts of viable cells on biofilms and the percentage of surface microhardness change (%SMC), lesion depth (LD) and integrated mineral loss (IML) on enamel slabs were assessed after 4 days of biofilm formation under the tested conditions. Counts of viable cells on biofilms were significantly affected by sucrose, fluoride and calcium concentrations (p < 0.05). There was a decrease in %SMC in response to increased fluoride and calcium concentrations (p < 0.001). Lower IML (p < 0.001) and LD (p < 0.05) were found in the presence of 0.8 and 1.0 ppm F. A negative correlation was found between the response variables (%SMC, LD and IML) and fluoride and calcium concentrations. The results suggest that the microbial caries model developed was able to show distinct levels of caries inhibition in response to fluoride and calcium concentrations, corroborating clinical observations. An effect of sucrose concentration on caries development was found only in the presence of the lowest fluoride concentration.

A comparison of sports and energy drinks--Physiochemical properties and enamel dissolution.

The consumption of sports and energy drinks by children and adolescents has increased at an alarming rate in recent years. It is essential for dental professionals to be informed about the physiochemical properties of these drinks and their effects on enamel. The present study measured the fluoride levels, pH, and titratable acidity of multiple popular, commercially available brands of sports and energy drinks. Enamel dissolution was measured as weight loss using an in vitro multiple exposure model consisting of repeated short exposures to these drinks, alternating with exposure to artificial saliva. The relationship between enamel dissolution and fluoride levels, pH, and titratable acidity was also examined. There was a statistically significant difference between the fluoride levels (p = 0.034) and pH (p = 0.04) of the sports and energy drinks studied. The titratable acidity of energy drinks (11.78) was found to be significantly higher than that of sports drinks (3.58) (p < 0.001). Five of the energy drinks (Red Bull Sugar Free, Monster Assault, Von Dutch, Rockstar, and 5-Hour Energy) were found to have the highest titratable acidity values among the brands studied. Enamel weight loss after exposure to energy drinks was significantly higher than it was after exposure to sports drinks. The effect of titratable acidity on enamel weight loss was found to vary inversely with the pH of the drinks. The findings indicated that energy drinks have significantly higher titratable acidity and enamel dissolution associated with them than sports drinks. Enamel weight loss after exposure to energy drinks was more than two times higher than it was after exposure to sports drinks. Titratable acidity is a significant predictor of enamel dissolution, and its effect on enamel weight loss varies inversely with the pH of the drink. The data from the current study can be used to educate patients about the differences between sports and energy drinks and the effects of these drinks on tooth enamel.

Cariogenic potential of pediatric liquid medicaments--an in vitro study.

UNLABELLED: Pediatric liquid medicaments (PLM) are popular and are easily accepted by both parents and children. They are widely prescribed and easily available. However the sugar content and properties of these preparations determines their cariogenic potential. AIMS AND OBJECTIVES: This study assessed the pH and viscosity of pediatric liquid medicaments, type and concentration of sugars present in them and their effect on the growth of Streptococcus mutans. METHODOLOGY: PLM included two each of the most commonly prescribed analgesics, antibiotics, nutritional supplements, antitussive and antiepileptic preparations. The endogenous pH was measured using a digital pH meter and the viscosity was measured using a digital Brookefield viscometer. Analysis of sugars (sucrose, glucose and sorbitol) was performed using High Performance Liquid Chromatography. The effect of PLM on Streptococcus mutans was done by ditch plate method. RESULTS: The pH of PLM ranged from 3.70 to 7.04 and viscosity varied from 307.33cP to 2408.33cP. Fifty percent of the PLM contained sucrose, glucose and sorbitol, and sucrose was present in nine of the PLM. The antibiotic preparations showed zones of inhibition against growth of Streptococcus mutans. CONCLUSIONS: The physical properties of Pediatric Liquid Medicaments as well as the type and concentration of sugars present in them can be indicative of their cariogenic potential.

Comparison of the effects of whole and juiced fruits and vegetables on enamel demineralisation in situ.

We compared the effect on enamel demineralisation in situ of both whole and juiced fruits and vegetables. Volunteers wore removable mandibular appliances carrying pre-demineralised human enamel slabs and consumed one of the test foods 7 times a day for 10 days. The test foods were apples, oranges, grapes, carrots, and tomatoes, consumed either whole (sugars located intrinsically) or as a juice (extrinsic or free sugars). Raisins containing 64% sugars, but intrinsic by definition, were also studied. The mineral profile of the enamel slabs was studied before and after the test period using transverse microradiography and showed further demineralisation for all test foods, irrespective of the form of consumption. Significant demineralisation was also observed with raisins. No significant differences were found between the solid and juiced foods. In conclusion, sugars present intrinsically on consumption had a similar demineralising potential as free sugars and could not be considered less cariogenic.

Cariogenic potential of oral nutritional supplements measured by intraoral plaque pH telemetry.

BACKGROUND & AIMS: Oral nutritional supplements (ONS) administered to malnourished elders and other patients contain high-levels of carbohydrates that could be a potential risk factor for dental caries. This study aimed to evaluate the cariogenic potentials of ONS using intraoral plaque telemetry. METHODS: Ten ONS were tested on five healthy volunteers (mean age: 76.8 ± 9.15 years). Participants were requested to refrain from performing oral hygiene 3-7 days prior to testing. The pH-value below the dental plaque on the tooth was measured while the ONS was being consumed. After neutralizing the participant's saliva, a control solution (10% sucrose) was administered and telemetry measurements were repeated. Mean relative cariogenicity (RC) was calculated for each ONS. ANOVA and post hoc tests were used for statistical analyses (p < 0.05). RESULTS: All ten ONS were potentially cariogenic on enamel with an overall RC of 0.519 ± 0.35 (Range: Min = 0.31 ± 0.16; Max = 1.00 ± 0.34). RC differed significantly between the ONS (p = 0.002). RC was lower in ONS that contained high-protein (p = 0.018). RC was not influenced by other factors such as readily consumable (p = 0.102), flavor (p = 0.869), consistency (p = 0.126), fiber containing (p = 0.134), style (p = 0.112), and age of plaque (p = 0.339). CONCLUSIONS: The ONS administered to elders and malnourished patients are potentially cariogenic. It is imperative that the administration of ONS must be based on individual needs to potentiate a maximum benefit. Wherever possible, an attempt to limit the use of high-carbohydrate containing ONS must be practiced along with the adoption of suitable preventive measures to arrest the development and progression of caries.

An analysis of concentration of sucrose, endogenous pH, and alteration in the plaque pH on consumption of commonly used liquid pediatric medicines.

BACKGROUND: Many parents are often unaware of the hidden, added sugars in many foods and drinks including pediatric liquid medicines; thus, hidden sugar in the form of pediatric medications has not been focused upon as cariogenic agents. OBJECTIVE: (i) assess concentration of sucrose in six pediatric drugs, (ii) determine endogenous pH of these drugs, and (iii) estimate drop in the plaque pH in the oral cavity in first 30 minutes after consumption of the drugs. MATERIALS AND METHODS: Ten adult volunteers with mean age of 22 years were double blinded for the study. Concentration of sucrose was assessed by volumetric method at Department of Chemical Branch of Engineering. Endogenous pH and drop in the plaque pH after consumption of the drugs were assessed using digital pH meter. STATISTICAL ANALYSIS: SPSS software was used to assess the pH level at different time intervals and expressed as mean +/- SD. Changes in pH were assessed by one-way ANOVA followed by Wilcoxons signed rank test. P-value was set at 0.05. RESULT: There were varying amounts of fermentable sucrose detected in the drugs; all the drugs were acidic. There is a significant drop of plaque pH after consumption of the drug. CONCLUSION: These sweeteners along with their low endogenic pH form a high cariogenic formulation. Thus, nonsucrose (noncariogenic) or sugar-free medications are needed to be prescribed along with proper oral hygiene care to the children under medication.

Cariogenic and erosive potential of the medication used by HIV-infected children: pH and sugar concentration.

OBJECTIVE: The aim of this work was to analyze pH and sugar concentration in seven antiretroviral and three antibacterial medications frequently prescribed to HIV infected paediatric patients. METHOD: Sugars (sucrose, glucose, lactose and fructose) and pH were measured from every one of ten medications with different serial numbers in two samples. The pH was determined by a previously calibrated digital pHmeter (Beckman). Analysis of free sugars was performed using thin-layer chromatography (TLC). The pH results and the amount of sugar originated from the two samples in each lot were added. The arithmetic mean of these results were computed. RESULTS: Two antiretrovirals (Zidovudin and Abacavir Sulphate) had pH below critical level (3.55 and 3.93, respectively). All three antibacterials analyzed had pH above 5.5, and one of them (Azithromycin) had the highest pH level of the ten medications examined (9.28). Sugar was present in seven out of 10 of the medications analyzed. The antibacterials contained the highest concentration of sucrose, ranging from 40% to 54%. Glucose was found in one of the ten, sucrose was present in seven of them and none showed lactose. Fructose was not observed with the technique used. CONCLUSIONS: A number of medications frequently used by HIV-infected children may cause a significant risk of both caries and dental erosion.

Determinantes sociais de saúde de crianças em consulta de puericultura: das condições socioeconômicas aos aspectos relacionados à saúde bucal / Social determinants of health of children in child care consultation: from socioeconomic conditions to aspects related to oral health / Determinantes sociales de la salud de los niños en la consulta infantil: de las condiciones socioeconómicas a los aspectos relacionados con la salud bucal

A imaturidade do sistema imunológico, associado a Determinantes Sociais de Saúde (DSS), promove doenças na infância. Especificamente, na cavidade oral, os DSS, representados pelo consumo elevado de açúcar, limitado acesso aos serviços de saúde e deficiência na higiene bucal, favorecem transtornos locais e sistêmicos. Assim, o estudo objetivou associar os DSS, no contexto das condições socioeconômicas, do acompanhamento pelo serviço de saúde e dos aspectos relacionados à saúde bucal de crianças atendidas em Unidades Básicas de Saúde (UBS) de um município cearense. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães em Acarape - CE. Após consentimento, essas preencheram um questionário. Os dados foram analisados. Das 70 mães, 87,14% e 90,00% tinham idade inferior ou igual a 30 anos e renda de até um salário mínimo, respectivamente. Das 70 crianças, 87,14% tinham seus dentes/gengiva higienizados por seus pais ou responsável. Do total, 94,29% nunca se submeteram a atendimento odontológico. Observou-se associação significativa entre a mãe ter escolaridade superior ao ensino fundamental incompleto e higienizar os dentes/gengiva do filho com escova dental e dentifrício. Constatou-se associação significativa entre a criança ingerir bolacha doce/recheada, não consumir refrigerante e usar escova dental e dentifrício na higienização oral. Conclui-se que as crianças eram acompanhadas nas UBS regularmente; no entanto, esse serviço não esteve relacionado ao atendimento odontológico. Apesar da ausência desse tipo de acompanhamento e do consumo de alimentos cariogênicos, as mães se preocupavam com a saúde bucal das crianças, higienizando a cavidade oral diariamente, com meios adequados.

The immaturity of the immune system, associated with Social Determi- nants of Health (SDH), promotes diseases in childhood. Specifically, in the oral cavity, SDH, represented by high sugar consumption, limited access to health services, and poor oral hygiene, favors local and systemic disorders. Thus, the study aimed to associate the SDH, in the context of socioeconomic conditions, monitoring by the health service and aspects related to children's oral health assisted in Basic Health Units (BHU) of a muni- cipality in Ceará. This is an observational, analytical, cross-sectional study with a quan- titative approach conducted with children and their mothers in Acarape - CE. After con- sent, they filled out a questionnaire. Data were analyzed. Of the 70 mothers, 87.14% and 90.00% were aged less than or equal to 30 years and had income up to one minimum wage, respectively. Of the 70 children, 87.14% had their teeth/gums cleaned by their pa- rents or guardian. Of the total, 94.29% never underwent dental care. There was a signifi- cant association between the mother having higher education than incomplete elementary school and cleaning the child's teeth/gums with a toothbrush and toothpaste. A significant association was found between the child eating sweet/stuffed biscuits, not consuming soft drink, and using a toothbrush and dentifrice for oral hygiene. It is concluded that the chil- dren were regularly monitored at the BHU; however, this service was not related to dental care. Despite the absence of this type of follow-up and the consumption of cariogenic foods, the mothers were concerned about their children's oral health, cleaning the oral cavity daily with adequate means.

La inmadurez del sistema inmunológico, asociada a los Determinantes So- ciales de la Salud (DSS), promueve enfermedades en la infancia. Específicamente, en la cavidad bucal, los DSS, representados por el alto consumo de azúcar, el acceso limitado a los servicios de salud y la mala higiene bucal, favorecen los trastornos locales y sisté- micos. Así, el estudio tuvo como objetivo asociar el DSS, en el contexto de las condicio- nes socioeconómicas, el seguimiento por el servicio de salud y los aspectos relacionados con la salud bucal de los niños atendidos en las Unidades Básicas de Salud (UBS) de un municipio de Ceará. Se trata de un estudio observacional, analítico, transversal con enfo- que cuantitativo, realizado con niños y sus madres en Acarape ­ CE. Después del consen- timiento, completaron un cuestionario. Los datos fueron analizados. De las 70 madres, 87,14% y 90,00% tenían edad menor o igual a 30 años e ingresos hasta un salario mínimo, respectivamente. De los 70 niños, al 87,14% se les limpió los dientes/encías por sus pa- dres o tutores. Del total, el 94,29% nunca realizó atención odontológica. Hubo una aso- ciación significativa entre la madre con educación superior a la primaria incompleta y la limpieza de los dientes/encías del niño con cepillo y pasta dental. Se encontró una asoci- ación significativa entre el niño que come galletas dulces/rellenas, no consume gaseosas y usa cepillo de dientes y dentífrico para la higiene bucal. Se concluyó que los niños eran monitoreados periódicamente en la UBS; sin embargo, este servicio no estaba relacionado con el cuidado dental. A pesar de la ausencia de este tipo de seguimiento y del consumo de alimentos cariogénicos, las madres se preocupan por la salud bucal de sus hijos, reali- zando la limpieza de la cavidad bucal diariamente, con medios adecuados.

Free sugar concentration and pH of paediatric medicines in Brazil.

OBJECTIVE: This study aimed to determine free sugar concentration and pH of paediatric syrup medicines. Setting Ten paediatric syrup medicines most frequently prescribed in urban centres in Brazil were randomly chosen to be tested. OUTCOME MEASURES: Three different bottles from each type of syrup medicine were analysed (n = 30). Analysis of free sugars was performed using normal phase High-Performance Liquid Cromatography (HPLC). Quantification of free sugars was achieved by peak height comparison with standards of sucrose, fructose, glucose and sorbitol (Merck). The results were average of replicates from three bottles of each medicine. The pH of the three different bottles of each medicine was determined using a digital pHmeter (Analion - PM 600). RESULTS: Sucrose and glucose were detected in seven of the ten types of paediatric syrup medicines, with concentrations varying from 3.7 to 49.4% (w/w) (Median 32.7%) and 2.1 to 23.2% (w/w) (Median = 6.1%), respectively. Only two medicines contained fructose, and three, sorbitol, with respective medians of 12.8% (3.1-22.4%) and 24.6% (22.8-27.4%). The median of pH values was 4.9 (2.6-6.1). CONCLUSIONS: Most paediatric syrup medicines showed high concentration of free sugars and pH below the critical value (5.5), which can increase their cariogenic and erosive potentials.

The cariogenicity of hydrolyzed starch foods by measuring the polyacrylamide hydroxyapatite (PAHA) disc.

OBJECTIVES: This study measured the degree of demineralization of starch foods affected by hydrolyzed starch in total starch using the polyacrylamide hydroxyapatite (PAHA) disc. DESIGN: A total of 10 ml of test food was added to a PAHA disc and 5 ml artificial saliva, followed by inoculation with 1 µl of S. mutans and incubation at 37 °C for 180 min. The demineralization effects were then determined using CLSM. RESULTS: The proportion of hydrolyzed starch in total starch in potato increased over time, while hydrolyzed starch in other test food decreased. When the amount of hydrolyzed starch in total starch increased after 180 min (p=0.000), the surface roughness of the PAHA disc in potato was significantly decreased. Wheat-based sugary snacks, such as chips and cookie, had relatively high cariogenic potentials, whereas baked potato had a relatively low cariogenic potential. CONCLUSIONS: Hydrolyzed starch in total starch increased over time, and cariogenic potential was notably decreased. Measurement of PAHA disc may be a valid method for assessing the cariogenic potential of hydrolyzed starch foods.

Changes in the prescribing of liquid oral medicines (LOMs) in the northern region of England between 1987 and 1992 with special regard to sugar content and long-term use in children.

OBJECTIVE: To assess the changes in prescribing of liquid oral medicines used long-term in children and to observe any patterns of change in sugar-free prescribing. DESIGN: Prescribing patterns in 1992 were compared with those in 1987. Information on these and on the sweetening agent in each liquid oral medicine was obtained from several relevant sources. SETTING: The survey covered the Northern region of England, and Great Britain overall. OUTCOME MEASURES: Data on numbers (in 1000s) and quantities (1) of liquid oral medicines prescribed and dispensed during 1992. All generic and propriety preparations with equivalent therapeutic effects were included. RESULTS: There was a small percentage reduction in the use of liquid oral medicines among all medicines dispensed in Great Britain in 1992 compared with 1987. The total volume of liquid oral medicines prescribed in the Northern region increased from 320,000 l to 442,600 l of which the total quantity prescribed as sugar-free increased from 35 per cent to 50 per cent. CONCLUSIONS: Children who require medicines long-term are often those for whom dental disease and treatment carry the greatest potential risks. Use of solid rather than liquid dose forms of medicine should be promoted and the trend towards the sugar-free options in liquid medicines should be encouraged and sustained.

Sugars present in tobacco extracts.

The presence of fructose, glucose, sucrose, maltose, and isomaltose in commercial tobacco products was identified and quantitated. Gas-liquid chromatographic studies showed that these five types of sugar were present in the water-soluble extracts of pouch and plug chewing tobacco, yet only fructose and glucose were found in extracts of snuff and unprocessed natural tobaccos. The amount of sucrose present in pouch chewing tobacco was twice that in plug chewing tobacco. No detectable amount of sucrose was found in snuff or unprocessed natural tobaccos. The content of maltose and isomaltose was much less than the content of fructose, glucose, or sucrose. All unprocessed natural tobacco leaves studied as controls contained low amounts of fructose and glucose, and no detectable amounts of sucrose, maltose, or isomaltose. The larger amounts of fructose and glucose, and the additional sucrose, maltose, and isomaltose present in pouch and plug chewing tobaccos are probably added during the manufacturing process.

Effect of plaque accumulation and salivary factors on enamel demineralization and plaque composition in situ.

This study evaluated the effect of some plaque and salivary factors on caries progression in situ. The salivary secretion rate, buffering capacity and mutans streptococci counts from 13 volunteers were determined. For three distinct periods of time, 4, 7 and 10 days, each of them wore a palatal appliance containing 4 bovine enamel blocks. They used a non-fluoridated dentifrice during the experiment and a 20% sucrose solution was dripped onto the blocks 10 times a day. Mutans streptococci (MS), calcium (Ca), and insoluble polysaccharide (IP) were quantified in the dental plaque formed on the enamel blocks, after each period. Enamel demineralization was assessed by surface microhardness, and the percentage of surface microhardness change (%SMC) in relation to the baseline values was calculated. Enamel demineralization occurred after each period of plaque accumulation (p < 0.05), and the %SMC increased with time (from 13.8 to 48.3%). The concentrations of Ca and IP in plaque were not statistically different among the experimental times, but significant correlations were found between these concentrations and %SMC. Neither the salivary factors assessed initially nor mutans streptococci in plaque presented statistically significant correlations to %SMC. The results suggest that enamel demineralization is time-dependent and is more related to the composition of the biofilm formed than to the salivary factors studied.

[Cariogenic carbohydrates in maltodextrin-containing breast milk food substitutes]. / Kariogene Kohlenhydrate in maltodextrinhaltigen Muttermilchersatznahrungen.

Ten infant formulas containing maltodextrin were analysed for fermentable carbohydrates using enzymatic analysis test-combinations and a spectrophotometer. Besides lactose, sucrose and fructose an assessment was made of sugars typically contained in maltodextrin and corn syrup, namely maltose, maltotriose and glucose. Total carbohydrate was up to 10.3 g in 100 ml standard sample. Cariogenic sugars were found in concentrations between 4.0 and 7.3 g/100 ml. Declaration of the different types of carbohydrates, especially of maltodextrin/corn syrup proved to be insufficient in some products and consequently the consumer is not able to understand their cariogenic potential.

[Cariogenic carbohydrates in maltodextrins, glucose syrups and maltodextrin-containing infant tea]. / Kariogene Kohlenhydrate in Maltodextrinen, Glukosesirupen und maltodextrinhaltigen Kindertees.

Five maltodextrins and five corn syrups each, seven instant teas containing maltodextrin and one tea produced on a protein-base were analysed for fermentable carbohydrates using enzymatic analyses test combinations and a spectrophotometer. Analysis of the maltodextrins and glucose syrups demonstrated the heterogenicity of this group of substances and also some incompleteness in the declaration of maltose, maltotriose and glucose, sugars typically contained in these products. In standard samples of the instant teas cariogenic sugars were found in concentrations up to 0.7%. As these sugars were not declared in any of the products, the consumer is not able to assess the cariogenic potential of the ingredient maltodextrin. The intake of products containing maltodextrins or corn syrups must lead to an uncontrolled sugar consumption.

Avaliação in vitro do potencial cariogênico e erosivo de corticosteroide de uso tópico / In vitro evaluation of cariogenic and erosive potential of topic corticosteroid

Introdução: o tratamento com bochechos de dexametasona elixir é bastante descrito na literatura para casos de lesões erosivas e ulceradas em mucosa bucal. Excipientes acrescentados aos medicamentos os tornam mais palatáveis e estáveis, embora possam resultar em efeitos adversos que comprometem a saúde bucal. Objetivo: este estudo propôs-se a avaliar, in vitro, o pH, a acidez total titulável (ATT) e o teor de sólidos solúveis totais (SST) de diferentes marcas de dexametasona elixir disponíveis no mercado da cidade de Salvador, correlacionando-os ao potencial erosivo e cariogênico do medicamento para os dentes. Metodologia: seis marcas (A, B, C, D, E e F) de laboratórios distintos foram incluídas neste estudo. O valor do pH foi aferido utilizando-se pHmetro e agitador magnético; a ATT foi determinada adicionando-se hidróxido de sódio (NaOH) 0,1 N e a aferição do SST foi através de refratômetro. Os dados foram expressos em valores médios e desvios padrão. Resultados: o pH de todas as marcas investigadas apresentou medidas abaixo de 5,5, logo, todas apresentaram potencial erosivo. Na avaliação da ATT, maior volume de NaOH 0,1N foi necessário pela marca D para alcançar pH 5,5 e 7,0. Dentre as marcas investigadas, a marca B foi a que apresentou maior teor de SST em sua composição. Conclusão: soluções para uso local de dexametasona elixir possuem potencial erosivo e alto teor de SST, tornando-se, então, importante a orientação de instrução de higiene oral dos pacientes que possuem maior risco de desenvolver alterações dentárias.

Introduction: treatment with mouthwash dexamethasone elixir is sufficiently described in the literature for cases of erosive and ulcerated lesions in oral mucosa. Excipients added to drugs make them more palatable and stable, however, may result in adverse effects that compromise the health of the oral cavity. Aim: this study sets out to evaluate in vitro pH, titratable total acidity (TTA) and the total soluble solids content (TSS) of different brands of dexamethasone elixir available on the market of Salvador city, correlating them to the potential of cariogenic and erosive medicine for the dental units. Methodology: six distinct laboratories brands (A, B, C, D, E and F) were included in this study. The pH value was assessed using a pH meter and magnetic stirrer, the TTA was determined by adding sodium hydroxide (NaOH) 0.1 N and measurement of TSS was made with refractometer. The data were expressed as average and standard deviations. Results: the pH of all brands investigated presented measures below 5.5, so, all presented erosive potential. In TTA, greater volume of NaOH 0, 1N was required by D brand to achieve pH 5.5 and 7.0. Among the brands investigated, brand B was the one that presented the highest content of TSS in its composition. Conclusion: solutions for local use of dexamethasone elixir have erosive potential and high content of TSS, becoming so important the guidance of oral hygiene instruction of patients who have higher risk of developing dental changes

Avaliação in vitro do potencial erosivo e cariogênico de antifúngicos tópicos / In vitro evaluation of erosive and cariogenic potential of topical antifungal agents

Introdução: a candidíase é uma infecção fúngica oportunista, causada pela proliferação e disseminação de espécies de Candida, que pode acometer a cavidade oral. Dentre os antifúngicos mais utilizados e de uso tópico, a nistatina é considerada o medicamento de primeira escolha. Objetivo: avaliar as propriedades físico-químicas de diferentes marcas de nistatina disponíveis no mercado, incluindo o pH, a acidez total titulável (ATT) e a determinação de sólidos solúveis totais (SST). Metodologia: trata-se de um estudo experimental in vitro, constituído por uma amostra de oito diferentes marcas de nistatina em suspensão oral de uso tópico. Foi analisado o potencial erosivo e cariogênico dessas soluções mediante a determinação de pH, ATT e SST (°Brix). Resultados: no tocante ao pH, verificou-se que a média obtida foi de 6,05 (± 0,66). Dois dos medicamentos analisados (marcas A e H) apresentaram pH abaixo do crítico para a dissolução do esmalte dental. Quanto à ATT das soluções, os valores variaram de 1,9 a 14,53 mL para atingir o pH neutro, indicando que as marcas B, C e E podem levar mais tempo para ser neutralizadas em razão da quantidade de solução necessária. A análise do °Brix revelou que a marca H apresentou o maior teor de açúcares em sua composição (44,9%). Conclusão: a formulação de nistatina da marca H apresentou pH endógeno mais crítico e percentual de sólidos solúveis totais elevado, sendo, portanto, a medicação com maior fator de risco para o desenvolvimento de cárie e erosão dentária, devendo ser consideradas as doses e frequências de uso, bem como os hábitos de higiene oral do paciente

Introduction: candidiasis is an opportunistic fungal infection caused by the proliferation and spread of Candida species that can affect the oral cavity. Among the most commonly used topical antifungal agents, nystatin is considered the first choice drug. Methodology: to evaluate the physical and chemical properties of different brands of nystatin available in the market, including pH, titratable acidity and determination of total soluble solids. Results: Regarding pH, it was verified that the mean obtained was 6.05 (± 0.66). Two of the analyzed drugs (A and H) presented pH below that considered critical for the dissolution of dental enamel. As for the titratable total acidity of the solutions, values ranged from 1.9 to 14.53 mL to reach neutral pH, indicating that the B, C and E marks may take longer to neutralize because of the amount of solution required. The analysis of ° Brix revealed that the H mark had the highest sugar content in its composition (44.9%). Conclusion: Nystatin brand H presented the worst indices in terms of endogenous pH and total sugar percentage, being therefore the medication with the highest risk factor for the development of caries and dental erosion.

Análise do potencial cariogênico e erosivo de diferentes marcas de leite fermentado / Analysis of the cariogenic and erosive potential of different brands of fermented milk

A dieta, quando realizada de forma inadequada, passa a ser um fator determinante para a ocorrência de cárie e erosão dentária, principalmente levando em consideração o aumento do consumo de alimentos e bebidas industrializadas por crianças e adolescentes. No presente estudo avaliaram- -se as propriedades bioquímicas dos leites fermentados encontrados em um supermercado da zona leste de Teresina, PI. Foram analisadas 36 amostras de 6 marcas comerciais diferentes, por meio das propriedades de pH endógeno e Sólidos Solúveis Totais (SST). As análises foram submetidas ao teste Kolmogorov-Smirnov e a análise da variância pela ANOVA, seguida de pós-teste Tukey para a comparação entre os grupos, no programa Minitab 16. As marcas analisadas apresentaram valor de pH que variaram de 3,13 a 3,68. Todas apresentaram valores de pH abaixo do valor considerado crítico para o processo de desmineralização do esmalte (5,5). Em relação aos sólidos solúveis totais, os valores oscilaram entre 5,93 e 11,2. Com os dados obtidos, pode-se sugerir que, se essas bebidas forem ingeridas com frequência, podem apresentar tanto um potencial cariogênico como erosivo. É de fundamental importância que os profissionais de saúde estejam cientes e alertem seus pacientes sobre os riscos que esses alimentos podem oferecer à saúde bucal dos mesmos.(AU)

Diet, when performed in inadequate ways, becomes a determining factor for occurrence of caries and dental erosion, mainly when taking into consideration the increasing consumption of industrialized foods and beverages by children and adolescents. This study aimed to evaluate the biochemical properties of fermented milks found in a supermarket in the eastern zone of Teresina-PI. Thirty-six samples from six different commercial brands were analyzed through their endogenous pH and Total Soluble Solids (TSS) properties. To analyze the data, Kolmogorov-Smirnov test and analysis of variance by ANOVA, followed by a Tukey post-test for comparison between the groups in the Minitab 16 program were performed. The analyzed brands presented pH values ranging from 3.13 to 3.68. All of them presented pH values below those considered critical for the enamel (5,5). The TSS data ranged from 5.93 to 11.2. With the data obtained, it can be suggested that if those drinks are frequently ingested, it can present both cariogenic and erosive potential. It is important that health professionals be aware and alert their patients about the risks that those sort of beverage can offer to their oral health.

Measurement of the cariogenicity of snacks using a radioisotope PAHA disc.

OBJECTIVES: This study aimed to establish a method for measuring the cariogenic potential of foods with high reproducibility in vitro. METHODS: Streptococcus mutans (S. mutans) was incubated in test foods with radioisotope polyacrylamide hydroxyapatite (PAHA) for 150 min at 37 °C. Then, the amount of radioisotope (32)P released from PAHA was measured using a liquid scintillation counter and scanning electron microscopy (SEM). RESULTS: The radioisotope PAHA discs that were soaked in 10% sucrose solutions had a high cariogenic potential and showed a remarkably demineralized surface (p < 0.05). The radioisotope PAHA disc that was incubated with snacks that had a high cariogenic potential showed a remarkably demineralized surface via SEM. Candy had a relatively high cariogenic potential, whereas xylitol gum had a relatively low potential. CONCLUSIONS: The cariogenicity of snacks can easily be evaluated by measuring the amount of (32)P released from radioisotope PAHA discs.

Recuento en saliva de Streptococcus mutans en niños de 6 a 12 años con y sin tinciones cromógenas / Counting of Streptococcus mutans in saliva of 6 to 12 years old children with and without black stain

Introducción: Las tinciones cromógenas o 'Black Stain' (BS) se han asociado a una baja experiencia de caries y un menor recuento de bacterias cariogénicas. El objetivo es determinar si existe diferencia en el número de pacientes que presenten un alto recuento de S. mutans (>105 UFC/ml saliva) entre niños con BS y sin ellas. Material y métodos: Estudio observacional analítico de corte transversal. Se incluyeron 158 escolares entre 6 y 12 años de establecimientos educacionales de la ciudad de Valdivia, Chile. Luego de un examen clínico se determinó la prevalencia de individuos con BS y se conformó un grupo con ausencia de tinciones para comparar el recuento de S. mutans. Se calculó la proporción del número de pacientes con valores >105 UFC/ ml en ambos grupos para establecer los sujetos con alto riesgo cariogénico, evaluando si las diferencias fueron significativas (p<0,05) mediante el test exacto de Fisher. Resultados: Se diagnosticó BS en 15 niños (6 hombres y 9 mujeres), estimando una prevalencia de 9,5% del total de examinados. De esta forma, los grupos de estudio se conformaron por 15 niños con BS y 30 sin la tinción. No hubo diferencia estadísticamente significativa (p=0,538) en la proporción de niños con recuento >105 UFC/ml de S. mutans entre los grupos. Discusión: La presencia de BS en pacientes de 6 a 12 años no se asocia a mayor o menor riesgo cariogénico (AU)

Introduction: Chromogenic staining or 'Black Stain'(BS) has been associated with a low caries frequency and less cariogenic bacteria count. The aim of the study was to determine the difference in the number of patients who have a high count of S. mutans (>105 CFU/ml saliva) among children with BS and without them. Material and methods: Analytical observational cross-sectional study. In this study were included 158 children between 6 and 12 years old, from educational establishments in the city of Valdivia, Chile. After clinical muexamination, the prevalence of individuals with BS was determined and a group was formed with no stains to compare the count of S. mutans. We calculate the ratio of patients with values> 105 CFU/ml in the two groups to identify the patients with high cariogenic risk. Statistical differences were evaluated by Fisher’s test (p <0.05). Results: BS was diagnosed in 15 children (6 men and 9 women), estimating a prevalence of 9.5% of all examined. Thus, the groups studied were formed by 15 children with BS and 30 without staining. There was no statistically significant difference (p=0.538) in the proportion of children with >105 CFU/ml of S. mutans between groups. Discussion: The presence of BS in patients aged 6 to 12 years is not associated with cariogenic risk (AU)