White spot lesions: diagnosis and treatment - a systematic review.

BACKGROUND: White spot lesions represent the first stage of caries and their prevalence has been increasing in recent years, particularly in patients undergoing orthodontic treatment. DIferential diagnosis and lesion activity are essential to decide on the clinical approaches to treatment. The aim of this study is to understand if the new diagnostic tools such as fluorescence, microradiography and computed microtomography have the potential to change the conventional treatment of white spots". METHODS: A systematic search of available studies in the literature was carried out, using PRISMA guidelines, in Pubmed and Scopus electronic databases and manually to identify relevant articles to answer the PICO question: "Do the new diagnostic tools have the potential to change the conventional treatment of white spots?". This systematic review included randomized controlled trials (RCT), cross-sectional and longitudinal studies complying with the following inclusion criteria: (i) studies in humans, (ii) studies about white spot lesions, (iii) studies published between 2012 and 2023, (iv) studies having both diagnosis and treatment and (v) studies with full text available. In this review we excluded other systematic reviews of clinical trials and in vitro studies. The RoB tool was used to assess the risk of bias. RESULTS: The systematic literature search identified 143 potentially relevant references, which after applying the exclusion criteria, resulted in 20 articles. Regarding diagnostic methods, most articles found were based on conventional methods of visual examination (n:10) or fluorescence (n:7). The least referenced diagnostic techniques were based on the use of clinical photographs (n:2), cross-sectional microradiography (n:1) and computed microtomography (n:1). The use of DIAGNOdent was reported by 3 in vitro studies. With regard to therapies, most studies reported the use of infiltrating resin (n:7) and fluoride-based products (n:5). Other studies have reported the use of self-assembling peptide P11-4 (n:1), home care (n:1), casein phosphopeptide-amorphous calcium phosphate (n:2) and hydrochloric acid (n:1). Combination therapies were also considered. CONCLUSION: Diagnostic tool does not have the potential to change the form of treatment, whether it is a conventional method or a more differentiated one.

Evaluating E-Health Literacy, Knowledge, Attitude, and Health Online Information in Portuguese University Students: A Cross-Sectional Study.

BACKGROUND: The main objective of the present study was to assess e-health literacy in a sample of Portuguese university students and its association with the level of knowledge and seeking for COVID-19-related information. METHODS: This cross-sectional online study was conducted on Portuguese university students. All students completed a questionnaire consisting of demographic characteristics, e-health Literacy Scale (eHEALS), and a questionnaire about knowledge, attitude, and health online information seeking. RESULTS: A total of 534 students (76.8% women), with a mean age of 24.3 years old (SD = 7.8), participated in this cross-sectional study, 53.0% of students were from non-health sciences. The mean score of eHEALS literacy was 28.8 (SD = 5.6). Most students (71.1%) classified the Internet as a useful, or very useful, tool in helping them make health related decisions. The use of the Internet as a tool to research health information for a period of two or more hours (OR = 1.9; CI 95% = 1.2; 3.4), to search online for health information on professional websites (OR = 2.3; CI 95% = 1.4; 3.6), to search in official media (OR = 2.3; CI 95% = 1.4; 3.9), and to study in the field of health sciences (OR = 1.6; CI 95% = 1.1; 2.6) increased the likelihood of having sufficient e-health literacy. CONCLUSION: From a public health perspective, there is a need to develop programs that increase health literacy among university students.

Oral Health Literacy and Determinants among an Elderly Community in Portugal.

High average life expectancy has caused an increase in the elderly population and with it arises the need to characterize this population regarding their health and, in particular, their oral health. The purpose of this study was to assess and characterize oral health, oral rehabilitation, oral health literacy, oral health perception and quality of life in a sample of elderly participants of a physical activity program in Portugal. An observational cross-sectional study was designed with a group of 206 individuals. All the individuals were clinically assessed, DMFT, PSR and the plaque index were registered, and a questionnaire was applied in the form of a "face-to-face" interview with questions related to the quality of life related to oral health (GOHAI index and the REALD-30 scale). Of the 206 study participants, 90.3% admit brushing their teeth daily, 6.3% practice daily flossing, and 5.8% had a dental appointment in the last 12 months. Applying the REALD-30 scale, 22.7% have a low level (score 0-14), 43.7% a moderate level (score 15-22) and 33.6% a high level (score 23-29) of oral health literacy. The GOHAI scale reveals that 37.4% have a high self-perception of their oral health. A considerable proportion of the sample studied present a moderate level of oral health literacy. Therefore, educating each person about their oral health when participating in a specific health program and developing proposals for oral health promotion activities should be widely considered as a strategy towards primary prevention. Future oral health literacy sessions should be held in order to improve oral health and quality of life among the community.

Light transmittance through resin-matrix composite onlays adhered to resin-matrix cements or flowable composites.

OBJECTIVE: The aim of this study was to evaluate the influence of the thickness of resin-matrix composite blocks manufactured by CAD-CAM on the light transmittance towards different resin-matrix cements or flowable composites. METHODS: Sixty specimens of resin-matrix composite CAD-CAM blocks reinforced with 89 wt% inorganic fillers were cross-sectioned with 2 or 3 mm thicknesses. The specimens were conditioned with adhesive system and divided in groups according to the luting material, namely: two dual-cured resin-matrix cements, two traditional flowable resin-matrix composites, and one thermal-induced flowable resin-matrix composite. Specimens were light-cured at 900 mW/cm2 for 40s. Light transmittance assays were preformed using a spectrophotometer with an integrated monochromator before and after light-curing. Microstructural analysis was performed by optical and scanning electron microscopy (SEM). Nanoindentation tests were performed to evaluate mechanical properties for indirect evaluation of degree of monomers conversion. RESULTS: Optical and SEM images revealed low thickness values for the cementation interfaces for the traditional flowable resin-matrix composite. The cement thickness increased with the size and content of inorganic fillers. The highest light transmittance was recorded for the onlay blocks cemented with the traditional flowable resin-matrix composites while a group cemented with the dual-cured resin-matrix cement revealed the lowest light transmittance. The elastic modulus and hardness increased for specimens with high content of inorganic fillers as well as it increased in function of the light transmittance. CONCLUSIONS: The light transmittance of flowable resin-matrix composites was higher than that for resin-matrix cement after cementation to resin-matrix composites blocks. The type, size, and content of inorganic fillers of the luting material affected the thickness of the cement layer and light transmittance through the materials. CLINICAL RELEVANCE: On chair-side light curing, the transmission of visible light can be interfered by the chemical composition and viscosity of the luting materials. The increase in size and content of inorganic fillers of resin-matrix composites and luting materials can decrease the light transmittance leading to inefficient polymerization.

Use of Local Melatonin with Xenogeneic Bone Graft to Treat Critical-Size Bone Defects in Rats with Osteoporosis: A Randomized Study.

The aim of this study was to evaluate the effect of local administration of melatonin (MLT) on molecular biomarkers and calvaria bone critical defects in female rats with or without osteoporosis, associated or not with a xenogeneic biomaterial. Forty-eight female rats were randomly divided into two groups: (O) ovariectomized and (S) placebo groups. After 45 days of osteoporosis induction, two critical-size defects (5 mm diameter) were created on the calvaria. The groups were subdivided according to the following treatment: (C) Clot, MLT, MLT associated with Bio-Oss® (MLTBO), and Bio-Oss® (BO). After 45 days, the defect samples were collected and processed for microtomography, histomorphometry, and biomolecular analysis (Col-I, BMP-2, and OPN). All animals had one femur harvested to confirm the osteoporosis. Microtomography analysis demonstrated a bone mineral density reduction in the O group. Regarding bone healing, the S group presented greater filling of the defects than the O group; however, in the O group, the defects treated with MLT showed higher mineral filling than the other treatments. There was no difference between the treatments performed in the S group (p = 0.05). Otherwise, O-MLT had neoformed bone higher than in the other groups (p = 0.05). The groups that did not receive biomaterial demonstrated lower levels of Col-I secretion; S-MLT and S-MLTBO presented higher levels of OPN, while O-C presented statistically lower results (p < 0.05); O-BO showed greater BMP-2 secretion (p < 0.05). In the presence of ovariectomy-induced osteoporosis, MLT treatment increased the newly formed bone area, regulated the inflammatory response, and increased OPN expression.

Oral health and quality of life of the geriatric patient: contexts of autonomy / Salud bucal y calidad de vida del paciente geriátrico: contextos de autonomía

Background: The state of oral health plays an important role in the concept of frailty among the elderly, as they tend to suffer from poor oral health conditions. Objective: The aim of our systematic review is to study the impact of oral health on the quality of life of the geriatric patient in different contexts of autonomy. Material and Methods: A systematic literature review was carried out of which the selection of articles, with publication date between 2008 and 2020 was conducted through computer platforms. The studies were analyzed and evaluated respecting the previously established inclusion criteria. The review corpus consisted of 16 articles, which presented methodological quality. Results: Oral health has an impact on the quality of life of the elderly, both in the context of institutionalization and at a community level. Oral health has an effect on the quality of life of the elderly, namely in the dimensions of physical pain, physical disability, psychological discomfort, functional limitation, psychological and social disability. The higher the level of dependency the lower the oral health which has the greatest impact on quality of life. The presence of periodontitis, dental caries, edentulism, oral lesions and unsuitable dental prostheses result in a worse perception of quality of life. Conclusion: The evidence found in this study reveals that the state of oral health among the elderly influences their quality of life, regardless of the context of autonomy, indicating the need for oral health policies aimed at this specific population.

Fundamento: El estado de salud bucal juega un papel importante en el concepto de fragilidad entre los ancianos, ya que tienden a padecer de malas condiciones de salud bucal. Objetivo: El objetivo de nuestra revisión sistemática es estudiar el impacto de la salud bucal en la calidad de vida del paciente geriátrico en diferentes contextos de autonomía. Material y Métodos: Se realizó una revisión sistemática de la literatura, se seleccionó artículos con fecha de publicación entre 2008 y 2020 a través de plataformas informáticas. Los estudios fueron analizados y evaluados respetando los criterios de inclusión previamente establecidos. El corpus de revisión estuvo compuesto por 16 artículos, que presentaron calidad metodológica. Resultados: La salud bucal tiene impacto en la calidad de vida de los ancianos, tanto en el contexto de institucionalización como a nivel comunitario. La salud bucal tiene un efecto sobre la calidad de vida de los ancianos, concretamente en las dimensiones de dolor físico, discapacidad física, malestar psicológico, limitación funcional, discapacidad psicológica y social. Cuanto mayor es el nivel de dependencia, menor es la salud bucal, lo que tiene un mayor impacto en la calidad de vida. La presencia de periodontitis, caries dental, edentulismo, lesiones bucales y prótesis dentales inadecuadas redundan en una peor percepción de la calidad de vida. Conclusión: Las evidencias encontradas en este estudio revelan que el estado de salud bucal de los ancianos influye en su calidad de vida, independientemente del contexto de autonomía, indicando la necesidad de políticas de salud bucal dirigidas a esa población específica.

Oral health behaviour perception scale applied among a sample of portuguese adolescents / Escala de percepción del comportamiento de salud bucal aplicada en una muestra de adolescentes portugueses

Introduction: The application of a scale can be particularly useful for the epidemiological studies comparing different populations and for analysis of the influence of distinct aspects of oral health on the development of certain health conditions. The aim of this study consists in the creation of a scale to classify the level of perception of the oral health behaviors applicable to a sample of Portuguese adolescents. Material and Methods: An observational cross-sectional study was designed with a total of 649 adolescents between the ages of 12 and 18 years old from five public schools in the Viseu and Guarda districts, in Portugal. Data was collected by the application of a self-administered questionnaire and, after analysis of data collection, the newly Universidade Católica Portuguesa (UCP) oral health perception scale was created. Statistical analysis was performed using SPSS-IBM software version 24.0 (IBM SPSS, Chicago, Il., USA). In the descriptive statistical analysis, absolute and descriptive frequencies were used for variables with nominal measurement level, mean as a measure of central tendency and standard deviation as a measure of dispersion for interval variables. Results: Oral health behaviors perception respecting the assumptions defined by the present scale has been elaborated. The result showed that 67% of the sample presented a poor perception of their oral health behaviors, 23.9% intermediate/sufficient, while 8.2% refer having good perception, respecting the assumptions defined for the elaboration of the present scale. Conclusion: For this purpose, through the scale to classify the level of oral health behaviors applicable to the sample of portuguese adolescents, it is possible to compare the data of several samples and understand what are the most frequent oral or eating habits among adolescents

Introducción: La aplicación de una escala puede ser particularmente útil para los estudios epidemiológicos que comparan diferentes poblaciones y para el análisis de la influencia de distintos aspectos de la salud bucal en el desarrollo de determinadas condiciones de salud. El objetivo de este estudio consiste en la creación de una escala para clasificar el nivel de percepción de las conductas de salud bucal aplicable a una muestra de adolescentes portugueses. Material y Métodos: Se diseñó un estudio observacional transversal con un total de 649 adolescentes de entre 12 y 18 años de cinco escuelas públicas de los distritos de Viseu y Guarda, en Portugal. La recolección de datos se realizó mediante la aplicación de un cuestionario autoadministrado y, tras el análisis de la recolección de datos, se creó la nueva escala de percepción de salud bucal de la Universidad Católica Portuguesa (UCP). El análisis estadístico se realizó utilizando el software SPSS-IBM versión 24.0 (IBM SPSS, Chicago, Il., EE. UU.). En el análisis estadístico descriptivo se utilizaron frecuencias absolutas y descriptivas para variables con nivel de medida nominal, media como medida de tendencia central y desviación estándar como medida de dispersión para variables de intervalo. Resultados: ha elaborado la percepción de conductas de salud bucal respetando los supuestos definidos por la presente escala. El resultado mostró que el 67% de la muestra presentó mala percepción de sus conductas de salud bucal, el 23,9% intermedia / suficiente, mientras que el 8,2% refiere tener buena percepción, respetando los supuestos definidos para la elaboración de la presente escala. Conclusión: Para ello, a través de la escala para clasificar el nivel de conductas de salud bucal aplicable a la muestra de adolescentes portugueses, es posible comparar los datos de varias muestras y comprender cuáles son los hábitos orales o alimentarios más frecuentes entre los adolescentes.

Dental caries and oral health behavior assessments among portuguese adolescents / Caries dental y evaluaciones del comportamiento de salud bucal en adolescentes portugueses

Introduction: Adolescents have a high risk of developing caries in Portugal. The present study is designed to assess dental caries experience among the adolescents by the application of DMFT index, characterize the oral health risk factors and to determine the association between caries experience and socio-demographic variables. The characterization of the oral health behaviors of adolescents of the central region of Portugal will help in the development of specific oral health education strategies to improve oral health among the local communities. Material and methods: A cross-sectional study was conducted among a convenient sample of 694 adolescents aged 12 to 18 years attending public schools in two Portuguese districts using a structured questionnaire designed to investigate oral health and behavior of participants. In addition, a clinical examination was carried out noting the decayed, missing and filled teeth. A descriptive analysis of the variables was performed using the Chi-square, Mann-Whitney and Kruskal-Wallis tests (p<0.05). A multivariate analysis was applied for analysis of the association between variables. Results: The mean DMFT index score of 2.91±2.9 was obtained. Of the total sample, 73% consumed sugary food daily, 50.1% considered having good oral health and 70.8% did not report pain in the last 12 months. Most adolescents (79.4%) brushed their teeth daily and 60% did not use dental floss. Of the total sample, 96.4% had a dental appointment in the last 12 months, 46.4% of which was for preventive purposes. Applying the Chi-square statistical test, we verified that the adolescents who brush their teeth daily presented a good perception about their oral health (p<0.001), the DMFT index scores were associated with the residence area (p=0.01) and the presence of dental caries was associated with the perception of oral health (p=0.049) and sugary food intake (p=0.029).Conclusion: Portuguese adolescents presented a low DMFT index. The DMFT index was associated with residence area, perception of oral health and sugary food intake. Daily toothbrushing was associated with self-perception of oral health. It is suggested that oral health promotion and prevention programs should aim to reduce the risks of oral disease development.

Introducción: Los adolescentes tienen un alto riesgo de desarrollar caries en Portugal. El presente estudio está diseñado para evaluar la experiencia de caries dental entre los adolescentes mediante la aplicación del índice CPOD, caracterizar los factores de riesgo para la salud bucal y determinar la asociación entre la experiencia de caries y las variables sociodemográficas. La caracterización de los comportamientos de salud bucal de los adolescentes de la región central de Portugal ayudará en el desarrollo de estrategias específicas de educación en salud bucal para mejorar la salud bucal entre las comunidades locales. Material y Métodos: Se realizó un estudio transversal en una muestra por conveniencia de 694 adolescentes de 12 a 18 años que asisten a escuelas públicas en dos distritos portugueses utilizando un cuestionario estructurado diseñado para investigar la salud bucal y el comportamiento de los participantes. Además, se llevó a cabo un examen clínico observando los dientes cariados, faltantes y obturados. Se realizó un análisis descriptivo de las variables mediante las pruebas de Chi-cuadrado, Mann-Whitney y Kruskal-Wallis (p <0,05). Se aplicó un análisis multivariado para el análisis de la asociación entre variables. Resultados: Se obtuvo la puntuación media del índice CPOD de 2,91 ± 2,9. Del total de la muestra, el 73% consumía alimentos azucarados diariamente, el 50,1% consideró tener buena salud bucal y el 70,8% no refirió dolor en los últimos 12 meses. La mayoría de los adolescentes (79,4%) se cepillaban los dientes a diario y el 60% no usaba hilo dental. Del total de la muestra, el 96,4% tuvo cita con el dentista en los últimos 12 meses, de la cual el 46,4% fue con fines preventivos. Aplicando la prueba estadística de Chi-cuadrado, verificamos que los adolescentes que se cepillan los dientes diariamente presentaban una buena percepción sobre su salud bucal (p <0.001), las puntuaciones del índice CPOD se asociaron al área de residencia (p = 0.01) y la caries dental se asoció con la percepción de salud bucal (p = 0,049) y con la ingesta de alimentos azucarados (p = 0,029). Conclusión: Los adolescentes portugueses presentaron un índice CPOD bajo. El índice CPOD se asoció con el área de residencia, la percepción de salud bucal y la ingesta de alimentos azucarados. El cepillado diario de los dientes se asoció con la autopercepción de la salud bucal. Se sugiere que los programas de promoción y prevención de la salud bucal deben ser enfocados en reducir los riesgos de desarrollo de enfermedades bucodentales.

Oral health behaviors, dental injuries and mouthguard awareness among a sample of portuguese athletes: a cross sectional study / Comportamientos de salud bucal, lesiones dentales y conciencia del uso de protectores bucales entre una muestra de atletas portugueses: estudio transversal

Aim: To determine the oral health behaviors, the prevalence of dental injuries, the level of information about first-aid procedures in the case of dental avulsion and the mouthguard awareness in a sample of Portuguese athletes. Materials and Methods: Cross-sectional researchamong 1,048 athletes from the district of Viseu, Portugal. A self-administered questionnaire included demographic data and questions about: I) oral hygiene habits, II) occurrence of orofacial trauma, III) use of mouthguards and IV) athletes' knowledge regarding first-aid management in case of dental avulsion was given. The comparison between different variables was made by Chi-square test with level of significant set at p-value ≤0.05. Results: The mean age of the sample (76.24% male) was 18.14±8.17 years. Overall, the results demonstrated a low use of dental floss (25.48%) and a high number of athletes (21.94%) that had not visited a dentist in more than a year. The prevalence of dental trauma was 5.06% and the most common dental injuries experienced by athletes were crown fractures (60.38%). Nearly half of the participants (45.23%) reported not knowing how to act following a dental avulsion. The rate of mouthguard use was very low (9.73%). There was a significant relationship between the prevalence of dental injuries and the use of mouthguards (p=0.000; Cramér's V=0.145). Conclusion: The prevalence of dental trauma in our population was low. A low number of athletes use a mouthguard and there is a lack of knowledge concerning dental trauma issues. Prevention programs and promoting actions among this population are important and should be adopted.

Objetivo: Determinar los comportamientos de salud bucal, la prevalencia delesiones dentales, el nivel de información sobre los procedimientos de primeros auxilios en el caso de la avulsión dental y el conocimiento de los protectores bucales en una muestra de atletas portugueses. Materiales y métodos: estudio transversal de 1048 atletas del distrito de Viseu, Portugal. Se utilizó un cuestionario auto administrado que incluyó datos demográficos y preguntas sobre: I) hábitos de higiene bucal, II) ocurrencia de traumatismos orofaciales, III) uso de protectores bucales y IV) conocimiento de los atletas sobre el manejo de primeros auxilios en caso de avulsión dental. La comparación entre diferentes variables se realizó mediante la prueba de chi-cuadrado con el nivel de significancia establecido en p≤0.05. Resultados: La edad promedia de la muestra (76,24% hombres) fue de 18,14±8,17 años. En general, los resultados demostraron un bajo uso de hilo dental (25,48%) y un alto número de atletas (21,94%) que no habían visitado un dentista en más de un año. La prevalencia de trauma dental fue de 5,06% y las lesiones dentales más comunes que experimentaron los atletas fueron las fracturas de corona (60,38%). Casi la mitad de los participantes (45,23%) informaron que no sabían cómo actuar después de una avulsión dental. La tasa de uso de protectores bucales fue muy baja (9,73%). Hubo una relación significativa entre la prevalencia de lesiones dentales y el uso de protectores bucales (p=0,000; V de Cramer=0,145). Conclusión: la prevalencia de trauma dental en nuestra población fue baja. Un número bajo de atletas usa un protector bucal y hay una falta de conocimiento sobre temas de trauma dental. Programas de prevención y acciones de promoción entre esta población son importantes y deben ser adoptados.

Gender and age differences in the sleep habits: a cross-sectional study in adolescents

OBJECTIVES: Analyze gender and age differences in sleep habits in a sample of adolescents. DESIGN: A cross-sectional study. SETTING: Public schools of Viseu, Portugal. PARTICIPANTS: Sample consisted of 7534 students, aged 11-20 years (mean age: 14.96 ± 1.81 years; 53.6% girls). Measurements: Data was collected using a self-administered questionnaire, answered in class and consists of questions to assess insomnia (DSM-IV criteria), sleep patterns, socio-demographic and daily habit variables. RESULTS: Mean sleep duration in this sample was 8.02 ± 1.13 h. Age interfered with sleep duration that decreased with the increasing of age, from 8.45 ± 1.14 h among 11/12 years old to 7.37 ± 1.04 h for ages ≥ 17 years old. Insomnia and symptoms of insomnia were associated with gender and with increasing of age. Nearly 80% of students reported daytime tiredness, 66.7% sleepiness during the day; 56.1% during classes and 47.6% reported waking up with headaches, all variables more prevalent among girls and older adolescents. CONCLUSIONS: The sleep problems and variables related to sleep have become more frequent among girls and with increasing age. We recommend that the promotion of sleep hygiene and prevention of the consequences should be encouraged in adolescents and their families, especially among the female gender and older adolescents

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Oral health attitudes and behaviours among Portuguese dental students

INTRODUCTION: Today's dental students are going to be the future dentists responsible for oral health education and promotion. Oral health professionals' attitudes and behaviours towards their own health reflect their understanding about the importance of oral problems prevention and may contribute to the improvement of their patients' oral health. OBJECTIVES: Evaluate oral health attitudes and behaviours (OHAB) among Portuguese students. MATERIALS AND METHODS: We conducted a cross sectional study in a sample constituted by 203 students of Portuguese Catholic University, Viseu. Data collection was performed through a self-administered questionnaire about OHAB, which included the Hiroshima University Dental Behavioural Inventory. RESULTS: We found that 69.5% of the students adopted less adequate OHAB. Only the year of the course influenced OHAB. Therefore, the higher the year, the better were OHAB. By calculating the variability, we found that the year was responsible for 8.87% of the variation in OHAB and the statistical differences were between the students of 1st and 4th year and 1st and 5th year. CONCLUSION: These results are consistent with some studies that point to the likely inluence of the exposure and acquisition of knowledge about OHAB transmitted along the academic education and clinical experience. As students' progress through the course, they are more aware and more attentive to their oral health. Consequently, they adopt better attitudes and preventive behaviours. It is very important to change the way we do oral health education. The planning of teaching strategies for oral health behavioural changes should give importance to teaching self-care techniques, towards to alert to the perception of risk factors what are in the origin of oral diseases

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Prevalence and determinants of oral microflora among Portuguese adolescentes

INTRODUCTION: The aim of the present study was to determine the prevalence and determinants of salivary Streptococcus mutans, Lactobacillus and Aggregatibacter actinomycetemcomitans and the associated risk of development of dental pathologies on a sample of Portuguese adolescents. MATERIALS AND METHODS: A cross-sectional study was designed including a final sample of 447 adolescents aged between 12 and 18 years old, attending a public school in Sátão, Portugal. A self-administered questionnaire was filled out by the adolescents. Clinical examination of oral health status was carried out and saliva collection was accomplished by the passive drool method. The identification of the different types of bacterial strains was accomplished using the Polymerase Chain Reaction technique. RESULTS: The prevalence of S. mutans in the studied sample was 99.5% Lactobacillus, 80.8% S. mutans and 15.2% A. actinomycetemcomitans. The presence of S. mutans was associated with gender (male = 76.1% vs female = 83.6%; P = .04) and dental pain in the presence of severe dental caries (77.3% vs 87.8%; P = .006). The infection with A. actinomycetemcomitans was associated with age (< 15 years = 12.3% vs ≥ 15 years = 20.3%; P = .03) and residence area (rural = 18.2% vs urban = 11.0%; P = .04), and may be related with a higher risk of periodontal disease development in adulthood. CONCLUSIONS: A. actinomycetemcomitans infection was found to be associated with socio-demographic variables, suggesting that, if not clinically well identified and treated, may cause serious oral diseases during adulthood. It has been described that the oral microflora is one of the main etiological factors for dental caries and periodontal diseases development, but cannot be considered in an isolated manner

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Prevalence and determinants of insomnia symptoms among schoolteachers

INTRODUCTION: Insomnia is the most common sleep disorder. In Portugal, teachers have a specific socioeconomic situation, caused by the distance between home and workplace, unstable job situation and students' behavioral problems. The aim of this study was to determine the prevalence of insomnia in a sample of Portuguese schoolteachers. Participants and methods: In a cross-sectional study 604 teachers were assessed of seventeen public schools, from the districts of Aveiro and Viseu, Portugal. Data was collected through a self-administered questionnaire. Insomnia had been defined according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as the presence of one or more of the following symptoms: a) difficulty initiating sleep; b) difficulty maintaining sleep; c) early morning awakening and difficulty getting back to sleep; d) non-restorative sleep, that lasts for a period of 1 month. RESULTS: Prevalence of insomnia symptoms in the sample was 40.6%. Prevalence of the variables difficulty initiating sleep, difficulty maintaining sleep, early morning awakening and difficulty getting back to sleep and non-restorative sleep were 14.3%, 28.7%, 19.7% and 20.7%, respectively. Insomnia symptoms had been associated with marital status (divorced; OR = 1.65; 95%CI, 0.78-3.48), years of teaching experience (10 to 20 years; OR = 0.46; 95%CI, 0.28-0.75) and job satisfaction (OR = 0.74; 95%CI, 0.53-1.0). CONCLUSION: Portuguese schoolteachers show a high prevalence of insomnia. Insomnia was associated with sociodemographic and occupational variables

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Eficácia da promoção da saúde oral no controlo do biofilme bucal / Oral health promotion efficiency in the control of oral biofilm / Eficácia de la promoción de la salud oral en el control del biofilm dental

Avaliar a eficácia das instruções de higiene oral, em particular no controlo dobiofilme dentário, bem como avaliar a eficácia do reforço dessas instruções. Métodos: Realizou-se estudo quasi-experimental na Clínica Universitária da Universidade Católica Portuguesa (UCP) em Viseu-Portugal, desenvolvido entre janeiro e junho de 2012. Efectuouse três avaliações a 30 indivíduos através do Índice de Placa de O?Leary e aplicação de questionário abordando o comportamento de saúde oral, com um mês de periodicidade entre cada medição. Na primeira avaliação, todos os indivíduos receberam as mesmas instruções de higiene oral, registo do Índice de Placa de O?Leary e aplicação do questionário. Na segunda avaliação, realizou-se um novo registo do índice a todos os indivíduos, mas apenas o grupo de intervenção (n=16) recebeu o reforço dessas instruções e na terceira avaliação executouse um novo registo a todos os indivíduos (n=30). Resultados: Tanto o grupo de intervenção como o controlo apresentaram uma redução do índice, mas aquele mostrou uma redução mais importante na última avaliação realizada quando comparada a este: 38,19% (n=16) vs. 69,57% (n=14), respectivamente (p<0,05). Relativamente à frequência de escovação dentária, no grupo de intervenção, 68,8% (n=11) escovavam pelo menos duas vezes por dia, enquanto no grupo de controlo apenas 57,1% (n=8) escovavam com a mesma frequência. Nesse caso, foram registadas diferenças significativas entre os dois grupos (p<0.05). Conclusão: A promoção da saúde oral por meio de instruções de higiene demonstrou ser eficaz na melhoria dos comportamentos de saúde e, consequentemente, no controlo do biofilme dentário...

To assess the efficacy of oral health instructions, particularly in the control of dental plaque, as well as assess the effectiveness of the reinforcement of the same instructions. Methods: A quasi-experimental study was conducted at the University Clinic of the Portuguese Catholic University (UCP) in Viseu-Portugal from January to June 2012. Three different assessments were performed with 30 participants using the O?Leary Plaque Index and a questionnaire on oral health behavior, with a one-month interval between each assessment. In the first assessment, all participants received the same instructions of oral hygiene and the O?Leary Plaque Index registration and the application of the questionnaire were performed; in the second assessment, a new registration of the O?Leary Index was made, but only the experimental group (n=16) received the reinforcement of oral health instructions, and in the third assessment, a new registration of the O?Leary Plaque Index was made for all the individuals (n=30). Results: Both control and experimental groups showed a decrease in the O?Leary Plaque Index, but the latter showed a more significant decrease in the last assessment: 38.19% (n=16) vs. 69.57% (n=14), p <0.05. Regarding the frequency of toothbrushing, in the experimental group, 68.8% (n=11) brushed the teeth at least twice a day, while in the control group only 57.1% (n=8) performed the same frequency of toothbrushing. In this case, statistically significant differences were found between the two groups (p<0.05). Conclusion: Oral health promotion through oral hygiene instruction was effective in improving oral health behaviors, and, consequentely, the control of dental biofilm...

Evaluar la eficacia de las instrucciones de higiene oral, en especial del control del biofilm dental así como evaluar la eficacia del refuerzo de dichas instrucciones. Métodos: Se realizó un estudio cuasi-experimental en la Clínica Universitariade la Universidad Católica Portuguesa (UCP) de Viseu- Portugal, desarrollado entre enero y junio de 2012. Se realizo tres evaluaciones en 30 individuos a través del Índice de Placa de O?Leary y la aplicación del cuestionario incluyendo la conducta de salud oral con un mes de intervalo para cada medición. Em la primera evaluación todos los individuos recibieron las mismas instrucciones de higiene oral, registro del Índice de Placa de O?Leary y la aplicación del cuestionario. En la segundaevaluación se realizó un nuevo registro del índice en todos los individuos pero solamente el grupo de intervención (n=16) recibió el refuerzo de esas instrucciones y en la tercera evaluación se hizo un nuevo registro de todos los individuos (n=30). Resultados: El grupo de intervención y el grupo control presentaron reducción del índice, pero el grupo de intervención mostro una reducción más importante en la última evaluación realizada al compararse al grupo control: el 38,19% (n=16) vs. el 69,57% (n=14), respectivamente (p<0,05). Respecto la frecuencia de cepillado dentario, en el grupo de intervención el 68,8% (n=11) cepillaban al menos dos veces al día mientras que en el grupo control solamente el 57,1% (n=8) cepillaban con la misma frecuencia.En ese caso, fueron registradas diferencias significativas entre los grupos (p<0.05). Conclusión: La promoción de la salud oral a través de instrucciones de higiene ha sido eficaz para la mejoría de conductas en salud y, por consiguiente, para el control Del biofilm dental...

Sleep patterns and insomnia among portuguese adolescents: a cross-sectional study

INTRODUCTION: Inadequate sleep patterns and insomnia are frequently linked and represent common sleep disorders among adolescents. The present study provides data on sleep patterns and insomnia among Portuguese adolescents. Material e methods: In a cross-sectional study we evaluated 6,919 students from the 7th to the 12th grade from twenty-six secondary schools. Data was collected using a self-administered questionnaire. Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and daytime sleepiness was assessed with the Epworth Sleepiness Scale. Sleep patterns evaluated both sleep duration ("insufficient" sleep was defined as < 8 hours per night) and bedtime schedules and regularity. RESULTS: The prevalence of insomnia was 8.3%, insomnia symptoms 21.4% and insufficient sleep 29.3%. All prevalence were higher among girls (P < .001). Average sleep time, on weeknights, was 8:04 ± 1:13 hours. On average adolescents went to bed at 22:18 ± 1:47 hours, took 21 minutes to fall asleep and woke up at 7:15 ± 0:35 hours. Only 6.4% of adolescents stated having a regular bedtime. The majority of adolescents (90.6%) reported having difficulty waking up, 64.7% experienced daytime sleepiness and 53.3% experienced sleep during classes. CONCLUSIONS: There are high prevalence of inadequate sleep patterns, insufficient sleep and insomnia among Portuguese adolescents. Insufficient sleep is associated with sleep patterns and social and behavioural factors. These results add to our knowledge of adolescent sleep worldwide

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