Ankyloglossia and Breastfeeding Duration: A Multicenter Birth Cohort Study.

Background and Objective: The prevalence of ankyloglossia and its impact on breastfeeding practices may be overestimated, leading to surgical overtreatment in newborns. The study was conducted to estimate the prevalence of ankyloglossia in the first year of life and investigate the association with exclusive and total breastfeeding duration in different regions of Brazil. Materials and Methods: This multicenter prospective cohort study involved the recruitment of mother-infant pairs soon after childbirth in public hospitals in three state capitals in Brazil. Interviews were held with the mothers after birth, at 6 and 12 months to collect sociodemographic variables and data on exclusive and total breastfeeding duration. At 12 months of age, the children were submitted to a dental examination for classification of the lingual frenulum using the Bristol Tongue Assessment Tool. Data analysis involved Poisson regression with robust variance, with the calculation of unadjusted and adjusted relative risk (RR). Results: The final sample was composed of 293 children. The prevalence of defined and suspected ankyloglossia was 1% and 4.8%, respectively, totaling 5.8% (confidence interval [95% CI]: 3.1-8.5). No significant difference was found in the prevalence of exclusive and total breastfeeding at 1, 4, and 6 months between children with defined/suspected ankyloglossia and those without ankyloglossia. The multivariable analysis showed that the probability of the child achieving 6 months of breastfeeding did not differ between groups (RR = 0.98; 95% CI: 0.79-1.23; p = 0.907). Conclusion: The prevalence of defined ankyloglossia was very low and defined/suspected ankyloglossia was not associated with exclusive or total breastfeeding duration. Clinical Trial Registration: Registered with clinicaltrials.gov (n° NCT03841123).

Primary Dentition Caries Patterns as Predictors of Permanent Dentition Caries: A Prospective Cohort Study.

The aims of this study were to estimate the risk of caries in the permanent teeth at 12 years of age and to describe the diagnostic accuracy of caries patterns in the primary dentition at age 4 years to predict caries at age 12 years. A prospective cohort study followed children from birth to age 12 years in the city of São Leopoldo, Brazil. Sociodemographic variables were collected at birth, and dental caries was measured at 4 and 12 years of age (n = 204). At 4 years, children were classified according to the presence of caries (cavitated and non-cavitated lesions), number of lesions, affected segment (anterior or posterior), and affected surface (occlusal, smooth, or proximal). Prediction of permanent dentition caries occurrence (DMFT ≥1) (primary outcome) involved Poisson regression with robust variance and standard diagnostic accuracy measures. The prevalences of caries at age 4 years (including non-cavitated lesions) and 12 years were 61.8% and 42.2%, respectively. All caries patterns in the primary dentition were associated with caries in the permanent dentition. In multivariable analysis, the strongest associations were carious lesions on the primary posterior teeth (RR 2.2; 95% CI 1.5-3.2) and occlusal surfaces (RR 2.1; 95% CI 1.4-3.0). Among patterns evaluated, the presence of any tooth with caries (cavitated or non-cavitated) had the highest sensitivity (73%), but any tooth with cavitated decay had the highest accuracy (67%). In conclusion, any dental caries experience in early childhood is strongly predictive of dental caries experience in early adolescence. Primary dentition carious lesions on the posterior teeth or occlusal surfaces and the presence of cavitated lesions were stronger predictors.

Exploring the risk factors for early-life sugar consumption: A birth cohort study.

BACKGROUND: Sugar consumption in early childhood is the primary cause of negative health outcomes, including early childhood caries. AIM: To investigate risk factors associated with early-life sugar consumption. DESIGN: Explanatory variables were collected at baseline of a birth cohort in Porto Alegre, Southern Brazil. At six months of age, data were collected on child feeding practices, including the number of foods and beverages containing sugar. Multivariate Poisson regression analysis with robust variance was performed. RESULTS: Virtually all children (98.3%) had consumed sugar by the age of 6 months. Multivariable analysis showed that the number of sweet items was significantly larger in children whose mothers were less than 20 years of age (MR = 1.19; 95% CI: 1.05-1.36), those from non-nuclear families (MR = 1.12; 95% CI: 1.04-1.20), those whose mothers had less than eight years of schooling (MR = 1.34; 95% CI: 1.20-1.50) and those whose mothers smoked (MR = 1.23; 95% CI: 1.13-1.35). Moreover, the number of sweet items was significantly lower among children who breastfed in the first hour of life (MR = 0.85; 95% CI: 0.76-0.95). CONCLUSION: Sugar consumption begins very early, especially in children with no access to breastfeeding in the first hours of life and those from younger, less educated, and smoking mothers.

Feeding frequency in infancy and dental caries in childhood: a prospective cohort study.

OBJECTIVES: Feeding patterns in infancy are plausible contributors to dental caries later in childhood, yet relatively few cohort studies have examined potential dietary risk factors at this age. This study aimed to investigate the associations between feeding frequency at age 12 months and caries prevalence at age 3 years. METHODS: In this prospective birth cohort of 345 Brazilian children, all foods and drinks consumed at age 12 months, including bottle-use and breastfeeding, were recorded using two 24-hour infant dietary recalls with mothers. The prevalence of early childhood caries (ECC) and severe ECC (S-ECC) at age 38 months were compared in groups defined according to 12-month feeding frequency, using regression models to adjust for sociodemographic characteristics and total carbohydrate intake. RESULTS: Independent of other variables, compared with children with infrequent bottle-use and breastfeeding at 12 months, at 38 months the ECC prevalence was 1.8-times higher in children breastfed more than three times/day (P = 0.001), 1.4-times higher in children bottle-fed more than three times/day (P = 0.07) and 1.5-times higher with combined high frequency of bottle and breastfeeding together (P = 0.04), but the association with consumption of other foods or drinks more than five times/day [risk ratio (RR) = 1.2; P = 0.10] was not statistically significant. Prevalence of S-ECC was significantly associated with frequent breastfeeding (RR = 2.4; P < 0.001) and with greater frequency of consumption of other foods or drinks (RR = 1.7, P = 0.001). CONCLUSIONS: High-frequency feeding in late infancy, including both bottle use and breastfeeding, were positively associated with dental caries in early childhood, suggesting possible early-life targets for caries prevention.

Amelogenesis imperfecta in a child with cerebral palsy / Amelogenese imperfecta em uma criança com paralisia cerebral

Amelogenesis Imperfecta (AI) is an inherited alteration that affects the enamel of primary and permanent teeth, with no systemic manifestations. Cerebral Palsy (CP) is a congenital condition that affects the central nervous system before the age of two, influencing the performance of activities usually conducted by children with normal development. The objective of this study was to describe the dental treatment performed in a 10-year-old child with both amelogenesis imperfecta and cerebral palsy. The family of the child sought the office of the extension project "Gaining Health: Dental Care for Patients with Disabilities" of the Lutheran University of Brazil, located in the city of Canoas, in search of aesthetic rehabilitation. Upon physical and radiographic examination, the AI diagnosis was confirmed. The use of physical restraint with the consent of the parents was necessary to perform dental care. The treatment began with orientations on oral hygiene and eating habits, in addition to supragingival scaling. Next, it was decided to cover the posterior teeth with glass ionomer and to reconstruct the anterior teeth with resin-based composite, using acetate crowns. In the follow-up of the case, an improvement in oral health and aesthetics of the patient was observed. Moreover, this report demonstrates that the complex dental care of disabled patients can be performed in an outpatient environment.

A Amelogênese Imperfeita (AI) é uma alteração hereditária que afeta o esmalte dentário dos dentes decíduos e permanentes, com ausência de manifestações sistêmicas. A Paralisia Cerebral (PC) é uma alteração congênita que afeta o sistema nervoso central antes dos dois anos de idade, dificultando o desempenho de atividades frequentemente realizadas por crianças com desenvolvimento normal. O objetivo deste estudo foi descrever o tratamento odontológico realizado em criança com 10 anos de idade com Amelogênese Imperfeita e Paralisia Cerebral. A família procurou a clínica do Projeto de Extensão "Conquistando Saúde: Atendimento odontológico à pacientes com deficiência" da Universidade Luterana do Brasil Canoas/RS em busca de reabilitação estética. Ao exame físico e radiográfico confirmou-se o diagnóstico de AI. A utilização de estabilização física com a concordância dos pais foi necessária para a realização do tratamento odontológico. O tratamento iniciou com orientações de higiene bucal, dieta e raspagens supra gengivais. Na sequência, optou-se pelo recobrimento com ionômero de vidro dos dentes posteriores e reconstrução dos anteriores com resina composta utilizando-se coroas de acetato. No acompanhamento do caso observou-se melhora na saúde bucal e estética da paciente. Além disso, este relato demonstra que o atendimento odontológico complexo em pacientes com deficiência pode ser realizado em ambiente ambulatorial.

Oral health-related quality-of-life scores differ by socioeconomic status and caries experience.

OBJECTIVES: (i) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience. METHODS: This study was a cross-sectional analysis of children in southern Brazil (n=456, mean age: 38 months) participating in an existing health centre-based intervention study. OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1-4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modelling, overall and within socioeconomic strata defined by maternal education, social class and household income. RESULTS: Caries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 vs dmft=0, a pattern that persisted regardless of family socioeconomic status (P for interaction: all >0.3). However, adjusted for dental status and sociodemographic characteristics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0) or in lower income households (ratio: 0.8; 95% CI: 0.6, 1.3). CONCLUSION: Dental caries was associated with negative child and family experiences and lower OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality-of-life impact at the same level of disease experience. Thus, subjective quality-of-life measures may differ under varying social contexts, with possible implications for service utilization, evaluating oral health interventions, or quantifying disease morbidity in low-SES groups.

Percepção de estudantes de graduação em Odontologia frente ao atendimento de pessoas com deficiência / Perception of Dental undergraduate students related to the attendance of special needs people or people with disabilities

O objetivo deste estudo foi identificar e analisar a percepção de estudantes frente ao atendimento de pessoas com deficiência no projeto de extensão "Conquistando saúde: atendimento odontológico de pessoas com deficiência" da Universidade Luterana do Brasil (ULBRA), em Canoas/RS. O delineamento do estudo foi qualitativo e envolveu 13 estudantes. Os dados foram obtidos por meio de entrevista semiestruturada realizada no ambulatório do curso de Odontologia por um pesquisador treinado e os dados foram analisados por análise de conteúdo. As questões versavam a respeito do conhecimento em relação a pessoas com deficiência, a motivação para participar do projeto e os sentimentos norteadores dos atendimentos. A maioria dos entrevistados modificou opiniões existentes sobre o que acreditavam ser uma pessoa com deficiência e seus sentimentos prévios aos atendimentos, acrescentando novos conceitos e sentimentos que fomentaram sua construção profissional. A oportunidade de vivenciar o atendimento odontológico de pessoas com deficiências ainda na graduação em Odontologia contribui para a formação de um profissional mais capacitado tanto técnica quanto emocionalmente. Com isto, há ampliação do atendimento, minimizando a dificuldade enfrentada por estes pacientes na busca pelo atendimento odontológico (AU).

This study aimed to identify and to analyze students' perceptions regarding the assistance of people with disabilities in the extension project "Conquering health: dental assistance of people with disabilities", of Universidade Luterana do Brasil (ULBRA) in Canoas/RS. It is a qualitative study developed with 13 students. Data were collected by a trained researcher using semistructured interviews in the Dental College Clinic and were analyzed with content analysis. The questions approached participants' knowledge regarding people with disabilities, their motivations to take part of the project, and feelings guiding their assistance. Most participants changed their opinions about what they believed to be a person with disabilities as well as their previous feelings towards assistance, adding new concepts and feelings that encourage professional performance. The opportunity to deeply experience dental assistance of people with disabilities while attending undergrad dentistry school contributes to the development of better professionals, both technically and emotionally. Therefore, there is an amplification of dental assistance, minimizing difficulties faced by patients with disabilities when looking for dental assistance (AU).

Feeding practices in infancy associated with caries incidence in early childhood.

BACKGROUND: Early-life feeding behaviors foretell later dietary habits and health outcomes. Few studies have examined infant dietary patterns and caries occurrence prospectively. OBJECTIVE: Assess whether patterns in food and drink consumption before age 12 months are associated with caries incidence by preschool age. METHODS: We collected early-life feeding data within a birth cohort from low-income families in Porto Alegre, Brazil. Three dietary indexes were defined, based on refined sugar content and/or previously reported caries associations: a count of sweet foods or drinks introduced <6-months (e.g., candy, cookies, soft drinks), a count of other, nonsweet items introduced <6-months (e.g., beans, meat), and a count of sweet items consumed at 12 months. Incidence of severe early childhood caries (S-ECC) at age 38 months (N = 458) was compared by score tertile on each index, adjusted for family, maternal, and child characteristics using regression modeling. RESULTS: Introduction to a greater number of presumably cariogenic items in infancy was positively associated with future caries. S-ECC incidence was highest in the uppermost tertile of the '6-month sweet index' (adjusted cumulative incidence ratio, RR, versus lowest tertile: 1.46; 95% CI: 0.97, 2.04) and the uppermost tertile of the '12-month sweet index' (RR: 1.55; 95% CI: 1.17, 2.23). The association was specific for sweet items: caries incidence did not differ by tertile of the '6-month nonsweet index' (RR: 1.00; 95% CI: 0.70, 1.40). Additionally, each one-unit increase on the 6-month and the 12-month sweet indexes, but not the 6-month nonsweet index, was statistically significantly associated with greater S-ECC incidence and associated with more decayed, missing, or restored teeth. Results were robust to minor changes in the items constituting each index and persisted if liquid items were excluded. CONCLUSIONS: Dietary factors observed before age 12-months were associated with S-ECC at preschool age, highlighting a need for timely, multilevel intervention.

Caries prevalence and need of student' s treatment

AIM: Investigating dental caries prevalence and the need of student's treatment in a small municipality. MATERIAL AND METHODS: A population composed by 217 students was studied, 161 (74.2%) from the urban zone and 56 (25.8%) from the rural zone, resident in Independência, Rio Grande do Sul. The indexes DMFT and dmft for dental caries were used, and the need of dentistry treatment was evaluated according to codes and criteria from Projeto SB Brasil, 2010. RESULTS: Regarding to the presence of dental caries, it was observed that 83.8% (93) of the students presented caries at 06 years old, and 94.3% (100) at 12 years old. The dmft at 6 years was 4.17 and DMFT at 12 years was 3.53. Regarding to the need of treatment, 71.8% (156) of students needed some type of attention, and the surface restoration was the most prevalent. CONCLUSION: High prevalence of dental caries was found, both at 6 and 12 years old (4.17 and 3.53) respectively, and 71.8% needed some type of treatment. The most prevalent treatments were dental surface restoration, dental extraction and sealing pits and fissures.

Exploring the impact of oral diseases and disorders on quality of life of preschool children.

OBJECTIVE: To assess the impact of oral health outcomes on Oral Health-Related Quality of Life (OHRQoL) in a school-based sample of Brazilian preschool children and their families. METHODS: A cross-sectional study was conducted in 1036 children aged 2-5 years attending all the public nurseries in Canoas, Brazil. Caregivers were asked to complete questionnaire on socioeconomic status and the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the children's OHRQoL. Clinical assessment included dental caries, traumatic dental injuries (TDI) and malocclusion. Multivariable Poisson regression models with robust variance were fitted to assess covariates for the prevalence of impacts on OHRQoL following a theoretical hierarchical framework. RESULTS: 17.4% of the caregivers reported that their child had an impact on at least one ECOHIS item. Negative impacts were more prevalent on items related to pain, difficult drinking and eating some foods. The multivariable Poisson regression analysis showed that dental caries, TDI and malocclusion were associated with the outcome. The prevalence of having any impact on OHRQoL was almost three times higher for children with dental caries (PR 2.74 95% CI 2.02-3.72) compared to those who were caries free; and approximately 1.5 times higher for those who presented TDI (PR 1.70 95% CI 1.27-2.27) and malocclusion (PR 1.42 95% CI 1.04-1.94). CONCLUSIONS: The findings showed that caregivers of young children with oral disease and disorders perceived that both the children and other family members had poorer quality of life. Oral health policies should be included into general health programs based on common risk approach.

Análise bibliométrica da produção científica da Revista da Faculdade de Odontologia da Universidade de Passo Fundo (RFO/UPF) / Bibliometric analysis of scientific production in the Revista da Faculdade de Odontologia da Universidade de Passo Fundo (RFO/UPF), Brazil

Objetivo: O objetivo do presente estudo transversal foi analisar o perfil das publicações da revista da Facul-dade de Odontologia da Universidade de Passo Fundo (RFO/UPF). Métodos: Foram feitas cópias dos resumos de cada artigo publicado no período de 1996 a 2010, totalizando 463 resumos. A categorização dos dados quanto ao delineamento metodológico, à especialida-de odontológica e à instituição de ensino superior de procedência dos autores foi feita por dois examinado-res independentes e os resultados, apresentados por meio da frequência de variáveis. Resultados: Os resul-tados mostraram que as especialidades odontológicas com maior número de publicações foram a dentística (14,7%) e a odontopediatria (10,8%). Os delineamen-tos mais utilizados foram estudos laboratoriais in vitro (30,5%), seguidos de estudos transversais (22,9%), re-latos de caso (19,4%) e revisões de literatura (19,2%). A instituição de ensino superior que mais publicou na revista foi a Unicamp (15,6%), seguida da UPF (12,1%) e PUCRS (11,9%). Conclusões: Conclui-se, que embo-ra a RFO/UPF tenha superado os problemas decorren-tes da endogenia, ainda são reduzidos os estudos com potencial de gerar evidências científicas e influenciar condutas clínicas.

Dens in dente bilateral: relato de caso e considerações de tratamento / Bilateral dens in dente: Case report and treatment considerations

Dens in dente é uma anomalia de desenvolvimento dentário caracterizada pela presença de tecidos calcificados, como esmalte e dentina, no espaço da cavidade pulpar. A invaginação destes tecidos mineralizados, antes da sua calcificação, é a causa mais provável desta anomalia. O dens in dente pode acometer qualquer dente, mas ocorre com maior frequência nos incisivos laterais superiores permanentes. Sua ocorrência normalmente é bilateral, mas não necessariamente simétrica. O objetivo deste trabalho é abordar os principais aspectos clínicos desta anomalia num paciente do sexo masculino, onze anos, portador de dens in dente nos quatros incisivos permanentes superiores. A partir do diagnóstico, o tratamento proposto foi o selamento nas fossas palatinas e a instrução de higiene bucal para os dentes acometidos.

Dens in dente is an anomaly of dental development with involves the presence of enamel and dentin mineralized dental tissue in the pulp cavit. The invagination of these mineralized tissues before their mineralization is the most probable cause of this anomaly. Dens in dente may occur in any tooth but it happens more frequently in permanent upper lateral incisors. The aim of this paper is to report a case of an eleven years old male patient with dens in dente on the four permanent upper incisors and discuss the most important aspects of this anomaly. The treatment adopted involved the use of sealant on the palatine fossas and oral hygiene orientation.