Effect of environmental and socioeconomic factors on the use of dental floss among children: a hierarchical approach.

The aim of this study was to evaluate the association of environmental and socioeconomic characteristics with the use of dental floss in preschool children. This cross-sectional study was conducted with a sample of 402 preschool children aged 1-5 years, from Santa Cruz do Sul, a Southern city in Brazil. Mothers answered questions about environmental, demographic, and socioeconomic characteristics. Behavior variables as use of dental floss (study outcome) and dental attendance were also evaluated. Poisson regression analysis with robust variance through a hierarchical approach was used to investigate the association of explanatory variables for use of dental floss. Prevalence ratio (PR) and 95% confidence intervals (95%CI) were estimated. The mean sample age was 3.32 years (standard deviation [SD] 1.10). Of the included children, 291 (73.12%) did not use dental floss. The environmental model indicated that children who attended daycare (PR 2.53; 95%CI 1.39-4.60) and those whose parents were members of volunteer networks (RP 1.58; 95%CI 1.02-2.46) were more likely to use dental floss. Children from families with higher income (PR 1.55; 95%CI 1.07-2.24) and maternal schooling (PR 2.21; 95%CI 1.31-3.74) presented a higher prevalence of dental floss use. Older children and those who attended dental services were also related to higher dental floss use. Our findings suggest that children who live in a supporting environment and those with a higher socioeconomic status are more likely to use dental floss.

Effect of environmental and socioeconomic factors on the use of dental floss among children: a hierarchical approach

Abstract The aim of this study was to evaluate the association of environmental and socioeconomic characteristics with the use of dental floss in preschool children. This cross-sectional study was conducted with a sample of 402 preschool children aged 1-5 years, from Santa Cruz do Sul, a Southern city in Brazil. Mothers answered questions about environmental, demographic, and socioeconomic characteristics. Behavior variables as use of dental floss (study outcome) and dental attendance were also evaluated. Poisson regression analysis with robust variance through a hierarchical approach was used to investigate the association of explanatory variables for use of dental floss. Prevalence ratio (PR) and 95% confidence intervals (95%CI) were estimated. The mean sample age was 3.32 years (standard deviation [SD] 1.10). Of the included children, 291 (73.12%) did not use dental floss. The environmental model indicated that children who attended daycare (PR 2.53; 95%CI 1.39-4.60) and those whose parents were members of volunteer networks (RP 1.58; 95%CI 1.02-2.46) were more likely to use dental floss. Children from families with higher income (PR 1.55; 95%CI 1.07-2.24) and maternal schooling (PR 2.21; 95%CI 1.31-3.74) presented a higher prevalence of dental floss use. Older children and those who attended dental services were also related to higher dental floss use. Our findings suggest that children who live in a supporting environment and those with a higher socioeconomic status are more likely to use dental floss.

O uso do fio dental reduz a ocorrência de sangramento gengival? / Does dental flossing reduce the occurrence of gingival bleeding?

Objetivos: tendo em vista a relevância da prevenção à gengivite, e consequentemente à periodontite, e a falta de consenso na literatura sobre a efetividade do fio dental como medida protetora ao sangramento gengival, este artigo buscou revisar a literatura objetivando responder a seguinte pergunta: "O uso do fio dental é efetivo para prevenir o sangramento gengival?". Material e métodos: revisões sistemáticas foram buscadas na base de dados Pubmed, sem limite de data e de linguagem. Resultados: duas revisões foram encontradas, e seus resultados foram sumarizados. Conclusão: a literatura científica sugere que o uso do fio dental associado à escovação é adequado para o controle do biofilme, e consequentemente, do sangramento gengival. Entretanto, essa evidência apresenta inúmeras limitações, e seus resultados precisam ser confirmados. Assim, são necessários mais estudos que demonstrem claramente o efeito do fio dental sobre o sangramento gengival.

Objectives: given the relevance of gingivitis prevention, and consequently periodontitis, and the lack of consensus in the literature on the effectiveness of dental floss as a protective measure of gingival bleeding, this article aimed to revise the literature in order to answer the following question: Is flossing effective in preventing gum bleeding? Material and methods: systematic reviews were searched on Pubmed database, with no limits for date and language. Results: two reviews were found, and their results were summarized. Conclusion: the scientific literature suggests that flossing associated with brushing is adequate for biofilm control, and consequently, for preventing gingival bleeding. However, this evidence has relevant limitations, therefore, these results need to be carefully considered. Thus, further studies are needed to clearly demonstrate the effect of dental floss on prevention of gingival bleeding.

Why do children and adolescents neglect dental flossing?

AIM: To identify the variables and actual difficulties related to children and adolescents' non-compliance with dental flossing. METHODS: This cross-sectional study with 36 children and 59 adolescents were selected from dental clinics at the Dental School, University of São Paulo. The percentage of surfaces with disclosed biofilm was used to evaluate general oral hygiene. Participants answered questions concerning dental flossing (difficulties, self-reported motivation, and previous instruction). An examiner observed how the participants flossed their teeth and their possible faults. Univariate and multiple logistic regression analyses were performed and odds ratio values were calculated in order to verify the association between non-compliance (or difficulties) with flossing and possible reasons for that. RESULTS: Similar non-compliance with daily flossing was observed among children and adolescents (p = 0.95). Children's flossing negligence was strongly associated with self-reported laziness in flossing (p = 0.02), and negatively associated with their previous practice by some dentists (p = 0.009). Self-described difficulties in flossing also showed an association with laziness in flossing (p = 0.03). No association was found between negligence of flossing and all variables tested among adolescents (p ≥ 0.05). CONCLUSIONS: Low compliance and difficulties in flossing among children and adolescents seemed to be more related to lack of motivation, although problems concerning manual skills were also observed.

Levantamento transversal da relação do índice de placa com o grau de escolaridade, idade e frequência do uso do fio dental e escova em pacientes de 31 a 69 anos de idade / The relationship of plaque index, educational degree, age, and frequency of dental fl oss in patients from 31 to 69 years-old ­ a cross-sectional study

Objetivo: estudar o índice de placa e a sua correlação com a técnica de higiene empregada, com o grau de escolaridade, idade, frequência e o conhecimento sobre a higiene oral. Material e métodos: em uma amostra da população da cidadede Divinópolis/MG, foi aplicado um questionário específico sobre os hábitos de higiene oral. O exame clínico foi realizado com sonda milimetrada, e a placa evidenciada pelo corante. Todos os pacientes foram divididos em quatro faixas etárias e receberam reforço na higiene oral. As possíveis associações entre os critérios foram investigadas com o teste Qui-quadrado. Resultados: 216 pacientes (86 homens, 130 mulheres) foram incluídos. No total, 5.853 dentes e 23.412 faces foram analisados. O nível de placa variou de 54,29% (60-69 anos) a 60,10% (40-49 anos), e as faces interproximais foram as mais coradas (83,27%). Um total de 140 pacientes não tinha realizado tratamento periodontal prévio; dos 76 pacientes com tratamento prévio, 34 não haviam sido instruídos sobre a higiene oral. Metade dos pacientes relatou usar a escova dental três vezes ao dia; 1/3 dos pacientes usavam o fio dental duas vezes e estavam no ensino médio. Conclusão: 1) há necessidade de uma campanha maciça sobre a importância da escova dental e do fio dental, e como usá-los; 2) os menores índices de placa estão nos indivíduos de grau superior; 3) as faces proximais coradas confirmam a falta de uso do fio dental, principalmente nos pacientes que foram submetidos ao tratamento periodontal, por ausência de informação profissional.

Objective: to study the plaque index and possible correlations with oral hygiene, educational levels, age, and frequency of dental flossing. Material and methods: a patient sample from Divinopolis/MG received an appropriate questionnaire survey regarding their oral hygiene habits. The clinical exam was made with a periodontal probe and a disclosing agent. All patients were divided according to 4 age conditions and receive further oral instructions. Possible associations were investigated with the Chi-square method. Results: 216 patients (86 men, 130 women) were included. Overall, 5,852 teeth and 23,412 surfaces were examined. Plaque levels varied from 54.29% (60-69 years) to 60.10% (40-49 years), being most prevalent at the proximal surfaces (83.27%). 140 patients did not have previous periodontal treatment; from 76 patients under active periodontal treatment, 34 had no oral hygiene instructions. Half of the patients reported the use of toothbrushing 3 times a day; 1/3 of patients reported flossing twice a day. Conclusion: 1) a massive campaign is needed to underscore the importance of oral hygiene and dental floss, 2) the lowest plaque scores were observed in people with higher education, 3) the proximal surfaces confirmed the lack of dental floss, particularly in patients under periodontal treatment due to the lack of professional information.

Self-reported Use of Dental Floss over 13 Years: Relationship with Family Income, Mother's Age and Educational Level.

PURPOSE: To determine whether family income, age and educational level of the mother of the family are associated with self-reported use of dental floss over a 13-year period in a city in southern Brazil. MATERIALS AND METHODS: A comparison of two household surveys was carried out where mothers of the family were interviewed using a structured questionnaire in order to obtain demographic, behavioural and socioeconomic information. In total, 852 and 984 households were included in 1996 and 2009, respectively. Self-reported use of dental floss was assessed dichotomously (yes/no). Poisson regression models were fitted to study the association between sociodemographic variables with the use of dental floss. Proportion ratios (PR) and 95% confidence intervals (95% CI) were reported. RESULTS: The proportion of dental floss use increased from 48% to 59% over 13 years. The probability of dental floss use increased 1.23 times from 1996 to 2009 (PR = 1.23; 95% CI 1.13-1.34). Households with mothers ≥50 years old presented a 28% lower probability of using dental floss than households with mothers ≤35 years old. In households with higher family income and higher educational level of the mother, probabilities of flossing were 90% and 97% higher. CONCLUSION: Family income, age and educational level of the mother of the family are associated with self-reported use of dental floss over 13 years.

BMP2 Is Associated with Caries Experience in Primary Teeth.

Bone morphogenetic proteins (BMPs) play an important role during the initial process of enamel development and therefore may play a role in caries susceptibility. The purpose of this study was to evaluate the association between the polymorphisms in the BMP2, BMP4 and BMP7 genes and their association with caries experience and primary enamel microhardness characteristics. DNA from buccal cells as well as clinical and demographic information from 1,731 subjects from three different data sets from Brazil were included. Polymorphisms in BMP2, BMP4 and BMP7 were analyzed by real-time polymerase chain reaction from genomic DNA. Association between caries experience, genotype, and allele distribution in both cohorts was evaluated using χ(2) and logistic regression analyses. In the family-based set, the association between caries experience and alleles was tested using the transmission disequilibrium test. In the Rio de Janeiro cohort, microhardness data on 108 exfoliated primary teeth before and after demineralization and remineralization challenges was included. Associations between microhardness values and genotype and allele distribution were evaluated using χ(2) and logistic regression analyses. Differences between caries experience and some risk factors were statistically significant. In the cohort from Nova Friburgo, BMP2 was associated with caries experience in primary dentition during logistic regression analysis (p = 0.023; OR = 2.58; 95% CI 1.13-5.86). There was no association between genotype and allele distribution for BMP polymorphisms and primary enamel microhardness alterations. Our result suggests that BMP2 may be involved in caries experience in primary dentition from a Nova Friburgo cohort.

Oral Health Education Program on Dental Caries Incidence for School Children.

OBJECTIVE: This 3-year retrospective controlled clinical trial assessed the effect of a school-based oral health education program on caries incidence in children. STUDY DESIGN: A total of 240 students, aged 5 to 7 years, from two public schools in Monte Sião, Brazil, were included in this study. A school-based oral health education program was developed in one of the schools (experimental group), including 120 students, while the 120 students from the other school did not participate in the program (control group). All children were initially examined for dental caries (dmf-t), and after 3 years, 98 children from the experimental group and 96 from the control group were again examined and answered a questionnaire on oral health issues. The between-groups difference in caries incidence on permanent teeth was calculated using Poisson regression analyses. Logistic regression was used to observe the association between caries incidence and other variables. RESULTS: More students from the experimental group stated knowing what was dental caries and declared that they use dental floss daily, but no significant differences in caries incidence was observed between the experimental and control groups. CONCLUSION: The school-based oral health education program is not adequately efficient to decrease caries incidence after three years, but some issues about oral health knowledge could be slightly improved.

Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment.

OBJECTIVE: The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. METHODS: A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. RESULTS: The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. CONCLUSION: Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment.

[Oral hygiene customs in 6-12 year old schoolchildren]. / Uso de auxiliares para la higiene bucal y su distribucion por edad u sexo en escolares de seis a 12 anos de edad.

OBJECTIVE. To characterize utilization of oral hygiene devices and customs in schoolchildren. MATERIAL AND METHODS. We performed a cross-sectional study in 1,404 schoolchildren (6- 12 year olds) from 14 public schools in Pachuca, Hidalgo, México, using a questionnaire for sociodemographic variables and 1) Tooth brushing frequency (<1/d vs. at least 1/d), 2) Use of toothpaste (not always vs. always), 3) Flossing (never, does not know vs. at least 1/week), 4) Use of mouthwash (never, does not know vs. at least 1/week). Analyses were performed with nonparametric tests. RESULTS. Mean age was 8.97 ± 1.99 years; 50.1% were male. Prevalence of utilization of oral hygiene devices and associated customs were 85.5% tooth brushing, 90.9% toothpaste, 19.4% flossing, and 28.2% mouthwash. Only 11.8% of participants reported utilization in all 4 categories. We observed differences (p < 0.05) across sexes only in the use of toothpaste, as women used it more often. Differences across age were observed (p < 0.05) for tooth brushing (younger children brushed more often) and flossing (older children flossed more often). CONCLUSIONS. Tooth brushing was the oral hygiene practice more often performed in this sample, with other frequencies being relatively low. There were differences by age and sex across some variables.

Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment

OBJECTIVE: The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. METHODS: A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. RESULTS: The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. CONCLUSION: Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment. .

OBJETIVO: o objetivo desse estudo foi verificar a associação entre volume gengival (AG) com condições periodontais e características sócio-demográficas em sujeitos com aparelho ortodônticos fixo. MÉTODOS: uma amostra, de 330 participantes com aparelho ortodôntico fixo, por pelo menos seis meses, foi examinada, por um único examinador calibrado, para os índices de placa e gengivais, profundidade de sondagem, nível de inserção clínico e aumento de volume gengival. O status socioeconômico, tempo com aparelho ortodôntico fixo e uso de fio dental foram verificados por entrevista oral. A verificação das associações foi realizada por meio de modelos de regressão de Poisson sem ajuste e ajustados. RESULTADOS: a presença de sangramento gengival (RR 1.01; 95% IC 1.00-1.01) e o excesso de resina em torno dos braquetes (RR 1.02; 95% IC 1.02-1.03) foram associadas a um aumento do AG. Não foram encontradas associações entre características sócio-demográficas e AG. CONCLUSÃO: sangramento gengival proximal na região anterior e excesso de resina no entorno dos braquetes estão associados a níveis mais altos de aumento de volume gengival na região anterior em sujeitos com aparelho ortodôntico fixo. .

Association among oral health parameters, periodontitis, and its treatment and mortality in patients undergoing hemodialysis.

BACKGROUND: Chronic periodontitis (CP) is a continuous, reversible source of inflammation with a potential impact on mortality in patients undergoing hemodialysis (HD). This study investigates the impact of oral health indicators, CP, and its treatment on survival rates in a group of patients undergoing HD. METHODS: Clinically stable patients undergoing HD were referred for a dental examination. All patients were prospectively followed in the dialysis clinic, and all-cause mortality was recorded. Three groups of patients were analyzed: those who received CP treatment, those who did not, and patients without CP as a control group. RESULTS: A total of 122 patients (79 males and 43 females, aged 23 to 77 years; mean age: 50 years; range: 23 to 77 years) were enrolled. Forty percent reported having rarely been evaluated by a dentist, and 59% had CP. There were 34 fatal events during a mean follow-up time of 64.1 ± 11.2 months. Oral factors associated with death in the univariate analysis were decreased frequency of dental visits; non-use of dental floss; increased decayed, missing, and filled teeth index; presence of CP; and absence of CP treatment. Patients with CP had a higher risk of death from all causes compared with patients without CP in the univariate analysis for untreated patients (hazard ratio 2.65 [95% confidence interval 1.06 to 6.59]; P = 0.036) and to a lesser extent for treated patients (2.36 [1.01 to 5.59]; P = 0.047). These significant differences were not maintained after adjustments for confounders in the multivariate model. CONCLUSIONS: These results suggest that poor oral health, including CP, is a common finding in patients undergoing HD. The results of this study call for intervention trials to test the hypothesis that treatment of CP improves survival in maintenance of patients undergoing HD.

Multilevel analysis of the association between posterior restorations and gingival health in young adults: a population-based birth cohort.

OBJECTIVE: To investigate the association of direct posterior restorations with gingival bleeding and dental calculus in young adults from a birth cohort. METHODS: A representative sample (n = 720) of 5914 infants born live in Pelotas, Brazil, in 1982, were prospectively investigated, and posterior restorations and periodontal health outcomes assessed when they were 24 years of age. Tooth-level exploratory variables included the presence and number of restoration's surfaces. Demographic and socio-economic characteristics, oral health instructions, dental floss usage, dental caries presence and smoking were also considered whilst gingival bleeding and dental calculus were the outcomes. Multilevel logistic regression was carried out. RESULTS: Class I cavities were found in 15.2% (95% CI 14.5-15.9) of the teeth and class II in 3.6% (3.3-4.0). Percentage of teeth with gingival bleeding was 6.1% (5.6-6.6) and that with dental calculus 22% (21.2-22.8). Even after all the individual variables were controlled for, the presence of a class I [OR1.51 (1.14-2.00)] and class II [OR 1.76 (1.04-2.97)] cavities was positively associated with gingival bleeding. Class I [OR1.36 (1.13-1.65)] and Class II [OR1.80 (1.28-2.53)] cavities were associated with dental calculus also. CONCLUSIONS: Posterior restoration and higher number of restored surfaces was associated with a higher prevalence of gingival bleeding and dental calculus around the restoration.

Frequency of mechanical removal of plaque as it relates to gingival inflammation: a randomized clinical trial.

AIM: This single blind, randomized clinical trial evaluated the relationship between frequency of mechanical removal of plaque (MRP) and gingival inflammation. MATERIALS & METHODS: Fifty-two patients (maximum 5% of sites with gingival bleeding and no history of periodontitis) were randomized to different frequencies of MRP: 12, 24, 48 and 72 h. Plaque index (PlI) and gingival index (GI) were evaluated at baseline, 15 and 30 days. Intra- and inter-group differences were determined by repeated measures anova and mixed models anova, respectively, both followed by Tukey's test. RESULTS: The mean GI between baseline and 30 days remained statistically unchanged in the 12 h (0.51 ± 0.17 versus 0.63 ± 0.23, p = 0.137) and 24 h (0.43 ± 0.19 versus 0.59 ± 0.21, p = 0.052) groups, but increased significantly in the 48 h (0.48 ± 0.18 versus 0.84 ± 0.21, p = 0.001) and 72 h (0.55 ± 0.20 versus 0.94 ± 0.25, p = 0.000) groups. At 30 days, the average percentage of sites with GI scores of 1 and 2 was significantly higher in the 48 and 72 h than in the 12 and 24 h groups (p < 0.05). CONCLUSIONS: Frequencies of mechanical removal plaque up to 24 h may prevent an increase in the severity of gingival inflammation over a period of 30 days in patients with no history of periodontitis.

Risk factors for gingivitis in a group of Brazilian schoolchildren.

OBJECTIVE: Studies on gingivitis in children and adolescents are scarce and the results are inconclusive. The aim of this study was to assess the prevalence and extension of gingivitis and associated factors in Brazilian schoolchildren. METHODS: Cross-sectional data from 1,211 schoolchildren 8 to 12 years old from Southern Brazil in 20 public and private schools were analyzed. Socioeconomic, demographic, and oral hygiene habits were assessed by questionnaires answered by parents and children. Buccal examination assessed presence of plaque, crowding, and gingivitis. Data were analyzed using Poisson regression [prevalence ratio (PR); 95% confidence interval (CI)]. RESULTS: Prevalence of visible plaque was 89.7% (95% CI 88.0-91.3) and gingival bleeding on probing was 78.4% (95% CI 76.1-81.0). The mean and median numbers of sites with gingival bleeding were 3.10 and 2 (SD ± 3.22), respectively. In multivariate adjusted analysis, the presence of a greater number of sites with plaque was significantly associated with gingivitis (PR 1.26; 95% CI 1.07-1.47) and its extension (PR 1.96; 95% CI 1.53-2.51). Lighter-skinned black children had a lower probability of having severe gingivitis (PR 0.69; 95% CI 0.48-0.98) compared with white children. This association was observed after adjusting for other variables. CONCLUSIONS: Gingivitis was associated with higher number of sites with plaque and with skin color, reflecting the influence of biological and demographic factors on this oral condition.

Periodontal disease, hypertension, and blood pressure among older adults in Puerto Rico.

BACKGROUND: Current scientific evidence addressing the relationship between periodontitis and hypertension is limited to studies producing inconsistent results. METHODS: All participants of an ongoing representative cohort of Puerto Rican elderly who were ≥70 years old and residing in the San Juan metropolitan area were invited to this cross-sectional study. Periodontal probing depth (PD) and attachment loss (AL) were summarized using the Centers for Disease Control and Prevention and the American Academy of Periodontology definition for severe periodontitis (≥2 teeth with AL ≥6 mm and ≥1 tooth with PD ≥5 mm). Three repeated blood pressure (BP) measurements taken were averaged using a standardized auscultatory method. Information on hypertension history, use of antihypertensive medications, and potential confounders (age, sex, smoking, heavy and binge drinking, diabetes, use of preventive dental services, flossing, body mass index, consumption of fruits, vegetables, whole wheat bread, and high-fiber cereal) was collected during in-person interviews. High BP was defined as average systolic BP ≥140 mm Hg or diastolic ≥90 mm Hg. Multivariate logistic regression models were used to study the relationship between severe periodontitis, hypertension history, and high BP. RESULTS: The study population comprised 182 adults. In multivariate analysis, there was no association between severe periodontitis and hypertension history (odds ratio [OR] = 0.99; 95% confidence interval [CI]: 0.40 to 2.48). Severe periodontitis was associated with high BP, with OR of 2.93 (95% CI: 1.25 to 6.84), after adjusting for age, sex, smoking, and binge drinking. This association was stronger when restricted to those with hypertension or taking antihypertensive medications: OR = 4.20 (95% CI: 1.28 to 13.80). CONCLUSION: The results of this study suggest that periodontitis may contribute to poor BP control among older adults.

Dental caries and fluorosis prevalence and their relationship with socioeconomic and behavioural variables among 12-year-old schoolchildren.

PURPOSE: To evaluate caries experience and fluorosis prevalence in 12-year-old schoolchildren in Piracicaba, Brazil in 2007 and to verify the relationship of these changes with socioeconomic and behavioural variables. MATERIALS AND METHODS: The sample consisted of 724 schoolchildren from public and private schools. A calibrated dentist performed the examination under natural light using CPI probes and mirrors. The mean number of decayed, missing and filled permanent teeth (DMFT) and the SiC (Significant Caries Index) were determined for dental caries and the Thylstrup and Fejerskov index (T-F) for fluorosis. Socioeconomic and behavioural variables were collected by means of a questionnaire. Multiple logistic regression analyses were performed to verify the relationship of caries and fluorosis with socioeconomic and behavioural variables. RESULTS: The DMFT and SiC indices were 0.85 (±1.54) and 2.52 (±1.72). Fluorosis prevalence was 29.42%. The regression models showed that children whose families earned up to four minimum wages were 2.58 times more prone to having caries than those whose families earned over four minimum wages. Furthermore, children who visited the dentist were 4.27 times more likely to have DMFT > 0. However, for fluorosis, the regression model was not significant. CONCLUSIONS: The 12-year-old schoolchildren in Piracicaba presented very low caries prevalence. Significant associations were observed between the presence of caries, monthly family income and visiting the dentist. Considering dental fluorosis, the majority of the sample presented no clinical signs of fluorosis.

Sickle cell disease does not predispose to caries or periodontal disease.

This study investigated the prevalence of dental caries and periodontal condition in a population with sickle cell disease (SCD), analyzing some associations with disease severity. The Decayed, Missing and Filled Teeth index (DMFT) and Community Periodontal Index (CPI) were recorded for 99 individuals with SCD and 91 matched controls. Socio-demographic status, oral health behaviors, and history of clinical severity of SCD were assessed. Statistical comparisons were performed between the group with SCD and the control group, as well as multivariate logistic regression analyses with DMFT index and CPI as the dependent variables. The mean number of decayed teeth was significantly higher in individuals with HbSS. Older age, female gender, and daily smoking were identified as risk factors for higher DMFT, while older age and absence of daily use of dental floss were risk factors for the development of periodontal disease. In conclusion, risk factors known to cause caries and periodontal disease had more influence on oral health than the direct impact of SCD.

Avaliação do fluxo e direcionamento do jato de água do sistema de refrigeração de turbinas de alta rotação / Evaluation of the flow and direction way of the water spray high-speed handpieces

O desgaste da dentina por turbinas de alta rotação pode produzir calor excessivo e comprometer o tecido pulpar. O objetivo da pesquisa foi avaliar o fluxo e o direcionamento da água das turbinas de alta rotação antes do uso clínico pelos alunos do Curso de Odontologia da Universidade Federal de Uberlândia. Sessenta turbinas de alta rotação tiveram fluxo e direção da água expirada avaliados. A avaliação do direcionamento do jato de spray ar/água foi feita através de uma documentação fotográfica com a turbina de alta rotação acionada, considerando-se direcionamento adequado quando o mesmo atingia diretamente a parte ativa da broca. O fluxo e o volume de água expirado por cada aparelho examinado foi verificado por meio do acionamento da turbina de alta rotação sobre um frasco graduado tipo Becker durante um minuto. Para avaliação do volume de água liberado, foi considerado fluxo adequado um volume de água maior ou igual a 30 ml por minuto. Os resultados da análise estatística demonstraram que 88,33% das turbinas apresentaram fluxo adequado e apenas 23,33% direcionamento adequado. Maior atenção deve ser dada ao direcionamento do fluxo de água das turbinas de alta rotação.

The dentin wear by high-speed handpieces can produce excessive heat and compromise the pulp tissue. The research aimed to evaluate the flow and direction of the water spray high-speed handpieces before clinical use by students of Dentistry, Federal University of Uberlandia. Sixty high-speed handpieces had flow and direction of water expired evaluated. The assessment of the direction of the jet of air / water spray was made by a photographic documentation with high-speed handpiece driven, considering the appropriate direction when it hit directly on the active part of the bur. The flow and volume of water exhaled by each turbine examined was assessed through the drive highspeed handpiece on a Becker type flask for one minute. To evaluate the volume of water released was considered an adequate flow volume of water greater than or equal to 30 ml per minute. The statistical analysis results showed that 88.33% of the turbines had adequate flow and only 23.33% adequate direction. Greater attention should be given to the direction of flow of water from high-speed handpieces

Caries status and proximal lesion behaviour during a 6-year period in young adult Danes: an epidemiological investigation.

Studies have indicated that many initial proximal caries lesions progress and are eventually restored even if the patients have been under comprehensive preventive programmes. The objectives of the study were (1) to describe the 1996-year baseline caries status of male Danish conscripts and (2) to assess their early proximal lesions 6-year behaviour. In 1996, all 20-year-old conscripts at Central Barrack Birkerød (n = 115) went through an oral examination, including visual surface-level fillings' recording and a radiographic examination with bitewing radiographs that assessed the proximal-surface caries and restoration patterns. After 6 years, the behaviour of proximal lesions was studied in 73 of these subjects, and oral health habits were assessed through a questionnaire. Mean number of filled surfaces was 7.5, of which 23% were posterior proximal. Radiographically, the mean number of proximal lesions was 5.5. Over the 6-year period, there was progression of lesions into deeper radiolucencies or fillings in 57% of cases. The questionnaire showed a poor compliance with regular flossing/tooth-stick use (18%). Based on these results, more efficacious preventive measures seem to be needed for proximal surfaces.