Caries en niños. ¿Maltrato infantil o ignorancia parental? / Caries in children. Child abuse or parental ignorance?

El maltrato infantil es un tema polémico en la actualidad, y se caracteriza por realizar acciones u omisiones intencionales destinadas a menoscabar o afectar la integridad física y/o psicológica de un menor. Frecuentemente se considera a la caries en niños como un indicador objetivo de maltrato infantil. La caries es una enfermedad extremadamente común en la población infantil en México y en el mundo, por lo que su relación con el maltrato infantil carece de un sustento real. El desarrollo de caries en niños no es un evento premeditado ni intencional, es más bien la consecuencia de malos hábitos higiénicos y dietéticos que el odontólogo tiene la obligación de corregir y erradicar para asistir a los pacientes pediátricos a recuperar su salud bucodental. El objetivo del presente artículo es debatir la relación entre la caries temprana de la infancia y el maltrato infantil (AU)

Child abuse is currently a controversial issue and is characterized by intentional actions or omissions intended to undermine the physical and/or psychological integrity of a minor. Caries in children is often considered an objective indicator of child abuse. Caries is an extremely common disease in the child population in Mexico and in the world, so its relationship with child abuse lacks any real support. The development of cavities in children is not a premeditated or intentional event, it is rather the consequence of poor hygienic and dietary habits that the dentist has the obligation to correct and eradicate in order to assist pediatric patients to regain their oral health. The aim of this article is to discuss the relationship between early childhood caries and child abuse (AU)

The influence of television on the food habits of schoolchildren and its association with dental caries.

OBJECTIVES: The consumption of food with a high-sugar content is encouraged by the food industry through television (TV) aimed at children and may be associated with dental caries. This study aims to evaluate the influence of TV on the food habits of schoolchildren aged years and its association with dental caries. MATERIAL AND METHODS: This was an observational, epidemiological, and cross-sectional study. Five neighborhoods of Belem District were selected, and then two schools from each neighborhood were drawn (one private and one public). All sixth and seventh grade students were selected. Data were extracted from questionnaires completed by schoolchildren and their parents and the decayed, missing, and filled teeth (DMFT/dmft) indices of the schoolchildren. The indices were carried out by three examiners previously calibrated (κ > .80). Logistic regression analysis was performed to investigate the association of variables of study with consumption of cariogenic foods and occurrence of dental caries. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Schoolchildren who watched TV for >90 min were more likely to consume cariogenic foods (OR = 2.38; 95% CI [1.57, 3.60]) and have a DMFT + dmft >1 (OR = 2.10; 95% CI [1.37, 3.26]). Those who consumed cariogenic foods while watching TV were more likely to have DMFT + dmft >1 (OR = 14.75; 95% CI [8.24, 6.40]). Parents who bought foods they saw on TV contributed to a higher consumption of cariogenic foods (OR = 3.29; 95% CI [2.07, 5.24]) and DMFT + dmft >1 (OR = 3.93; 95% CI [2.09, 7.37]) among their children. CONCLUSIONS: TV can influence the eating habits of schoolchildren aged 10 to 12 and the food purchases of their parents, stimulating the consumption of cariogenic foods and contributing to the development of dental caries.

The role of human milk and sucrose on cariogenicity of microcosm biofilms.

This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Enfermedades bucales y factores de riesgo en la población geriátrica perteneciente a un consultorio médico / Oral diseases and risk factors in the geriatric population of a family doctor's office

Se realizó un estudio descriptivo y transversal, desde noviembre de 2016 hasta abril de 2017, de los 166 adultos mayores pertenecientes al consultorio médico No 20 del Policlínico Carlos Juan Finlay del municipio de Santiago de Cuba, para evaluar la presencia de enfermedades bucodentales y los factores de riesgo. Para la recolección de la información se utilizó la encuesta de salud bucal de la Organización Mundial de la Salud y la historia de salud bucal familiar. Los hábitos nocivos como la deficiente higiene bucal y la dieta cariogénica, además de las enfermedades crónicas no transmisibles, fueron los factores de riesgo más comunes en esta población, en quienes la disfunción masticatoria y la caries dental constituyeron los problemas principales

A descriptive and cross-sectional study of 166 elderly belonging to the family doctor office No 20 of Carlos J Finlay Polyclinic in the municipality of Santiago de Cuba, was carried out from November, 2016 to April, 2017, to evaluate the presence of oral-dental diseases and risk factors. The survey of oral health from the World Health Organization and the medical record of family oral health were used for gathering the information. Harmful habits as poor oral hygiene and a cariogenic diet, besides non communicable chronic diseases, were the most common risk factors in this population, for whom masticatory dysfuntion and dental decay constituted the main problems

The role of human milk and sucrose on cariogenicity of microcosm biofilms

Abstract This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Prevalencia y factores de riesgo de caries dental en pacientes del municipio Urbano Noris / Prevalence and Risk Factors of Dental Caries in Patients of Urbano Noris Municipality

Introducción: la caries dental es una enfermedad multifactorial de alta prevalencia en el municipio Urbano Noris.Objetivo: determinar la prevalencia de caries dental e identificar sus principales factores de riesgo.Métodos: estudio transversal en el área de salud No. 2 de la Policlínica Manuel Fajardo Rivero del municipio Urbano Noris, desde julio 2011 a enero 2013. Se seleccionó una muestra aleatoria simple de 352 pacientes entre 15 y 69 años. Para la recolección de la información se realizó una consulta de estomatología donde se efectuó el examen bucal y control de placa dentobacteriana con sustancia reveladora. Los datos se recogieron en las historias clínicas. Se calcularon los Odds Ratio (OR) y los intervalos de confianza del 95% (IC95%) de los factores de riesgo en el programa EPIDAT 3,1 (Junta de Galicia, OPS, 2006).Resultados: la prevalencia de caries dental fue de 56,9% con predominio en el grupo de 25-29 años. El riesgo de caries dental fue mayor en pacientes con higiene bucal deficiente (OR=5,98; IC95%=3,24-11,01), dieta cariogénica (OR=4,87; IC95%=3,06-7,75), apiñamiento dentario (OR=6,11; IC95%=3,95-10,06) y uso de prótesis parciales removibles (OR=3,10; IC95%=1,78-5,41).Conclusiones: la prevalencia de la caries dental es elevada, con tendencia a incrementarse con el proceso de envejecimiento y sin diferencias entre sexos. Los factores de riesgo de caries dental fueron la higiene bucal deficiente, la dieta cariogénica, el apiñamiento dentario y el uso de prótesis parciales removibles.(AU)

Introduction: the dental caries is a multifactorial disease of high prevalence in Urbano Noris municipalityObjective: to determine the prevalence of dental caries and to identify the main risk factors.Method: a cross- sectional study in the health area No. 2 of Manuel Fajardo Rivero Polyclinic of Urbano Noris municipality, from July 2011 to January 2013. A simple random sample of 352 patients between 15 and 69 years was selected. To collect information Stomatology consultation was done where the oral examination and control of plaque with developing substance was made. Data were collected in medical records. The Odds Ratio (OR) and confidence intervals of 95% (95% CI) of risk factors in the EPIDAT 3.1 program were calculated.Results: the prevalence of dental caries was 56.9% in the group of 25-29 years. The risk of dental caries was higher in patients with poor oral hygiene (OR = 5.98; 95% CI = 3.24 to 11.01), cariogenic diet (OR = 4.87; 95% CI = 3.06 to 7, 75), dental crowding (OR = 6.11; 95% CI = 3.95 to 10.06) and use of removable partial dentures (OR = 3.10; 95% CI = 1.78 to 5.41).Conclusions: The prevalence of dental caries is high, with a tendency to increase with the aging process and no differences between sexes. Risk factors for dental caries were poor oral hygiene, cariogenic diet, dental crowding and the use of removable partial dentures.

Intervención educativa sobre caries dental en escolares de sexto grado / Educational intervention on dental caries in sixth grade school children

Introducción: la caries dental es el problema de salud pública que más aqueja a la sociedad, desde los grandes faraones egipcios hasta los actuales presidentes, casi todos, en algún momento de su vida, han padecido esta enfermedad.Objetivo: evaluar la efectividad de una intervención educativa referente a la caries dental en escolares de sexto grado. Métodos: se realizó un estudio de intervención educativa, en escolares de sexto grado de la escuela primaria Dalquis Sánchez, de Holguín, en el período septiembre de 2015-abril de 2016. El universo de la investigación fue de 138 escolares, la muestra conformada por 58 pacientes diagnosticados con caries dental. Se estudiaron variables, como sexo y nivel de conocimiento sobre la enfermedad.Resultados: de los escolares afectados con caries dental 31 (53,4 por ciento) pertenecían al sexo masculino, con predominio sobre el femenino. Antes de aplicar el programa educativo, 43 escolares (74,1 por ciento) presentaban conocimientos inadecuados sobre generalidades de caries y algunos factores de riesgo; luego el 52 (89,7 por ciento) de los escolares tuvieron un conocimiento adecuado. Previo a la labor educativa, el 84,5 por ciento de los participantes poseían conocimiento inadecuado en lo que respecta al correcto cepillado y su frecuencia; al realizarla, el 91,4 por ciento logró un conocimiento adecuado. Al analizar lo referente a la dieta cariogénica y dieta protectora, observamos que al inicio de la intervención sólo 11 estudiantes presentaban un conocimiento adecuado del tema en cuestión, al aplicar el programa 48 escolares (82,8 por ciento) tuvieron una apreciación correcta del tema.Conclusiones: el nivel de conocimiento referente a caries dental era inadecuado antes de aplicar el programa educativo, luego de aplicado, la intervención educativa demostró ser un método certero, lo cual comprobó la efectividad del programa implementado.(AU)

Introduction: tooth decay is the public health problem that afflicts most of society, from the great Egyptian pharaohs to the current presidents, almost everyone at some point in their lives, have suffered from this disease.Objective: to evaluate the effectiveness of an educational intervention regarding dental caries in sixth grade school students.Methods: an educational intervention study was carried out in 6th grade students of the Dalquis Sánchez primary school in Holguín, in the period September 2015-April 2016. The universe of the research was 138 patients, in a sample consisting of 58 patients diagnosed with dental caries. Variables were studied, such as sex and level of knowledge about the disease.Results: of the students affected with dental caries 31 (53.4 percent) belonged to the male sex, with predominance over the female. Before applying the educational program, 43 schoolchildren (74.1 percent) had inadequate knowledge about dental caries and some risk factors; then 52 (89.7 percent) of the students had adequate knowledge. Prior to the educational work, 84.5 percent of the participants had inadequate knowledge regarding the correct brushing and its frequency; 91.4 percent achieved adequate knowledge. When analyzing the reference to the cariogenic diet and protective diet, it was found that at the beginning of the intervention only 11 students had an adequate knowledge of the subject in question, when applying the program 48 students (82.8 percent) had a correct appreciation of the topic.Conclusions: the level of knowledge regarding dental caries was inadequate before applying the educational program, after applied the educational intervention proved to be an accurate method, which proved the effectiveness of the implemented program.(AU)

Association between Type, Amount, and Pattern of Carbohydrate Consumption with Dental Caries in 12-Year-Olds in Puerto Rico.

OBJECTIVE: To identify the types, food sources, and pattern of carbohydrates that significantly contribute to dental caries in Puerto Rican children. METHODS: As part of an island-wide cross-sectional oral health study in 1,587 twelve-year-olds, diet intake was assessed in a representative subset (n = 801) with a 24-hour dietary recall. Carbohydrate intake was quantified using a computer-based diet analysis program. Caries was assessed using the National Institute of Dental and Craniofacial Research diagnostic criteria. Odds ratios were used to associate carbohydrate intake quartiles with caries, after controlling for important confounders. RESULTS: A total of 723 subjects had complete data. Most were females (54%) and attended public schools (77%). The caries prevalence was 33%. The highest quartile intake for the following sugars significantly increased the odds of caries compared to the lowest quartile: total carbohydrates (OR = 1.93, 95% CI = 1.08-3.46), total sugars (OR = 1.88, 95% CI = 1.01-351), sucrose (OR = 2.05, 95% CI = 1.13-3.70), fructose (OR = 1.95, 95% CI = 1.05-3.62), and inositol (OR = 2.52, 95% CI = 1.38-4.63). The main food sources of these sugars were juices, including natural juices with no added sugars, and sweetened beverages. The odds of caries also increased significantly in children whose 10% of total energy intake was from total sugars (OR = 3.76, 95% CI = 1.03-13.7). CONCLUSION: After adjusting for important caries risk factors, total carbohydrates, total sugars, ≥10% kilocaloric energy from total sugars, and sucrose, fructose, and inositol intake significantly increased caries risk. Our findings can help raise awareness about the potential caries risk from the main sources of these sugars, natural fruit juices and sweetened beverages, which are consumed in great quantities in many societies.

Avaliação de diários alimentares de crianças atendidas na clínica infantil de uma universidade privada de São Paulo / Daily food records evaluation of children treated in children's dental clinic of a private universidade de São Paulo

Como o início da ingestão da sacarose tem sido cada vez mais precoce, a avaliação da dieta infantil tem sido fundamental para enquadrar o paciente em um programa preventivo odontológico de qualidade e eficiência, para promoção de saúde bucal. Para a pesquisa, foram utilizados 60 diários alimentares, obtidos de prontuários de crianças atendidas na Clínica Odontológica Infantil de uma universidade privada de São Paulo, após aprovação do Comitê de Ética em Pesquisa (CAAE 49117815.0.000.5512). O objetivo foi estabelecer o risco cariogênico da dieta. Esses diários foram analisados em relação à frequência de ingestão de sacarose e à pegajosidade dos alimentos ingeridos, para determinação do risco cariogênico da dieta. A pegajosidade dos alimentos ingeridos nas refeições principais e nas entre refeições apresentou uma diferença estatisticamente significante (p=0,0003). O número de entre refeições, apresentou um valor maior que o preconizado para um risco cariogênico baixo da dieta, que seria dois, porém não mostrou resultado estatisticamente significante. Os resultados permitiram concluir que o risco cariogênico da dieta foi alto e que para a elaboração de um protocolo preventivo é necessária a avaliação dos alimentos que apresentam consistência pegajosa, que implicam em um maior risco cariogênico da dieta, assim como a frequência de ingestão de alimentos, principalmente os que contem sacarose. Palavras-chave: cárie dental; dieta cariogênica; fatores de risco(AU)

Since the ingestion of sucrose has been increasingly premature, the assessment of a child's diet has been essential to integrate the patient in a quality and efficiency preventive dental program in order to promote the oral health. For the research, it was used 60 daily food records from the children treated at Children's Dental Clinic of the Universidade Paulista (FOUNIP) - Campus Indianópolis, São Paulo, after sanction by the Research Ethics Committee (CAAE 49117815.0.000.5512). The diaries were analyzed by the frequency of ingestion of sucrose and the stickiness of the food ingested, to determine the cariogenic risk's in a diet. The stickiness of the food eaten at main meals and between the meals showed a statistically significant difference (p = 0.0003). The number between meals, presented an higher recommended value for a low risk cariogenic diet, although it would be two, however it presented no significant results. Moreover, the results presented that for the preparation of a preventive protocol is necessary to estimate foods that have sticky consistency, which results in an higher cariogenic risk in a diet, furthermore as the frequency of ingested food, especially those that contain sucrose.(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.

Erosive effects of beverages in the presence or absence of caries simulation by acidogenic challenge on human primary enamel: an in vitro study.

AIM: To evaluate in vitro the erosive effects of beverages in the presence or absence of caries simulation (acidogenic challenge) on the microhardness of primary enamel. METHODS: Forty human primary teeth were submitted to the erosive effects: 3 × 20-min-long daily immersion in fresh orange juice (orange group), strawberry yogurt drink (yog group), or cola soft drink (cola group) separately or in combination with acidogenic challenge (pH cycling for 10 days). Specimens were also submitted to acidogenic challenge alone, and in the negative control group specimens were not submitted to any treatment. Mineral loss was evaluated by cross-sectional microhardness determination. The data (Knoop hardness numbers, KHN) were subjected to 2-way analysis of variance and Tukey's post hoc test (α = 0.05%). RESULTS: All the test beverages significantly reduced the sample cross-sectional enamel hardness (KHN ± SD, 235.93 ± 18.15, 257.23 ± 21.79, and 253.23 ± 13.86 in the orange, yog, and cola groups, respectively) compared to samples in the negative control group (290.27 ± 3.92). In vitro acidogenic challenge exacerbated the mineral loss induced by all beverages (166.02 ± 4.28, 190.43 ± 17.55, and 198.39 ± 21.39 in the orange, yog, and cola groups combined to acidogenic challenge, respectively) compared to acidogenic challenge alone. CONCLUSIONS: All beverages exhibited erosive effects on primary enamel. Simulated caries challenge considerably exacerbated the enamel softening of primary teeth.