Recommendations from Pediatric and Pediatric Dentistry Associations of the Americas Regarding Pacifier Use

ABSTRACT Objective: To identify online recommendations from pediatric and pediatric dentistry associations of the Americas regarding the pacifier habit. Material and Methods: A search was conducted on the associations' website (November/2021 to March/2023) to the questions: (1) Recommend using a pacifier?, (2) What care?, (3) Advantages and (4) disadvantages, (5) Ideal age, and (6) methods for habit removal. Results: Among the 36 American countries, 21 were represented on websites, social media, and official guides. The most significant portion of pediatric dentistry associations (23.81%) does not recommend the use of a pacifier if the infant is exclusively breastfeeding, and recommends avoiding the offer of a pacifier in the first days of life to facilitate the establishment of breastfeeding. Some pediatric (29.63%) associations suggested that use reduces the risk of sudden infant death syndrome. Most pediatric dentistry associations (85.71%) and some pediatric associations (22.22%) linked pacifier use to breastfeeding difficulties and the occurrence of orthodontics. Most of the 20 pediatric dentistry associations stated that the habit should be removed by a maximum of three years of age (90.48%). The most reported recommendations were behavior modification techniques and positive reinforcement. Conclusion: Most pediatric dentistry associations recommend the care and disadvantages of pacifiers and the ideal age to remove them. The few pediatric associations that provide information address indications, care, advantages and disadvantages of pacifiers, age, and methods for removing them.

Effect of oral hygiene in infants before dental eruption on Candida spp. colonization and the occurrence of oral candidiasis: A randomized clinical trial.

Background: To assess the influence of oral hygiene in infants before the primary tooth eruption on colonization by Candida spp. and the occurrence of oral candidiasis. Material and Methods: Fifty-six infants were randomly selected in their first 48 hours of life and allocated into 2 groups: Group I (Mothers were instructed to sanitize the oral cavity of the infant with gauze and filtered water once a day) and Group II (Mothers were instructed not to sanitize the oral cavity of the infant before the dental eruption). Data collection was performed one month after the birth of the infant, in their residence, including saliva collection for identification and quantification of Candida spp. Results: Colonization by Candida spp. species was found in 49.1% of the infants evaluated. There was no statistically significant difference between colonization by Candida spp. and intervention groups (p=0.947). 13.2% of the participants presented oral candidiasis during the first month of life, this prevalence was 15.4% in the control group and 11.1% in the intervention group, however, this difference was not significant (p=0.704). Conclusions: The Candida spp. colonization and the oral candidiasis occurrence, in the first month of the life of the infant, were not influenced by oral hygiene. Key words:Infants, oral hygiene, oral health, oral candidiasis.

Family income modifies the association between frequent sugar intake and dental caries.

AIM: The aim of this cross-sectional study was to investigate whether family income modifies associations between dental caries and sex, age, mother's education, type of preschool, sugar intake, and toothbrushing. BACKGROUND: Dental caries is a multifactorial dyanamic disease primarily mediated by biofilm and sugar. DESIGN: A randomly selected sample of 308 Brazilian preschool children aged 1-3 years underwent a clinical oral examination for the assessment of moderate/extensive dental caries using codes 3-6 of the International Caries Detection and Assessment System. Mothers were asked to fill out a form addressing the child's demographic and socioeconomic characteristics as well as the frequency of sugar intake. Statistical analysis involved descriptive statistics, the chi-squared test, and Poisson regression models. RESULTS: The prevalence of moderate/extensive dental caries was 42.5%. The adjusted model revealed that within low-income families (<2 times the monthly minimum wage), the prevalence of dental caries was higher among children with a high frequency of sugar intake (≥ twice per day) than in those with a low frequency of sugar intake (< twice a day) (RR = 1.79; CI: 1.38-2.33). In families with higher income (≥2 times the monthly wage), no significant association between sugar intake and dental caries was, however, found. CONCLUSIONS: In conclusion, monthly family income can modify the association between the high frequency of sugar intake and dental caries.

Association between child's behaviour during first dental appointment and effectiveness of dental plaque removal by caregivers.

OBJECTIVE: To evaluate the association between the behaviour of children aged 1 to 4 years during their dental appointment and the effectiveness of dental plaque removal by caregivers. METHODS: This longitudinal study with intervention had the participation of 146 children (mean age = 34.89 months), 75 of whom (51.4%) showed positive behaviour (+ and ++) and 71 (48.6%), negative behaviour (- and - -). The children were evaluated at the first dental appointment, according to the Frankl scale. They were subjected to an assessment of oral conditions, and their plaque level was recorded (Quigley-Hein Index modified by Turesky) using the Evince® device. Caregivers received oral hygiene guidance. The dental plaque assessment was performed before giving the oral hygiene guidance and 14 days later. The statistical analysis included a descriptive assessment and the Wilcoxon test (p < 0.05). RESULTS: Mean dental plaque levels dropped significantly from the first to the second assessment (p < 0.001). The sample was divided according to the child's behaviour, observing that only the group of children with positive behaviour showed significantly less dental plaque in the second assessment (p < 0.001). CONCLUSION: The positive behaviour of children aged 1 to 4 years during the first dental appointments is associated with more effective dental plaque removal by caregivers.

Association between asthma and oral conditions in children and adolescents: a systematic review with meta-analysis.

OBJECTIVE: To investigate the association between asthma and oral conditions in children and adolescents. MATERIAL AND METHODS: Observational studies that evaluated the association between asthma and oral conditions in children and/or adolescents were retrieved from five databases, grey literature and reference lists up to April 7th, 2022. Meta-analyses were performed, and I2 statistics were calculated. The mean difference was used as a measure of effect for continuous variables. Event frequencies were evaluated to determine odds ratios for dichotomous variables. Publication bias was investigated using Egger's test. The methodological quality (JBI) and certainty of the evidence (GRADE) were assessed. RESULTS: Forty-two studies were eligible, and sixteen were included in the meta-analysis. Mean dmft (MD: 1.11, 95%CI: 0.48-1.73), DMFT (MD: 1.01, 95% CI: 0.45-1.56), dmfs (MD: 3.62, 95%CI: 2.60-4.63) and DMFS (MD: 4.47, 95%CI: 0.98-7.96) indices were significantly higher in asthmatic children and adolescents compared to those without asthma. In the analysis of biofilm, asthmatic children and adolescents had a higher Plaque Index compared to those without asthma (MD: 0.18, 95%CI: 0.03-0.33). CONCLUSION: Asthmatic children and adolescents may be more likely to develop tooth decay and build up biofilm compared to those without asthma. It is suggested that there are no differences between asthmatic and non-asthmatic children and adolescents regarding gingivitis, developmental defects of enamel or erosive tooth wear. The certainty of the evidence was classified as 'very low'. CLINICAL RELEVANCE: Knowledge of the risks that asthma and asthma medications for oral health can assist in counselling families of children and adolescents with this condition in terms of control and prevention measures for oral problems.

The effectiveness of apple, sugar-free chewing gum, Rolly Brush® and tooth brushing in the reduction of plaque index: Crossover randomized clinical trial

Background: The implementation of the self-cleaning practice is of fundamental importance for the maintenance of oral health and to remove the human dental biofilm which is considered the main etiological factor for the development of caries and periodontal diseases. Objective: This study aimed to evaluate the use of chewing gum, Rolly Brush® and apples as forms of mechanical control and removal of the dental biofilm in the absence of brushing. Materials and Methods: Eighteen volunteers were submitted to plaque index evaluation after a period of 24 hours of no oral hygiene. Then, they would use one of the methods: chewing gum, Rolly Brush®, apple or tooth brushing, chosen by a draw, for one minute, and then, plaque index was evaluated again. This stage was repeated until all participants were submitted to all selected methods, in periods of 24 hours each. Results: Dental brushing was more effective when compared to each of the other methods applied and there was a statistically significant reduction of dental plaque index after apllying all methods of cleaning in all groups. Conclusion: Chewing gum, Rolly Brush® and apple may be used as auxiliary to dental brushing or when such method is impossible to be performed. Clinicaltrials.gov: number of protocol NCT 03.601.585.

Fundamento: A implementação da prática de autolimpeza é de fundamental importância para a manutenção da saúde bucal e remoção do biofilme dental humano que é considerado o principal fator etiológico para o desenvolvimento de cáries e doenças periodontais. Objetivo: Este estudo teve como objetivo avaliar a utilização de goma de mascar, Rolly Brush® e maçã como formas de controle mecânico e remoção do biofilme dental na ausência de escovação. Materiais e Métodos: Dezoito voluntários foram submetidos à avaliação do índice de placa após um período de 24 horas sem higiene bucal. Em seguida, utilizariam um dos métodos: goma de mascar, Rolly Brush®, ingerir uma maçã e escovar os dentes, escolhida por sorteio, por um minuto, e então, o índice de placa era novamente avaliado. Essa etapa foi repetida até que todos os participantes fossem submetidos a todos os métodos selecionados, em períodos de 24 horas cada. Resultados: A escovação dentária foi mais eficaz quando comparada a cada um dos outros métodos aplicados e houve redução estatisticamente significativa do índice de placa dentária após a aplicação do método de limpeza em todos os grupos. Conclusão: Goma de mascar, Rolly Brush® e maçã podem ser utilizados como auxiliares da escovação dentária ou quando tal método for impossível de ser realizado. Clinicaltrials.gov: Número do protocolo NCT 03.601.585.