Estrategia mediadora para la promoción de salud bucal en niños y adolescentes con síndrome de Down / No disponible

Objetivo: Diseñar, implementar y evaluar juegos colectivos con componente didáctico adaptados a los intereses y potencialidades de personas con síndrome de Down, como estrategias mediadoras para la promoción de la salud bucal. Materiales y métodos: Participaron en el estudio 100 niños y adolescentes Down de 4 a 19 años, 47 padres y 49 docentes, integrantes de APADIM, escuela de discapacitados intelectuales de la Ciudad de Córdoba (Argentina). Se diseñaron juegos colectivos con componente didáctico de acuerdo con el diagnóstico psico-pedagógico y los aportes de los docentes. Dichos juegos se incluyeron en las actividades del aula y fuera del aula con la participación de otros mediadores: padres, hermanos, abuelos. Los juegos fueron evaluados por partes de los mediadores (maestros y padres) a través de encuestas. Resultados: La evaluación de las estrategias implementadas resultó positiva. Los mediadores expresaron que hubo cambio de conducta en los niños y adolescentes respecto al cuidado de su salud; el examen clínico reveló disminución en el Índice de Higiene oral y un importante aumento en el número de elementos obturados, lo que evidenciaría la toma de conciencia y movilización de la familia con respecto a la necesidad de consulta e intervención del profesional odontólogo; en relación a los hábitos de higiene, se observó aumento del uso de cepillo y mejora sustancial en la calidad del cepillado. Conclusiones: Los juegos con contenidos de salud bucal dotaron a los mediadores de una herramienta apropiada para que los niños y adolescentes lograran la apropiación de conductas saludables, dado que el diseño de las mismas respetó el diagnóstico de sus potencialidades (AU)

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[Oral health status evaluation of pre-school children: longitudinal epidemiologic study (1993-1994), Córdoba, Argentina]. / Evaluación del estado de salud bucodental en preescolares: estudio epidemiológico longitudinal (1993-1994), Córdoba, Argentina.

A one-year longitudinal survey was carried out on a sample of the Cordoba City 4-year old kindergarten population (n = 820); so as to determine the role of several variables upon the incidence of caries. The dmf-t, dmf-s, oral hygiene and oral health indexes as well as incidence rates and caries relative risks of caries were inversely related to the socioeconomic level (SEL) of the children involved. Thus in the SEL III (typical proletariat, non-typical proletariat and sub-proletariat) children, the relative risk of caries was almost five times higher (RR = 4.9) than in the SEL I (entrepreneureal and managerial bourgeoisie) children. In SEL I, almost all new lesions occurred on smooth surfaces (61.2%), while in SEL III the molar occlusal faces were mainly affected (66.3%). Daily sugar intake was higher in SEL III children but experience of caries showed poor correlation to the amount (r = 0.40) and frequency (r = 0.52) of carbohydrate intake. No significant interlevel differences were observed in the biochemical salivary parameters analyzed. Assisted toothbrushing and fluoride topications strongly lowered the incidence of caries among SEL III children, also making the corresponding rates fall almost to SEL I values (0.31, 0.23 and 0.22 vs. 0.21). In conclusion, SEL III children should be treated prophylactically with effective preventive measures, because of their susceptibility to caries. Such preventive measures include assisted toothbrushing and fluoride topications.

Effects of xylitol, sorbitol and fluoride mouthrinses on glucose clearance in adolescents.

The present work describes and analyzes the results of a randomized clinical trial on 98 healthy adolescents (age 18 +/- 0.7 years) in order to evaluate the effects of a 14 days treatment with mouthrinses containing xylitol (0.2%; 0.5% and 1%), sorbitol (1%), NaF (0.1% respectively) on salivary glucose clearance. In all volunteers oral glucose clearance followed an exponential curve as a function of time, which fitted almost exactly to the equation log Ct = log Co - bt from 1 to 16 minutes after sugar rinsing. Xylitol treatment provoked an increase in oral glucose clearance, which was proportional to its concentration in the mouthrinse formula. The average AUC (area under curve) decrease was 9.1% in subjects rinsing with 0.2% xylitol; 21.5% with 0.5% xylitol and 40.0% with 1% xylitol. 1% sorbitol or 0.1% NaF did not modify any of the pharmacokinetical parameters over the same treatment time. The mouthrinses containing 1% xylitol and 0.1% NaF produced the same results as 1% xylitol alone on oral glucose clearance. No significant changes in the salivary flow rate nor in oral health parameters were observed concomitant to the faster oral glucose clearance by xylitol treatment. Since the sugars salivary clearance is part of a process intended to prevent dental caries, our results suggest that xylitol adds another mechanism of action to its well known cariostatic and anticaries properties.

[Effects of local treatment with sodium fluoride mouthrinse on peroxidase and hypothiocyanite saliva levels in adolescent]/. / Efectos del tratamiento local con enjuagatorios de fluoruro de sodio sobre los niveles de peroxidasa e hipotiocianito salivales en adolescentes.

The present work describes and analyzes the results of a randomized clinical trial on adolescents (age 18.2 +/- 0.6) carried out in order to evaluate the effects of a twice daily mouthrinse application containing xylitol, sorbitol, sacarine, ciclamate, aspartame, chlorhexidine, hexetidine or NaF for 14 days on amylase, peroxidase, thiocyanate, hypothiocyanite, secretory IgA and total proteins in whole saliva. No significative changes were observed in health and bucodental parameters nor in flow salivary rate, protein, secretory Ig A, or thiocyanate levels as a consequence of the mouthrinses application. On the other hand, NaF treatment (0.02%, 0.05% or 0.1%) did cause an increase in salivary peroxidase and hypothiocyanite, being the former increase higher than the second one. Peroxidase increase was proportional to the mouthrinse dose (r = 0.78; p < 0.01), but not to the hypothiocyanite increase (r = 0.407; p = 0.12). Since the adolescents' health condition was the adequate, it is suggested that the peroxidase increase was due to a higher enzyme synthesis and/or secretion by the parotid and/or submaxillar glands. It is concluded that the increases in salivary peroxidase and hypothiocyanite caused by the NaF treatment favour the host, as they potentiate one of the mechanisms that modulate dental plaque composition, preventing in such a way the colonization by cariogenic pathogens.

Efectos del tratamiento local con enjuagatorios de fluoruro de sodio sobre los niveles de peroxidasa e hipotiocianito salivales en adolescentes / Effects of local treatment with sodium fluoride mouthrinse on peroxidase and hypothiocyanite saliva levels in adolescents

Se describen y analizan los resultados de un ensayo clínico controlado realizado en adolescentes de ambos sexos (edad 18,2+0,6 años) para evaluar los efectos de dos aplicaciones diarias de enjuagatorios a base de xilitol, sorbitol, sacarina, ciclamato, aspartamo, clorhexidina, hexetidina o NaF, durante 14 dÝas, sobre el contenido de amilasa, peroxidase, tiocianato, hipotiocianito, IgA secretoria y proteínas totales de la saliva completa. Como consecuencia de la aplicación de los enjuagatorios no se observaron modificaciones significativas en los indicadores de salud e higiene bucodental, ni en la velocidad de flujo, niveles de proteínas totales, IgA secretoria y tiocianato salivales. En cambio, el tratamiento con NaF (0,02 por ciento, 0,05 por ciento y 0,1 por ciento) produjo un aumento de la peroxidasa salival y del hipotiocianito, siendo el primero de dichos efectos de mayor magnitud que el segundo. El incremento de peroxidasa fue proporcional a la dosis del enjuagatorio (r = 0,78; p<0,01), no así el aumento de hipotiocianito (r = 0,407; p = 0,12). Por cuanto el estado de salud gingival de los adolescentes era adecuado, se sugiere que el aumento de peroxidasa se debió a una mayor sÝntesis y/o secreción de la enzima por parte de las glándulas parótidas y/o submaxilares. Se concluye que los aumentos de peroxidase salival y de hipotiocianito producidos por el trtamiento con NaF son fenómenos favorables para el huésped, al potenciar uno de los mecanismos que regulan la composición de la placa dental, y de tal modo prevenir la colonización por gérmenes cariógenos.

Efectos del tratamiento local con enjuagatorios de fluoruro de sodio sobre los niveles de peroxidasa e hipotiocianito salivales en adolescentes / Effects of local treatment with sodium fluoride mouthrinse on peroxidase and hypothiocyanite saliva levels in adolescents

Se describen y analizan los resultados de un ensayo clínico controlado realizado en adolescentes de ambos sexos (edad 18,2+0,6 años) para evaluar los efectos de dos aplicaciones diarias de enjuagatorios a base de xilitol, sorbitol, sacarina, ciclamato, aspartamo, clorhexidina, hexetidina o NaF, durante 14 dYas, sobre el contenido de amilasa, peroxidase, tiocianato, hipotiocianito, IgA secretoria y proteínas totales de la saliva completa. Como consecuencia de la aplicación de los enjuagatorios no se observaron modificaciones significativas en los indicadores de salud e higiene bucodental, ni en la velocidad de flujo, niveles de proteínas totales, IgA secretoria y tiocianato salivales. En cambio, el tratamiento con NaF (0,02 por ciento, 0,05 por ciento y 0,1 por ciento) produjo un aumento de la peroxidasa salival y del hipotiocianito, siendo el primero de dichos efectos de mayor magnitud que el segundo. El incremento de peroxidasa fue proporcional a la dosis del enjuagatorio (r = 0,78; p<0,01), no así el aumento de hipotiocianito (r = 0,407; p = 0,12). Por cuanto el estado de salud gingival de los adolescentes era adecuado, se sugiere que el aumento de peroxidasa se debió a una mayor sYntesis y/o secreción de la enzima por parte de las glándulas parótidas y/o submaxilares. Se concluye que los aumentos de peroxidase salival y de hipotiocianito producidos por el trtamiento con NaF son fenómenos favorables para el huésped, al potenciar uno de los mecanismos que regulan la composición de la placa dental, y de tal modo prevenir la colonización por gérmenes cariógenos. (AU)

Bucodental health condition in patients with Down syndrome of Cordoba City, Argentina.

The oral health condition of children and youngsters with Down Syndrome (DS) was evaluated on a sample of 86 mongolic subjects ages 3 to 19, both sexes, residents in the city of Córdoba (Argentina), and compared with control groups. Those persons were attended special educational institutions for the care of that type of disabled individuals. In every age group, the dmf-t and dmf-s indexes were higher in the mongolic children than in the control population, while from the age of 10 onwards the DMF-T and DMF-S of the control population were higher than those of the DS individuals. In spite of this, the scarce participation of the DF component in the mentally disabled showed deficiencies in their dental care. This population exhibited a high frequency of retarded eruption, agenesis, conoidism, Angle's type III malocclusion, posterior cross bite and deficient gingival health. A positive correlation was found between tha activity of Lactobacillus and the amount of Streptococcus and the caries indicators. A high concentration of calcium and secretory IgA was found in the group of mongolic subjects. Our analysis evidences that DS patients are at a disadvantage in relation with healthy individuals in terms of oral health. An early program of preventive measures is proposed (dental hygiene, anti-plaque agents, Therapy of Orofacial Regulation) which would involve the education of parents and teachers.

[Dental health status of students living in places supplied with drinking water of very high and very low levels of fluorides]. / Estado de salud bucodental de escolares residentes en localidades abastecidas con agua de consumo humano de muy alto y muy bajo contenido de fluoruros.

The results of a cross sectional epidemiological survey for the purpose of evaluating the state of dental health of schoolchildren (aged 6-7 and 12-13) living in Sampacho and Porteña, two towns in the Province of Córdoba (Argentina), supplied with drinking water containing quite different levels of fluoride, are described and analized. In Sampacho, F- level is 9.05 mg/l. while in Porteña the concentration is of 0.19 mg/l. The proportion of schoolchildren (aged 6-7 and 12-13) without caries was significaticantly higher in Sampacho than in Porteña, while the dmf-t, dmf-s, DMF-T and DMF-S indexes were considerably higher in the latter place. The severity of caries in children (age 12-13) living in Sampacho ranged from low to moderate (DMF-T = 2.53), whilst in Porteña the range went from moderate to high (DMF-T = 4.41). No cases of dental fluorosis were recorded in Porteña; but in Sampacho, there was a high proportion of children with mild fluorosis (aged 6-7) and mild or severe fluorosis (aged 12-13). Calcium, phosphate, thiocyanate, protein and secretory Ig A salivary levels were similar not only among schoolchildren of both towns but also among those with different experience of caries and different degrees of severity of fluorosis. It is concluded that urgent (preventive and/or curative) sanitary measures are necessary for the purpose of reducing or controlling caries in Porteña as well as dental fluorosis in Sampacho.