Enamel fluorosis related with fluoride-containing water ingestion and urinary excretion in schoolchildren.

Background: Natural water sources are considered as the major environmental exposure of fluoride, resulting in increased prevalence of enamel fluorosis. This type of natural exposure should be permanently monitored to avoid the interactions with other non-natural fluoride sources. We evaluated the prevalence of enamel fluorosis in Colombian schoolchildren and its relationship with fluoride-containing water ingestion exposure dose and urinary fluoride excretion. Material and Methods: We included 923 schoolchildren aged 7-12 years residing in eight municipalities in Colombia. Sampling of consumption water was performed in major aquifers used for daily supply. Samples were collected in 98 polyethylene containers and refrigerated until analysis. Water and urine fluoride concentrations were measured using the fluoride selective electrode method. Enamel fluorosis was evaluated using Thylstrup and Ferjerskov Index (TFI). Demographic and anthropometric characteristics were assessed. Besides, other exposures to non-natural fluoride were also evaluated. Logistic regression was applied for multiple analyses. Results: The median fluoride concentration in water and urine samples was 10.5 mg/L and 0.63 mg/L respectively, with the highest value found in Algarrobo-Magdalena, and the lowest value found in Manzanares-Caldas. The overall prevalence of enamel fluorosis was 86.1%, being more frequent the mild codes with TFI-1 to TFI-2. The highest prevalence was found in Margarita-Bolívar and Manzanares-Caldas, and the most severe codes (TFI-5 to TFI-9) were detected in Manzanares-Caldas. The multiple analysis revealed water ingestion exposure dose, urinary excretion, involuntary intake of toothpaste, amount of table salt consumption and sex as significant factors (p< 0.001). Conclusions: The fluoride ingestion exposure dose and its subsequent urinary excretion could be used as estimators of past fluoride exposure, explaining the current prevalence of enamel fluorosis in Colombian schoolchildren. Key words:Fluoride, groundwater ingestion, enamel fluorosis, prevalence, severity.

Knowledge about emergency dental trauma management among school teachers in Colombia: A baseline study to develop an education strategy.

BACKGROUND/AIM: Dental trauma in school populations has a high frequency and school teachers are often close to the place where such injuries occur. However, many studies have confirmed the lack of knowledge as to how to act in these cases. The aim of this study was to determine the knowledge in regard to dental trauma of school teachers in Colombia. MATERIALS AND METHODS: A multicentre, descriptive cross-sectional study was performed in 251 schools using a stratified randomized sampling. A structured hard copy survey was personally delivered to 2390 school teachers in the selected schools. The survey contained questions related to work experience, teaching level and demographic data, as well as questions related to their knowledge of and attitude towards emergency dental trauma management. RESULTS: The response rate was 96%. Most of the school teachers (95%) had never received training related to dental trauma, although 35% had witnessed at least 1 case. Of 2296 school teachers surveyed, only 5.8% would have replanted an avulsed tooth. An association was found between work experience and appropriate management of an avulsed tooth. No significant differences were found in regard to school location (city), school type (private/public), gender and school teachers' education level. CONCLUSIONS: The knowledge of school teachers in Colombia about emergency dental trauma management is inadequate. The findings strongly suggest a need for an education strategy with the involvement of the government, dentistry schools and private organizations.

Prevalencia de fluorosis dental en infantes de 8 a 12 años de colegios públicos, Villavicencio 2013 / Prevalencia de fluorosis dental em infantes de 8 a 12 anos de colegios públicos, villavicencio 2013 / Prevalence dental fluorosis in 8 to 12 years old infants of public schools, villavicencio 2013

Objetivo: Determinar la prevalencia y severidad de fluorosis dental en población de 8 a 12 años de edad de los colegios públicos de Villavicencio, Colombia. Materiales y Métodos: Estudio descriptivo con participación voluntaria y previo consentimiento informado de los adultos responsables de 459 infantes de 8 a 12 años de edad, seleccionados de una población de 32.306 matriculados en los colegios públicos de Villavicencio, mediante muestreo probabilístico. Trabajo avalado por el Comité de Bioética de la Universidad Cooperativa de Colombia. El examen clínico fue realizado por 6 odontólogos previamente calibrados por un experto en el diagnóstico de fluorosis dental según índice de Thylstrup y Fejerskov (TFI) obteniéndose índices de Kappa > 0,80. Se realizó análisis exploratorio de datos (AED), distribución de frecuencias y estadística inferencial (prueba de asociación Chi2 de Pearson con α = 0,05), usando el programa estadístico SPSS versión 21.0 con licencia de la Universidad Cooperativa de Colombia. Resultados: La prevalencia de fluorosis (TFI ≥ 1) fue de 65,8% (n = 302) (IC 95% = 61,5% a 68,5%). El sexo masculino presentó una prevalencia del 51,3% (n = 155) (IC 95% = 47,3% a 55,3%) (p = 0,94). En la zona urbana la comuna de procedencia más afectada fue la número 6 con una prevalencia de 70,8% (IC 95% = 59,8% a 81,8%) (p = 0,84). El 31,4% de los niños presentaron un TFI = 2, el 23% un TFI = 1. Los dientes más afectados fueron los premolares superiores (48,2%) e inferiores (40,6%), seguidos de los incisivos laterales (40,2%). Conclusión: En la población infantil de 8 a 12 años de los colegios públicos de Villavicencio se presenta una elevada prevalencia de fluorosis con una severidad leve y moderada, representando un problema de salud pública que requiere una intervención de los organismos de control

Objective: To determine the prevalence and severity of dental fluorosis in the population aged 8-12 years old in public schools in Villavicencio, Colombia. Materials and Methods: A descriptive study, with voluntary participation and previous consent of the responsible adults, of 459 children aged 8 to 12 years, selected from a population of 32,306 students enrolled in public schools in Villavicencio, using probability sampling. This work is supported by the bioethics committee of the Universidad Cooperativa de Colombia. Clinical examination was carried out by six dentists previously calibrated by an expert in the diagnosis of dental fluorosis according Thylstrup and Fejerskov (TFI) obtaining Kappa indexes > 0.80. Exploratory data analysis (EDA), frequency distribution and inferential statistics (test partnership with Pearson Chi2 α = 0.05) were performed with SPSS version 21.0. Licensed by Universidad Cooperativa de Colombia. Results: The prevalence of fluorosis (TFI ≥ 1) was 65.8% (n = 302) (95% CI = 61.5% to 68.5%). Boys presented a prevalence of 51.3% (n = 155) (95% CI = 47.3% to 55.3%) (p = 0.94). In urban areas the most affected district of origin was No. 6 with a prevalence of 70.8% (95% CI = 59.8% to 81.8%) (p = 0,84). The 31.4% of children had a TFI = 2, 23% one TFI = 1. The most affected teeth were premolars (48.2%) (40.6%), followed by lateral incisors (40.2%). Conclusion: In the population of 8-12 years old children of public Villavicencio schools a higher prevalence of fluorosis with a mild to moderate severity is present, representing a public health problem that requires intervention by the supervisory bodies

Objetivo: Determinar a prevalência e severidade de fluorose dentaria em povoação de 8 a 12 anos de idade dos colégios públicos de Villavicencio, Colômbia. Materiais e Métodos: Estudo descritivo com participação voluntaria e prévio consentimento informado dos adultos responsáveis de 459 infantes de 8 a 12 anos de idade, selecionados de uma povoação de 32.306 matriculados nos colégios públicos de Villavicencio, através de uma amostra probabilística. Trabalho avaliado pelo Comitê de Bioética da Universidade Cooperativa de Colômbia. No teste clinico foi realizado por 6 dentistas previamente calibrados por um especialista no diagnostico de fluorose dentaria segundo índice de Thylstrup e Fejerskov (TFI) obtendo se índices de Kappa > 0,80. Realizou se analise exploratório de dados (AED), distribuição de freqüências estadística inferencial (prova de associação Chi2 de Pearson com α = 0,05), usando o programa estatístico SPSS versão 21.0 com licencia da Universidade Cooperativa de Colômbia. Resultados: A prevalência de fluorose (TFI ≥ 1) foi de 65,8% (n = 302) (IC 95% = 61,5% a 68,5%). O sexo masculino apresentou uma prevalência do 51,3% (n = 155) (IC 95% = 47,3% a 55,3%) (p = 0,94). Na zona urbana a comuna de procedência mais afetada foi a numero 6 com uma prevalência 70,8% (IC 95% = 59,8% a 81,8%) (p = 0,84). O 31,4 das crianças apresentaram um TFI = 2, o 23% um TFI = 1.Os dentes mais afeitados foram os pré- molares superiores (48,2%) e inferiores (40,6%), seguidos dos incisivos laterais (40,2%). Conclusão: Na povoação infantil de 8 a 12 anos dos públicos de Villavicencio apresenta se uma elevada prevalência de fluorose com uma severidade leve e moderada, representando um problema de saúde publica que requere uma intervenção dos organismos de controle

Extracurricular factors influence perceived stress in a large cohort of Colombian dental students.

The aim of this study was to investigate the association of extracurricular factors including socioeconomic status and career choice with perceived stress in dental school in a large cohort of Colombian dental students. Participants in the study were 5,700 students enrolled in seventeen Colombian dental schools. The study employed a Spanish adaptation of the Dental Environment Stressors (DES30-Sp) questionnaire and recorded an array of demographic, socioeconomic, career choice, and dental studies-related information. Data analyses relied on descriptive, bivariate, and multivariate methods based on multi-level mixed-effects linear regression and post hoc estimation of predictive margins. "Fear of failing a course or year" emerged as the highest ranked item. Male students consistently reported less perceived stress than females, and stress scores were higher among seniors. Independent of gender, age, and study year, having dentistry as one's first career choice, relying on financial support, and belonging to higher socioeconomic strata were associated with lower stress levels. Academic environment interventions aimed to improve students' educational well-being will need to account for the individual heterogeneity among them. These data from a robust cohort of predoctoral dental students underscore the importance of considering students' educational experiences in a broader social and economic context.

Musicoterapia para el control de ansiedad odontológica en niños con síndrome de down / Music therapy to control dental anxiety in children with Down syndrome / Musicoterapia para o controle de ansiedade odontológica em crianças com síndrome de down

Objetivo: Valorar la eficacia de la musicoterapia en el control de la ansiedad durante el tratamiento odontológico preventivo en pacientes con síndrome de Down entre los 5 y 14 años de edad. Metodología: Estudio experimental aleatorizado, con la participación voluntaria de 30 niños con síndrome de Down entre 5 y 14 años de edad, seleccionados por conveniencia de tres instituciones educativas de Villavicencio y Acacías (Meta) en el 2011, asignados aleatoriamente en dos grupos: grupo control y grupo expuesto a la música, cada uno con 15 niños. Se evaluó el grado de ansiedad odontológica de los padres mediante escala de Corah, los antecedentes de comportamiento en consulta odontológica, edad, sexo, frecuencia de visita al odontólogo y sensibilización musical previa de los niños. Durante la consulta odontológica se evaluaron la ansiedad previa, durante y después del procedimiento utilizando la escala analógica de caras. El comportamiento durante la consulta se evalúo con la escala de Frankl, se monitorizaron los cambios en la frecuencia cardiaca y presión arterial en ambos grupos. Resultados: Al comparar el nivel de ansiedad y el comportamiento de los grupos durante la consulta odontológica se evidenció un 80% de niños sin ansiedad en el grupo expuesto vs. el 27% en el grupo control, con un RR = 0,28; IC95%: 0,10-0,81; Chi-cuadrado = 8,28; p = 0,0039; RRR = 53%; NNT = 2. La frecuencia cardiaca presentó una disminución en el grupo expuesto a la musicoterapia (p>0,05). Conclusión: El uso de la musicoterapia disminuyó significativamente los niveles de ansiedad en el grupo expuesto a la música

Objective: Music therapy efficacy for anxiety control during the dental prevention treatment in patients with Down syndrome between 5 and 14 years old. Method: Experimental at random study with the voluntary participation of 30 children between 5 and 14 years old with Down syndrome, selected conveniently in three education institutes of Villavicencio and Acacías (Meta) during 2011. They were classified at random in two groups: control group and exposed to music group, each one with 15 children. The parents’ degree of anxiety was measured using Corah’s scale, the history of behavior in dental consultation, age, sex, frequency of vistis to the dentist, and previous musical sensitization of the children. During the dental consultation anxiety was measured before, during and after the procedure using the faces analog scale. The behavior during the consult was measured using Frankl’s scale. The change in cardiac rate and blood pressure was also measured. Results: When comparing the anxiety level and the behavior of the groups during dental consultation, the following was observed: 80% of children without anxiety in the music therapy exposed group, versus 27% in the control group, with an RR = 0.28; IC95%: 0.10- 0.81; Chi-square = 8.28; p = 0.0039; RRR = 53%; NNT = 2. The cardiac rate had a reduction in the group exposed to music therapy (p>0.05). Conclusion: The use of music therapy significantly reduced the anxiety levels in the group exposed to music

Objetivo: Valorar a eficiência da musicoterapia no controle da ansiedade durante o tratamento odontológico preventivo em pacientes com síndrome de Down entre os 5 e 14 anos de idade. Metodologia: Estudo experimental aleatorizado, com a participação voluntaria de 30 crianças com síndrome de Down entre 5 e 14 anos de idade, selecionados por conveniência de três instituições educativas de Vilavicencio e Acácias (Meta) no 2011, atribuídos aleatoriamente em dois grupos: grupo controle e grupo exposto à musica, cada um com 15 crianças. Avaliou se o grau de ansiedade odontológica dos pais mediante escada de Corah, os antecedentes de comportamento em consulta odontológica, idade, sexo, frequência de visita ao dentista e sensibilização musical previa das crianças. Durante a consulta odontológica se avaliaram a ansiedade previa, durante e depois do procedimento utilizado a escada analógica de caras. O comportamento durante a consulta se avaliou com a escada de Frankl, monitoraram se os câmbios na frequência cardíaca e pressão arterial nos dois grupos. Resultados: Ao comparar o nível de ansiedade e o comportamento dos grupos durante a consulta odontológica se evidenciou um 80% de crianças sem ansiedade no grupo exposto vs. O 27% no grupo controle, com um RR = 0,28; IC95%: 0,10-0,81; Quadrado = 8,28; p = 0,0039; RRR = 53%; NNT = 2. A frequência cardíaca apresentou uma diminuição no grupo exposto à musicoterapia (p>0,05). Conclusão: O uso da musicoterapia diminuiu significativamente os níveis de ansiedade no grupo exposto a musica