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1.
Artículo en Inglés | MEDLINE | ID: mdl-33316869

RESUMEN

The present study aimed to investigate the association between bone diseases and community water fluoridation (CWF). An ecological study with a natural experiment design was conducted in Cheongju, South Korea, from 1 January 2004 to 31 December 2013. The community water fluoridation program was implemented in Cheongju and divided into CWF and non-CWF areas. To observe adverse health effects related to bone diseases, we conducted a spatio-temporal analysis of the prevalence of hip fracture, osteoporosis, and bone cancer in residents who have lived in CWF and non-CWF areas using National Health Insurance Service data. First, we used standardized incidence ratios to estimate the disease risk. Second, the hierarchical Bayesian Poisson spatio-temporal regression model was used to investigate the association between the selected bone diseases and CWF considering space and time interaction. The method for Bayesian estimation was based on the R-integrated nested Laplace approximation (INLA). Comparing the CWF area with the non-CWF area, there was no clear evidence that exposure to CWF increased health risks at the town level in Cheongju since CWF was terminated after 2004. The posterior relative risks (RR) of hip fracture was 0.95 (95% confidence intervals 0.87, 1.05) and osteoporosis was 0.94 (0.87, 1.02). The RR in bone cancer was a little high because the sample size very small compared to the other bone diseases (RR = 1.20 (0.89, 1.61)). The relative risk of selected bone diseases (hip fractures, osteoporosis, and bone cancer) increased over time but did not increase in the CWF area compared to non-CWF areas. CWF has been used to reduce dental caries in all population groups and is known for its cost-effectiveness. These findings suggest that CWF is not associated with adverse health risks related to bone diseases. This study provides scientific evidence based on a natural experiment design. It is necessary to continue research on the well-designed epidemiological studies and develop public health prevention programs to help in make suitable polices.


Asunto(s)
Enfermedades Óseas , Fluoruración , Teorema de Bayes , Enfermedades Óseas/epidemiología , Estudios de Casos y Controles , Femenino , Fluoruración/estadística & datos numéricos , Humanos , Masculino , República de Corea/epidemiología
2.
Artículo en Inglés | MEDLINE | ID: mdl-33317121

RESUMEN

Despite increasing concerns about neurotoxicity of fluoride in children, sources of fluoride exposure apart from municipal water fluoridation are poorly understood. We aimed to describe the associations of demographics, drinking water characteristics, diet, and oral health behaviors with plasma fluoride concentrations in U.S. children. We used data from 3928 6-19-year-olds from the 2013-2016 National Health and Nutrition Examination Survey. We used a 24-h dietary recall to estimate recent consumption of fluoridated tap water and select foods. We estimated the associations of fluoridated tap water, time of last dental visit, use of toothpaste, and frequency of daily tooth brushing with plasma fluoride concentrations. The participants who consumed fluoridated (≥0.7 mg/L) tap water (n = 560, 16%) versus those who did not had 36% (95% CI: 22, 51) higher plasma fluoride. Children who drank black or green tea (n = 503, 13%) had 42% higher plasma fluoride concentrations (95% CI: 27, 58) than non-tea drinkers. The intake of other foods and oral health behaviors were not associated with plasma fluoride concentrations. The consumption of fluoridated tap water and tea substantially increases plasma fluoride concentrations in children. Quantifying the contribution of diet and other sources of fluoride is critical to establishing safe target levels for municipal water fluoridation.


Asunto(s)
Fluoruros , Encuestas Nutricionales , Adolescente , Adulto , Niño , Ingestión de Alimentos , Femenino , Fluoruración/estadística & datos numéricos , Fluoruros/sangre , Humanos , Masculino , Plasma/química , Adulto Joven
3.
Swiss Dent J ; 130(9): 677-683, 2020 09 07.
Artículo en Alemán | MEDLINE | ID: mdl-32893610

RESUMEN

This article will provide an overview of the principles and modes of action of fluorides in oral care products, followed by a brief outline of the history and current situation regarding salt fluoridation in Switzerland. Recommendations for the use of fluoridated oral care products, current research results on the use of fluoride-containing dental care products and controversies related to fluorides are presented. Finally, the changes in fluoride concentration for children's toothpastes in Europe and the corresponding implementation in Switzerland as well as changes regarding the use of fluoride in school dentistry are discussed.


Asunto(s)
Caries Dental , Fluoruros , Cariostáticos , Niño , Fluoruración , Humanos , Suiza
5.
Evid Based Dent ; 21(3): 90-91, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32978536

RESUMEN

Data sources Medline, Embase, CINAHL and PubMed.Study selection Studies published in peer-reviewed journals focusing on dental caries of primary teeth and risk and/or protective factors, in healthy children aged equal to or less than six years, including randomised controlled trials (RCTs) with an intervention period of at least one year for caries, other intervention studies, and observational studies (such as cohort, case-control, ecologic and cross-sectional studies); risk and/or protective factors included: breastfeeding beyond one year of age, breastfeeding beyond two years of age, consumption of liquids that contain free sugars from an infant feeding bottle, consumption of complementary drinks that contain free sugars, consumption of complementary foods that contain free sugars, oral hygiene provided by a parent/caregiver, oral health education for caregivers, water with an optimum concentration of fluoride, consumption of fluoridated milk and salt fluoridation.Data extraction and synthesis Five reviewers independently screened the title and abstract of the identified citations and 5% of them were screened by all reviewers. Data extraction was undertaken by two reviewers. The evidence was classified into 12 groups in accordance with the 12 review questions. Eligible studies were synthesised and meta-analysis performed where appropriate. Risk of bias was tested by the Cochrane 'risk of bias' tool for RCTs and the ROBINS-I for non-randomised trials. The quality of evidence related to each of the 12 review questions was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).Results After initial search of 13,831 studies, 137 eligible studies were included in the systematic review and grouped into 10 out of 12 review questions (no eligible study was identified for two review questions). Among those ten review questions, only two review questions had RCTs to address the answers; others were answered by observational studies and/or quasi-experimental studies. A prospective cohort study displayed no significant difference was found in severity of caries among five-year-old children inbetween those breastfed for nearly 23 months and those breastfed up to one year. Observational studies showed increased risk of early childhood caries (ECC) was associated with consumption of sugar in both bottles and complementary foods. Results of meta-analysis of three RCTs stated that children of caregivers who received oral health education had lower chance of having ECC than those who had never received oral health education (OR 0.39, 95% CI 0.19 to 0.79, P = 0.009). Another result from meta-analysis demonstrated that lower pooled mean dmft was found in children living in areas with fluoridated water than those who lived in non-fluoridated areas (-1.25, 95% CI -2.14 to -0.36, P = 0.016). Children who consumed fluoridated milk and fluoridated salt reduced the risk of ECC compared to those who did not. No publication bias was observed in the meta-analysis.Conclusions Evidence with moderate quality demonstrated that children with access to fluoridated water and fluoridated supplements could lower their risk of ECC; children with caregivers who had received oral health education had lower levels of ECC. Evidence with low quality suggested that breastfeeding up to two years old did not increase the risk of ECC; consumed sugars in bottles and complementary foods increased the risk of ECC.


Asunto(s)
Caries Dental , Animales , Niño , Preescolar , Estudios Transversales , Femenino , Fluoruración , Fluoruros , Humanos , Estudios Prospectivos
7.
Value Health ; 23(8): 1109-1118, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32828224

RESUMEN

OBJECTIVES: To describe and summarize evidence on economic evaluations (EEs) of primary caries prevention in preschool children aged 2 to 5 years and to evaluate the reporting quality of full EE studies using a quality assessment tool. METHODS: A systematic literature search was conducted in several databases. Full and partial EEs were included. The reporting quality of full EE studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. RESULTS: A total of 808 studies were identified, and 39 were included in the review. Most papers were published between 2000 and 2017 and originated in the United States and the United Kingdom. The most common type of intervention investigated was a complex multicomponent intervention, followed by water fluoridation. Cost analysis and cost-effectiveness analysis were the most frequently used types of EE. One study employed cost-utility analysis. The proportion of full EEs increased over time. The parameters not reported well included study perspective, baseline year, sensitivity analysis, and discount rate. The CHEERS items that were most often unmet were characterizing uncertainty, study perspective, study parameters, and estimating resources and costs. CONCLUSIONS: Within the past 2 decades, there has been an increase in the number of EEs of caries prevention interventions in preschool children. There was inconsistency in how EEs were conducted and reported. Lack of preference-based health-related quality-of-life measure utilization in the field was identified. The use of appropriate study methodologies and greater attention to recommended EE design are required to further improve quality.


Asunto(s)
Caries Dental/prevención & control , Prevención Primaria/economía , Preescolar , Análisis Costo-Beneficio , Fluoruración/economía , Humanos , Educación del Paciente como Asunto/economía , Selladores de Fosas y Fisuras/economía , Reino Unido , Estados Unidos
9.
Rev Bras Epidemiol ; 23: e200086, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32725092

RESUMEN

INTRODUCTION: The adjusted effect of the characteristics of sanitation companies on the provision of fluoridation into public water supply in Brazilian municipalities was evaluated. METHODS: Cross-sectional and ecological study based on the 2010 Demographic Census, 2008 National Survey on Basic Sanitation (PNSB), and 2010 Atlas of Human Development. The independent variables were the characteristics of utilities and municipalities, and the outcome was the lack of provision of fluoridation. Prevalence ratio was estimated with Poisson regression with robust variance. RESULTS: 5,565 Brazilian municipalities were included. In the adjusted analysis, the outcome was independently and positively associated to municipalities in the North, Northeast, Central-West and Southeast macro-regions, with coverage rates for water and sewage services below the median value, with less than 10,000 inhabitants, medium and low/very low in human development. Regarding the independent effect of the utilities' characteristics, they were more likely not to provide fluoridation, all the companies that were not classified as indirect administration of the government or mixed-capital company or mixed-capital company of public character; municipal and intermunicipal (PR=1.21; 95%CI 1.19-1.23); and when the municipal government is the only provider (PR=1.22; 95%CI 1.20-1.25). CONCLUSION: The lack of provision of water fluoridation was greater when the service was mainly provided by municipal administrations and private companies associated or not to public entities, regardless of the characteristics of the municipalities.


Asunto(s)
Fluoruración/estadística & datos numéricos , Saneamiento/estadística & datos numéricos , Brasil , Ciudades , Estudios Transversales , Humanos
10.
Environ Monit Assess ; 192(8): 514, 2020 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-32666298

RESUMEN

Public health monitoring of Community Water Fluoridation (CWF) schemes requires estimates of exposure to fluoride in public water supplies (PWS). We aimed to use routine data to estimate population exposure to PWS-fluoride in England and to determine whether PWS-fluoride exposure from 2005 to 2015 could be used as a proxy for exposure for 1995-2004, when fluoride concentration data that could be linked to population health data were unavailable. We calculated annual mean water supply zone PWS-fluoride concentrations from monitoring data for 1995-2015, stratified by fluoridation scheme-flagging. We allocated annual 2005-2015 mean PWS-fluoride concentrations to small area boundaries to describe population exposure within five concentration categories (< 0.1 to ≥ 0.7 mg/L). We compared zone-level 1995-2004 and 2005-2015 mean PWS-fluoride concentrations using Spearman correlation. Most (72%) of the population received PWS with < 0.2 mg/L fluoride and 10% with ≥ 0.7 mg/L. Fluoride concentrations in 1995-2004 and 2005-2015 were similar (median 0.11 mg/L (lower quartile-upper quartile (LQ-UQ) 0.06-0.17) and 0.11 mg/L (LQ-UQ 0.07-0.17), respectively) and highly correlated (coefficient 0.93) if un-fluoridated but differed (1995-2004 median 0.78 mg/L (LQ-UQ 0.59-0.92); 2005-2015 0.84 mg/L (LQ-UQ 0.72-0.95)) and correlated weakly (coefficient 0.31) if fluoridated. Fluoride concentrations in 2005-2015 approximate those in 1995-2004 but with a greater risk of misclassification in fluoridation schemes.


Asunto(s)
Monitoreo del Ambiente , Fluoruros/análisis , Inglaterra , Fluoruración , Abastecimiento de Agua
11.
Rev Saude Publica ; 54: 51, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32491111

RESUMEN

OBJECTIVE To discuss the negative and positive concepts of liberty and postulate its interdependent and complementary relationship in the evaluation of public policy intersectoral actions, taking water fluoridation as a case. METHOD To describe scopes and limits regarding 1950s Isaiah Berlin's distinction, showing its validity in facing the harmful effects of an uncontrolled market economy and an autocratic political regime. RESULTS Both the rights that protect citizens against a powerful state and the rights that protect the state against powerful citizens were equally acknowledged as crucial. CONCLUSION We argued that, in a context in which negative and positive liberties are balanced, regulatory policies have double meaning. Thus, there should be a balance between the establishment of necessary rules for social protection and limits for them not to violate individuals' rights.


Asunto(s)
Fluoruración , Libertad , Política Pública , Derecho a la Salud , Caries Dental/prevención & control , Humanos , Factores Socioeconómicos
12.
Cad Saude Publica ; 36(4): e00208418, 2020.
Artículo en Portugués | MEDLINE | ID: mdl-32374811

RESUMEN

The aim of this study was to analyze legislative proceedings on fluoridation policies in Brazil from 1963 to 2019. The theoretical reference was Pierre Bourdieu. A document search was performed on legislative proceedings that address the theme of fluoridation in Brazil as a public health measure and the discussions in the National Congress. The sources for the article were the official websites of the Chamber of Deputies (lower house) and the Senate to consult the legislative acts related to fluoridation in Brazil. The study showed that from 1963 to 2001 and in 2017 there was a dispute between fluoridation methods for the water supply, mineral water, and table salt fluoridation. However, there was a crosscutting understanding of the importance and benefits of systemic fluoride use. From 2003 to 2013, the bills challenged the use of systemic fluoride, proposing its use only in topical applications. In the 1960s, 1970, and 2017, the legislative bills showed a closer approach to the scientific field and were submitted by opposition members of Congress. Unlike the issue of water fluoridation, of the 6 legislative bills in favor of salt fluoridation, only one was drafted by a health professional da health, and only two by legislators from the Southeast region. There were more bills by legislators from the Central and Northeast. Those with training in health exhibited positions in defense of some method of systemic fluoridation. The analysis allowed interpreting the historical process of developing the response to the caries problem and the different strategies employed in this process.


Asunto(s)
Caries Dental/prevención & control , Fluoruración/historia , Fluoruros/uso terapéutico , Brasil , Política de Salud , Historia del Siglo XX , Humanos , Legislación como Asunto , Salud Bucal , Salud Pública
13.
BMC Oral Health ; 20(1): 115, 2020 04 16.
Artículo en Inglés | MEDLINE | ID: mdl-32299417

RESUMEN

BACKGROUND: Community water fluoridation (CWF) is considered one of the 10 greatest public health achievements of the twentieth century and has been a cornerstone strategies for the prevention and control of dental caries in many countries. However, for decision-makers the effectiveness and safety of any given intervention is not always sufficient to decide on the best option. Economic evaluations (EE) provide key information that managers weigh, alongside other evidence. This study reviews the relevant literature on EE in CWF. METHODS: A systematic database search up to August 2019 was carried out using MEDLINE, EMBASE, Cochrane Library, LILACS, Paediatric Economic Database Evaluation and National Health Service Economic Evaluation Database. The review included full economic evaluations on CWF programs, written in English, Spanish or Portuguese. The selection process and data extraction were carried out by two researchers independently. A qualitative synthesis of the results was performed. RESULTS: Of 498 identified articles, 24 studies met the inclusion criteria; 11 corresponded to cost-benefit analysis; nine were cost-effectiveness analyses; and four cost-utility studies. Two cost-utility studies used Disability-Adjusted Life Years,, one used Quality-Adjusted Tooth Years, and another Quality-Adjusted Life Years. EEs were conducted in eight countries. All studies concluded that water fluoridation was a cost-effective strategy when it was compared with non-fluoridated communities, independently of the perspective, time horizon or discount rate applied. Four studies adopted a lifetime time horizon. The outcome measures included caries averted (n = 14) and savings cost of dental treatment (n = 4). Most of the studies reported a caries reduction effects between 25 and 40%. CONCLUSION: Findings indicated that CWF represents an appropriate use of communities' resources, using a range of economic evaluation methods and in different locations. These findings provide evidence to decision-makers which they could use as an aid to deciding on resource allocation.


Asunto(s)
Caries Dental/prevención & control , Fluoruración/economía , Análisis Costo-Beneficio , Humanos , Años de Vida Ajustados por Calidad de Vida , Medicina Estatal
14.
Environ Health ; 19(1): 38, 2020 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-32248806

RESUMEN

BACKGROUND: Previous studies have shown a correlation between fluoride concentrations in urine and community water fluoride concentrations. However, there are no studies of the relationship between community water fluoridation, urine, serum, and amniotic fluid fluoride concentrations in pregnant women in the US. The aim of this study was to determine the relationship between maternal urine fluoride (MUF), maternal urine fluoride adjusted for specific gravity (MUFSG), maternal serum fluoride (MSF), amniotic fluid fluoride (AFF) concentrations during pregnancy, and community water fluoridation in Northern California. METHODS: Archived samples of urine, serum and amniotic fluid collected from second trimester pregnant women in Northern California from 47 different communities in Northern California and one from Montana (n = 48), were analyzed for fluoride using an ion specific electrode following acid microdiffusion. Women's addresses were matched to publicly reported water fluoride concentrations. We examined whether fluoride concentrations in biospecimens differed by fluoridation status of the community water, and determined the association between water fluoride concentrations and biospecimen fluoride concentrations using linear regression models adjusted for maternal age, smoking, Body Mass Index (BMI), race/ethnicity, and gestational age at sample collection. RESULTS: Fluoride concentrations in the community water supplies ranged from 0.02 to 1.00 mg/L. MUF, MSF , and AFF concentrations were significantly higher in pregnant women living in communities adhering to the U.S. recommended water fluoride concentration (0.7 mg/L), as compared with communities with less than 0.7 mg/L fluoride in drinking water. When adjusted for maternal age, smoking status, BMI, race/ethnicity, and gestational age at sample collection, a 0.1 mg/L increase in community water fluoride concentration was positively associated with higher concentrations of MUF (B = 0.052, 95% CI:0.019,0.085), MUFSG (B = 0.028, 95% CI: -0.006, 0.062), MSF (B = 0.001, 95% CI: 0.000, 0.003) and AFF (B = 0.001, 95% CI: 0.000, 0.002). CONCLUSIONS: We found universal exposure to fluoride in pregnant women and to the fetus via the amniotic fluid. Fluoride concentrations in urine, serum, and amniotic fluid from women were positively correlated to public records of community water fluoridation. Community water fluoridation remains a major source of fluoride exposure for pregnant women living in Northern California.


Asunto(s)
Líquido Amniótico/química , Fluoruración , Fluoruros/metabolismo , Exposición Materna/estadística & datos numéricos , Adulto , California , Agua Potable/química , Femenino , Feto/química , Fluoruros/sangre , Fluoruros/orina , Humanos , Montana , Embarazo , Segundo Trimestre del Embarazo , Adulto Joven
15.
Ciênc. Saúde Colet ; 25(4): 1507-1518, abr. 2020. tab
Artículo en Portugués | LILACS | ID: biblio-1089535

RESUMEN

Resumo Fluoretação da água é uma estratégia de controle da cárie, recomendada pela OMS. No Brasil ela é regulamentada por lei, mas não tem sido implementada com sucesso na região Norte. Os objetivos desta pesquisa foram levantar dados sobre a existência do heterocontrole nos 10 maiores municípios tocantinenses e analisar a concentração de fluoreto presente na água de abastecimento público destas cidades. A pesquisa foi realizada de maio-agosto/17 e teve como marco teórico-metodológico a análise quantitativa, descritiva e transversal. Coletas de água foram realizadas mensalmente, utilizando protocolo de amostragem de coleta de água da rede. A concentração de fluoreto nas águas foi feita com eletrodo íon específico pela técnica direta. Constatou-se que a vigilância da fluoretação da água está em operação na capital do estado desde 2016. Com relação a concentração de fluoreto na água, foi encontrado que 31,6% das amostras analisadas estavam adequadas para o máximo benefício de redução de cárie e 27,5% delas apresentavam risco alto ou muito alto de fluorose dentária. É necessário implementar um programa de controle da concentração de flúor na água no Tocantins, a fim de garantir que a população não seja privada dos benefícios anticárie da agregação de flúor à agua tratada.


Abstract Water fluoridation is a strategy for caries control recommended by the WHO. In Brazil, it is regulated by law but this program has not been successfully implemented in the North region. This research aimed to collect data on the existence of external control (heterocontrol) in the ten largest municipalities in the state of Tocantins, Brazil, and to analyze fluoride concentration in the public water supply of these cities. The study was conducted from May-August/17, and its theoretical-methodological framework was a quantitative, descriptive and cross-sectional analysis. Water collections were carried out monthly, using sampling protocol of water collection of the network. Fluoride concentration in the waters was determined with ion specific electrode by the direct technique. It was verified that water fluoridation monitoring is only been done in Palmas, capital of the state, starting in 2016. Thirty-two percent of waters samples analyzed showed fluoride concentration to obtain the maximum benefit of reduction caries and 27.5% of them presented a high or very high risk of dental fluorosis. It is necessary to implement a program to control the concentration of fluoride in the water of the municipalities of Tocantins, in order to ensure that the population is not deprived of the anticaries' benefits of the adjustment of fluoride concentration of the treated water.


Asunto(s)
Cariostáticos/análisis , Fluoruración/estadística & datos numéricos , Estudios Transversales/normas , Fluoruros/análisis , Abastecimiento de Agua , Brasil , Estudios Transversales , Ciudades/estadística & datos numéricos
16.
Artículo en Inglés | MEDLINE | ID: mdl-32204333

RESUMEN

Despite improvements in the prevalence of dental caries, disparities are still observed globally and in the U.S. This study examined whether community water fluoridation (CWF) reduced dental caries disparities in permanent teeth of 10- to 19-year-old schoolchildren in North Carolina. We used cross-sectional data representing K-12 schoolchildren in North Carolina (NC) public schools. A poisson regression model was used to determine whether the association between children's parental educational attainment and the prevalence of dental caries of children differed by children's lifetime CWF exposure. We analyzed data on 2075 students. Among the children without any CWF exposure in their life, statistically significant caries disparities by parental educational attainment were observed. Compared to the children of parents with more than high school education, the relative risk for those with a parent with a high school education was 1.16 (95% CI = 1.01, 1.33) and those with less than a high school education was 1.27 (95% CI = 1.02, 1.60). In contrast, these disparities were not observed among children exposed to CWF throughout their lives. Socioeconomic disparities in dental caries were not observed among 10-19-year-old schoolchildren with lifetime CWF exposure. CWF seemed to reduce dental caries disparities.


Asunto(s)
Caries Dental , Dentición Permanente , Fluoruración , Disparidades en el Estado de Salud , Adolescente , Adulto , Niño , Estudios Transversales , Índice CPO , Caries Dental/epidemiología , Femenino , Humanos , Masculino , North Carolina/epidemiología , Prevalencia , Adulto Joven
17.
J Dent Hyg ; 94(1): 14-20, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32127425

RESUMEN

Purpose: The purpose of this study was to understand the beliefs, experiences and practices regarding drinking water among the North Carolina (NC) Latino community, and to gather information on what would make effective messages to promote fluoridated community water (CW) consumption among Latino families.Methods: Phone interviews were conducted with Latino stakeholders, consisting of parents of young children and key community informants (n=15). The interviews were audio-recorded, and transcripts were analyzed qualitatively using Atlas. ti.8 software.Results: Major themes emerging from the interviews included: poor characteristics of CW misconceptions and lack of knowledge about CW fluoridation and safety, ingrained culture/upbringing that devalued CW consumption, and reasons for consuming CW. Participants suggested that effective efforts to promote fluoridated CW consumption among the NC Latino community should be implemented in a variety of formats and involve a collaborative approach between Spanish-speaking health professionals and community workers.Conclusion: Successful promotion of fluoridated CW consumption among NC Latino communities requires engagement of both health professionals and community stakeholders. Effective interventions aimed to promote fluoridated CW consumption need to be widespread, informative, persuasive, credible, culturally sensitive, and interactive.


Asunto(s)
Caries Dental , Agua Potable , Niño , Preescolar , Fluoruración , Hispanoamericanos , Humanos , North Carolina , Investigación Cualitativa
18.
Braz Oral Res ; 34: e010, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049111

RESUMEN

Relevant public policies in oral health have been implemented in Brazil since 2004. Changes in the epidemiological status of dental caries are expected, mainly in the child population. This study aimed to assess the dental caries experience and associated factors among 12-year-old children in the state of São Paulo, Brazil. A cross-sectional population-based study was conducted with data obtained from 415 cities, including a total of 26,325 schoolchildren who were included by the double-stage cluster technique, by lot and by systematic sampling. The statistical model included data from the São Paulo Oral Health Survey (SBSP 2015), the Human Development Index (HDI) and the Social Vulnerability Index (SVI). A theoretical-conceptual model categorized the variables into three blocks, namely, contextual (HDI, SVI, region of residence and fluoridation of water), individual (sex and ethnicity) and periodontal conditions (gingival bleeding, dental calculus and the presence of periodontal pockets), for association with the experience of caries (DMFT). Statistically significant associations were verified by hierarchical multivariate logistic (L) and Poisson (P) regression analyses (p < 0.05). The results showed that 57.7% of 12-year-old children had caries experience. Factors that determined a greater prevalence of dental caries in both models were nonwhite ethnicity (ORL = 1.113, ORP = 1.154) and the presence of gingival bleeding (ORL = 1.204, ORP = 1.255). Male children (ORL = 0.920 ORP = 0.859) and higher HDI (ORL = 0.022), ORP = 0.040) were associated with a lower prevalence of dental caries experience. Water fluoridation was associated with a lower DMFT index (ORP = 0.766). Dental caries experience is still associated with social inequalities at different levels. Policymakers should direct interventions towards reducing inequalities and the prevalence of dental caries among 12-year-old children.


Asunto(s)
Caries Dental/epidemiología , Brasil/epidemiología , Niño , Estudios Transversales , Índice CPO , Caries Dental/etiología , Femenino , Fluoruración/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Análisis Multivariante , Índice Periodontal , Prevalencia , Factores de Riesgo , Distribución por Sexo , Factores Socioeconómicos , Poblaciones Vulnerables/estadística & datos numéricos
19.
PLoS One ; 15(2): e0228843, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32101553

RESUMEN

Vertebrate fossils embedded in amber represent a particularly valuable paleobiological record as amber is supposed to be a barrier to the environment, precluding significant alteration of the animals' body over geological time. The mode and processes of amber preservation are still under debate, and it is questionable to what extent original material may be preserved. Due to their high value, vertebrates in amber have never been examined with analytical methods, which means that the composition of bone tissue in amber is unknown. Here, we report our results of a study on a left forelimb from a fossil Anolis sp. indet. (Squamata) that was fully embedded in Miocene Dominican amber. Our results show a transformation of the bioapatite to fluorapatite associated with a severe alteration of the collagen phase and the formation of an unidentified carbonate. These findings argue for a poor survival potential of macromolecules in Dominican amber fossils.


Asunto(s)
Ámbar , Huesos/metabolismo , Fluoruración , Lagartos , Animales , Fósiles
20.
J Dent ; 93: 103277, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31931026

RESUMEN

OBJECTIVES: We report efficacy of resin infiltration to arrest progression of caries lesions as compared with non-invasive measures and oral hygiene education alone after a mean observation time of seven years. MATERIALS AND METHODS: This randomized split-mouth placebo-controlled clinical trial included 22 young adults having 29 pairs of interproximal non-cavitated caries lesions with radiographic extensions into inner half of enamel (E2) or outer third of dentin (D1). Lesion pairs were randomly allocated to two treatment groups: infiltration (Icon, pre-product; DMG) or mock (control) treatment. All subjects received risk-related instructions for diet, flossing and fluoridation. The primary outcome was radiographic (digital subtraction radiography) lesion progression after seven years. Secondly, Kaplan-Meier-analyses were applied to analyze time-to-failure additionally including patients followed up for less than 54 months as well. RESULTS: Two lesion pairs were excluded due to invasive treatment decision by another dentist, five lesion pairs were lost to follow-up prior to 54 months but included in the survival analysis. No unwanted effects could be observed. For the primary outcome in 17 patients followed up in mean for 84 months 2/22 infiltrated lesions (9 %) compared with 10/22 control lesions (45 %) progressed (p = 0.018). The relative risk reduction for test in relation to control was 80 % (CI 95 % = 19-95 %). For the survival analysis within a mean (SD) observation time of 73 (25) months mean failure rates of 1.3 % and 7.8 % could be observed for test and controls, respectively. Hazard risk (95 % CI) for caries progression was 6.6 (2-22) for the control compared with the test lesions (p = 0.002). CONCLUSIONS: We conclude that resin infiltration of proximal caries lesions extending radiographically around the enamel dentin junction is efficacious to reduce lesion progression after a mean observation time of seven years. CLINICAL SIGNIFICANCE: This randomized clinical trial proves that caries infiltration is highly efficacious compared with non-invasive measures and oral hygiene education alone after a considerably longer observation time of 7 years than studied so far before.


Asunto(s)
Caries Dental , Radiografía Dental Digital , Atención Odontológica , Esmalte Dental , Fluoruración , Humanos , Adulto Joven
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