Oral health status in victims of child abuse: a case-control study.

BACKGROUND: Few studies have evaluated the oral health status of children with a history of maltreatment. AIM: This case-control study evaluated oral health in children who were victims of abuse and in child protective services in Curitiba, Brazil. DESIGN: One hundred twenty-two children who were victims of abuse and 240 children with no history of abuse (mean ages, 8.56 and 8.24 years, respectively) were included in the study. Dental caries were assessed according to the Decayed, Missing, or Filled Teeth index (dmft index and DMFT index) by two calibrated examiners. The presence of anterior open bite and posterior crossbite was recorded. Data were analyzed using bivariate and adjusted odds ratios using a multivariate logistic regression model analyses. RESULTS: In the case group, we found a higher DMFT index (P < 0.001) and a significantly higher prevalence of missing primary teeth (P = 0.04), untreated decayed permanent teeth (P < 0.001), filled permanent teeth (P < 0.001), and anterior open bite (P = 0.04). Children who were victims of abuse presented an odds ratio of 6.48 (95% CI: 3.52-11.95) for caries in permanent teeth and an odds ratio of 2.28 (95% CI: 1.04-4.99) for open bite. CONCLUSION: Victims of child abuse had a worse oral health status, demonstrating the need to establish special policies for oral healthcare for this population.

Epidemiological study to determine factors associated with dental caries in schoolers

Introduction:Dental caries is a large problem affecting all population. In Brazil, caries prevalence has decreased over the last years, but it is still a public health issue requiring frequent evaluation and care by dentists. Objective: To evaluate the oral health conditions of schoolers aged 5-12 years relating them with socioeconomic and demographic determinants. Material and methods: The children were examined by a previously calibrated examiner to obtain DMF and dmf scores. The parents answered a questionnaire regarding to the socioeconomic condition. Prior to the examinations, the parents signed a free and clarified consent form and only their children were evaluated. The results were analyzed descriptively and by Chi-square test, at significance level of p<0.05. Results: : The sample (n=111) showed a mean age of 7+1.7 years (mean + standard deviation), composed of 58 boys and 58 girls. 66.6% of the sample exhibited dmf values = 0, while 102 schoolers had DMF values = 0. With regard to the parents' education level, 78.37% of the mothers had more than 9 years of education and 43.34% of the fathers had 9 to 11 years of study. Concerning to family income, 36.93% of the families presented mean income of 1-3 minimum wages (R$ 788.00 to R$ 2,364.00). No statistically significant differences (p≤0.05) were seen between caries rates vs. parents' education and caries rates vs. family income. Conclusion: 5-12 year schoolers showed low dmf and DMF values, suggesting that parents' education and income might have influenced on the results. Further studies are necessary to understand/assess the predisposing factors to dental caries development.

Maus tratos infantis: avaliação do currículo dos cursos em odontologia / Child abuse: curriculum evaluation of dental courses in Brazil

O objetivo desta pesquisa foi avaliar se o tema maus tratos infantis é abordado nos cursos de graduação em Odontologia no Brasil. Trata-se de um estudo exploratório transversal descritivo, desenvolvido com todos os cursos de Odontologia do país. Foram enviados questionários aos 201 coordenadores e 174 foram recebidos, porém somente 28 retornaram respondidos (taxa de resposta de 16,09%). Destes, 19 (67,8%) correspondem a instituições privadas, 06 (21,4%) públicas e 03 (10,7%) de gestão compartilhada. A temática é abordada em 21 cursos (75%), principalmente nas disciplinas de odontopediatria, odontologia legal e saúde coletiva. Quanto à carga horária destinada a este tema, 16 cursos (21,19%) afirmaram ser igual ou menor que 08 horas e 14 coordenadores (66,66%) declararam ser obrigatória a abordagem de tal tema dentro do conteúdo programático do curso. Devido à importância do tema maus tratos infantis e frente aos resultados deste estudo, é pertinente concluir que este assunto tem sido trabalhado de forma incipiente nos cursos de odontologia no Brasil (AU).

The aim of this study was to evaluate whether the theme child abuse is addressed in the undergraduate dentistry in Brazil. This is a cross-sectional exploratory study, in which all universities in the country with the course of dentistry were questioned. Questionnaires were forwarded to all 201 coordinators of education of dentistry in Brazil, which consist in all existing courses at the time of the research. 174 questionnaires were received by the coordinators; however, only 28 were answered (response rate of 16.09%). Of these, 19 (67.8%) were private institutions, 06 (21.4%) public and 03 (10.7%) were joint management. The theme is approached by 21 institutions (75%), mainly in the disciplines of Dentistry, Forensic Dentistry and Public Health. Regarding the amount of hours designated for this theme, 16 institutions (21.19%) mentioned to reserve 08 hours or less during the course, on the other hand, 14 institutions (66.66%) stated that they were required to approach this issue within the course. Due to the importance of the theme child abuse and compared to the results of this study, it seems reasonable to conclude that this matter has been worked very incipient in Dental Courses in Brazil (AU).

Surgery management of rare hypertrophic frenum in an infant.

To report a rare case of a lateral frenum hypertrophy in an infant, this paper describes the case of a girl who came to a first dental appointment when she was 4 months old. A hypertrophic lateral frenum in the upper left canine region was detected. A great depression in the gingival rodet separated the anterior maxillary segment from the posterior one and also decreased the lip mobility in this region. A frenectomy was performed when the patient was 11 months old and the clinical follow-up was done up to the age of 30 months. There was normalization in the vestibular insertion of the lateral frenum, lip mobility, physiological development of the maxilla, and eruption of the upper incisors, canines, and first primary molars. Infants should go to a dental examination precociously in order to detect possible congenital and development alterations.

Mudanças do pH salivar em crianças após a ingestão de suco de frutas industrializado / Salivary pH changes in children after industrialized fruit juice consumption

Introdução: As crianças apresentam erosão dentária e cáries precoces na infância associadas a uma dieta rica em carboidratos, a qual incluia ingestão freqüente de sucos industrializados em caixa. A ingestão de bebidas com pH inferior a 5,5 pode causar erosão principalmente se o ataque for de longa duração e freqüente. A proteção natural dos dentes é a saliva, por intermédio de seu tamponamento salivar. Objetivo: Medir o pH salivar em crianças antes e após a ingestão de suco de uva (DelValle Kids). Material e métodos: Participaram do trabalho 31 crianças com idade entre 6 e 12 anos, de ambos os sexos. A variação do pH foi medida com uma fita colorimétrica. Aferiu-se o pH antes, imediatamente após a ingestão do suco, 5, 10 e 15 minutos após a ingestão. Resultados:Houve diferença estatisticamente significante entre os grupos. Observou-se uma redução imediatamente 5 e 10 minutos após a ingestão do suco em relação ao basal. No tempo imediato o valor do pH de 16 crianças foi acima de 5,5, e 15 apresentaram pH igual ou abaixo de 5,5. No tempo de 5 minutos, 3 crianças mantiveram esse pH, e após10 minutos todas as crianças apresentaram pH acima de 5,5.Conclusão: Pode-se concluir que o suco de fruta apresenta pH baixo eque após 10 minutos da ingestão do suco o pH salivar de todos os participantes tinha valor acima de 5,5, elevando-se próximo aos valores normais com o tempo de 15 minutos.

Introduction: The children presented dental erosion and caries in early infancy that were associated to a rich diet in sugars, including the frequent ingestion of industrialized fruit juice (conditioned in boxes).The drink ingestion with pH lower than 5.5 can cause teeth erosionmainly if it is associated with frequent and prolonged teeth contact.The natural protection of teeth is the saliva through its buffering capacity. Objective: Measure the children salivary pH before and after the grape fruit juice (Del Valle Kids) ingestion. Material and methods: Thirty one children with age between 6 and 12 years of both sexes participated in the study. The pH was measured with pH paper indicator. The salivary pH was measured before, immediately after, and at the 5, 10 and 15min following the ingestion of the juice. Results: There was a significant difference of the pH at different time measurement. A reduction was observed immediately, 5 and 10 minutes after juice ingestion in relation to the basal one. Immediately after fruit ingestion the pH measurementof 16 children was above 5.5 while 15 children presented a pH equalor below of 5.5. At 5 minutes, 3 children still had a pH equal or below5.5. At 10 minutes, all the children had pH above 5.5. Conclusion: It was concluded that, in children, immediately after the ingestion of fruitjuice, there is a clinically significant pH decrease, which can reduce the salivary buffer capacity, but after 10 minutes this ingestion salivarypH reached values above 5.5, raising to next to the normal values atthe time of 15 minutes.

O uso do agregado de trióxido mineral (MTA) em odontopediatria / The use of mineral trioxide aggregate in pediatric dentistry

O material MTA (Agregado de Trióxido Mineral) foi inicialmente desenvolvido para selar comunicações entre o dente e a superfície externa periodontal. Foram encontradas no MTA propriedades como a alta alcalinidade, baixa solubilidade, excelente selamento marginal, capacidade antimicrobiana, radiopacidade, estabilidade dimensional, resistência à compressão e elvada biocompatibilidade, com formação de barreira de tecido mineralizado pela polpa dentária em maior quantidade e qualidade que o hidróxido de cálcio. Diante destas características, o MTA passou a ser credenciado com um material promissor para uso em procedimentos conservadores com pulpotomias de dentes decíduos e capeamento pulpar direto e pulpotomias em dentes permanentes jovens, procedimentos usuais na odontologia infanto-juvenil. Este trabalho tem como objetivo, através de revisão da literatura, demonstrar a viabilidade da utilização do matrial MTA para os procedimentos realizados em odontopediatria e seu potencial futuro de vir a ser o material de eleição para esses procedimentos