Unraveling the signs and symptoms of oral conditions that affect daily life activities and oral health-related quality of life.

OBJECTIVES: Since oral conditions negatively affect oral health-related quality of life (OHRQoL), this study evaluated which oral clinical condition, signs, and symptoms are associated with the impact on OHRQoL, its domains, and specific daily life activities among adults. MATERIALS AND METHODS: Data from a probabilistic sample of adults (35-44 years old) was used. The Oral Impacts on Daily Performance (OIDP) was used to evaluate OHRQoL, its domains (physical, psychological, and social), and nine daily life activities. Signs and symptoms of oral diseases (dental caries, periodontal disease, need for dental prothesis, and tooth loss) and oral self-perception were considered. Descriptive, bivariate, and multi-level analyses were conducted. RESULTS: A total of 5,834 adults were included, of which 52.9% had some negative impact of oral conditions on OHRQoL. Difficulty in eating was the most affected daily life activity. For multiple models, dental caries lesions (cavities), filled teeth with caries, gingival bleeding, periodontal pocket, dental pain, need for upper or lower dental prosthesis, and oral health self-perception were associated (p < 0.05) with overall OHRQoL or at least one of its domains. The impact on daily life activities of each individual was associated with at least one oral condition. Dental caries lesions (cavity) and dental pain were associated (p < 0.05) with the impact on most daily life activities evaluated. CONCLUSIONS: Different signs and symptoms of prevalent oral diseases are associated with the impact on specific daily life activities among adults, which may compromise the OHRQoL. CLINICAL RELEVANCE: Knowledge of how signs, symptoms, and oral conditions affect OHRQoL and daily life activities can provide essential information for clinicians to establish proper disease management and preventive strategies focusing on improving patients' lives.

Proteomic profile of the saliva and plasma protein layer adsorbed on Ti-Zr alloy: the effect of sandblasted and acid-etched surface treatment.

Titanium-zirconium (Ti-Zr) alloy has been widely used as a biomaterial for implant devices, and it is commonly treated by sandblasting followed by acid etching (SLA) to improve biological responses. Although protein adsorption is the first biological response, the effect of this SLA treatment on the proteomic profile of proteins adsorbed from saliva and blood plasma has not been tested. In this study, the proteomic profile was evaluated by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Streptococcus sanguinis was used to test whether the protein layer affects bacterial adhesion. SLA treatment affected the proteomic profile, showing exclusive proteins adsorbed from saliva (14) and plasma (3). However, both groups exhibited close patterns of intensity for common proteins, molecular functions and biological processes mediated by proteins. Interestingly, Ti-ZrSLA showed higher bacterial adhesion (∼1.9 fold over) for the surface coated with plasma proteins. Therefore, SLA treatment of Ti-Zr alloy changed the proteomic profile, which may affect bacterial adhesion.

Titanium particles and ions favor dysbiosis in oral biofilms.

OBJECTIVE: To evaluate the effect of titanium (Ti) particles and ions on oral biofilm growth and composition. BACKGROUND: Particles and ions of Ti released from dental implants can trigger unfavorable biological responses in human cells. However, their effect on oral biofilms composition has not been tested. METHODS: In this blind in situ study, volunteers wore a palatal appliance containing Ti disks for 7 days to allow biofilm formation. Disks were then collected and biofilms were treated, in vitro, with Ti particles (0.75% and 1%), ions (10 and 20 ppm), or a combination of both (1% particles + 20 ppm ions). Biofilms exposed only to medium was used as control group. After 24 hours, biofilms were collected and analyzed by checkerboard DNA-DNA hybridization. Direct effects of Ti particles and ions on biofilm/cellular morphology were evaluated by transmission electron microscopy (TEM). RESULTS: Ti particles affected biofilm composition, increasing population of four bacterial species (P < .05), while Ti ions showed higher levels of putative pathogens from the orange complex with reduction in species from the yellow complex (P < .05), compared with control. The combination of particles + ions increased green complex and reduced yellow complex proportions (P < .05). TEM showed clusters of particles agglomerated in extracellular environment, while Ti ions were precipitated in both extracellular and intracellular sites. CONCLUSIONS: Ti products, especially Ti ions, have the potential to change the microbiological composition of biofilms formed on Ti surfaces. Therefore, the presence of Ti products around dental implants may contribute to microbial dysbiosis and peri-implantitis.

[Dissatisfaction with dental services among dentate and edentulous elderly Brazilians: a multilevel analysis]. / Insatisfação com os serviços odontológicos entre idosos brasileiros dentados e edentados: análise multinível.

The scope of this study was to evaluate dissatisfaction with dental services among dentate and edentulous elderly Brazilians and its association with contextual and individual variables. The data from the National Oral Health Survey conducted in 2010 and contextual variables related to cities were used. Descriptive, bivariate and multilevel analysis was conducted among 1,989 elderly individuals. Of these, 11.2% of dentate and 22.1% of edentulous elderly people were dissatisfied. Among the dentate individuals, dissatisfaction was associated with contextual variables (location of municipality, human development index, GINI Index, the presence of Dental Specialty Centers and the coverage of oral health in public service) and persons related to health care and oral health conditions. For the edentulous individuals, no associated contextual variables were identified. Only the motive for the use of the service and satisfaction with teeth and mouth were associated with dissatisfaction with dental services. A considerable prevalence of dissatisfaction with the services was identified, being higher among edentulous elderly Brazilians. Among dentate elderly Brazilians, an association with contextual variables was detected.

Avaliou-se a insatisfação com os serviços odontológicos entre idosos brasileiros dentados e edentados e sua associação com variáveis contextuais e individuais. Foram utilizados os dados do Levantamento Nacional de Saúde bucal realizado em 2010 e dados contextuais referentes aos municípios. Análises descritivas, bivariadas e multinível foram realizadas. Incluiu-se 1.989 idosos. Destes, 11,2% dos idosos dentados e 22,1% dos edentados estavam insatisfeitos. Entre os dentados, a insatisfação foi associada com variáveis contextuais (localização do município, índice de desenvolvimento humano, Índice de GINI, presença de Centro de Especialidades Odontológicas e cobertura das equipes de saúde bucal) e individuais pertencentes à atenção à saúde e condições de saúde bucal. Para os idosos edentados, não foi identificado associação com variáveis contextuais. Apenas o motivo do uso do serviço e a satisfação com dentes e boca foram associados. Identificou-se uma prevalência considerável de insatisfação com os serviços, sendo maior entre os idosos edentados. Entre os idosos dentados, foi observado associação com variáveis contextuais.

Insatisfação com os serviços odontológicos entre idosos brasileiros dentados e edentados: análise multinível / Dissatisfaction with dental services among dentate and edentulous elderly Brazilians: a multilevel analysis

Resumo Avaliou-se a insatisfação com os serviços odontológicos entre idosos brasileiros dentados e edentados e sua associação com variáveis contextuais e individuais. Foram utilizados os dados do Levantamento Nacional de Saúde bucal realizado em 2010 e dados contextuais referentes aos municípios. Análises descritivas, bivariadas e multinível foram realizadas. Incluiu-se 1.989 idosos. Destes, 11,2% dos idosos dentados e 22,1% dos edentados estavam insatisfeitos. Entre os dentados, a insatisfação foi associada com variáveis contextuais (localização do município, índice de desenvolvimento humano, Índice de GINI, presença de Centro de Especialidades Odontológicas e cobertura das equipes de saúde bucal) e individuais pertencentes à atenção à saúde e condições de saúde bucal. Para os idosos edentados, não foi identificado associação com variáveis contextuais. Apenas o motivo do uso do serviço e a satisfação com dentes e boca foram associados. Identificou-se uma prevalência considerável de insatisfação com os serviços, sendo maior entre os idosos edentados. Entre os idosos dentados, foi observado associação com variáveis contextuais.

Abstract The scope of this study was to evaluate dissatisfaction with dental services among dentate and edentulous elderly Brazilians and its association with contextual and individual variables. The data from the National Oral Health Survey conducted in 2010 and contextual variables related to cities were used. Descriptive, bivariate and multilevel analysis was conducted among 1,989 elderly individuals. Of these, 11.2% of dentate and 22.1% of edentulous elderly people were dissatisfied. Among the dentate individuals, dissatisfaction was associated with contextual variables (location of municipality, human development index, GINI Index, the presence of Dental Specialty Centers and the coverage of oral health in public service) and persons related to health care and oral health conditions. For the edentulous individuals, no associated contextual variables were identified. Only the motive for the use of the service and satisfaction with teeth and mouth were associated with dissatisfaction with dental services. A considerable prevalence of dissatisfaction with the services was identified, being higher among edentulous elderly Brazilians. Among dentate elderly Brazilians, an association with contextual variables was detected.

Uso de diamino fluoreto de prata em crianças atendidas em uma unidade básica de saúde do norte do Paraná / Use of diamino silver fluoride in children of a Basic Health Unit located in north of the state of Paraná

O presente estudo avaliou o uso e a aceitação de diamino fluoreto de prata (DFP) em criançasatendidas em uma Unidade Básica de Saúde (UBS) do Norte do Paraná, bem como o cumprimento do protocolomunicipal para aplicação do DFP. Prontuários (n=43) de crianças de0 a5 anos residentes na área de abrangênciada UBS foram analisados. Foram coletadas informações sobre idade da criança, utilização e indicação do DFP,dentes submetidos ao tratamento e quantidade de reaplicações. Observou-se que o DFP foi aplicado em 79% das crianças devido à Cárie Precoce na Infância (CPI), 60% dos dentes que receberam a aplicação do DFP eram posteriores e 86% dos responsáveis aceitaram utilizar o DFP. Portanto, conclui-se que o DFP tem sido utilizado no serviço público do Paraná e que o procedimento é aceito pela maioria dos responsáveis das crianças, mas o cumprimento do protocolo municipal para aplicação do DFP ainda merece atenção. (AU)

This study evaluated the use and acceptance of silver diamine fluoride (SDF) in children treated in a Basic Health Unit (UBS) in the North of the state of Paraná, as well as the compliance with the municipal protocol for SDF application. Medical records (n=43) of children aged from 0 to 5 years old residing in the area covered by the UBS were analyzed. Information about child's age, use and indication of SDF, teeth treated, and number of SDF reaplications were collected. It was observed that SDF was used in 79% of children due to Early Childhood Caries (ECC), 60% of the teeth treated were posterior teeth, and 86% of the children's tutors accepted SDF use. Therefore, SDF has been used in Paraná's public health service, the treatment was well accepted by most children's tutors, but the compliance with the municipal protocol for SDF treatment still needs attention. (AU)

Is the fluoride intake by diet and toothpaste in children living in tropical semi-arid city safe?

Data about total fluoride intake in children living in a tropical semi-arid climate city is scarce, thus we conducted this study. Fifty-eight children aged two to five years, living in a Brazilian tropical city with optimally fluoridated water were selected. Dietary samples were collected using the duplicate diet method on two non-consecutive days in the children's home toothpaste was determined by subtracting the amount of fluoride recovered after brushing from the amount placed on the toothbrush. The mean total dose (SD) of fluoride intake was 0.043(0.016) mg F·kg-1·d-1, with the major (60.6%) contribution from water. The factors associated with the ingestion of fluoride from toothpaste were fluoride concentration of the toothpaste (p = 0.03) and the use of kids toothpaste (p = 0.02). The findings suggest that children have a low fluoride intake, measured by at-home meals and use of fluoride toothpaste; drinking water is the main source of fluoride ingestion.

Falta de dentição funcional influencia na autopercepção da necessidade de tratamento em adultos: estudo de base populacional no Brasil / Absence of functional dentition influences self-perception need of dental treatment in adults: population-based study in Brazil

Resumo Introdução A falta de dentição funcional compromete a qualidade de vida dos indivíduos, podendo refletir nas suas percepções, incluindo a autopercepção da necessidade de tratamento odontológico. No entanto, essa relação ainda não é bem esclarecida na literatura. Objetivo Avaliar se a falta de dentição funcional em adultos está associada à autopercepção da necessidade de tratamento odontológico. Método Foi realizado estudo transversal analítico, no qual foram utilizados dados da Pesquisa Nacional de Saúde Bucal, realizada no ano de 2010. A faixa etária avaliada foi de 35 a 44 anos. Após análise bivariada e múltipla, foi verificada a associação entre a falta de dentição funcional e outras variáveis, como a autopercepção da necessidade de tratamento, as condições sociodemográficas e os desfechos em saúde. Resultados Dos 9.564 adultos, aproximadamente 20% dos indivíduos não possuíam dentição funcional. A falta de dentição funcional foi menor em adultos que perceberam a necessidade de tratamento odontológico (OR:0,55; IC95%:0,39-0,75). O sexo feminino (OR:1,76; IC95%:1,39-2,22), a idade mais avançada (OR:2,53; IC95%:2,01-3,18) e a menor escolaridade (OR:0,82; IC95%:0,79-0,85) estavam associados à falta de dentição funcional. Conclusão A falta de dentição funcional é maior em adultos que não têm autopercepção da necessidade de tratamento odontológico.

Abstract Introduction The absence of functional dentition compromises people´s quality of life, reflecting on their perceptions, including the self-perceived need for dental treatment in adults. However, this relation is not very clear in literature. Objective To evaluate if the absence of functional dentition is associated to the self-perceived need for dental treatment in adults. Method Analytical cross-sectional study was performed, in which data of the National Oral Health Survey conducted in 2010 was used. The age group evaluated was 35 to 44 years. After bivariate and multivariate analyzes, the association between the absence of functional dentition and other variables as the self-perceived need for dental treatment, sociodemographic conditions and health endpoints was verified. Results From the 9.564 adults, approximately 20% of the individuals did not show functional dentition. The absence of functional dentition was lower in adults who were aware of the self-perceived need for dental treatment (OR:0.55; IC95%:0.39-0.75). The female gender (OR:1.76; IC95%:1.39-2.22), older age (OR:2.53; IC95%:2.01-3.18) and lower schooling (OR:0.82; IC95%:0.79-0.85) were associated with the absence of functional dentition. Conclusion The absence of functional dentition is greater in adults who do not have self-perceived need for dental treatment.

Dose-response effect of chlorhexidine on a multispecies oral biofilm formed on pure titanium and on a titanium-zirconium alloy.

This study aimed to test the dose-response effect of chlorhexidine on multispecies biofilms formed on commercially pure titanium (cpTi) and titanium-zirconium (TiZr) alloy. Biofilms were formed on cpTi and TiZr discs and treated two times per day with five different chlorhexidine concentrations (0.12, 0.20, 0.50, 1, 2%). The biofilms were collected for microbiological, biochemical and microscopic analyses. The significance of differences among groups was evaluated by linear regression, ANOVA, Bonferroni and Tukey tests. The mean number of colony-forming units decreased as the chlorhexidine concentration increased for both cpTi and TiZr (p < 0.05). The maximum effect was observed with the 0.5% concentration. Confocal microscopy images suggested an increase in the number of dead bacterial cells with increased chlorhexidine concentration. The biofilm pH increased after chlorhexidine exposure (p < 0.05). Chlorhexidine showed an antimicrobial dose-response effect in controlling biofilm on cpTi and TiZr. 0.5% chlorhexidine can be used to achieve the maximum antimicrobial effect on both materials.

Perfil, atuação e satisfação de cirurgiões-dentistas em Residências Multiprofissionais em Saúde da região Sul do Brasil / Profile, performance, and satisfaction of Dentists in Multiprofessional Health Residences in Southern Brazil

As Residências Multiprofissionais em Saúde (RMS) encontram-se distribuídas por todo o território nacional e estão estruturadas em abordagem multiprofissional com uma visão mais humana e abrangente, cujo foco não se restringe apenas aos procedimentos curativos. O objetivo do presente estudo foi avaliar o perfil dos cirurgiões-dentistas regularmente matriculados em RMS da região Sul do país, bem como sua atuação e satisfação com os programas. Para isso, foi realizada uma pesquisa quantitativa, exploratória e descritiva, utilizando-se um questionário on-line, cujo link foi enviado a cirurgiões-dentistas matriculados em RMS (Atenção Básica, Saúde da Família e Comunidade e Saúde Coletiva), localizadas na região Sul do Brasil. Os dados coletados foram tabulados no Microsoft Excel® e tratados por estatística descritiva (frequência simples e relativa). Constatou-se que a maioria dos residentes era do gênero feminino (75%) com graduação em IES privada (70%), sem experiência profissional prévia (70%) e com experiência acadêmica prévia em saúde pública (85%). Para os dados referentes à RMS, a maioria relatou como motivo pela escolha da residência o interesse em atuar na atenção básica. Oitenta e cinco por cento dos dentistas relataram atuar em Unidades Básicas de Saúde. A maioria dos residentes mostrou-se satisfeito com a RMS (75%) e a falta de capacitação dos docentes foi apontada como a principal fragilidade dos programas. O estudo possibilitou traçar um panorama do perfil, atuação e satisfação dos cirurgiões-dentistas inseridos em RMS da região Sul do Brasil. Os dados podem auxiliar na melhoria das práticas e organização das RMS com cirurgiões-dentistas, conduzindo melhor a atuação de residentes e docentes frente às principais fragilidades apontadas (AU).

Multi-professional Health Residences (MHR) are distributed throughout the national territory and have an approach with a more human, comprehensive vision and whose focus is not restricted to therapeutic procedures. Therefore, the present study aimed to evaluate the professional profile of dentists in MHR in southern Brazil, as well as their performance and satisfaction with the residency program. Thus, quantitative, exploratory and descriptive research was carried out using an online questionnaire, whose link was sent to all dentists attending MHR in South Brazil. Subsequently, the data collected were tabulated in the Microsoft Excel® and treated by descriptive statistics analysis. Among the main results of personal and professional profiles, the majority of the residents were female (75%) with a degree in private Higher Education Institutions (70%), without prior professional experience (70%) and with previous academic experience in Public health (85%). For MHR data, the majority reported the interest in acting in the primary health care as a reason for choosing the residence. Concerning the place of performance, the Primary Health Unit represented 85%. Most residents were satisfied with MHR (75%) and reported the lack of teacher training as the main program weakness. Therefore, with this study, it was possible to draw a panorama of the professional profile and the performance of dentists inserted in MHR in Southern Brazil. Furthermore, data can support and improve the practices and organization of MHR with dentists, leading to better performance of residents and teachers in the main weaknesses pointed out (AU).

Is the fluoride intake by diet and toothpaste in children living in tropical semi-arid city safe?

Abstract: Data about total fluoride intake in children living in a tropical semi-arid climate city is scarce, thus we conducted this study. Fifty-eight children aged two to five years, living in a Brazilian tropical city with optimally fluoridated water were selected. Dietary samples were collected using the duplicate diet method on two non-consecutive days in the children's home toothpaste was determined by subtracting the amount of fluoride recovered after brushing from the amount placed on the toothbrush. The mean total dose (SD) of fluoride intake was 0.043(0.016) mg F·kg-1·d-1, with the major (60.6%) contribution from water. The factors associated with the ingestion of fluoride from toothpaste were fluoride concentration of the toothpaste (p = 0.03) and the use of kids toothpaste (p = 0.02). The findings suggest that children have a low fluoride intake, measured by at-home meals and use of fluoride toothpaste; drinking water is the main source of fluoride ingestion.

Caries, Toothbrushing Habits, and Fluoride Intake From Toothpaste by Brazilian Children According to Socioeconomic Status.

PURPOSE: The purpose of this study was to evaluate the prevalence of dental caries, toothbrushing habits, fluoride intake, and factors associated with the use of toothpaste in Brazilian children according to socioeconomic status (SES). METHODS: A cross-sectional observational study was conducted with 148 three- to four-year-olds of both low and high socioeconomic status. Data collection consisted of administering a questionnaire to guardians, brushing to determine fluoride intake, and examining the children's teeth to evaluate dental caries. RESULTS: In this study, 42 percent of children from high SES and 2.7 percent of children from low SES used toothpaste without fluoride or with a concentration below 1,000 ppm F. Fluoride intake was associated with SES, frequency of brushing, the amount of toothpaste used, and the concentration of fluoride present in toothpastes (P<0.05). Low SES children had a higher fluoride intake during brushing (0.045 mg F/kg body weight/day), compared to high SES children (0.023 mg F/kg body weight/day). Unlike low SES children (68.9 percent), all high SES children were caries free. CONCLUSIONS: A lower socioeconomic status was associated with a higher prevalence of dental caries and a higher intake of fluoride from toothpaste.

Is there an association between the presence of dental fluorosis and dental trauma amongst school children?

Our objective was to evaluate whether there is an association with the different levels of dental fluorosis and the presence of dental trauma amongst school children. A transversal study was conducted amongst school children from the age of 12. Dental examinations were conducted by 24 well trained and fully qualified dental surgeons. Data was collected from 36 randomly selected public schools amongst 89 schools in a municipality. The criteria used to diagnose dental fluorosis was based on the Dean's fluorosis Index and for diagnosing dental trauma we looked for clinical signs of crown fractures and dental avulsions. Multiple descriptive analysis, which was bivariate, was carried out. Amongst the 2,755 school children that took part in the study 1,089 (39.6%) were diagnosed with dental fluorosis and 106 (3.8%) had one tooth or more with dental trauma. We noted a high prevalence of dental fluorosis, independent of the level of severity, amongst individuals with one tooth or more who had dental trauma. This association was even more evident where there were severely high levels of fluorosis. We also noted that the presence of fluorosis was greater amongst those that actively paid more attention to discoloration on their teeth and who received treatment from a dental professional at their schools. Nevertheless dental fluorosis was associated with the presence of dental trauma, independent of its severity.

A presença de fluorose dentária estaria associada ao traumatismo dentário entre escolares? / Is there an association between the presence of dental fluorosis and dental trauma amongst school children?

Resumo Objetivou-se avaliar se diferentes graus de fluorose dentária estão associados à presença de traumatismo dentário entre escolares. Trata-se de um estudo transversal conduzido entre escolares de 12 anos. Os exames foram realizados por 24 cirurgiões-dentistas treinados e calibrados. A coleta de dados ocorreu em 36 escolas públicas sorteadas entre as 89 do município. Adotou-se como critério de diagnóstico para fluorose dentária o Índice de Dean e para o traumatismo dentário considerou-se sinais clínicos de fraturas coronárias e avulsão dentária. Foram conduzidas análises descritivas, bivariadas e múltiplas. Entre os 2755 escolares incluídos, 1089 (39,6%) foram diagnosticados com fluorose dentária e 106 (3,8%) possuíam um dente ou mais com traumatismo. Identificou-se maior prevalência da fluorose dentária, independente do grau de severidade, entre indivíduos com um dente ou mais com traumatismo dentário. Essa associação foi mais forte com os graus mais severos de fluorose. Além disso, constatou-se que a presença de fluorose foi maior entre aqueles com autopercepção da presença de manchas nos dentes e que recebiam assistência odontológica na escola. Portanto, a fluorose dentária foi associada à presença de traumatismo dentário, independente de sua severidade.

Abstract Our objective was to evaluate whether there is an association with the different levels of dental fluorosis and the presence of dental trauma amongst school children. A transversal study was conducted amongst school children from the age of 12. Dental examinations were conducted by 24 well trained and fully qualified dental surgeons. Data was collected from 36 randomly selected public schools amongst 89 schools in a municipality. The criteria used to diagnose dental fluorosis was based on the Dean’s fluorosis Index and for diagnosing dental trauma we looked for clinical signs of crown fractures and dental avulsions. Multiple descriptive analysis, which was bivariate, was carried out. Amongst the 2,755 school children that took part in the study 1,089 (39.6%) were diagnosed with dental fluorosis and 106 (3.8%) had one tooth or more with dental trauma. We noted a high prevalence of dental fluorosis, independent of the level of severity, amongst individuals with one tooth or more who had dental trauma. This association was even more evident where there were severely high levels of fluorosis. We also noted that the presence of fluorosis was greater amongst those that actively paid more attention to discoloration on their teeth and who received treatment from a dental professional at their schools. Nevertheless dental fluorosis was associated with the presence of dental trauma, independent of its severity.