Health professionals' recommendations on the use of fluoride varnish for caries prevention in preschool children.

BACKGROUND: Fluoride varnish (FV) is widely recommended for caries prevention in preschool children, despite its anticaries benefits being uncertain and modest. Dentists often report using clinical practice guidelines (CPGs) as a source of scientific information. AIM: To identify and analyze recommendations for clinical practice on the use of FV for caries prevention in preschool children and to assess the methodological quality of the CPG on this topic. DESIGN: Two researchers independently used 12 search strategies and searched the first five pages of Google Search™ and three guideline databases for recommendations freely available to health professionals on the use of FV for caries prevention in preschoolers. Then, they retrieved and recorded recommendations that met the eligibility criteria and extracted the data. A third researcher resolved disagreements. Each included CPG was appraised using the AGREE II instrument. RESULTS: Twenty-nine documents were included. Recommendations varied according to age, patients' caries risk, and application frequency. Of the six CPGs, only one scored above 70% in the AGREE II overall assessment. CONCLUSION: Recommendations on the use of FV lacked scientific evidence, and CPGs were of poor quality. Application of FV is widely recommended despite recent evidence showing an uncertain, modest, and possibly not clinically relevant anticaries benefit. Dentists should be aware that it is necessary to critically appraise CPGs since they may be of poor quality.

Avaliação da condição de saúde bucal e impacto na qualidade de vida relacionada à saúde bucal de gestantes adolescentes e adultas jovens / Evaluation of oral health status and impact on oral health quality of adolescents and young adults

A adolescência (10 a 19 anos) e juventude (15 a 24 anos) são períodos de transição marcados por diversas mudanças. A gestação nesta fase, principalmente até os 19 anos, é considerada um problema de saúde pública. A condição de saúde bucal (CSB) pode gerar impactos na qualidade de vida relacionada à saúde bucal (QVRSB). O objetivo deste estudo foi descrever a CSB e o seu impacto na QVRSB de gestantes adolescentes e adultas jovens. Este estudo transversal avaliou gestantes de 15 a 24 anos atendidas em uma maternidade escola, divididas em grupos por faixas etárias. A CSB foi avaliada por um único examinador pré-treinado a partir dos indicadores CPOD, IPC e má oclusão, de acordo com a Organização Mundial de Saúde. A QVRSB foi analisada por meio do OIDP. A diferença entre os grupos foi analisada pelo Teste qui-Quadrado e Teste T Student (p<0,05) e uma possível correlação entre os indicadores de CSB e a QVRSB foi avaliada pelo Teste de Spearman (p<0,05). Do total de 86 gestantes incluídas, 56,8% tinham entre 20 e 24 anos (G2) e 40,9% entre 15 e 19 anos (G1) (p<0,05). O CPOD médio foi igual a 5,83 (± 4,23) no G1 e 6,36 (± 3,93) no G2 (p<0,05). Independente do grupo, a maioria, apresentou algum nível de doença periodontal e má oclusão normal ou leve. Não houve correlação entre os indicadores clínicos CPOD, IPC e má oclusão e a QVRSB (p>0,05), independente do grupo. O impacto mais observado foi a dificuldade de comer e apreciar a comida. A CSB das gestantes adolescentes e adultas jovens pode ser considerada ruim. Ao menos um impacto na QVRSB foi relatado pela maioria das gestantes. No entanto, os indicadores de CSB não tiveram associação com os impactos gerados na QVRSB. (AU)

Adolescent and youth pregnancy is considered a public health issue. The oral health status can produce impacts on the oral health related quality of life (OHRQoL). This study aims to describe the oral health status and its impacts on OHRQoL of pregnant adolescent and youth. This cross-sectional study evaluated pregnant women from 13 to 24 years of age who attended the prenatal program at Federal University of Rio de Janeiro's maternity school. They were divided in groups by age. The oral health status was collected by a pre-trained single evaluator with the DMFT, IPC and malocclusion indexes, according to the World Health Organization. The OHRQoL was collected with the OIDP and Child-OIDP questionnaires. The difference between the groups was analyzed by chi-square tests (p<0,05) and student's t test, and the possible correlation between the oral health status's indexes and the OHRQoL was evaluated with Spearman correlations (p<0,05). Out of the 86 pregnant women included in the study, 56.8% aged between 20 and 24 years old (G2), 40.9% between 15 and 19 years (G1) (p<0,05). The mean DMFT index was 5.83 (± 4.23) in G1 and 6.36 (± 3.93) in G2 (p<0,05). Most of the women, regardless of the group, had at least one indicator of periodontal disease and normal or light malocclusion. There was no correlation between the DMFT, IPC and malocclusion indexes and the OHRQoL (p>0,05), regardless of the group. The most prevalent impact was difficulty eating and enjoying food. The oral health status of adolescent and young pregnant women may be considered low. Most of the women reported at least one impact on their OHRQoL. However, oral health status had no correlation to the impacts on OHRQoL. (AU)