Are low serum levels of Vitamin D associated with dental developmental defects in primary teeth? A systematic review.

OBJECTIVE: To identify, qualify and synthesize all studies that assessed if low serum level of 25(OH)D (<50 nmol/L) is associated with dental developmental defects (DDD) in primary teeth. MATERIALS AND METHODS: Observational studies or clinical trials were included if measured 25(OH)D serum levels in pregnant women and/or in their children (up to 3 years old) and evaluated the occurrence of DDD in the primary dentition of offspring associated with the low 25(OH)D levels. Literature reviews, case reports, laboratory and/or animals' studies, conference abstracts, letters to the editor, book chapters and clinical protocols were excluded. Searches were carried out in 6 electronic databases and in the gray literature until March 2023, without restrictions. The study quality was assessed by the Newcastle-Ottawa Scale and the certainty of the evidence by GRADE. Data were descriptively synthesized considering the association between DDD and 25(OH)D levels. RESULTS: Seven studies were included. Only developmental enamel defects (DED) were observed after examination of 6651 children. The incidence of DED ranged from 8.9% to 66%. Six studies found no association between low levels of 25(OH)D and DED. However, one reported correlation between hypomineralization of the primary second molar (HSMD) and low levels of 25(OH)D at birth. Methodological flaws were observed in all studies and the certainty of the evidence was very low. CONCLUSION: Although HSMD was the only DDD associated with low levels of 25(OH)D in children, the available evidence is still not conclusive. More robust studies are needed to endorse the biological plausibility of DDD in primary teeth due to low serum levels of 25(OH)D in pregnant women or in their children. FAPERJ financed this study, which was registered in PROSPERO (CRD42022357511).

In-vitro effect of a single application of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets.

OBJECTIVE: To assess the in-vitro effect of single applications of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets. MATERIAL AND METHODS: Tooth/bracket sets (n=65) were immersed in artificial saliva (1h at 37ºC) and randomly subjected to single applications (100µL; 1min) of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP emulsion), CPP-ACP with fluoride (CPP-ACPF emulsion), solutions of titanium tetrafluoride (TiF4) or sodium fluoride (NaF), or no treatment (CG). Multispecies biofilm (5 x 105 CFU/mL) was formed in the presence of 2% sucrose. After 24 h, the pH and the concentration of total soluble fluoride (TSF) were analyzed by culture medium. The presence of active white spot lesions (WSL) evaluated by macroscopic examination and the percent surface mineral loss (%SML) were analyzed. Also, the topography of enamel was detected by analysis of scanning electron microscopy (SEM). The data was assessed by chi-square, Kruskal-Wallis, and Mann-Whitney tests (p < 0.05). RESULTS: Fluoride-containing compounds led to a smaller pH reduction than did CPP-ACP and CG (p<0.05). There was difference in TSF between the groups (p<0.05), denoted as TiF4> NaF > CPP-ACPF > CPP-ACP > CG. Regarding the presence of WSL and %SML, the NaF group obtained lower values (p<0.05), while TiF4 and CPP-ACPF were similar (p>0.05). SEM demonstrated that fluoride-free groups had a larger surface dissolution. CONCLUSION: Fluoridated groups including solutions and CPP-ACPF were more effective than CPP-ACP in reducing enamel demineralization around orthodontic brackets after a single application.

The mandibular bone structure in children by fractal dimension and its correlation with pixel intensity values: a pilot study.

OBJECTIVES: To identify a normal pattern of mandibular trabecular bone in children based on the fractal dimension (FD), and its possible correlation with pixel intensity (PI) values, to facilitate the early diagnosis of possible diseases and/or future bone alterations. MATERIALS AND METHODS: The 50 panoramic images were selected and divided into two groups, according to the children's age: 8-9 (Group 1; n = 25) and 6-7 (Group 2; n = 25). For FD and PI analyses, three regions of interest (ROIs) were selected, and their mean values were evaluated for each ROI, according to each group, using the t test for independent samples and the model of generalized estimation equations (GEE). Subsequently, these mean values were correlated by the Pearson test. RESULTS: Comparing the groups, FD and PI did not differ from each other for any of the measured regions (p > 0.00). It was observed that in the mandible branch (ROI1), FD and PI means were 1.26 ± 0.01 and 81.0 ± 2.50, respectively. In the mandible angle (ROI2), the means were 1.21 ± 0.02 (FD) and 72.8 ± 2.13 (PI); and in the mandible, cortical (ROI3) values of FD = 1.03 ± 0.01 and PI = 91.3 ± 1.75 were obtained. There was no correlation between FD and PI in any of the analyzed ROI (r < 0.285). The FD means of ROI1 and ROI2 did not differ from each other (p = 0.053), but both were different from ROI3 (p < 0.00). All PI values differed from each other (p < 0.00). CONCLUSION: The bone trabeculate pattern in 6-9-year-old children presented FD between 1.01 and 1.29. Besides that, there was no significant correlation between FD and PI.

Association between molar hypomineralization, genes involved in enamel development, and medication in early childhood: A preliminary study.

BACKGROUND: Molar hypomineralization (MH) is defined as a multifactorial condition, and thus, its presence may be defined by interactions between environmental and genetic factors. AIM: To evaluate the association between MH, genes involved in enamel development, and the use of medication during pregnancy in early childhood. DESIGN: One hundred and eighteen children, 54 with and 64 without MH, were studied. The data collected included demographics, socioeconomic data, and the medical history of mothers and children. Genomic DNA was collected from saliva. Genetic polymorphisms in ameloblastin (AMBN; rs4694075), enamelin (ENAM; rs3796704, rs7664896), and kallikrein (KLK4; rs2235091) were evaluated. These genes were analyzed by real-time polymerase chain reaction using TaqMan chemistry. The software PLINK was used to compare allele and genotype distributions of the groups and to assess the interaction between environmental variables and genotypes (p < .05). RESULTS: The variant allele KLK4 rs2235091 was associated with MH in some children (odds ratio [OR]: 3.75; 95% confidence interval [CI] = 1.65-7.81; p = .001). Taking medications in the first 4 years of life was also associated with MH (OR: 2.94; 95% CI = 1.02-6.04; p = .041) and specifically in association with polymorphisms in ENAM, AMBN, and KLK4 (p < .05). The use of medications during pregnancy was not associated with MH (OR: 1.37; 95% CI = 0.593-3.18; p = .458). CONCLUSION: The results of this study suggest that taking medication in the postnatal period appears to contribute to the etiology of MH in some evaluated children. There may be a possible genetic influence of polymorphisms in the KLK4 gene with this condition.

Association Between Attention-Deficit/Hyperactivity Disorder Symptoms and Sleep, Bruxism and Dental Trauma in Pediatric Population: A Preliminary Study.

Purpose: To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) symptoms reported by parents and the variables sleep problems, possible sleep bruxism, possible awake bruxism and dental trauma (DT), and its mode of occurrence in children and adolescents.
Methods: A cross-sectional study was conducted with the parents of 144 four- to 16-year-old subjects through a questionnaire on demographics, subjects' sleep, self-reported bruxism and DT mode of occurrence. The Swanson, Nolan and Pelham scale IV was used to assess ADHD signs and subtypes. Bivariate and multivariate analysis were performed (P <0.05).
Results: The subjects' mean age was 7.9 years (±2.8 years) and 50.7 percent were boys. DT was reported in 80 percent of those with the hyperactive/impulsive subtype (ADHD-HI) and 72.7 percent of those with the combined subtype (ADHD-C). DT was caused solely by falls in the ADHD-C and inattention subtypes (ADHD-I). ADHD-C was associated with somniloquy (prevalence ratio [PR]=1.075; P =0.010). ADHD-HI was associated with bad sleep quality (PR=1.194; P =0.005), possible sleep bruxism (PR=1.088, 95% confidence interval=1.006 to 1.176; P =0.034), possible awake bruxism (PR=1.146; P =0.024) and sleep duration (PR=0.88; P =0.02).
Conclusion: ADHD-C and -HI subtypes were associated with sleep characteristics. Possible sleep and awake bruxism were associated with symptoms of ADHD-HI. Despite no significant association, DT was present in most ADHD subjects, mostly due to falls.

Did the Use of Minimum Interventions for Caries Management Change during the COVID-19 Pandemic? A Cross-Sectional Study.

The aim of this study was to evaluate changes in the frequency of use of minimum intervention (MI) techniques for caries management during the COVID-19 pandemic. A questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of noninvasive, microinvasive, minimally invasive, and mixed interventions, nonaerosol or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test, and the effect size (ES) was calculated. An α = 0.05 was adopted. A total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the noninvasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p < 0.01; ES = 0.11). The frequency of sealants to repair defective restorations was the only microinvasive technique that increased during the pandemic (p < 0.01; ES = 0.03). Among the minimally invasive techniques, the use of atraumatic restorative treatment increased significantly (p < 0.01; ES = 0.06), while the use of air abrasion decreased (p = 0.02; ES = 0.04) during COVID-19 pandemic. Moreover, nonrestorative cavity control (mixed intervention) increased during pandemic period (p < 0.001; ES = 0.11). Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.

Odontopediatría en el contexto de la COVID-19: publicaciones científicas y práctica clínica / Odontopediatria no contexto da COVID-19: publicações científicas e prática clínica / Pediatric dentistry in the context of COVID-19: scientific publications and clinical practice

El propósito es analizar las características de los estudios y las tendencias en las publicaciones científicas y las recomendaciones clínicas relacionadas con el COVID-19 en odontopediatría. La búsqueda electrónica se realizó en las bases de datos MEDLINE, Scopus, Web of Science Core Collection y LILACS/BVS, sin restricciones. Se incluyeron estudios que usaron términos referentes a COVID-19, odontología pediátrica y niños en el título, resumen o palabras clave. Se extrajeron datos bibliométricos y características de los estudios. Cada estudio se categorizó de acuerdo con su diseño, muestra y tema principal. Se incluyeron 49 estudios, la mayoría revisiones (n=25; 51,00%), estudios observacionales (n=23; 47,00%) y estudio clínico (n=1; 2%). Los principales temas fueron urgencias odontológicas (n=9; 18,30%), bioseguridad (n= 8; 16,30%) y teleodontología (n=6; 12,20%). Las urgencias odontológicas más reportadas fueron trauma (n=12; 63,10%), edema (n=9; 47,30%) y dolor (n=9; 47,30%). Se concluyó que se realizaron pocos estudios sobre COVID-19 y odontología pediátrica, y la mayoría de las revisiones y estudios observacionales sobre emergencias dentales se publicaron en Asia.

O objetivo é analisar as características dos estudos e tendências nas publicações científicas e recomendações clínicas relacionadas ao COVID-19 em odontopediatria. A busca eletrônica foi realizada nas bases de dados MEDLINE, Scopus, Web of Science Core Collection e LILACS/BVS, sem restrições. Foram incluídos estudos que usaram termos referentes a COVID-19, odontopediatria e crianças no título, resumo ou palavras-chave. Os dados bibliométricos e as características do estudo foram extraídos. Cada estudo foi categorizado de acordo com seu desenho, amostra e tema principal. Quarenta e nove estudos foram incluídos, sendo a maioria revisões (n=25; 51,00%), estudos observacionais (n=23; 47,00%) e estudo clínico (n=1; 2%). Os principais temas foram emergências odontológicas (n=9; 18,30%), biossegurança (n= 8; 16,30%) e teleodontologia (n=6; 12,20%). As emergências odontológicas mais relatadas foram trauma (n=12; 63,10%), edema (n=9; 47,30%) e dor (n=9; 47,30%). Concluiu-se que poucos estudos sobre COVID-19 e odontopediatria foram realizados, com a maioria das revisões e estudos observacionais sobre emergências odontológicas publicados na Ásia

The purpose is to analyze the characteristics of the studies and trends in scientific publications and the clinical recommendations related to COVID-19 in pediatric dentistry. Electronic search was performed on MEDLINE, Scopus, Web of Science Core Collection, and LILACS/VHL databases, without restrictions. Studies that used terms referring to COVID-19, pediatric dentistry, and children in the title, abstract, or keywords were included. Bibliometric data and studies' characteristics were extracted. Each study was categorized according to its design, sample, and main subject. Forty-nine studies were included, most of them reviews (n=25; 51.00%), observational studies (n=23; 47.00%), and clinical study (n=1; 2%). The main topics were dental emergencies (n=9; 18.30%), biosafety (n= 8; 16.30%) and teledentistry (n=6; 12.20%). The most reported dental emergencies were trauma (n=12; 63.10%), edema (n=9; 47.30%), and pain (n=9; 47.30%). It was concluded that few studies on COVID-19 and pediatric dentistry were conducted, and most reviews and observational studies regarding dental emergencies were published in Asia.

In-vitro effect of a single application of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets

ABSTRACT Objective: To assess the in-vitro effect of single applications of CPP-ACP pastes and different fluoridated solutions on the prevention of dental caries around orthodontic brackets. Material and Methods: Tooth/bracket sets (n=65) were immersed in artificial saliva (1h at 37ºC) and randomly subjected to single applications (100µL; 1min) of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP emulsion), CPP-ACP with fluoride (CPP-ACPF emulsion), solutions of titanium tetrafluoride (TiF4) or sodium fluoride (NaF), or no treatment (CG). Multispecies biofilm (5 x 105 CFU/mL) was formed in the presence of 2% sucrose. After 24 h, the pH and the concentration of total soluble fluoride (TSF) were analyzed by culture medium. The presence of active white spot lesions (WSL) evaluated by macroscopic examination and the percent surface mineral loss (%SML) were analyzed. Also, the topography of enamel was detected by analysis of scanning electron microscopy (SEM). The data was assessed by chi-square, Kruskal-Wallis, and Mann-Whitney tests (p < 0.05). Results: Fluoride-containing compounds led to a smaller pH reduction than did CPP-ACP and CG (p<0.05). There was difference in TSF between the groups (p<0.05), denoted as TiF4> NaF > CPP-ACPF > CPP-ACP > CG. Regarding the presence of WSL and %SML, the NaF group obtained lower values (p<0.05), while TiF4 and CPP-ACPF were similar (p>0.05). SEM demonstrated that fluoride-free groups had a larger surface dissolution. Conclusion: Fluoridated groups including solutions and CPP-ACPF were more effective than CPP-ACP in reducing enamel demineralization around orthodontic brackets after a single application.

RESUMO Objetivo: Avaliar in-vitro o efeito de uma aplicação única de cremes dentais de CPP-ACP e diferentes soluções fluoretadas na prevenção da cárie dentária ao redor de braquetes ortodônticos Material e Métodos: O conjunto dentes/braquetes (n=65) foi imerso em saliva artificial (1h em 37°C) randomizado e submetido a tratamento único (100µL; 1 min) de emulsão de fosfopeptídeo de caseína-fosfato de cálcio amorfo (CPP-ACP) e CPP-ACP associado ao flúor (CPP-ACPF); soluções de tetrafluoreto de titânio (TiF4) e fluoreto de sódio (NaF); e ausência de tratamento (GC). Biofilmes multiespécie (5 x 105 CFU/mL) foram formados na presença de sacarose a 2%. Após 24h, o pH e a concentração de fluoreto solúvel total (FST) foram analisados pelo meio de cultura. Foram avaliadas a presença de lesões de mancha branca (LMB), por meio da análise de macroscopia visual, e a porcentagem de perda de dureza (%PD). Também foi verificada a topografia do esmalte, usando microscopia eletrônica de varredura (MEV). Os dados foram analisados pelos testes Qui-quadrado, Kruskal-Wallis e Mann-Whitney (p < 0,05). Resultados: Os compostos contendo flúor levaram a uma redução do pH menor do que o CPP-ACP e GC (p<0,05). Houve diferença no FST entre os grupos (p <0,05), sendo TiF4> NaF > CPP-ACPF > CPP-ACP > GC. Quanto à presença de LMB e à %PD, o grupo NaF obteve os menores valores (p<0,05), enquanto TiF4 e CPP-ACPF foram semelhantes (p> 0,05). A MEV demonstrou que os grupos sem flúor tiveram uma dissolução superficial maior. Conclusão: Os grupos fluoretados, incluindo soluções e CPP-ACPF, foram mais eficazes do que o CPP-ACP sem flúor na redução da desmineralização do esmalte ao redor dos braquetes ortodônticos após uma única aplicação.

The effect of socioeconomic aspects and dental history on pediatric patients' dental anxiety.

This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A cross-sectional study design with a sample of 120 children aged 7-12 years old was used. Data relating to anxiety levels prior to dental care, socioeconomic aspects (family income, education level, child's school type), and child's dental history (previous dental appointments, previous treatment, caries experience) were collected. Additionally, participants completed the Brazilian version of the Children's Fear Survey Schedule- Dental Subscale (B-CFSS-DS) to assess dental anxiety. Descriptive analyses, chi-squared (X 2 ) tests, and Mann-Whitney U tests were performed, with a significance level of 5%. A total of 51 boys (42.5%) and 69 girls (57.5%) were included. There was no significant difference in dental anxiety between them. However, younger children had higher mean B-CFSS-DS scores (p = 0.036, Mann-Whitney). A higher prevalence of dental anxiety was found in participants from low-income families (p = 0.012, X 2 ) and in patients who did not receive endodontic treatment (p=0.034, X 2 ). Higher mean B-CFSS-DS scores were also observed in participants who did not receive endodontic treatment (p=0.001, Mann-Whitney) compared with those that did receive endodontic treatment. No relationship was found between education level, patient school type, first dental appointment, caries experience, and dental anxiety data. Younger children presented a profile of greater dental anxiety. Socioeconomic factors and dental data exerted some effect on dental anxiety, where children from low-income families and those not subjected to endodontic treatment displayed higher rates of dental anxiety.

Fatores comportamentais e socioeconômicos são fortes preditores de cárie dentária em pré- escolares: um estudo transversal / Behavioral and socioeconomic factors are strong predictors of dental caries in preschoolers: a cross-sectional study

Avaliaram-se possíveis preditores para a cárie dentária em pré-escolares sem experiência odontológica prévia, que buscaram a clínica de odontopediatria de uma universidade pública. Analisaram-se 191 prontuários, dos quais 87 foram incluídos. Coletaram-se dados demográficos, socioeconômicos, histórico de cárie da mãe, orientação prévia sobre cárie, frequência de escovação, uso de dentifrício fluoretado, consumo de doces/biscoitos e/ou líquidos açucarados, ceo-d e a presença ou ausência de defeitos de desenvolvimento do esmalte. Análises descritivas e de regressão logística binária foram realizadas para investigar quais variáveis prediziam um ceod>0. O modelo múltiplo incluiu consumo de doces/biscoitos, dados socioeconômicos, histórico de cárie na mãe e orientação prévia sobre cárie. Das crianças (2,69±1,18 anos), a maioria (67,8%) apresentava ceod>0 (3,78±3,82), sendo 50,6% meninas e 73,3% da classe baixa. A maioria (56,5%) das mães tinha 12 anos de estudos completos, histórico de cárie (78,6%) e receberam orientação prévia sobre cárie (52,9%). A maior parte (80,6%) escova os dentes pelo menos 2 vezes ao dia, utiliza dentifrício fluoretado (75,9%) e consome líquidos açucarados (90,8%), além de doces/biscoitos (86,9%) entre as refeições. Pertencer à classe baixa aumentou em 7 vezes a chance de ceod>0 (OR=7,354; IC 95%=1,951-27,723), histórico de cárie na mãe em 4 vezes (OR=4,131; IC 95%=1,042-16,369) e consumo de doces/biscoitos em quase 2 vezes (OR=1,786; IC 95%=1,072-2,976). Classe econômica baixa, histórico de cárie da mãe e consumo de doces/biscoitos entre as refeições mostraram-se fatores associados ao ceod>0 nos pacientes sem experiência prévia odontológica de uma clínica de odontopediatria de uma universidade pública.

Possible predictors of dental caries in preschool children without previous dental experience, who sought a pediatric dentistry clinic at a public university, were evaluated. Medical records (n=191) were analyzed; 87 were included. Demographic, socioeconomic data, mother's history of caries, previous orientation on caries, brushing frequency, use of fluoridated toothpaste, consumption of sweets/cookies and/or sugary liquids, dmft and the presence or absence of enamel development defects were collected. Descriptive and binary logistic regression analyzes were performed to investigate which variables predicted a dmft>0. The multiple model included consumption of sweets/cookies, socioeconomic data, mother's history of caries and previous orientation on caries. Of the children (2.69±1.18 years), most (67.8%) had dmft>0 (3.78±3.82), with 50.6% girls and 73.3% from the lower class. Most mothers had completed 12 years of schooling (56.5%), reported history of caries (78.6%) and received previous orientation on caries (52.9%). Most of children brush their teeth at least twice a day (80.6%), use fluoridated toothpaste (75.9%) and consume sugary liquids (90.8%), in addition to consumption of sweets/cookies (86 .9%) among the meals. Belonging to the lower class increased the chance of having dmft>0 by 7 times (OR=7,354; 95% CI=1,951-27,723), mother's history of caries by 4 times (OR=4,131;95% CI=1,042-16,369) and consumption of sweets/cookies by almost twice (OR=1,786;95% CI=1,072-2,976). Low economic class, mother's history of caries and consumption of sweets/cookies between meals were factors associated with dmft>0 in the patients without previous dental experience in a pediatric dentistry clinic at a public university.

Knowledge of health professionals about breastfeeding and factors that lead the weaning: a scoping review.

This review evaluated the knowledge of health professionals (HP) about breastfeeding and factors that leading the weaning. A search was performed in four electronics databases and the grey literature. The search strategy included Mesh terms and synonyms. No language or date restrictions were adopted. Studies that evaluated the knowledge of HP about breastfeeding and weaning were considered eligible. The studies retrieved by the searches were evaluated by two independently examiners. From 1,417 studies retrieved, 35 were included. Many countries and professionals from different health areas were analyzed. No studies evaluated the dentists' knowledge. Although the included HP know the benefits of breastfeeding for health, the length of breastfeeding recommended by the World Health Organization, exclusive or not, was not aligned with all professionals' endorsement. Information about weaning is scarce; however, HP are mindful of the main potential causes of early weaning. The knowledge of HP is conflicting about breastfeeding and unusual about weaning. Furthermore, no studies were found that presented data on the knowledge of dentists on the subject. Thus, assessments of dentists' knowledge and education measures for HP are necessary since they are frequently questioned about these issues.

Development, validation, and application of a Brazilian sleep myths and truths assessment scale (SLEEP-MTAS).

OBJECTIVE: This study aimed to develop, validate, and apply a scale assessing knowledge of sleep-related myths and truths and associate it with sociodemographic factors. METHODS: A scale with 15 questions was created, containing statements about the characteristics of sleep and related to sleep and dentistry. Each answer ranged from 0 to 4 points, generating a total score from 0 to 60, where higher scores represented greater knowledge. A preliminary study with 200 people assessed its convergent and discriminant construct validity, internal consistency, and temporal stability. The main study included 1965 respondents over 18 years. Additionally, sociodemographic data were collected and a classification of the level of knowledge was performed. Data were analyzed with Student's t-test and one-way ANOVA (p < 0.05). RESULTS: The questionnaire showed convergent (p < 0.001) and discriminant (p = 0.024) construct validity, internal consistency (alpha = 0.7), and temporal stability (ICC = 0.87). In the main study, 90.3% of the participants had moderate and high knowledge, with the score ranging from 24 to 58. Adults over 28 years old (p < 0.001), from the southern region of Brazil (p < 0.001), who lived in capital or metropolitan areas (p < 0.001), with higher education (p < 0.001), without religion (p < 0.001), and involved in dentistry (p < 0.001) had greater knowledge than their peers. CONCLUSIONS: The scale presented good psychometric properties. Most participants had moderate and high knowledge on sleep, with a difference in knowledge related to the age, region and area of residence, education, involvement with dentistry, and religion.

Critical appraisal of the information available on traumatic dental injuries found in applications.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are a public health problem and the search for information becomes essential to help in their management. The aim of this study was to search existing TDI applications (Apps) to critically describe the characteristics and main information found in them regarding TDI. METHODOLOGY: Searches were performed in the Play Store (Android) and App Store (iOS), using MeSH terms, synonyms and terms related to dental emergencies and TDI, in English, Spanish and Portuguese. Apps with information on the management of post-TDI emergencies or TDI prevention were included. The type of operating system (Android/iOS), cost (free/paid), target audience (dentist/patient), age of classification (free/>17 years old), language, star rating (1★ to 5★), number of downloads and post-download ratings, type of dentition (primary/permanent), reference used for classification according to TDI type and management (International Association for Dental Traumatology/Andreasen/others/not reported), and available content (prevention/emergency management/preservation/illustrations) were evaluated. RESULTS: Among 486 apps, 13 were eligible: 11 for Android and 2 for iOS. Most were free (92.3%), for patients (38.4%) and had a free age classification (90.9%). The main language was English (53.8%), and most of the Apps either had no information on star ratings (46.1%) or received 4★ (23.1%). The number of downloads was not reported (23.1%) or was fewer than 100 (23.1%). Most of the Apps were for permanent teeth (61.5%) and had explanations about dental management for TDI emergencies (92.3%) and multiple TDIs (61.5%). Most Apps addressed the importance of monitoring TDIs (76.9%) and contained illustrative images (76.9%). However, many did not report the TDI classification (46.1%), and 38.5% reported TDI prevention. CONCLUSIONS: Information on dental trauma management according to dental injury, inclusion of images, target audience, type of TDI and their prevention varied in the available Apps. However, most were focused on permanent teeth and addressed several TDI in English language only.

The effect of socioeconomic aspects and dental history on pediatric patients' dental anxiety

Abstract This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A cross-sectional study design with a sample of 120 children aged 7-12 years old was used. Data relating to anxiety levels prior to dental care, socioeconomic aspects (family income, education level, child's school type), and child's dental history (previous dental appointments, previous treatment, caries experience) were collected. Additionally, participants completed the Brazilian version of the Children's Fear Survey Schedule- Dental Subscale (B-CFSS-DS) to assess dental anxiety. Descriptive analyses, chi-squared (X 2 ) tests, and Mann-Whitney U tests were performed, with a significance level of 5%. A total of 51 boys (42.5%) and 69 girls (57.5%) were included. There was no significant difference in dental anxiety between them. However, younger children had higher mean B-CFSS-DS scores (p = 0.036, Mann-Whitney). A higher prevalence of dental anxiety was found in participants from low-income families (p = 0.012, X 2 ) and in patients who did not receive endodontic treatment (p=0.034, X 2 ). Higher mean B-CFSS-DS scores were also observed in participants who did not receive endodontic treatment (p=0.001, Mann-Whitney) compared with those that did receive endodontic treatment. No relationship was found between education level, patient school type, first dental appointment, caries experience, and dental anxiety data. Younger children presented a profile of greater dental anxiety. Socioeconomic factors and dental data exerted some effect on dental anxiety, where children from low-income families and those not subjected to endodontic treatment displayed higher rates of dental anxiety.

Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study

Abstract Objective: To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dentin caries lesions when applied under different concentrations and times. Material and Methods: Forty-two bovine blocks were selected and fixed in 24-well plates. Each well received a mixed bacterial inoculum added to the culture medium with 5% sucrose. The plates were incubated in microaerophilia (7 days) for caries formation, confirmed by micro-CT (M1). SDF was applied over the carious lesions for different times and concentrations (n=6): SDF 30% - immediate removal, 1 minute and 3 minutes; SDF 38%, - immediate removal, 1 minute and 3 minutes. The group without treatment was the control. Then, the samples were again scanned by micro-CT (M2) and submitted to a second cariogenic challenge for 21 days. Then, a final scan was performed (M3). Results: Mean pH at the culture medium and lesion depth were compared using Kruskal-Wallis and Wilcoxon tests. 38% SDF showed the lowest metabolic activity of the biofilm. All 38% groups and 30% 1 and 3 minutes did not show an increase in mean lesion depth comparing M3 with M1. However, only 30% 3 minutes and 38% 1 and 3 minutes showed a significant reduction of lesion depth. Conclusion: The minimum application time of 30% SDF to arrest dentin caries lesion was 1 minute, while 38% SDF arrested with application and immediate removal.

The Xylitol Applicability and its Effects in Health Area Worldwide: A Bibliometric Analysis Based on Randomized Controlled Trials

ABSTRACT Objective To describe and evaluate the xylitol products' applicability and its effects in the health area worldwide utilizing a bibliometric analysis from randomized controlled trials (RCT) with humans. Material and Methods Electronic searches were carried out in Medline/PubMed, Scopus, Cochrane Library, Web of Science, and VHL databases. The main data extracted were: year, area of applicability, type of treatment, country, journal, xylitol posology and concentration, presentation form, outcomes, and effects. Results From 1476 studies, 257 were included. These studies were published between 1973-2021. The majority was carried out in dentistry (73.9%) and under preventive treatment (67.4%). These studies were developed in the USA (15.4%) and published in Caries Research (6.6%). The posology and concentration ranged between 0.004-67 g/day and 0.002-100%, respectively. The xylitol is usually used in the chewing gum form (44.0%), and for antimicrobial activity evaluation (38.5%). A positive effect was observed in 204 studies (79.3%) and was associated with xylitol concentration ≥ 15(p=0.007). Side effects were reported in 8.2and were associated with posology ≥ 5 g/day (p=0.03). Conclusion Most studies with xylitol were conducted to prevent diseases in the dentistry field. The chewing gum form and antimicrobial activity evaluation were more frequent. Most xylitol products have a positive effect, and few studies report side effects.

Knowledge of health professionals about breastfeeding and factors that lead the weaning: a scoping review / Conhecimento de profissionais de saúde sobre amamentação e fatores que levam ao desmame: uma revisão de escopo

Abstract This review evaluated the knowledge of health professionals (HP) about breastfeeding and factors that leading the weaning. A search was performed in four electronics databases and the grey literature. The search strategy included Mesh terms and synonyms. No language or date restrictions were adopted. Studies that evaluated the knowledge of HP about breastfeeding and weaning were considered eligible. The studies retrieved by the searches were evaluated by two independently examiners. From 1,417 studies retrieved, 35 were included. Many countries and professionals from different health areas were analyzed. No studies evaluated the dentists' knowledge. Although the included HP know the benefits of breastfeeding for health, the length of breastfeeding recommended by the World Health Organization, exclusive or not, was not aligned with all professionals' endorsement. Information about weaning is scarce; however, HP are mindful of the main potential causes of early weaning. The knowledge of HP is conflicting about breastfeeding and unusual about weaning. Furthermore, no studies were found that presented data on the knowledge of dentists on the subject. Thus, assessments of dentists' knowledge and education measures for HP are necessary since they are frequently questioned about these issues.

Resumo Esta revisão avaliou o conhecimento dos profissionais de saúde (PS) sobre amamentação e fatores que levam ao desmame. Realizou-se buscas em quatro bancos de dados eletrônicos e literatura cinzenta. A estratégia de busca incluiu termos Mesh e sinônimos. Não se adotou restrição de idioma ou data. Estudos avaliando o conhecimento dos PS sobre amamentação e desmame foram elegíveis. Estudos recuperados pelas buscas foram avaliados por dois examinadores independentes. Dos 1.417 estudos recuperados, 35 foram incluídos. Muitos países e PS de diferentes áreas foram analisados. Nenhum estudo avaliou o conhecimento dos dentistas. Embora os PS conheçam os benefícios da amamentação, a duração recomendada pela Organização Mundial da Saúde, exclusiva ou não, não está alinhada com o endosso de todos os PS. Considerando o desmame, a informação é escassa. No entanto, os PS estão atentos às principais causas potenciais do desmame precoce. O conhecimento dos PS é conflitante sobre amamentação e incomum sobre o desmame. Não foram encontrados estudos que apresentassem dados sobre o conhecimento de dentistas sobre a temática. Investigações quanto ao conhecimento dos mesmos e medidas de educação para todos os PS são necessárias, considerando que são frequentemente questionados sobre o tema.

In vitro effect of experimental nanocomposites solutions on the prevention of dental caries around orthodontic brackets.

This study aimed to evaluate the in vitro effect of a single application of experimental nanocomposite solutions on the prevention of dental caries around orthodontic brackets. The specimens were exposed to mesoporous silica (MS) nanocomposites containing fluoride by association with titanium tetrafluoride (TiF4) or sodium fluoride (NaF). Nanocomposites also could contain calcium and groups were described as MSCaTiF4, MSTiF4, MSCaNaF, MSNaF, and controls (TiF4, and NaF). Specimens were subjected to the formation of a multispecies biofilm to generate a cariogenic challenge. After 24h, both pH and total soluble fluoride concentration of the culture medium were assessed. Mineral loss was evaluated by percentage of surface mineral loss (%SML), mineral volume variation (ΔZ) of inner enamel and polarized light microscopy (PL). Linear (Ra) and volumetric (Sa) surface roughness and scanning electronic microscopy (SEM) were used to assess enamel topography. Statistical analyses were conducted considering p<0.05. MSNaF had the highest value of culture medium pH after cariogenic challenge, similarly to MSTiF4. All nanocomposite solutions released less fluoride than their controls NaF and TiF4 (p<0.05). All nanocomposite solutions presented lower %SML compared to their respective control groups (p<0.05). Lower Ra, Sa and ΔZ were observed for experimental groups compared to TiF4 (p<0.05). The results were confirmed by PL and SEM analysis. The experimental nanocomposite solutions contributed for lower enamel demineralization around orthodontic brackets.