Quilombola children and adolescents show high prevalence of developmental defects of enamel. / Crianças e adolescentes quilombolas apresentam alta prevalência de defeitos de desenvolvimento do esmalte.

Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children's parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

Dentes com defeitos de desenvolvimento do esmalte (DDE) apresentam porosidades e/ou irregularidades que os tornam suscetíveis a acúmulo de biofilme e predisposição à cárie e doenças periodontais. O objetivo deste artigo é determinar a prevalência de DDE e fatores associados em crianças e adolescentes residentes em comunidade quilombola. A população foi censitária e composta por indivíduos na faixa etária de 3 a 14 anos. Os responsáveis responderam a questionário contendo dados socioeconômicos demográficos e histórico de agravos durante a gravidez e infância. Foi aplicado o Índice DDE modificado. Foram realizadas análise descritiva e regressão de Poisson com variância robusta (p<0,05). Foram examinados 406 indivíduos. A prevalência de DDE foi de 80,5%, sendo que em dentes decíduos foi de 42,2% e permanentes 61,1%. Houve associação entre DDE e maior idade da criança (RP=1,09; IC95%=1,01-1,17), uso de antibiótico na gravidez (RP=1,14; IC95%=1,07-1,22) e relato de desnutrição durante a primeira infância (RP=1,12; IC95%=1,03-1,22). A prevalência de DDE em crianças e adolecentes da comunidade quilombola foi alta. E os fatores associados foram maior idade da criança, uso de antibióticos na gravidez e desnutrição durante a primeira infância.

Crianças e adolescentes quilombolas apresentam alta prevalência de defeitos de desenvolvimento do esmalte / Quilombola children and adolescents show high prevalence of developmental defects of enamel

Resumo Dentes com defeitos de desenvolvimento do esmalte (DDE) apresentam porosidades e/ou irregularidades que os tornam suscetíveis a acúmulo de biofilme e predisposição à cárie e doenças periodontais. O objetivo deste artigo é determinar a prevalência de DDE e fatores associados em crianças e adolescentes residentes em comunidade quilombola. A população foi censitária e composta por indivíduos na faixa etária de 3 a 14 anos. Os responsáveis responderam a questionário contendo dados socioeconômicos demográficos e histórico de agravos durante a gravidez e infância. Foi aplicado o Índice DDE modificado. Foram realizadas análise descritiva e regressão de Poisson com variância robusta (p<0,05). Foram examinados 406 indivíduos. A prevalência de DDE foi de 80,5%, sendo que em dentes decíduos foi de 42,2% e permanentes 61,1%. Houve associação entre DDE e maior idade da criança (RP=1,09; IC95%=1,01-1,17), uso de antibiótico na gravidez (RP=1,14; IC95%=1,07-1,22) e relato de desnutrição durante a primeira infância (RP=1,12; IC95%=1,03-1,22). A prevalência de DDE em crianças e adolecentes da comunidade quilombola foi alta. E os fatores associados foram maior idade da criança, uso de antibióticos na gravidez e desnutrição durante a primeira infância.

Abstract Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children's parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

Molar-incisor hypomineralization in quilombola children and adolescents: A study of prevalence and associated factors.

OBJECTIVES: This cross-sectional observational study determined the prevalence and factors associated with molar-incisive hypomineralization (MIH) in quilombola children and adolescents in north-eastern Brazil. METHODS: The sample consisted of 251 children and adolescents (8 to 14 years old) living in the rural quilombola community Lagoas in São Raimundo Nonato, Piauí (census population). Sociodemographic and health-related data were collected from pre-, peri- and post-natal health records and a clinical examination for MIH diagnosis was performed by four previously trained and calibrated examiners. Descriptive data analysis and Poisson regression were performed. The magnitude of the association was determined by adjusted prevalence ratio (PR) and confidence intervals (95% CI). RESULTS: The prevalence of MIH was 46.6%. The presence of MIH was associated with gestational diabetes (PR = 2.49, 95% CI 2.08-2.99; p <0.001) and acute foetal distress (PR = 1.39; 95% CI 1.04-1.86; p = 0.025). CONCLUSION: It was concluded that the prevalence of MIH in the quilombola community was high and associated with gestational diabetes and acute foetal distress.

Is severe early childhood caries predictive of caries and fluorosis in permanent teeth? Ten-year follow-up / A cárie severa da infância é um fator preditivo para cárie e fluorose na dentição permanente? Acompanhamento por 10 anos

Introduction: Severe early childhood caries is defined as the presence of any sign of decay in children younger than three years. Objective: This retrospective longitudinal observational study investigated caries and fluorosis in children with S-ECC from a city with fluoridated water. Material and method: We included children under the age of three years who followed a maternal and child dental care program between the years of 1997 and 2003. The children were divided into 2 groups: group 1 (S-ECC) and group 2 (no caries). Guardians were contacted by telephone or mail. Caregivers completed questionnaire on socio-demographic and behavioral variables. The clinical dental examinations were performed in a dental clinic to assess caries experience and dental fluorosis. Multiple linear regression was used to determine factors associated with DMFT, and multivariate analysis by multiple logistic regression was used to determine the possible independent factors associated with the occurrence of fluorosis. Result: The sample consisted of 126 patients aged 8-12 years, of whom 52.4% were male. The presence of S-ECC increased the DMFT by an average of 0.84 (p = 0.02). Both the frequency of tooth brushing and the use of standard toothpaste were protective factors from the development of caries in the permanent dentition (p <0.05). Parents who reported that their children refused to brush their teeth had 70% less chance of developing fluorosis (p = 0.02). Conclusion: The presence of S-ECC was a risk factor for the development of caries in the permanent dentition, but not for the development of fluorosis.

Introdução: Cárie severa da infância (S-ECC) é definida como a presença de qualquer sinal de cárie em crianças menores de três anos. Objetivo: Este estudo observacional longitudinal retrospectivo objetivou avaliar cárie e fluorose em crianças com S-ECC de uma cidade com água fluoretada. Material e método: Foram incluídas crianças com idade inferior a três anos acompanhadas em um programa de atendimento odontológico materno e infantil entre os anos de 1997 e 2003. As crianças foram divididas em 2 grupos: grupo 1 (S-ECC) e grupo 2 (sem cárie). Os responsáveis foram contatados por telefone ou correio. Os exames clínicos dentários foram realizados no consultório odontológico para avaliar a experiência de cárie e fluorose dentária. Regressão linear múltipla foi utilizada para determinar os fatores associados ao CPOD, e análise multivariada por regressão logística múltipla foi utilizada para determinar os possíveis fatores independentes associados com a ocorrência de fluorose. Resultado: A amostra foi composta por 126 pacientes com idade entre 8 e 12 anos, dos quais 52,4% eram do sexo masculino. A presença de S-CEC aumentou o CPOD em média de 0,84 (p = 0,02). Tanto a frequência de limpeza, uso de dentifrício padrão foram fatores de proteção para desenvolvimento de cárie na dentição permanente (p <0,05). As crianças cujos pais relataram que se recusaram a escovar os dentes tinham 70% menos chance de desenvolver fluorose (p = 0,02). Conclusão: A presença de S-ECC não foi fator de risco para o desenvolvimento de fluorose, mas foi para cárie na dentição permanente.

Functional and esthetic rehabilitation of a child with amelogenesis imperfecta: a case report.

Amelogenesis imperfecta (AI) is a tooth disorder characterized by the abnormal development of the enamel in response to mutations in the genes involved in amelogenesis. The objective of this article is to present the clinical case of a child with AI in the primary dentition phase. A 4-year-old boy was presented to a clinic by his mother, who complained that her son's smile esthetics were compromised by "weak and yellow teeth." All the teeth showed yellowish discoloration as well as crumbling or missing enamel. Due to the absence of carious lesions and the presence of normal pulp in the teeth, it was decided to restore the dentition with indirect crowns of ceramic-optimized polymer, also known as ceromer. No preparations were performed on the teeth. For this patient, indirect ceromer restorations presented a good treatment option for the rehabilitation of primary teeth affected by AI.

Nível de satisfação dos pais/responsáveis de crianças atendidas em programa odontológico de atenção materno-infantil / Satisfaction level of parents of children in a dental program of maternal child attention

Objetivo: avaliar o nível de satisfação dos pais e/ou responsáveis de crianças atendidas em programa odontológico deatenção materno-infantil e implantar um sistema permanente de avaliação simplificada das ações desenvolvidas.Metodologia: estudo transversal quantitativo, desenvolvido no Instituto de Perinatologia Social do Piauí onde funciona oPrograma Preventivo para Gestantes e Bebês (PPGB). Os dados foram coletados através de um questionário estruturadoauto administrado e uma escala visual simplificada que continha questões relativas à percepção dos mesmos logo após oatendimento. Foram aplicados 569 questionários no período de março a outubro de 2014. Foi realizada a análisedescritiva das variáveis categóricas. Resultados: os itens acolhimento, ambiente, atendimento, importância doatendimento e localização do programa tiveram aprovação “ótimo” e “bom” entre 91% e 97,7% no questionário, enquantona escala visual os valores ficaram entre 76,6% e 98,8% de satisfação. A localização obteve o menor índice de satisfaçãotanto no questionário como na escala visual. Conclusão: o Programa Preventivo para Gestantes e Bebês foi bem avaliadopor pais e/ou responsáveis pelas crianças atendidas e a implantação de um sistema permanente de avaliação simplificadadas ações desenvolvidas é viável e de fácil aplicação.

Objective: evaluating the level of satisfaction of the parents and/or caregivers of children attending a dental program formaternal and child care and establishing a permanent system of simplified evaluation of the actions developed.Methodology: a quantitative cross-sectional study, developed at the Institute of Social Perinatology of Piauí where thePreventive Program for Pregnant Women and Babies (PPGB) works. The data were collected through a structured selfadministeredquestionnaire and a simplified visual scale that contained questions regarding their perception soon after thecare. A total of 569 questionnaires were applied from March to October 2014. A descriptive analysis of the categoricalvariables was performed. Results: the items welcoming, ambience, attendance, importance of attendance and location ofthe program had "excellent" and "good" approval between 91% and 97.7% in the questionnaire, whereas in the visual scalethe values were between 76.6% and 98.8% satisfaction. The location obtained the lowest index of satisfaction in both thequestionnaire and the visual scale. Conclusion: the Preventive Program for Pregnant Women and Babies was wellevaluated by parents and/or caregivers of children and the implementation of a permanent system of simplifiedevaluation of actions developed is feasible and easy to apply.

Factors Associated with Early Weaning According to the Report of Mothers in a Child Friendly Hospital Initiative

Objective: To determine the prevalence and factors associated with early weaning according to the report of mothers in a Child Friendly Hospital Initiative. Material and Methods: This is an observational, cross-sectional study with a sample of 252 mother/child binomials, participants in a maternal and childcare program, in a Child Friendly Hospital Initiative in Teresina, Brazil. A semi-structured questionnaire was used as the data collection instrument, administered to the mothers in individual interviews, with questions about socioeconomic conditions, breastfeeding, period, reason and way of weaning; and non-nutritive sucking habits. Early weaning was considered when the supply of breast milk was interrupted before the six months of life. For data analysis, descriptive and bivariate analyses were performed (Pearson's Chi-Square Test and Fisher's Exact Test), with a level of significance of 5%. Results: The prevalence of early weaning was 11.9%. The reasons given for interrupting breastfeeding by the mothers were: 23,% attributions of the mother; 46.% attributions of the infant; 23.3 % organic deficiency of the mother; 6.7% influence of others; and 4.8% of the mothers were still breastfeeding. The finger and/or pacifier sucking habits (p=0.002), and the use of a bottle (p=0.003) were associated with early weaning. A significant association between the total weaning period and the socioeconomic variables was not observed (p>0.05). Conclusion: The prevalence of early weaning was low. The main factors were related to "infant attributions", associated to children with non-nutritive sucking habits, bottle use, first tooth erupted with less than 6 months and whose mothers had formal employment.

Qualidade de vida relacionada à saúde bucal de crianças com bruxismo do sono / Quality of life related to oral health of children with sleep bruxism

Bruxismo é um hábito parafuncional provocado por atividades musculares repetitivas e caracterizado pelo apertamento ou ranger de dentes. Pode ocorrer durante o sono, bruxismo do sono (BS) ou durante a vigília, bruxismo diurno. Poucos estudos avaliaram o impacto dessa condição na qualidade de vida dos indivíduos e de seus familiares. Este estudo teve como objetivo avaliar o impacto do BS na qualidade de vida relacionada à saúde bucal de crianças de acordo com a percepção de seus pais/responsáveis. Trata-se de um estudo observacional transversal com amostra composta por pais/responsáveis de crianças na faixa etária de 2 a 5 anos, atendidas na Clínica Odontológica Infantil da UFPI. A coleta de dados foi realizada através da aplicação do formulário socioeconômico e do questionário de qualidade de vida Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). A presença de BS foi considerada pelo relato dos pais/responsáveis. Para análise estatística adotou-se análise descritiva e regressão de Poisson com nível de significância p < 0,05. A prevalência do bruxismo do sono nas crianças foi de 33,0%. O impacto negativo na qualidade de vida relacionada à saúde bucal da criança foi associado ao bruxismo do sono (RP = 1,238; IC 95%: 1,055­1,452). O bruxismo do sono teve impacto negativo na qualidade de vida relacionada à saúde bucal das crianças na percepção de pais/responsáveis.(AU)

Bruxism is a parafunctional habit caused by repetitive muscle activity and characterized by clenching or gnashing of teeth. It may occur during sleep, sleep bruxism (BS) or during waking hours, daytime bruxism. Few studies have evaluated the impact of health on quality of life for individuals and their families. This study aimed at assessing the BS impact on quality of life related to oral health of children in accordance with the perception of their parents/guardians. This cross-sectional observational study with a sample of parents/guardians of children aged 2- 5 years attending the Children's Dental Clinic of the Federal University of Piauí. Data collection was performed by applying the socio-economic form and the quality of life questionnaire Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). The presence of BS was considered the report of the parent/guardian. For the statistical analysis was adopted the descriptive analysis and Poisson regression with significance level of p < 0.05. The prevalence of sleep bruxism in children was 33.0%. The negative impact on quality of life related to oral health of children was associated with sleep bruxism (RP = 1.238; IC 95% : 1,055-1,452). Sleep bruxism had a negative impact on quality of life related to oral health of children in the perception of parents/guardians. (AU)

Oral Health of Children and Adolescents Victims of Maltreatment Housed in Foster Care: A Case-Control Study

Objective: To compare the oral health condition of children and adolescents victims of maltreatment housed in foster care with that of children and adolescents that have not been victims of maltreatment. Material and Methods: This is a case-control study with children and adolescents that have not been victims of maltreatment. In Group 1, the population was composed of 56 children victims of abuse housed in foster care. Group 2 was composed of an equal number of children and adolescents attending pediatric dentistry clinic at UFPI. Both groups were matched for sex and age. Data collection was divided into two phases: questionnaire application to children's parents / guardians and clinical examination of the oral cavity. The questionnaire was composed of questions about socioeconomic variables, reasons for admission in the foster care and oral health-related habits. To assess the oral health condition, epidemiological indexes dmft, DMFT and Gingival Bleeding Index (GBI) were determined and soft tissues were inspected to evaluate possible maltreatment sequelae. Results: Neglect was reported as the major cause of entry into the foster care (84%). There were no statistically significant differences between the mean dmft (p=0.240), DMFT (p=0.862) and GBI (p=0.275) values between groups evaluated. No sequelae or lesions characteristic of physical aggression were found; however, all individuals have been institutionalized for more than four months. Conclusion: Child and adolescents victims of maltreatment showed oral health condition similar to that of individuals that have not been victims of maltreatment.

Natal and neonatal teeth: a review of 23 cases.

Natal teeth erupt in utero, whereas neonatal teeth present during the first month of life. The lower central incisors are the most frequently affected teeth. The etiology is unknown, and the choice of treatment depends on several factors. The purpose of this paper is to review 23 cases of children with natal or neonatal teeth who attended a dental care program in a university maternal and infant oral health clinic. There was no gender predilection. Most were natal teeth (83 percent) and presented a mild degree of mobility (64 percent). Only two patients had breast-feeding difficulties (nine percent). Tooth maintenance was the most common treatment of choice (64 percent), and only two patients presented Riga-Fede disease (nine percent).

Breastfeeding and sucking habits in children enrolled in a mother-child health program.

BACKGROUND: Early weaning can cause changes in posture and strength of the phonoarticulatory organs, favoring the installation of undesirable oral habits. The objective of the research was to evaluate the relationship between the practice of exclusive breastfeeding and its influence on the development of deleterious oral habits in children. This was a cross sectional observational study with 252 children of both sexes, between 30 and 48 months of age, attending a program of dental care for mothers and newborns. As an instrument of data collection was a questionnaire semistructured mothers of children with questions about the form and duration of breastfeeding and non-nutritive oral habits in children. RESULTS: In this sample, 48.4% of the children were exclusively breastfed for six months; 20.2% exhibited sucking habits involving the use of a pacifier, which was more frequent among the girls. As factors associated with the decreasing of the occurrence of non-nutritive sucking habits, are a longer exclusive breastfeeding, predominant breastfeeding and breastfeeding. Children who were breastfed for six months until twelve months in an exclusive way decreased by 69.0% chances of coming to have non-nutritive sucking habits when compared with those who were breastfed up to one month. CONCLUSION: The longer the duration of breastfeeding, that is, exclusive, predominant or breastfeeding, the lower are the chances of children develop non-nutritive sucking habits.

Apresentação do programa preventivo para gestantes e bebês / Oral health preventive program for pregnant women and infants

O presente trabalho tem por objetivo apresentar à comunidade odontológica um programa de extensão universitária, com proposta de atendimento simplificado educativo/preventivo, desenvolvido por alunos de graduação e orientado por professores do Curso de Odontologia da UFPI. O programa é desenvolvido no Instituto de Perinatologia Social do Piauí e tem como público-alvo gestantes e bebês

Prevalência de lesäo cariosa em primeiros molares permanentes de escolares residentes em regiöes com flúor e sem flúor na água de abastecimento (estudo comparativo baseado em exames clínico e radiográfico) / Prevalence of dental caries in first permanent molars of school children resident in regions with and without fluor in drinking water (a comparative study based on clinical and radiological exams)

Analisou-se comparativamente a prevalência de lesöes cariosas, através de índice CPO-S, e verificou-se a distribuiçäo da referida lesäo nas superfícies oclusal, vestibular, lingual, mesial e distal dos priemiros molares permanentes. Estes dentes foram examinados clínica e radiograficamente pela técnica intrabucal interproximal, numa amostra de 360 escolares de baixo nível sócio-econômico, na faixa etária de sete a 12 anos, de ambos os sexos, sem distinçäo de raça, que nasceram e sempre residiram nas cidades de Teresina e Barras, muicípios do Piaui - Brasil, a primeira, com flúor na água de abastecimento público (teor médio de 0,68 ppm) e a segunda desprovida deste alogênio. Após análise estatística dos resultados, constatou-se uma reduçäo de 26,10 por cento do índice CPO-S das crianças de Teresina em relaçäo às de Barras. O teste "t" de Student mostrou-se significante para as idades de sete, oito nove, dez e doze anos e total, e, ainda, para todos os tipos de superfícies, independentemente da idade e sexo. Nas crianças de uma mesma comunidade näo houve diferença significante entre os sexos. Em todas as idades, nas duas comunidades, ocorreu um crescimento anual do índice CPO-S, o que demonstra o aspecto cumulativo e progressivo da cárie dentária, sendo menor na cidade provida com flúor