Association of sociodemographic characteristics, mental health, and sleep quality with COVID-19 fear in an elderly Brazilian population

Aim: This study determined whether COVID-19 fear is correlated with sociodemographic characteristics, general health, mental health, and sleep quality in an elderly Brazilians. Methods: Elderly people aged ≥ 60 years replied to an online survey containing questions about their sociodemographic characteristics; general health; levels of stress, anxiety, and depression; sleep quality; and COVID fear. Results: Data were statistically analyzed using descriptive statistics (α = 5%). In total, 705 elderly people with mean age of 66 ± 5 years, and most (82.7%) respondents were women, graduated and from southeastern Brazil. COVID-19 fear correlated positively and moderately with sleep quality and symptoms of depression, anxiety, and stress (all p < 0.001). It was associated with females. Elderly people from northern and northeastern Brazil and diabetics had increased COVID-19 fear (all p < 0.05). Conclusion: The fear of COVID-19 exists among Brazilian female old people, diabetics, increases anxiety and stress symptoms, and worsen sleep quality in elderly people

Speaking Space, Chewing Rotational Denture Movement, OHRQoL, and Patient Expectations for Single-Implant Mandibular Overdentures.

PURPOSE: To compare the speaking space, perceived rotational movement during chewing, and oral health-related quality of life (OHRQoL) of elderly people rehabilitated with new conventional complete dentures (CDs) and single-implant mandibular overdentures (SIMOs) using a paired design. Patient expectations for SIMO use were also evaluated. MATERIALS AND METHODS: The participants were 22 elderly users of unsatisfactory CDs. They received new sets of conventional CDs, and assessment was performed after 2 months of use. Speaking space was recorded with a kinesiograph while participants read a list of words. Participants were asked two questions about perceived posterior rotational denture movement during chewing. The Dental Impact on Daily Living (DIDL) questionnaire was used to examine OHRQoL, and a visual analog scale was used to quantify participants' SIMO expectations. Subsequently, the mandibular CDs were converted to SIMOs, and the assessment was repeated after 2 months of use. Speaking space and OHRQoL data were submitted to ANOVA and Student t test, and perceived mandibular movement and expectation data were examined using likelihood-ratio chi-square test. RESULTS: The speaking space and perceived rotational movement did not differ between CD and SIMO use. General performance and eating restriction DIDL scores increased after SIMO insertion. Participants' SIMO expectations regarding speaking, cleaning, esthetics, and general aspects were met. CONCLUSION: Relative to CD use, SIMO use did not change the speaking space or perceived rotational movement when chewing among elderly patients. It improved OHRQoL via enhancement of two DIDL dimensions and met most elderly patients' expectations.

Speech in implant-supported and removable complete denture wearers: A systematic review.

STATEMENT OF PROBLEM: Prosthetic rehabilitation, especially with removable complete dentures (CDs), can contribute to speech problems, although the prevalence of the problem is unclear. PURPOSE: The purpose of this systematic review was to examine the influence of implant-supported fixed complete dentures (FCDs), implant-supported overdentures, and removable CDs on speech articulation disorders in patients with at least 1 completely edentulous jaw. MATERIAL AND METHODS: This study was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020182705). The PubMed/Medline, Embase, Web of Science, Scopus, Latin American and Caribbean Health Sciences, Brazilian Clinical Trials Registry, and Cochrane Library databases were searched through April 2020 to identify clinical trials comparing maxillary and/or mandibular implant-supported dentures with removable CD use in terms of speech articulation in participants with at least 1 completely edentulous jaw. The risk of bias of selected studies was assessed with the Joanna Briggs Institute critical appraisal tools, and the quality of evidence was tested by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Initially, 2586 articles were identified, and their titles and abstracts were read. Sixteen articles were read in full, and 8 studies (4 paired clinical trials and 4 cross-sectional studies) were included in this review. In total, 290 prosthesis users aged 29 to 90 years, approximately 44 of whom had hearing difficulties, were included. Four studies had a low risk of bias, and 4 studies had a high risk of bias. Distortions of the /s/ phoneme were observed more often in the first 6 months of maxillary FCD use than with removable CD use. Speech articulation did not differ between mandibular FCD and removable CD users. The quality of evidence for speech articulation disorders was low. CONCLUSIONS: Given the low quality of evidence on speech articulation disorders, further research on speech articulation disorders in prosthesis wearers is needed.

Influence of energy drinks on enamel erosion: In vitro study using different assessment techniques.

BACKGROUND: Dental erosion has become a relevant public health problem in recent years and is related to the increase in the consumption of acidic beverages. Objective: The aim of the present study was to evaluate the erosive potential of energy drinks on dental enamel using an in vitro erosion model. MATERIAL AND METHODS: Thirty-eight blocks of human enamel were divided into four groups: G1- TNT Energy Drink®(n=8), G2- Red Bull® (n=10), G3- Monster Energy® (n=10), and G4- Coca-Cola® (n=10) (positive control). For the chemical analysis, the pH values, titratable acidity, and buffering capacity of the beverages were measured in triplicate. For the erosive test, the specimens were immersed in the beverages (5ml/block) for 30 minutes at room temperature with gentle shaking. Initial and final surface microhardness values were measured and the percentage of the loss of surface microhardness was calculated. Profilometry (surface loss and lesion depth) and mineral loss analysis (quantitative light-induced fluorescence) were performed. The data were analysed statistically using ANOVA followed by the Bonferroni correction, Pearson's correlation test, and multiple linear regression (p<0.05). RESULTS: The energy drinks had pH values ranging from 2.36 to 3.41. The lowest titratable acidity value was recorded for Monster Energy® and the highest was recorded for TNT Energy Drink®. All energy drinks had buffering capacity values higher than Coca-Cola®. Analysing the eroded enamel surface, the specimens submitted to TNT Energy Drink® had the greatest percentage loss of surface microhardness, surface loss, depth, and mineral loss, followed by those submitted to Red Bull® and Monster Energy®. Surface loss was the only predictor of mineral loss (p<0.001). CONCLUSIONS: Based on the study model employed, all the energy drinks examined were erosive to tooth enamel and TNT Energy Drink® had the worst behaviour. Key words:Energy drinks, tooth erosion, tooth demineralisation, hardness tests, quantitative light-induced fluorescence.

Delay in diagnosis of oral cancer: a systematic review / Retraso en el diagnóstico del cáncer bucal: una revisión sistemática

Background: Oral cancer represents a worldwide public health problem, being among the most prevalent, associ-ated with high morbidity and mortality rates. This systematic review aimed to review the causes of the delayeddiagnosis of oral cancer mainly in the elderly, in developed and developing countries.Material and Methods: Search strategy was developed for MEDLINE databases (via PubMed), EMBASE, Webof Science, SCOPUS, and LILACS and for grey literature (Google Scholar, ProQuest and OpenGrey), withoutlanguage or period restrictions. The risk of bias was assessed using instruments from the Joanna Briggs Instituteand the quality of evidence according to the GRADE system.Results: The search resulted in 14,473 records, of which only 13 met the eligibility criteria. The total sample was1,705 participants, with a predominance of males. All studies included reported causes of delayed diagnosis of oralcancer related to the patient and five also reported causes related to health professionals. The scarce knowledge ofthe population was pointed out as the main cause of delayed diagnosis of this cancer. Regarding the risk of bias,ten studies were classified as low risk and three, as moderate risk. The quality of the evidence was very low forthe outcome related to delayed diagnosis of oral cancer.Conclusions: Wide dissemination of information on oral cancer is needed, especially for the elderly, such as itsinitial signs and symptoms, in developed and developing countries. Further studies should be conducted to bet-ter understand the causes of delayed diagnosis of oral cancer in countries with different socioeconomic statuses.(AU)

Speech and the swallowing threshold in single implant overdenture wearers: A paired control study.

BACKGROUND: Single implant mandibular overdentures (SIMOs) can improve mastication in edentulous elderly people. However, little attention has been paid to their effects on articulation disorders and the swallowing threshold relative to those of conventional complete dentures (CDs). OBJECTIVE: To compare the effects of new conventional CD set and SIMOs on articulation disorders, mandibular movements during speech and swallowing threshold using a paired study design. METHODS: Twenty-two edentulous Brazilian Portuguese-speaking elderly people (mean age 66.7 ± 4.6 years) were first evaluated whilst wearing their old conventional CDs. Articulation disorders were analysed by audio and video recordings, mandibular movements during speech were measured by kinesiography, and the swallowing threshold was assessed by masticatory cycle counting and medium particle size (X50 ) calculation. Participants then received new conventional CDs, and evaluations were repeated 2 months later. Subsequently, single implants were installed in the midlines of subjects' mandibles, and the conventional CDs were converted to SIMOs. After 2 months of SIMOs use, the evaluations were repeated. Data were submitted to the Cochran-Mantel-Haenszel and ANOVA. RESULTS: No difference in articulation disorders was found between new conventional CD and SIMO use. The frequency of anterior lisp during /s/ and /z/ phoneme pronunciation was reduced with new conventional CD use relative to old conventional CD use (p < .05). The X50 decreased progressively with new conventional CD and SIMO use (both p < .05). CONCLUSION: SIMOs do not alter speech relative to new well-fitted conventional CDs, but improved the swallowing threshold, in edentulous elderly people.

Single implant overdenture reinforced with a metallic framework: A 2-year clinical follow-up.

INTRODUCTION: To prevent single-implant overdenture (SIO) fracture, the inclusion of a framework in the overdenture has been suggested. However, no investigations verified their benefits. OBJECTIVE: To evaluate prosthetic maintenance events, patient satisfaction, and mastication of SIO reinforced by metallic framework users. MATERIAL AND METHODS: Fifteen volunteers had a new set of complete dentures converted into an SIO containing a framework. Maintenance events were recorded, while patient satisfaction was assessed using a visual analog scale. Masticatory performance (MP) was evaluated using the sieving method, maximum bite force (MBF) by pressure sensors, and masseter thickness by ultrasound. Measurements were performed 2, 12, and 24 months after SIO use. Repeated-measures ANOVA and paired Student's t-tests (p < 0.05) were applied. RESULTS: Matrix exchange was the most prevalent maintenance event (83.6%), and no SIO was fractured during the entire follow-up. Satisfaction with the SIO stability decreased (p < 0.01) after 12 months. MP did not change between evaluations (p > 0.05). Conversely, MBF and masseter thickness improved after 12 and 24 months of SIO use (p < 0.05). CONCLUSIONS: Reinforced SIO did not fracture during 2 years but requires maintenance. It improves bite force and muscle thickness, maintaining MP values. Satisfaction with SIO stability decreased in the first year of use.

Erosive effect of industrialized fruit juices exposure in enamel and dentine substrates: An in vitro study.

BACKGROUND: Erosive tooth wear has been a highly prevalent and emerging phenomenon related to eating habits of the population. Aim: This study sought to investigate industrialized fruit juices exposure in enamel and dentine substrates in terms of erosive effect. MATERIAL AND METHODS: Human enamel and dentine specimens were randomized into 8 groups (n=8): Grape juice - Ades®, Grape juice - Del Valle Kapo®, Grape juice - Aurora®, Orange juice - Del Valle Kapo®, Orange juice - Ades®, Strawberry juice - Mais Vita®, Strawberry juice - Ades®, Citrus fruit juice - Tampico®. Specimens were submitted to an in vitro erosive challenge and to a microhardness test to evaluate the percentage of surface microhardness loss. The pH, titratable acidity, buffering capacity, degree of saturation and critical pH concerning hydroxyapatite and fluorapatite of the juices were measured as well as their composition of calcium, phosphate, fluoride, and total protein. Data were submitted to the analysis of variance and multivariate linear regression (α=0.05). RESULTS: All test agents were undersaturated concerning hydroxyapatite and fluorapatite. A significant interaction between the type of juice and substrate was found (α=0.000, ß=0.99). However, Orange juice - Del Valle Kapo®, Orange juice - Ades®, and Strawberry juice - Mais Vitta® demonstrated no difference between substrates. Grape juice - Ades® promoted less mineral than other juices in enamel and dentine. The calcium concentration in juices was a protective variable for microhardness loss in both substrates. CONCLUSIONS: The erosive effect of industrialized fruit juices affects enamel differently from dentine, and this effect differed between some, but not all, tested juices. Key words:Tooth erosion, dental enamel, dentine. beverages, food habits.

Nanoencapsulated fluoride as a remineralization option for dental erosion: an in vitro study.

OBJECTIVE: To compare the in vitro performance of different dentifrices indicated for dental erosion and a new dentifrice with controlled fluoride release system (NanoF) in terms of surface microhardness remineralization in enamel erosion lesions. MATERIALS AND METHODS: 72 human enamel specimens were divided into 6 groups (n = 12): PC (100% NaF - positive control); NC (Placebo - negative control); 50%nF (50% NanoF + 50% free NaF), 100%nF (100% NanoF); PN (Sensodyne® ProNamel™) and AG (Colgate® Sensitive Pro-Relief™). A surface microhardness analysis was performed before (SH0) and after (SH1) the erosion lesion formation. The blocks were submitted to a 5-day de-remineralization cycling model, consisting of 90 s immersion on 0.1% citric acid (4x/day) and 1 min treatment with dentifrice slurries along with 1 mL/block of human saliva (2x/day). Lastly, the final surface microhardness analysis (SH2) was measured and the percentage of surface microhardness remineralization (%SMHR) was calculated. Data were analysed with 2-way ANOVA and Tukey's test (p < .05). RESULTS: Statistically significant differences were observed for SH2 and %SMHR between NC and AG with the other groups (p < .05). The best %SMHR from the experimental groups was found in 100%nF and PN. CONCLUSION: Dentifrices with NanoF exhibited a surface microhardness remineralization similar to sodium fluoride (PC). Therefore, NanoF dentifrice can be an alternative to prevent and treat patients with dental erosion.

Investigation of the Erosive Potential of Different Types of Alcoholic Beverages

Abstract Objective: To evaluate the erosive potential of different alcoholic beverages according to pH, titratable acidity and buffering capacity. Material and Methods: Thirteen industrialized alcoholic beverages of different brands were selected and divided into five groups according to their type and composition. The pH measurement and titratable acidity for pH 5.5 and 7.0 were performed in triplicate in 50 mL of each beverage. The buffering capacity was calculated based on pH and titratable acidity for pH 7.0. ANOVA, Tukey, and Pearson correlation, with p<0.05, were used for data analysis. Results: Data showed normal distribution by Shapiro-Wilk test. The pH of alcoholic beverages ranged from 2.49 (Miks Ice Tea - Green Fruits) to 7.64 (Smirnoff). The highest values of acid titration (4.68) and buffer capacity (19.97) were observed in Smirnoff Ice. The following correlations (p<0.01) were noted between: pH and titratable acidity; buffering capacity and pH; buffering capacity and titratable acidity. Conclusion: Some beers and alcopops presented erosive potential due to their lower pH associated with high acid titration values. The whisky and sugarcane liquor examined were not potentially erosive.

Prostheses satisfaction and diet of elderly wearing a single implant overdenture: A six-month assessment.

AIMS: To compare prosthesis satisfaction and nutritional intake of edentulous elderly people wearing a conventional complete denture (CD) with those wearing a single implant mandibular overdenture (SIO) after 6 months of use. METHODS AND RESULTS: Completely edentulous elderly patients (n = 22) were divided between a group rehabilitated with CDs in both dental arches and a group receiving a mandibular SIO with a conventional CD in the upper arch (n = 11/group). Patients completed a visual analog scale for degree of satisfaction with their prostheses in seven categories. Nutritional intake of patients (based on patient diaries) was evaluated over a 3-day period. SIO wearers were more satisfied with their prostheses than were CD wearers. Six months after rehabilitation, the SIO group consumed foods higher in vitamins B2 and B6, whereas the CD group consumed more sodium. CONCLUSION: SIO wearers are more satisfied with their prosthesis and consume greater amounts of vitamin B2 and vitamin B6 in their diets than CD wearers. Brazilian Registry of Clinical Trials (#RBR-3kgttj and #RBR-37gdst).

Erosive potential of soy-based beverages on dental enamel.

BACKGROUND: This study aimed to investigate the erosive potential of soy-based beverages in comparison to fruit juices of the same flavor. METHODS: Human enamel blocks were randomly divided into 9 groups (n = 8), according to the beverage category (soy or non-soy juices). The initial pH, TA and ß at the original pH value were measured in triplicate. The composition of calcium, phosphate and total protein was analyzed using the specific colorimetric method. The fluoride analysis was performed using a selective electrode. The degree of saturation (DS) and the critical pH (CpH) of each beverage with respect to hydroxyapatite (HAp) and fluorapatite (FAp) were calculated using the computational software. Enamel samples were immersed into 67.5 mL of each drink for 120 minutes. Enamel surface loss (ESL) and differences in surface roughness (ΔRaE-S) were analyzed by a 3D non-contact profilometer. RESULTS: Non-soy beverages exhibited the lowest pH values (2.93 to 3.40). The highest values of calcium concentration were founded in soy-based formulations. Juices with soy in their composition tend to have high DS when compared with non-soy based beverages (p = .0571). Soy beverages produced less ESL than non-soy beverages (p < .05). ΔRaE-S was not significantly different between the categories. The ESL and ΔRaE-S were positively correlated with initial pH and buffering capacity in soy-based beverages. On the other hand, in non-soy beverages, the ESL was negatively correlated with the TA to 7.0 and the fluoride composition whereas the ΔRaE-S was negatively correlated with the TA to 5.5. CONCLUSIONS: The erosive potential of soy beverages was lower than non-soy based beverages.

Multidisciplinaridade no cuidado e atenção à saúde bucal do idoso / Multidisciplinarity in the care and attention for the oral health of elderly individuals

Este artigo tem como objetivo revisar a literatura acerca da importância da equipe multidisciplinar no cuidado e atenção à saúde bucal do idoso. Foram realizadas buscas bibliográfi cas nas seguintes bases de dados: Bireme, SciELO, LILACS, PubMed e MedLine utilizando os seguintes descritores: "Odontologia geriátrica", "Assistência integral à saúde do idoso" e "Reabilitação bucal", assim como os respectivos termos em inglês: "Geriatric dentistry", "Comprehensive health care" e "Mouth reabilitation". Foram incluídos artigos científicos em inglês e português, bem como documentos de entidades públicas nacionais e internacionais, publicados entre 2000 e 2016. Foram excluídas as teses, dissertações e estudos que não abordavam a temática principal da presente pesquisa. Como resultado, a partir da revisão de literatura realizada, verificou-se que os idosos fazem parte de um grupo populacional que apresenta, frequentemente, alterações fisiológicas e patológicas diversas, tanto relacionadas à saúde geral como à saúde bucal, podendo estar associadas ao uso crônico de medicamentos, aos hábitos de alimentação e higiene e à própria motivação do paciente. Portanto, conclui-se ser necessária uma abordagem multidisciplinar em todas as fases de atendimento do idoso, desde o diagnóstico precoce, assim como durante o planejamento e tratamento integrado, para contribuir na melhoria de sua qualidade de vida.

To review the literature about the importance of multidisciplinary teams in the care and attention for the oral health of elderly people. The following databases were searched: Bireme, SciELO, LILACS, PubMed and MedLine, using specific keywords: "Geriatric dentistry", "Comprehensive health care" and "Mouth rehabilitation". Scientific articles both in English and Portuguese were included, and documents of national and international public entities, published between 2000 and 2016. Theses, dissertations and studies that did not address the main topic of this research were excluded. From the literature review, it was verified that the elderly represent a population group that often presents a high level of physiological and pathological alterations, both related to general health and oral health, and may be associated to the chronic use of medications, dietary and hygiene habits, and the patient's own motivation. A multidisciplinary approach is required in all stages of care for elderly patients, from early diagnosis to an integrated planning and treatment, contributing to the improvement of their quality of life.

Erosive Potential of Industrialized Teas: An in vitro study

Objective: To evaluate the erosive potential of manufactured teas according to pH, titratable acidity and buffering capacity. Material and Methods: Eight types of manufactured teas of different brands and flavors acquired in supermarkets of João Pessoa, Brazil, were investigated. Indaiá® mineral water and Coca-Cola® were controls. The pH measurement and titratable acidity for pH 5.5 and 7.0 were performed in triplicate in 50 ml of each beverage. The buffering capacity was calculated based on pH and titratable acidity for pH 7.0. ANOVA, Tukey, and Pearson correlation, with p <0.05, were used for data analysis. Results: Data showed normal distribution by Kolmogorov-Smirnov test for all variables. There was a statistically significant relationship between groups analyzed in all variables (ANOVA, p <0.001). The pH of teas ranged from 2.70 (Black Tea with lemon-Leão Fuze®) to 4.03 (Natural Mate Tea - Matte Leão®). The following significant correlations (p <0.01) were observed: pH and titratable acidity; buffering capacity and pH; buffering capacity and titratable acidity. Conclusion: All teas analyzed were potentially erosive; however, Black Tea with lemon (Leão Fuze®) had the lowest pH, the highest titratable acidity and buffering capacity, demonstrating that the saliva will have greater difficulty in buffering this tea in the oral environment.