Is there an association between dental caries and genetics? Systematic review and meta-analysis of studies with twins.

OBJECTIVE: This review aimed to assess the agreement of dental caries experience between monozygotic (MZ) and dizygotic (DZ) twins. DATA RESOURCES: This systematic review was performed by reviewers in the databases Embase, MEDLINE-PubMed, Scopus, Web of Science and manual searches and gray literature Google Scholar® and Opengray. Observational studies that evaluated dental caries in twins were included. The risk of bias was analyzed using the Joanna Briggs checklist. Meta-analyses were performed to assess the pooled Odds Ratio to estimate the agreement values of dental caries experience and DMF index between pairs of twins (p < 0.05). To assess the certainty of evidence, the GRADE scale was used. STUDY SELECTION: 2533 studies were identified, of which 19 were included in the qualitative analysis, six in the quantitative synthesis, with two meta-analyses being carried out. Association between genetics and the development of the disease was observed in most studies. In the risk of bias analysis, 47.4% had moderate risk. Higher agreement of dental caries experience was observed in MZ twins than DZ in both dentitions (OR: 5.94; 95% CI: 2.00-17.57). However, there was no difference between the MZ and DZ twin groups in the analysis comparing DMF index agreement (OR: 2.86; 95%CI: 0.25-32.79). The certainty of evidence was considered low and very low for all studies included in meta-analyses. CONCLUSION: With very low certainty of the evidence, the genetic factor seems to influence the agreement of the caries experience. CLINICAL RELEVANCE: Understanding the genetic influence on the disease has the potential to contribute to the development of studies that may use biotechnologies for prevention and treatment as well as guide future research involving gene therapies aiming to prevent the occurrence of dental caries.

Association between genetic factors and molar-incisor hypomineralisation or hypomineralised second primary molar: A systematic review.

OBJECTIVE: To determine the association between genetic factors and molar-incisor hypomineralisation (MIH) and/or hypomineralised second primary molars by means of a systematic review. DESIGN: A search was performed in Medline-PubMed, Scopus, Embase and Web of Science databases; manual search and search in gray literature were also performed. Selection of articles was performed independently by two researchers. A third examiner was involved in cases of disagreement. Data extraction was performed using an Excel® spreadsheet and independent analysis was performed for each outcome. RESULTS: Sixteen studies were included. There was an association between MIH and genetic variants related to amelogenesis, immune response, xenobiotic detoxification and other genes. Moreover, interactions between amelogenesis and immune response genes, and SNPs in the aquaporin gene and vitamin D receptors were associated with MIH. Greater agreement of MIH was found in pairs of monozygotic twins than dizygotic twins. The heritability of MIH was 20 %. Hypomineralised second primary molars was associated with SNPs in the hypoxia-related HIF-1 gene and methylation in genes related to amelogenesis. CONCLUSION: With very low or low certainty of evidence, an association was observed between MIH and SNPs in genes associated with amelogenesis, immune response, xenobiotic detox and ion transport. Interactions between genes related to amelogenesis and immune response as well as aquaporin genes were associated to MIH. With very low certainty of evidence, hypomineralised second primary molars was associated to a hypoxia-related gene and to methylation in genes related to amelogenesis. Moreover, higher agreement of MIH in pairs of monozygotic twins than dizygotic twins was observed.

Early childhood caries management using fluoride varnish and neutral fluoride gel: a randomized clinical trial.

The aim of this study was to evaluate the clinical efficacy of varnish and neutral fluoride gel in the management of early childhood caries (ECC). A randomized clinical trial was conducted to compare two strategies for ECC management: topical application of neutral fluoride gel (NFG group) and varnish (FV group) every four months for a period of one year. The sample consisted of children between the ages of three and four years, enrolled in public daycare centers. The incidence of ECC between the groups was compared by assessing values (new dmfs) at two levels: d2 when enamel/dentin were affected and d3 when dentin affected. Pearson's Chi-square, Fisher's Exact, Kolmogorov-Smirnov and Mann-Whitney tests were used to compare the incidence and increment of caries between the NFG and FV groups (p<0.05). A total of 240 children were included in this study and 213 children (88.7%) were followed up for 12 months. The incidence of ECC was 24.1% in the GF and 21.0% in the FV groups (p=0.586). The increment of caries in d2mfs was 1.36 (95% CI = 0.83 - 1.89) in the NFG and 1.33 (95% CI = 0.75 - 1.89) in FV (p=0.756) groups. Increment of caries in d3mfs was 1.60 (95% CI = 0.95 - 2.25) in NFG and 1.40 (95% CI = 0.75 - 2.04) in FV (p=0.468). Neutral fluoride gel and fluoride varnish exhibited similar efficacy in the management of ECC after 12 months of follow-up.

Impact of hypomineralised second primary molar on preschoolers' oral health-related quality of life-A hierarchical approach.

BACKGROUND: Hypomineralised second primary molar (HSPM) is a developmental enamel defect associated with dental caries. AIM: To evaluate the impact of HSPM on oral health-related quality of life (OHRQoL) in preschoolers through hierarchical analysis. DESIGN: This population-based cross-sectional study assessed 834 5-year-old preschoolers, in Teresina, Piauí, Brazil, using sociodemographic questionnaires and Early Childhood Oral Health Impact Scale (ECOHIS). Dental examination was performed by two calibrated examiners (κ ≥ 0.80) for the diagnosis of HSPM (EAPD), dental caries (dmft and pufa indices), and malocclusion (Foster and Hamilton criteria). Analysis of the determinants of OHRQoL was stratified at three levels (P < .05). RESULTS: Severe HSPM was associated with OHRQoL in bivariate analysis (P < .05). In adjusted final multivariate analysis (model 1), the presence of dental caries with or without clinical consequences was associated with worse OHRQoL (P < .05). In model 2, after the removal of dental caries, preschoolers with severe HSPM had greater probability of having a negative impact on OHRQoL in the child impact section (RR = 2.14; 95% CI = 1.26-3.65), family impact section (RR = 1.99; 95% CI = 1.16-3.42), and total score (RR = 2.09; 95% CI = 1.25-3.49) of the ECOHIS. CONCLUSION: Severe HSPM had a negative impact on the OHRQoL of preschoolers and their families, but the presence of dental caries neutralised this impact.

Early childhood caries management using fluoride varnish and neutral fluoride gel: a randomized clinical trial

Abstract The aim of this study was to evaluate the clinical efficacy of varnish and neutral fluoride gel in the management of early childhood caries (ECC). A randomized clinical trial was conducted to compare two strategies for ECC management: topical application of neutral fluoride gel (NFG group) and varnish (FV group) every four months for a period of one year. The sample consisted of children between the ages of three and four years, enrolled in public daycare centers. The incidence of ECC between the groups was compared by assessing values (new dmfs) at two levels: d2 when enamel/dentin were affected and d3 when dentin affected. Pearson's Chi-square, Fisher's Exact, Kolmogorov-Smirnov and Mann-Whitney tests were used to compare the incidence and increment of caries between the NFG and FV groups (p<0.05). A total of 240 children were included in this study and 213 children (88.7%) were followed up for 12 months. The incidence of ECC was 24.1% in the GF and 21.0% in the FV groups (p=0.586). The increment of caries in d2mfs was 1.36 (95% CI = 0.83 - 1.89) in the NFG and 1.33 (95% CI = 0.75 - 1.89) in FV (p=0.756) groups. Increment of caries in d3mfs was 1.60 (95% CI = 0.95 - 2.25) in NFG and 1.40 (95% CI = 0.75 - 2.04) in FV (p=0.468). Neutral fluoride gel and fluoride varnish exhibited similar efficacy in the management of ECC after 12 months of follow-up.

Prevalência e fatores associados a defeitos de desenvolvimento do esmalte em crianças de 5 anos de idade matriculadas em creches na cidade de Teresina, Brasil / Prevalence and factors associated with developmental defects of enamel in five-year-old children enrolled in preschools in the city of Teresina, Brazil

Resumo Introdução Crianças com defeitos de desenvolvimento de esmalte (DDE) são mais suscetíveis à hipersensibilidade dentinária, maloclusões e dificuldades relativas à adesão de materiais restauradores. O conhecimento sobre a prevalência de DDE e seus fatores associados permite aos profissionais obter maior compreensão desse problema de saúde bucal, minimizando, dessa forma, as sequelas e melhorando a saúde bucal e a qualidade de vida dos indivíduos afetados. Objetivo Determinar a prevalência de DDE e seus fatores associados na dentição decídua. Método Trata-se de estudo transversal com amostra probabilística de 566 pré-escolares de 5 anos de idade, matriculados em creches públicas e privadas de Teresina, Piauí, Brasil. Foi aplicado questionário socioeconômico e de história médica da criança aos responsáveis. Os exames clínicos foram conduzidos por um único examinador (kappa = 0,93 para DDE e 0,86 para cárie) que utilizou os índices DDE modificado e ceo-d. Foi realizada a análise descritiva dos dados, além dos testes qui-quadrado e exato de Fisher e a regressão de Poisson, considerando como significativo p ≤ 0,05. Resultados A prevalência de DDE foi de 33,7%. A média de dentes com DDE por criança foi de 3,12 ± 2,23. O tipo mais prevalente de DDE foi opacidade demarcada (9,5%). Os segundos molares superiores foram os dentes mais afetados (11,9%). Houve associação entre DDE e estudar em creche pública (p = 0,026) e cárie (p = 0,012). Crianças com experiência de cárie apresentaram maior prevalência de DDE (RP: 1,29; IC95%: 1,01-1,64). Conclusão A prevalência de DDE na dentição decídua foi de 33,7% e se mostrou associada à experiência de cárie.

Abstract Background Children with Developmental Defects of Enamel (DDE) are more susceptible to dentin hypersensitivity, malocclusions, and difficulties related to the adhesion of restorative materials. Knowledge about the prevalence and factors associated with DDE allows professionals to gain a greater understanding of this oral health problem, minimizing sequelae, improving oral health and quality of life of affected individuals. Objective To determine the prevalence and factors associated with DDE in primary dentition. Method This is a cross-sectional study assessing a random sample of 566 preschool five-year-old children, enrolled in public and private preschools in Teresina, Piauí, Brazil. It was applied the socioeconomic and medical history of the child questionnaire for the parents or guardians. Clinical examinations were conducted by a single examiner (kappa = 0.93 for DDE and 0.86 for caries) that used the modified DDE index and dmft. Descriptive analysis, chi-square and Fisher's exact tests, and Poisson regression were performed, considering significant p ≤ 0.05. Results the prevalence of DDE was 33.7%. The mean DDE teeth per child was 3.12 ± 2.23. The most prevalent type of DDE was demarcated opacity (9.5%). The second molars were the most affected teeth (11.9%). There was an association between DDE and study at public preschool (p = 0.026) and dental caries (p = 0.012). Children with experience of caries were more likely to DDE (PR: 1.29; 95% CI: 1.01 to 1.64). Conclusion prevalence of DDE in the primary dentition was 33.7% and was associated with caries experience.

Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice.

This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

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.

Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice

Abstract This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

Resumo Este estudo transversal avaliou a prevalência e severidade de cárie dentária e fluorose em crianças de 5 anos e adolescentes de 12 anos usuários de dentifrício fluoretado, em áreas com e sem água fluoretada. Os responsáveis pelas crianças e adolescentes responderam questionários para determinação de características socioeconômicas e demográficas e hábitos relacionados à saúde. Os indivíduos foram examinados e a cárie e a fluorose foram mensuradas pelos índices ceo-d / CPOD e TF, respectivamente. Foram realizadas análises descritivas, bivariadas e de regressão logística (p <0,05). Dos 692 participantes, 47,7% tinham 5 anos e 52,3% tinham 12 anos. A média de ceod / CPOD em crianças de 5/12 anos dos grupos de exposto e não exposto à água fluoretada foi 1,53 (± 2,47) e 3,54 (± 4,10) / 1,53 (± 1,81) e 3,54 (± 3,82), respectivamente. Crianças (OR = 2,86, IC 95% = 1,71-4,75) e adolescentes (OR = 1,95, IC 95% = 1,24-3,05) que não consumiram água fluoretada tiveram maior experiência de cárie. Entre os adolescentes, houve associação entre a água fluoretada e a prevalência de fluorose muito leve / leve (OR = 5,45, IC 95%: 3,23-9,19) e fluorose moderada (OR = 11,11, IC 95% = 4,43-27,87). Crianças e adolescentes que consumiram água fluoretada apresentaram menor prevalência e severidade de cárie dentária em comparação com aqueles que usaram apenas dentifrício fluoretado como fonte de flúor. Houve uma associação entre a fluoretação da água e fluorose muito leve / leve e moderada em adolescentes.

Breathing problems, being an only child and having parents with possible sleep bruxism are associated with probable sleep bruxism in preschoolers: a population-based study.

PURPOSE: To determine the prevalence of probable sleep bruxism (SB) in preschoolers and associated factors. METHODS: A cross-sectional, population-based study was carried out with 862 dyads of parents/preschoolers aged 5 from Teresina, Brazil. Data collection was performed through a questionnaire answered by parents/guardians about socioeconomic, demographic, and health condition data. Each child was examined for diagnosis of probable SB based on the presence of dental wear associated or not with the report of teeth grinding by parents/guardians. The analysis of independent variables was stratified into four levels of determinants: demographic characteristics of the child (distal), characteristics of the family, environmental factors (intermediate), and health conditions (proximal). Descriptive analysis and bivariate and multivariate Poisson's regression were performed using a hierarchical approach (p < 0.05). RESULTS: The prevalence of probable SB was 36%. In the final adjusted multivariate hierarchical model, a preschooler who was the only child (PR = 1.25; 95%CI = 1.02-1.51), with breathing problems (PR = 1.43; 95%CI = 1.19-1.73), and having parents/guardians with possible sleep bruxism (PR = 1.65; 95%CI = 1.32-2.07) had a higher prevalence of probable SB. CONCLUSION: The prevalence of probable SB in preschoolers was high and associated with the condition of being an only child, the presence of breathing problems, and having parents/guardians with possible sleep bruxism.

Timing of sugar introduction in diet and early childhood caries: a population-based study in preschoolers / Momento de introdução de açúcar na dieta e cárie na primeira infância: um estudo de base populacional em pré-escolares

Abstract Introduction Sugar ingestion is the most important isolated factor related to dental caries. Contact with sugary foods at an early age may represent a risk to the oral health of preschool children. Objective To evaluate the timing of the introduction of sugar in the diet of preschoolers and its association with early childhood caries. Material and method Cross-sectional population-based study with 888 five-year-old preschoolers from public and private schools. Parents answered a questionnaire on sociodemographic data, eating habits and oral health. The variables timing of sugar introduction (>1 year and ≤1 year) and dental caries experience were dichotomized and data were analyzed using descriptive statistics and Poisson regression (p<0.05). Result The introduction of sugar in the diet occurred during the first twelve months of life for 73.8% of preschoolers. There was no association between the timing of sugar introduction and early childhood caries (p>0.05). The interruption of exclusive breastfeeding and low family income increased the prevalence of preschoolers having early contact with sugar by 32% and 23%, respectively (p<0.05). The prevalence of early childhood caries was 42.3% and was associated with a lower level of maternal education, low income, increased frequency of ingestion of candy and the use of nonfluoridated toothpaste (p<0.05). Conclusion The introduction of sugar in the diet occurred during the first year of life in most preschoolers and there was no association with early childhood caries.

Resumo Introdução A ingestão de açúcar é um importante fator relacionado à cárie dentária. O contato com alimentos açucarados em idade precoce pode representar risco para a saúde bucal de crianças em idade pré-escolar. Objetivo Avaliar o momento de introdução do açúcar na dieta de pré-escolares e sua associação com a cárie na primeira infância. Material e método Estudo transversal de base populacional com 888 pré-escolares de cinco anos de escolas públicas e privadas. Os pais responderam questionário sobre dados sociodemográficos, hábitos alimentares e saúde bucal. As variáveis ​​tempo de introdução do açúcar (> 1 ano e ≤1 ano) e experiência de cárie dentária foram dicotomizadas e os dados foram analisados ​​por meio de estatística descritiva e regressão de Poisson (p <0,05). Resultado A introdução do açúcar na dieta ocorreu nos primeiros doze meses de vida para 73,8% dos pré-escolares. Não houve associação entre o momento de introdução do açúcar e a cárie na primeira infância (p> 0,05). A interrupção do aleitamento materno exclusivo e a baixa renda familiar aumentaram a prevalência de pré-escolares com contato precoce com açúcar em 32% e 23%, respectivamente (p <0,05). A prevalência de cárie na primeira infância foi de 42,3% e esteve associada à menor escolaridade materna, baixa renda, maior frequência de ingestão de doces e uso de dentifrício não fluoretado (p <0,05). Conclusão A introdução de açúcar na dieta ocorreu durante o primeiro ano de vida na maioria dos pré-escolares e não houve associação com cárie na primeira infância.

Topography of Primary Molar Pulp Chamber Floor: A Scanning Electron Microscopy and Micro-Computed Tomography Analysis

ABSTRACT Objective: To determine in vitro the frequency, shape, type, diameter, and patency of accessory canals in the primary molars pulp chamber floor. Material and Methods: Sixteen healthy primary molars were evaluated by micro-computed tomography and scanning electron microscopy. Descriptive analyses of the frequency, shape (round, oval, or irregular), type (blind, true, or hidden), patency and diameter of the accessory canals were performed. Results: Half of the teeth presented accessory canals, 62.5% of which were located in the upper molars and 37.5% in the lower molars. The most frequent shape was irregular. In three-dimensional analysis, blind accessory canals (12.5%) and with patency (18.7%) of the teeth were observed. The average accessory canal diameter was 51.97 µm (± 26.03 µm). Conclusion: Upper molars showed a higher frequency of accessory canals with larger diameters. The irregular shape was the most frequent. 18.7% of accessory channels showed patency.

Dentin Thickness of Pulp Chamber Floor in Primary Molars: Evaluation by Cone-Beam Computed Tomography

ABSTRACT Objective: Use cone-beam computed tomography (CBCT) images to evaluate the dentin thickness of the pulp chamber floor in primary molars. Material and Methods: Cross-sectional study, conducted with CBCT images of teeth of children. Primary molars with preserved pulp chamber floor were included. The dentin thickness of the pulp chamber floor in the primary molars was measured linearly in CBCT cross-sections. Data were descriptively analyzed and the Mann-Whitney test was applied (p<0.05). Results: 27 CBCT exams and 123 primary molars of children aged 4 to 13 years were analyzed; the majority was female (52.0%). In maxillary molars, the median dentin thickness was 1.50 (0.6-2.2) mm in the first and 1.65 (0.6-2.3) mm in the second (p=0.049) molars. In mandibular molars, the median was 1.20 (0.3-1.7) mm in the first and 1.60 (1.0-2.2) mm in the second (p<0.001) molars. Children aged 4 to 8 years showed less dentin thickness (p<0.001). Conclusion: The median dentin thickness of the pulp chamber floor in primary molars was 1.50 mm, ranging from 0.3 to 2.3 mm. Less dentin thickness was associated with younger children, teeth in the mandibular arch, and first molars.

Does low-cost GIC have the same survival rate as high-viscosity GIC in atraumatic restorative treatments? A RCT.

Atraumatic Restorative Treatment (ART) is one of the strategies used to control dental caries; it involves hand instruments for removal of carious tissue, and restorations using high-viscosity Glass Ionomer Cement (GIC). The present controlled clinical trial aimed to evaluate the performance of low-cost GIC indicated for ART in primary teeth, compared with high-viscosity GIC, after one year of follow-up. Two-to six-year-old children with dentin caries lesions on one or two surfaces of anterior and posterior teeth were selected. The children were randomly assigned to 2 groups according to the restorative material used: G1 (control) - Ketac Molar®; G2 (experimental) - Vitro Molar®. Treatments were performed in a school setting, following the guidelines of the ART. A total of 728 restorations were performed in 243 children. Descriptive analysis and Poisson regression were applied, with a significance level of p < 0.05. After 12 months, 559 (76.8%) restorations were re-evaluated. The success rate was evaluated by the prevalence ratio (PR), associated with restorations performed in primary second molars (PR = 1.21; 95%CI = 1.03-1.42), and with small (PR = 1.35; 95%CI = 1.14-1.60) or medium cavities (PR = 1.29; 95%CI = 1.08-1.55), using Ketac Molar® material (PR= 1.07; 95%CI = 1.01-1.15), considering p < 0.05. Small or medium restorations in primary second molars performed with high-viscosity GIC (Ketac Molar®) were more successful than restorations performed with low-cost GIC indicated for ART.

Pre-term birth and asthma is associated with hypomineralized second primary molars in pre-schoolers: A population-based study.

BACKGROUND: Hypomineralized second primary molar (HSPM) is a developmental enamel defect that represents a caries-risk factor. There are few studies about HSPM epidemiology in representative populations. AIM: To determine the prevalence and factors associated with HSPM in pre-schoolers. DESIGN: This is a cross-sectional population-based study of 5-year-old pre-schoolers from Teresina, Brazil. The sample was randomly selected and stratified by geographic region of the city, type of school (public and private), and sex of the pre-schoolers (n = 811). Sociodemographic status and pre-, peri-, and post-natal conditions were collected by structured questionnaires. Two calibrated examiners diagnosed HSPM using the criteria of the European Academy of Paediatric Dentistry for molar-incisor hypomineralization. Severity, colour, location, and extent of lesions were also evaluated. Descriptive analysis of the data and a Poisson regression analysis were performed (P < .05). RESULTS: The prevalence of HSPM was 14.9. Demarcated opacities (75.6%) and white/cream colour were the most prevalent (71.4%). Pre-term pre-schoolers had 66% (PR = 1.66, 95% CI = 1.07-2.58), and those who reported asthma in the first year of life had 69% (PR = 1.69, 95% CI = 1.01-2.85) higher prevalence of HSPM. CONCLUSIONS: Pre-term birth and reported asthma in the first year of life were associated with HSPM. The prevalence of HSPM in pre-schoolers aged 5 years old in Teresina was high.

Consumption of Acidic Beverages is a Predisposing Factor for Erosive Tooth Wear in Preschool Children: A Population-based Study.

Purpose: In a cross-sectional population-based study of 888 5-year-old preschoolers from Teresina, Brazil, to determine the prevalence and factors associated with erosive tooth wear (ETW).
Materials and Methods: In a questionnaire, parents provided information on sociodemographic factors, their children's eating/drinking habits, and oral health. Dental examination was performed at the schools by two calibrated examiners for the diagnosis of ETW, following the criteria of the modified O'Brien Index.
Results: The prevalence of ETW was 3.3%. The maxillary incisors were the most highly affected teeth, followed by the mandibular and maxillary molars. The majority of the lesions reached only the enamel (72.1%) and up to 1/3 of the dental surface (63.1%). The occlusal surface was the most affected (47.8%). Preschoolers who had an acidic food-consumption profile had a 2.74 times (95% CI = 1.03-7.30) higher chance of having ETW than children without this profile.
Conclusion: The prevalence of erosive tooth wear on the deciduous teeth was low and associated with the consumption of acidic beverages.

Is Low Income Associated with Malocclusion in Primary Dentition Among Preschoolers?

Abstract Objective: To determine the prevalence and factors associated with malocclusion in the primary dentition of preschool children in a city of Brazilian Northeast. Material and Methods: A cross-sectional study was conducted with 566 five-years-old preschool children who were enrolled in public and private preschools in the city of Teresina, Piauí, Brazil. Data were collected using a sociodemographic questionnaire administrated to parents/caregivers and clinical oral examination of the children was performed. Foster and Hamilton Index for primary teeth was used for the diagnosis of malocclusions. Descriptive analysis was carried out and Poisson regression was used to assesses the association with independent variables. Results: The prevalence of malocclusion was 51.2%. The most frequent types were Class II canines (17% and 16.8%), increased overjet (15.2%) and reduced overbite (14%). Anterior crossbite was present in 3.5% of the preschool children evaluated. There was an association between malocclusion and low family income (PR = 1.22; 95% CI = 1.01-1.47). Conclusion: The prevalence of malocclusion in the primary dentition was high and associated with a low family income.

Impacto da cárie dentária na qualidade de vida de pré-escolares mensurado pelo questionário PedsQL / Impact of dental caries on the quality of life of preschoolers measured by PedsQL questionnaire

Resumo O objetivo do estudo foi avaliar o impacto da cárie dentária na qualidade de vida de pré-escolares. A população foi constituída por pré-escolares com idade de 5 anos, matriculados em instituições públicas e privadas de Teresina, PI, Brasil. Instrumento de qualidade de vida validado para população brasileira (Pediatric Quality of Life Inventory - PedsQL™) foi aplicado para as crianças e responsáveis, além de questionário socioeconômico-demográfico para os responsáveis. No exame dentário o índice ceod foi utilizado para avaliar a experiência de cárie. Das 566 crianças examinadas, 50,2% apresentaram experiência de cárie. Foi observada associação entre experiência de cárie e pior qualidade de vida no domínio de saúde bucal na percepção das crianças (RR= 0,981; IC95% = 0,97-0,99) e dos pais (RR= 0,955; IC95% = 0,94-0,97). De acordo com a percepção das crianças, cárie em dentes posteriores foi associada a pior qualidade de vida no domínio capacidade física (RR= 0,985; IC95% = 0,97-0,99). Concluiu-se que experiência de cárie impactou negativamente na QVRSB (qualidade de vida relacionada à saúde bucal) no domínio saúde bucal da criança de acordo com a percepção das crianças e dos pais. Cárie localizada em molares impactou negativamente na QVRSB no domínio capacidade física segundo a percepção das crianças.

Abstract The objective of this study was to evaluate the impact of dental caries on the quality of life of preschool children. The population was made up of preschoolers aged 5 years, enrolled in public and private institutions of Teresina, PI, Brazil. The Pediatric Quality of Life Inventory (PedsQL™) was applied to children and caregivers, as well as a socioeconomic-demographic questionnaire for those responsible. In the dental examination the ceod index was used to evaluate the caries experience. Of the 566 children examined, 50.2% presented with caries experience. It was observed an association between caries experience and poorer quality of life in the oral health domain in the children's perception (RR = 0.981, 95% CI = 0.97-0.99) and parents (RR = 0.955, 95% CI = 0, 94-0.97). According to the children's perception, caries in the posterior teeth was associated with poorer quality of life in the physical capacity domain (RR = 0.985, 95% CI = 0.97-0.99). It was concluded that caries experience had a negative impact on the OHRQoL (oral health-related quality of life) in children's oral health according to the perception of children and parents. Caries located in molars had a negative impact on HRQoL in the physical ability domain according to the children's perception.

Impact of dental caries on the quality of life of preschoolers measured by PedsQL questionnaire. / Impacto da cárie dentária na qualidade de vida de pré-escolares mensurado pelo questionário PedsQL.

The objective of this study was to evaluate the impact of dental caries on the quality of life of preschool children. The population was made up of preschoolers aged 5 years, enrolled in public and private institutions of Teresina, PI, Brazil. The Pediatric Quality of Life Inventory (PedsQL™) was applied to children and caregivers, as well as a socioeconomic-demographic questionnaire for those responsible. In the dental examination the ceod index was used to evaluate the caries experience. Of the 566 children examined, 50.2% presented with caries experience. It was observed an association between caries experience and poorer quality of life in the oral health domain in the children's perception (RR = 0.981, 95% CI = 0.97-0.99) and parents (RR = 0.955, 95% CI = 0, 94-0.97). According to the children's perception, caries in the posterior teeth was associated with poorer quality of life in the physical capacity domain (RR = 0.985, 95% CI = 0.97-0.99). It was concluded that caries experience had a negative impact on the OHRQoL (oral health-related quality of life) in children's oral health according to the perception of children and parents. Caries located in molars had a negative impact on HRQoL in the physical ability domain according to the children's perception.

O objetivo do estudo foi avaliar o impacto da cárie dentária na qualidade de vida de pré-escolares. A população foi constituída por pré-escolares com idade de 5 anos, matriculados em instituições públicas e privadas de Teresina, PI, Brasil. Instrumento de qualidade de vida validado para população brasileira (Pediatric Quality of Life Inventory - PedsQL™) foi aplicado para as crianças e responsáveis, além de questionário socioeconômico-demográfico para os responsáveis. No exame dentário o índice ceod foi utilizado para avaliar a experiência de cárie. Das 566 crianças examinadas, 50,2% apresentaram experiência de cárie. Foi observada associação entre experiência de cárie e pior qualidade de vida no domínio de saúde bucal na percepção das crianças (RR= 0,981; IC95% = 0,97-0,99) e dos pais (RR= 0,955; IC95% = 0,94-0,97). De acordo com a percepção das crianças, cárie em dentes posteriores foi associada a pior qualidade de vida no domínio capacidade física (RR= 0,985; IC95% = 0,97-0,99). Concluiu-se que experiência de cárie impactou negativamente na QVRSB (qualidade de vida relacionada à saúde bucal) no domínio saúde bucal da criança de acordo com a percepção das crianças e dos pais. Cárie localizada em molares impactou negativamente na QVRSB no domínio capacidade física segundo a percepção das crianças.