Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study

Abstract Objective: To evaluate in vitro erosive effect of analgesics on primary tooth enamel. Material and Methods: The pH and the titratable acidity measurements of the medicines were performed in triplicate using a digital pH meter. Enamel slabs of primary teeth flat and polished were selected by initial surface microhardness analysis. Medications were selected and specimens were assigned into five groups (n=12): Dalsy; Magnopyrol; Paracetamol; Tylenol; and distilled water (negative control). Specimens were immersed in 5 ml of each group solution for 30 min, 4x/day for three days and stored in artificial saliva at 37 °C between immersions and at night. Final microhardness was determined. The data were submitted to Oneway ANOVA and Tukey's test. Scanning electron microscopy (SEM) analysis was performed in three specimens of each group. Results: Medicines showed acidic pH and mean values of titratable acidity ranged from 1.46 to 11.66 ml of 0.1N NaOH. The mineral loss of Magnopyrol was statistically significant in relation to the control group (p<0.01). Magnopyrol showed higher values when compared to Tylenol (p<0.05). SEM images displayed microstructure alterations in the Paracetamol group. Conclusion: Despite the low pH values, only Magnopyrol showed greater enamel softening. Paracetamol demonstrated morphological changes in primary tooth enamel (AU).

Parents' Emotional and Social Experiences of Caring a Child with Cleft Lip and/or Palate

ABSTRACT Objective: To evaluate the emotional and social experiences of parents or caregivers of children with cleft lip and/or palate (CL/P) in a city in the Northeastern of Brazil. Material and Methods: A quantitative and cross-sectional study was conducted among parents or caregivers of children with CL/P by interviews based on a questionnaire. Interviews were conducted during the First Smile Project in Sobral, Ceará, Brazil. All participants (n=41) agreed to participate in the interview and signed an informed consent. The data was analyzed in SPSS software version 22.0. Results: The majority of participants were female (87.2%), with a mean age of 37 years, with a low level of education and low family income. The great majority (90.2%) of the parents were not prenatally diagnosed to have CL/P babies. Of those interviewed, 56.1% mentioned that the first diagnosis of cleft lip and palate was not presented by the professionals in a clarifying way to the family. Fear (36.6%) and sadness (19.5%) were the main feelings experienced when the child was diagnosed with fissure. Feeding (48.8%) was pointed out as the main concern in caring for a child with CL/P. Conclusion: The parents and caregivers interviewed faced important emotional and social problems that must be addressed by the professional team that assists the child with CL/P.

Parents and caregivers' knowledge and attitudes toward children's toothbrushing

Introduction: Fluoride prevents tooth decay, but especially in young children, it is important to balance the anticaries effect of fluoride toothpastes versus the risk of dental fluorosis. Objective: The aim of this study was to analyze parents' and caregivers' knowledge and attitudes toward their children's toothbrushing habits from 12 to 71 months of age, as well as to verify their knowledge about fluoride and toothpastes' dispensed amount. Methods: A semi-structured interview script was applied to a convenience sample of parents and caregivers (n = 63) at the Pediatric Dentistry Clinic of a public university. Respondents were asked to simulate the amount of toothpaste used in their children's brushing. Results were presented with absolute and relative frequencies. Results: Regarding their children's toothbrushing, 49.2% performed oral hygiene of their children; 31.7% mentioned that their children brushed under adult supervision; and 19.1% said their children brushed alone. When asked if they had already received guidance regarding the adequate amount of toothpaste to be dispensed, 54% stated they were never oriented. In 74.6% of cases, the amount dispensed exceeded the recommended dose for preschoolers. In addition, 57.1% reported that the toothpaste is within the reach of the child. Of the respondents, 66.7% pointed out the role of fluoride in caries prevention, and 73% were unaware of its toxicity. Conclusion: In general, parents had good oral hygiene practices with their children. However, most respondents did not use the appropriate amount of toothpaste for their children's age and were unaware of fluoride toxicity, although they could identify its purpose.

Introdução: O flúor pode prevenir a cárie dentária, porém, especialmente em crianças menores, é importante equilibrar o efeito anticárie dos dentifrícios fluoretados versus o risco de fluorose dentária. Objetivo: O objetivo deste estudo foi analisar o conhecimento e atitudes de pais e cuidadores sobre os hábitos de escovação de seus filhos de 12 a 71 meses de idade, bem como verificar seu conhecimento sobre flúor e quantidade utilizada de creme dental. Métodos: Um roteiro de entrevista semi-estruturado foi aplicado a uma amostra de conveniência de pais e cuidadores (n=63) na Clínica de Odontopediatria de uma universidade pública. Solicitou-se que os entrevistados simulassem a quantidade de creme dental utilizada na escovação de seus filhos. Os resultados foram apresentados de forma descritiva com frequências absolutas e relativas. Resultados: Quanto à supervisão da escovação, 49,2% realizavam a higienização de seus filhos; 31,7% mencionaram que as próprias crianças escovavam sob supervisão de um adulto, e 19,1% responderam que seus filhos escovavam sozinhos. Quando perguntados como aprenderam a dispensar dentifrício na escova, 54% afirmaram que nunca foram orientados. Em 74,6% dos casos, a quantidade dispensada superou a dose recomendada para pré-escolares. Ademais, 57,1% relataram que o dentifrício fica ao alcance da criança. Dos entrevistados, 66,7% apontaram o papel do flúor na prevenção da cárie e 73% desconheciam sua toxicidade. Conclusão: Em geral, os entrevistados praticavam bons hábitos de escovação em seus filhos. Entretanto, a maioria da amostra estudada não utilizou a quantidade apropriada de dentifrício para a idade e desconhecia a toxicidade do flúor, apesar de identificar sua finalidade.

Proliferative Periostitis in a Pediatric Patient.

Proliferative periostitis is a rare condition that can affect children and adolescents. It is characterized by the successive deposition of layers of bone caused by low-virulence infection or chronic inflammatory stimulation. The purpose of this paper is to report a case of proliferative periostitis in a pediatric patient, emphasizing the clinical and radiographic aspects as well as the therapeutic management.

Bruxismo infantil e sua associação com fatores psicológicos ­ revisão sistemática da literatura / Bruxism in children and its association with psychological factors - a systematic review of literature

O bruxismo compreende uma atividade parafuncional caracterizado pelo ato de ranger ou apertar os dentes de forma voluntária e/ou involuntariamente, ocorrendo durante o período diurno e/ou noturno, podendo acarretar vários prejuízos ao sistema estomatognático. Diversos são os fatores etiológicos que podem estar associados a esta desordem, como fatores locais, sistêmicos, hereditários, psicossociais e comportamentais. Pesquisadores têm sugerido que fatores comportamentais, como estresse, ansiedade e traços de personalidade se sobressaem a fatores locais. Portanto, o objetivo deste estudo foi realizar uma revisão sistemática da literatura a fim de avaliar se há relação entre bruxismo e fatores psicológicos em crianças. Foram realizados levantamentos nas bases de dados: PubMed, BVS Biblioteca Virtual em Saúde e SciELO no período de fevereiro de 2007 a setembro de 2017. Os descritores utilizados foram "bruxism", "children", "stress", "anxiety", "pshychological factors". Sendo assim, 97 publicações foram identificadas na busca inicial. Após aplicação dos critérios de inclusão e exclusão, a amostra final foi composta por sete estudos. Houve evidência significativa de uma associação entre estresse, ansiedade e fatores psicológicos com o bruxismo infantil. Porém, ainda existe uma enorme necessidade de estudos bem delineados e com metodologias padronizadas a fim de verificar a associação entre o bruxismo e fatores psicológicos.

Bruxism comprises a parafunctional activity characterized by the act of grinding or clenching the teeth voluntarily and/or involuntarily, occurring during the day and / or night, and may cause several damages to the stomatognathic system. Several etiological factors may be associated with this disorder, such as local, systemic, hereditary, psychosocial and behavioral factors. Researchers have suggested that behavioral factors such as stress, anxiety, and personality traits stand out from local factors. Therefore, the aim of this study was to perform a systematic review of the literature in order to evaluate if there is a relation between bruxism and psychological factors in children. Data were collected in the databases: PubMed, BVS Virtual Health Library and SciELO from February 2007 to September 2017. The descriptors used were "bruxism", "children", "stress", "anxiety" and "pshychological factors". Thus, 97 publications were identified in the initial search. After applying the inclusion and exclusion criteria, the final sample consisted of seven studies. There was significant evidence of an association between stress, anxiety, and psychological factors with infant bruxism. However, there is still a great need for well-designed studies with standardized methodologies in order to verify the association between bruxism and psychological factors.

Effect of Er:Yag laser on dentin demineralization around restorations.

The aim of this study was to evaluate the effect of cavity preparation with Er:YAG laser on dentin adjacent to restorations submitted to cariogenic challenge in situ, by subsuperficial microhardness analysis. Bovine incisors were sectioned, flattened, and polished, resulting in 40 dentin slabs. The slabs were randomly assigned to four groups (n = 10), according to the cavity preparation method: I-high-speed handpiece (control); II-Er:YAG laser (160 mJ; 3 Hz); III-Er:YAG laser (260 mJ; 3 Hz); IV-Er:YAG laser (300 mJ; 3Hz). Cavities were restored with composite resin, and the specimens were fixed in intra-oral appliances, which were worn by 10 volunteers for 14 days for simulating cariogenic challenge in situ. During the experimental period, 20% sucrose solution was dripped over each specimen 6 times a day. Samples were removed, sectioned, and examined for subsuperficial Knoop microhardness at 100, 200, and 300 µm from the restoration and at 30 µm from dentin surface. Split-plot analysis of variance showed no significant difference among the cavity preparation techniques (p = 0.1129), among distances (p = 0.9030), as well as no difference in the interaction between the main factors (p = 0.7338). It was concluded that the cavity preparation with Er:YAG laser did not influence on dentin microhardness submitted to cariogenic challenge in situ.

Impact of CO2 laser and stannous fluoride on primary tooth erosion.

This study evaluated in vitro the effect of input power of CO2 laser, either associated or not to stannous fluoride (SnF2) gel, for the control of intrinsic erosion in primary teeth. One hundred four enamel slabs (3 × 3 × 2 mm) from human primary molars were flattened and polished. Adhesive tapes were placed on their surface leaving a window of 3 × 1 mm. Slabs were then cycled four times in 0.01 M hydrochloric acid (pH 2, 2 min) and in artificial saliva (2 h) for creation of erosive lesions. Specimens were randomly assigned into eight groups (n = 13) according to fluoride application [absent (control) or 0.4% stannous fluoride gel (SnF2)] and input power of CO2 laser [unlased (control), 0.5, 1.0 or 1.5 W]. The CO2 laser irradiation was performed in an ultra-pulse mode (100 µs of pulse duration), 4-mm working distance, for 10 s. Specimens were then submitted to further erosive episodes for 5 days and evaluated for enamel relative permeability. Fluoride did not show any protective effect for any of the laser-treated groups or control (p = 0.185). However, a significant effect was detected for input power of CO2 laser (p = 0.037). Tukey's test showed that there was a significant statistically difference between specimens irradiated with 0.5 and 1.5 W (p = 0.028). The input power of 0.5 W showed lower permeability. Variation of input power CO2 laser can influence enamel permeability, at the power of 1.5 W which promoted greater permeability.

Enamel microabrasion as treatment of dental fluorosis in child - case report / Microabrasão do esmalte como tratamento da fluorose dentária em criança – relato de caso

Enamel microabrasion is an efficient method for treating fluorosis since it is a controlled non-invasive technique to remove surface stains promoting a minimum wear of the tooth structure. This paper aimed to report a case of stains removal on the upper incisors using the microabrasion technique. After detailed history taking, clinical examination and confirmation of the diagnosis of dental fluorosis, it was used a paste at 1:1 proportion of 37% phosphoric acid and pumice stone on the surface of the affected teeth. This technique can be used to re¬cover aesthetics of permanent teeth in children presenting opaque patches suggestive of fluorosis, being well accepted by the patient for being a conservative technique, easy to perform and fast, while presenting immediate aesthetic result that motivates the patient immediately.

Para o tratamento da fluorose dentária, a microabrasão do esmalte é um eficiente método para remover manchas superficiais, por consistir em uma técnica controlada e não invasiva promovendo uma quantidade mínima de desgaste da estrutura dentária. Este trabalho tem como objetivo relatar um caso clínico de remoção dessas manchas nos incisivos permanentes superiores utilizando a técnica de microabrasão. Após anamnese e exame clínico minucioso e confirmação do diagnóstico de fluorose dentária, foi empregada uma pasta de ácido fosfórico a 37% e pedra pomes numa proporção de 1:1 com ponta abrasiva na superfície dos dentes afetados. Esta técnica de microabrasão pode ser utilizada para a recuperação estética de dentes permanentes em crianças que apresentam manchas opacas sugestivas de fluorose, sendo bem aceita pelo paciente infantil por ser uma técnica conservadora, de fácil execução e rápida, além de apresentar um resultado estético imediato que motiva o paciente.

Eruption sequestrum--case report and histopathological findings.

Eruption sequestrum is an uncommon disturbance in eruption and consists of small fragments of calcified tissue overlying the crowns of erupting permanent molar teeth, especially at the time of eruption of the mandibular first molars. This paper reports a case of unilateral eruption sequestrum in a 7-year-old Brazilian boy and describes its histopathological findings. A white small fragment, 0.5 cm in diameter, with hard consistency, irregular shape and located on the occlusal surface of the erupting mandibular left first molar was excised. Microscopic examination revealed large trabeculae with empty lacunae and a minimal amount of existing spongy bone consisting of acute inflammatory cells (neutrophils). Signs of necrosis were found on the periphery. The histological analysis was consistent with non-vital bone and the diagnosis of eruption sequestrum was established. Clinical and radiographic follow-up visits scheduled at short intervals and then every 6 months revealed normal postoperative conditions.

Eruption sequestrum - case report and histopathological findings

Eruption sequestrum is an uncommon disturbance in eruption and consists of small fragments of calcified tissue overlying the crowns of erupting permanent molar teeth, especially at the time of eruption of the mandibular first molars. This paper reports a case of unilateral eruption sequestrum in a 7-year-old Brazilian boy and describes its histopathological findings. A white small fragment, 0.5 cm in diameter, with hard consistency, irregular shape and located on the occlusal surface of the erupting mandibular left first molar was excised. Microscopic examination revealed large trabeculae with empty lacunae and a minimal amount of existing spongy bone consisting of acute inflammatory cells (neutrophils). Signs of necrosis were found on the periphery. The histological analysis was consistent with non-vital bone and the diagnosis of eruption sequestrum was established. Clinical and radiographic follow-up visits scheduled at short intervals and then every 6 months revealed normal postoperative conditions.

Sequestro de erupção é um distúrbio raro da erupção e consiste de pequenos fragmentos de tecido calcificado que envolvem as coroas dos dentes molares permanentes em erupção, principalmente no momento da erupção dos primeiros molares inferiores. O objetivo deste trabalho é relatar um caso unilateral de sequestro de erupção em um menino brasileiro de 7 anos de idade e descrever seus achados histopatológicos. Um fragmento branco e pequeno, de 0,5 cm de diâmetro, com consistência dura, de forma irregular e localizado na superfície oclusal do primeiro molar inferior esquerdo em erupção foi excisado. O exame microscópico revelou trabéculas grandes com lacunas vazias e uma quantidade mínima de osso esponjoso existente consistindo de células inflamatórias agudas (neutrófilos). Na periferia, sinais de necrose foram evidenciados. A análise histológica foi consistente com osso não-vital e o diagnóstico de sequestro de erupção foi estabelecido. Exames clínicos e radiográficos em intervalos curtos e posteriormente semestrais revelaram condições pós-operatórias normais.

Root canal treatment of an immature dens invaginatus with apical periodontitis: a case report.

The purpose of this paper was to describe the case of an 11-year-old patient who presented a dens invaginatus, detected in the permanent maxillary left lateral incisor, with an immature open apex and extensive apical periodontitis and sinus tract. The mineralized invaginated barrier was removed, and a nonsurgical root canal treatment was performed using both calcium hydroxide as a root canal dressing to stimulate apexification and a mineral trioxide aggregate (MTA) plug to permit root canal filling. After a 14-month period of root canal dressing changes, no evidence of apical periodontitis was observed, and the MTA plug was placed in the root canal's apical portion. The root canal filling was performed using the thermoplasticized gutta-percha technique. At the 12-month follow-up, complete radiographic periapical healing, characterized by bone formation in the area around the tooth apex, and no clinical or radiographic evidence of refractory apical periodontitis were detected.

Variation of dentin dysplasia type I: report of atypical findings in the permanent dentition.

Dentin dysplasia is a rare defect of dentin development with an autosomal dominant pattern of inheritance, which is generally divided into 2 main classes based on the clinical and radiographic appearance of the affected dental tissues: type I, which affects the root portion and type II, which affects the coronal portion of the tooth. This paper reports the case of a child aged 10 years and 8 months with both classic and atypical features of dentin dysplasia type I in the permanent dentition. Only few mandibular teeth were affected and presented clinically normal appearing crowns, moderate to severe mobility, short, blunt or almost absent roots. However, no evidence of pulp chamber obliteration or periapical radiolucencies was found. The clinical and radiographic characteristics observed in this patient are different from those reported in the literature, which suggests that this may be a variation of dentin dysplasia type I expression.

Variation of dentin dysplasia type I: report of atypical findings in the permanent dentition

Dentin dysplasia is a rare defect of dentin development with an autosomal dominant pattern of inheritance, which is generally divided into 2 main classes based on the clinical and radiographic appearance of the affected dental tissues: type I, which affects the root portion and type II, which affects the coronal portion of the tooth. This paper reports the case of a child aged 10 years and 8 months with both classic and atypical features of dentin dysplasia type I in the permanent dentition. Only few mandibular teeth were affected and presented clinically normal appearing crowns, moderate to severe mobility, short, blunt or almost absent roots. However, no evidence of pulp chamber obliteration or periapical radiolucencies was found. The clinical and radiographic characteristics observed in this patient are different from those reported in the literature, which suggests that this may be a variation of dentin dysplasia type I expression.

A displasia dentinária é uma alteração do desenvolvimento da dentina rara, de origem autossômica dominante, o qual é geralmente dividida em 2 tipos principais baseados na aparência clínica e radiográfica dos tecidos dentais afetados: tipo I, que afeta a porção radicular e o tipo II, que afeta a porção coronária do dente. O objetivo deste trabalho é relatar o caso de um paciente de 10 anos e 8 meses de idade com ambas alterações clássicas e atípicas da displasia dentinária do tipo I na dentição permanente. Alguns dentes da arcada inferior foram acometidos, apresentando-se com coroas clinicamente normais, mobilidade dental de moderada a severa e raízes curtas ou ausentes, porém sem evidência de obliteração das câmaras pulpares e de lesões periapicais. As características clínicas e radiográficas observadas neste paciente foram diferentes daquelas relatadas na literatura, o que sugere que esta possa ser uma variação da expressão da displasia dentinária do tipo I.

Erosão Dental na Infância e sua Associação com o Refluxo gastroesofágico / Dental Erosion during Childhood and its Association with Gastroesophageal Reflux

Introdução: A erosão dental é definida como a perda progressiva e irreversível de tecido dental duro por um processo químico que não envolve a ação bacteriana. A sua etiologia apresenta caráter multifatorial e está relacionada à fonte de ácidos de origem extrínseca ou intrínseca. Dentre os fatores de origem intrínseca, esta condição tem sido relacionada à presença de refluxo gastroesofágico, principalmente em crianças. O refluxo gastroesofágico refere-se ao fluxo retrógrado, repetido e involuntário do conteúdo gástrico para o esôfago, que pode consistir de gás (eructação) ou fluido (regurgitação).Objetivo: Este trabalho discutiu, por meio de uma revisão de literatura, conhecimentos sobre a etiopatogenia e o diagnóstico do refluxo gastroesofágico e as evidências científicas acerca de sua associação com a erosão dental na infância. Foram apresentadas também algumas estratégias para a prevenção e o controle dessas lesões. Conclusão: O controle da erosão pela doença do refluxo gastroesofágico deve priorizar a eliminação ou a redução do contato do suco gástrico com a estrutura dental, por meio do tratamento da patologia de base; porém, durante o manejo do refluxo, o profissional deve estar atento à necessidade de prescrever ou adotar estratégias que minimizem o desgaste dental, como bochechar com solução aquosa de bicarbonato e adiar a escovação imediatamente após os episódios de regurgitação ou de êmese, evitar o consumo frequente de bebidas e de alimentos ácidos e otimizar a remineralização do esmalte ou da dentina por meio da aplicação de produtos fluoretados

Introduction: Dental erosion is defined as the progressive and irreversible loss of hard dental tissue by a chemical process that does not involves bacteria. Its etiology has a multifatorial nature and is related to acids of extrinsic or intrinsic origin. Among the intrinsic factors, this condition has been associated with the presence of gastroesophageal reflux, especially in children. Gastroesophageal reflux refers to the repeated and involuntary retrograde flow of the gastric content to esophagus in the form of gas (eructation) or fluid (regurgitation).Objective: This literature review addressed the knowledge of the etiopathogenesis and diagnosis of gastroesophageal reflux and the scientific evidence about its association with dental erosion during childhood. Some strategies for the prevention and control of these lesions were also presented. Conclusion: The control of dental erosion caused by gastroesophageal reflux disease should focus on eliminating or reducing the contact of gastric juice with the dental structures by treating the causative pathology. However, while dealing with the gastroesophageal reflux, the dentist should identify the need of prescribing and adopting strategies that minimize dental wear, such as, using oral rinses with a bicarbonate aqueous solution; delaying toothbrushing immediately after regurgitation or emesis episodes; avoiding frequent consumption of beverages and acid foods; and optimizing enamel/dentin remineralization by the application of fluoridated products

Abordagem odontológica em pacientes com diabetes mellitus tipo 1 / Dental management in patients with diabetes mellitus type 1

Objetivos: Abordar, por meio de revisão de literatura, as manifestações bucais predominantes e as precauções que devem ser tomadas para o tratamentoodontológico de crianças com diabetesmellitus tipo 1. Fontes pesquisadas: Artigos advindos de base de dados (Bireme e PubMed) relacionados à diabetes mellitus tipo 1 e ao tratamentoodontológico. Síntese dos dados: Após arevisão da literatura, destaca-se a presença de várias manifestações bucais em crianças com diabetes mellitus tipo 1. Além disso, torna-se evidente que o tratamento destes pacientes deve ser interdisciplinar, já que o controle glicêmico, obtido por meio da reeducação alimentar e aplicações regulares de insulina, proporcionarão à criança diabética melhoria da qualidade de vida e melhores chances de sucesso ao tratamento odontológico, uma vez que em crianças com glicemia controlada ocorre redução de alterações bucais, como xerostomia, periodontite, gengivite, cárie dental e infecçõesoportunistas. Também se ressaltam os cuidados que devem ser tomados no atendimento odontológico destas crianças, para que recebam um tratamento odontológico seguro, efetivo e voltado para suas reais necessidades. Conclusão: Crianças diabéticas devem receber atenção odontológica criteriosa, visto que estão mais sujeitas a xerostomia, periodontite, gengivite, cárie dental e infecções oportunistas, principalmente quando a glicemia nãoestá bem controlada. A identificação destas alterações bucais pelo cirurgião-dentista pode indicar essa condição e um encaminhamento ao médico responsável deve ser realizado. Durante o atendimento desses pacientes no consultório odontológico, cuidados como antibioticoterapia profilática, horário das consultas, dieta, tratamento de complicações bucais e monitoramento do controle glicêmico devem ser tomados.

Objectives: To discuss, through a literature review, the predominant oral manifestations and emphasizedthe precautions to be taken by the dental treatment of children with type 1 diabetes mellitus. Researched sources: Papers from the database (Bireme and PubMed) related to type 1 diabetes and dental treatment. Data source: After review of the literature, there is the presence of several oral manifestations in children with type 1 diabetes mellitus. Furthermore, it becomes clear that their treatment must be interdisciplinary,since the glycemic control achieved through diet and regular applications of insulin will providebetter quality of life for diabetic children and improvechances of dental treatment success. In children with controlled glicemy, there is a decline of some oral manifestations such as dry mouth, periodontitis, gingivitis, dental caries and opportunistic infections. Also itis emphasized that care must be taken in the dental care of these children to receive dental treatment safe, effective and focused on their real needs. Conclusion: Diabetic children should receive dental care judiciously, since they are more susceptible to dry mouth, periodontitis, gingivitis, dental caries and opportunistic infections, especially when glicemy is not well controlled. The identification of these oral diseases by the dentist may suggest this condition and referral to a medical treatment should be performed. During treatment of these patients in the dental office, precautions as use of prophylactic antibiotics, appointment hour, diet, treatment of oral complications and monitoring of glycemic control should be taken.

Febre na infância: conhecimento, percepção e atitude materna / Fever in childhood: mothers? knowledge, perception and attitude

Introdução: O objetivo deste trabalho é determinar o conhecimento, a percepção e a atitude de mães diante da febre de suas crianças, atendidas na Disciplina de Odontopediatria da Faculdade de Odontologia de Ribeirão Preto-USP. Métodos: Sessenta mulheres, com faixa etária entre 17 e 45 anos foram selecionadas. Um questionário foi aplicado, incluindo-se perguntas sobre as causas, consequências e cuidados domiciliares com a febre. Informações adicionais sobre o uso de medicamentos para tratamento da febre e efeitos colaterais decorrentes também foram obtidas. Os dados foram agrupados e submetidos à análise percentual. Resultados: Para detectar a presença de febre, 58 (96,7%) mães tocavam a pele da criança em locais como testa (58,3%) e pescoço (31,7%) e 46 (76,7%) das mães utilizavam o termômetro. Todas as mães relataram que febre alta pode provocar problemas graves de saúde, como convulsão (90%), delírio (66,7%) e perda de peso (55%). Antipirético era sempre oferecido às crianças com febre, mas antibióticos não eram administrados (96,7%). 71,6% das mães acreditavam que antibióticos provocam efeitos colaterais, principalmente alergia (46,7%) e alterações nos dentes (86,7%), como a cárie dentária (63,3%). Conclusão: Assim, apesar da crescente ênfase em educação em saúde, informações básicas sobre febre são necessárias para reduzir o medo e ansiedade das mães.

Introduction: The aim of this study is to determine mothers? knowledge, perception and attitude against the fever of their children, attended the Discipline of Pediatric Dentistry, School of Dentistry of Ribeirão Preto-USP. Methods: Sixty women, aged between 17 and 45 years were selected. A questionnaire was administered, including questions about the causes, consequences and care home with fever. Additional information about the use of medicines to treat fever and caused side effects also were obtained. Data were grouped and submitted to analysis percentage. Results: To detect the presence of fever, 58 (96.7%) mothers played the skin of children in places like forehead (58.3%) and neck (31.7%) and 46 (76.7%) mothers using the thermometer. All mothers reported that high fever can cause serious health problems such as seizures (90%), delirium (66.7%) and weight loss (55%). Antipyretic was always offered to children with fever, but antibiotics were not administered (96.7%). 71.6% mothers believed that antibiotics cause side effects, especially allergic (46.7%) and changes in teeth (86.7%), such as dental caries (63.3%). Conclusion: Thus, despite the increasing emphasis on health education, basic information about fever are necessary to reduce mothers? fear and anxiety.

Oral findings and dental treatment in a child with West syndrome.

West syndrome (WS) is a rare, severe form of epilepsy that typically manifests early in infancy. It is considered a malignant condition that combines episodes of spasms that occur in clusters (infantile spasm), hypsarrhythmia on the electroencephalogram, and neuropsychomotor delay. Although WS has been widely investigated from a medical standpoint, few reports have focused on the oral findings in patients with this syndrome. This article reports the case history of a 7-year-old child diagnosed with WS. The major clinical features were generalized tooth wear and gingival enlargement, altered chronology and sequence of dental eruption, primary canine cusp-to-cusp relationship, ectopic dental eruption, and mildly arched palate. Multiple white spot lesions were also observed, possibly associated with poor oral hygiene, due to a fermentable carbohydrate-rich diet, and continuous use of sugar-containing medications. Dental care management of patients with special needs is discussed and the dental treatment for this child with WS is described.

Hepatite C na odontologia: riscos e cuidados / Hepatitis C in dentistry: risks and cares

A hepatite C é uma infecção que merece destaque especial na Odontologia. O vírus da hepatite C já foidetectado na saliva de indivíduos infectados, o que confere uma possível via de transmissão não parenteraldo mesmo. Desse modo, o cirurgião-dentista está suscetível, tendo em vista seu grande contato com fluidoscorporais, além de estar sujeito a injúrias pérfuro-cortantes durante o trabalho. O objetivo deste trabalhoé realizar uma revisão de literatura sobre a hepatite C, com o intuito de esclarecer os profissionais da áreaodontológica e discutir sobre os riscos e os cuidados que devem ter durante a prática clínica

Hepatitis C is an infection that deserves special prominence in Dentistry. The virus of hepatitis C was already detected in the saliva of infected individuals, and that confers a possible way of its nonparenteraltransmission. In this way, the surgeon-dentist is susceptible, in view of his great contact with corporal fluids, besides being subject to percutaneous injuries during the work. The objective of this work is to carrythrough a literature review about hepatitis C, with intention to clarify the surgeons-dentists, and to argue then on the risks and the cares that they must have during their practical clinic

Scanning electron microscopic preliminary study of the efficacy of SmearClear and EDTA for smear layer removal after root canal instrumentation in permanent teeth.

This study aimed to evaluate the efficacy of SmearClear (SybronEndo, Orange, CA) and EDTA for smear layer removal from root canals of permanent teeth after instrumentation. Thirty extracted human permanent teeth (n = 10) were randomly assigned to the following groups: group 1 = 14.3% EDTA, group 2 = SmearClear, and group 3 = no smear layer removal procedure was undertaken (control). The specimens were submitted to scanning electron microscopy analysis. Magnifications of 200x and 750x were used to evaluate cleaning at the apical, middle, and cervical thirds according to a three-point scoring system. Data were analyzed statistically by the Mann-Whitney U test (5% significance level). Groups 1 and 2 differed significantly from group 3 (p < 0.01). However, there was no statistically significant difference (p > 0.05) between groups 1 and 2. In conclusion, SmearClear was able to remove the smear layer from the root canals of permanent teeth similarly as 14.3% EDTA, suggesting that both solutions may be indicated for such purpose.

Dental findings in Kabuki make-up syndrome: a case report.

This article documents the case history of a 9-year-old Brazilian child diagnosed with Kabuki make-up syndrome (KMS). The clinical features are described, with emphasis on the craniofacial and orodental manifestations. The patient had the distinctive KMS craniofacial features consisting of long palpebral fissure, hypertelorism, high-arched eyebrows with sparse hair in the lateral one-third, eyes with eversion of the lateral one-third of the lower eyelids, long and curved eyelashes, palpebral ptosis, large anteverted prominent ears in a lower position, broad, depressed nasal root with a flat nasal tip, and mild neuropsychomotor developmental deficits. The intraoral examination revealed an anterior open bite, overretention of primary teeth, and a high-arched palate. Two findings in this child have not been previously reported in patients with KMS: the presence of supernumerary teeth and taurodontic teeth in the maxillary arch. The clinical and radiographic detection of these unique dental features may be helpful in identifying children who may have milder forms of KMS.