Oral manifestations of congenital Zika virus infection in children with microcephaly: 18-month follow-up case series.

AIMS: To describe oral manifestations in children born with microcephaly attributed to congenital Zika virus syndrome (CZS). METHODS: Data was collected in semiannual intervals from 2017 to 2019, by oral exams of the children and interview with caregivers at a Public Dental Center in Rio de Janeiro, Brazil. A single calibrated examiner performed clinical examinations. RESULTS: Of 38 eligible children, 34 were followed-up from 12 to 30 months of age, 20 boys and 14 girls. The mean age of emergence of their first primary tooth was 12.4 months (SD = 2.9). By 30 months of age only 14.7% (n = 5) had complete primary dentition. Alteration in the sequence of tooth emergence was observed in 41.1% (n = 14). Radiographic examination demonstrated dental agenesis (14.7% n = 5). Dental developmental alterations (38.2%, n = 13), enamel defects (14.7%, n = 5), eruption cysts/hematoma (23.5%, n = 8), gingival bleeding (55.8%, n = 19), narrow palate, and bruxism (64.7%, n = 22) were also observed. No child had dental caries. CONCLUSION: Children with microcephaly attributed to CZS presented oral manifestations early in life.

Um ano de e-mails não solicitados: o modus operandi de revistas e editoras predatórias / One year of unsolicited e-mails: the modus operandiof predatory journals and publishers

Objetivo: Quantificar, caracterizar e analisar e-mails de revistas predatórias (RP) recebidos por uma pesquisadora da área de odontologia. Materiais e métodos: E-mails recebidos em 2019 e suspeitos de serem potencialmente predatórios foram pré-selecionados. O checklist do Ottawa Hospital Research Institute (OHRI) para identificar RP biomédicas suspeitas foi aplicado, incluindo os seguintes critérios: taxa/preço de publicação (TP), fator de impacto falso, a revista estar listada no Directory of Open Access Journals (DOAJ) e no Committee on Publication Ethics (COPE). Também foram extraídas informações sobre a falta de um fator de impacto no Journal Citations Reports, endereço de contato de e-mail não afiliado à revista, linguajar lisonjeiro, citação pessoal e/ou de um artigo, link de cancelamento de inscrição do tipo unsubscribe, estar listado no catálogo atual da National Library of Medicine (NLM) e estar indexado no Medline. Resultados: Um total de 2.812 e-mails suspeitos não solicitados foram recebidos e 1.837 requisitaram algum tipo de manuscrito; entre eles, 1.751 preencheram algum critério do OHRI. Menos da metade (780/1.837, 42%) referiu-se a alguma área da odontologia. A TP mediana foi de US$ 399. Um falso fator de impacto foi mencionado em 11% (201/1.837) dos e-mails e 27% (504/1.837) correspondiam a periódicos atualmente listados no catálogo da NLM. Os periódicos listados no DOAJ e COPE enviaram 89 e-mails. Conclusão: A campanha editorial das RP, sob a forma de e-mails, foi intensa e recorrente. Os pesquisadores devem estar bem informados sobre o modus operandi das RP para proteger sua própria reputação como autores, assim como a reputação da ciência

Objectives: To quantify, characterize and analyze e-mail from predatory journals (PJ) received by an academic in dentistry. Materials and methods: E-mails received in 2019 and suspected of being potentially predatory were pre-selected. The Ottawa Hospital Research Institute (OHRI) checklist was applied to identify the suspected biomedical PJ, including the following criteria: article processing charge (APC), fake impact factor, the journal being listed in the Directory of Open Access Journals (DOAJ) and the Committee on Publication Ethics (COPE). We also extracted information on the lack of an impact factor on Journal Citations Reports, non-journal affiliated contact e-mail address, flattering language, article and/or personal citation, unsubscribe link, being listed in the National Library of Medicine (NLM) current catalog and indexed on Medline. Results: A total of 2,812 unsolicited suspected e-mails were received, and 1,837 requested some sort of manuscript; among these, 1,751 met some of the OHRI criteria. Less than half (780/1,837, 42%) referred to some area of dentistry. The median APC was US$399. A false impact factor was mentioned in 11% (201/1,837) of the e-mails, and 27% (504/1,837) corresponded to journals currently listed in the NLM catalog. Journals listed in DOAJ and COPE sent 89 e-mails. Conclusions: The email campaign from PJ was high and recurrent. Researchers should be well informed about PJ' modus operandi to protect their own reputation as authors and that of science.

One year of unsolicited e-mails: The modus operandi of predatory journals and publishers.

OBJECTIVES: To quantify, characterize and analyze e-mail from predatory journals (PJ) received by an academic in dentistry. METHODS: E-mails received in 2019 and suspected of being potentially predatory were pre-selected. The Ottawa Hospital Research Institute (OHRI) checklist was applied to identify the suspected biomedical PJ, including the following criteria: article processing charge (APC), fake impact factor, the journal being listed in the Directory of Open Access Journals (DOAJ) and the Committee on Publication Ethics (COPE). We also extracted information on the lack of an impact factor on Journal Citations Reports, non-journal affiliated contact e-mail address, flattering language, article and/or personal citation, unsubscribe link, being listed in the National Library of Medicine (NLM) current catalog and indexed on Medline. RESULTS: A total of 2812 unsolicited suspected e-mails were received, and 1837 requested some sort of manuscript; among these, 1751 met some of the OHRI criteria. Less than half (780/1837, 42 %) referred to some area of dentistry. The median APC was US$399. A false impact factor was mentioned in 11 % (201/1837) of the e-mails, and 27 % (504/1837) corresponded to journals currently listed in the NLM catalog. Journals listed in DOAJ and COPE sent 89 e-mails. CONCLUSIONS: The email campaign from PJ was high and recurrent. Researchers should be well informed about PJ' modus operandi to protect their own reputation as authors and that of science. CLINICAL SIGNIFICANCE: Peer review and established academic practices and etiquette contribute to ensuring scientific progress, which is essential to protect the health of patients in particular and of people in general. Predatory journals constitute a threat to peer review and scientific etiquette and, as such, may hinder scientific progress and public health.

Risk communication in the context of clinical research.

Physicians and dentists usually make clinical decisions and recommendations without a clear understanding of the meaning of the numbers regarding the accuracy of diagnostic tests and the efficacy of treatments. This critical review aimed to identify problems in the communication of diagnostic test accuracy and treatment benefits and to suggest strategies to improve risk communication in these contexts. Most clinical decisions are taken under uncertainty. Health professionals cannot predict the outcome in one individual patient. This uncertainty invites these professionals to make decisions based on heuristics, which gives rise to several cognitive biases. Cognitive biases are automatic and unconscious, so how is it possible to mitigate their undesirable effects on risk interpretation in the context of clinical practice? Some forms of risk communication reinforce cognitive bias, while others weaken them. Maybe one of the most difficult obstacles to overcome is the difficulty to think with numbers. This difficulty probably arises from a mismatch of ancestral adaptations of the brain having to deal with modern environments, which are quite different from the ancestral ones. There are two quite common, but bad, forms of risk communication: the conditional probability and the relative risk reduction or efficacy. People, including physicians and dentists, are confused with this kind of information. The main methods discovered so far to facilitate a clearer understanding are to emphasize the base rates of the events and to use absolute numbers, that is to use natural frequencies, instead of percentages and conditional probabilities.

Strategies to deal with the COVID-19 pandemic.

The World Health Organization declared a COVID-19 pandemic on March 11, 2020, when there were 4,293 confirmed cumulative deaths. By May 17, 2020 this number increased to 315,005. The risk of death is higher above the age of 60, but there are many deaths below 60 (for example, in Sao Paulo, 25%). Due to the lack of a vaccine or specific treatment, there are at least three types of interventions used in the first wave of this pandemic: increased alertness and hygiene (e.g. Sweden); identification and isolation of infected people and their contacts (e.g. South Korea); lockdown (e.g. Italy). These interventions are complementary. Choices of the right mix of interventions will vary from society to society and in the same society at different times. The search for a miracle drug is dangerous because it is based on the mistaken belief that any treatment option is better than "nothing". Brazilian society will not be able to maintain lockdown for a long period. Naturally, in the near future, regardless of the advice from scientists, doctors and authorities, commerce, services and schools will reopen. In order to implement any strategy aimed to control the pandemic and preserve the economy, the country needs leadership that centralizes and coordinates actions. Unfortunately, the Brazilian government is not fulfilling this role; on the contrary, it is a hindrance. This negative leadership and lack of coordination are causing many deaths and are severely damaging the lives of survivors by delaying the resuming of economic and social activities.

Strategies to deal with the COVID-19 pandemic

Abstract The World Health Organization declared a COVID-19 pandemic on March 11, 2020, when there were 4,293 confirmed cumulative deaths. By May 17, 2020 this number increased to 315,005. The risk of death is higher above the age of 60, but there are many deaths below 60 (for example, in Sao Paulo, 25%). Due to the lack of a vaccine or specific treatment, there are at least three types of interventions used in the first wave of this pandemic: increased alertness and hygiene (e.g. Sweden); identification and isolation of infected people and their contacts (e.g. South Korea); lockdown (e.g. Italy). These interventions are complementary. Choices of the right mix of interventions will vary from society to society and in the same society at different times. The search for a miracle drug is dangerous because it is based on the mistaken belief that any treatment option is better than "nothing". Brazilian society will not be able to maintain lockdown for a long period. Naturally, in the near future, regardless of the advice from scientists, doctors and authorities, commerce, services and schools will reopen. In order to implement any strategy aimed to control the pandemic and preserve the economy, the country needs leadership that centralizes and coordinates actions. Unfortunately, the Brazilian government is not fulfilling this role; on the contrary, it is a hindrance. This negative leadership and lack of coordination are causing many deaths and are severely damaging the lives of survivors by delaying the resuming of economic and social activities.

Risk communication in the context of clinical research

Abstract Physicians and dentists usually make clinical decisions and recommendations without a clear understanding of the meaning of the numbers regarding the accuracy of diagnostic tests and the efficacy of treatments. This critical review aimed to identify problems in the communication of diagnostic test accuracy and treatment benefits and to suggest strategies to improve risk communication in these contexts. Most clinical decisions are taken under uncertainty. Health professionals cannot predict the outcome in one individual patient. This uncertainty invites these professionals to make decisions based on heuristics, which gives rise to several cognitive biases. Cognitive biases are automatic and unconscious, so how is it possible to mitigate their undesirable effects on risk interpretation in the context of clinical practice? Some forms of risk communication reinforce cognitive bias, while others weaken them. Maybe one of the most difficult obstacles to overcome is the difficulty to think with numbers. This difficulty probably arises from a mismatch of ancestral adaptations of the brain having to deal with modern environments, which are quite different from the ancestral ones. There are two quite common, but bad, forms of risk communication: the conditional probability and the relative risk reduction or efficacy. People, including physicians and dentists, are confused with this kind of information. The main methods discovered so far to facilitate a clearer understanding are to emphasize the base rates of the events and to use absolute numbers, that is to use natural frequencies, instead of percentages and conditional probabilities.

Searching and selecting the best evidence efficiently: a tool for clinicians, professors and dental students / Como buscar e selecionar a melhor evidência de forma eficiente: uma ferramenta para cirurgiões-dentistas, professores e alunos de odontologia

ABSTRACT The aim of this article was to offer an efficient systematic search strategy appropriate for clinicians, professors and dental students, for when they have a question regarding the effectiveness of clinical intervention. We adapted the "6-S System" proposed for Medicine in order to build a search strategy focused on oral health, which is speedy, easy to use and arrives at the appropriate evidence. With a focus on validity and search efficiency, the following searching sequence is proposed: critical abstracts of systematic reviews (SR) of randomized controlled trials (RCTs), SR of RCTs, critical abstracts of RCTs, and RCTs. These can be searched in the Cochrane library; evidence-based journals; websites and blogs; and in Pubmed using the tool Clinical Queries. This strategy can enhance the ability to quickly retrieve evidence that is important to dental education, clinical practice and delivery of oral health care. The adoption of strategies such as the one proposed in this paper is likely to increase evidence based dental practice.

RESUMO O objetivo deste artigo foi apresentar uma estratégia de busca sistemática e eficiente, apropriada para cirurgiões-dentistas, professores e alunos de Odontologia, para ser utilizada quando eles tiverem dúvidas sobre a efetividade de uma intervenção clínica. O sistema proposto para a Medicina, chamado de "Sistema 6-S", foi adaptado para que uma estratégia de busca com foco na Odontologia fosse construída. Essa estratégia é fácil e rápida de usar e alcança a melhor evidência científica disponível. A sequência de busca proposta, com foco na validade da evidência e eficiência da busca, consiste em: resumos críticos de revisões sistemáticas (RS) de ensaios controlados randomizados (ECR), RS de ECR, resumos críticos de ECR e, por último, ECR. A busca por esses artigos pode ser feita na biblioteca Cochrane; em revistas de odontologia baseada em evidência; sites da Internet e blogs; e no Pubmed através da ferramenta "Clinical Queries". Essa estratégia pode aprimorar a habilidade de obter rapidamente evidência importante para informar a prática clínica, a educação em Odontologia e o cuidado em saúde bucal. A adoção de estratégias como a proposta neste artigo pode aumentar a prática da Odontologia Baseada em Evidência.

Clinical accuracy data presented as natural frequencies improve dentists' caries diagnostic inference: Evidence from a randomized controlled trial.

BACKGROUND: The authors assessed whether dentists' diagnostic inferences differ when test accuracy information is communicated using natural frequencies versus conditional probabilities. METHODS: A parallel, randomized controlled trial with dentists was carried out in Rio de Janeiro, Brazil. The dentists received a question on the probability of a patient having interproximal caries, given a positive bite-wing radiograph. This question was asked using information that was formulated into either natural frequencies or conditional probabilities. RESULTS: Only 14 (13.9%) of the dentists gave the correct answer; 13 in the natural frequencies group, and 1 in the conditional probabilities group (P < .001). There were 7 nearly correct answers in the natural frequencies group and none in the conditional probabilities group (P = .005). CONCLUSIONS: Representing diagnostic test accuracy in natural frequencies substantially helped dentists make diagnostic inferences. Nearly twice as many dentists overestimated the presence of interproximal caries when given information in conditional probabilities. PRACTICAL IMPLICATIONS: Our study findings show information shared using natural frequencies may be more accurately interpreted by dentists than that based on conditional probabilities. Patients will probably receive different standards of care depending on the format in which dentists receive diagnostic test accuracy information.

Evidence-based pediatric dental practice within the clinician's reach: the case of the esthetic effect of topical silver diamine fluoride for caries control in primary dentition / Prática odontopediátrica baseada em evidência científica ao alcance do clínico: o caso do efeito estético do uso tópico de diaminofluoreto de prata para o controle da cárie na dentição decídua

ABSTRACT Objective: The aim of this paper was to demonstrate how a general dental practitioner tried to answer, based on scientific evidence, to the question: "Does the darkening of caries lesions caused by silver diamine fluoride treatment contribute to reducing parents' acceptance of such treatment?". Methods: The dentist adopted the following approach: formulation of a specific question; bibliographic search using controlled vocabulary and free terms; selection of full-text articles for reading; reading and critical appraisal of selected articles; summary of the available evidence; translation of the evidence into clinical practice. The dentist identified 45 studies and selected 20 to be read in full, but only three could be used; two controlled trials from China and one from Brazil. Results: Results showed that the esthetic effect was neither a major issue nor a decisive factor for the indication of the proposed treatment. However, although there is robust scientific evidence on the effectiveness of silver diamine fluoride in arresting and preventing caries lesions, there is scarce information about its esthetic effect. Thus, the lack of studies assessing the impact of the darkening of caries lesions and the esthetic effect of the treatment on the quality of life of children and their parents must be emphasized. Conclusion: The dentist concluded that there is insufficient evidence about the esthetic effect of silver diamine fluoride applications on primary teeth and opted to inform it to his/her patients' caregivers and to share with them the decision whether to use it or not in each specific case.

RESUMO Objetivo: Mostrar como um cirurgião-dentista clínico geral procurou responder, com base em evidência científica, à pergunta: "O escurecimento das lesões de cárie em dentes decíduos tratados com diaminofluoreto de prata contribui para a redução da aceitação desse tipo de tratamento pelos pais?". Métodos: O dentista seguiu o seguinte roteiro: formulação de uma pergunta específica; realização da busca bibliográfica utilizando descritores e termos livres; seleção dos artigos científicos completos para leitura; leitura e avaliação crítica dos artigos selecionados; resumo da evidência disponível e aplicação da evidência à sua prática clínica. O dentista localizou 45 trabalhos e selecionou 20 para leitura na íntegra, mas apenas três puderam ser utilizados, sendo dois ensaios controlados realizados na China e um no Brasil. Resultados: Os resultados mostraram que a estética não foi uma questão importante nem um fator decisivo para a indicação do tratamento proposto. No entanto, embora haja evidência científica robusta sobre a efetividade do diaminofluoreto de prata em paralisar e prevenir lesões de cárie, há pouca informação sobre seu efeito estético. Assim, a falta de estudos que avaliam o impacto do escurecimento das lesões de cárie e o efeito estético do tratamento sobre a qualidade de vida das crianças e seus familiares deve ser ressaltada. Conclusão: O dentista concluiu que não existe evidência suficiente sobre o efeito estético das aplicações de diaminofluoreto de prata em dentes decíduos e optou por informar os responsáveis por seus pacientes a respeito e compartilhar com eles a decisão sobre a indicação do mesmo para cada caso específico.

Efeito do dentifrício fluoretado na incidência de cárie na dentição decídua e fluorose na dentição permanente: revisões sistemáticas e metanálises / Effect of fluoride toothpaste on caries incidence inpermanent teeth: review sistemáticas e metanálises

Apesar do potencial anticárie do dentifrício fluoretado na dentição permanente estar bem estabelecido, existe uma lacuna no conhecimento em relação ao seu efeito na dentição decídua; não existe consenso quanto à concentração ideal de fluoreto no dentifrício capaz de maximizar o benefício anticárie na dentição decídua e simultaneamenteminimizar o risco de desenvolver fluorose clinicamente importante na dentição permanente. O artigo 1 desta tese avaliou o efeito dos dentifrícios de concentração baixa (menos de 600 ppm) e padrão (1000 a 1500 ppm) de fluoreto comparados com placebo ou nenhuma intervenção e o artigo 2 comparou diretamente o efeito do dentifrício de concentração sistemática de ensaios clínicos randomizados ou quasi-randomizados. Dois examinadores leram, de forma independente, 1932 resumos ou citações e 159 estudos na íntegra. As discordâncias foram resolvidas por um terceiro examinador. Oito estudos foram incluídos no artigo 1 e cinco no artigo 2. Para avaliar o efeito dos dentifrícios fluoretados sobre o número de crianças com cárie e fluorose, foram estimados frações prevenidas (FP) e riscos relativos (RR) combinados, respectivamente. Quando os dentifrícios de concentração padrão de fluoreto foram comparados com placebo ou nenhuma intervenção, houve reduções significativas de cárie no nível de superfície (FP=31%; IC 95% 18 - 43), dente (FP= 16%; ic 95% 7 - 24) e indivíduo (RR=0,86; IC 95% 0,85 - 0,93). Quando os dentifrícios de concentração baixa de fluoreto foram comparados com nenhuma intervenção, houve redução significativa de cárie apenas no nível de superfície (FP=40%; IC 95% 5 - 75) (artigo 1)...

Survey of Brazilian governmental health agencies shows conflicting recommendations concerning oral hygiene practices for children / Pesquisa com Secretarias de Saude no Brasil revela recomendacoes divergentes relacionadas a praticas de higiene bucal em criancas

The aims of this study were to detect whether recommendations concerning oral hygiene practices for children among Brazilian health agencies are consistent and to verify whether possible inconsistencies in these recommendations might be associated with an apparent gap in the scientific evidence. Fifty-four Brazilian health agencies were contacted by mail or electronic mail and were asked to send any material containing recommendations on oral hygiene practices aimed at children. A search was subsequently carried out on the Cochrane Oral Health Review Group and PubMed-Clinical Queries websites in order to assess the scientific evidence available on this subject. Forty (74 percent) agencies answered and 21 materials containing oral hygiene recommendations were obtained. Eleven pertinent systematic reviews were identified. This preliminary study detected some conflicting and not evidence-based oral hygiene messages, which emphasizes the need to carry out and disseminate systematic reviews on these controversial issues in order to bridge the gap between knowledge and practice.

Os objetivos deste estudo foram verificar se as recomendacoes fornecidas por orgaos governamentais brasileiros sobre higiene bucal em criancas sao consistentes e se possiveis inconsistencias nessas recomendacoes estao associadas a uma aparente falta de evidencia cientifica. Cinquenta e quatro orgaos governamentais brasileiros foram contatados por endereco eletronico ou postal. Foi solicitado que enviassem materiais contendo recomendacoes sobre praticas de higiene bucal para criancas. Em seguida, realizou-se uma busca nos sites Cochrane Oral Health Review Group e PubMed-Clinical Queries para avaliar a evidencia cientifica disponivel sobre o assunto. Quarenta (74 por cento) orgaos governamentais responderam e 21 materiais contendo recomendacoes sobre higiene bucal foram obtidos. Foram identificadas 11 revisoes sistematicas pertinentes. Este estudo preliminar detectou algumas recomendacoes divergentes e nao baseadas em evidencia cientifica, ressaltando a necessidade de se realizar revisoes sistematicas da literatura sobre esses topicos para aproximar a pesquisa cientifica da pratica clinica.

Avaliação clínica do efeito adicional do verniz fluoretado sobre a inativação de lesões iniciais de cárie em dentes decíduos / Clinical evaluation of the additional effect of fluoride varnish on the arrestment of initial caries lesions in primary teeth

O objetivo deste ensaio clínico foi avaliar o efeito adicional do verniz fluoretado sobre a inativação de lesões iniciais de cárie em dentes decíduos submetidos a 6 sessões de escovação profissional com dentifrício fluoretado. Critério de inclusão: mancha branca ativa (MBA) na face vestibular de incisivo/canino decíduo superior. Participaram 12 crianças(9 a 48 meses de idade), totalizando 29 MBA. As crianças foram alocadas aleatoriamente em 2 grupos: sem vernizfluoretado (SF) e com verniz fluoretado (CF). Ambos receberam 6 sessões de escovação dentária profissional com dentifrício fluoretado com intervalo médio de 1,2 semanas. O grupo CF recebeu aplicação de verniz fluoretado após cada escovação. Um único examinador cego, calibrado para cárie dentária (k=0,71) e biofilme dental (BF) (k=0,71) e treinadopara sangramento gengival (SG), avaliou os dentes em: baseline, intermediário e final. Os dados foram analisados no SPSS, utilizando os testes χ2 e exato de Fisher. Ao final, 22 (75,7%) lesões foram consideradas inativas e não houve diferença entre os grupos (p=0,295). A combinação dos dados de BF e SG originou o padrão de higiene da superfície dentária (PHD) que esteve associado à inativação das lesões (p=0,010). Clinicamente, não se observou efeito adicional do verniz fluoretado na inativação das lesões de cárie. Esta esteve associada à melhora do PHD, uma vez que a maiorproporção de inativação ocorreu dentre as superfícies que apresentaram melhor qualidade de higiene.

Oral hygiene frequency and presence of visible biofilm in the primary dentition.

The purpose of this study was to associate oral hygiene frequency and presence of visible biofilm in the primary dentition. The sample consisted of 90 children, aged up to 4 years old, outpatients of the University Hospital of the Rio de Janeiro State University. The examinations were carried out in a dental office by a single trained examiner who was aided by an assistant. The parents answered a structured questionnaire about oral hygiene methods and frequency. Two biofilm indices, one simplified (BF1) and the other conventional (BF2), were used. BF1 classifies biofilm as absent, thin or thick, in anterior and/or posterior teeth, and provides a score for the patient, whereas BF2 classifies biofilm as absent or present, provides scores for three surfaces of each tooth and the final score is the percentage of tooth surfaces with biofilm. More than half of the parents (51 - 56.7%) reported they cleaned their child's teeth at least twice a day, while 7 (7.8%) had never cleaned their child's teeth. BF1 revealed that 12.2% (11) of the children had no visible biofilm, 37.8% (34) had thin biofilm in anterior and/or posterior teeth, 27.8% (25) had thick biofilm in anterior or posterior teeth and 22.2% (20) had thick biofilm in both anterior and posterior teeth. BF2 revealed a mean value of 21.8% (s.d. 16.5). No statistically significant correlations were found between oral hygiene frequency and the two biofilm indices (p > 0.05), indicating that oral hygiene frequency was not associated to oral hygiene quality in the evaluated sample.

Oral hygiene frequency and presence of visible biofilm in the primary dentition

The purpose of this study was to associate oral hygiene frequency and presence of visible biofilm in the primary dentition. The sample consisted of 90 children, aged up to 4 years old, outpatients of the University Hospital of the Rio de Janeiro State University. The examinations were carried out in a dental office by a single trained examiner who was aided by an assistant. The parents answered a structured questionnaire about oral hygiene methods and frequency. Two biofilm indices, one simplified (BF1) and the other conventional (BF2), were used. BF1 classifies biofilm as absent, thin or thick, in anterior and/or posterior teeth, and provides a score for the patient, whereas BF2 classifies biofilm as absent or present, provides scores for three surfaces of each tooth and the final score is the percentage of tooth surfaces with biofilm. More than half of the parents (51 - 56.7 percent) reported they cleaned their child's teeth at least twice a day, while 7 (7.8 percent) had never cleaned their child's teeth. BF1 revealed that 12.2 percent (11) of the children had no visible biofilm, 37.8 percent (34) had thin biofilm in anterior and/or posterior teeth, 27.8 percent (25) had thick biofilm in anterior or posterior teeth and 22.2 percent (20) had thick biofilm in both anterior and posterior teeth. BF2 revealed a mean value of 21.8 percent (s.d. 16.5). No statistically significant correlations were found between oral hygiene frequency and the two biofilm indices (p > 0.05), indicating that oral hygiene frequency was not associated to oral hygiene quality in the evaluated sample.

O objetivo deste estudo foi associar freqüência de higiene bucal e presença de biofilme visível na dentição decídua. A amostra constou de 90 crianças com idade até 4 anos, cadastradas no Hospital Universitário da Universidade do Estado do Rio de Janeiro. Os exames foram realizados em consultório odontológico por um único examinador treinado, auxiliado por um anotador. Os pais responderam a um questionário estruturado sobre métodos e freqüência de higiene bucal. Foram utilizados dois índices de biofilme: um simplificado (BF1) e um convencional (BF2). O BF1 classifica o biofilme como ausente, fino ou espesso, em dentes anteriores e/ou posteriores, gerando um escore para o paciente, enquanto o BF2 classifica o biofilme como ausente ou presente, fornece escores a três superfícies de cada dente e o escore final corresponde ao percentual de superfícies com biofilme. Mais da metade dos pais (51 - 56,7 por cento) relataram limpar os dentes dos filhos pelo menos duas vezes ao dia ao passo que 7 (7,8 por cento) nunca tinham limpado os dentes dos filhos. O BF1 demonstrou que 12,2 por cento (11) das crianças não apresentavam biofilme visível, 37,8 por cento (34) apresentavam biofilme fino em dentes anteriores e/ou posteriores, 27,8 por cento (25), biofilme espesso em dentes anteriores ou posteriores, e 22,2 por cento (20), biofilme espesso em dentes anteriores e posteriores. O BF2 revelou uma média de 21,8 por cento (d.p. 16,5). Não foram encontradas correlações estatisticamente significativas entre a freqüência de higiene bucal e os índices de biofilme (p > 0,05), demonstrando que a freqüência de higiene bucal não esteve associada à qualidade da mesma na amostra estudada.

Diagnóstico de cárie sob o enfoque da odontologia baseada em evidências / Caries diagnosis under the focus of the evidence-based dentistry

Todo cirurgião-dentista, principalmente o odontopediatria, necessita ter conhecimento suficiente quanto aos métodos de diagnóstico disponíveis para a detecção de cárie dentária, além de entender a efetividade desses métodos para dar apropriado peso ao resultado nos momentos de decisão clínica. O objetivo deste trabalho é verificar o que diz a literatura sobre os procedimentos utilizados no diagnóstico da cárie dentária, em odontopediatria, por meio da metodologia proposta pela Odontologia baseada em evidências (OBE). Este estudo foi dividido em duas etapas. Na primeira, foi realizada uma busca na base de dados MEDLINE de textos relacionados ao assunto, em língua inglesa, e revisão de alguns livros de epidemiologia. Em seguida, todos os resumos dos trabalhos apresentados pela base de dados, a partir das palavras-chave indicadas pelo Medical Subject Headings (MeSH), foram lidos e classificados quanto à relevância e pertinência ao tema. O periódico que mais publicou artigos relevantes foi o Caries Research, e os países que mais pesquisaram com a metodologia da OBE foram o Reino Unido e os Estados Unidos. Nenhuma metanálise pertinente ao tema foi realizada até o presente momento

Any dental clinician, specially the pediatric dentist, needs to have know-how about the available diagnostic procedures for dental caries detectionand understand the effectiveness of these procedures in order to give appropriate weight to the result in clinical decision taking. The purpose of the present paper is to verify the status of the literature about the procedures available in dental caries diagnosis, in pediatric dentistry,using the evidence-based dentistry methodology. This study was carried out in two phases. The first one consisted in a search for texts related to the theme, in English language and indexed in the MEDLINE database,as well as a review of some Epidemiology books. After that, all abstractsof the papers obtained through the key words provided by the Medical Subject Headings (MeSH), were read and classified according to their relevance and pertinence. The journal and the countries that most published relevant and pertinent papers were Caries Research and the United Kingdom (UK) and United States of America (USA), respectively. No pertinent meta-analysis has been made until the present moment

Caries prevalence and risk factors among children aged 0 to 36 months.

The aim of this study was to assess the prevalence of caries and risk factors in outpatients of the Pediatric Ambulatory of the Pedro Ernesto University Hospital aging up to 36 months. After signing informed consent forms, the parents answered a structured questionnaire in order to evaluate risk factors for dental caries, including socioeconomic status, oral hygiene and dietary habits. A single investigator carried out the dental examination which assessed the presence of caries, biofilm and gingival bleeding. The data were analyzed by means of the Epi Info program, utilizing the chi-squared test. The children's mean age was 22.9 months. The prevalence of caries, including white spot lesions, was 41.6%, and the mean def-s was 1.7 (+/- 2.5). The most affected teeth were the maxillary incisors, and the most common lesion was the white spot. No significant associations were found between the prevalence of caries and socioeconomic status, frequency of oral hygiene, nocturnal bottle- and breast-feeding or cariogenic food and beverage intake during the day. However, the association between caries and oral hygiene quality (dental biofilm) was statistically significant (p < 0.001). The results suggest that the presence of a thick biofilm was the most important factor for the occurrence of early childhood caries in the evaluated sample.

Caries prevalence and risk factors among children aged 0 to 36 months / Prevalência de cárie e fatores de risco em crianças de 0 a 36 meses

O objetivo deste trabalho foi avaliar a prevalência de cárie e de fatores de risco em crianças com idade até 36 meses cadastradas no Ambulatório de Pediatria do Hospital Universitário Pedro Ernesto (HUPE-UERJ).Após a obtençäo de consentimento livre e informado, foi realizada uma entrevista com os responsáveis por meio da qual foram avaliados os fatores de risco à cárie, incluindo condiçöes sócio-econômico-culturais, hábitos de higiene oral e de dieta. Um único examinador realizou o exame bucal das crian;as para a avaliaçäo de cárie, de biofilme dental e de sangramento gengival. Os dados obtidos foram analisados através do programa EpiInfo, utilizando-se o teste Qui-quadrado. As crianças tinham em média 22,9 meses de idade. A prevalência de cárie encontrada, incluindo lesöes näo cavitadas, foi de 41,6 por cento e o índice ceo-s foi de 1,7 (ñ2,5). Os dentes mais afetados foram os anteriores superiores e o tipo de lesäo mais comum foi a mancha branca ativa. Näo houve associaçäo significativa estatisticamente entre a prevalência de cárie e os fatores sócio-econômico-culturais, freqüência de higiene, hábito de amamentaçäo noturna e dieta cariogênica durante o dia. Entretanto, a associaçäo entre cárie e presen;a de biofilme dental foi considerada altamente