Relationship between parental adverse childhood experiences and the prevalence of early childhood caries.

OBJECTIVES: The aim of this study was to examine the behavioural health conditions associated with parents' retrospective adverse childhood experiences (ACEs) scores and their children's early childhood caries (ECC) in parent-child dyads. MATERIALS AND METHODS: Parents with children younger than 72 months were included in the study. A relational screening model was used. Interaction among ACEs, ECC, nutritional habits and oral hygiene habits were evaluated. Chi-square tests and t-tests were used in the study. Multiple variables were evaluated using the artificial neural network (ANN) model. RESULTS: The mean age of the 535 children included in the study was 46.5 months, and 52% were female. Using the ANN model, there was a statistically significant relationship between the educational status of the mothers in both the ECC and severe ECC (S-ECC) groups and the socioeconomic status of the family (p < 0.05). If the number of snacks consumed daily was three or more, the risk of ECC was statistically significantly higher (chi-square test p = 0.034). The parents' ACEs scores had an impact on both ECC and S-ECC formation (p = 0.001, t-test). The higher the ACEs score, the higher the risk of S-ECC. The mean ACEs scores of the parents were also significantly higher in both the ECC and S-ECC groups compared to those of the parents of children without dental caries (p = 0.001, t-test). It was calculated that ACEs scores were effective at a rate of 18.2% on ECC (p = 0.045, ANN). CONCLUSIONS: The ACEs scores of parents have an impact on the oral health of young children and ECC/S-ECC formation. CLINICAL RELEVANCE: The long-term effects of parental ACEs are reflected in their children's oral health. Therefore, reducing the psychosocial determinants ACEs and providing parental support may help in overcoming barriers to the well-being of young children and may facilitate better oral health.

Factors affecting maternal decision making about grandparents' cariogenic dietary choices for children: A qualitative study.

BACKGROUND: Added sugar in children's diets puts them at higher risk of developing caries. Researchers have reported that grandparents frequently give their grandchildren cariogenic foods and beverages (for example, those with added sugars) and disagreements between grandparents and parents can ensue over this issue. This study's objective was to examine factors that influence whether mothers address grandparents about giving their grandchildren cariogenic foods and beverages. METHODS: In-person, semistructured qualitative interviews were conducted with 126 mothers of children aged 3 through 5 years from Pittsburgh, Pennsylvania, and West Virginia from 2018 through 2020. Qualitative data for this study were audio recorded, transcribed verbatim, imported into NVivo for coding, and analyzed using iterative theme development via a constant comparative process. RESULTS: In this study, 72% of mothers (91 of 126) indicated that grandparents gave their grandchildren cariogenic foods and beverages, and 51% of those mothers (46 of 91) addressed the issue with grandparents. Mothers described that the following factors influenced whether they addressed grandparents on this issue: frequency of interaction between grandparents and children, mothers' dependency on grandparents for childcare, quantity of cariogenic foods and beverages that grandparents provided, and strength of mothers' relationships with grandparents. CONCLUSIONS: There is evidence that some mothers consider the frequency and quantity of cariogenic foods and beverages, as well as social factors, when deciding whether to engage with grandparents about the cariogenic foods and beverages they give to their grandchildren. PRACTICAL IMPLICATIONS: Initiatives aimed to decrease childhood caries should consider how interpersonal family relationships may need to be addressed as part of successful sugar-reduction interventions.

Mother's Experience of Conflict Within Their Family Social Network when Advocating for Children's oral Health.

OBJECTIVES: Examine whether mothers perceived that child oral health was a source of conflict in family relationships. METHODS: This cross-sectional qualitative study consisted of 126 semi-structured interviews with mothers of 3-5 year-old children from West Virginia and Pittsburgh, Pennsylvania. Interviews consisted of open-ended questions on the mother's social relationships that affected child dental visits, oral hygiene, and diet. The data were analyzed using template analysis. RESULTS: Over 85% (n = 111/126) of mothers reported interpersonal conflict in their familial relationships related to child oral health. Most (78%) mothers reported conflict with their partners and 58% of mothers reported conflict with the child's grandparents. Conflicts primarily centered around keeping a consistent oral hygiene routine for the child and the promotion of a low-cariogenic diet. CONCLUSIONS FOR PRACTICE: Mothers perceived child oral health promotion as a source of conflict in the family. This study suggests that identifying effective strategies to reduce conflict with caretakers are indicated. Oral health professionals can take an active role not only in communicating with the mother, but also with other caretaking adults in the family to promote oral health practices that benefit all children.

Influence of Breastfeeding and Feeding on Children Dental Caries: a Cross-Sectional Study / Influência da Amamentação e da Alimentação na Cárie Dentária Infantil: um Estudo Transversal

Abstract The objective was to investigate the experience of dental caries and associated factors from the children's and adolescents' medical records who visited the Children's Dental Clinic of a College of southern Brazil. A cross-sectional study was carried out by analyzing 262 medical records. For data collection, information on demographic data, oral hygiene, food, breastfeeding and oral clinical data were used to investigate. A multivariate analysis was used to estimate the odds ratios (OR) and their 95% confidence intervals, by the exposure variables in a Binary Logistic Regression model (p-value< 0.05). Of the sample, 86.3% had some teeth with experience of dental caries, with only 13.7% free of caries. The average dental caries was 5.3 ± 3.1 in children between 6 and 8 years and 2.0 ± 1.9 between 9 and 12 years. There was a statistically significant association between age and dental caries, with the largest age group being a protective factor for dental caries (OR 0.30; 95%CI 0.17-0.53). Children who were breastfed naturally had a protective factor for caries (OR 0.29; 95%CI 0.10-0.88). The experience of dental caries in children was high, especially in primary teeth, with a higher average of decayed teeth. Breastfeeding and age were a protective factor for dental caries. (AU)

Resumo O objetivo foi investigar a experiência de cárie dentária e fatores associados em prontuários de crianças e adolescentes que procuraram o Ambulatório de Odontologia Infantil de uma Faculdade do Sul do Brasil. Realizou-se um estudo transversal por meio da análise de 262 prontuários. Para a coleta de dados, foram utilizadas informações sobre dados demográficos, higiene bucal, alimentação, aleitamento materno e dados clínicos bucais para investigação. Uma análise multivariada foi utilizada para estimar os odds ratios (OR) e seus intervalos de confiança de 95%, pelas variáveis de exposição em um modelo de Regressão Logística Binária (p-valor <0,05). Da amostra, 86,3% tinham alguns dentes com histórico de cárie dentária, e apenas 13,7% livre de cárie. A média de cárie dentária foi de 5,3 ± 3,1 em crianças entre 6 e 8 anos e 2,0 ± 1,9 entre 9 e 12 anos. Houve associação estatisticamente significativa entre idade e cárie dentária, sendo a maior faixa etária fator de proteção para cárie dentária (OR 0,30; IC95% 0,17-0,53). Crianças amamentadas naturalmente apresentaram fator de proteção para cárie (OR 0,29; IC95% 0,10-0,88). O histórico de cárie dentária em crianças foi elevado, principalmente nos dentes decíduos, com maior média de dentes cariados. O aleitamento materno e a idade foram fatores de proteção para cárie dentária. (AU)

Milk Consumption and Prostate Cancer: A Systematic Review.

Prostate cancer is the third most common cancer in men globally, and the most common cancer among men in the United States. Dietary choices may play an important role in developing prostate cancer; in particular, a higher dairy product intake has been associated with an increased risk of developing prostate cancer. The overall positive association between milk consumption and the risk of prostate cancer development and prostate cancer mortality has been well documented in multiple epidemiological studies. However, there is limited literature on the association between types of milk, as classified by fat content (skim, low fat, and whole), and the risk of developing prostate cancer. When further examining current state of the literature on this topic, there is a number of epidemiologic studies assessing the relationship between prostate cancer and milk consumption. On the contrary, very few experimental studies explore this topic. Further experimental research may be necessary to examine the relationship between dairy and dairy products consumption and the increased risk of development of prostate cancer. At this time, there are no formal clinical recommendations regarding dairy products consumption for patients who are at risk of prostate cancer development or who have a history of prostate cancer. In this manuscript, we sought to systematically review the existing literature on the association between milk consumption classified by fat content, and the risk of developing prostate cancer. These findings may be useful for the clinicians who provide recommendations for the patients at risk of developing prostate cancer.

Can Schoolchildren Substitute Mothers' Reports of Cariogenic Foods Consumption?

ABSTRACT Objective: To investigate the influence de two instruments for evaluation of cariogenic foods consumption by schoolchildren. Material and Methods: The convenience sample comprised of 30 active-caries children (7-10 years old) attended in a public dental clinic and their mothers, who have not received dietary orientation before study. A trained evaluator administered the Previous Day Food Questionnaire (PDFQ) to children and other examiner applied the 24-hour dietary recall with mothers. Internal consistency between PDFQ and 24-hour dietary recall regarding frequency of sugar intake was calculated using intraclass correlation coefficient. Bivariate analyses (Mann-Whitney test) were performed to investigate the factors associated with frequency of sugar intake when using both instruments (α=0.05). Results: A moderate correlation (ICC = 0.51; 95%CI: -0.04-0.77; p=0.03) was found between instruments. Mean frequency of sugar intake reported by mothers and children was 3.5 (± 1.8) and 3.7 (± 1.5) times a day, respectively. When using the PDFQ, the frequency of cariogenic foods consumption varied depending on frequency of toothbrushing, i.e., children that had higher frequency of sugar intake brushed their teeth at least two times a day (p=0.016). Conclusion: Previous Day Food Questionnaire applied with schoolchildren could substitute the mothers' reports of cariogenic foods consumption when dietary interventions for controlling dental caries are necessary. If doubts remain regarding the children's response, mothers should be consulted.

Caries de la temprana infancia y factores de riesgo en niños de nivel socioeconómico medio-bajo, Ecuador / Early childhood caries and risk factors in young children of medium-low socioeconomic status, Ecuador / Cárie na primeira infância e fatores de risco em crianças de nível socioeconômico médio-baixo, Equador

Introducción: La caries de la temprana infancia (CTI) es una de las enfermedades infecciosas más comunes en infantes y niños preescolares. Objetivo: Evaluar la caries de la temprana infancia y los factores de riesgo asociados con prácticas dietarías y el estado nutricional en niños de 10-48 meses de edad. Materiales y Métodos: Se realizó un estudio transversal en 142 niños de nivel socioeconómico medio-bajo de un centro infantil gubernamental en Cuenca, Ecuador. La salud dental, estado nutricional y patrones dietarios se evaluaron mediante exámenes clínicos, mediciones antropométricas y recordatorios de 24 horas, respectivamente. Resultados: La prevalencia de caries de la temprana infancia fue alta (95.8%) mayoritariamente en etapa avanzada (83.1%). No se observaron asociaciones con el estado nutricional. El consumo diario de alimentos cariogénicos fue significativamente mayor entre semana (11,1 ± 1,4) (p<0,001). La dieta fue categorizada como de bajo riesgo cariogénico (<34). La edad del niño (OR=1.1; IC 95%: 1.041, 1.160, p=0.001) y el índice de placa (OR=4.9; IC 95%: 1.331, 17.82; p=0.017) fueron determinantes positivos de caries avanzada. Conclusión: El deterioro de la salud dental de esta población se evidenció, empeorando a edades mayores sin asociación con los patrones dietarios.

Introduction. Early childhood caries (ECC) is one of the most common infectious diseases for infants and preschool children. Objective: To evaluate early childhood caries and risk factors associated with dietary practices and nutri- tional status in children of 10-48 months old. Materials and Methods: A cross-sectional study was performed on 142 children of medium-low so- cio-economic status from a governmental child-care center in Cuenca, Ecuador. Dental health, nutritional status and dietary patterns were assessed through clinical examination, anthropometric measurements and 24-hours dietary recalls, respectively. Results: Early childhood caries prevalence was high (95.8%) mostly of advanced stage (83.1%). No as- sociations with nutritional status. Daily consumption of cariogenic foods was significantly higher during weekdays (11.1 ± 1.4) (p<0.001). The diet was categorized as low cariogenic risk (<34). Child's age (OR=1.1; 95% CI: 1.041, 1.160, p=0.001) and the plaque index (OR=4.9; 95% CI: 1.331, 17.82; p=0.017) were positive determinants for advanced caries. Conclusions: The deteriorated dental health of this population was evidenced, being worse at older ages without any association with dietary patterns.

Introdução. A cárie da primeira infância (CPI) é uma das enfermidades infecciosas mais comuns em crianças pre-escolares. Objetivo: Avaliar a cárie da primeira infância e fatores de risco associados com práticas dietárias e estado nutricional de crianças de 10-48 meses. Materiais e métodos. Realizou-se um estudo transversal em 142 crianças de nível socioeconômico médio-baixo do centro infantil governamental em Cuenca, Equador. A saúde dental, estado nutricio- nal e patroes dietários se avaliaram mediante exames clínicos, medições antropométricas e lembretes de 24 horas respectivamente. Resultados: A prevalência de cárie da primeira infância foi alta (95.8%) principalmente em estágio avançado (83.1%). Não se observaram relações com o estado nutricional. O consumo diário de ali- mentos cariogênicos foi significativamente maior entre semana (11,1 ± 1,4) (p<0,001). A dieta foi categorizada como de baixo risco cariogênico (<34). A idade das crianças (OR=1.1; IC 95%: 1.041, 1.160, p=0.001) e o índice de placa (OR=4.9; IC 95%: 1.331, 17.82; p=0.017) foi determinante em cárie avançada positiva. Conclusão: O deterioro da saúde dental dessa população se evidenciou, piorando as idades mais velhas sem relação com os patroes dietários.

Risk Factors of Dental Caries: Consumption of Sugary Snacks Among Indonesian Adolescents

Objective: To determine the risk factors of caries among adolescents in Padang City, by assessing the frequency of sugary snack consumption. Material and Methods: A cross-sectional study was conducted on 150 randomly selected junior high school students using a selfadministered questionnaire along with oral examinations. The questionnaire consisted of questions on socio-demographic characteristics, oral health behavior, and frequency of consumption of sugary foods. Data were analyzed using the Chi-square tests and multivariate analysis. Results: Dental caries was found in 61% of the total students and was more prevalent in males when compared with females. The mean DMFT score was 1.3±1.4. Sugary snack consumption, attitude, and protective factors were significantly related to the occurrence of caries (p<0.001). The risk of dental caries in subjects with high amounts of sugary snack consumption was 5.67 times higher (OR=5.7; CI: 2.7-11.9) than those with low consumption. Subjects with low protective factors, high consumption of sugary foods and drinks, and bad attitude presented with a caries prevalence of 94%. Conclusion: The consumption of sugary foods was found to play an important role in the development of caries in the current study.

Feeding Practices of Potential Risk to Dental Caries in Early Childhood and its Relationship with Sociodemographic Variables and Prematurity

Objective: To verify the relationship of feeding practices of potential risk to dental caries in early childhood with sociodemographic variables, prematurity and Neonatal Intensive Care Unit admission (NICU). Material and Methods: Data from medical records of infants and preschool children, including feeding practices (breastfeeding, bottle feeding, feeding during sleep, introduction and frequency of sugar use), sociodemographic variables, prematurity and NICU admission were collected. Chi-square, Fisher and Maximum Likelihood Ratio tests were used. Results: The number of medical records was 222 in the age group of 01-45 months. Breastfeeding was not present in 66.7% of preterm infants (p=0.003) and 66.1% of infants admitted at NICU (p=0.011). The use of feeding bottle occurred in 58.4% of infants whose mothers work / study; 58.4% of preterm infants and 60.9% of children admitted at NICU (p<0.001). Feeding during sleep occurred in 70.5% of infants aged 1-24 months (p<0.001); 51.4% were single children (p=0.010) and 76.7% did not attend daycare centers (p=0.003). The introduction of sugar occurred in 60.6% in the age group of 01-24 months. The use of sugar more than 3x / day occurred in 52.6% of infants aged 25-45 months (p=0.003) and; 51.8% with mothers whose schooling corresponded to elementary school (p=0.039). Conclusion: Among caries-risk feeding practices, there was relationship between breastfeeding and prematurity and NICU admission; use of feeding bottle and mothers who worked and / or studied, prematurity and NICU admission; feeding during sleep and younger children, single child and those who did not attend daycare centers; and higher frequency of sugar use and older infants, and maternal schooling corresponding to elementary school.

Determinant Factors of Dental Caries in Indonesian Children Age 8-12 Years

Objective: To evaluate the determinant factors of dental caries in Indonesian children aged 8-12 years. Material and Methods: This study was observational and analytical with a cross-sectional design. A total of 114 children were selected using simple random sampling technique. Primary data was obtained from a questionnaire about tooth brushing habits, the use of toothpaste containing fluoride and cariogenic eating habits and data of dental caries obtained from direct observed by a dentist. Univariat data were analyzed using descriptive and bivariate data were analyzed using Chi-square tests. Results: The results obtained by 44.8% fair category of children who have toothbrushing habits, use of toothpaste containing fluoride was 100%, and 71% middle category children who have cariogenic eating habits. The most consumed cariogenic food was ice cream with 76.3% participants consumed it one to three times a week. The most eaten cariogenic foods every day in this sample were syroup/pop ice soft drink (42.1%). No significant association between gender and dental caries incidence was observed (p>0.05). Conclusion: There is significant association between tooth brushing habits with dental caries in Indonesian children aged 8-12 years at primary school in district of East Luwu Regency Tomoni.

Análise de Ph, Sólidos Solúveis Totais e Alterações Microestruturais em Esmalte Promovidas por Refrigerantes à Base de Cola / Analysis of Ph, Total Soluble Solids and Microstructural Changes in Enamel Promoted by Cola-Addedsoft Drinks

Objetivo: Avaliar o pH, a quantidade de sólidos solúveis totais (SST) de diferentes apresentações comerciais de refrigerantes (A - Coca-Cola®; B - Coca-Cola Zero®; C Coca-Cola Light®), e as alterações microestruturais promovidas por estes refrigerantes na estrutura adamantina. Material e Métodos: A avaliação do pH foi realizada mediante o uso de pHmetro digital (Quimis®), executando-se três aferições para cada amostra, sendo o pH final obtido pelo cálculo da média destes valores. Para a quantificação dos SST (°Brix) utilizou-se 4 gotas de cada produto e com auxílio de um refratômetro (Atago®), com faixa de leitura de °Brix de 0~32%, obteve-se o valor de °Brix dos produtos analisados, sendo a média obtida por meio de três aferições para cada refrigerante. Blocos de esmalte bovino foram submetidos à exposição dos refrigerantes por 5 minutos e posteriormente preparados e analisados em microscopia eletrônica de varredura (MEV). Resultados: Os valores de pH e SST (média e desvio padrão) para as amostras foram, respectivamente: A - 2,54(±0,03); 9,47%(±1,29%); B 2,88(±0,04); 0,0%(±0,0%); C - 3,10(±0,03); 0,0%(±0,0%). As microfotografias revelaram dissolução na periferia dos prismas de esmalte, bem como presença de perda da integridade superficial. Conclusão: As bebidas analisadas apresentam potencial erosivo, promovendo alterações na microestrutura adamantina indicativas de erosão, em consequência do seu baixo pH. Somente a Coca-Cola® demonstrou potencial cariogênico, conferido pela presença de SST. (AU)

Objective: To evaluate the pH, the amount of total soluble solids (TSS) of different commercial presentations of soft drinks (A - Coke®; B ­ Coke Zero®, C - Diet Coke®), and the microstructural changes promoted by these soft drinks in the adamantine structure. Materials and Methods: The pH evaluation was performed by a digital pH meter (Quimis®) by running three measurements for each sample, and the final pH was obtained by calculating the average of these values. For SST (°Brix) quantification, 4 drops of each product were used to acquire the °Brix values, which were determined by a refractometer (Atago®) with a read range of 0~32%.Means of three measurements were obtained for each product. Bovine enamel blocks were exposed to soft drinks for 5 minutes and then prepared and analyzed in a scanning electron microscope (SEM). Results: The values of pH and TSS (mean and standard deviation) for the samples were, respectively: A - 2.54 (± 0.03); 9.47% (± 1.29%); B - 2.88 (± 0.04); 0.0% (± 0.0%); C - 3.10 (± 0.03); 0.0% (± 0.0%). The micrographs showed dissolution on the edgesof enamel prisms, as well as loss of surface integrity. Conclusion: The soft drinks analyzed showederosive potential, promoting changes in the adamantine microstructure, which can be explained due to the low pH of the drinks. Only Coke® showed cariogenic potential, given the presence of SST. (AU)

Hábitos de dieta e cárie precoce da infância em crianças atendidas em faculdade de odontologia brasileira / Dietary habits and early childhood caries in children treated at a brazilian dental school

Objetivo: Avaliar a associação entre hábitos de dieta e a presença de Cárie Precoce da Infância (CPI) em um grupo de crianças atendidas em uma Universidade Pública, Minas Gerais - Brasil. Método: Foram incluídas 69 crianças (30 meninos; 39 meninas), com idade entre 13 e 60 meses. O índice ceo-d foi determinado por um único examinador treinado (coeficiente de kappa = 1), segundo critérios preconizados pela Organização Mundial da Saúde. Diário alimentar de três dias foi preenchido pelos pais e/ou responsáveis para obtenção dos dados sobre a dieta. A análise estatística incluiu os testes Qui-Quadrado e Exato de Fischer, seguidos por análise de regressão logística múltipla. Adotou-se o nível de significância de 5% (alfa = 0,05). Resultados: A CPI foi diagnosticada em 87% da amostra (60/69 crianças). Registrou-se um índice ceo-d médio igual a 9,20. A frequência média de ingestão de carboidratos foi alta (mais de cinco vezes por dia) para 82,6% das crianças (57/69). Não houve associação significativa entre frequência de ingestão de açúcar e presença de cárie (P = 0,183). O modelo de regressão logística múltipla demonstrou associação inversa entre consumo de "outros alimentos" e ausência de cárie (P = 0,02). Estes resultados sugerem a necessidade de aconselhamento de dieta com respeito ao consumo de certos alimentos associados à CPI na amostra estudada. Conclusão: A alta frequência média de ingestão de dieta cariogênica não se associou à presença de Cárie Precoce da Infância, assim como indicaram que o consumo de certos alimentos se associou à ausência da doença.

Objective: To evaluate the association between dietary habits and presence of early childhood caries (ECC) in a group of children treated at a public University in the state of Minas Gerais, Brazil. Method: Sixty-nine children (30 boys and 39 girls) aged 13 to 60 months were enrolled in the styudy. The dmf-t index was determined by a single trained examiner (kappa coefficient = 1), according to criteria preconized by the World Health Organization. A three-day diet journal was filled out by parents and/or caregivers to collect data from the children's diet. The statistical analysis included the chi-square and Fisher's exact tests, followed by multiple logistic regression analysis. A significance level of 5% was adopted (alpha = 0.05). Results: ECC was diagnosed in 87% of the sample (60/69 children). A mean dmf-t index of 9.20 was recorded. The mean frequency of ingestion of carbon hydrates was high (more than five times a day) for 82.6% of the children (57/69). There was no significant association between frequency of sugar ingestion and presence of caries (p=0.183). The multiple logistic regression model revealed an inverse association between consumption of "other foods" and absence of caries (p=0.02). These results suggest the need of dietary counseling with respect to the consumption of certain foods associated with ECC in the studied sample. Conclusion: The high mean frequency of ingestion of a cariogenic diet was not associated with the presence of ECC, and the consumption of certain foods was related to the absence of the disease.

Avaliação microestrutural do esmalte bovino exposto a bebidas lácteas fermentadas e propriedades físico químicas / Microstructural evaluation of bovine enamel exposed to fermented dairy beverages and analysis of their physical-chemical properties

Objetivo: Analisar o padrão de desmineralização do esmalte bovino submetido à ação de bebidas lácteas fermentadas frente a variações de tempo e avaliar as propriedades físico-químicas destes componentes da dieta líquida. Método: Analisaram-se seis marcas de bebidas lácteas, utilizando-se refrigerante a base de cola e água destilada como controle positivo (CP) e negativo (CN), respectivamente. Avaliou-se o pH por meio de pHmêtro digital enquanto a concentração de sólidos solúveis totais (°Brix) foi mensurada por um refratômetro específico de campo. Por meio de um viscosímetro capilar aferiu-se a viscosidade cinemática. Analisou-se a ação das bebidas sobre o esmalte em Microscopia Eletrônica de Varredura (MEV) após exposição às soluções nos intervalos de tempo: 5, 15 e 30 minutos, sendo as alterações microestruturais classificadas em escores, de acordo com o grau de desmineralização promovido na estrutura dentária. Resultados: Os valores de pH variaram de 2,59 (CP) a 6,24 (CN), estando as demais bebidas lácteas fermentadas abaixo do pH 3,92. Os valores de °Brix oscilaram de 0° a 19° Brix e a viscosidade variou de 2,41 mm²/s a 7,26 mm²/s. Alterações sugestivas de erosão foram evidentes nos espécimes submetidos ao CP e ao produto de menor pH. A maioria das bebidas registrou dissoluções iniciais a partir de 15 minutos, correspondendo a alterações Grau 1 (leve alteração microestrutural). Conclusão: As bebidas lácteas revelaram-se potencialmente erosivas e cariogênicas, apresentando valores de pH críticos para dissolução do esmalte, bem como presença de sólidos solúveis totais e expressiva variação de viscosidade. A análise morfológica pela MEV da superfície dentária revelou alterações microestruturais de leve a acentuada, de acordo com o tempo de exposição às bebidas.

Objective: The aim of this study was to analyze the pattern of demineralization of bovine enamel subjected to the action of fermented dairy beverages after different times and to evaluate their physical-chemical properties. Method: Six brands of dairy beverages were analyzed, having cola-type soft drink and distilled water as positive (PC) and negative (NC) controls, respectively. The pH was evaluated using a digital pH-meter and the soluble solids content (°Brix) was measured using a specific refractometer. A capillary viscometer measured the kinematic viscosity. The action of the beverages on enamel was analyzed by scanning electron microscopy (SEM) after exposure to solutions at the following time intervals: 5, 15 and 30 minutes. The microstructural alterations were scored according to the degree of demineralization observed on tooth structure. Results: The pH values ranged from 2.59 (PC) to 6.24 (NC), while the pH of the fermented dairy beverages was below 3.92. The soluble solids content values ranged from 0° to 19° Brix and viscosity ranged from 2.41 to 7.26 mm²/s. Changes suggestive of erosion were evident in the specimens submitted to the PC and to the beverage with the lowest pH. Most beverages promoted initial enamel dissolution after 15 minutes, corresponding to grade 1 alterations (mild microstructural alteration). Conclusion: The fermented dairy beverages were found to be potentially erosive and cariogenic, presenting pH values compatible with the critical value for enamel dissolution as well as total soluble solids and significant viscosity variation. Morphological analysis of tooth surface by SEM revealed microstructural changes from mild to severe, according to the exposure time to the beverages.

Cariogenicidade do leite materno: mito ou evidência científica / Human milk cariogenicity: myth or scientific evidence

Introdução:A amamentação materna tem sido destacada como medida de promoção de saúde, fazendo parte da Política Nacional de Saúde, envolvendo o profissional da Odontologia, porém o leite materno tem sido sugerido como um fator de risco para o desenvolvimento da cárie precoce da infância. Objetivo: Buscar evidências científicas na literatura que comprovem ou refutem a afirmação de que o aleitamento materno está associado com a Cárie Precoce da Infância. Método: A partir da consulta das bases de dados Medline e SciELO, foram incluídos desde estudos laboratoriais a levantamentos epidemiológicos que relacionam o aleitamento materno com a presença da doença cárie. Os descritores utilizados para esta busca foram: "breast feeding" e "dental caries". Constatou-se que não existem evidências científicas adequadas que demonstrem relação clara sobre a cariogenicidade do leite materno, em virtude da doença cárie ser multifatorial, o que a torna susceptível a presença de fatores confundidores, como por exemplo, a introdução precoce da sacarose a dieta do lactente e o início tardio de hábitos de higiene bucal. O aleitamento materno exclusivo deve ser estimulado pelo cirurgião dentista, uma vez que, além dos inegáveis benefícios para a saúde física e psicológica da criança, favorece um crescimento facial harmônico e previne o desenvolvimento de deglutição atípica e de maloclusões, em conjunto com a inserção precoce de hábitos de higiene e dieta não cariogênica. Conclusão: Não existem evidências científicas que suportem a afirmação de que o aleitamento materno está associado com a Cárie Precoce da Infância.

Introduction: Breast-feeding has stood out as health care measure and is part of the Government's National Health Policy, involving dental professionals. However, it has been suggested that breast milk could be a risk factor for the development of early childhood caries. Objective: The purpose of this report was to search for scientific evidence that would support or refute the statement that breastfeeding is associated with the development of early childhood caries. Method: Medline and SciELO databases were consulted to retrieve studies, ranging from laboratory investigations to epidemiological surveys, which relate breastfeeding to dental caries. The key words 'breast-feeding' and 'dental caries' were used on the reference search. There was no scientific evidence that could demonstrate a clear relationship between breast milk and cariogenicity. This is attributed to fact that dental caries is a multifactorial disease that is susceptible to multiple confusing factors, among which the early introduction of sucrose to the infant's diet and late introduction of oral hygiene habits. The dentist should encourage exclusive breast-feeding because, in addition to the undeniable benefits to the child's physical and psychological health, it contributes to a harmonic facial growth and prevents the development of atypical deglutition and malocclusions, in combination with early introduction of oral hygiene habits and noncariogenic diet. Conclusion: There is no scientific evidence to demonstrate an association between breast-feeding and early childhood caries.

The effect of consumption of carbonated beverages on the oral health of children: a study in real life situation / Efeito do consumo de refrigerantes na saúde bucal de crianças: estudo em uma situação real

Objetivo: Avaliar a saúde bucal de crianças que consomem refrigerantes e também conhecer as razões para o consumo excessivo dessas bebidas. Método: Um estudo de natureza transversal CAP (conhecimento, atitude e prática) com uma amostra de 200 crianças na faixa etária de 12-13 anos de idade foi realizado em Maharishi Markandeshwar International School, Mullana, Ambala, na Índia. Um questionário foi elaborado e distribuído para verificar as razões para o alto consumo de refrigerantes e os seus efeitos sobre a saúde bucal. Os dados coletados foram analisados estatisticamente. Resultados: Em média, as crianças na faixa etária de 12-13 anos consumiam entre 7 e 8 refrigerantes (latas - 250ml) por semana, ou seja, de 1500mL a 2000mL. Verificou-se que a gravidade da cárie dentária foi elevada quando os resultados foram comparados a crianças que não consumiram bebidas carbonatadas na mesma escola. Os resultados também confirmam que as crianças não estão conscientes dos efeitos nocivos dos refrigerantes sobre a saúde bucal. Conclusão: As crianças que consomem refrigerantes regularmente são mais propensas a cárie dentária.

Objective: To assess the oral health of children consuming carbonated beverages and also to ascertain the reasons for excess consumption of these beverages. Methods: A cross-sectional KAP (knowledge, attitude and practice) survey of 200 children in the age group of 12 - 13 years was carried out in Maharishi Markandeshwar International School, Mullana, Ambala, India. A questionnaire was designed and distributed to ascertain the reasons for high consumption of carbonated beverages and its effects if any on oral health. The data collected was analysed statistically. Results: The results of the study revealed that on an average, children in the age group of 12-13 years consumed 7-8 drinks (cans - 250ml) per week, i.e. 1500 - 2000 ml consumption. The severity of tooth decay was seen to be high, when the results were compared to those children who did not consume carbonated drinks in the same school. The findings also confirm that children are not aware of the detrimental effects of carbonated beverages on oral health. Conclusion: The children who consume carbonated drinks regularly are more prone to tooth decay.

Cárie Dentária em Pré-Escolares: um Estudo em Áreas Cobertas pela Estratégia Saúde da Família do Recife, PE, Brasil / Dental Caries in Preschoolers: A Study in Areas Assisted by the Family Health Strategy of the city of Recife, PE, Brazil

Objeti vo: Analisar o padrão de distribuição da cárie dentáriaem pré-escolares residentes em áreas assisti das pela EstratégiaSaúde da Família do Recife, Pernambuco, em dois distritossanitários e, estabelecer comparações.Método: Um inquérito epidemiológico de cárie dentária foiconduzido no ano de 2006 em 2020 crianças de 18-36 meses e5 anos de idade cadastradas nas unidades de saúde da famílianos Distritos Sanitários II e IV, Recife/PE. Uti lizou-se o índiceceo-d, segundo padronizações da Organização Mundial deSaúde e do Ministério da Saúde. A amostra foi probabilísti capor conglomerados (famílias) em um estágio. Calculou-sedistribuição de freqüência, testes de comparação de médias(t-Student e ANOVA), de proporções (Qui-quadrado) comnível de signifi cância de 5,0% e fatores de ponderação pararepresentati vidade da amostra. As análises foram produzidaspor distrito e microrregiões.Resultados: Nos dois Distritos as prevalências e médias ceo-dforam elevadas, sendo de 29,7% no total de crianças de 18-36meses e 63,8% aos 5 anos. Entre os Distritos o ceo-d variou de0,99 a 1,15 (18-36 meses) e 3,01 a 3,65 (5 anos). Contudo, asrazões de prevalência não apresentaram diferenças signifi cantesentre distritos e idades. Entre microrregiões, as diferençasna prevalência e severidade ocorreram apenas na idade de 5anos.Conclusão: Os indicadores de cárie uti lizados informama existência de nichos infanti s com piores situações desaúde bucal em áreas pobres de aparente homogeneidadesocioeconômica devendo-se assim reorientar as intervençõescoleti vas e individuais em áreas/microáreas, onde esses índicessão mais elevados...

Objecti ve: To analyze comparati vely the distributi on patt ernof dental caries in preschoolers living in areas assisted by theFamily Health Strategy of the city of Recife, PE, in two sanitarydistricts.Method: An epidemiological survey of dental caries wasconducted in 2006 in 2,020 children aged 18-36 months and5 years enrolled in the Family Health Centers of the SanitaryDistricts II and IV of the city of Recife, PE. The dmft index wasused as recommended by the World Health Organizati onand the Brazilian Ministry of Health. A probabilisti c sampleby conglomerates (families) was used in one stage. It wascalculated frequency distributi on, tests for comparison of themeans (Student’s t-test and ANOVA) and proporti ons (chisquare)with 5.0% signifi cance level, and ponderati on factorsfor sample representati veness. The analyses were produced bydistrict and by microregions.Results: In both districts, the prevalence and dmft means werehigh, being 29.7% among children aged 18-36 months and63.8% among those aged 5 years. Comparing the districts, thedmft ranged from 0.99 to 1.15 (18-36 months) and from 3.01to 3.65 (5 years). However, the prevalence rati os did not showsignifi cant diff erences between districts or ages. Comparing themicroregions, the diff erences in caries prevalence and severityoccurred only at the age of 5.Conclusion: The caries indicators used in this study revealedthe existence of niches of children with worse oral healthconditi ons in poor areas with apparent socioeconomichomogeneity, suggesti ng a reorientati on of collecti ve andindividual interventi ons in areas/microareas in which higherindices are observed...

Praticas alimentares cariogenicas e fatores associados em criancas do sul do Brasil / Cariogenic feeding habits and associated factors in children from the southern Brazil

Objetivo: Identificar praticas alimentares cariogenicas e estimar os fatores associados ao consumo de guloseimas entre as refeicoes em pre-escolares de Ijui-RS. Metodo: A amostra consisti u em 481 criancas de 0 a 6 anos pertencentes a 12 pre-escolas deste municipio, sorteadas aleatoriamente. O instrumento de pesquisa foi questionario estruturado respondido pelos pais, que avaliou variaveis demograficas, socioeconomicas e as seguintes praticas alimentares: idade de introducao do acucar e o comportamento de consumir guloseimas (doces ou salgadinhos) entre as refeicoes. Foi utilizada regressao de Poisson com variancia robusta para identificar e quantificar os fatores associados ao consumo de guloseimas entre as refeicoes. Resultados: Aproximadamente 90% das criancas da amostra tiveram o acucar introduzido na dieta antes de completar o primeiro ano de vida. Alem disso, 3/4 dos pre-escolares consomem guloseimas entre as refeicoes, nao havendo diferenca entre os sexos, categorias de renda e estruturacao familiar. O modelo multivariavel mostrou que a probabilidade de consumir guloseimas entre as refeicoes foi 16% maior em criancas de 5 a 6 anos em relacao as criancas de ate 2 anos (RP=1,16; IC 95%= 1,00?1,34) e 14% maior quando a mae tinha 4 anos ou menos de escolaridade (RP=1,14; IC 95%= 1,01-1,29) em relacao as maes com mais de 8 anos de estudo. Fazer chantagem para receber guloseimas aumentou em 72% a probabilidade deste comportamento (RP= 1,72; IC 95%= 1,46-2,03). Conclusao: A introducao de acucar e precoce nesta populacao e um percentual elevado dos pre-escolares consome guloseimas entre as refeicoes, estando este desfecho associado a maior idade da crianca, menor escolaridade materna e comportamento da crianca. Programas preventivos devem incluir orientacao para praticas alimentares desde o primeiro ano de vida, especialmente para maes com menor escolaridade.

Objective: To identify cariogenic feeding habits and estimate the factors associated with the consumption of snacks between meals in preschoolers from the city of Ijui, RS, Brazil. Method: The sample was composed of 481 children aged 0 to 6 years attending 12 preschools of this city, chosen at random. The research instrument was a structured questionnaire filled out by the parents, which assessed demographic and socioeconomic data and information on feeding habits (age of introduction of sugar in the diet and consumption of sweet and salty snacks between meals). Poisson's regression with robust variance was used to identify and quantify the factors associated with the consumption of snacks between meals. Results: Approximately 90% of the children had sugar introduced in their diet before 1 year of age. In addition, ó of the preschoolers consume sweets between meals, without statistically significant difference between genders, income levels and family structure. The multi variable model showed that the probability of consuming snacks between meals was 16% higher in 5-6-year-old children compared to those up to the age of 2 (PR=1.16; 95% CI= 1.00-1.34), and 14% higher when the mother's educational level was up to 4 years (PR=1.14; 95% CI= 1.01-1.29) compared to those with more than 8 years of school education. Blackmailing to receive snacks increased in 72% the probability of this behavior (PR= 1.72; 95% CI= 1.46-2.03). Conclusion: The introduction of sugar was premature in the studied population, and a high percentage of the preschoolers were found to eat snacks between meals. This outcome is associated with older children, low maternal educational level, and child's behavior. Preventive programs must include diet counseling since the first year of life, especially for mothers with low educational level.

Características físico-químicas da dieta líquida cafeinada / Physicochemical characteristics of the caffeinated liquid diet

Objetivo: Estudar as características físico-químicas de bebidas líquidas cafeinadas comercializados na cidade de João Pessoa, PB.Método: Produtos utilizados: Nescafé®, Santa Clara®, São Brás®, Pilão® (cafés); Dr. Oetker®, Madrugada®, Leão® (chás pretos); Coca Cola® , Coca Cola light lemon®, Coca Cola zero®, Coca Cola light® (refrigerantes de cola). O preparo das soluções foi convencionado a uma proporção de 0,8g do pó, medido em balança digital, no caso do café, e um sachê para o chá, utilizando 50ml de água destilada fervida para ambos. Os refrigerantes foram analisados naturalmente, após sua abertura. Utilizando-se pHmetro digital foram feitas as aferições dos valores de pH, logo após o preparo das amostras, sendo obtida a média das três medições para cada produto analisado. Procedeu-se a medição da ATT utilizando 5ml de cada produto, adicionando-se 100ml de água destilada e deionizada acrescida de 5 gotas de indicador fenoftale??na a 1%. Adicionou-se NaOH a 0,01 N à solução até atingir o ponto de viragem. A medição do Brix foi feita com auxílio de um refratômetro com faixa de leitura de ºBrix de 0~32% e precisão de 0,2, utilizando-se aproximadamente 2 gotas de cada produto. Os dados foram analisados descritivamente.Resultados: Os valores de pH, acidez e sólidos solúveis, para os cafés: variaram, respectivamente de 4,69 a 4,78, 0,07% a 0,09%, 1,0 a 2,0 ºBrix; para os chás: foram respectivamente de 4,81 a 4,93, 0,06% a 0,07%, 0,0 ºBrix; e para os refrigerantes obteve-se os respectivos resultados: de 2,33 a 2,83, 0,23% a 0,49%, 0,0 a 0,7 ºBrix.Conclusão: O pH de algumas bebidas cafeinadas é baixo, confirmado pelo valor encontrado para acidez, além disso, o açúcar presente nestas amostras contribui para agravar o potencial cariogênico e erosivo das mesmas.

Adequação do meio bucal através de tratamento restaurador atraumático modificado em pacientes pediátricos infectados pelo Vírus da Imunodeficiência Humana Adquirida (SIDA) / Adequacy of the oral cavity by means of modified atraumatic restorative treatment in pediatric patients infected with the Acquired Human Immunodeficiency Virus (AIDS)

Objetivo: Descrever os procedimentos realizados em crianças infectadas pelo vírus da imunodeficiência humana (HIV), pacientes do ambulatório de imunologia do Hospital Universitário Gafrée e Guinle (UNI-RIO) e constatar a efetividade da adequação do meio bucal comparando os níveis de Streptococcus mutans (S mutans) e Lactobacillus. Método: Realização de procedimentos de adequação do meio bucal; instrução de higiene bucal, melhorando a técnica já utilizada, orientação de dieta (para as crianças e seus responsáveis); fluorterapia nos dentes onde havia presença de manha branca ativa (aplicação de verniz fluoretado) e tratamento restaurador atraumático modificado utilizando cimento ionômero de vidro (FUJI IX®). Resultados: Os pacientes que participaram da pesquisa se encontravam em diferentes níveis de imunossupressão, graves (50,0%), moderados (33,0%) e ausente (17,0%), todos apresentando fluxo salivar abaixo de 0,7ml/min. Quanto à contagem de S. mutans e Lactobacillus, 33,0% mantiveram os valores encontrados na primeira avaliação de colônias/ml, devido à presença de restos radiculares que preservam os sítios de colonização destes microorganismos. Constatou-se que 67,0% das crianças apresentaram, na 2ª avaliação, uma diminuição do número de colônias/ml. Conclusão: Os procedimentos realizados se mostraram eficientes na diminuição dos valores de colônias/ml de Streptococcus mutans e Lactobacillus na cavidade bucal das crianças, melhorando a saúde bucal dos participantes da pesquisa.

Purpose: To describe the procedures performed in children infected with the human immunodeficiency virus (HIV) under treatment at the Immunology Outpatient Service of the UniversityHospital Gafr‚e and Guinle (UNI-RIO) and to verify the effectiveness of the adequacy of the oral cavity comparing the levels of Streptococcus mutans (S mutans) and Lactobacillus.Method: The protocol consisted of procedures for adequacy ofthe oral cavity; oral hygiene instruction, improving the toothbrushing technique already used; diet counseling (for children and parents/guardians); fluoride therapy in the teeth with active white spotlesions (application of fluoridated varnish); and modified atraumatic restorative treatment using glass ionomer cement (FUJI IX©).Results: The patients enrolled in this study were in different levels of immunosuppression, namely severe (50%), moderate (33%) orabsent (17%), and all of them presented salivary flow <0.7 mL/min.Regarding S. mutans and Lactobacillus counting, 33% maintainedthe values recorded in the first evaluation of the number of colonies/mL, due to the presence of root remnants that preserve thecolonization sites of these microorganisms. It was observed that 67% of the children presented, at the second evaluation, a decrease in the number of colonies/mL.Conclusions: The procedures performed in this study were effective in decreasing the numbers of colonies/mL of S. mutansand Lactobacillus in the oral cavity of the children, improving theiroral health.