Salud oral: influencia de los estilos de vida en adolescentes / Adolescent lifestyle and its influence on oral health

INTRODUCCIÓN: la alta prevalencia de patología bucodental en adolescentes, junto con la relación directa o indirecta entre patología y hábitos, hacen necesaria la prevención y promoción oral a nivel escolar, sanitario y familiar. Nuestro objetivo principal fue mediante un cuestionario sobre hábitos de estilo de vida en adolescentes, conocer la prevalencia de estos y su relación con la salud bucodental. MATERIAL Y MÉTODOS: estudio observacional de corte transversal en 39 escolares, preadolescentes y adolescentes de 12 a 17 años. Se realizó un cuestionario de 42 preguntas que fue entregado a los participantes. Los resultados obtenidos se analizaron mediante tablas de contingencia y con un valor de significación p <0,05. RESULTADOS: la prevalencia de escolares con correcta frecuencia de cepillado es del 54% y solo el 48,7% visita al odontólogo una vez al año. Existe relación significativa entre la nacionalidad y las visitas al dentista (p = 0,02) o entre la frecuencia de cepillado con el desayuno (p = 0,005), consumo de bollería industrial o bocadillos (p = 0,02), o refrescos (p = 0,011), utilización de ordenador, televisión y videoconsola (p = 0,049); y el sedentarismo (p = 0,00). CONCLUSIÓN: se obtuvieron resultados estadísticamente significativos al relacionar hábitos de estilo de vida y salud oral. En la adolescencia es fundamental la creación de estrategias de prevención y promoción en salud dental, para instaurar rutinas correctas que no afecten a la salud general del adolescente

INTRODUCTION: the high prevalence of oral disease in adolescents, together with the direct or indirect association between disease and lifestyle habits, call for the implementation of oral health prevention and promotion strategies at the school, household and public health levels. Our main objective was to design a questionnaire on lifestyle habits in adolescents to determine their prevalence and assess their association with oral health. MATERIALS AND METHODS: we conducted a cross-sectional observational study in 39 preadolescent and adolescent students aged 12 to 17 years. We developed a 42-item questionnaire and administered it to participating students. We analysed the obtained responses using contingency tables, defining statistical significance as a p-value of <0.05. RESULTS: we found that the frequency of brushing was correct in 54% of participating students, while only 48.7% visit the dentist every year. We found a significant association between nationality and visits to the dentist (p = 0.02) and between the frequency of brushing with: eating breakfast (p = 0.005), consumption of industrial baked goods or snacks (p = 0.02) and consumption of sugary drinks (p = 0.011), the use of computer, television and gaming consoles (p = 0.049), and a sedentary lifestyle (p = 0.00). CONCLUSION: we found statistically significant associations between lifestyle habits and oral health. The development and implementation of oral health prevention and promotion strategies targeting the adolescent population is essential in order to establish adequate habits that will not have a detrimental effect on the general health of the adolescent

Salud bucodental en los niños: ¿debemos mejorar su educación? / Oral health in children. Should we improve their education?

La caries dental es una enfermedad infecciosa caracterizada por la destrucción de los tejidos duros dentarios. Es la enfermedad infantil crónica más común, pero es prevenible y curable. La salud bucodental se define como la ausencia de dolor orofacial, llagas bucales, infecciones, caries y enfermedades periodontales. Disponer de una buena salud bucodental es fundamental para gozar de una buena salud y buena calidad de vida. Se realiza un estudio descriptivo de la higiene y salud bucodental de una población pediátrica

Dental caries is an infectious disease characterized by the destruction of hard dental tissues. It is the most common chronic disease in children, yet it is preventable and curable. Oral health is defined as the absence of orofacial pain, mouth sores, infections, caries and periodontal disease. A good oral health is essential to enjoy a good overall health and quality of life. We performed a descriptive study of the oral health and hygiene in a paediatric population

Gingivitis, Psychological Factors and Quality of Life in Children.

PURPOSE: To evaluate the associations between gingivitis, emotional status and quality of life in children. MATERIALS AND METHODS: Sixty-four Brazilian students (11 to 12 years old) were examined for clinical and self-reported gingivitis. The participants were divided into two groups: those with gingivitis (n = 21) and controls (n = 43). Quality of life, anxiety and depression were measured using self-administered questionnaires. Saliva was collected 30 min after waking and at bedtime to measure the diurnal decline in salivary cortisol. The results were analysed using bivariate and multivariate analyses. RESULTS: There were significantly more female participants in the control group. Approximately 90% of the children with gingivitis had good oral hygiene and 10.5% had satisfactory oral hygiene. There was a significant positive correlation between anxiety and depression in both clinical groups. Anxiety was negatively correlated with quality of life in the control group. Depression was negatively correlated with quality of life and cortisol concentrations in the group with gingivitis, and with quality of life in the control group. Children with gingivitis were more likely to be older and males. CONCLUSIONS: Older children are more likely to experience gingival bleeding. The presence of gingivitis in children may be associated with worse psychological well-being, possibly compromising the quality of life.

Orthodontics and enamel demineralization: clinical study of risk factors.

UNLABELLED: The appearance of white spots on the vestibular surface of teeth fitted with brackets has been described as one of the potential iatrogenic effects of orthodontic treatment. These enamel demineralizations, more commonly known as "white spot lesions" (WSL), lead in some rare cases to the creation of true cavities, causing both esthetic and functional problems. The aim of our retrospective clinical study was to evaluate the incidence of the appearance of these WSL in a Moroccan orthodontic population and to determine possible associations with a number of risk factors. PATIENTS AND METHODS: The study was based on intraoral photographs of a pool of 69 patients who underwent orthodontic treatment with or without extractions in the DFO unit of the Rabat CCDT (Center for dental consultation and treatment). Patients with prostheses or WSL before the beginning of the study were excluded. Digital start- and end-of-treatment photos for each patient were compared by a single operator looking for the appearance of WSL on the vestibular surfaces of the incisors, canines, premolars and first molars. WSL were classed according to three degrees of severity: slight, severe and cavitation. Data were processed using SPSS 13.0 software. RESULTS: The results of the study showed that the prevalence of WSL in the sample was 66.7%, with a highly significant predominance of localization in the premolar/molar segment and in patients with poor oral hygiene. CONCLUSION: Poor oral and dental hygiene was identified as the most important risk factor for the development of white spots during multibracket orthodontic treatment.

The effect of oral care on intracranial pressure in critically ill adults.

A major goal in the care of patients with neurological problems is to prevent or minimize episodes of increased intracranial pressure (ICP). Elevations in ICP in response to nursing interventions have been acknowledged since the 1960s when ICP monitoring was first introduced in the clinical setting. Until recently, few studies have specifically examined the effect of oral care on ICP, and oral care and other hygiene measures were combined or not specified, prohibiting a direct interpretation of the influence of oral care alone on ICP. The purpose of this study was to describe the relationship between routine oral care interventions and the changes in ICP specifically focusing on the effect of intensity and duration of this intervention. Twenty-three patients with a clinical condition requiring ICP monitoring were enrolled over a 12-month period. Oral care provided by neuroscience intensive care nurses was observed and videotaped. Characteristics of the intervention were documented including products used, patient positioning, and duration of the intervention. A 1-5 subjective scale was used to score intensity of oral care. Wrist actigraphy data were collected from the nurses to provide an objective measure of intensity. Patient physiologic data were collected at 12-second epochs 5 minutes before, during, and 5 minutes after oral care. The mixed-effect repeated measures analysis of variance model indicated that there was a statistically significant increase in ICP in response to oral care (p = .0031). There was, however, no clinically significant effect on ICP. This study provides evidence that oral care is safe to perform in patients in the absence of preexisting elevated ICP.

Factors relating to usage patterns of amalgam and resin composite for posterior restorations--a prospective analysis.

OBJECTIVES: This study prospectively analyzed the use of amalgam and resin composite posterior restorations placed by general dentists in relation to dentist, patient and cavity factors. METHODS: One thousand posterior restorations placed by a representative sample of general dentists working in the Ministry of Health (MOH), Kuwait, during routine clinical practice were included. Information about the restorations was recorded using a survey questionnaire. Descriptive statistics and multivariate logistic regression analysis were used to determine the factors associated with the use of amalgam versus tooth coloured restoratives. RESULTS: Dentists chose amalgam for 30.8% of the 1000 restorations. Dentists with longer work experience (>15 years) were more likely to choose amalgam (OR=2.61, 95% CI=1.06, 6.40). Younger dentists (≤30 years) were less likely to choose amalgam (OR=0. 45, 95% CI=0.26, 0.77). Amalgam was more likely to be chosen for patients with poor oral hygiene (OR=1.58, 95% CI=1.08, 2.32) and a higher number (≥4) of restorations (OR=1.44, 95% CI=1.07, 1.94) with large cavity sizes (OR=6.33, 95% CI=3.88, 10.32). Tooth-coloured restorations were more likely to be chosen for cavities of smaller sizes. CONCLUSIONS: The use of resin composite materials as the dominant choice among dentists in Kuwait reflects the trend worldwide. Nevertheless, clinicians still find a use for amalgam in posterior load-bearing teeth and in the high-caries risk population. CLINICAL SIGNIFICANCE: The findings give insight into factors influencing material usage under different clinical conditions and provides information about the perceived deficiencies or shortcomings of resin composite materials in a general dental practice setting. This information can be useful for identifying perceived barriers to the usage of newer restorative materials and finding ways to overcome them.

Effect of academic stress on plaque and gingival health among dental students of Moradabad, India.

OBJECTIVE: Stress has an adverse effect on oral health and is a risk factor for plaque-associated diseases. The present study aims to assess the effect of academic stress on plaque and gingival health among dental students of Moradabad, India. METHODS: Fifty eligible dental students (age 18 - 22 years) undergoing university examinations participated in the study. Students were examined for plaque index (PII) and gingival index (GI) scores during and after their examinations. Stress levels (using the DASS 21 questionnaire) and oral hygiene behavior were also assessed during and after university examinations and the data were subjected to statistical analysis. RESULTS: The average PII and GI were 1.213 and 0.944, respectively, during examinations and 0.845 and 0.467, respectively, after examinations. The average stress scores were 15.66 and 9.94 during and after examinations, respectively. Eighty-eight percent of the students brushed once and 12% of the students brushed twice during the university examinations, whereas 76% brushed once and 24% of the students brushed twice after their examinations. Thirty-four percent of the subjects rated their thoroughness of brushing as good during university examinations whereas the percentage increased to 80% after the examinations. All the differences were found to be statistically significant. CONCLUSION: Students appearing for the university examinations showed increased stress levels. Moreover, under conditions of stress, the students generally neglected their oral health care and adverse effects on their plaque and gingival scores were observed. Thus, it might be concluded that academic stress has an adverse effect on plaque levels and gingival status in students.

Efecto comparativo de nuevo colutorio-gel de clorhexidina en colutorios comerciales en el crecimiento de placa en 24 horas / Comparative effect again mouthrinses-gel of chlorhexidine with commercial mouthrinses in the growth of plaque in 24 hours

Introducción. Las soluciones de clorhexidina (CHX), estándares en prevención de formación de placa presentan algunos efectos indeseados como el dolor por alcohol. Objetivos. El propósito de este estudio fue determinar la eficacia clínica de colutorio-gel acuoso de clorhexidina al 0,1% y compararla con colutorios al 0,12% y 0,1% con alcohol, evaluando el crecimiento de placa bacteriana. Materiales y métodos. En un estudio cruzado, doble ciego y randomizado, 25 alumnos de buena salud oral, participaron de cuatro estudios con abstención de limpieza oral por 24 horas, separados entre sí por 4 semanas. Los alumnos se enjuagaron por una vez con uno de los siguientes colutorios: CHX 0,12% + alcohol (Oralgene®), CHX 0,12% + alcohol (Perio.Aid®), CHX 0,1%+ alcohol (Dentilim®) y CHX 0,1% + HMC 2,5% (Colutoriogel®, acuoso nueva fórmula). Después de un día se midió formación de placa, se completó y registro el cuestionario de parámetros clínicos. Resultados. Las formulaciones de CHX 0,12% + alcohol y CHX 0,1% + HMC 2,5% se mostraron eficientes en retardar el crecimiento de placa dental de novo, esto obtenido de las mediciones clínicas, y siempre superior (p<0,05) a la formulación del colutorio de CHX 0,1%+ alcohol (Dentilim®). Conclusiones. Los resultados de este estudio demuestran el potencial clínico de este nuevo colutorio-gel sin alcohol de CHX 0,1% + HMC 2,5% (Colutoriogel®) como un efectivo agente antiplaca y con reducidas efectos secundarios registrados (AU)

The chlorhexidine solutions (CHX) standars in prevention of plaque formation present some undesired effects like the pain by alcohol. The aim of this study was to determine the clinical effectiveness of Colutoriogel® (new formulation) of chlorhexidine to the 0,1% and to compare with mouthrinses to the 0,12% and 0,1% with alcohol being evaluated growth of bacterial plaque. In double-blind, randomised, cross-over study, 25 young dental students with a healthy periodontium, abolished all means of mechanical plaque control during 4 experimental periods of 1 day (separated from each other by a washout period of 4 weeks). During each experimental period, they rinsed 1 daily with one of the following mouthrinses in a randomised order: CHX 0,12% + alcohol (Oralgene ®), CHX 0,12% + alcohol (Perio.Aid®), CHX 0,1%+ alcohol (Dentilim®) and CHX 0,1% + HMC 2,5% (Colutoriogel®). After 1 days of undisturbed plaque formation, clinical parameters were recorded and questionnaires completed. The CHX 0,12% + alcohol and the and CHX 0,1% + HMC 2,5% formulations were efficient in retarding de novo plaque formation (proven by clinical observations data), and always superior (p<0,05) to the CHX 0,1%+ alcohol (Dentilim®) solution. Conclusions. The results of this study demonstrated the potential of a new mouthrinses-gel Colutoriogel®) nonalcoholic formulation as an effective anti-plaque agent with reduced unpleasant subjective side-effects (AU)

Lesiones bucales en un grupo de pacientes con trasplante renal / Oral lesions in a group of kidney transplant patients

Objetivo: Determinar la prevalencia de lesiones de la mucosabucal (LB) en un grupo de pacientes con trasplante renal (TR),y analizar las posibles asociaciones de las lesiones entre sí, con el uso de fármacos y con variables clínicas y de laboratorio relevantes. Metodología. Estudio transversal, en el que se examinó a pacientes consecutivos con TR de la consulta de nefrología de un hospital General de Zona del Instituto Mexicano del Seguro Social. Se determinó la frecuencia y el tipo de lesiones bucales. Se analizaron las posibles asociaciones de las LB entre sí y conla cuenta de leucocitos totales, la función renal, el índice de higiene oral simplificado (IHO-S), los niveles de ciclosporina A(CsA) en sangre y el uso de nifedipina. Se utilizó un modelo de regresión logística para analizar la asociación entre hiperplasia gingival (HG) y la dosis de CsA y de nifedipina. Resultados. Se examinaron 50 (55.6%) hombres y 40 (44.4%)mujeres. El 60% de los pacientes presentaron al menos una lesión bucal. Se presentó candidosis bucal (CB) en 18.7%, lesiones clínicamente compatibles con leucoplasia vellosa (CLV) en13%. Se identificó asociación entre la presencia de CB y CLV(P<0.05). Se encontró lengua saburral (LS) en 22% de los pacientes,e HG en 49%; Grado 1 en 11 (12.2%); Grado 2 en 26(28.9%) y Grado 3 en 7 (7.8%). Los resultados de la regresión logística demostraron asociación de HG con mala higiene bucal(P<0.001), pero no con la dosis o los niveles de CsA, ni con el uso de nifedipina (P=0.075). Conclusión. El 60% de los pacientes con TR presentó al menos una lesión en la mucosa bucal. La asociación entre HG y mala higiene bucal demuestra la necesidad de supervisar la higiene bucal en el paciente trasplantado

Aim: To assess the prevalence of oral mucosa lesions (OL) in a group of kidney transplant (KT) patients, and analyze possible OL associations with one another and with drugs use and relevant clinical and laboratory variables. Methodology. Transversal study, in which consecutive KT patients from the nephrology outpatient service at a General Zonal Hospital were examined. The prevalence of several types of OL was assessed, and their possible statistical associations with one another and total leukocyte count, renal function, the simplified oral hygiene index (S-OHI), cyclosporin-A (CsA) dose and blood levels, and nifedipine use was analyzed. A logistic regression model was used to analyze the association between gingival hyperplasia (GH) and CsA dose and nifedipine use. Results. Fifty (55.6%) men and forty (44.4%) women were studied. Sixty percent of the patients had at least one OL. Oral candidiasis (OC) was found in 18.7%; 13% had lesions clinically compatible with hairy leukoplakia (CHL). An association was found between OC and CHL (P<0.05). Saburral tongue(ST) was found in 22% of the patients and gingival hyperplasia (GH) in 49%, which was distributed as follows: Grade 1 in11 (12.2%); Grade 2 in 26 (28.9%), and Grade 3 in 7 (7.8%).Logistic regression results showed an association between GH and poor oral hygiene (P<0.001), but not to either CsA dose or blood levels, or nifedipine use (P=0.075). Conclusion. Sixty percent of the KT patients had at least one OL. The association between GH and poor oral hygiene corroborate the need for oral hygiene practices supervision in the transplant patient

Oral hygiene in children with Down's syndrome.

The clinical examination comprised 62 children with Down's syndrome: 12 children had low grade mental retardation, 36 children--moderate grade mental retardation and 14 children--high grade mental retardation. The study showed that oral hygiene was unsatisfactory and was found to be dependent upon the grade of mental retardation. Most children had birth weight over 2,500 g. Besides, also birth length was found to be dependent upon the grade of mental retardation. In most families the child with Down's syndrome was the last baby born among other healthy siblings. Educational career in children with Down's syndrome was found to be dependent upon the grade of mental retardation.