Entrevista motivacional como estrategia de mejoramiento de la salud bucal de niños y cuidadores. Revisión en sombrilla / Motivational interviewing as a strategy to improve the oral health of children and caregivers. Umbrella review

Objetivo: demostrar la efectividad de la entrevista motivacional (EM) en el mejoramiento de algunos indicadores de salud bucal en niños de 0 a 12 años y sus cuidadores. Material y métodos: estudio de revisión en sombrilla (umbrella review). Se realizó búsqueda en bases de datos electrónicas (PubMed, MEDLINE, SCOPUS, EBSCO) y Google Scholar desde el año 2010 hasta el año 2020, con las siguientes palabras clave: ('motivational interviewing' OR 'motivational interview' OR 'motivational interviewing style' OR 'motivational intervention' OR 'motivational counseling' OR 'brief motivational counseling' OR 'maternal counseling' OR 'behavioral intervention') AND (“caries” OR 'dental caries' OR 'tooth decay' OR 'dental decay' OR 'carious lesions' OR 'DMFT index' OR “ICDAS”) AND ('gingival diseases' OR “gingivitis” OR “CPITN” OR 'gingival bleeding' OR 'dental calculus') AND (“children” OR “families” OR “caregivers”). Se incluyeron artículos originales sobre la efectividad de la entrevista motivacional en salud bucal (EMSB) en niños de hasta 12 años y cuidadores, tipo revisión sistemática de la literatura y metanálisis, desde el año 2010 hasta el 2020. Resultados: 69 artículos (2 revisiones sistemáticas y 4 metanálisis). Los indicadores encontrados fueron: cambios en la presentación de caries de la infancia temprana, higiene bucal, condiciones gingivales y frecuencia de visitas a la consulta odontológica, con resultados alentadores y, en otros, contradictorios. Conclusiones: la evidencia sobre la efectividad de la entrevista motivacional en comparación con la educación convencional muestra cambios positivos en indicadores de salud bucal, como mejoramiento de la higiene dental y de la presentación de la caries en la primera infancia. (AU)

Objective: to demonstrate, the effectiveness of motivational interviewing in improving oral health indicators in children aged 0 to 12 years and their caregivers. Material and method: an umbrella review design. Search in electronic databases (PubMed, MEDLINE, SCOPUS, EBSCO) and Google Scholar since 2010 to 2020, with the following keywords: ('Motivational interviewing' OR 'motivational interview' OR 'motivational interviewing style' OR 'motivational intervention' OR 'motivational counseling' OR 'brief motivational counseling' OR 'maternal counseling' OR 'behavioral intervention') AND (“caries” OR 'dental caries' OR 'tooth decay' OR 'dental decay' OR 'carious lesions' OR 'DMFT index' OR “ICDAS”) AND ('gingival diseases' OR “gingivitis” OR “CPITN” OR 'gingival bleeding' OR 'dental calculus') AND (“children” OR “families” OR “caregivers”), original articles on the effectiveness of motivational interviewing in oral health (EMSB) in children between 0 and 12 years of age and caregivers, type systematic review of the literature and metaanalysis. Results: 69 articles were found (2 systematic reviews and 4 metaanalysis). The indicators found: change in early childhood caries, oral hygiene, gingival conditions and frequency of visits to the dental office with promise results and others contradictories. Conclusion: the evidence on the effectiveness of motivational interviewing compared to conventional education shows positive changes in oral health indicators such as improvement in dental hygiene and the presentation of caries in early childhood, among others. (AU)

Oral Health-Related Risk Factors Among Students in Southeast Serbia.

BACKGROUND An association between insufficient or irregular oral hygiene with the occurrence of dental caries, gingival/periodontal diseases, and consequently general diseases has been established. The null hypothesis that there is no difference in the oral health status among students in a preclinical medical program and those who went through a clinical medical program was tested. The main objective of the study was to analyze oral health risk factors (oral hygiene practices, attitudes, and behavior) as well as their impact on oral health by using convenience sampling. MATERIAL AND METHODS We investigated risk factors for oral health conditions by examining oral hygiene practices, attitudes, and behaviors among the students in the medical program of the University of Nis, collecting data using questionnaires. The study included 396 students of medicine, dentistry, pharmacy, and vocational studies. Participants filled out the anonymous questionnaire. RESULTS In both groups, parents were mostly employed, with the representation of employed fathers significantly higher in student group 1 (P<0.05), which is also the only statistically significant difference between the groups. In terms of oral hygiene practices, students were most often trained by parents (68.69%). A very high percentage of students brushed their teeth every day (97.22%), and 54.55% did this twice a day. Of the total number of students, 78.28% thought that it was necessary to use interdental brushes/floss/toothpick. The duration of teeth cleaning was 3 minutes in 39.39%, whereas 55.30% thought that it should be longer than 3 minutes. The most common brushing movements were combined movements and were used by 60.35% of all students. Of all students, 253 (63.89%) never smoked, 182 (49.96%) regularly went to the dentist, and 141 (35.61%) visited the dentist 6 months ago. The majority of students, 265 (66.92%), obtained the greatest amount of information about oral and tooth care from their dentist, which was the case in both age groups. CONCLUSIONS This study highlights oral health risk factors among students at the University of Nis. It is essential to determine their oral health knowledge, as it is of great significance both to patients and to students. Also, these students will be the major providers of health services and will be responsible for public oral health promotion. It could help in reformation of the oral health education program. The results of this research indicate that it is necessary to educate preclinical students to solve oral health issues.

mHealth para mejorar la higiene oral de niños. Revisión de literatura / mHealth to improve oral health in children. Literature review

Las intervenciones educativas en salud oral han cambiado a travès del tiempo, partiendo desde la simple entrega de información se ha avanzado hacia programas que utilizan estrategias psicológicas para motivar el cambio de conducta. La incorporación de internet en smartphones junto con el amplio uso de ellos entrega la oportunidad para realizar intervenciones innovadoras en salud con mHealth (salud móvil) para mejorar la salud y calidad de vida a nivel mundial. El uso de nuevas tecnologías está presente en el día a día de los niños, lo que entrega la oportunidad de promocionar la salud oral de una forma didáctica a los nativos digitales. El objetivo de la presente revisión de literatura es describir los resultados de la evidencia reciente del uso de aplicaciones móviles o Apps para mejorar la higiene oral en niños. La tecnología con smartphones ha crecido a un ritmo acelerado junto con el desarrollo de Apps, sin embargo, la investigación no ha llevado el ritmo. Se necesitan estudios estandarizados y específicos para cada población, especialmente en niños, antes de aprobar una App y dejarla disponible para descargar. De esta manera se podrán generar cambios efectivos a largo plazo respecto a los hábitos de salud oral de niños y adultos

Educational interventions in oral health have changed over time, starting from the simple delivery of information, progress has been made towards programs that use psychological strategies to motivate behavior change. The incorporation of the internet in smartphones along with the wide use of them provides the opportunity to carry out innovative health interventions with mHealth (mobile health) to improve health and quality of life worldwide. The use of new technologies is present in the daily lives of children, which gives the opportunity to promote oral health in a didactic way to digital natives. The aim of this literature review is to describe the results of recent evidence of the use of mobile applications or Apps to improve oral hygiene in children. Technology with smartphones has grown at an accelerated pace along with the development of Apps, however, research has not kept pace. Standardized and specific studies are needed for each population, especially in children, before approving an App and making it available for download. In this way, effective long-term changes can be generated regarding the oral health habits of children and adults

A pragmatic, multi-centered, stepped wedge, cluster randomized controlled trial pilot of the clinical and cost effectiveness of a complex Stroke Oral healthCare intervention pLan Evaluation II (SOCLE II) compared with usual oral healthcare in stroke wards.

BACKGROUND: Patients with stroke-associated pneumonia experience poorer outcomes (increased hospital stays, costs, discharge dependency, and risk of death). High-quality, organized oral healthcare may reduce the incidence of stroke-associated pneumonia and improve oral health and quality of life. AIMS: We piloted a pragmatic, stepped-wedge, cluster randomized controlled trial of clinical and cost effectiveness of enhanced versus usual oral healthcare for people in stroke rehabilitation settings. METHODS: Scottish stroke rehabilitation wards were randomly allocated to stepped time-points for conversion from usual to enhanced oral healthcare. All admissions and nursing staff were eligible for inclusion. We piloted the viability of randomization, intervention, data collection, record linkage procedures, our sample size, screening, and recruitment estimates. The stepped-wedge trial design prevented full blinding of outcome assessors and staff. Predetermined criteria for progression included the validity of enhanced oral healthcare intervention (training, oral healthcare protocol, assessment, equipment), data collection, and stroke-associated pneumonia event rate and relationship between stroke-associated pneumonia and plaque. RESULTS: We screened 1548/2613 (59%) admissions to four wards, recruiting n = 325 patients and n = 112 nurses. We observed marked between-site diversity in admissions, recruitment populations, stroke-associated pneumonia events (0% to 21%), training, and resource use. No adverse events were reported. Oral healthcare documentation was poor. We found no evidence of a difference in stroke-associated pneumonia between enhanced versus usual oral healthcare (P = 0.62, odds ratio = 0.61, confidence interval: 0.08 to 4.42). CONCLUSIONS: Our stepped-wedge cluster randomized control trial accommodated between-site diversity. The stroke-associated pneumonia event rate did not meet our predetermined progression criteria. We did not meet our predefined progression criteria including the SAP event rate and consequently were unable to establish whether there is a relationship between SAP and plaque. A wide confidence interval did not exclude the possibility that enhanced oral healthcare may result in a benefit or detrimental effect. TRIAL REGISTRATION: NCT01954212.

The Seychelles Dental Service.

The Seychelles Dental Service dates back to the 1920s, growing from rudimentary dentistry to the evidence-based dentistry of today. Until the 1970s, dental care was provided by a small number of dentists. However, since the establishment of the School Dental Service (SDS) in the 1980s, child oral health has been the responsibility of Dental Therapists (DTs). Today Seychelles has a well organised oral health care system in place with modern infrastructure and equipment and trained personnel. Locally trained DTs constitute 85% of the SDS workforce. A national oral health plan serves as a guide to ensure that programmes are developed in accordance with WHO global oral health goals, guided by periodic reviews. We present a resume of the major strengths and challenges of the Seychelles Dental Service, concluding with recommendations for staff development. Findings and recommendations of reviews and assessments of various dental health issues conducted in the country between 1977 and 1999 are summarised in the appendix.

Factores asociados a fluorosis dental en niños de 10 a 12 años del cantón Pimampiro, provincia de Imbabura, Ecuador 2016-2017 / Associated factors to dental fluorosis in children between 10 and 12 years in the canton of Pimampiro, province of Imbabura, Ecuador 2016- 2017

Resumen Introducción: Determinar la prevalencia de fluorosis dental y los factores asociados a su presencia, en escolares de 10 a 12 años del cantón Pimampiro, provincia de Imbabura, Ecuador. Metodología: Muestra de 302 alumnos de centros educativos del cantón Pimampiro, provincia de Imbabura que cumplieron con criterios de inclusión, previo consentimiento de sus padres o representantes, y que fueron evaluados en cuanto a su alimentación y hábitos de higiene oral, acompañado de un registro fotográfico de los dientes anteriores definitivos de cada participante, las fotografías obtenidas analizadas por tres evaluadores calibrados en la detección de fluorosis mediante el índice de Thylstrup y Fejerskov. Resultados: La prevalencia de la fluorosis dental fue de 81,4 %, el grado 2 fue el más frecuente en un 32,6%. Al relacionar las variables establecidas en la encuesta y la presencia de fluorosis se encontró relación de la patología con el consumo de bebidas envasadas, con la cantidad de dentífrico usado y con su ingesta accidental (p = 0,000). Conclusión: La prevalencia de fluorosis en la población de estudio se considera alta, el grado 2 según TF fue el más frecuente, y se encontró una relación con el consumo de bebidas envasadas, la cantidad de dentífrico usado y con la ingesta accidental.

Abstract Introduction: We aimed to determine the prevalence of dental fluorosis and its associated factors, in children from 10 to 12 years old from Pimampiro, province of Imbabura, Ecuador. Methodology: 302 school children from Pimampiro, province of Imbabura who complied inclusion criteria, with the prior consent of their parents and /or representatives were evaluated in terms of their diet and oral hygiene habits, accompanied by a photographic record of the final anterior teeth of each participant, the photographs obtained were analyzed by three calibrated evaluators in the detection of fluorosis using the Thylstrup and Fejerskov index. Results: The prevalence of dental fluorosis was 81.4%, grade 2 was the most frequent with 32.6%. When relating the variables established in the survey and the presence of fluorosis, a relationship was found between the pathology and the consumption of bottled beverages, with the amount of toothpaste used and with accidental intake (p = 0.000). Discussion and Conclusion: The prevalence of fluorosis in the study population is considered high; grade 2 according to TF was the most frequent, finding a relationship with the consumption of bottled beverages, the amount of toothpaste used and with accidental intake.

President's Message.

This is the last Editorial for me as President of IFDH. It has been an unforgettable time during the last 6 years on the Board and I am very grateful for all the support from colleagues around the world and from my Executive team. Corrie Jongbloed, our President Elect from the Netherlands will be assuming the role and I wish her the very best in her future endeavour.I recently read an article "The 100-year evolution of the science and practice of dental hygiene"1 which caused me to investigate and reflect on where our profession has come from and what will be the future. This article is protected by copyright. All rights reserved.

Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient? A multicentre, prospective, randomised controlled open trial.

BACKGROUND: Pathogenic enteric bacteria aspirated from the oropharynx are the main cause of ventilator-associated pneumonia (VAP). Using chlorhexidine (CHX) orally or selective decontamination has been shown to reduce VAP. In a pilot study we found that oral care with the probiotic bacterium Lactobacillus plantarum 299 (Lp299) was as effective as CHX in reducing enteric bacteria in the oropharynx. To confirm those results, in this expanded study with an identical protocol we increased the number of patients and participating centres. METHODS: One hundred and fifty critically ill patients on mechanical ventilation were randomised to oral care with either standard 0.1% CHX solution (control group) or a procedure comprising final application of an emulsion of Lp299. Samples for microbiological analyses were taken from the oropharynx and trachea at inclusion and subsequently at defined intervals. Student's t test was used for comparisons of parameters recorded daily and Fisher's exact test was used to compare the results of microbiological cultures. RESULTS: Potentially pathogenic enteric bacteria not present at inclusion were identified in oropharyngeal samples from 29 patients in the CHX group and in 31 samples in the probiotic group. Considering cultures of tracheal secretions, enteric bacteria were found in 17 and 19 samples, respectively. Risk ratios show a difference in favour of the Lp group for fungi in oropharyngeal cultures. VAP was diagnosed in seven patients in the Lp group and in 10 patients among the controls. CONCLUSIONS: In this multicentre study, we could not demonstrate any difference between Lp299 and CHX used in oral care procedures regarding their impact on colonisation with emerging potentially pathogenic enteric bacteria in the oropharynx and trachea. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01105819 . Registered on 9 April 2010. First part: Current Controlled Trials, ISRCTN00472141 . Registered on 22 November 2007 (published Critical Care 2008, 12:R136).

Re-architecting oral healthcare for the 21st century.

The convergent forces of rising costs, growing consumerism, expensive new treatments, sociodemographic shifts and increasing health disparities are exerting intense and unsustainable pressures on healthcare systems. As with the other health domains, these disruptive forces demand new approaches and delivery models for oral healthcare. Technological innovations and practices borrowed from the e-commerce and tech sectors could facilitate the move to a sustainable 21st century oral healthcare system, one that delivers high-quality, value-based care to wider groups of patients. The broad reach of mobile technologies and changing digital lifestyles provide unique opportunities for using remote monitoring and self-care tools to reinforce preventive oral hygiene behaviours. By leveraging big data analytics and insights gleaned from the use of sensor-enabled oral care devices, providers will be able to engage patients more effectively and deliver timely, personalized behavioural nudges to support optimal oral health. Dental insurers and payers will need to reinvent their business models to incentivize dental providers and patients who embrace the digital-dentistry paradigm. This could involve increasing reimbursements for mHealth-delivered preventive dental services and holding individuals accountable for behaviours that put them at higher risk for dental disease. While Dentistry 1.0 was defined largely by the treatment of established dental disease, Dentistry 2.0 portends a new era of patient-centric, technology-enabled, outcomes-driven, and prevention-focused oral healthcare delivery with significant individual, provider and societal benefits.

[Caries prevention in historical perspective. Oral hygiene]. / Serie: Cariëspreventie in historisch perspectief. Mondhygiëne.

Since the beginning of the twentieth century, the ability to prevent caries has greatly improved. This is due to both increased knowledge about the origin of dental caries, and to the availability of effective aids to oral hygiene, such as fluoride toothpaste. The effect of oral hygiene on the general population has also risen because more and more people brush their teeth.

Impact of systemic lupus erythematosus on oral health-related quality of life.

Oral symptoms in systemic lupus erythematosus (SLE) patients are often unexplored and affect the health-related quality of life. The aims of this study were: (a) to evaluate the oral health condition of SLE patients compared to control subjects without rheumatic diseases; (b) to determine the consequences of oral health condition in the quality of life of these two groups. Individuals with SLE ( n = 75) and without SLE ( n = 78) (control group), paired for gender and age, underwent complete oral examination. Sociodemographic and clinical information was obtained, and interviews were conducted using the Brazilian version of the oral health impact profile. The activity and damage of SLE disease were assessed, respectively, by the systemic lupus erythematosus disease activity index 2000 and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. When we analysed the oral health condition and hygiene habits of the participants, SLE patients exhibited an increased number of missing teeth despite their higher frequency of tooth brushing. No significant differences were verified in other habits and clinical parameters evaluated such as smoking, flossing, salivary flux, periodontitis, decayed and filled teeth. Patients with SLE presented with worse oral health-related quality of life than controls ( P = 0.011). The significant difference was on individuals' physical disability ( P = 0.002). The determinant of the negative impact on the oral health-related quality of life was prosthesis wearing ( P < 0.05). Overall, the oral health impact profile score was higher in individuals with moderate SLE damage compared to SLE individuals with no damage ( P = 0.043). Patients with SLE had a negative impact of oral condition on their quality of life. The evaluation of the oral health-related quality of life might be useful to monitor the effects of SLE on oral condition.

Síndrome de boca ardiente y factores asociados: estudio retrospectivo de casos y controles / Burning mouth syndrome and associated factors: A case-control retrospective study

Antecedentes y objetivo: El síndrome de boca ardiente (SBA) puede definirse como ardor o disestesia en la lengua y/u otras áreas de la mucosa bucal, en ausencia de lesiones que puedan justificarlo. Su incidencia es mayor en pacientes de sexo femenino, de edades comprendidas entre 50 y 60 años. Estas molestias suelen recurrir diariamente, provocando un deterioro de la calidad de vida. El objetivo del estudio fue evaluar la asociación entre diversos factores patogénicos y el SBA. Pacientes y métodos: Se estudiaron de forma retrospectiva 736 historias clínicas de pacientes diagnosticados de SBA y 132 historias clínicas de pacientes control. El período de estudio se extendió desde enero de 1990 a diciembre de 2014. El protocolo incluyó: sexo, edad, tipo de molestia bucal y localización, entre otras variables. Resultados: El análisis de la asociación entre los factores patogénicos y el diagnóstico de SBA mostró significación estadística en solo 3 de ellos: factores desencadenantes (p = 0,003), hábitos parafuncionales (p = 0,006) e higiene oral (p = 0,012). No se encontraron diferencias significativas en la incidencia del SBA por sexos (p = 0,408), ni asociación entre el SBA y los factores de abuso de sustancias (p = 0,915), patología sistémica (p = 0,685) y hábitos alimentarios (p = 0,904). Conclusiones: Los hábitos parafuncionales como el bruxismo y los movimientos anormales de la lengua y labios pueden explicar la sintomatología del SBA. Hay que tener siempre en cuenta los aspectos psicológicos y los factores sistémicos. Como alteración de carácter multifactorial que es, el tratamiento del SBA debe enfocarse de manera holística (AU)

Background and objective: Burning mouth syndrome (BMS) can be defined as burning pain or dysesthesia on the tongue and/or other sites of the oral mucosa without a causative identifiable lesion. The discomfort is usually of daily recurrence, with a higher incidence among people aged 50 to 60 years, affecting mostly the female sex and diminishing their quality of life. The aim of this study was to evaluate the association between several pathogenic factors and burning mouth syndrome. Patients and methods: 736 medical records of patients diagnosed of burning mouth syndrome and 132 medical records for the control group were studied retrospectively. The study time span was from January 1990 to December 2014. The protocol included: sex, age, type of oral discomfort and location, among other factors. Results: Analysis of the association between pathogenic factors and BMS diagnosis revealed that only 3 factors showed a statistically significant association: triggers (P = .003), parafunctional habits (P = .006), and oral hygiene (P = .012). There were neither statistically significant differences in BMS incidence between sex groups (P= .408) nor association of BMS with the pathogenic factors of substance abuse (P = .915), systemic pathology (P = .685), and dietary habits (P = .904). Conclusions: Parafunctional habits like bruxism and abnormal movements of tongue and lips can explain the BMS main symptomatology. Psychological aspects and systemic factors should be always considered. As a multifactorial disorder, the treatment of BMS should be executed in a holistic way (AU)

Higiene bucal, caries dental y necesidades de tratamiento en escolares de 5, 7 y 12 años, municipio de Istmina, Chocó, Colombia (2013) / Oral Hygiene, Dental Caries and Treatment Needs in 5, 7 and 12 Year-Old School Children in the Village of Istmina, Chocó, Colombia (2013)

Antecedentes: Es necesario identificar la situación de salud bucal en grupos específicos para establecer programas efectivos. Objetivo: Describir el estado de higiene bucal, caries dental y de necesidades de tratamiento en escolares de 5, 7 y 12 años del municipio de Istmina (Chocó, Colombia). Métodos: Se realizó un estudio descriptivo en 294 escolares (48 % niñas), seleccionados por conveniencia, de 6 instituciones educativas oficiales. Por medio de encuesta y examen clínico se recogió información sociodemográfica, de uso de elementos de higiene bucal, grado de higiene bucal, índices ceo-d y COP-D (y sus componentes) y necesidades de tratamiento. Se efectuó análisis descriptivo univariado y bivariado e inferencia! mediante chi cuadrado. Resultados: Dos terceras partes de la población analizada tenían una higiene oral deficiente (mayor porcentaje en niños y en escolares de 7 años). El promedio ceo-d M fue de 2,5 ± 3,2, lo cual equivale a una prevalencia y experiencia de caries dental del 57 % y 59 % respectivamente. El promedio COP-D M file de 0,6 ± 1,2, con una prevalencia y experiencia de caries dental del 24 % y 28 % respectivamente. El índice de caries significativa fue de 1,9 ± 1,5. El 47 % requería obturaciones (promedio de 1,9 ± 1,5). Se presentaron diferencias significativas por edad y sexo tanto para caries dental como para necesidades de tratamiento. Conclusiones: Los indicadores de caries dental estaban en consonancia con las metas internacionales. Se identificaron algunas diferencias según factores sociodemográficos que requieren estudios a mayor profundidad desde la perspectiva de determinantes sociales.

Background There is a need to identify the oral health situation in every specific group in order to implement effective programs. Objective: To describe the oral hygiene status and treatment needs in 5, 7 and 12 year-old school children in the village of Istmina (Chocó, Colombia). Methods: A descriptive study was carried out in 294 school children (48% girls) selected for convenience reasons from six public schools. Clinical examinations were conducted, and surveys applied in order to gather information on sociodemographic, use of oral hygiene elements, oral hygiene level, ceo-d index and COP-d indexes (and its components), and treatment needs. A descriptive univariate analysis and an inferential bivariate analysis were conducted based on a Chi-square statistics. Results: Two thirds of the studied population had poor oral hygiene habits (a greater percentage was found in 7 year-old boys). The average ceo-d M index was 2.5 ± 3.2, which indicates a dental caries prevalence and experience of 57% and 59%, respectively. The average COP-DM index was 06 ± 1.2, with a dental caries prevalence and experience of 24% and 28%, respectively.The significant dental caries index was 1.9 ± 1.5; 47% of them required obturations (average: 1.9 ± 1.5). Signifi cant differences were found as per age and gender, both for dental caries and treatment needs. Conclusions: Dental caries indicators were similar to the expected international goals. Some differences were identified based on some sociodemographic factors, which requires more in-depth studies under a social determinant perspective.

High-Tech Hygiene: Technologies Making a Difference in Oral Care.

Technology has greatly influenced all phases of the dental hygiene process of care. Chairside diagnostic tools and self-monitoring devices improve early detection of lesions and previously undetected oral/systemic diseases, facilitate assessment of systemic health status, and support patient engagement in self-care. Collectively, improved patient assessment reduces risks for medical emergencies and promotes patient safety. Technological advances enable better visualization of hard and soft tissues during the assessment phase, aid decision-making with planning and delivery of appropriate oral care interventions, and facilitate evaluation of patient outcomes related to dental hygiene treatment. Additional research is needed to support the benefits of patient-centered technologies designed to affect behavioral change.

Salud bucal en escolares con síndrome de Down en Cartagena (Colombia) / Oral health in school children with Down syndrome in Cartagena (Colombia)

Objetivo. Describir el estado de salud bucal en escolares con Síndrome de Down (SD) en Cartagena, Colombia. Diseño del estudio. Estudio descriptivo transversal. Emplazamiento. Instituciones Escolares con niños con SD de Cartagena de Indias. Participantes. 158 estudiantes entre 3 y 41 años Mediciones principales. Se diseñó un instrumento para evaluar variables sociodemográficas e instrumento clínico para evaluar el estado de salud bucal, considerando prevalencia de caries dental (COP), fluorosis dental (índice de Dean), maloclusiones (Clasificación Angle), placa bacteriana (índice de placa comunitario IPC), presencia de enfermedad periodontal, lesiones en tejidos blandos y anomalías dentales (forma, tamaño y número). Los datos fueron analizados a partir de proporciones y se utilizó la prueba chi cuadrado para significancia en las relaciones, asumiendo un límite de 0,05 para la significación. Resultados. La prevalencia de caries dental fue 45 % (IC95 %:37-53), fluorosis dental 45,5 % (IC95 %: 37,7-53,4) y enfermedad periodontal en 58,8 % (IC95 %: 51,1-66,6); relación molar clase III derecha 62 % (IC95 %: 40,2-74,2), clase III izquierda 60,7 % (IC95 %: 49,6-73,5) y mordida abierta 41,8 % (IC95 %: 33,9-49,5). Se encontraron relaciones con significancia estadística entre presencia de caries dental y enfermedad periodontal en escolares adolescentes y aquellos con ausencia de cepillo dental propio; entre uso de crema dental fluorada con menor presencia de caries dental, baja frecuencia de cepillado dental (≤2 veces al día) con menor presencia de fluorosis y mayor presencia de enfermedad periodontal; también entre esta última y el cepillado no supervisado (p<0,05). Conclusiones. Los escolares con SD presentan altas prevalencias de caries dental, fluorosis y enfermedad periodontal que requieren más atención y educación para lograr mejorar su salud bucal (AU)

Objective. To describe the state of oral health in school children with Down Syndrome (DS) in Cartagena, Colombia. Study Design. This was a cross-sectional descriptive study. Participants. 158 students between 3 and 41 years Location. School institutions with children with DS of Cartagena de Indias Main measurements. An instrument was designed to assess sociodemographic variables, as well as a clinical tool to assess the state of oral health considering Dental caries prevalence evaluated by DMFT, dental fluorosis (Dean index), malocclusion (Angle classification), dental plaque (community plaque index CPI), presence of periodontal disease, soft tissue injuries and dental anomalies (shape, size and number). Data were analyzed from proportions and Chi-Square test was used for significance in relationships, assuming a limit of 0.05 for significance Results. Caries prevalence was 45% (37-53 95 %CI), dental fluorosis prevalence 45.5% (37.7 to 53.4 95 %CI) and periodontal disease 58.8% (51.1 to 66.6 95 %CI); Class III molar on the right side 62% (40.2 to 74.2 95 %CI), Class III molar on the left side 60.7% (49.6 to 73.5 95 %CI) and open bite 41.8% (33.9 to 49.5 95 %CI). Bivariate analysis revealed statistical significance between the presence of dental caries and periodontal disease in school adolescents and those that do not have their own toothbrush; in use of fluoride toothpaste with less presence of dental caries, low frequency of tooth brushing (≤2 times a day) with less presence of fluorosis and more presence of periodontal disease; also between periodontal disease and unsupervised brushing (p <0.05). Conclusion. School children with DS presented high prevalence of dental caries, fluorosis and periodontal disease requiring more care and education in order to improve their oral health (AU)

Conocimiento de pediatras y padres andaluces sobre caries de aparición temprana / Knowledge of andalusian pediatricians and parents about early-onset tooth decay

OBJETIVOS: Investigar el conocimiento de pediatras y padres andaluces sobre las caries de aparición temprana y valorar si los pediatras proporcionan información a los padres sobre salud oral infantil y visitas al odontopediatra. Material y método Una muestra aleatoria de 113 pediatras y 112 padres con ni˜nos menores de 3 a˜nos recibieron un cuestionario anónimo compuesto por 14 ítems para pediatras y 16 ítems para padres. Las preguntas se agruparon en 5 bloques: visitas al dentista, higiene oral, caries, hábitos nutricionales y tratamiento de caries. Las diferencias entre los 2 grupos se establecieron mediante la prueba chi-cuadrado. RESULTADOS: Los pediatras mostraron escasos conocimientos con respecto a las visitas al dentista y al tratamiento de las caries; sin embargo, su nivel de conocimientos sobre higiene oral, caries y hábitos nutricionales era adecuado. Los padres tenían bajos conocimientos en todos los aspectos del estudio, especialmente sobre el tratamiento de las caries. No hubo diferencias significativas en el conocimiento sobre visitas al dentista entre pediatras y padres, sin embargo, los pediatras tenían un mayor conocimiento sobre higiene, caries, hábitos nutricionales y tratamiento (p < 0,001). La mayoría de los padres indicaron que los pediatras no les informaban detalladamente sobre cuidados orales ni sobre la posibilidad de visitar al odontopediatra. CONCLUSIONES: Los pediatras andaluces deberían mejorar sus conocimientos sobre las caries de aparición temprana e informar más a los padres sobre cuidados orales y sobre la posibilidad de visitar al odontopediatra. Los padres tienen unos conocimientos muy escasos sobre caries de aparición temprana, especialmente sobre tratamiento

OBJECTIVES: To determine the level of knowledge of pediatricians and parents from Andalucía (southern Spain) about early-onset tooth decay, and to assess if pediatricians provide information to parents about pediatric oral care and visits to the pediatric de Material and method A random sample of 113 pediatricians and 112 parents with children under 3 years of age received an anonymous questionnaire comprising 14 items for pediatricians and 16 items for parents, grouped into five blocks: visits to the dentist, oral hygiene, caries, nutritional habits, and treatment of caries. The chi-squared test was used to assess differences between groups. RESULTS: Pediatricians showed deficiencies in their knowledge about visits to the dentist and treatment of caries, however their level of knowledge on oral hygiene, tooth decay and nutritional habits were adequate. Parents showed a low level of knowledge in all aspects of the study, mainly about the treatment of tooth decay. There were no significant differences between pediatricians and parents in the knowledge about visits to the dentist, however pediatricians had more knowledge than the parents about hygiene, tooth decay, nutritional habits and treatment (P<0.001). Most of the parents indicated that pediatricians did not provide them detailed information on oral care, and about the possibility of visiting a pediatric dentist. CONCLUSIONS: Andalusian pediatricians should improve their knowledge about early-onset tooth decay, and provide more information to parents about the oral care and the possibility of visiting a pediatric dentist. Parents have a very low level of knowledge about early-onset tooth decay, and particularly about treatmen