Impacto de uma alimentação rica em açúcar e das condições socioeconômicas na experiência da cárie em crianças e adultos jovens / Impact of a high-sugar diet and socioeconomic conditions on caries experience in children and young adults

Objetivo: Avaliar a associação entre a prevalência de cárie dentária em relação a frequência de consumo de alimentos ricos em açúcar, condições socioeconômicas e escolaridade dos pais de crianças e adultos jovens. Material e Métodos: Aplicou-se questionários socioeconômicos com pais e/ou responsáveis de 36 crianças e adolescentes na faixa etária entre 7 e 20 anos de um clube do Município de Alegre - ES. A cárie dentária foi avaliada através do Índice de Dentes Cariados, Perdidos e Obturados (CPO-D) e a placa bacteriana por meio do Índice de Higiene Oral Simplificado (IOHS). Posteriormente, realizaram-se palestras e atividades educativas de higiene bucal e de educação nutricional. Reavaliou-se então índice de placa bacteriana duas semanas após a intervenção. Para avaliação estatística usou-se regressão logística para testar associações e teste t pareado para índice de placa bacteriana. Resultados: Do total de crianças avaliadas, 67% apresentou história pregressa e atual de cárie, na qual a mediana do CPO-D encontrado foi de 2. Para a avaliação do índice de placa bacteriana, observou-se que a intervenção apresentou efetividade (p<0,05) uma vez que IHOS inicial foi de 1,98 e o final foi de 1,43. Conclusão: Foi encontrada alta prevalência de COP-D polarizado na amostra avaliada, e também detectado que as ações de educação em saúde foram efetivas na redução de placa bacteriana

Objective: to evaluate the association between the prevalence of dental caries, sugary food intake and socioeconomic conditions of children and young adults. Material and methods: socioeconomic questionnaires were applied to parents and/or guardians of 36 children and adolescents attending a soccer club in the city of Alegre ­ ES, Brazil, aged between 7 and 20 years. To assess food intake, a Food Frequency Questionnaire (FFQ) was applied. Tooth decay was assessed using the Decayed, Missing, Filled Teeth Index (DMFT) and plaque through the Simplified Oral Hygiene Index (OHI-S). Subsequently, lectures and oral hygiene and nutritional education activities were held. The plaque index was then reevaluated two weeks after the intervention. The presence of caries was expressed using relative frequency. In order to evaluate the factors associated with dental caries, a logistic regression model was used (p <0.05), and to evaluate the effect of the intervention, the paired t-test was used to compare the plaque index. Results: 67% out of the assessed children had past and current history of decay, with a median DMFT of 2. Among the variables assessed 'family income', 'parents' educational level' and 'consumption of high-sugar foods' no statistically significant association (p <0.05) with the presence of dental caries was observed. To evaluate the bacterial plaque index, it was observed that the intervention was effective (p <0.05) with an initial OHI-S of 1.98 and final of 1.43. Conclusion: a high prevalence of polarized DMFT was found in the sample. The health education actions were effective in reducing plaque. Almost all of the sample was found to have the habit of consuming sugary food four or more times a week. No significant associations were found between dental caries and the variables analyzed.

Avaliação dos hábitos alimentares de interesse odontológico em crianças com paralisia cerebral / Assessment of dietary habits of dental interest in children with cerebral palsy

Introdução - As dificuldades na mastigação e deglutição em crianças com Paralisia Cerebral (PC) são identificadas como fatores de risco para hábitos alimentares inadequados podendo estar associada a presença da doença cárie. O objetivo do estudo foi avaliar os hábitos alimentares de interesse odontológico em crianças com PC em comparação a crianças normoreativas (grupo controle). Material e Métodos - Participaram do estudo 60 crianças pareadas pela idade, 30 com diagnóstico médico de PC e 30 normoreativas. Foram incluídas crianças de ambos os gêneros, na faixa etária de 5 a 11 anos de idade (média = 7,45). Avaliou-se a presença visível de biofilme nos dentes anteriores, e um questionário foi aplicado ao responsável referente à preferência da consistência dos alimentos, necessidade de auxilio na alimentação, utensílio utilizado para alimentação e o conteúdo da dieta. Um diário alimentar foi entregue ao responsável, para ser preenchido durante 5 dias. A avaliação clínica visual da presença de biofilme e a análise dos diários foram realizadas por um único examinador. Resultados - As crianças com PC apresentaram uma frequência significantemente mais alta de alimentos líquidos ou pastosos, assim como maior uso de colher, maior necessidade de auxilio durante a alimentação e maiores índices de biofilme, em comparação ao grupo controle (p < 0,01). A frequência de ingestão de sacarose foi mais alta em crianças com PC, mas sem associação à presença de biofilme dentário. Conclusões - As crianças com PC são mais dependentes no momento da alimentação, possuem uma dieta de consistência mais líquida a pastosa e apresentam maior quantidade de biofilme dentário em comparação com as crianças normoreativas.

Introduction - The difficulties in chewing and swallowing in children with Cerebral Palsy (CP) are possible risk factors for an inadequate nutritional state. The objective of the study was to evaluate the dietary habits of dental interest in children with CP compared to normoreactive children(control group). Material and Methods - Sixty children matched by age participated; 30 with medical diagnosis of CP and 30 normoreactive. Children of both genders were included, aged 5 to 11years (mean = 7.45). The presence of biofilm in anterior teeth was evaluated, and a questionnaire was applied to the guardian regarding the consistency of food, need for assistance during feeding, utensil used for feeding and content of the diet. A food diary was given to the guardian to be completed for 5 days. Visual clinical evaluation of the presence of biofilm and the food diary analysis were performed by a single examiner. Results - Children with CP had a significantly higher frequency of liquid or paste foods, as well as a greater use of spoon, greater need for help during feeding and higher rates of biofilm compared to the control group (p < 0.01). The frequency of sucrose intake was higher in children with CP, but no association with the presence of dental biofilm was found. Conclusions - Children with CP are more dependent during feeding, they have a diet of liquid to paste consistency and they have a greater amount of dental biofilm compared to normoreactive children.

Grape products and oral health.

Oral diseases, including dental caries, periodontal disease, and tooth loss, affect the majority of the population and can affect a person's overall health. Raisins contain polyphenols, flavonoids, and high levels of iron that may benefit human health. However, their oral health benefits are less well understood. We hypothesized that raisins contain antimicrobial phytochemicals capable of suppressing oral pathogens associated with caries or periodontal diseases and thus benefit oral health. Through antimicrobial assay-guided fractionation and purification, compounds identified with growth inhibition against oral pathogens were oleanolic acid, oleanolic aldehyde, linoleic acid, linolenic acid, betulin, betulinic acid, 5-(hydroxymethyl)-2-furfural, rutin, beta-sitosterol, and beta-sitosterol glucoside. Oleanolic acid suppressed in vitro adherence of cariogenic Streptococcus mutans biofilm. When the effect of raisins and raisin-containing bran cereal on in vivo plaque acidogenicity was examined in 7- to 11-y-old children, it was found that raisins did not reduce the plaque pH decline below pH 6 over the 30-min test period. Compared with commercial bran flakes or raisin bran cereal, a lower plaque pH drop was noted in children who consumed a raisin and bran flake mixture when no sugar was added (P < 0.05). Grape seed extract, high in proanthocyanidins, positively affected the in vitro demineralization and/or remineralization processes of artificial root caries lesions, suggesting its potential as a promising natural agent for noninvasive root caries therapy. Raisins represent a healthy alternative to the commonly consumed sugary snack foods.

Physiological approaches to the control of oral biofilms.

Evidence that physiological strategies may be potential routes for oral biofilm control has come from (i) observations of the variations in the intra-oral distribution of members of the resident oral microflora, (ii) changes in plaque composition in health and disease, and (iii) data from laboratory model systems. Key physiological factors that were identified as significant in modulating the microflora included the local pH, redox potential (Eh), and nutrient availability. Increases in mutans streptococci and lactobacilli occur at sites with caries; growth of these species is selectively enhanced at low pH. In contrast, periodontal diseases are associated with plaque accumulation, followed by an inflammatory host response. The increases in Gram-negative, proteolytic, and obligately anaerobic bacteria reflect a low redox potential and a change in nutrient status due to the increased flow of gingival crevicular fluid (GCF). Consequently, physiological strategies for oral biofilm control should focus on reducing the frequency of low pH in plaque by (i) inhibiting acid production, (ii) using sugar substitutes, and (iii) promoting alkali generation from arginine or urea supplements. Similarly, strategies to make the pocket environment less favorable to periodonto-pathogens include (i) anti-inflammatory agents to reduce the flow of (and hence nutrient supply by) GCF, (ii) bacterial protease inhibitors, and (iii) redox agents to raise the Eh locally. Most laboratory and clinical findings support the concept of physiological control. However, some data suggest that the ordered structure and metabolically interactive organization of mature dental plaque could generate a community with a high level of homeostasis that is relatively resistant to deliberate external manipulation.

Reduction in accumulation of plaque, stain, and calculus in dogs by dietary means.

We conducted 215 evaluations for plaque, stain, and calculus in 120 dogs at two research sites. Dogs were balanced in groups of five according to baseline plaque index scores; groups were randomly assigned to treatment or control dietary regimens. Dental cleanings were done on Day 0. Dogs in the treatment group were fed a food formulated to reduce accumulation of plaque, stain, and calculus. Control group dogs were fed a commercially available dry dog food. No other foods, treats, or snacks were given to either group. We graded 22 teeth for plaque accumulation on Day 7 and for stain and calculus accumulation on Day 21. Six trials were conducted and the results reported as a combined mean for all treatment and control groups. Dogs fed the treatment food had significantly less plaque, stain, and calculus accumulation (p = 0.001) than dogs fed the control food. Plaque, stain, and calculus accumulation can be reduced by dietary means.

Effects of sugar restriction on Streptococcus mutans and Streptococcus sobrinus in saliva and dental plaque.

The effect of sugar restriction on the oral levels of mutans streptococci was studied in 20 subjects fulfilling three criteria: (1) having more than 300,000 CFU mutans streptococci/ml saliva, (2) harbouring both Streptococcus mutans and Streptococcus sobrinus in saliva, and (3) eating sugar frequently. The subjects were randomly divided into a test group (n = 12), who were asked to refrain from using sugar-containing foods between meals and to reduce sugar in main meals for 6 weeks, and a control group (n = 8), who did not receive any dietary advice. Saliva and plaque samples were collected at baseline and at 3, 6 and 12 weeks. The results showed that the levels of S. mutans and S. sobrinus decreased in saliva and plaque during the 6-week sugar restriction period. The decrese in mutans streptococci was more pronounced on buccal than on approximal tooth surfaces. Both species seemed to react in a similar way to the sugar restriction in saliva as well as in dental plaque. At the follow-up examination at 12 weeks, i.e. 6 weeks after completing the sugar restriction period, the numbers of S. mutans and S. sobrinus had increased again, but were still lower when compared to the baseline values.

Modificação do meio de Ikeda e Sandhan no isolamento de Streptococcus Mutans de placa dental / Modification of the Ikeda e Sandhan medium for the Streptococcus Mutans isolation from dental plaques

Desde que Fitzgerald, Keyes mostraram que o Streptococcus Mutans determinam formação de cárie em animais livres de germes, os pesquisadores procuram formular um meio de cultura para isolá-los. Uma série de meios foram empregados com a finalidade referida. Em nosso trabalho optamos pelo meio "Mitis Salivarius Agar" 40 por cento de sacarose (M.S.A. 40 S), substituindo a sacarose pelo açúcar comercial. O material foi colhido de 40 escolares de ambos os sexos, com idade variando entre 9 e 14 anos. O material colhido foi semeado em meio de cultivo Mitis Salivarius Agar com 40 por cento de sacarose e 40 por cento de açúcar comercial. A incubação procedeu-se em anaerobiose e microaerofilia. Os resultados encontrados na pesquisa estão expressos em tabelas que permitem avaliar as condições experimentais pesquisadas

By the skin of your teeth.

Plaque Watchers is an organized community programme to educate, motivate and facilitate the acquisition of adequate personal oral health habits, particularly for children in schools. Working with other health providers and the help of industry, teachers, parents and the media, Project Supertooth resources (plaque tunnels, t-shirts, stickers, community service announcements in the media and oral health courses) should provide a significant step towards promoting dental health and prevention of dental disease in the community by controlling the 'skin of your teeth'.