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1.
Cochrane Database Syst Rev ; 12: CD008367, 2020 12 24.
Artigo em Inglês | MEDLINE | ID: mdl-33368159

RESUMO

BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, swab, toothbrush, or combination, together with suction of secretions, may reduce the risk of VAP in these patients. OBJECTIVES: To assess the effects of oral hygiene care (OHC) on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs). SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 25 February 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 1), MEDLINE Ovid (1946 to 25 February 2020), Embase Ovid (1980 to 25 February 2020), LILACS BIREME Virtual Health Library (1982 to 25 February 2020) and CINAHL EBSCO (1937 to 25 February 2020). We also searched the VIP Database (January 2012 to 8 March 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomised controlled trials (RCTs) evaluating the effects of OHC (mouthrinse, gel, swab, toothbrush or combination) in critically ill patients receiving mechanical ventilation for at least 48 hours. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed search results, extracted data and assessed risk of bias in included studies. We contacted study authors for additional information. We reported risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, using the random-effects model of meta-analysis when data from four or more trials were combined. MAIN RESULTS: We included 40 RCTs (5675 participants), which were conducted in various countries including China, USA, Brazil and Iran. We categorised these RCTs into five main comparisons: chlorhexidine (CHX) mouthrinse or gel versus placebo/usual care; CHX mouthrinse versus other oral care agents; toothbrushing (± antiseptics) versus no toothbrushing (± antiseptics); powered versus manual toothbrushing; and comparisons of other oral care agents used in OHC (other oral care agents versus placebo/usual care, or head-to-head comparisons between other oral care agents). We assessed the overall risk of bias as high in 31 trials and low in two, with the rest being unclear. Moderate-certainty evidence from 13 RCTs (1206 participants, 92% adults) shows that CHX mouthrinse or gel, as part of OHC, probably reduces the incidence of VAP compared to placebo or usual care from 26% to about 18% (RR 0.67, 95% confidence intervals (CI) 0.47 to 0.97; P = 0.03; I2 = 66%). This is equivalent to a number needed to treat for an additional beneficial outcome (NNTB) of 12 (95% CI 7 to 128), i.e. providing OHC including CHX for 12 ventilated patients in intensive care would prevent one patient developing VAP. There was no evidence of a difference between interventions for the outcomes of mortality (RR 1.03, 95% CI 0.80 to 1.33; P = 0.86, I2 = 0%; 9 RCTs, 944 participants; moderate-certainty evidence), duration of mechanical ventilation (MD -1.10 days, 95% CI -3.20 to 1.00 days; P = 0.30, I2 = 74%; 4 RCTs, 594 participants; very low-certainty evidence) or duration of intensive care unit (ICU) stay (MD -0.89 days, 95% CI -3.59 to 1.82 days; P = 0.52, I2 = 69%; 5 RCTs, 627 participants; low-certainty evidence). Most studies did not mention adverse effects. One study reported adverse effects, which were mild, with similar frequency in CHX and control groups and one study reported there were no adverse effects. Toothbrushing (± antiseptics) may reduce the incidence of VAP (RR 0.61, 95% CI 0.41 to 0.91; P = 0.01, I2 = 40%; 5 RCTs, 910 participants; low-certainty evidence) compared to OHC without toothbrushing (± antiseptics). There is also some evidence that toothbrushing may reduce the duration of ICU stay (MD -1.89 days, 95% CI -3.52 to -0.27 days; P = 0.02, I2 = 0%; 3 RCTs, 749 participants), but this is very low certainty. Low-certainty evidence did not show a reduction in mortality (RR 0.84, 95% CI 0.67 to 1.05; P = 0.12, I2 = 0%; 5 RCTs, 910 participants) or duration of mechanical ventilation (MD -0.43, 95% CI -1.17 to 0.30; P = 0.25, I2 = 46%; 4 RCTs, 810 participants). AUTHORS' CONCLUSIONS: Chlorhexidine mouthwash or gel, as part of OHC, probably reduces the incidence of developing ventilator-associated pneumonia (VAP) in critically ill patients from 26% to about 18%, when compared to placebo or usual care. We did not find a difference in mortality, duration of mechanical ventilation or duration of stay in the intensive care unit, although the evidence was low certainty. OHC including both antiseptics and toothbrushing may be more effective than OHC with antiseptics alone to reduce the incidence of VAP and the length of ICU stay, but, again, the evidence is low certainty. There is insufficient evidence to determine whether any of the interventions evaluated in the studies are associated with adverse effects.


Assuntos
Estado Terminal , Higiene Bucal/métodos , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Respiração Artificial/efeitos adversos , Adulto , Criança , Clorexidina/uso terapêutico , Humanos , Incidência , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação , Antissépticos Bucais/uso terapêutico , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Pneumonia Associada à Ventilação Mecânica/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Respiração Artificial/estatística & dados numéricos , Escovação Dentária/instrumentação , Escovação Dentária/métodos
2.
Rev Assoc Med Bras (1992) ; 66Suppl 2(Suppl 2): 96-101, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965365

RESUMO

COVID-19, caused by SARS-CoV-2, can present respiratory complications that often lead patients to depend on mechanical ventilation (MV) for several days. It is known that Pneumonia Associated with Mechanical Ventilation (PAMV) is frequent in patients who use this equipment for a long time. As a consequence of COVID-19, its prolonged use can lead to a worse prognosis for the patients. For this reason, in addition to the insufficiency of devices for mechanical ventilation to meet the current demand, it is necessary to adopt measures aimed at preventing complications that may aggravate the patient's clinical condition and, consequently, increase the average hospital stay and the respective hospital care costs. Therefore, the objective of this study was to discuss, in a concise and practical way, and based on the available literature, the importance of adopting adequate oral hygiene protocols for patients on mechanical ventilation. Based on the data obtained, it was identified that the adoption of effective oral hygiene measures, especially under the supervision of dental professionals, can contribute to the reduction of morbidity and mortality associated with MV, resulting in greater availability of mechanical ventilation equipment. Since such equipment is in great demand during the COVID-19 pandemic, the knowledge and implementation of effective oral hygiene measures will undoubtedly have an impact on improving the quality of care offered to patients, therefore benefiting all those in critical health conditions and assisted in ICUs.


Assuntos
Infecções por Coronavirus/terapia , Higiene Bucal , Pandemias , Pneumonia Viral/terapia , Respiração Artificial/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Unidades de Terapia Intensiva , Antissépticos Bucais/uso terapêutico , Pneumonia Viral/epidemiologia , Qualidade da Assistência à Saúde , Escovação Dentária/métodos
3.
PLoS One ; 15(7): e0236692, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730310

RESUMO

AIMS: To assess feasibility, acceptability, and early efficacy of monetary incentive-based interventions on fostering oral hygiene in young children measured with a Bluetooth-enabled toothbrush and smartphone application. DESIGN: A stratified, parallel-group, three-arm individually randomized controlled pilot trial. SETTING: Two Los Angeles area Early Head Start (EHS) sites. PARTICIPANTS: 36 parent-child dyads enrolled in an EHS home visit program for 0-3 year olds. INTERVENTIONS: Eligible dyads, within strata and permuted blocks, were randomized in equal allocation to one of three groups: waitlist (delayed monetary incentive) control group, fixed monetary incentive package, or lottery monetary incentive package. The intervention lasted 8 weeks. OUTCOMES: Primary outcomes were a) toothbrushing performance: mean number of Bluetooth-recorded half-day episodes per week when the child's teeth were brushed, and b) dental visit by the 2-month follow-up among children with no prior dental visit. The a priori milestone of 20% more frequent toothbrushing identified the intervention for a subsequent trial. Feasibility and acceptability measures were also assessed, including frequency of parents syncing the Bluetooth-enabled toothbrush to the smartphone application and plaque measurement from digital photographs. FINDINGS: Digital monitoring of toothbrushing was feasible. Mean number of weekly toothbrushing episodes over 8 weeks was 3.9 in the control group, 4.1 in the fixed incentive group, and 6.0 in the lottery incentive group. The lottery group had 53% more frequent toothbrushing than the control group and 47% more frequent toothbrushing than the fixed group. Exploratory analyses showed effects concentrated among children ≤24 months. Follow-up dental visit attendance was similar across groups. iPhone 7 more reliably captured evaluable images than Photomed Cannon G16. CONCLUSIONS: Trial protocol and outcome measures were deemed feasible and acceptable. Results informed the study protocol for a fully powered trial of lottery incentives versus a delayed control using the smart toothbrush and remote digital incentive program administration. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT03862443.


Assuntos
Assistência Odontológica para Crianças , Recompensa , Escovação Dentária , Pré-Escolar , Placa Dentária/diagnóstico , Placa Dentária/patologia , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Feminino , Humanos , Lactente , Masculino , Aplicativos Móveis , Pais/psicologia , Projetos Piloto , Escovação Dentária/instrumentação , Escovação Dentária/métodos
4.
BMC Oral Health ; 20(1): 161, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493283

RESUMO

BACKGROUND: The aim of this in vitro study was to examine the possible enhancement of the biofilm peeling effect of a sonic toothbrush following the use of an antimicrobial mouth rinse. METHODS: The biofilm at a noncontact site in the interdental area was treated by sound wave convection with the test solution or by immersion in the solution. The biofilm peeling effect was evaluated by determining the bacterial counts and performing morphological observations. A Streptococcus mutans biofilm was allowed to develop on composite resin discs by cultivation with stirring at 50 rpm for 72 h. The specimens were then placed in recesses located between plastic teeth and divided into an immersion group and a combination group. The immersion group was treated with phosphate buffer, chlorhexidine digluconate Peridex™ (CHX) mouth rinse or Listerine® Fresh Mint (EO) mouth rinse. The combination group was treated with CHX or EO and a sonic toothbrush. RESULTS: The biofilm thickness was reduced by approximately one-half compared with the control group. The combination treatment produced a 1 log reduction in the number of bacteria compared to the EO immersion treatment. No significant difference was observed in the biofilm peeling effect of the immersion group compared to the control group. CONCLUSIONS: The combined use of a sonic toothbrush and a mouth rinse enhanced the peeling of the biofilm that proliferates in places that are difficult to reach using mechanical stress.


Assuntos
Esmalte Dentário/microbiologia , Antissépticos Bucais/farmacologia , Streptococcus mutans/efeitos dos fármacos , Escovação Dentária/instrumentação , Ultrassom/instrumentação , Aderência Bacteriana , Carga Bacteriana , Biofilmes/efeitos dos fármacos , Clorexidina , Humanos , Escovação Dentária/métodos
5.
BMC Oral Health ; 20(1): 136, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32384897

RESUMO

BACKGROUND: Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility. METHODS: Five different sizes of commercially marketed IRP with elastomeric fingers (IRP-F) (GUM SOFT-PICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) or slats (IRP-S) (TePe EasyPick™, TePe D-A-CH GmbH, Hamburg, Germany) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N]. RESULTS: IRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area. CONCLUSIONS: New interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Escovação Dentária/instrumentação , Alemanha , Humanos , Fotografia Dentária , Pressão , Reprodutibilidade dos Testes , Escovação Dentária/métodos
6.
J. negat. no posit. results ; 5(5): 491-503, mayo 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194125

RESUMO

INTRODUCCIÓN: El uso de dentífricos y enjuagues bucales o colutorios que tienen fluoruro en su composición se ha ampliado ya que se ha demostrado que este elemento tiene una alta actividad contra las bacterias cariogénicas. Sin embargo, una ingesta excesiva de cualquiera de estos productos, puede producir intoxicaciones que conducen a diversas patologías a largo plazo. OBJETIVOS: El objetivo de este estudio es determinar el contenido de fluoruro de productos dentales (dentífricos y colutorios) para evaluar si existe algún tipo de riesgo al ingerir accidentalmente grandes cantidades de estos en ciertos grupos de población y comparar los niveles experimentales con los declarados en el etiquetado. MATERIAL Y MÉTODOS: Se han analizado un total de 117 muestras de productos dentales mediante potenciometría con electrodo de ion selectivo de fluoruro. RESULTADOS Y DISCUSIÓN: Se ha registrado la mayor concentración de fluoruro (18412±0.009 mg/kg) en el dentífrico Vitis® junior sabor tutti frutti. El mayor nivel de fluoruro encontrado en los colutorios (2703±38.4 mg/L) ha sido registrado en la marca Lacer® Oros. CONCLUSIONES: No existe ningún tipo de riesgo si el cepillado se realiza correctamente y, en el caso de los niños, de forma supervisada para evitar ingestiones accidentales. No obstante, de producirse, se necesitarían cantidades muy altas de estos productos para desencadenar un efecto tóxico a corto y largo plazo


INTRODUCTION: The use of dentifrices and mouthwashes or mouthwashes that have fluoride in their composition has been extended since it has been shown that this element has a high activity against cariogenic bacteria. However, excessive intake of any of these products can cause poisoning that leads to various long-term pathologies. OBJECTIVES: The objective of this study is to determine the fluoride content of dental products (dentifrices and mouthwashes) to assess whether there is any type of risk by accidentally ingesting large amounts of these in certain population groups and comparing the experimental levels with those declared in the labelling. MATERIAL AND METHODS: A total of 117 samples of dental products have been analyzed by potentiometry with fluoride selective ion electrode. RESULTS AND DISCUSSION: The highest concentration of fluoride (18412±0.009 mg/kg) has been recorded in the Vitis® junior tutti frutti flavor toothpaste. The highest level of fluoride found in mouthwashes (2703±38.4 mg/L) has been registered under the Lacer® Oros brand. CONCLUSIONS: There is no risk if brushing is done correctly and, in the case of children, in a supervised way to avoid accidental ingestion. However, if produced, very high amounts of these products would be needed to trigger a toxic effect in the short and long term


Assuntos
Dentifrícios/química , Antissépticos Bucais/química , Fluoretos/isolamento & purificação , Potenciometria/métodos , Medidas de Toxicidade , Escovação Dentária/métodos , Dentifrícios/toxicidade , Antissépticos Bucais/toxicidade
8.
Acta Odontol Scand ; 78(4): 265-274, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32285744

RESUMO

Objective: Power toothbrushes is considered an effective tool for maintaining oral health; however, its efficacy as compared to manual toothbrushes is still not completely clarified. This article aims to evaluate the efficacy of power toothbrushes compared with the manual toothbrushes in terms of plaque, gingivitis and bleeding reduction.Methods: An electronic search was performed on PUBMED, Web of Science, Wiley and Research Gate. Studies comparing the effectiveness of plaque, gingivitis and bleeding reduction between power and manual toothbrushes were included. Results and effect sizes analysis are presented as standard mean difference (SMD), and subgroup analysis stratified by mode of action of the power toothbrush was performed. Study quality and risk of bias were assessed using the Cochrane assessment tool.Results: A total of 21 randomized clinical studies were included. Power toothbrushes were significantly more effective in reducing plaque index (26 trials: SMD = 0.86, 95% CI: 0.58 to 1.14, I2 = 91.5%, p < .0001), gingival index (14 trials: SMD = 0.47, 95% CI: 0.12 to 0.82, I2 = 88.7%, p < .0001), and bleeding index (11 trials: SMD = 0.92, 95% CI: 0.43 to 1.40, I2 = 91.8%, p < .0001) compared with the manual toothbrushes, except that there was no significant differences between the oscillating-rotating toothbrushes and manual toothbrushes regarding gingivitis reduction (7 trials: SMD = 0.07, 95% CI: -0.20 to 0.33, I2 = 57.2%, p = .03).Conclusions: Power toothbrushes is more effective in reducing dental plaque, gingivitis and bleeding compared with the manual toothbrush.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Saúde Bucal , Escovação Dentária/instrumentação , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Desenho de Equipamento , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Escovação Dentária/métodos
9.
J Am Dent Assoc ; 151(4): 265-275.e6, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32111341

RESUMO

BACKGROUND: The aim of this study was to systematically review and analyze the difference in efficacy of oscillating-rotating toothbrushes compared with other powered toothbrushes. METHODS: The authors performed a systematic search of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors used the population, intervention, comparison, and outcome format to develop a search strategy to answer the study question. The authors searched PubMed-MEDLINE databases. Inclusion criteria were randomized controlled clinical trials comparing oscillating-rotating (OR) toothbrushes with other powered toothbrushes published from January 1, 2009 through March 1, 2019. RESULTS: The authors' search resulted in 454 articles; 21 articles were downloaded for review, 15 articles were included in the report, and 12 could be used for meta-analysis. All of the studies were randomized controlled clinical trials that assessed plaque removal and gingival inflammation indexes. Results of the meta-analysis of the randomized controlled clinical trials showed that OR toothbrushes had superior, statistically significant outcomes for whole-mouth plaque reduction, assessed using the Rustogi Modified Navy Plaque Index (P < .01), and gingivitis, assessed by using number of bleeding sites (P < .001), but not for the modified gingival index (P > .05) or gingival bleeding index (P > .05). PRACTICAL IMPLICATIONS: There is some evidence to suggest that OR powered toothbrushes might remove more plaque and reduce the number of bleedings sites better than other powered toothbrushes, specifically, sonic action toothbrushes.


Assuntos
Placa Dentária , Gengivite , Escovação Dentária , Índice de Placa Dentária , Desenho de Equipamento , Humanos , Método Simples-Cego , Escovação Dentária/instrumentação , Escovação Dentária/métodos
10.
BMC Res Notes ; 13(1): 112, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32103773

RESUMO

OBJECTIVE: This study aimed to determine the relative amounts of Streptococcus mutans (SM) and lactobacilli (LBs) and their relationship with dental caries among a Yemeni adult population. RESULTS: A positive correlation appeared between SM and LB counts from saliva and caries tissue samples and the decayed, missing and filled teeth (DMFT) score (p < 0.05). There was a significant correlation between SM and LBs in caries tissue (p < 0.05). However, there was no significant difference between SM and LBs isolated from saliva samples (p > 0.05). The number of SM and LBs in subjects with active caries was significantly higher than that in those without active caries (p < 0.05). There was no significant difference between the daily habits and SM and LB or DMFT scores (p > 0.05), except for a significant difference between brushing frequency and DMFT score (p < 0.05).


Assuntos
Cárie Dentária/diagnóstico , Lactobacillus/isolamento & purificação , Saliva/microbiologia , Streptococcus mutans/isolamento & purificação , Índice CPO , Cárie Dentária/microbiologia , Feminino , Humanos , Lactobacillus/fisiologia , Masculino , Streptococcus mutans/fisiologia , Escovação Dentária/métodos , Escovação Dentária/normas , Escovação Dentária/estatística & dados numéricos , Iêmen , Adulto Jovem
11.
J Clin Nurs ; 29(11-12): 2023-2030, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31945246

RESUMO

AIMS AND OBJECTIVES: To describe the proportion of toothbrushing task steps, long-term care residents had an opportunity to complete; the duration and quality of toothbrushing by both residents and caregivers; and the feedback caregivers provided. BACKGROUND: Poor oral health is widespread among older adults in long-term care homes; however, little is known about their actual oral health practices. DESIGN: Secondary analysis of video recordings. METHODS: A total of 58 video-recorded sessions were analysed from two long-term care homes in Canada. Eligible residents had at least one natural tooth, required oral care assistance, had Alzheimer's disease and understood English. Eligible caregivers spoke English and had worked for at least 1 year with people with dementia. Toothbrushing success was identified by the resident's participation in, and completion of, nine toothbrushing steps. Total time spent brushing teeth was calculated by summing the duration of time spent brushing teeth. Quality was described by time spent brushing the facial versus the lingual or occlusal surfaces. Caregiver verbal feedback was pulled from transcripts and analysed using content analysis. STROBE guidelines were used in reporting this study. RESULTS: The two step residents most frequently completed or attempted were brushing their teeth (77% complete, 7% attempt) and rinsing their mouth (86% complete, 2% attempt). The average time spent brushing teeth was 60.33 s (SD = 35.15). In 66% of observed videos, toothbrushing occurred only on the facial tooth surfaces, with no time spent brushing the lingual or occlusal surfaces. CONCLUSION: Caregivers are supporting residents to independently complete toothbrushing; however, the duration and quality of toothbrushing are not sufficient to ensure optimal oral health. RELEVANCE TO CLINICAL PRACTICE: Clear, detailed guidelines are required to ensure adequate oral care for long-term care residents. Staff need to be aware that all surfaces should be brushed to ensure proper oral health.


Assuntos
Doença de Alzheimer/complicações , Saúde Bucal/normas , Escovação Dentária/métodos , Idoso , Cuidadores/organização & administração , Feminino , Humanos , Assistência de Longa Duração , Masculino , Gravação em Vídeo
12.
Rev. Ciênc. Plur ; 6(2): 192-204, 2020.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1100328

RESUMO

Introdução:Os projetos de extensão universitáriaapresentam grande importância para os estudantes e para a sociedadecomo um todo, uma vez que possibilitamuma reflexão crítica nos indivíduos, a fim de integrar os conhecimentos acadêmicos à sociedade.O projeto Formando Sorrisosda Universidade Federal do Rio Grande do Norte(UFRN), promove atendimento odontológico aos estudantes da instituição que sejam caracterizados como vulneráveis socioeconomicamente; durante as atividades os pacientes são constantemente instruídos sobre cuidados orais e incentivados a levar as práticas às suas residências, configurando-se um vetor inicial para prevenção de agravos orais.Objetivo:Relatar a contribuição do projeto na formação do estudante de Odontologia.Metodologia:Trata-se de um estudo descritivo do tipo relato de experiência com base na rotina clínica dos alunos de odontologia do segundo ao décimoperíodo de um projeto de extensão daUFRN. Os dados se referem ao período de 2018 a 2019, avaliando desde a recepção dos pacientes até a finalização de seus tratamentos odontológicos.Resultados:A experiência nas diferentes atividades doprojeto possibilitaaosestudantesum olhar mais integraldo paciente. A vivência clínica desde cedo na graduação auxiliaao aluno um maior entendimento sobre a Odontologia, motivando-oem relação ao curso, facilitando o aprendizado e contribuindo para a formação profissional.Conclusões:As atividades desenvolvidas pelo projeto contribuempara a formação acadêmica do estudante de Odontologiae proporciona aos estudantes universitários atendimento odontológico de qualidade e em horários flexíveis (AU).


Introduction:University extension projects are of great importance for students and society as a whole since they allow critical reflection on individuals, to integrate academic knowledge into society. The Formando Sorrisos project of the Federal University of Rio Grande do Norte (UFRN) promotes dental care to the institution's students who are characterized as socioeconomically vulnerable; during activities, patients are constantly instructed about oral care and encouraged to take the practices to their homes, setting up an initial vector for preventing oral diseases.Objective:To report the project's contribution to the training of dentistry students.Methodology:This is a descriptive study of the type of experience report based on the clinical routine of dentistry students from the second to the tenth period of an extension project at UFRN. The data refer to the period from 2018 to 2019, evaluating from the reception of patients to the completion of their dental treatments. Results:Experience in the different activities of the project allows students to have a more comprehensive view of the patient. The clinical experience from an early stage in graduation helps students to gain a better understanding of Dentistry, motivating them concerning the course, facilitating learning, and contributing to professional training.Conclusions:The activities developed by the project contribute to the academic education of dentistry students and provide university students with quality dental care and flexible hours (AU).


Introducción: Los proyectos de extensión universitaria son de gran importancia para los estudiantes y para la sociedad en general, ya que permiten la reflexión crítica sobre las personas, para integrar el conocimiento académico en la sociedad. El proyecto Formando Sorrisos de la Universidad Federal de Río Grande del Norte(UFRN), promueve la atención dental a los estudiantes de la institución que se caracterizan por ser socioeconómicamente vulnerables; Durante las actividades, los pacientes reciben constantemente instrucciones sobre el cuidado bucal y se les alienta a llevar las prácticas a sus hogares, estableciendo un vector inicial para laprevención de enfermedades orales.Objetivo: Informar la contribución del proyecto a la formación de estudiantes de odontología. Metodología: Este es un estudio descriptivo del tipo de informe de experiencia basado en la rutina clínica de los estudiantes de odontología del segundo al décimo período de un proyecto de extensión en la UFRN. Los datos se refieren al período de 2018 a 2019, evaluando desde la recepción de pacientes hasta la finalización de sus tratamientos dentales.Resultados: La experiencia en las diferentes actividades del proyecto permite a los estudiantes tener una visión más completa del paciente. La experiencia clínica desde una etapa temprana de la graduación ayuda a los estudiantes a comprender mejor la odontología, motivándolos en relación con el curso, facilitando el aprendizaje y contribuyendo a la formación profesional.Conclusiones: Las actividades desarrolladas por el proyecto contribuyen a la educación académica de los estudiantes de odontología y brindan a los estudiantes universitarios atención dental de calidad y horarios flexibles (AU).


Assuntos
Humanos , Masculino , Feminino , Estudantes de Odontologia , Relações Comunidade-Instituição , Aprendizagem Baseada em Problemas/métodos , Serviços de Saúde Bucal , Educação em Odontologia , Escovação Dentária/métodos , Brasil , Epidemiologia Descritiva
13.
Cochrane Database Syst Rev ; 12: CD012213, 2019 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-31825092

RESUMO

BACKGROUND: Halitosis or bad breath is a symptom in which a noticeably unpleasant breath odour is present due to an underlying oral or systemic disease. 50% to 60% of the world population has experienced this problem which can lead to social stigma and loss of self-confidence. Multiple interventions have been tried to control halitosis ranging from mouthwashes and toothpastes to lasers. This new Cochrane Review incorporates Cochrane Reviews previously published on tongue scraping and mouthrinses for halitosis. OBJECTIVES: The objectives of this review were to assess the effects of various interventions used to control halitosis due to oral diseases only. We excluded studies including patients with halitosis secondary to systemic disease and halitosis-masking interventions. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 April 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 3) in the Cochrane Library (searched 8 April 2019), MEDLINE Ovid (1946 to 8 April 2019), and Embase Ovid (1980 to 8 April 2019). We also searched LILACS BIREME (1982 to 19 April 2019), the National Database of Indian Medical Journals (1985 to 19 April 2019), OpenGrey (1992 to 19 April 2019), and CINAHL EBSCO (1937 to 19 April 2019). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (8 April 2019), the World Health Organization International Clinical Trials Registry Platform (8 April 2019), the ISRCTN Registry (19 April 2019), the Clinical Trials Registry - India (19 April 2019), were searched for ongoing trials. We also searched the cross-references of included studies and systematic reviews published on the topic. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomised controlled trials (RCTs) which involved adults over the age of 16, and any intervention for managing halitosis compared to another or placebo, or no intervention. The active interventions or controls were administered over a minimum of one week and with no upper time limit. We excluded quasi-randomised trials, trials comparing the results for less than one week follow-up, and studies including advanced periodontitis. DATA COLLECTION AND ANALYSIS: Two pairs of review authors independently selected trials, extracted data, and assessed risk of bias. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included 44 trials in the review with 1809 participants comparing an intervention with a placebo or a control. The age of participants ranged from 17 to 77 years. Most of the trials reported on short-term follow-up (ranging from one week to four weeks). Only one trial reported long-term follow-up (three months). Three studies were at low overall risk of bias, 16 at high overall risk of bias, and the remaining 25 at unclear overall risk of bias. We compared different types of interventions which were categorised as mechanical debridement, chewing gums, systemic deodorising agents, topical agents, toothpastes, mouthrinse/mouthwash, tablets, and combination methods. Mechanical debridement: for mechanical tongue cleaning versus no tongue cleaning, the evidence was very uncertain for the outcome dentist-reported organoleptic test (OLT) scores (MD -0.20, 95% CI -0.34 to -0.07; 2 trials, 46 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Chewing gums: for 0.6% eucalyptus chewing gum versus placebo chewing gum, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.10, 95% CI -0.31 to 0.11; 1 trial, 65 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Systemic deodorising agents: for 1000 mg champignon versus placebo, the evidence was very uncertain for the outcome patient-reported visual analogue scale (VAS) scores (MD -1.07, 95% CI -14.51 to 12.37; 1 trial, 40 participants; very low-certainty evidence). No data were reported for dentist-reported OLT score or adverse events. Topical agents: for hinokitiol gel versus placebo gel, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.27, 95% CI -1.26 to 0.72; 1 trial, 18 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Toothpastes: for 0.3% triclosan toothpaste versus control toothpaste, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -3.48, 95% CI -3.77 to -3.19; 1 trial, 81 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Mouthrinse/mouthwash: for mouthwash containing chlorhexidine and zinc acetate versus placebo mouthwash, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.20, 95% CI -0.58 to 0.18; 1 trial, 44 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Tablets: no data were reported on key outcomes for this comparison. Combination methods: for brushing plus cetylpyridium mouthwash versus brushing, the evidence was uncertain for the outcome dentist-reported OLT scores (MD -0.48, 95% CI -0.72 to -0.24; 1 trial, 70 participants; low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. AUTHORS' CONCLUSIONS: We found low- to very low-certainty evidence to support the effectiveness of interventions for managing halitosis compared to placebo or control for the OLT and patient-reported outcomes tested. We were unable to draw any conclusions regarding the superiority of any intervention or concentration. Well-planned RCTs need to be conducted by standardising the interventions and concentrations.


Assuntos
Halitose/terapia , Antissépticos Bucais/uso terapêutico , Higiene Bucal/métodos , Adolescente , Adulto , Idoso , Goma de Mascar , Clorexidina/uso terapêutico , Raspagem Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal , Ensaios Clínicos Controlados Aleatórios como Assunto , Língua/microbiologia , Escovação Dentária/métodos , Cremes Dentais , Adulto Jovem
14.
Int Orthod ; 17(4): 719-725, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31466932

RESUMO

OBJECTIVE: The objective of this trial was to compare the plaque removal ability of a triple-headed toothbrush to a conventional manual toothbrush in adolescents with fixed orthodontic appliances. MATERIALS AND METHODS: Sixty adolescent patients undergoing orthodontic treatment were randomly assigned to brush one time with either a conventional manual toothbrush or a triple-headed toothbrush. The main outcome was the post-brushing plaque index as measured by the Silness-Löe plaque index. RESULTS: Sixty patients (mean age, 14.2; standard deviation, 1.65) were randomized in a 1:1 ratio to either a manual toothbrush group or a triple-headed toothbrush group. Baseline characteristics were similar between the two groups. There were no dropouts. The mean post-brushing plaque index was 0.84 (95% CI, 0.67-1.02; SD, 0.60) for the conventional manual toothbrush group, and 0.31 (95% CI, 0.13-0.49; SD, 0.48) for the triple-headed toothbrush group. There was a statistically significant difference in the mean plaque index of 0.53 (95% CI, 0.28-0.78; P<0.001) between the two groups after brushing. No harms were observed. CONCLUSION: The results of this study indicate strong evidence that the triple-headed toothbrush leads to a significantly lower plaque index compared to the conventional manual toothbrush post-brushing.


Assuntos
Placa Dentária/terapia , Aparelhos Ortodônticos Fixos/efeitos adversos , Escovação Dentária/métodos , Adolescente , Criança , Índice de Placa Dentária , Desenho de Equipamento , Feminino , Humanos , Masculino , Método Simples-Cego
15.
BMC Oral Health ; 19(1): 168, 2019 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357960

RESUMO

BACKGROUND: The purpose of this study was to evaluate the mitigating effect of the use of interdental brushes on periodontal health inequality. METHODS: This study was based on the data acquired in the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI; 2013-2015). A total of 17,583 participants (7,633 males and 9,950 females)) aged 19 years or older completed the KNHANES VI between 2013 and 2015. Multivariable logistic regression analysis was performed using socioeconomic characteristics (sex, age, level of education, individual income), personal health practice (smoking, toothbrushing, dental flossing, interdental brushing, dental clinic visiting), systematic medical factors (diabetes mellitus, hypercholesterolemia, hypertension, obesity) and the community periodontal index. We confirmed differences in the prevalence of periodontal disease with the use of an interdental brushes stratified according to individual income. RESULTS: Three logistic regression models adjusted for covariates hierarchically. In all models, individuals who used an interdental brush were not significantly different from individuals who did not use an interdental brush. The adjusted odds ratio (OR) for interdental brushing was 0.918 with a 95% confidence intervals (CIs) of 0.797-1.057. When periodontal disease was the outcome of the model, the lowest income group had 1.266 (95% CIs 1.066 to 1.502) times the odds of having periodontal disease than the highest income group. In interdental brush nonusers, the lowest income group had 1.276 (95% CI 1.061-1.533) times the odds of having periodontal diseases than the highest income group. However, in the interdental brush users, there were no significant differences in periodontal disease prevalence among income groups. CONCLUSIONS: The results suggest that the use of interdental brushes could alleviate periodontal health inequality.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Cárie Dentária/prevenção & controle , Dispositivos para o Cuidado Bucal Domiciliar , Disparidades nos Níveis de Saúde , Higiene Bucal/métodos , Periodontite/prevenção & controle , Escovação Dentária/métodos , Adulto , Idoso , Dispositivos para o Cuidado Bucal Domiciliar/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Higiene Bucal/instrumentação , Periodontite/epidemiologia , República da Coreia/epidemiologia , Escovação Dentária/instrumentação , Adulto Jovem
16.
J Complement Integr Med ; 16(3)2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31339857

RESUMO

Ayurveda recommends sound and healthy life. It basically focuses on prevention rather than treatment. It includes a systematic lifestyle pattern which is composed of several principles and activities. Dinacharya (Daily routine) is one of the important principles. It includes various activities started from just before sunrise. All these activities are necessary for the maintenance of homeostasis of the body. Tooth brushing is one of the essential routines of Ayurveda daily practices. Traditionally it has been advocated with a soft twig of medicinal plants with or without herbal tooth powder. There are so many medicinal plants have been described in this context. Contradictory plants have also been described. Oral hygiene products are so much advanced and globalized nowadays. There are so many types of toothbrushes; dentifrices, dental floss, tongue scrapers, mouthwashes, oral irrigators, etc. are available along with specifications. Contemporary oral hygiene products esp. dentifrices are chemically rich and have their own side effects. No doubt these products have their own advantages like easy availability and adjustability according to current lifestyle. But their safety is questionable on long-term use. Herbal products have additional benefits over it that those are natural and easily adjustable and acceptable with body physiology.


Assuntos
Medicina Ayurvédica/métodos , Plantas Medicinais/química , Escovação Dentária/métodos , Humanos , Medicina Ayurvédica/instrumentação , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Escovação Dentária/instrumentação
17.
J Periodontal Res ; 54(6): 601-611, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31206663

RESUMO

The aim of this systematic review (SR) was to assess whether toothbrushing-based oral heath measure (OHM), performed in intensive care units, can reduce the risk of ventilator-associated pneumonia (VAP). Dental biofilm removal has been considered important to prevent VAP. PUBMED, SCOPUS, WEB OF SCIENCE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to and including December 2018 to identify randomized clinical trials (RCT) on the use of toothbrushing procedures in the prevention of VAP. Search was conducted by two independent reviewers. The risk of bias of each included study was assessed using the Cochrane Collaboration's domain-based, two-part tool. Random effects meta-analyses were conducted thoroughly. Search strategy identified 215 potentially eligible articles, of which 12 RCT were included. All studies evidenced the importance of OHM in mechanically ventilated patients in order to prevent VAP. Seven RCT (58.3%) found some degree of positive association between toothbrushing, alone or associated to oral topical chlorhexidine (CHX), and a potential reduction of mechanical ventilation-related outcomes and dental biofilm/oral bacteria. However, pooled estimates did not identify an additional decrease of VAP incidence for any of the tested procedures (ie, toothbrushing + CHX versus swab/gauze cleaning + CHX or toothbrushing + CHX versus toothbrushing alone or + placebo). Toothbrushing does not seem to promote a reduction of VAP-outcomes compared to swab/gauze cleaning, when topic CHX is applied for oral hygiene of patients submitted to mechanical ventilation.


Assuntos
Clorexidina/uso terapêutico , Unidades de Terapia Intensiva , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Escovação Dentária/métodos , Humanos , Higiene Bucal , Ensaios Clínicos Controlados Aleatórios como Assunto , Respiração Artificial
18.
Cochrane Database Syst Rev ; 5: CD012628, 2019 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-31149734

RESUMO

BACKGROUND: Periodontal (gum) disease and dental caries (tooth decay) are the most common causes of tooth loss; dental plaque plays a major role in the development of these diseases. Effective oral hygiene involves removing dental plaque, for example, by regular toothbrushing. People with intellectual disabilities (ID) can have poor oral hygiene and oral health outcomes. OBJECTIVES: To assess the effects (benefits and harms) of oral hygiene interventions, specifically the mechanical removal of plaque, for people with intellectual disabilities (ID). SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases to 4 February 2019: Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Register of Studies), MEDLINE Ovid, Embase Ovid and PsycINFO Ovid. ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. The Embase search was restricted by date due to the Cochrane Centralised Search Project, which makes available clinical trials indexed in Embase through CENTRAL. We handsearched specialist conference abstracts from the International Association of Disability and Oral Health (2006 to 2016). SELECTION CRITERIA: We included randomised controlled trials (RCTs) and some types of non-randomised studies (NRS) (non-RCTs, controlled before-after studies, interrupted time series studies and repeated measures studies) that evaluated oral hygiene interventions targeted at people with ID or their carers, or both. We used the definition of ID in the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). We defined oral hygiene as the mechanical removal of plaque. We excluded studies that evaluated chemical removal of plaque, or mechanical and chemical removal of plaque combined. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search records, identified relevant studies, extracted data, assessed risk of bias and judged the certainty of the evidence according to GRADE criteria. We contacted study authors for additional information if required. We reported RCTs and NRSs separately. MAIN RESULTS: We included 19 RCTs and 15 NRSs involving 1795 adults and children with ID and 354 carers. Interventions evaluated were: special manual toothbrushes, electric toothbrushes, oral hygiene training, scheduled dental visits plus supervised toothbrushing, discussion of clinical photographs showing plaque, varied frequency of toothbrushing, plaque-disclosing agents and individualised care plans. We categorised results as short (six weeks or less), medium (between six weeks and 12 months) and long term (more than 12 months).Most studies were small; all were at overall high or unclear risk of bias. None of the studies reported quality of life or dental caries. We present below the evidence available from RCTs (or NRS if the comparison had no RCTs) for gingival health (inflammation and plaque) and adverse effects, as well as knowledge and behaviour outcomes for the training studies.Very low-certainty evidence suggested a special manual toothbrush (the Superbrush) reduced gingival inflammation (GI), and possibly plaque, more than a conventional toothbrush in the medium term (GI: mean difference (MD) -12.40, 95% CI -24.31 to -0.49; plaque: MD -0.44, 95% CI -0.93 to 0.05; 1 RCT, 18 participants); brushing was carried out by the carers. In the short term, neither toothbrush showed superiority (GI: MD -0.10, 95% CI -0.77 to 0.57; plaque: MD 0.20, 95% CI -0.45 to 0.85; 1 RCT, 25 participants; low- to very low-certainty evidence).Moderate- and low-certainty evidence found no difference between electric and manual toothbrushes for reducing GI or plaque, respectively, in the medium term (GI: MD 0.02, 95% CI -0.06 to 0.09; plaque: standardised mean difference 0.29, 95% CI -0.07 to 0.65; 2 RCTs, 120 participants). Short-term findings were inconsistent (4 RCTs; low- to very low-certainty evidence).Low-certainty evidence suggested training carers in oral hygiene care had no detectable effect on levels of GI or plaque in the medium term (GI: MD -0.09, 95% CI -0.63 to 0.45; plaque: MD -0.07, 95% CI -0.26 to 0.13; 2 RCTs, 99 participants). Low-certainty evidence suggested oral hygiene knowledge of carers was better in the medium term after training (MD 0.69, 95% CI 0.31 to 1.06; 2 RCTs, 189 participants); this was not found in the short term, and results for changes in behaviour, attitude and self-efficacy were mixed.One RCT (10 participants) found that training people with ID in oral hygiene care reduced plaque but not GI in the short term (GI: MD -0.28, 95% CI -0.90 to 0.34; plaque: MD -0.47, 95% CI -0.92 to -0.02; very low-certainty evidence).One RCT (304 participants) found that scheduled dental recall visits (at 1-, 3- or 6-month intervals) plus supervised daily toothbrushing were more likely than usual care to reduce GI (pocketing but not bleeding) and plaque in the long term (low-certainty evidence).One RCT (29 participants) found that motivating people with ID about oral hygiene by discussing photographs of their teeth with plaque highlighted by a plaque-disclosing agent, did not reduce plaque in the medium term (very low-certainty evidence).One RCT (80 participants) found daily toothbrushing by dental students was more effective for reducing plaque in people with ID than once- or twice-weekly toothbrushing in the short term (low-certainty evidence).A benefit to gingival health was found by one NRS that evaluated toothpaste with a plaque-disclosing agent and one that evaluated individualised oral care plans (very low-certainty evidence).Most studies did not report adverse effects; of those that did, only one study considered them as a formal outcome. Some studies reported participant difficulties using the electric or special manual toothbrushes. AUTHORS' CONCLUSIONS: Although some oral hygiene interventions for people with ID show benefits, the clinical importance of these benefits is unclear. The evidence is mainly low or very low certainty. Moderate-certainty evidence was available for only one finding: electric and manual toothbrushes were similarly effective for reducing gingival inflammation in people with ID in the medium term. Larger, higher-quality RCTs are recommended to endorse or refute the findings of this review. In the meantime, oral hygiene care and advice should be based on professional expertise and the needs and preferences of the individual with ID and their carers.


Assuntos
Deficiência Intelectual , Saúde Bucal , Higiene Bucal , Doenças Periodontais/prevenção & controle , Placa Dentária , Humanos , Escovação Dentária/métodos
19.
Caries Res ; 53(6): 628-635, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31132765

RESUMO

OBJECTIVES: Performing proper toothbrushing is a complicated process for children. Therefore, the aim of this study was to investigate the effect of a smartphone app for improving manual toothbrushing via a gravitation sensor. METHODS: In this prospective, controlled, single-blinded, randomized clinical trial, 49 children (mean age 5.1 ± 0.6 years, 27 female) were randomly assigned to test (n = 26) and control (n = 23) groups. All children were provided with manual toothbrushes with an integrated gravitation sensor and they received oral health instructions. Only the children of the test group got an additional smartphone app to visualize and reward proper brushing in form and time. At baseline and recalls after 6 and 12 weeks, plaque and gingival indices (QHI, PBI) were recorded for analysis between the two groups. RESULTS: At baseline, there were no significant differences between the test and control group regarding plaque and gingival indices (QHI: 2.36 ± 0.7 and 2.42 ± 0.8; p = 0.94; PBI: 0.42 ± 0.2 and 0.47 ± 0.3; p = 0.59). At the 6- and 12-week recalls, the test group showed statistically -significantly better oral health indices than the controls (6-week recall, QHI: 0.8 ±0.5 and 1.88 ± 0.9; p < 0.001; PBI: 0.08 ± 0.1 and 0.26 ± 0.2; p < 0.001; 12-week recall, QHI: 0.44 ± 0.5 and 1.49 ± 0.7; p < 0.001; PBI: 0.05 ± 0.18 and 0.21 ± 0.1; p < 0.001). CONCLUSION: The results highlight the enormous possibilities of a toothbrushing application via the smartphone, at least for medium-term oral hygiene improvement in preschool children and even after excluding the app. The long-term effect should also be investigated to exclude the expected novelty effect.


Assuntos
Placa Dentária/prevenção & controle , Aplicativos Móveis , Smartphone , Escovação Dentária/métodos , Pré-Escolar , Índice de Placa Dentária , Feminino , Humanos , Masculino , Estudos Prospectivos , Método Simples-Cego
20.
BMC Oral Health ; 19(1): 71, 2019 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046747

RESUMO

BACKGROUND: This study evaluated the efficacy of four methods in removing Candida albicans from the acrylic base material used to fabricate removable orthodontic appliances. METHODS: Heat-processed bars of orthodontic acrylic were incubated in a suspension of C. albicans for 2 h at 37 °C. Samples were allocated into five groups (five bars per group) according to the cleaning method: (1) manual brushing using a toothbrush; (2) soaking in a commercial denture cleaning solution; (3) soaking in a commercial mouthwash solution; (4) using an ultrasonic cleaner; and (5) soaking in distilled water as a negative control. Yeast remaining attached to the bars after cleaning were removed by vortexing in growth medium and plated on Sabouraud dextrose agar. The reduction in yeast colony count after cleaning was calculated and expressed as the number of colony forming units per acrylic bar (CFU/bar). The experiment was carried out three times. RESULTS: All four cleaning methods resulted in a significant decrease in viable yeast cells associated with the acrylic bars compared to the control group. The mean percentage reduction in viable yeast cells affected by the cleaning methods was: brushing 89.9%; chlorhexidine 95.8%; ultrasonic cleaning 99.9%; and denture tablet 100%. CONCLUSIONS: All four methods evaluated in this study were effective, to some extent, in removing C. albicans from orthodontic acrylic samples. The most effective, and readily available, cleaning method was the use of commercial denture sterilizing tablets.


Assuntos
Resinas Acrílicas/química , Biofilmes/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Bases de Dentadura/microbiologia , Higienizadores de Dentadura/farmacologia , Prótese Total/microbiologia , Higiene Bucal/métodos , Escovação Dentária/métodos , Contagem de Colônia Microbiana , Higienizadores de Dentadura/química , Desinfecção/métodos , Humanos , Água/química
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