Knowledge about emergency dental trauma management among school teachers in Colombia: A baseline study to develop an education strategy.

BACKGROUND/AIM: Dental trauma in school populations has a high frequency and school teachers are often close to the place where such injuries occur. However, many studies have confirmed the lack of knowledge as to how to act in these cases. The aim of this study was to determine the knowledge in regard to dental trauma of school teachers in Colombia. MATERIALS AND METHODS: A multicentre, descriptive cross-sectional study was performed in 251 schools using a stratified randomized sampling. A structured hard copy survey was personally delivered to 2390 school teachers in the selected schools. The survey contained questions related to work experience, teaching level and demographic data, as well as questions related to their knowledge of and attitude towards emergency dental trauma management. RESULTS: The response rate was 96%. Most of the school teachers (95%) had never received training related to dental trauma, although 35% had witnessed at least 1 case. Of 2296 school teachers surveyed, only 5.8% would have replanted an avulsed tooth. An association was found between work experience and appropriate management of an avulsed tooth. No significant differences were found in regard to school location (city), school type (private/public), gender and school teachers' education level. CONCLUSIONS: The knowledge of school teachers in Colombia about emergency dental trauma management is inadequate. The findings strongly suggest a need for an education strategy with the involvement of the government, dentistry schools and private organizations.

Enamel fluorosis related with fluoride-containing water ingestion and urinary excretion in schoolchildren.

Background: Natural water sources are considered as the major environmental exposure of fluoride, resulting in increased prevalence of enamel fluorosis. This type of natural exposure should be permanently monitored to avoid the interactions with other non-natural fluoride sources. We evaluated the prevalence of enamel fluorosis in Colombian schoolchildren and its relationship with fluoride-containing water ingestion exposure dose and urinary fluoride excretion. Material and Methods: We included 923 schoolchildren aged 7-12 years residing in eight municipalities in Colombia. Sampling of consumption water was performed in major aquifers used for daily supply. Samples were collected in 98 polyethylene containers and refrigerated until analysis. Water and urine fluoride concentrations were measured using the fluoride selective electrode method. Enamel fluorosis was evaluated using Thylstrup and Ferjerskov Index (TFI). Demographic and anthropometric characteristics were assessed. Besides, other exposures to non-natural fluoride were also evaluated. Logistic regression was applied for multiple analyses. Results: The median fluoride concentration in water and urine samples was 10.5 mg/L and 0.63 mg/L respectively, with the highest value found in Algarrobo-Magdalena, and the lowest value found in Manzanares-Caldas. The overall prevalence of enamel fluorosis was 86.1%, being more frequent the mild codes with TFI-1 to TFI-2. The highest prevalence was found in Margarita-Bolívar and Manzanares-Caldas, and the most severe codes (TFI-5 to TFI-9) were detected in Manzanares-Caldas. The multiple analysis revealed water ingestion exposure dose, urinary excretion, involuntary intake of toothpaste, amount of table salt consumption and sex as significant factors (p< 0.001). Conclusions: The fluoride ingestion exposure dose and its subsequent urinary excretion could be used as estimators of past fluoride exposure, explaining the current prevalence of enamel fluorosis in Colombian schoolchildren. Key words:Fluoride, groundwater ingestion, enamel fluorosis, prevalence, severity.

Prescribing antibiotics by dentists in Colombia: Toward a conscientious prescription.

OBJECTIVES: Inappropriate prescription of antibiotics contributes to antibiotic resistance. Therefore, the objective of this study was to determine the awareness, attitudes, and intention to practice of dentists prescribing antibiotics in Colombia in order to design a virtual learning environment on this subject. METHODS: In a descriptive study across seven cities, 700 dentists from different Colombian cities were requested to complete a validated questionnaire containing five sections: general information, awareness on antibiotic effectiveness and antibiotic resistance, attitudes regarding prescription decision, intention to practice concerning clinical cases, and complementary information. The level of awareness, attitudes, and intention to practice was determined and Chi-square test was used to determine the existence of significant differences among cities. RESULTS: The majority of dentists showed a medium level regarding the number of correct answers on awareness (62.4 percent) and attitudes (88.7 percent) and a high level on intention to practice (91.7 percent). Common errors within the awareness section included the meaning of the term "antibiotic resistance" (35 percent) and most dentists were not convinced that such resistance could be derived from prescription of antibiotics (51.2 percent). In the attitudes section, only 45 percent declared that they prescribe antibiotics based mainly on symptoms, and the intention to practice section showed a significant percentage of unnecessary prescription (51 percent for pacemaker users) or absence of prescription (53.9 percent for ventricular septal defect) in antibiotic prophylaxis for infectious endocarditis (IE). CONCLUSION: The dentists interviewed should be trained and made aware of antibiotic resistance, microbiological and clinical foundations, and current antibiotic prophylaxis guidelines.

Coronal microleakage of enterococcus faecalis in three types of endodontic filling (warm vertical compaction, lateral compaction, and single cone) / Microfiltración coronal de enterococcus faecalis en tres tipos de obturación endodóntica (compactación vertical caliente, compactación lateral y cono único)

ABSTRACT. Introduction: the adequate sealing of endodontic fillings is critical for a successful treatment, as it prevents the entry of microorganisms and/or their growth in case they persist within the root system. The purpose of this study was to determine bacterial microleakage time in root canals filled with the lateral compaction, warm vertical compaction, and single cone techniques. Methods: 30 single-rooted teeth extracted from humans were randomly distributed into three experimental groups (n = 8); positive and negative controls were also used (n = 6). Teeth were prepared with the corono-apical ProTaper Universal technique and obturations were performed using lateral compaction, warm vertical compaction (System B - Obtura II) and single cone. Top Seal resin-based cement was used in the three groups. Enterococcus faecalis (E. faecalis) microleakage was assessed every 24 hours for 30 days using the dual chamber model, with the lower chamber containing a pH indicator in the culture medium, which showed bacterial microleakage time. The data were statistically analyzed using one-way Anova test and Bonferroni and Tukey's post-tests. Results: the single-cone technique showed the highest level of bacterial microleakage of E. faecalis as a function of time, while lateral compaction and warm vertical compaction showed better results, with no statistically significant differences between them, being the techniques with the best sealing results against E. faecalis microleakage. Conclusions: under the conditions of this study, it can be concluded that the single-cone technique is not suitable for root canal sealing, as it does not prevent bacterial microleakage of E. faecalis compared to the other two techniques.

RESUMEN. Introducción: un adecuado sellado de la obturación endodóntica es crucial para el éxito del tratamiento, ya que impide la entrada de microorganismos y/o el crecimiento de los mismos en caso de persistir en la anatomía radicular. El propósito de este estudio fue determinar el tiempo de microfiltración bacteriana en conductos obturados con condensación lateral, condensación vertical caliente y cono único. Métodos: 30 dientes unirradiculares extraídos de humanos se distribuyeron aleatoriamente en tres grupos experimentales (n = 8); adicionalmente, se usaron controles positivos y negativos (n = 6). Los dientes fueron conformados con técnica coronoapical ProTaper universal y las obturaciones se realizaron usando compactación lateral, compactación vertical caliente (System B - Obtura II) y cono único. Para los tres grupos se utilizó cemento resinoso Top Seal. La microfiltración con Enterococcus faecalis (E. faecalis) se evalúo cada 24 horas por 30 días usando el modelo de doble cámara, donde la cámara inferior presentaba un indicador de pH en el medio de cultivo, el cual indicaba el momento de microfiltración bacteriana. Los datos fueron analizados estadísticamente usando el test de Anova de una vía y los postests de Bonferroni y Tukey. Resultados: la técnica de cono único presentó la mayor microfiltración bacteriana de E. faecalis en función del tiempo, mientras que las técnicas de compactación lateral y compactación vertical caliente presentaron mejores resultados, aunque entre ellas no presentaron diferencias estadísticamente significativas, siendo estas dos últimas técnicas las que mejores resultados presentaron a nivel de sellado contra la microfiltración de E. faecalis. Conclusiones: bajo las condiciones de este estudio, se puede concluir que la técnica de cono único no es adecuada para el sellado de conductos radiculares, ya que no impide la microfiltración bacteriana de E. faecalis en comparación con las otras técnicas.