Trends in the prevalence of traumatic crown injuries and associated factors in Brazilian preschool children: 10-year observational data.

OBJECTIVE: To assess trends in the prevalence of traumatic crown injuries (TCI) in children aged 1-4 years living in Diadema city (Brazil) and to investigate whether TCI were associated with socio-demographic and clinical variables. METHODS: Six cross-sectional surveys with representative samples were carried out from 2002 to 2012 following the same criteria and methodology. A total of 6389 children were evaluated and systematically selected on the National Children's Vaccination day. Calibrated examiners performed the children's oral examination for TCI according to Andreasen's criteria. Chi-square test for trends was used to perform comparative analysis. Poisson regression was used to associate TCI to socio-demographic and clinical variables. RESULTS: The prevalence of TCI in 2002 for preschool children aged 1, 2, 3 and 4 years was 4.5%, 11.4%, 14% and 13.9%, respectively, and the prevalence in 2012 for the same age groups was 10.4%, 15.9%, 25.7% and 28.1%, respectively. There was a significant increase in the prevalence of TCI for all age groups and for the total sample (P < 0.05). Children's age was associated with TCI in all the surveys. Male gender, presence of anterior open bite and inadequate lip coverage were associated with TCI in some surveys along the years (P < 0.05). CONCLUSION: This study has shown an increase of TCI prevalence in Brazilian preschool children in the last 10 years and its association with children's age, male gender, presence of anterior open bite and inadequate lip coverage. However, this increase does not seem to be relevant to decisions on public policy.

Trends in the prevalence of erosive tooth wear in Brazilian preschool children.

OBJECTIVES: To report trends in the prevalence of ETW in Brazilian preschool children. METHODS: Three cross-sectional surveys were carried out on boys and girls aged 3-4 years living in Diadema, in the years 2008, 2010 and 2012 following the same criteria and methodology. A total of 2801 children were systematically examined during a National Day of Children's vaccination. Examiners were trained and calibrated to diagnose ETW using a modified version of the O'Brien index. RESULTS: The prevalence of ETW was 51.6% (95% CI 48.4-55.0) in 2008, 53.9% (95% CI 50.7-57.0) in 2010 and 51.3% (95% CI 47.8-54.7) in 2012. There was no significant association between prevalence of ETW from 2008 to 2012 (χ(2) for trend: P = 0.92). There was no significant association in the severity of ETW during this study's period. Most lesions were confined to enamel in all three studies. CONCLUSIONS: A high prevalence of ETW was found in this sample of preschool children in 2008, 2010 and 2012. No trends of increase or decrease in the prevalence and severity of ETW during this study's period.

Impact of traumatic dental injuries and malocclusions on quality of life of preschool children: a population-based study.

BACKGROUND: Few studies assessed the impact of traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) in preschool children. AIM: To assess the impact of the presence of TDI and malocclusions, as well as its severity and types, respectively, on the OHRQoL of preschool children. DESIGN: The study was conducted in 1215 children aged 1-4 years old who attended the National Day of Children Vaccination in Diadema, Brazil. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and socio-demographic conditions. Calibrated dental examiners performed the oral examinations for TDI and malocclusions. Poisson regression models adjusted by dental caries associated the clinical and socio-demographic conditions with the outcome. RESULTS: The multivariate adjusted models showed associations between some individual domains of the B-ECOHIS and clinical and socio-demographic conditions (P < 0.05). The severity of TDI showed a negative impact on the symptoms domain and self-image/social interaction domain (P < 0.05). Children with complicated TDI were more likely to experience a negative impact on total B-ECOHIS scores (PR = 2.10; P = 0.048). CONCLUSIONS: The presence of complicated TDI and dental caries were associated with worse OHRQoL of Brazilian preschool children, whereas malocclusions do not.

Risk indicators for erosive tooth wear in Brazilian preschool children.

The aim of this study was to assess the prevalence and risk indicators for erosive tooth wear (ETW) in Brazilian preschool children. A total of 967 children aged 3-4 years were examined. ETW was assessed using a modified version of the index recommended by O'Brien [London, Her Majesty's Stationary Office, 1994]. The 16 examiners were trained and calibrated. Hierarchical logistic regression was applied to investigate the association between ETW and socio-economic, environmental, nutritional and behavioural factors, as well as factors related to the child's characteristics. ETW was present in 51.6% of children. Most lesions were confined to enamel (93.9%) and involved over two thirds of the tooth surface's area (82%). There were no significant associations between ETW and socio-economic, environmental and nutritional variables. ETW was significantly associated with soft drink intake twice or 3 or more times a day (p = 0.043 and 0.023, respectively), frequent reported gastro-oesophageal reflux (p = 0.005) and age (p = 0.003). In conclusion, there was a high prevalence of ETW in the preschool children examined, and the risk indicators were frequent consumption of soft drinks, reported gastro-oesophageal reflux and age.

Prevalence and associated factors of dental erosion in children and adolescents of a private dental practice.

BaCKGROUND. The prevalence of dental erosion seems to be rising in young populations, particularly among individuals of higher socioeconomic status. AIM. To assess the prevalence and associated factors of dental erosion in children and adolescents of a private dental practice. DESIGN. A total of 232 participants, aged 2-20 years, were examined. Dietary habits, oral hygiene, and medical data were collected from dental records. Logistic regression analyses were conducted. RESULTS. Dental erosion prevalence was of 25.43% and was highest on the occlusal surfaces (76%). Associated factors were: frequent consumption of soft drinks (OR = 2.33; 95% CI = 1.01-5.38) and candies (OR = 3.23; 95% CI = 1.25-8.32); and interaction between these two factors (OR = 3.95; 95% CI = 1.60-9.75). On anterior teeth, associated factors were: frequent consumption of fruits (OR = 2.53; 95% CI = 1.09-5.91); and age (OR = 1.07 95% CI = 1.01-1.14). Milk consumption was associated with a lower prevalence of dental erosion (OR = 0.40; 95% CI = 0.17-0.94). CONCLUSIONS. A relatively high prevalence of erosion was found in association with frequent intake of soft drinks, candies, and fruits. The consumption of milk seemed to protect against dental erosion on anterior teeth.

Efficacy of two methods for restorative materials' removal in primary teeth.

AIM: This in vitro study aimed to compare the time required for removal, the presence of residues of restorative material, tooth structure loss and dental surface morphology after removal of composite resin and amalgam restorations from occlusal cavities in primary molars using conventional high-speed bur and CVDentus® ultrasonic diamond tips. MATERIALS AND METHODS: A total of 37 primary molars were allocated into four groups: Group 1 (n=9)-amalgam restorations removed using high-speed bur; Group 2 (n=10)-amalgam restorations removed using ultrasonic tip; Group 3 (n=8)- composite resin restorations removed using high-speed bur; Group 4 (n=10)-composite resin restorations removed using ultrasonic tip. After being restored, teeth were sectioned and analyzed through stereoscopic microscope images before and after restoration removal. The structural loss was analyzed by software of image analysis, and an examiner assessed for the presence of residues. Scanning electron microscopy was used to evaluate the morphology. Time and structural loss values were compared using ANOVA, and the percentages of samples with residues using Fisher test. RESULTS: There was no statistically significant difference in the tooth structure loss among different methods and restorative materials, as well as in the presence of residues of restorative material. However, diamond burs were faster than the ultrasonic method for both materials. Differences in dental morphology were observed between the methods of restoration removal, but not related to the restorative material. CONCLUSION: Both conventional high-speed bur and ultrasonic diamond tip methods remove similar amounts of tooth structure, but the removal performed with diamond tips in ultrasonic devices is slower. CLINICAL SIGNIFICANCE: This study shows that both ultrasonic and conventional high-speed bur methods for removing restorations generate similar loss of sound dental tissue, but the former is slower.

Dental treatment of children with Angelman syndrome: a case report.

Angelman syndrome (AS) is a rare genetic neurological disorder. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, speech impairment, movement or balance disorder, and a behavioural uniqueness. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking/swallowing disorder, mandibular prognathism, a wide mouth, frequent drooling, and excessive chewing behaviour. The dental literature on the syndrome is scarce. The purpose of paper is to describe the interesting aspects of the dental treatment of a child with AS.

Associated factors to erosive tooth wear and its impact on quality of life in children with cerebral palsy.

To evaluate the presence and associated factors of erosive tooth wear (ETW) in children with cerebral palsy (CP), as well as its impact on the oral health-related quality of life (OHRQoL). Parents of 60 CP children, between 6 and 14 years of age, answered the Brazilian version of the parental-caregivers perception questionnaire (P-CPQ). The ETW diagnosis was performed by a single calibrated examiner according to the O'Brien´s modified index. Associated factors such as family income, behavioral factors, and type of CP were also collected. OHRQoL was measured through P-CPQ domains and total score, and Poisson regression was used to correlate ETW to associated factors and to the scores. ETW was present in 48.3% of the children. The multivariate adjusted model showed that the presence of ETW was associated with more than 2 days of soft drink intake per week (p = 0.003), daily intake of powdered juice (p = 0.002) and reported gastroesophageal reflux (p = 0.016). The family income higher than one Brazilian minimum wage showed a positive impact on the CP children's OHRQoL (RR = 0.53; p ≤ 0.001). ETW in CP children is associated to frequent consumption of soft drinks, powdered juices, and reported gastroesophageal reflux; however, ETW has not a negative impact on the OHRQoL.

Does erosive tooth wear affect the oral health-related quality of life of preschool children? / Os desgastes dentários erosivos afetam a qualidade de vida relacionada à saúde bucal em pré-escolares?

ABSTRACT Objective: The aim of this study was to investigate the impact of erosive tooth wear on the Oral Health-Related Quality of life (OHRQoL) of preschool children. Methods: Dental examinations were conducted on 815 children aged 3-4 years during the Children's Vaccination National Day when their parents were also invited to answer the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). ETW prevalence and severity were measured using a modified version of the O'Brien index (1994). Data collected included socioeconomic factors and child's variables. OHRQoL was measured through B-ECOHIS domains and total score. Poisson regression was used to associate ETW to the outcome and this association was adjusted for dental caries and dental trauma. Results: The proportion of children who had at least 1 ETW tooth was 51.2%. Most erosive lesions were confined to enamel (42.7%). The multivariate adjusted model showed that child's age (children aged 4year-old) was associated to a negative impact on the symptom domain (RR=1.70; p=0.010), functional limitation domain (RR=1.85; p=0.005) and total B-ECOHIS score (RR= 1.63; p=0.006). Families with 2 or more children in the house have a negative impact on the self-image/social interaction domain (RR=5.41; p=0.043). ETW was not associated to total B-ECOHIS scores (RR= 0.79; p=0.163) and individual domains. Conclusion: Erosive tooth wear does not affect the OHRQoL in this sample of preschool children.

RESUMO Objetivo: O objetivo deste estudo foi investigar o impacto das lesões de desgaste dentário erosivo na qualidade de vida relacionada à saúde bucal (QVRSB) de pré-escolares. Métodos: Exames clínicos foram conduzidos em 815 crianças de 3 e 4 anos de idade durante a Campanha Nacional de Multivacinação Infantil. Os pais ou responsáveis foram convidados a responderam a versão brasileira do Early Childhood Oral Health Impact Scale (B-ECOHIS). A prevalência e a gravidade das lesões de desgastes dentários erosivos foram avaliadas de acordo com o índice de O'Brien (1994). Também foram coletados dados socioeconômicos e variáveis da criança. A QVRSB foi mensurada por meio dos domínios e escore total do B-ECOHIS. A análise de regressão de Poisson foi adotada para associar as lesões de desgaste dentário erosivo ao desfecho e ajustada para cárie dentária e lesões dentárias traumáticas. Resultados: A proporção de crianças que apresentavam pelo menos 1 dente apresentando desgaste dentário erosivo foi 51,2%. A maioria das lesões de desgaste dentário erosivo estava confinada ao esmalte (42,7%). A análise ajustada multivariada revelou que apenas que a idade (crianças de 4 anos) foi associada a um impacto negativo nos domínios de sintomas (RR=1,70; p=0,010), limitação funcional (RR=1,85; p=0,005) e escore total do B-ECOHIS (RR= 1,63; p=0,006). Famílias com 2 ou mais filhos tiveram um impacto negativo nos dominíos de autoestima e interação social (RR=5,41; p=0,043). As lesões de desgaste dentário erosivo não foram associadas ao escore total de B-ECOHIS (RR= 0,79; p=0,163) e domínios individuais. Conclusão: As lesões de desgaste dentário erosivo não afetaram a qualidade de vida de pré-escolares da amostra estudada.

Focal dermal hypoplasia: a case report and literature review.

Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings.

Medical problems and oral care of patients with Down syndrome: a literature review.

When planning the dental treatment of patients with Down syndrome (DS), dental practitioners should always consider their general health, in order to achieve a holistic and interdisciplinary approach. This article presents a literature review of the primary medical conditions in patients with DS that may affect their general health care and the appropriate clinical delivery of oral health care.

Effect of fluoride varnish and gel on dental erosion in primary and permanent teeth.

OBJECTIVE: To assess the effect of a fluoride varnish and gel on the erosive wear of primary and permanent teeth. DESIGN: Sixty human primary (n=30) and permanent (n=30) enamel specimens were randomly assigned to one of the following groups: APF gel (1.23% F), NaF varnish (2.26% F), and control (no treatment). Fluoride gel was applied for 4 min and fluoride varnish for 24 h. Six daily demineralisation-remineralization cycles of 5 min of immersion in a cola drink (pH 2.3) and 30 min in artificial saliva were conducted during 7 days. All specimens were stored in artificial saliva between and after cycles. Surface Knoop microhardness (%SMHC) readings were performed at baseline, 48 h and 7 days. Data were tested using ANOVA and Tukey's tests (p<0.05). RESULTS: For primary enamel, the mean %SMHC (+/-SD) after 48 h and 7 days was, respectively: gel (31.0+/-14.4 and 36.9+/-7.5), varnish (26.7+/-9.5 and 38.3+/-8.7), and control (35.8+/-8.6 and 45.0+/-8.6). For permanent enamel, such values were: gel (37.5+/-7.7 and 27.8+/-7.5), varnish (31.7+/-9.6 and 27.4+/-11.1) and control (48.6+/-6.4 and 43.1+/-6.4). In primary enamel, erosion inhibition by fluoride was not significant at 48 h (p=0.203) and 7 days (p=0.082). In permanent specimens, both products showed a significant effect (p<0.001). CONCLUSIONS: Both fluoride varnish and gel were able to inhibit erosive enamel loss but mainly in the permanent experimental groups. Primary and permanent enamel substrates reacted differently to both demineralization by a cola drink and remineralization by fluoridated compounds.

Diagnóstico, prevenção e tratamento clínico da erosão dentária / Clinical diagnasis, preventian and treatment af dental erosian

Estudos epidemiológicos recentes evidenciam um aumento na prevalência de erosão dentária em vários países, principalmente entre crianças e adolescentes. O diagnóstico precoce das lesões erosivas viabiliza a instituição de medidas preventivas logo no início do processo de perda de estrutura dentária, evitando procedimentos reabilitadores extensos. Porém, o diagnóstico diferencial entre a abrasão, a atrição e a erosão dentárias ainda é um assunto controverso entre os clínicos e os pesquisadores, sendo necessário estabelecer critérios claros para distinção entre as características destes tipos de lesões. Uma vez diagnosticada a erosão dentária, terapias preventivas e restauradoras são necessárias e diversas pesquisas têm sido geradas com este propósito nos últimos anos. Portanto, o presente trabalho se propõe a apresentar uma revisão baseada nas evidências científicas encontradas na literatura sobre o diagnóstico e o tratamento da erosão dentária.

Recent epidemiological studies revealed an increase in the prevalence of dental ero- sion around the world, mainly among children and teenagers. Early diagnosis of erosive lesions enables the implementation of preventive measures at the beginning of process of dental structure loss, thus avoiding the need for extensive rehabilitation procedures. However, differential diagnosis of dental abrasion, attrition and erosion remains a con- troversial issue among clinicians and researchers. Therefore, there is a need to establish clear criteria to make it possible to distinguish between the different characteristics of each type of tooth wear lesion. Once dental erosion is diagnosed, preventive and res- torative procedures are needed and a variety of researches have been published on this subject. Thus, the present paper aims to review concepts of dental erosion diagnosis and treatment, based on the scientific evidence found in literature.

Prevalência de erosão dental em crianças e adolescentes de São Paulo / Prevalence of dental erosion in children and adolescents in São Paulo

Erosão dental é um processo de perda de esmalte e dentina, cujo aumento de prevalência nos últimos anos tem sido alarmante. Este trabalho objetiva determinar a prevalência de erosão dental numa amostra de crianças e adolescentes em São Paulo. Todos os elementos dentários de cinqüenta indivíduos foram analisados, sob campo seco e com boa iluminação, e a ocorrência de lesão erosiva por dente foi determinada. No caso de presença da lesão, esta foi classificada quanto à área e à profundidade que acometia em cada face dental. A prevalência encontrada neste estudo foi de 58 por cento. Houve maior prevalência na dentição decídua, especificamente em molares. A prevalência de erosão dental foi alta e os resultados obtidos condizem com resultados encontrados em estudos prévios.