Methodological considerations concerning the development of oral dental erosion indexes: literature survey, validity and reliability

Within the context of preventing non-communicable diseases, the World Health Report (2002) and the WHO Global Oral Health Program (2003) put forward a new strategy of disease prevention and health promotion. Greater emphasis is placed on developing global policies in oral health promotion and oral disease prevention. The Decayed, Missing, Filled Teeth (DMFT) index does not meet new challenges in the field of oral health. Dental erosion seems to be a growing problem, and in some countries, an increase in erosion of teeth is associated with an increase in the consumption of beverages containing acids. Therefore, within a revision of the WHO Oral Health Surveys Basic Methods, new oral disease patterns, e.g. dental erosion, have to be taken into account. Within the last 20 years, many studies on dental erosion have been carried out and published. There has been a rapid growth in the number of indexes quantifying dental erosion process in different age groups. However, these indexes are not comparable. This article discusses quality criteria which an index intended for assessing tooth erosion should possess

Estudo de alterações na cavidade oral em pacientes com doença do refluxo gastroesofágico Study in oral cavity alterations in patients with gastroesophageal reflux disease

RACIONAL: A doença do refluxo gastroesofágico, afecção de elevada e crescente incidência, pode se manifestar através de sintomas típicos (pirose e regurgitação) e atípicos (pulmonares, otorrinolaringológicos e bucais). OBJETIVO:Analisar as alterações na cavidade oral de pacientes com a doença do refluxo gastroesofágico. MÉTODOS: Foram estudados 100 pacientes, sendo 50 acometidos por doença do refluxo gastroesofágico (grupo 1) e 50 controles (grupo 2). Todos os pacientes foram submetidos a exame clínico oral e questionário específico, e naqueles do grupo 1, foram realizadas endoscopia digestiva alta e manometria e pHmetria esofágicas. RESULTADOS: A endoscopia digestiva alta demonstrou esofagite em todos os pacientes, sendo erosiva em 20, não-erosiva em 30 e hérnia hiatal em 38. A pressão média no esfíncter inferior do esôfago foi de 11 ± 4,8 mm Hg e no superior de 75 ± 26,5 mm Hg. Em 42 pacientes do grupo 1 (84%) foi observado refluxo gastroesofágico patológico. O exame clínico oral mostrou: erosões dentárias no grupo 1: 273 faces e no grupo 2: 5; dentes cariados no grupo 1: 23 e 115 no grupo 2; abrasão no grupo 1: 58 e no grupo 2: 95; desgaste por atrito: 408 no grupo 1 e 224 no grupo 2. A face dental mais acometida foi a palatina. No grupo 1, 21 pacientes referiam queixas de aftas freqüentes, 35 sensibilidade dentária, 26 ardência bucal e 42 gosto azedo na boca. Naqueles do grupo 2 estas queixas foram observadas em menor número de pacientes. CONCLUSÕES: Os doentes com doença do refluxo gastroesofágico apresentam maior incidência de erosões dentárias, aftas, ardência bucal, sensibilidade dentária e gosto azedo que os controles e menor incidência de lesões cariosas em relação aos controles.<br>BACKGROUND: The gastroesophageal reflux disease, which has become highly and increasingly incident, may be manifested by typical (pyrosis and regurgitation) and atypical (pulmonary, otorhinolaryngological and buccal) symptoms. AIM: To analyze alterations in the oral cavity patients with gastroesophageal reflux disease. METHODS: One hundred patients were studied being 50 gastroesophageal reflux disease patients (group 1) and 50 controls (group 2). All patients were submitted to an oral clinical exam and specific survey. Patients in group 1 were submitted to upper endoscopy, manometry and esophageal pH monitoring. RESULTS: The upper endoscopy revealed esophagitis in all patients, 20 erosive esophagitis, 30 no-erosive esophagitis and 38 hiatal hernia. Average pressure of the lower esophageal sphincter was 11 ± 4,8 mm Hg and of the upper esophageal sphincter 75 ± 26,5 mm Hg. In 42 patients of group 1 (84%) pathological gastroesophageal reflux was observed. Clinical exams revealed: dental erosions in group 1: 273 faces and in group 2: 5 tooth decays in group 1: 23 and 115 in group 2; abrasion in group 1: 58 and in group 2: 95; attrition wear: 408 in group 1 and 224 in group 2. The most damages was the palatine face. In group 1, 21 patients complained about frequent episodes of cankers sores, 35 of tooth sensibility, 26 of burning mouth and 42 of sour taste in the mouth. In group 2 the complaints were observed in lower number of patients. CONCLUSIONS: Patients with gastroesophageal reflux disease present higher incidence of dental erosion, cankers sores, mouth burning sensation, sensitivity and sour taste than controls. Patients with gastroesophageal reflux disease show lower incidence of tooth decays as compared to controls

A cross-species approach to disorders affecting brain and behaviour.

Structural and functional elements of biological systems are highly conserved across vertebrates. Many neurological and psychiatric conditions affect both humans and animals. A cross-species approach to the study of brain and behaviour can advance our understanding of human disorders via the identification of unrecognized natural models of spontaneous disorders, thus revealing novel factors that increase vulnerability or resilience, and via the assessment of potential therapies. Moreover, diagnostic and therapeutic advances in human neurology and psychiatry can often be adapted for veterinary patients. However, clinical and research collaborations between physicians and veterinarians remain limited, leaving this wealth of comparative information largely untapped. Here, we review pain, cognitive decline syndromes, epilepsy, anxiety and compulsions, autoimmune and infectious encephalitides and mismatch disorders across a range of animal species, looking for novel insights with translational potential. This comparative perspective can help generate novel hypotheses, expand and improve clinical trials and identify natural animal models of disease resistance and vulnerability