Risk indicators associated to the prevalence of dental erosion in preschool children in Diadema, São Paulo

O presente estudo teve como objetivos avaliar a prevalência, a distribuição e o grau de acometimento das lesões de erosão dentária em crianças de 36 a 59 meses de idade no município de Diadema, São Paulo. Em posse desses dados, também se objetivou investigar os indicadores de risco socioeconômicos, ambientais, nutricionais, comportamentais e de características da criança associados à prevalência de erosão dentária. Cirurgiões dentistas treinados e calibrados (Kappa interexaminadores = 0,77 para erosão e 0,83 para cárie) examinaram 967 crianças em Unidades Básicas de Saúde (UBS) do município de Diadema durante a primeira etapa da Campanha Nacional de Multivacinação Infantil em Junho de 2008. Para avaliar a erosão dentária, utilizou-se o índice de O\'Brien (1994) modificado, para as lesões de cárie dentária o índice de Knutson (1944) e para o estado nutricional o padrão de referência da OMS (WHO Child Growth Standards, 2006). A ocorrência de fatores associados foi investigada por meio de um questionário elaborado especificamente para esta pesquisa, com base na literatura. Análises de regressão logística univariada e múltipla com modelo hierárquico (p<0,05) foram realizadas. A prevalência de erosão dentária foi de 51,6%, sendo a maioria das lesões encontradas em esmalte (82,5%). As lesões erosivas foram mais prevalentes em incisivos superiores do que em molares inferiores e houve uma tendência de bilateralidade no padrão de acometimento. O modelo logístico hierárquico final revelou associação significativa entre a prevalência de erosão dentária e as variáveis comportamentais de consumo de refrigerantes duas vezes ao dia (OR = 0,78; IC 95%: 0,43-1,40; p= 0,043) e três ou mais vezes ao dia (OR=1,74; IC 95%; 1,02-2,99; p=0,023), consumo de sucos nos últimos dois dias prévios ao estudo (OR=1,55; IC95%; 1,11-2,16; p=0,009) e a presença de refluxo gastroesofágico relatado (OR=2,06; IC95%; 1,24-3,41; p=0,005). Dentre as variáveis relacionadas com as características da criança apenas o aumento da idade foi significativo (OR=1,48; IC95%; 1,15- 1,92; p=0,003). Não houve associação significativa entre a prevalência de erosão dentária e variáveis socioeconômicas, ambientais e o estado nutricional. Portanto, pode-se inferir que, nesta população, a prevalência de erosão dentária foi alta e estava associada à ingestão frequente de bebidas ácidas, à presença de refluxo gastroesofágico relatado e à idade da criança.The aim of the present study was to assess the prevalence, distribution and severity of erosive lesions in a sample of 36 to 59-month-old children in the city of Diadema, São Paulo. Moreover, the association between dental erosion prevalence and socioeconomic, environmental, nutritional, behavioral, and child characteristics variables was investigated. Trained and calibrated dentists (interexaminer Kappa = 0.77 for dental erosion and interexaminer Kappa = 0.83 for dental caries) examined 967 children in the Basic Health Units (BHU) of the city of Diadema during the first stage of the National Childrens Vaccination Day in 2008. Dental erosion, dental caries and nutritional status were assessed through the use of a modified version of the OBrien (1994) index, Knutson (1944) index, and the WHO Child Growth Standards (2006), respectively. Variables associated to the prevalence of dental erosion were investigated using a questionnaire that was specifically developed for the present research, based on the literature. Statistical analysis was conducted through univariate and multivariate regressions based on a hierarchical model (p<0.05). Dental erosion prevalence was of 51.6% and most of the erosive lesions observed were confined to the enamel (82,5%). Erosive lesions were more prevalent in the upper incisors than in lower molars and a symmetrical pattern of distribution was noted. The final hierarchical logistic model revealed a significant association between dental erosion prevalence and the consumption of soft drinks twice (OR = 0.78; CI 95%: 0.43-1.40; p= 0.043) or three or more (OR=1.74; CI 95%; 1.02-2.99; p=0.023) times a day, juice intake on the last two days before the study (OR=1.55; CI 95%; 1.11-2.16; p=0.009), the presence of frequent reported gastroesophageal reflux (OR=2.06; CI 95%; 1.24-3.41; p=0.005) and increasing age (OR=1.48; CI 95%; 1.15-1.92; p=0.003). No statistically significant associations were found between dental erosion prevalence and socioeconomic, environmental or nutritional variables. In conclusion, a high prevalence of dental erosion was found in this population of preschool children, which was associated with frequent consumption of acidic beverages, frequent episodes of reported gastroesophageal reflux, and an increase in age

Application of different fluoridated agents for the prevention of enamel erosion and abrasion in vitro

O objetivo deste estudo foi investigar o potencial inibidor de desgaste dentário ocasionado por erosão e abrasão de um novo produto, o verniz ClinPro XT Varnish, em comparação com vernizes fluoretados convencionais à base de TiF4 e NaF. Sessenta amostras de esmalte bovino (n=15/grupo) com microdureza superficial entre 300-380KHN foram selecionadas e aleatoriamente tratadas com: verniz de NaF (Duraphat®, 2,26% F-), verniz de TiF4 (2,45% F-), ClinPro XT varnish (fluoraluminiosilicato e glicerofosfato de cálcio) e controle (sem tratamento). Após receberem os respectivos tratamentos, as amostras foram submetidas a 3 dias de desafios erosivos de 4x5 min/dia (Sprite® Zero) e a abrasão 2x15s/dia, utilizando uma máquina de escovação. Entre os ciclos de erosão e abrasão, as amostras permaneceram em saliva artificial. A perda de esmalte foi medida com perfilômetro óptico. Os dados foram submetidos ao teste Kruskal-Wallis seguido pelo Dunn (p<0,05) .Ambos vernizes de NaF (-5,84m [-12,06; 1,64]b) (mediana ± 95%IC) e TiF4 (-3,60m [-8,72; -0,45]b) foram eficazes em reduzir o desgaste do esmalte quando comparados ao grupo controle (-16,60m [-19,92; -10,04]a). O ClinPro XT varnish permaneceu na superfície do esmalte (106,21m [30,67; 126,22]c), impedindo completamente o desgaste. Assim foi possível concluir que o ClinPro XT teve um efeito superior aos outros vernizes, impedindo completamente a erosão e abrasão do esmalte por 3 dias in vitro.The purpose of this study was to investigate the erosion and abrasion inhibiting effect of a newly released product, Vanish XT varnish, and compare it to conventional TiF4 and NaF varnishes. Sixty bovine enamel blocks (300-380 KHN) were selected and randomly allocated into 4 treatment groups (n=15/group): NaF varnish (Duraphat®, 2.26% F-), TiF4 varnish (2.45% F-), Vanish XT varnish (fluoroaluminosilicate and calcium glycerophosphate), and control (no treatment). The samples received their respective treatments one single time at the beginning of the experiment. During a total of 3 days, erosive challenges were done 4x5min/day (Sprite Zero®) and abrasion 2x15s/day using a brushing machine. In between the erosive and abrasive challenges and overnight the samples remained immersed in artificial saliva. Enamel loss was measured using a non-contact profilometer. The data were subjected to Kruskal-Wallis and Dunn tests (p<0.05). Both NaF (-5.84m [-12.06; 1.64]b) (median ± 95%CI) and TiF4 (-3.60m [-8.72; -0.45]b) varnishes were able to reduce enamel wear when compared to the control group (-16.60m [-19.92; -10.04]a). Vanish XT varnish remained on the enamel surface (106.21m [30.67; 126.22]c), completely preventing enamel wear. Therefore, we concluded that Vanish XT presented a superior effect when compared to conventional varnishes, completely preventing enamel erosion and abrasion for 3 days in vitro

Impacto de los principales problemas de salud bucal en la calidad de vida de preescolares

Los principales problemas de salud bucal que afectan a los niños menores de 5 años de edad son la Caries Dental (CD) Traumatismo   Dentario (TD) e recientemente el Desgaste Dentario Erosivo (DDEr). Objetivo: Evaluar el impacto de la prevalencia y severidad de CD, TD y DDEr en la Calidad de Vida Relacionada a la Salud Bucal (CVRSB) de preescolares y de sus padres/cuidadores, asociadas con variables sociodemográficas. Materiales y Métodos: Fueron seleccionados sistemáticamente 617 niños de 3 y 4 años de edad durante la Campaña Nacional de Vacunación Infantil del Municipio de Diadema, São Paulo-Brasil. Los padres y/o cuidadores respondieron el cuestionario de la versión brasileña de calidad de vida (B-ECOHIS) y datos sociodemográficos relacionados al niño(a). Fue firmado el Consentimiento informado previo al examen clínico. Cirujanos Dentistas entrenados y calibrados realizaron los exámenes clínicos para CD, TD y DDEr. Para el análisis estadístico fue realizada la Regresión de Poisson con un intervalo de confianza de 95%. Resultados: Los valores de Kappa (Inter e intra-examinador) para todas las condiciones clínicas estudiadas fueron > 0.8. La prevalencia de CD, TD y DDEr del total de la muestra fue de 33.1%, 26.9% y 52.4% respectivamente.  Fue observada una asociación del score total del B-ECOHIS con la edad del niño(a) (RP= 1.62 / p= 0.005), la presencia de CD (RP= 2.88 / p 6 (RP= 4.76 / p< 0.001). La presencia y la severidad de TD y DDEr no mostraron un impacto negativo en la CVRSB de los preescolares. Conclusiones: La edad del niño, la presencia y severidad de la CD están asociadas con la peor CVRSB de preescolares y de sus padres/cuidadores. TD y DDEr no mostró impacto en la CVRSB

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. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: e11-e18)Univ São Paulo, Fac Odontol, Dept Orthodont & Pediat Dent, BR-22270550 São Paulo, BrazilUniv São Paulo, Dept Pediat Dent, BR-22270550 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Morphol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Morphol, São Paulo, BrazilWeb of Scienc

Does erosive tooth wear affect the oral health-related quality of life of preschool children?

<div><p>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.</p></div