Dental treatment of a child with oral cleft: a case report

Introduction:The cleft lip and palate are the most common facial congenital malformations, developing in the early embryonic stages between the fourth and eighth week of intrauterine life. Objective: To present the dental treatment of a child with cleft lip and palate under general anesthesia. Case report: Patient, aged four years, with cleft lip and palate, living in an indigenous village in the city of Vilhena, Rondônia, Brazil, with poor hygienic conditions and with dental caries, needed dental treatment under general anesthesia. The clinical examination revealed that the child had impaired general health by the presence of several wounds in the feet and nails, low weight, and many carious lesions. Discussion: In addition to parents' instructions and monitoring of multidisciplinary team, it is important to know the life of the patients with oral cleft, to target the most appropriate treatment to be successful in their rehabilitation process. Conclusion:Children with cleft lip and palate can have their quality of life improved through adequate care.

Evaluation of oral hygiene index, monitoring and oral hygiene instruction in visually impaired people

Introduction: Eyesight can be considered a major human interaction promoter in motor, perceptual and mental activities and its loss can cause social environment changes. Objective: To evaluate and determine Simplified Oral Hygiene Index (OHI-S) in visually impaired individuals, as well as to provide information to promote oral health, to verify the effectiveness of educational activities for index change and to promote the social inclusion of visually impaired people. Material and methods: Study population was constituted by 28 visually impaired people of both genders, aged from 14 to 75 years old, residents and students at the Parana Institute for the Blind (IPC), Curitiba (PR, Brazil). The study was conducted in three stages. At first, the participants individually answered a questionnaire, performed tooth brushing and then the disclosure of oral biofilm was made, as well as the evaluation of Simplified Oral Hygiene Index, oral hygiene instruction and supervised toothbrushing. The second step was performed after seven days and the third after thirty days to reassess the Simplified Oral Hygiene Index to check whether there would a change in their values. Participants were divided into two groups according to Simplified Oral Hygiene Index: those who had only bacterial plaque and those who had plaque and calculus. Results: At the first day, patients with plaque and calculus had initial OHI-S mean of 2.3 (regular), 2.1 (regular) after seven days, and 2.4 (regular) after one month. Patients with only plaque at the first day had an average OHI-S of 0.71 (regular), 0.74 (regular) after seven days, and 0.78 (regular) after one month. Conclusion: Within this context, it is possible to understand that it is necessary to implement frequent supervised toothbrushing, oral instruction and motivation activities to promote wellness and health for these patients.

Oral rehabilitation of patient with severe early childhood caries: a case report

Introduction: Severe early childhood caries (S-ECC) is very common in pre-school children and shows a pattern of development which is defined and symmetrical, beginning on the cervical third of labial surface of maxillary anterior teeth. Accordingly, it can damage speech, swallowing, feeding, development, esthetics and self-esteem of the child. Objective: To report a case of a 5-year-old female patient with S-ECC on teeth #51, #52, #61 and #62. Case report: The patient came to dental clinic of the university with her mother for dental care. During the interview, the mother reported that her daughter used to drink milk in baby bottle at day and night with sugar content. Moreover, oral hygiene was not performed after bottle feeding at night. On clinical examination, the teeth #51, #52, #61 and #62 presented coronal destruction, and the mucosa associated at these teeth was very inflamed. Radiographically, it was found that carious lesions were limited to inner dentin. The treatment plan included education on oral hygiene and diet guidance. Rehabilitation with acetate matrixes was the treatment chosen for teeth destroyed by caries. Conclusion: This study demonstrated that the use of acetate matrixes is an effective alternative to return aesthetics and functionality to teeth of patients with severe early childhood caries.

Participação dos pais na tomada de decisões no atendimento odontológico de seus filhos / Parent?s role On the decision taking Of their children?s dental treatment

Introdução: Segundo o Código de Ética Odontológica, é considerada infração o atendimento de pacientesinfantis sem o consentimento dos pais ou responsáveis, salvo em situações de urgência. No tratamentoodontopediátrico, é indispensável o esclarecimento dos pais em relação aos procedimentos a que seus filhos serão submetidos, as opções de tratamento existentes e seus custos, para que eles possam emitir um consentimentorealmente esclarecido. O objetivo deste estudo é analisar se e de que forma os pais participam da tomada de decisões no atendimento odontológico de seus filhos. Para tanto, realizou-se uma pesquisa, utilizando-se um questionário, junto a 122 pais, cujos filhos tinham idades entre 0 e 6 anos e encontravamsematriculados em uma escola pública no município de Florianópolis. Verificou-se que 70,2% dos paisautorizaram o tratamento de seus filhos de forma verbal, apenas 5,3% deles assinaram um Termo de Consentimento Livre e Esclarecido e 61,6% não receberam opções de tratamento. Concluiu-se que a postura paternalista do profissional, tem imperado também nos consultórios odontopediátricos, onde as decisões deveriam ser compartilhadas com os responsáveis legais pela criança

Introduction: According to the Brazilian Dental Ethical Code it is considered an infration to treat childrenwithout parents or guardians consent except in emergencial needs. On pediatric dental treatment it ismandatory that parents should be informed about the procedures that their children will receive as wellas treatment options and their costs to allow them to emit a clarified consent. The aim of this study is toanalyse if and how parents participate on decisions about their children?s dental treatment. It was used aquestionnaire to 122 parents or guardians, of children between 0 and 6 years of age, attending a publicschool in Florianópolis. 70,2% of parents did authorize orally dental treatment of their children, only 5,3%signed a written consent and 61,6% did not receive treatment options. It was concluded that paternalistposture is still present nowadays in dental pediatric office, where children?s treatment choices should beshared with parents

Mudanças do pH salivar em crianças após a ingestão de suco de frutas industrializado / Salivary pH changes in children after industrialized fruit juice consumption

Introdução: As crianças apresentam erosão dentária e cáries precoces na infância associadas a uma dieta rica em carboidratos, a qual incluia ingestão freqüente de sucos industrializados em caixa. A ingestão de bebidas com pH inferior a 5,5 pode causar erosão principalmente se o ataque for de longa duração e freqüente. A proteção natural dos dentes é a saliva, por intermédio de seu tamponamento salivar. Objetivo: Medir o pH salivar em crianças antes e após a ingestão de suco de uva (DelValle Kids). Material e métodos: Participaram do trabalho 31 crianças com idade entre 6 e 12 anos, de ambos os sexos. A variação do pH foi medida com uma fita colorimétrica. Aferiu-se o pH antes, imediatamente após a ingestão do suco, 5, 10 e 15 minutos após a ingestão. Resultados:Houve diferença estatisticamente significante entre os grupos. Observou-se uma redução imediatamente 5 e 10 minutos após a ingestão do suco em relação ao basal. No tempo imediato o valor do pH de 16 crianças foi acima de 5,5, e 15 apresentaram pH igual ou abaixo de 5,5. No tempo de 5 minutos, 3 crianças mantiveram esse pH, e após10 minutos todas as crianças apresentaram pH acima de 5,5.Conclusão: Pode-se concluir que o suco de fruta apresenta pH baixo eque após 10 minutos da ingestão do suco o pH salivar de todos os participantes tinha valor acima de 5,5, elevando-se próximo aos valores normais com o tempo de 15 minutos.

Introduction: The children presented dental erosion and caries in early infancy that were associated to a rich diet in sugars, including the frequent ingestion of industrialized fruit juice (conditioned in boxes).The drink ingestion with pH lower than 5.5 can cause teeth erosionmainly if it is associated with frequent and prolonged teeth contact.The natural protection of teeth is the saliva through its buffering capacity. Objective: Measure the children salivary pH before and after the grape fruit juice (Del Valle Kids) ingestion. Material and methods: Thirty one children with age between 6 and 12 years of both sexes participated in the study. The pH was measured with pH paper indicator. The salivary pH was measured before, immediately after, and at the 5, 10 and 15min following the ingestion of the juice. Results: There was a significant difference of the pH at different time measurement. A reduction was observed immediately, 5 and 10 minutes after juice ingestion in relation to the basal one. Immediately after fruit ingestion the pH measurementof 16 children was above 5.5 while 15 children presented a pH equalor below of 5.5. At 5 minutes, 3 children still had a pH equal or below5.5. At 10 minutes, all the children had pH above 5.5. Conclusion: It was concluded that, in children, immediately after the ingestion of fruitjuice, there is a clinically significant pH decrease, which can reduce the salivary buffer capacity, but after 10 minutes this ingestion salivarypH reached values above 5.5, raising to next to the normal values atthe time of 15 minutes.

Tooth ankylosis in deciduous teeth of children with cleft lip and/or palate

Este estudo avaliou a prevalência de anquilose dentária em molares decíduos de portadores de fissura de lábio e/ou palato, brancos, de ambos os sexos, com idade entre 5 e 12 anos. Um total de 330 pacientes atendidos no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo para tratamento de rotina foi clinicamente avaliado. A prevalência de anquilose foi analisada em relação a gênero, idade (5-7; 8-10; 11-12 anos), tipo de fissura, dente e arco afetados. O grupo total demonstrou prevalência de 18%, sem diferença estatística entre gêneros e tipos de fissura, sendo mais acometido o arco mandibular, o primeiro molar inferior e as faixas etárias de 8 a 10 e de 11 a 12 anos. Os resultados estão de acordo com aqueles observados na literatura para pacientes sem fissuras, destacando a ausência da influência das fissuras na prevalência de anquilose. Isso reforça a importância do diagnóstico precoce dessa anomalia e do tratamento de escolha, que são similares aos de pacientes sem fissuras.