Factors associated with dental cavity in children aged six to 36 months old, in Salvador-BA / Fatores associados à cárie dentária em crianças de seis a 36 meses, em Salvador-BA

Abstract Objectives: to analyze the factors associatedwith dental cavity in early childhood. Methods: this is a cross-sectional study on oral health condition of 535 children aged between six and 36 months old, at Family Health Units, in Salvador-BA. Information was collected on socioeconomic conditions, mother and child's health, eating and oral hygiene habits, and oral examination. Results: the prevalence of dental cavity was 13.64% (CI95%=11.44 -15.84) and the factors associated were: child's age, number of rooms in the house, "Bolsa Família" (Family Welfare) benefit, prenatal consultations, birth weight and exclusive breastfeeding. Conclusions: socioeconomic conditions strongly influenced oral health, as well as prenatal care and breastfeeding. To prevent childhood cavities, it is pertinent to invest in intersectoral actions and systematized programs, including the medical and nursing staff, as these actions are essential for integral care for the child's health and quality of life

Resumo Objetivos: analisar os fatores associados à cárie dentária na primeira infância. Métodos: trata-se de um estudo transversal das condições de saúde oral de 535 crianças entre seis e 36 meses, em Unidades de Saúde da Família, em Salvador-BA. Foram coletadas informações sobre as condições socioeconômicas, saúde da mãe e da criança, hábitos alimentares e de higiene oral e exame oral. Resultados: a prevalência de cárie dentária foi de 13,64% (IC95%=11,44-15,84) e os fatores associados foram: idade da criança, número de cômodos da casa, benefício "Bolsa Família", consultas de pré-natal, peso ao nascer e aleitamento materno exclusivo. Conclusões: as condições socioeconômicas influenciam fortemente na saúde oral, bem como o pré-natal e o aleitamento materno. Para prevenir cárie na infância, é pertinente investir em ações intersetoriais e programas sistematizados, incluindo a equipe médica e de enfermagem, pois estas ações são imprescindíveis para o cuidado integral à saúde da criança e qualidade de vida

Dynamic circadian fluctuations of glycemia in patients with type 2 diabetes mellitus

BACKGROUND: Diabetes mellitus (DM) has glucose variability that is of such relevance that the appearance of vascular complications in patients with DM has been attributed to hyperglycemic and dysglycemic events. It is known that T1D patients mainly have glycemic variability with a specific oscillatory pattern with specific circadian characteristics for each patient. However, it has not yet been determined whether an oscillation pattern represents the variability of glycemic in T2D. This is why our objective is to determine the characteristics of glycemic oscillations in T2D and generate a robust predictive model. RESULTS: Showed that glycosylated hemoglobin, glycemia, and body mass index were all higher in patients with T2D than in controls (all p < 0.05). In addition, time in hyperglycemia and euglycemia was markedly higher and lower in the T2D group (p < 0.05), without significant differences for time in hypoglycemia. Standard deviation, coefficient of variation, and total power of glycemia were significantly higher in the T2D group than Control group (all p < 0.05). The oscillatory patterns were significantly different between groups (p = 0.032): the control group was mainly distributed at 2-3 and 6 days, whereas the T2D group showed a more homogeneous distribution across 2-3-to-6 days. CONCLUSIONS: The predictive model of glycemia showed that it is possible to accurately predict hyper- and hypo-glycemia events. Thus, T2D patients exhibit specific oscillatory patterns of glycemic control, which are possible to predict. These findings may help to improve the treatment of DM by considering the individual oscillatory patterns of patients.

Psammolestes tertius Lent & Jurberg, 1965 (Hemiptera, Reduviidae, Triatominae): first report in Sergipe State, Brazil

Abstract INTRODUCTION: This study reports the first occurrence of Psammolestes tertius (Hemiptera, Reduviidae, Triatominae) in the state of Sergipe, Brazil. METHODS: In 2020, 95 specimens were collected from the municipality of Porto da Folha, Sergipe, Brazil. RESULTS: This finding expands the geographical distribution of the species from 15 states in Brazil to 16 and increases the biodiversity of triatomines in the state of Sergipe. CONCLUSIONS: The presence of P. tertius in the state of Sergipe demonstrated a wider distribution of this species in northeastern Brazil.

Effects of enriched-potassium diet on cardiorespiratory outcomes in experimental non-ischemic chronic heart failure

BACKGROUND: Chronic heart failure (CHF) is a global health problem. Increased sympathetic outflow, cardiac arrhythmogenesis and irregular breathing patterns have all been associated with poor outcomes in CHF. Several studies showed that activation of the renin-angiotensin system (RAS) play a key role in CHF pathophysiology. Interestingly, potassium (K+) supplemented diets showed promising results in normalizing RAS axis and autonomic dysfunction in vascular diseases, lowering cardiovascular risk. Whether subtle increases in dietary K+ consumption may exert similar effects in CHF has not been previously tested. Accordingly, we aimed to evaluate the effects of dietary K+ supplementation on cardiorespiratory alterations in rats with CHF. METHODS: Adult male Sprague-Dawley rats underwent volume overload to induce non-ischemic CHF. Animals were randomly allocated to normal chow diet (CHF group) or supplemented K+ diet (CHF+K+ group) for 6 weeks. Cardiac arrhythmogenesis, sympathetic outflow, baroreflex sensitivity, breathing disorders, chemoreflex function, respiratory- cardiovascular coupling and cardiac function were evaluated. RESULTS: Compared to normal chow diet, K+ supplemented diet in CHF significantly reduced arrhythmia incidence (67.8 ± 15.1 vs. 31.0 ± 3.7 events/hour, CHF vs. CHF+K+), decreased cardiac sympathetic tone (ΔHR to propranolol: - 97.4 ± 9.4 vs. - 60.8 ± 8.3 bpm, CHF vs. CHF+K+), restored baroreflex function and attenuated irregular breathing patterns. Additionally, supplementation of the diet with K+ restores normal central respiratory chemoreflex drive and abrogates pathological cardio-respiratory coupling in CHF rats being the outcome an improved cardiac function. CONCLUSION: Our findings support that dietary K+ supplementation in non-ischemic CHF alleviate cardiorespiratory dysfunction.

Heart rate and cardiac autonomic responses to concomitant deep breathing, hand grip exercise, and circulatory occlusion in healthy young adult men and women

BACKGROUND: Deep breathing (DB) and handgrip (HG) exercise -with and without circulatory occlusion (OC) in muscle-, have been shown to have beneficial effects on cardiovascular function; however, the combination of these maneuvers on heart rate (HR) and cardiac sympathovagal balance have not been previously investigated. Therefore, the aim of the present study was to evaluate the effect of simultaneous DB, HG, and OC maneuvers on the sympathovagal balance in healthy women and men subjects. METHODS AND RESULTS: Electrocardiogram and ventilation were measured in 20 healthy subjects (Women: n = 10; age = 27 ± 4 years; weight = 67.1 ± 8.4 kg; and height = 1.6 ± 0.1 m. Men: n = 10; age = 27 ± 3 years; weight = 77.5 ± 10.1 kg; and height = 1.7 ± 0.1 m) at baseline and during DB, DB + HG, or DB + HG + OC protocols. Heart rate (HR) and respiratory rate were continuously recorded, and spectral analysis of heart rate variability (HRV) were calculated to indirectly estimate cardiac autonomic function. Men and women showed similar HR responses to DB, DB + HG and DB + HG + OC. Men exhibited a significant HR decrease following DB + HG + OC protocol which was accompanied by an improvement in cardiac autonomic control evidenced by spectral changes in HRV towards parasympathetic predominance (HRV High frequency: 83.95 ± 1.45 vs. 81.87 ± 1.50 n.u., DB + HG + OC vs. base-line; p < 0.05). In women, there was a marked decrease in HR after completion of both DB + HG and DB + HG + OC tests which was accompanied by a significant increase in cardiac vagal tone (HRV High frequency: 85.29 ± 1.19 vs. 77.93 ± 0.92 n.u., DB + HG vs. baseline; p < 0.05). No adverse effects or discomfort were reported by men or women during experimental procedures. Independent of sex, combination of DB, HG, and OC was tolerable and resulted in decreases in resting HR and elevations in cardiac parasympathetic tone. CONCLUSIONS: These data indicate that combined DB, HG and OC are effective in altering cardiac sympathovagal balance and reducing resting HR in healthy men and women.

La enfermedad renal crónica en los niños y su calidad de vida; un reto para los trabajadores de salud / Chronic kidney disease in children and their quality of life; a challenge for health workers

OBJETIVO: identificar la calidad de vida de los niños de 8 a 18 años, con diagnóstico de enfermedad renal crónica, en una institución de salud de la ciudad de Bogotá. MATERIALES y MÉTODO: se llevó a cabo un estudio descriptivo de corte transversal con una población de estudio de 62 niños con diagnóstico de enfermedad renal crónica que asistieron a la consulta de nefrología pediátrica utilizando el instrumento KIDSCREEN 27. RESULTADOS: se analizaron cinco dimensiones, donde cada una tuvo un puntaje ponderado mayor a 70, que se relaciona con una buena calidad de vida; la dimensión con menor puntaje, la de actividad física, tuvo un puntaje de 70,1, seguida por la de apoyo social y amigos. CONCLUSIONES: En el grupo de estudio se encontró alterada la calidad de en la dimensión de actividad física y apoyo social y amigos; se debe tener en cuenta que, el que los niños no se sientan enfermos puede generar también riesgo para su adherencia al tratamiento. Se necesita diseñar programas que permitan realizar seguimiento y apoyo a los niños, niñas y adolescentes, pero estos deben ser novedosos y atractivos. Es indispensable que el personal de salud se prepare para poder respuesta a las demandas de los niños con enfermedades crónicas con el fin de contribuir a que ellos y sus familias tengan una buena calidad de vida.

OBJECTIVE: to identify the quality of life of children from 8 to 18 years old, diagnosed with chronic kidney disease, in a health institution in the city of Bogotá. MATERIALS AND METHOD: a descriptive cross-sectional study was conducted with a study population of 62 children diagnosed with chronic kidney disease who attended the pediatric nephrology clinic using the KIDSCREEN 27 instrument. RESULTS: five dimensions were analyzed, where each had a weighted score greater than 70, which is related to a good quality of life; the dimension with the lowest score, that of physical activity, had a score of 70.1, followed by that of social support and friends. CONCLUSIONS: chronic kidney disease can alter the quality of life, however in the study group the quality of life was not altered but its score in physical activity and social support and friends evidences the need to improve these aspects; it should be borne in mind that the fact that children do not feel sick can also generate risk for their adherence to treatment. Programs need to be designed to monitor and support children and adolescents, but these must be novel and attractive. It is essential that health personnel prepare to be able to respond to the demands of children with chronic diseases in order to contribute to ensuring that they and their families have a good quality of life

Dental Neglect, one type of child abuse - Narrative review / Negligência dentária, uma modalidade de abuso infantil - revisão narrativa

Dental neglect is defined as an intentional failure of the caretaker in the pursuit and continuity of necessary treatment to achieve an oral health that allows adequate function, free from pain and infection. We intend to clarify, according to the current scientific literature, the clinical indications for the identification of dental neglect in children. After the search in databases and search engines with the keywords "child", "dental" and "neglect", between 1996 and 2016, the results revealed that identifying this condition requires not only a detailed clinical history and clinical data that clearly show the lack of oral health care but also investigating the social and parental determinants in which the child is involved. Thus, inserting the dentist in teams of analysis in case of suspicion proves to be indispensable for the detection of this and other situations of abuse.

A negligência dentária é definida como a falta intencional do responsável pela criança na procura e manutenção do tratamento necessário para garantir um nível de saúde oral essencial para a função adequada, livre de dor e infeção. Neste sentido, pretendemos esclarecer, de acordo com a literatura científica atual, os indícios clínicos para a identificação de negligência dentária em crianças. Após pesquisa em bases de dados e motores de busca, com as palavras-chave "child", "dental", "neglect", entre 1996 e 2016, os resultados revelaram que a identificação desta condição requer, não só a obtenção de uma história clínica detalhada e de dados clínicos que evidenciem claramente a falta de cuidados na saúde oral como também a investigação dos determinantes sociais e parentais em que a criança se insere. Assim, inserir o médico dentista nas equipas de análise nos casos de suspeita revelou-se indispensável para o despiste desta e outras situações de abuso.

Conscious sedation vs general anesthesia in pediatric dentistry: a review / Sedação consciente vs anestesia geral em pediatria odontológica: uma revisão

INTRODUCTION: Performing dental treatments on pediatric patients who present behavioral problems is usually a great clinical challenge. Depending on the patients’ emotional maturity and their physical, psychological and mental skills, the usual behavior control techniques may not offer adequate efficacy and safety when dental procedures are being carried out. In these circumstances, alternative and more invasive methods such as conscious sedation and general anesthesia may become necessary. OBJECTIVE: To compare the indications and contraindications of conscious sedation and general anesthesia in pediatric dentistry. METHOD: Literature research undertaken through the MEDLINE/Pubmed, Science Direct and B-on search engines between April and June 2013 using a 5 year time frame and the following keywords: conscious sedation, general anesthesia, pediatric dentistry and guidelines. RESULTS: Conscious sedation is recommended to anxious patients who have dental and needle phobia, to patients that present an increased vomiting reflex and also to patients with special needs but capable of communicating. General anesthesia is indicated for non-cooperating patients under the age of four, in mouth breathers, in children ASA III or higher and in pediatric patients who do not communicate. CONCLUSIONS: Each technique must be selected according to the characteristics showed by patient. Although conscious sedation and general anesthesia introduce benefits to pediatric dentistry, they should not be regarded as priority intervention techniques for behavior control. The pediatric dentist’s previous knowledge of these techniques provides a better level of dental care quality as well as more safety and less discomfort for their patients.

RESUMO INTRODUÇÃO: A execução de tratamentos odontológicos em pacientes pediátricos que apresentam alterações comportamentais constitui frequentemente um grande desafio clínico para o odontopediatra. Dependendo da maturidade emocional dos pacientes e de suas habilidades físicas, psicológicas e mentais, as técnicas de controle de comportamento usuais podem não oferecer a eficácia e a segurança adequadas à realização dos procedimentos dentários. Nestas circunstâncias, podem ser necessários métodos alternativos e mais invasivos, como a sedação consciente e a anestesia geral. Neste trabalho comparam-se as indicações e contra-indicações de sedação consciente e anestesia geral em odontopediatria. MÉTODO: A revisão da literatura foi realizada através dos motores de pesquisa MEDLINE/PubMed, Science Direct e B-ON, entre abril e junho de 2013, com uma limitação temporal de cinco anos e as seguintes palavras-chave: sedação consciente, a anestesia geral, odontopediatria e diretrizes. RESULTADOS: A sedação consciente é recomendada para pacientes ansiosos, com "medo de dentista e de agulhas", para pacientes que apresentam um maior reflexo do vómito e também para pacientes com necessidades especiais, mas capazes de comunicação. Por outro lado, a anestesia geral é recomendada para pacientes com idade inferior a quatro anos que não colaboram, para respiradores orais, para crianças ASA III ou superior e para crianças que não se comunicam. CONCLUSÕES: Cada técnica deve ser escolhida de acordo com as características do paciente. Apesar da anestesia geral e da sedação consciente introduzirem benefícios no atendimento dentário do paciente infantil, estas não devem ser consideradas como técnicas de intervenção prioritária no controle comportamental. O conhecimento prévio das indicações e contraindicações destas técnicas permitem ao odontopediatra proporcionar um maior nível de qualidade no atendimento dentário, assegurando a maior segurança e o menor desconforto para os seus pacientes jovens.

Comparative Study of the Prevalence of Occlusal Anomalies in Down Syndrome Children and Their Siblings.

Aims: The aim of this study was to characterize occlusal anomalies in a Portuguese population with Down Syndrome (DS) and to compare its distribution with that of their siblings. Study Design: A sibling-matched, population-based and cross-sectional survey was performed. Methodology: This study involved 132 children with DS and 84 of their siblings, aged 2 to 26 years. Data were gathered through the use of a complete questionnaire and clinical observation. Data analysis was performed by using SPSS® v.20.0 and any p-value <.05 was considered significant. Results: Seventy six percent of the DS children and 72% of their siblings showed class I of Angle. There were no statistically significant differences between both groups regarding class I (P=.60). Only 4% of the DS children presented class II versus 22% of the siblings (P=.001). Twenty percent of the DS children and 6% of the siblings presented class III (P=.008). The DS group presented occlusal anomalies more frequently, especially posterior crossbite (P<.001), anterior open bite (P=.005) and anterior crossbite (P=.001). Deep overbite was only found in the siblings group (P=.001). Conclusions: The results of this study suggest that children with Down syndrome have more occlusal anomalies than general population.

Análise bibliométrica da pesquisa na América do Sul em ciências do esporte 1970-2012 / Análisis bibliométrico de la investigación en América del Sur en las ciencias del deporte 1970-2012 / Bibliometric analysis of South American research in sports science from 1970 to 2012

Sports science article publication in South American countries (n=11) was studied between 1970-2012, using all citation database of ISI Web of Knowledge. We evaluated: number of published articles; the number of publications divided by the number of people in science and technology (number pub/number peo); the top incidence of research subjects; public or private institutional predominance; impact factor (IF); average citations per document per country; and frequency of published articles per journals per country. Brazil showed the highest number of published articles, followed by Argentina. Bolivia showed the highest number pub/number peo, followed by Peru. Most studied themes were physiology, orthopedic and rehabilitation. Public institutions showed a higher published articles number than did private institutions. Peru and Bolivia were the only countries with a mean IF of 2 or higher. Average citation was higher in Peru (higher coefficient variation). In conclusions, our results show that, in most South American countries, their published articles rate has increased over time. This could be related to new government and institutional policies. However, production was low compared with other areas of science.

Produção de artigos científicos do esporte em países da América do Sul (n = 11) foi estudada entre 1970-2012 utilizando: todos os dados de citações do ISI Web of Knowledge. Foram avaliados: número de artigos publicados; número de artigos publicados/número de pessoas em ciência e tecnologia (no.pub/no.pes); assuntos mais estudados; predominância de instituições publicas ou privadas; fator de impacto (FI); citações média por documento por país no ISIweb; frequência de artigos publicados por periódicos por país. Brasil teve o maior número de artigos publicados, seguido pela Argentina. Bolívia mostra o mais elevado no.pub/no.pes, seguido pela Peru. Os temas mais estudados foram: ortopedia, fisiologia e reabilitação. As instituições públicas que apresentam maior número de artigos publicados. Peru e Bolívia foram os únicos países com uma média IF de 2 ou superior. Citação média foi maior no Peru (maior coeficiente de variação). Nas conclusões, nossos resultados mostram que, na maioria dos países, a sua taxa de artigos publicados aumenta ao longo do tempo. Isso pode estar relacionado com o novo governo e políticas institucionais. No entanto, a produção foi baixa em comparação com outras áreas.

Se estudió la producción de artículos en ciencias del deporte en países de América del Sur (n=11) entre 1970-2012, usando: todas las bases de datos de citaciones de ISI Web Knowledge. Se evaluó: número de publicaciones de artículos; número de publicaciones de artículos / número de personas en ciencia y tecnología (no.pub/no.peo); temas más estudiados; predominancia de instituciones públicas y privadas; factor de impacto (IF); promedio de citas por documento por país; frecuencia de publicaciones de artículos por revista por país. Brasil tuvo más publicaciones de artículos, seguido de Argentina. Bolivia muestra el mayor no.pub/no.peo, seguido por Perú. Los temas más estudiados fueron fisiología, ortopedia y rehabilitación. Las instituciones públicas muestran un mayor número de publicaciones de artículos. Perú y Bolivia son los únicos países con una media de IF de 2 o mayor. El promedio de citaciones fue elevado en Perú (elevado coeficiente de variación). En conclusión, nuestros resultados muestran que en la mayoría de los países el rango de publicaciones de artículos se incrementó con el tiempo. Esto puede ser relacionado con nuevas políticas gubernamentales e institucionales. Sin embargo, la producción es baja comparado con otras áreas.

Efectos de una sesión de ejercicio aeróbico en la presión arterial de niños, adolescentes y adultos sanos / Effects of a single bout of aerobic exercise on body weight and blood pressure among healthy participants

Background: Physical inactivity is a major risk factor and aerobic exercise is protective for cardiovascular health. Aim: To determine the effects of aerobic exercise on systolic and diastolic blood pressure in children, adolescents and adults. Material and Methods: We studied 13 children aged 10 ± 1.9 years, 13 adolescents aged 14.3 ± 1.5 and 55 adults aged 41 ± 11.5 years. Participants completed 60 minutes of aerobic exercise in one session. Body weight, systolic and diastolic blood pressure, and resting heart rate were measured before and after the exercise period. Results: Adult men and women experienced a significant decrease in body weight after exercise (-8 and -6%, respectively). No significant changes in weight were observed in children and adolescents. After exercise systolic and diastolic blood pressure decreased significantly in children (-8.3 and -5.4% respectively), adolescents (-7.6 and -8.4% respectively) and adults (-7 and -5.1% respectively). Conclusions: A 60 minute period of aerobic exercise is associated with a reduction in blood pressure in children, adolescents and adults.

Prevalence and distribution of tooth agenesis in a pediatric population:a radiographic study / Prevalência e distribuição de agenesias dentárias em pacientes pediátricos: um estudo radiográfico

Objective: The purpose of this study was to assess the prevalence of hypodontia and its distribution by sex, arch and quadrant, through the analysis of panoramic radiographs from the pediatric population of the Faculty of Dentistry of the University of Oporto, in Portugal. Methods: Panoramic radiographs of 1,438 patients of the Faculty of Dentistry of the University of Oporto (714 boys and 724 girls between the ages of 6 and 15) were evaluated to determine the occurrence and distribution of tooth agenesis. Chi-square and Fisher?s Exact Tests were performed. The level of significance was set at 5%. Results: The prevalence of hypodontia was 8% (excluding the third molar). Hypodontia was found in the mandible of 74 patients (64.3%). The most commonly missing teeth were the mandibular second premolars (28.6%). The maxilla had 52.3% of the dental agenesis detected. Similarity in the distribution of missing teeth between left and right sides of the dental arches was also detected. The prevalence of oligodontia was 0.42% and the average number of missing teeth per affected child was 2.31. There were no statistically significant differences between sexes. Conclusion: In a pediatric population of 1,438 patients, the prevalence of hypodontia was 8% (excluding the third molar). The results are consistent with those previously described in different populations.

Objetivo: Realizar um estudo epidemiológico sobre as agenesias dentárias, através da análise radiográfica de uma população pediátrica da Faculdade de Medicina Dentária da Universidade do Porto, definindo a sua prevalência e conhecendo a sua distribuição por sexo, arcada e quadrante. Métodos: As radiografias panorâmicas de 1.438 pacientes da Faculdade de Medicina Dentária da Universidade do Porto (714 do sexo masculino e 724 do sexo feminino, de idades compreendidas entre os 6 e os 15 anos) foram analisadas para determinar a ocorrência e distribuição de agenesias dentárias. A análise estatística foi realizada através da aplicação do Teste do Qui-quadrado de independência e do Teste Exato de Fisher, utilizando o nível de significância de 5%. Resultados: A prevalência de hipodontia foi de 8,0% (excluindo o 3º molar). Foram identificados 74 pacientes (64,3%) com agenesias na mandíbula. Ospré-molares inferiores foram os dentes com maior frequência de agenesia (28,6%). A maxila continha 52,3% das agenesias detetadas. Não foi detetada diferença estatisticamente significativa entre o lado esquerdo e direito das arcadas. A prevalência de oligodontia foi de 0,42% e obteve-se uma média de 2,31 dentes ausentes por paciente afetado. Não se encontraram diferenças estatisticamente significativas na variávelsexo. Conclusão: Numa população de 1438 pacientes pediátricos, 8,0% apresentaram agenesias dentárias (excluindo o 3º molar). Os resultados obtidos enquadram-se nos anteriormente descritos em diferentes populações.

Caries in Portuguese children with Down syndrome

OBJECTIVES: Oral health in Down syndrome children has some peculiar aspects that must be considered in the follow-up of these patients. This study focuses on characterizing the environmental and host factors associated with dental caries in Portuguese children with and without Down syndrome. METHODS: A sibling-matched, population-based, cross-sectional survey was performed. RESULTS: Down syndrome children presented a significantly greater percentage of children without caries, 78 percent vs. 58 percent of non-Down syndrome siblings. This difference in the DMFT index (number of decayed, missing and filled teeth) essentially reflects data obtained from treated teeth, for which 91 percent of children with Down syndrome had never had a tooth treated vs. 67 percent of siblings. This result was statistically significant, whereas results for decayed and lost teeth did not differ between Down syndrome children and their unaffected siblings. Additionally, in Down syndrome children, a delayed eruption of the second molar occurs. Down syndrome children and their siblings have similar oral hygiene habits, but a higher percentage of Down syndrome children visit a dentist before the age of three years, in comparison to their siblings. Bruxism was also more common in Down syndrome children compared to their siblings. CONCLUSIONS: Our results show that Portuguese children with Down syndrome have lower caries rates than children without Down syndrome. This reduced prevalence may be associated with the parents' greater concern about oral health care in Down syndrome children, resulting in their taking them sooner to visit a dentist, as well as to a higher bruxism prevalence and delayed tooth eruption.