Visual Inspection and Toothbrush Care: A Mother-Baby Paired Cross-Sectional Study

ABSTRACT Objective To evaluate the physical conditions and presence of residues of toothbrushes used by mothers and their babies and mothers' knowledge about toothbrush care. Material and Methods This was a cross-sectional study comprising a convenience sample represented by 60 mother-baby pairs. The mothers answered a questionnaire to evaluate their knowledge of toothbrush care. A calibrated dentist performed a visual inspection of the toothbrushes. Statistical analysis was performed using the chi-square and Fisher's exact tests, with a significance level of 5%. Results It was found that 82% of the mothers had never received instructions regarding the care of toothbrushes after use (p=0.024). Most of them believed that their toothbrushes (70%) and their children's toothbrushes (88%) were in good condition to use (p=0.043). However, most mother's toothbrushes presented an unacceptable deformity of the bristles (65%) and the presence of residues (60%). In addition, babies' toothbrushes also presented unacceptable deformities of the bristles (52%) and residues (55%). There was an association between the lack of instructions received by the mother and the presence of deformity and residues on the mother's toothbrush bristles (p=0.037 and p=0.003, respectively). Conclusion Most mothers had never received instructions regarding toothbrush care, which is reflected in the condition of their and their baby's toothbrushes, which presented unacceptable physical conditions concerning deformation and presence of residues.

Perfil epidemiológico e social de crianças e adolescentes com Anemia Falciforme e sua relação com a cárie dentária / Epidemiological and social profile of children and adolescents with sickle cell anemia and association with dental caries

Introdução: a Anemia Falciforme (AF) é a patologia hereditária monogênica mais prevalente associada à presença de hemoglobina SS no mundo. Pode provocar alterações no corpo, face e dentes dos indivíduos afetados, que podem levar a uma maior predisposição ao desenvolvimento da cárie dentária. Objetivo: avaliar o perfil epidemiológico e social de crianças e adolescentes com AF, a prevalência de cárie e influência da dieta. Metodologia: estudo de corte transversal com 124 indivíduos de 5 a 18 anos provenientes do ambulatório de referência em AF para o grupo AF (n=61) e sem hemoglobinopatias matriculados em colégio público da Bahia (n=63) para o grupo comparação. Anamnese, exame dos dentes e aplicação de questionários sobre a condição de saúde, história da doença e dieta foram realizados. Resultados: a maioria era da raça parda, cursava o 1º grau, a renda era de um salário mínimo, mas em relação à procedência, a maioria das crianças com AF era do interior. Estas também frequentavam mais as consultas odontológicas, apesar de o CPO-D ter sido maior (CPO-D=2,1) que o grupo comparação (CPO-D=1,1), bem como o ceo-d de 2,3 e 0,88, respectivamente. Crianças e adolescentes com AF consumiam menos carboidratos e tiveram um índice de cárie mais alto (ceo-d=2,0; CPO-D=4,2) que os do grupo comparação (ceo-d=0,9; CPO-D=1,0). O grupo com AF apresentou nível socioeconômico baixo e maior índice de cárie em ambas as dentições, apesar da dieta ter sido menos cariogênica. Conclusão: é possível que a prevalência maior de cárie para indivíduos com AF esteja associada a outros fatores inerentes à doença.

Introdution: sickle cell anemia (SCA) is the most prevalent hereditary monogenic pathology associated with the presence of SS hemoglobin in the world. It can affect ibody, face and teeth, which can lead to a higher predisposition to the development of dental caries. Objective: evaluate the epidemiological and social profile of children and adolescents with Sickle Cell Anemia (SCA), prevalence of caries and influence of diet. Methodology: a cross-sectional study was realized with 124 individuals ages of 5 to 18 years originated from the reference ambulatory in SCA for the SCA group (n=61) and without SCA matriculate in a public school in Bahia (n=63) for the comparation group. Anamnesis, teeth examination and application of questionnaires about health condition, disease and diet history were realized. Results: most of them were brown, was in elementary school, income of a minimum wage, but in relation to provenance, most children with SCA were from the countryside. These ones also attended more dental consultations, although the DMFT was higher than the comparation group, 2.1 and 1.1, as well as the dmft 2.3. and 0.88, respectively. Children and adolescents with SCA consumed less carbohydrates and had a higher caries index (dmft = 2.0; DMFT = 4.2) than those in the comparation group (dmft = 0.9; DMFT = 1.0). The group with SCA presented low socioeconomic level and higher caries index in both dentitions, even if the diet was less cariogenic. Conclusion: it is possible that higher prevalence of caries for individuals with SCA may be associated with other factors inherent to the disease.

Atividade Antimicrobiana de Dentifrícios Fitoterápicos Contra Streptococcus mutans e Staphylococcus aureus / Antimicrobial activity of phytotherapic toothpastes against Streptococcus mutans and Staphylococcus aureus

O dentifrício é o meio mais racional para a liberação de agentes antimicrobianos na cavidade oral. O objetivo desse trabalho foi avaliar in vitro a atividade antimicrobiana de diferentes dentifrícios fitoterápicos disponíveis no mercado, contra cepas de referência de Streptococcus mutans (ATCC 25175) e Staphylococcus aureus (ATCC 29213). Os dentifrícios utilizados foram Colgate Herbal Branqueador®, Even® Juá e Hortelã, Malvatricin®, Parodontax® e os controles Closeup®, que contém flúor, Colgate® Total 12, que contém flúor associado à triclosan e gel de Clorexidina® 2%. A técnica utilizada foi por difusão em Ágar, padronizada pelo FDA (Food and Drugs Administration), na qual os dentifrícios foram colocados em três orifícios equidistantes no meio de cultura. Após incubação a 37 °C por 48 horas, os halos de inibição de crescimento bacteriano foram mensurados com régua milimetrada. Dentre os dentifrícios fitoterápicos avaliados, Malvatricin®, que contém extrato de Malva em sua composição, e Colgate Total 12® foram os mais efetivos para as espécies bacterianas testadas. Assim, apesar de todos os dentifrícios fitoterápicos terem apresentado halo de inibição, o Malvatricin® mostrou resultado mais eficaz, podendo atuar no combate a infecções bacterianas bucais.

The toothpaste is the most rational method for releasing antimicrobial agents in the oral cavity. The aim of this study was to evaluate the in vitro antimicrobial activity of different herbal toothpastes available in the market against the reference strains of Streptococcus mutans (ATCC 25175) and Staphylococcus aureus (ATCC 29213). The toothpastes were Colgate Herbal Whitening®, Even Juá® and Mint, Malvatricin®, Parodontax® and the controls Closeup® as it contains fluoride, and Colgate Total® 12, which contains fluoride associated with triclosan and chlorhexidine gel® 2%. Agar diffusion method standardized by the FDA (Food and Drug Administration) was used.The toothpastes were placed at three equidistant holes in the culture medium, followed by incubation at 37 °C for 48 hours. Then, the inhibition halo of bacterial growth was measured with a millimeter ruler. Among the herbal toothpastes evaluated, Malvatricin® containing Mallow extracts in its composition, and Colgate Total® 12 were the most effective for the bacterial species tested. Thus, despite all the herbal toothpastes have shown inhibition zone, the Malvatricin® showed more effective results, and can prevent and fight oral bacterial infections.

Antifungal activity of the ethanolic extracts of Punica granatum L. and evaluation of the morphological and structural modifications of its compounds upon the cells of Candida spp.

Ethanolic crude extracts prepared from the arils and seeds, pericarp, peels and from the whole fruit of Punica granatum, known as pomegranate, had their antifungal activity tested against Candida spp. The ethanolic crude extracts were analyzed by Mass Spectrometry and yielded many compounds such as punicalagin and galladydilacton. The extracts from the pericarp and peel showed activity against Candida spp., with MICs of 125 µg/mL. The effect of pericarp and peel extracts upon the morphological and structure of C. albicans and C. krusei were examined by scanning and transmission electron microscopy, with the visualization of an irregular membrane and hyphae, formation of vacuoles and thickening of the cell wall. The data obtained revealed potential antimicrobial activity against yeasts cells of the Candida genus, and the bioactive compounds could be responsible for changes in cell morphology and structure. The data obtained open new perspectives for future research in continuation to this study, where information such as determination of the site of action of the compounds could contribute to an alternative therapy against these organisms.

Conventional and alternative antifungal therapies to oral candidiasis

Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS). These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.

Abordagem odontológica em pacientes com diabetes mellitus tipo 1 / Dental management in patients with diabetes mellitus type 1

Objetivos: Abordar, por meio de revisão de literatura, as manifestações bucais predominantes e as precauções que devem ser tomadas para o tratamentoodontológico de crianças com diabetesmellitus tipo 1. Fontes pesquisadas: Artigos advindos de base de dados (Bireme e PubMed) relacionados à diabetes mellitus tipo 1 e ao tratamentoodontológico. Síntese dos dados: Após arevisão da literatura, destaca-se a presença de várias manifestações bucais em crianças com diabetes mellitus tipo 1. Além disso, torna-se evidente que o tratamento destes pacientes deve ser interdisciplinar, já que o controle glicêmico, obtido por meio da reeducação alimentar e aplicações regulares de insulina, proporcionarão à criança diabética melhoria da qualidade de vida e melhores chances de sucesso ao tratamento odontológico, uma vez que em crianças com glicemia controlada ocorre redução de alterações bucais, como xerostomia, periodontite, gengivite, cárie dental e infecçõesoportunistas. Também se ressaltam os cuidados que devem ser tomados no atendimento odontológico destas crianças, para que recebam um tratamento odontológico seguro, efetivo e voltado para suas reais necessidades. Conclusão: Crianças diabéticas devem receber atenção odontológica criteriosa, visto que estão mais sujeitas a xerostomia, periodontite, gengivite, cárie dental e infecções oportunistas, principalmente quando a glicemia nãoestá bem controlada. A identificação destas alterações bucais pelo cirurgião-dentista pode indicar essa condição e um encaminhamento ao médico responsável deve ser realizado. Durante o atendimento desses pacientes no consultório odontológico, cuidados como antibioticoterapia profilática, horário das consultas, dieta, tratamento de complicações bucais e monitoramento do controle glicêmico devem ser tomados.

Objectives: To discuss, through a literature review, the predominant oral manifestations and emphasizedthe precautions to be taken by the dental treatment of children with type 1 diabetes mellitus. Researched sources: Papers from the database (Bireme and PubMed) related to type 1 diabetes and dental treatment. Data source: After review of the literature, there is the presence of several oral manifestations in children with type 1 diabetes mellitus. Furthermore, it becomes clear that their treatment must be interdisciplinary,since the glycemic control achieved through diet and regular applications of insulin will providebetter quality of life for diabetic children and improvechances of dental treatment success. In children with controlled glicemy, there is a decline of some oral manifestations such as dry mouth, periodontitis, gingivitis, dental caries and opportunistic infections. Also itis emphasized that care must be taken in the dental care of these children to receive dental treatment safe, effective and focused on their real needs. Conclusion: Diabetic children should receive dental care judiciously, since they are more susceptible to dry mouth, periodontitis, gingivitis, dental caries and opportunistic infections, especially when glicemy is not well controlled. The identification of these oral diseases by the dentist may suggest this condition and referral to a medical treatment should be performed. During treatment of these patients in the dental office, precautions as use of prophylactic antibiotics, appointment hour, diet, treatment of oral complications and monitoring of glycemic control should be taken.

Evidências científicas da colonização de Candida spp. em bolsas periodontais / Scientific evidence of Candida spp. colonization in periodontal pockets

Objetivo: o objetivo do presente trabalho é apresentar uma breve revisão de literatura a respeito da colonização de Candida spp. em bolsas periodontais, seus principais fatores de virulência e possível influência sobreas doenças periodontais. Revisão de Literatura: Apesar de a mucosa bucal ser considerada o principal reservatóriode Candida spp, este micro-organismo pode estar coagregado a bactérias do biofilme dental, sendo considerado um fator importante para o processo decolonização de bolsas periodontais. Além disso, possui vários fatores de virulência relevantes na patogênese dadoença periodontal, tais como a capacidade de aderir ao epitélio e invadir o tecido conjuntivo gengival. Também pode inibir a função de neutrófilos polimorfonucleares, bem como produzir enzimas como colagenases e proteinases, que são capazes de degradar imunoglobulinas.Considerações finais: Os fatores de virulência de Candida spp. associada à suscetibilidade do hospedeiro poderiam desempenhar um papel importante nasalterações inflamatórias associadas com as doenças periodontais destrutivas

Hepatite C na odontologia: riscos e cuidados / Hepatitis C in dentistry: risks and cares

A hepatite C é uma infecção que merece destaque especial na Odontologia. O vírus da hepatite C já foidetectado na saliva de indivíduos infectados, o que confere uma possível via de transmissão não parenteraldo mesmo. Desse modo, o cirurgião-dentista está suscetível, tendo em vista seu grande contato com fluidoscorporais, além de estar sujeito a injúrias pérfuro-cortantes durante o trabalho. O objetivo deste trabalhoé realizar uma revisão de literatura sobre a hepatite C, com o intuito de esclarecer os profissionais da áreaodontológica e discutir sobre os riscos e os cuidados que devem ter durante a prática clínica

Hepatitis C is an infection that deserves special prominence in Dentistry. The virus of hepatitis C was already detected in the saliva of infected individuals, and that confers a possible way of its nonparenteraltransmission. In this way, the surgeon-dentist is susceptible, in view of his great contact with corporal fluids, besides being subject to percutaneous injuries during the work. The objective of this work is to carrythrough a literature review about hepatitis C, with intention to clarify the surgeons-dentists, and to argue then on the risks and the cares that they must have during their practical clinic